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Decio Brunoni, Silvana Maria Blascovi-Assis, Ana Alexandra Caldas Osório, Alessandra Gotuzo Seabra, Cibelle Albuquerque de la Higuera Amato, Maria Cristina Triguero Veloz Teixeira, Marina Monzani da Rocha, Luiz Renato Rodrigues Carreiro
The present study aimed to present an overview of recent national and international research on the Zika virus (ZIKV), as well as to explore possible action plans focused on children, their families and the health teams involved.Therefore, the study proposes the implementation of tracking systems in order to identify, describe and characterize the potential correlates of prenatal exposure to ZIKV, divided into three lines of action: 1. Diagnostic and etiological evaluation as well as screening of developmental problems in children confirmed or suspected of prenatal ZIKV infection...
October 2016: Ciência & Saúde Coletiva
Carlo Signorelli, Veronica Ciorba, Federica Pezzetti, Anna Odone, Armando Gozzini, Antonello Zangrandi
Health authorities, medical directors and managers are called to face increasing and inter-related challenges regarding the ongoing financial crisis, aging of the population and the need to acquire innovative medical technologies. These challenges need to be tackled in order to ensure sustainability of the healthcare systems and appropriateness and quality of healthcare services. In Italy, the role of medical directors has progressively evolved over the years and now requires strengthened managerial skills and additional professional expertise and skills to plan, implement and evaluate the new systems of government...
July 2016: Igiene e Sanità Pubblica
Denise M Hynes, Michael Fischer, Linda A Schiffer, Rani Gallardo, Ifeanyi Beverly Chukwudozie, Anna Porter, Michael Berbaum, Jennifer Earheart, Marian L Fitzgibbon
INTRODUCTION: Using a quasi-experimental design, we implemented the Patient-Centered Medical Home for Kidney Disease (PCMH-KD), a comprehensive, multidisciplinary care team to improve quality of life and healthcare coordination for adult chronic hemodialysis (CHD) patients. This paper highlights our experience in the first two years of the study.We focus on the process dimensions of Reach, Adoption, and Implementation within the context of the RE-AIM framework. MATERIALS AND METHODS: We established a new PCMH-KD model at two outpatient dialysis centers...
October 18, 2016: Contemporary Clinical Trials
Magaly Rodriguez de Bittner, Viktor V Chirikov, Ian M Breunig, Roxanne W Zaghab, Fadia Tohme Shaya
OBJECTIVE: To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. SETTING: The Patients, Pharmacists Partnerships (P(3) Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. PRACTICE DESCRIPTION: Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2...
October 18, 2016: Journal of the American Pharmacists Association: JAPhA
Denis Querleu, Jacques Meurette, Emile Daraï, Philippe Morice, François Planchamp
Surgery has evolved as a mainstay of the management of ovarian cancer since evidence of the major benefit of complete surgery, i.e. achieving complete resection of the disease without visible macroscopic residue in a comprehensively explored abdominal cavity, has been made available. This objective may be difficult to complete in case of advanced ovarian cancer, as it requires the use of advanced techniques of peritoneal and visceral surgery, in the setting of adapted perioperative care, generally in institutions where the caseload is sufficient to ensure an appropriate surgical experience, and where specifically trained surgeons are available...
October 18, 2016: Bulletin du Cancer
Pauliina Mattila-Holappa, Matti Joensuu, Kirsi Ahola, Aki Koskinen, Katinka Tuisku, Jenni Ervasti, Marianna Virtanen
BACKGROUND: We examined the extent to which psychotherapeutic and work-oriented interventions were included in a medical treatment and rehabilitation plan and whether they predicted future employment among young adults with work disability due to a mental disorder. METHODS: Data were obtained from the treatment and rehabilitation plans of 1163 young adults aged 18‒34 years, who in 2008 were granted fixed-term work disability compensation due to a mental disorder and were followed for 5 years...
2016: International Journal of Mental Health Systems
Debbie Van Biesen, Florentina Hettinga, Katina McCulloch, Yves C Vanlandewijck
PURPOSE: To understand how athletes invest their energy over a race, differences in pacing ability between athletes with and without intellectual impairment (II) were explored using a novel field test. METHODS: Well-trained runners (n=67) participated in this study, including 34 runners with II (age = 24.4 ± 4.5 years; IQ = 63.1 ± 7.7) and 33 runners without II (age = 31.4 ± 11.2 years). The ability to perform at a pre-planned submaximal pace was assessed. Two 400m running trials were performed on an athletics track, with an individually standardized velocity...
