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https://www.readbyqxmd.com/read/28453773/increased-cerebrospinal-fluid-levels-of-gaba-testosterone-and-estradiol-in-women-with-polycystic-ovary-syndrome
#1
Jennifer F Kawwass, Kristen M Sanders, Tammy L Loucks, Lisa Cencia Rohan, Sarah L Berga
STUDY QUESTION: Do cerebrospinal fluid (CSF) concentrations of gamma-aminobutyric acid (GABA), testosterone (T) and estradiol (E2) differ in women with polycystic ovary syndrome (PCOS) as compared to eumenorrheic, ovulatory women (EW)? SUMMARY ANSWER: Women with PCOS displayed higher CSF levels of GABA and E2, and possibly T, than EW. WHAT IS KNOWN ALREADY: The chronic anovulation characteristic of PCOS has been attributed to increased central GnRH drive and resulting gonadotropin aberrations...
April 27, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28453719/civil-war-contested-sovereignty-and-the-limits-of-global-health-partnerships-a-case-study-of-the-syrian-polio-outbreak-in-2013
#2
Jonathan Kennedy, Domna Michailidou
States and the World Health Organization (WHO), an international organization that is mandated to respect the sovereignty of its member states, are still the leading actors in global health. This paper explores how this discrepancy inhibits the ability of global health partnerships to implement programmes in conflict-affected areas that are under the de facto control of rebel organizations. We concentrate on a single crucial case, the polio outbreak in Syria in 2013, analysing a variety of qualitative data-twenty semi-structured interviews with key actors, official documents, and media reports-in order to investigate the events that preceded and followed this event...
June 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28449332/behavioural-disinhibition-in-the-general-population-during-the-antiretroviral-therapy-roll-out-in-sub-saharan-africa-systematic-review-and-meta-analysis
#3
REVIEW
Eva M Legemate, Jan A C Hontelez, Caspar W N Looman, Sake J De Vlas
OBJECTIVES: Improved life expectancy and reduced transmission probabilities due to ART may result in behavioural disinhibition - i.e. an increase in sexual risk behaviour in response to a perceived lower risk of HIV. We examined trends in sexual risk behaviour in the general population of sub-Saharan African countries 1999 - 2015. METHODS: We systematically reviewed scientific literature of sexual behaviour, and reviewed trends in Demographic and Health Surveys...
April 27, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28449308/a-qualitative-study-of-the-knowledge-behaviour-and-attitudes-of-patients-with-skin-cancer-regarding-sunlight-exposure-and-vitamin-d
#4
D Rutkowski, M D Farrar, J E Osman, A R Webb, L E Rhodes
BACKGROUND: Solar UVR is a major cause of skin cancer but also an important source of vitamin D (VitD), essential for musculoskeletal health. Conflicting public health messages may confuse skin cancer patients prone to further skin cancer. OBJECTIVE: To explore the knowledge, behaviour and attitudes of skin cancer patients to sunlight exposure and VitD sources. METHODS: Patients (n=10) previously treated for multiple basal cell cancer in a hospital setting, participated in focus group sessions with semi-structured discussions to explore: knowledge of VitD, sun-avoidance behaviour, and attitude towards sunlight exposure messages...
