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Four pillar

Ellen Morrow, Megan Call, Robin Marcus, Amy Locke
DEFINING THE PROBLEM: A growing body of evidence highlights the need for wellness programs to support health care professionals. Although much of the existing literature centers on practicing physicians and physician trainees, there is growing awareness that these challenges are not unique to physicians and affect all members of the health care team. Traumatic and stressful events will always be a part of health care; how these events are addressed on a personal and team level is essential to the success of a health care system...
May 2018: Joint Commission Journal on Quality and Patient Safety
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
Qiu-Dan Shen, Hua-Yuan Zhu, Li Wang, Lei Fan, Jin-Hua Liang, Lei Cao, Wei Wu, Yi Xia, Jian-Yong Li, Wei Xu
BACKGROUND: The combination of rituximab, gemcitabine, and oxaliplatin (R-GemOx) has shown high efficacy with a low toxicity profile in elderly patients with relapsed and refractory diffuse large B-cell lymphoma. We aimed to evaluate the efficacy, safety, and feasibility of the R-GemOx regimen as a first-line treatment in elderly patients with diffuse large B-cell lymphoma. METHODS: In this single-arm, open-label, phase 2 clinical trial, we enrolled patients with previously untreated, histologically confirmed, CD20-positive diffuse large B-cell lymphoma, aged 70 years or older, or aged 60-69 years with an Eastern Cooperative Oncology Group (ECOG) performance status score of 2 or greater...
May 8, 2018: Lancet Haematology
Fuqiang Gao, Jun Han, Zike He, Zirong Li
PURPOSE: Cystic lesions are a common complication in osteonecrosis of the femoral head (ONFH). This study will discuss the cause of cystic lesion formation and the feature of cystic lesion distribution in ONFH. According to the feature of cystic lesion in ONFH, we will discuss the possible mechanisms of cystic lesions and their  influence on collapse of the femoral head. MATERIALS AND METHODS: We retrospectively gathered 102 ONFH patients (168 hips) from November in 2015 to August in 2016 on China-Japan Friendship Hospital...
April 27, 2018: International Orthopaedics
Vincenzo De Rosa, Meryle Laurent, Federico Canavese, Laura Merlini
BACKGROUND: In children older than 5 years with a mild form of Legg-Calvé-Perthes disease, the outcome is difficult to predict. In this study, we retrospectively correlated gadolinium-enhanced subtracted (DGS) and diffusion (DWI) MRI findings to the radiographic assessment according to the Catterall and Herring et al. classifications and to the final score according to Stulberg et al.: the aim was to identify a precocious, simple, and objective criterion to differentiate between forms evolving favourably and forms requiring an early surgical treatment in order to avoid femoral head deformity and subsequent osteoarthritis...
April 25, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Luciana Martins, Marcos Tavares
Two new species in the genera Thyone and Havelockia are described and illustrated based upon specimens collected from off the southeastern Brazilian coast. Thyone florianoi sp. nov. is characterized by having two pillared body wall tables with four-holed discs and introvert with multilocular tables. Thyone crassidisca is recorded herein for the first time from the South Atlantic Ocean (Brazil). Havelockia mansoae sp. nov. is distinctive in having two pillared body wall tables with four-holed discs and introvert with plates...
April 12, 2018: Zootaxa
Ramesh K Singh, N Rai, Amareesh K Singh, Prashant Kumar, T Chaubey, B Singh, Satya N Singh
Genetic diversity during prebreeding or postbreeding programme, is the key pillar to characterize the valuable traits and gene of interest. Whereas, superior or inferior heterotic performance of F1 depend on the diverse nature of their pedigree. Therefore, the aim of this study was to see the diversity between the interspecific crosses and effect of heterosis, and inheritance for the morphological traits and ToLCV resistance. All the 24 F1 interspecific crosses were classified into four clusters on the basis of morphological traitsas well as simple sequence repeat (SSR) markers...
March 2018: Journal of Genetics
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
Alexandra Bayão Horta, Cátia Salgado, Marta Fernandes, Susana Vieira, João M Sousa, Ana Luísa Papoila, Miguel Xavier
INTRODUCTION: Co-management between internists and surgeons of selected patients is becoming one of the pillars of modern clinical management in large hospitals. Defining the patients to be co-managed is essential. The aim of this study is to create a decision tool using real-world patient data collected in the preoperative period, to support the decision on which patients should have the co-management service offered. METHODS: Data was collected from the electronic clinical health records of patients who had an International Classification of Diseases, 9th edition (ICD-9) code of colorectal surgery during the period between January 2012 and October 2014 in a 200 bed private teaching hospital in Lisbon...