October 5, 2016: Medicine and Science in Sports and Exercise
Traci M Kazmerski, Daniel J Weiner, Janice Matisko, Diane Schachner, Whitney Lerch, Carol May, Scott H Maurer
INTRODUCTION: Advance care planning (ACP), though recommended, has not been studied in adolescents with cystic fibrosis (CF). This quality improvement project engaged adolescents with advanced CF disease in ACP and assessed patient and CF provider attitudes and preferences regarding ACP discussions and tools. MATERIALS AND METHODS: Patients ≤22 years with advanced CF (FEV1 ≤40% predicted, >2 pulmonary exacerbations requiring IV antibiotics in 1 year, and/or use of home oxygen or non-invasive ventilation) were referred to the pediatric palliative care team (PC)...
October 17, 2016: Pediatric Pulmonology
Susmita Chatterjee, Manish Pant, Pradeep Haldar, Mahesh Kumar Aggarwal, Ramanan Laxminarayan
BACKGROUND & OBJECTIVES: India's Universal Immunization Programme (UIP) is one of the largest programmes in the world in terms of quantities of vaccines administered, number of beneficiaries, number of immunization sessions, and geographical extent and diversity of areas covered. Strategic planning for the Programme requires credible information on the cost of achieving the objectives and the financial resources needed at national, State, and district levels. We present here expenditures on immunization services in India in 2012 (baseline) and projected costs for five years (2013-2017)...
June 2016: Indian Journal of Medical Research
Mohd Raashid Sheikh, Houssam Osman, Muhammad Umar Butt, Dhiresh Rohan Jeyarajah
BACKGROUND: Hepatopancreatobiliary (HPB) surgery experience during residency in the Americas is limited. Residents interested in HPB surgery have different options available for further training. This study evaluated training in HPB surgery received during general surgery (GS) residency, and sought to determine the perception of fellowship training in HPB surgery. METHODS: An anonymous survey was distributed to all 259 GS residency programs in the United States...
October 13, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Sarkis Kiramijyan, Romain Didier, Edward Koifman, Smita I Negi
BACKGROUND: It has become challenging for cardiovascular fellows-in-training (FIT) to determine which national cardiovascular conference (NCC) to attend given the broad range of meetings and the breadth of information offered. The aim of this study was to report our own experiences of the utility and individual strengths of the NCCs and to further understand the interventional cardiology (IC) FITs' viewpoint regarding the benefits of the individual NCCs. METHODS: A survey was formulated with questions and scenarios regarding topics deemed to be of highest importance for an IC-FIT...
October 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Deepak Dimri, Venkatashiva Reddy B, Amit Kumar Singh
Background. The pattern of skin morbidity in an area depends on climate, geography, socioeconomic status, nutrition, genetics, and habits of the community. Objective. The objective of the present study was to describe the morbidity profile of patients attending dermatology outpatient department in a tertiary care centre of Garhwal hills, North India. Methodology. This is a record based study carried out using the morbidity registers. Patient details, diagnosis, and treatment provided by physicians were documented in the morbidity register...
2016: Dermatology Research and Practice
Joël Ladner, Marie-Hélène Besson, Etienne Audureau, Mariana Rodrigues, Joseph Saba
BACKGROUND: Cervical cancer is the greatest cause of age-weighted years of life lost in the developing world. Human papillomavirus (HPV) infection is associated with a high proportion of cervical cancers, and HPV vaccination may help to reduce the incidence of cancer. The aim of the study was to identify barriers, obstacles, and strategies and to analyze key concerns and lessons learned with respect to the implementation of HPV vaccination program in low- and middle-income countries. METHODS: The Gardasil Access Program (GAP) is a donation program established to enable organizations and institutions in eligible low-resource countries to gain operational experience designing and implementing HPV vaccination programs...
