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Zaher Nazzal, Hisham Sholi, Suha B Sholi, Mohammad B Sholi, Rawya Lahaseh
BACKGROUND: Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. METHODS: This cross-sectional study included all governmental primary health-care centres in the West Bank...
February 21, 2018: Lancet
Tiziana Leone, Diego Alburez-Gutierrez, Rula Gandour, Ernestina Coast, Rita Giacaman
BACKGROUND: Armed conflicts can undermine a country's health-care capacity and disrupt the delivery of basic health services. Yet the public health consequences of war remain difficult to quantify, mainly because adequate data do not exist. We hypothesised that the ongoing conflict in the occupied Palestinian territory (including the restrictions on free movement and the strain on health-care services) have had detrimental effects on maternal and child health outcomes. METHODS: We reconstructed data on delivery by caesarean section and diphtheria, pertussis, and tetanus vaccination with pooled data from Demographic and Health Surveys for 2000-14...
February 21, 2018: Lancet
Shadi Saleh, Mohamad Alameddine, Angie Farah, Nour El Arnaout, Hani Dimassi, Carles Muntaner, Christo El Morr
OBJECTIVES: Assess the effect of selected low-cost eHealth tools on diabetes/hypertension detection and referrals rates in rural settings and refugee camps in Lebanon and explore the barriers to showing-up to scheduled appointments at Primary Healthcare Centers (PHC). METHODS: Community-based screening for diabetes and hypertension was conducted in five rural and three refugee camp PHCs using an eHealth netbook application. Remote referrals were generated based on pre-set criteria...
March 15, 2018: International Journal of Public Health
P Karen Simmavong, Loretta M Hillier, Robert J Petrella
Health eSteps is a pragmatic, evidence-based lifestyle prescription program aimed at reducing the rates of chronic disease, in particular, type 2 diabetes. A process evaluation was completed to assess the feasibility of the implementation of HealtheSteps in primary care and community-based settings across Canada. Key informant interviews (program providers and participants) were conducted to identify facilitators and barriers to implementation and opportunities for future program adaptation and improvement...
March 1, 2018: Health Promotion Practice
Guo Yu, Dan-Na Wu, Yan Gong, Guo-Fu Li, Hong-Hao Zhou
PURPOSE: The labeling information, authorized by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA), is expected to guide the method of drug administration with reference to meal intake, aiming at ensuring favorable safety profile and achieving optimal drug exposure. However, interactions between meals and a specific oral anticancer medication are complicated in that could be strongly affected by inter-individual variability in pharmacokinetics, meal compositions, and the timing of drug administration with respect to meal intake, which could lead to conflicting meal recommendations between regulatory authorities...
March 13, 2018: European Journal of Clinical Pharmacology
Tiffany A Radcliff, Karen Chu, Claudia Der-Martirosian, Aram Dobalian
INTRODUCTION: Although little research has examined impacts of disasters on scheduled ambulatory care services, routine care delivery is important for emergency planning and response because missed or delayed care can lead to more urgent care needs. This article presents potential measures of ambulatory care recovery and resilience and applies the measures to data around a recent disaster. METHODS: We conceptualize "ambulatory care recovery" as the change in median business days to complete appointments that were canceled, and "ambulatory care resiliency" as the change in percentage of completed appointments in time frames before, during, and after disasters...
March 2018: Journal of the American Board of Family Medicine: JABFM
Lisa C Hiura, Lavinia Tan, Timothy D Hackenberg
The present research measured social reinforcement in rats, using a social-release procedure in which lever presses permitted 10-s access to a familiar social partner. The work requirements for reinforcement increased systematically according to progressive-ratio (PR) schedules. Social and food reinforcement value were compared across blocks of sessions (Experiment 1) and concurrently within the same sessions (Experiment 2). To assess motivational effects, response and reinforcer rates for both reinforcer types were studied under food restriction, social restriction, and combined food and social restriction...