May 2018: International Journal of Medical Informatics
Bernadette Bernie Pauly, Kate Vallance, Ashley Wettlaufer, Clifton Chow, Randi Brown, Joshua Evans, Erin Gray, Bonnie Krysowaty, Andrew Ivsins, Rebecca Schiff, Tim Stockwell
INTRODUCTION AND AIMS: People with severe alcohol dependence and unstable housing are vulnerable to multiple harms related to drinking and homelessness. Managed Alcohol Programs (MAP) aim to reduce harms of severe alcohol use without expecting cessation of use. There is promising evidence that MAPs reduce acute and social harms associated with alcohol dependence. The aim of this paper is to describe MAPs in Canada including key dimensions and implementation issues. DESIGN AND METHODS: Thirteen Canadian MAPs were identified through the Canadian Managed Alcohol Program Study...
March 24, 2018: Drug and Alcohol Review
Giovanni De Feo, Sabino De Gisi, Sabato De Vita, Michele Notarnicola
The main aim of this study was to define and apply a multidisciplinary and multi-criteria approach to sustainability in evaluating alternative end-uses for disused areas. Taking into account the three pillars of sustainability (social, economic and environmental dimension) as well as the need for stakeholders to have new practical instruments, the innovative approach consists of four modules stated (i) sociological, (ii) economic, (iii) environmental and (iv) multi-criteria assessment. By means of a case study on a small Municipality in Southern Italy, three end-uses alternatives, representing three essential services for citizens, were selected: Municipal gym; Market area; Municipal Solid Waste (MSW) separate collection centre...
August 1, 2018: Science of the Total Environment
A Odone, B Roberts, M Dara, M van den Boom, H Kluge, M McKee
SETTING: The first pillar in the World Health Organisation's (WHO's) End TB strategy is 'Integrated, patient-centred tuberculosis (TB) care and prevention'. However, what are patient- and people-centred care, and why are they important for TB care and prevention? OBJECTIVE AND RATIONALE: To define the concept of patient-centred care, the rationale for it, and its evolution into people-centred care; and to explore evidence on whether people-centred approaches work for TB and present key areas where continuous efforts are needed to support their implementation...
February 1, 2018: International Journal of Tuberculosis and Lung Disease
Yuchi Zhang, Yuanhua Wu, Xin He, Junhan Ma, Xuan Shen, Dunru Zhu
Using polynuclear metal clusters as nodes, many high-symmetry high-connectivity nets, like 8-connnected bcu and 12-connected fcu, have been attained in metal-organic frameworks (MOFs). However, construction of low-symmetry high-connected MOFs with a novel topology still remains a big challenge. For example, a uninodal 8-connected lsz network, observed in inorganic ZrSiO4 , has not been topologically identified in MOFs. Using 2,2'-difluorobiphenyl-4,4'-dicarboxylic acid (H2 L) as a new linker and 1,2,4-triazole (Htrz) as a coligand, a novel three-dimensional CdII -MOF, namely poly[tetrakis(μ4 -2,2'-difluorobiphenyl-4,4'-dicarboxylato-κ5 O1 ,O1' :O1' :O4 :O4' )tetrakis(N,N-dimethylformamide-κO)tetrakis(μ3 -1,2,4-triazolato-κ3 N1 :N2 :N4 )hexacadmium(II)], [Cd6 (C14 H6 F2 O4 )4 (C2 H2 N3 )4 (C3 H7 NO)4 ]n , (I), has been prepared...
March 1, 2018: Acta Crystallographica. Section C, Structural Chemistry
Lin-Quan Tang, Dong-Ping Chen, Ling Guo, Hao-Yuan Mo, Ying Huang, Shan-Shan Guo, Bin Qi, Qing-Nan Tang, Pan Wang, Xiao-Yun Li, Ji-Bin Li, Qing Liu, Yuan-Hong Gao, Fang-Yun Xie, Li-Ting Liu, Yang Li, Sai-Lan Liu, Hao-Jun Xie, Yu-Jing Liang, Xue-Song Sun, Jin-Jie Yan, Yi-Shan Wu, Dong-Hua Luo, Pei-Yu Huang, Yan-Qun Xiang, Rui Sun, Ming-Yuan Chen, Xing Lv, Lin Wang, Wei-Xiong Xia, Chong Zhao, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Ming-Huang Hong, Zhi-Qiang Nie, Qiu-Yan Chen, Hai-Qiang Mai
BACKGROUND: Cisplatin-based concurrent chemoradiotherapy is currently considered to be the standard treatment regimen for patients with advanced nasopharyngeal carcinoma, but has well known side-effects such as gastrointestinal reactions, nephrotoxicity, and ototoxicity. Nedaplatin was developed to decrease the toxic effects induced by cisplatin, and in this trial we assessed whether a nedaplatin-based concurrent chemoradiotherapy regimen was non-inferior to a cisplatin-based regimen in patients with locoregional, stage II-IVB nasopharyngeal carcinoma...