October 13, 2016: BMC Health Services Research
Shelly Lachish, Elena Svirko, Michael J Goldacre, Trevor Lambert
BACKGROUND: The greater participation of women in medicine in recent years, and recent trends showing that doctors of both sexes work fewer hours than in the past, present challenges for medical workforce planning. In this study, we provide a detailed analysis of the characteristics of doctors who choose to work less-than-full-time (LTFT). We aimed to determine the influence of these characteristics on the probability of working LTFT. METHODS: We used data on working patterns obtained from long-term surveys of 10,866 UK-trained doctors...
October 13, 2016: Human Resources for Health
Sue Kildea, Sally Tracy, Juanita Sherwood, Fleur Magick-Dennis, Lesley Barclay
The well established disparities in health outcomes between Indigenous and non-Indigenous Australians include a significant and concerning higher incidence of preterm birth, low birth weight and newborn mortality. Chronic diseases (eg, diabetes, hypertension, cardiovascular and renal disease) that are prevalent in Indigenous Australian adults have their genesis in utero and in early life. Applying interventions during pregnancy and early life that aim to improve maternal and infant health is likely to have long lasting consequences, as recognised by Australia's National Maternity Services Plan (NMSP), which set out a 5-year vision for 2010-2015 that was endorsed by all governments (federal and state and territory)...
October 17, 2016: Medical Journal of Australia
Deepak Prakash Borde, Antony George, Shreedhar Joshi, Suresh Nair, Thomas Koshy, Uday Gandhe, Murali Chakravarthy
CONTEXT: Use of perioperative transesophageal echocardiography (TEE) has expanded in India. Despite attempts to standardize the practice of TEE in cardiac surgical procedures, variation in practice and application exists. This is the first online survey by Indian College of Cardiac Anaesthesia, research and academic wing of the Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA). AIMS: We hypothesized that variations in practice of intraoperative TEE exist among centers and this survey aimed at analyzing them...
October 2016: Annals of Cardiac Anaesthesia
Debra Singh, Joel Negin, Christopher Garimoi Orach, Robert Cumming
BACKGROUND: Community Health Volunteers (CHVs) can be effective in improving pregnancy and newborn outcomes through community education. Inadequate supervision of CHVs, whether due to poor planning, irregular visits, or ineffective supervisory methods, is, however, recognized as a weakness in many programs. There has been little research on best practice supervisory or accompaniment models. METHODS: From March 2014 to February 2015 a proof of concept study was conducted to compare training alone versus training and supportive supervision by paid CHWs (n = 4) on the effectiveness of CHVs (n = 82) to deliver education about pregnancy, newborn care, family planning and hygiene...
October 3, 2016: Reproductive Health
Edmund Ndudi Ossai, Kenechi Anderson Uwakwe, Uchenna Chidi Anyanwagu, Ntat Charles Ibiok, Benedict Ndubueze Azuogu, Ngozi Ekeke
BACKGROUND: In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training...
October 4, 2016: BMC Medical Education
Juan-Miguel Gil-Jaurena, Ramón Pérez-Caballero, Ana Pita-Fernández, María-Teresa González-López, Jairo Sánchez, Juan-Carlos De Agustín
BACKGROUND: Mid-line sternotomy is the commonest incision for cardiac surgery. Alternative approaches are becoming fashionable in many centres, amidst some reluctance because of learning curves and overall complexity. Our recent experience in starting a new program on minimally invasive pediatric cardiac surgery is presented. The rationale for a stepwise onset and the short-medium term results for a three-year span are displayed. METHODS: A three-step schedule is planned: First, an experienced surgeon (A) starts performing simple cases...
July 2016: Translational pediatrics
E Yusuf, D S Y Ong, A Martin-Quiros, C Skevaki, J Cortez, K Dedić, A E Maraolo, D Dušek, P J Maver, M Sanguinetti, E Tacconelli
The purpose of this investigation was to perform a survey among European clinical microbiology (CM) and infectious disease (ID) trainees on training satisfaction, training tools, and competency assessment. An online, anonymous survey in the English language was carried out between April and July 2015. There were 25 questions: seven in a 5-point Likert scale (1: worst scenario, 5: best scenario) and the remainder as closed multiple-choice questions in five areas (satisfaction, adequacy, system, mentorship, and evaluation of training)...
October 4, 2016: European Journal of Clinical Microbiology & Infectious Diseases
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