April 27, 2017: Photodermatology, Photoimmunology & Photomedicine
https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#5
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448779/effect-of-a-pharmacist-led-program-on-improving-outcomes-in-patients-with-type-2-diabetes-mellitus-from-northern-cyprus-a-randomized-controlled-trial
#6
Eylem Ilktac Korcegez, Mesut Sancar, Kutay Demirkan
BACKGROUND: The management of type 2 diabetes mellitus is complex, requiring continuous medical care by health care professionals and considerable self-care efforts by patients. Pharmacist-led care programs have been shown to help patients with diabetes succeed in achieving treatment goals and improving outcomes. Pharmacist-led care is a new health care concept in Northern Cyprus. OBJECTIVE: To evaluate the effect of a pharmacist-led care program on glycemic control, determined by hemoglobin A1c (A1c), and secondarily on blood pressure, lipid profile, body mass index (BMI), waist circumference, medication adherence, and self-care activities, for patients with type 2 diabetes over a 12-month period...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448777/effect-of-an-advanced-pharmacy-practice-experience-on-medication-therapy-management-services-in-a-centralized-retail-pharmacy-program
#7
Joseph P Vande Griend, Melissa Rodgers, Wesley Nuffer
BACKGROUND: Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448775/exploring-electronic-medical-record-and-self-administered-medication-risk-screening-tools-in-a-primary-care-clinic
#8
Mark J Makowsky, Ken Cor, Tat Wong
BACKGROUND: Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. OBJECTIVES: To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448307/explaining-performance-in-health-care-how-and-when-top-management-competencies-make-the-difference
#9
Milena Vainieri, Francesca Ferrè, Giorgio Giacomelli, Sabina Nuti
BACKGROUND: One of the most distinctive management competencies is related to the ability to structure the strategic vision, develop long-term plans, and communicate them efficiently to the employees in order to empower them to enact. These managerial competencies in complex organizations are strongly related to the capacity to engage professionals as a predictor of high-performing organizations. PURPOSE: The aim of this study was to investigate the relationship between top management competencies, information sharing, and organizational performance in public health care system and to look at the management role in assuring information sharing on organizational strategies to achieve professionals' engagement...
April 26, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28447138/-endocrine-disruptors-evidence-from-epidemiological-studies-necessitates-a-critical-review-of-model-systems
#10
REVIEW
M Hoffmann, S Gebauer, M Nüchter, R Baber, J Ried, M von Bergen, W Kiess
Endocrine disruptive chemicals (EDCs) cause adverse health effects through interaction with endocrine systems. They are classified by chemical structure, effects on specific endocrine systems, bioaccumulation, persistence in the environment, or clinically observable effects. For research of the complex mechanisms of action in the human body, only in vitro model systems have so far been available, that have insufficient high-throughput capacity, which makes risk evaluation more difficult. In addition, in industrial nations, living people are often exposed to mixtures of substances, with various effects...
April 26, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28445517/motivation-factors-for-suicidal-behavior-and-their-clinical-relevance-in-admitted-psychiatric-patients
#11
Naoki Hayashi, Miyabi Igarashi, Atsushi Imai, Yuka Yoshizawa, Kaori Asamura, Yoichi Ishikawa, Taro Tokunaga, Kayo Ishimoto, Yoshitaka Tatebayashi, Hirohiko Harima, Naoki Kumagai, Hidetoki Ishii, Yuji Okazaki
BACKGROUND: Suicidal behavior (SB) is a major, worldwide health concern. To date there is limited understanding of the associated motivational aspects which accompany this self-initiated conduct. AIMS: To develop a method for identifying motivational features associated with SB by studying admitted psychiatric patients, and to examine their clinical relevance. METHODS: By performing a factor analytic study using data obtained from a patient sample exhibiting high suicidality and a variety of SB methods, Motivations for SB Scale (MSBS) was constructed to measure the features...
2017: PloS One
https://www.readbyqxmd.com/read/28444039/the-health-regionalization-process-from-the-perspective-of-the-transation-cost-theory
#12
Leyla Gomes Sancho, Daniela Savi Geremia, Sulamis Dain, Fabiano Geremia, Cláudio José Silva Leão
This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444036/theoretical-reflections-on-governance-in-health-regions
#13
Nilo Bretas, Helena Eri Shimizu
This article analyzes governance in health regions, through the contributions of two studies: one on a governance model and the other on duties in the management of public policies networks. The former conducted a meta-analysis of 137 case studies in the literature on collaborative governance aimed at preparing an explanatory and analytical model. Authors identified critical variables that will influence the results: a previous history of conflict or cooperation, incentives for participation, power imbalances, leadership and institutional design...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444005/promoting-and-regulating-generic-medicines-brazil-in-comparative-perspective
#14
Elize Massard da Fonseca, Kenneth C Shadlen
Promoting the use of generic drugs can constitute a core instrument for countries' national pharmaceutical policies, one that reduces drug expenditure while expanding health care access. Despite the potential importance of such policy measures and the differences among national practices, scholars embarking on comparative analysis lack a roadmap for determining which dimensions of generic drug policy to assess and compare. This report fills that gap by considering national rules and regulations across four dimensions deemed crucial to any evaluation: demonstrated therapeutic equivalence; pharmaceutical packaging and labeling; drug prescription; and drug substitution...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28443450/letter
#15
G Goddard
I feel conflicted about striking over pay. I don't want patients to suffer but feel that this government and previous ones have abused the goodwill of health service workers.