April 2018: Lancet Oncology
Dorota Szcześniak, Rose-Marie Dröes, Franka Meiland, Dawn Brooker, Elisabetta Farina, Rabih Chattat, Shirley B Evans, Simon C Evans, Francesca Lea Saibene, Katarzyna Urbańska, Joanna Rymaszewska
BACKGROUND: The "pathway to care" concept offers a helpful framework for preparing national dementia plans and strategies and provides a structure to explore the availability and accessibility of timely and effective care for people with dementia and support for their informal carers. Within the framework of the JPND-MEETINGDEM implementation project the pathways to regular day-care activities and the Meeting Centers Support Programme (MCSP), an innovative combined support form for people with dementia and carers, was explored...
February 13, 2018: International Psychogeriatrics
Yu-Jie Wang, Yang-Yang Zhou, Hong-Guo Hao, Man Song, Na Zhang, Shuang Yao, Jing-Hui Yan, Zhi-Ming Zhang, Tong-Bu Lu
Two robust metal-organic frameworks (MOFs), {H4 [Ni(π-H2 O)2 ]2 [Ni(rt-H2 O)2 ]8 Ni4 (Tri)24 }[VIV W12 O40 ]2 ·24H2 O (1) and {H[Ni(π-O)2 ]2 [Ni(rt-H2 O)2 ]8 Ni4 (Tri)24 }[VIV W10 VV 2 O40 V2 ][VIV W9 VV 3 O40 VIV 2 ]·24H2 O (2) (Tri = 1,2,4-triazole), composed of polyoxometalates (POMs) and metal-organic units, were designed and synthesized by a hydrothermal method. Structure analysis indicates that there is a metal-organic crown [{Ni3 (Tri)6 (H2 O)4 }4 ] ({Ni12 }) in these two compounds. In 1, the {Ni12 } crown embraces four pendant Tri ligands that could capture a cationic [Ni(H2 O)2 ]2+ group, resulting in the Ni13 -Tri building unit [Ni(H2 O)2 {Ni3 (Tri)6 (H2 O)4 }4 ] ({Ni13 })...
February 5, 2018: Inorganic Chemistry
Jessica D Schaefer, John M Welton
AIM: To analyse and define the concept "evidence based practice readiness" in nurses. BACKGROUND: Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. METHOD: A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences...
January 15, 2018: Journal of Nursing Management
Hyunjun Cho, Shailabh Kumar, Daejong Yang, Sagar Vaidyanathan, Kelly Woo, Ian Garcia, Hao J Shue, Youngzoon Yoon, Kevin Ferreri, Hyuck Choo
Label-free optical detection of insulin would allow in vitro assessment of pancreatic cell functions in their natural state and expedite diabetes-related clinical research and treatment; however, no existing method has met these criteria at physiological concentrations. Using spatially uniform 3D gold-nanoparticle sensors, we have demonstrated surface-enhanced Raman sensing of insulin in the secretions from human pancreatic islets under low and high glucose environments without the use of labels such as antibodies or aptamers...
January 26, 2018: ACS Sensors
Can Ince
This paper introduces the concept of personalized physiological medicine that is specifically directed at the needs of the critically ill patient. This differs from the conventional view of personalized medicine, characterized by biomarkers and gene profiling, instead focusing on time-variant changes in the pathophysiology and regulation of various organ systems and their cellular and subcellular constituents. I propose that personalized physiological medicine is composed of four pillars relevant to the critically ill patient...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
Chenlu Li, Yongmei Lu, Jianing Liu, Xiaoxu Wu
Dengue Fever (DF) has become one of the most serious infectious diseases in China. Dengue virus and its vector (Aedes mosquito) are known to be sensitive to climate condition. Climate impacts DF through affecting three essential bioecological aspects: DF virus, vector (mosquito) and DF transmission environment. Weather-based DF model, mosquito model and climate model are the three pillars to help the prediction of DF distribution. Through a systematic review of literature between 1980 and 2017, this paper summarizes empirical evidences in China on the impact of climate change on DF; it further reviews the related DF incidence models and their findings on how changes in weather factors may impact DF occurrences in China...
May 1, 2018: Science of the Total Environment
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