March 10, 2018: Behavioural Processes
Glenwood D Goss, Everett E Vokes, Michael S Gordon, Leena Gandhi, Kyriakos P Papadopoulos, Drew W Rasco, JuDee S Fischer, Katharine L Chu, William W Ames, Rajendar K Mittapalli, Ho-Jin Lee, Jiewei Zeng, Lisa A Roberts-Rapp, Lise I Loberg, Peter J Ansell, Edward B Reilly, Christopher J Ocampo, Kyle D Holen, Anthony W Tolcher
BACKGROUND: Epidermal growth factor receptor (EGFR) alterations are associated with multiple cancers. Current EGFR-directed therapies have led to increased efficacy but are associated with specific side effects. The antibody-drug conjugate depatuxizumab mafodotin (depatux-m) targets EGFR with a monoclonal antibody linked to a cytotoxin, and is highly tumor-specific. METHODS: This phase 1/2 study evaluated the safety, pharmacokinetics, and efficacy of depatux-m in patients who had advanced solid tumors with known wild-type EGFR overexpression, amplification, or mutated EGFR variant III...
March 13, 2018: Cancer
Malhar P Patel, Priscille Schettini, Colin P O'Leary, Hayden B Bosworth, John B Anderson, Kevin P Shah
PURPOSE: Ideally, a referral from a primary care physician (PCP) to a specialist results in a completed specialty appointment with results available to the PCP. This is defined as "closing the referral loop." As health systems grow more complex, regulatory bodies increase vigilance, and reimbursement shifts towards value, closing the referral loop becomes a patient safety, regulatory, and financial imperative. OBJECTIVE/DESIGN: To assess the ability of a large health system to close the referral loop, we used electronic medical record (EMR)-generated data to analyze referrals from a large primary care network to 20 high-volume specialties between July 1, 2015 and June 30, 2016...
March 12, 2018: Journal of General Internal Medicine
Paulo Arnaldo, Eduard Rovira-Vallbona, Jerónimo S Langa, Crizolgo Salvador, Pieter Guetens, Driss Chiheb, Bernardete Xavier, Luc Kestens, Sónia M Enosse, Anna Rosanas-Urgell
BACKGROUND: Malaria in pregnancy leads to serious adverse effects on the mother and the child and accounts for 75,000-200,000 infant deaths every year. Currently, the World Health Organization recommends intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) at each scheduled antenatal care (ANC) visit. This study aimed to assess IPTp-SP coverage in mothers delivering in health facilities and at the community. In addition, factors associated with low IPTp-SP uptake and malaria adverse outcomes in pregnancy were investigated...
March 12, 2018: Malaria Journal
Fahed Zairi, Camille Troux, Tarek Sunna, Mélodie-Anne Karnoub, Ghassan Boubez, Daniel Shedid
OBJECTIVES: The surgical management of dumbbell tumors of the lumbar spine remains controversial, because of their large volume and complex location, involving both the spinal canal and the retro peritoneum. While sporadically reported, our study aims to confirm the value of minimally invasive posterior access for the complete resection of large lumbar dumbbell tumors. PATIENTS AND METHODS: In this prospective study, we included all consecutive patients who underwent the resection of a voluminous dumbbell tumor at the lumbar spine through a minimally invasive approach, between March 2015 and August 2017...
March 5, 2018: Clinical Neurology and Neurosurgery
Rita S Suri, Alan S Kliger
The use of frequent hemodialysis (HD) is growing, with the hope of improving outcomes in end-stage renal disease. We narratively review the three randomized trials, 15 comparative cohort studies, and several case series of frequent HD that empirically demonstrate the potential efficacy and adverse effects of these regimens. Taken together, the randomized studies suggest frequent HD may result in left ventricular mass regression. This effect is most pronounced when left ventricular mass is abnormal, but attenuated by significant residual urine output...
March 12, 2018: Seminars in Dialysis
Dominick DePhilippis, Nancy M Petry, Marcel O Bonn-Miller, Sarah B Rosenbach, James R McKay
BACKGROUND: In 2011, the Department of Veterans Affairs launched an initiative to expand patients' access to contingency management (CM) for the treatment of substance use disorders, particularly stimulant use disorder. This study evaluates the uptake and effectiveness of the VA initiative by presenting data on participation in coaching, fidelity to key components of the CM protocol, and clinical outcomes (CM attendance and substance use). METHODS: Fifty-five months after the first VA stations began offering CM to patients in June 2011, 94 stations had made CM available to 2060 patients...