April 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28443375/human-fatalities-caused-by-animal-attacks-a-six-year-autopsy-study
#16
Nilesh Keshav Tumram, Vipul N Ambade, Pradeep G Dixit
Deaths caused by animal attacks in urban as well as rural areas are rising. With dwindling forest cover and with more interaction of animals with humans in day-to-day life, we need to understand the reasons, manner and causes of these fatal events. We studied 151 cases of fatal animal/human conflicts and in particular, the manner and mechanism of causation of injuries with respect to different types of animals. In this region there were more fatal snake bites followed by cattle attacks. Humans are at some risk while in the vicinity of animals whether in the wild or in human settlements...
January 1, 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/28443367/preventing-risky-behaviours-among-young-adolescents-in-eastern-democratic-republic-of-congo-a-qualitative-study
#17
Anjalee Kohli, Mitima Mpanano Remy, Arsene Kajabika Binkurhorhwa, Clovis Murhula Mitima, Alfred Bacikenge Mirindi, Nadine Bufole Mwinja, Jean Heri Banyewesize, Gisele Mushengezi Ntakwinja, Nancy A Perrin, Nancy Glass
This qualitative study explores and describes adolescent risk behaviours, specifically consumption of alcohol and use of violence; the perceived consequences of these behaviours on future well-being and relationships; and collaboratively identifies the essential components of a prevention intervention for risk behaviours (alcohol use, violence) among young adolescents while strengthening the protective individual and relationship factors in post-conflict Democratic Republic of Congo. One-on-one in-depth interviews were conducted with 28 male and female youth, 20 parents/guardians and 20 stakeholders in three rural villages of South Kivu Province...
April 26, 2017: Global Public Health
https://www.readbyqxmd.com/read/28441974/evaluating-effectiveness-and-cost-effectiveness-of-a-group-psychological-intervention-using-cognitive-behavioural-strategies-for-women-with-common-mental-disorders-in-conflict-affected-rural-pakistan-study-protocol-for-a-randomised-controlled-trial
#18
Anna Chiumento, Syed Usman Hamdani, Muhammad Naseem Khan, Katie Dawson, Richard A Bryant, Marit Sijbrandij, Huma Nazir, Parveen Akhtar, Aqsa Masood, Duolao Wang, Mark van Ommeren, Atif Rahman
BACKGROUND: The impact of humanitarian disasters upon mental health is well recognised. The evidence for psychological interventions for mental health is mounting, but few interventions have been rigorously tested in humanitarian settings. To be sustainable in humanitarian settings interventions need to be short, simple, deliverable by nonspecialists under supervision, and adopt a transdiagnostic approach where an array of mental health outcomes are addressed simultaneously. These elements have been incorporated into the newly developed WHO Problem Management Plus (PM+) Group intervention...
April 26, 2017: Trials
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#19
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28438177/responding-to-non-communicable-diseases-in-zambia-a-policy-analysis
#20
Mulenga M Mukanu, Joseph Mumba Zulu, Chrispin Mweemba, Wilbroad Mutale
BACKGROUND: Non-communicable diseases (NCDs) are an emerging global health concern. Reports have shown that, in Zambia, NCDs are also an emerging problem and the government has begun initiating a policy response. The present study explores the policy response to NCDs by the Ministry of Health in Zambia using the policy triangle framework of Walt and Gilson. METHODS: A qualitative approach was used for the study. Data collected through key informant interviews with stakeholders who were involved in the NCD health policy development process as well as review of key planning and policy documents were analysed using thematic analysis...
April 24, 2017: Health Research Policy and Systems
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