February 16, 2018: Drug and Alcohol Dependence
Michael W M Gerrickens, Roel H D Vaes, Bastiaan Govaert, Joep A W Teijink, Marc R Scheltinga
INTRODUCTION: Some hemodialysis patients with a brachial arteriovenous fistula (AVF) have an unsuitable upper arm needle access segment (NAS) necessitating basilic vein transposition (BVT). It was frequently observed that a portion of these patients spontaneously experienced a warmer and less painful dialysis hand after BVT. Aim of this study was to determine whether BVT for an inadequate NAS attenuated hemodialysis access-induced distal ischemia in patients with a brachial AVF. METHODS: Patients with a brachial AVF and an unsuitable NAS also reporting hand ischemia and scheduled to undergo BVT between 2005 and 2016 in a single facility were studied...
March 8, 2018: Hemodialysis International
Rachel L Tomko, Kevin M Gray, Stephanie R Oppenheimer, Amy E Wahlquist, Erin A McClure
BACKGROUND: The use of ambulatory assessment to study behavior and physiology in daily life is becoming more common, yet barriers to implementation remain. Limitations in budget, time, and expertise may inhibit development or purchase of dedicated ambulatory assessment software. Research Electronic Data Capture (REDCap) is widely used worldwide, offering a cost-effective and accessible option for implementing research studies. OBJECTIVES: To present a step-by-step guideline on how to implement ambulatory assessment using REDCap and provide preliminary evidence of feasibility...
March 7, 2018: American Journal of Drug and Alcohol Abuse
C L Jay, M M Abecassis
For decades, evidence has been available demonstrating the superiority of kidney transplantation for patients with end-stage renal disease (ESRD) compared with dialysis in terms of improved survival, better quality of life, and long-term cost-effectiveness.(1, 2) Yet, many barriers continue to exist to increasing patient access to kidney transplant through utilization of higher risk deceased donor kidney transplants (DDKT) or blood type (ABO) or immunologically (HLA) incompatible living donor kidney transplants (LDKT)...
March 7, 2018: American Journal of Transplantation
Kimberley Jacobs, Molly Posa, Whitney Spellicy, Jaclyn Otero, Maria Kelly
BACKGROUND: Pediatric exposure to influenza-infected adult caregivers (AC) is a significant risk factor for developing influenza. Poor access to vaccines contributes to low adult vaccination rates. We offered adult vaccination at regularly scheduled pediatric office visits and examined barriers to improve future vaccination rates. METHODS: Via a retrospective chart review, we identified ACs who received an influenza vaccination at one of three pediatric clinics within an academic center from August 2015 to May 2016...
March 2, 2018: Pediatric Infectious Disease Journal
Yong Zhou, Wen-Zhang Zha, Xu-Dong Wu, Ren-Gen Fan, Biao Zhang, Yong-Hua Xu, Cheng-Lin Qin, Jing Jia
BACKGROUND: Hepatectomy and additional common bile duct exploration are required for the treatment of left-sided hepatolithiasis (LSH). METHODS: Eligible LSH patients (n = 62) scheduled for open left lateral segmentectomy or left hemihepatectomy with intraoperative biliary exploration via the left hepatic duct orifice (LHD group, n = 35) or the common bile duct (CBD group, n = 27) were retrospectively studied. T-tube insertion was performed on selected patients...
January 2018: Medicine (Baltimore)
Sanjay K Mohanty, Rockli Kim, Pijush Kanti Khan, S V Subramanian
Policy Points: Per-capita household health spending was higher in economically developed states and was associated with ability to pay, but catastrophic health spending (CHS) was equally high in both poorer and more developed states in India. Based on multilevel modeling, we found that the largest geographic variation in health spending and CHS was at the state and village levels, reflecting wide inequality in the accessibility to and cost of health care at these levels. Contextual factors at macro and micro political units are important to reduce health spending and CHS in India...
March 2018: Milbank Quarterly
M Antonia Biggs, Shelly Kaller, Cynthia C Harper, Lori Freedman, Aisha R Mays
OBJECTIVE: To assess community health centers' (CHCs) capacity to offer streamlined intrauterine devices (IUDs) services. METHODS: Prior to implementing a contraceptive training project, we surveyed health care staff (N=97) from 11 CHC sites that offer IUDs onsite. Twenty interviews with clinicians explored more deeply their challenges offering IUDs in the CHC setting. RESULTS: Most practices required multiple visits for IUD placement, most (66%) clinician survey respondents had placed an IUD and 19% had placed an IUD as emergency contraception...
2018: Journal of Health Care for the Poor and Underserved
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