Journal articles: 'Louis Park Medical Center'

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Dennis, Janice, and Delois Long. "Transitioning psychiatric patients for positive outcomes." Journal of Nursing Education and Practice 8, no. 12 (2018): 45. http://dx.doi.org/10.5430/jnep.v8n12p45.

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A study was conducted at the Louis Stokes Cleveland Veterans Administration Medical Center (LSCVAMC) to examine if moving 20 psychiatric patients from one location to another affected their anxiety level. The LSCVAMC closed their Brecksville facility to consolidate the two Branches (Wade Park and Brecksville), and build a new Capital Asset Realignment for Enhanced Services (CARES) Tower. These changes were implemented to reduce operating costs for LSCVAMC and reduce the number of inpatient psychiatric beds. A five-question survey was given to each patient one week prior to the move, and immediately following the move to assess their thoughts related to the move. The results showed that despite 45% expressing thoughts that the move to Wade Park made them nervous/anxious prior to the move, no patients expressed that they were anxious post move when asked. Eighty percent of the patients expressed that they would enjoy being in a newly renovated facility. The post report of the patients was no nervousness/anxiety related to the move.

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Nelson, Glen D. "Park Nicollet Medical Center." Postgraduate Medicine 77, no. 2 (1985): 11–16. http://dx.doi.org/10.1080/00325481.1985.11698864.

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Compher, Charlene. "Treatment of malnourished CAPD patients with an amino acid based dialysate JD KOPPLE, D BERNARD, J MESSANA, ET AL Harbor-UCLA Medical Center, California; University Hospital, Boston; University of Michigan, Ann Arbor; Karolinska Institute, Huddinge, Sweden; University of Iowa, Iowa City; Washington University, St. Louis; Baxter Healthcare, McGaw Park, Illinois." Nutrition in Clinical Practice 11, no. 1 (1996): 33. http://dx.doi.org/10.1177/088453369601100108.

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Book, Linda K., та Vatche H. Ayvazian. "Review from The Burn Center, St Johnʼs Mercy Medical Center, St Louis". Journal of Burn Care & Rehabilitation 8, № 6 (1987): 570. http://dx.doi.org/10.1097/00004630-198708060-00026.

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Book, Linda K., та Vatche H. Ayvazian. "Review from The Burn Center, St Johnʼs Mercy Medical Center, St Louis". Journal of Burn Care & Rehabilitation 8, № 6 (1987): 570. http://dx.doi.org/10.1097/00004630-198711000-00026.

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Schultz, Joan, Steve R. Richter, and Ali A. Ehsani. "Cardiac Rehabilitation Program at the Washington University Medical Center, St. Louis." Journal of Cardiopulmonary Rehabilitation 5, no. 6 (1985): 293. http://dx.doi.org/10.1097/00008483-198506000-00017.

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Schwartz, Henry G. "Barnes Hospital and the Washington University Medical Center." Journal of Neurosurgery 77, no. 2 (1992): 318–20. http://dx.doi.org/10.3171/jns.1992.77.2.0318.

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✓ The author documents the development of the Medical School at Washington University since 1891, when the St. Louis Medical College was first included as part of the University. In 1909, Robert Brookings, President of the Corporation of Washington University, acquired a large endowment and moved the clinical and hospital facilities to a new location, enabled by the estate of Robert Barnes. Harvey Cushing was offered the chair of surgery but eventually decided in favor of Harvard University in 1910. Dr. Ernest Sachs was recruited to Washington University by Dr. Fred Murphy, and in 1919 became the first ever Professor of Neurological Surgery. The history of neurosurgery and those who served it at the Washington University Medical Center and Barnes Hospital is recounted.

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Cummings-Vaughn, Lenise, Dulce Cruz-Oliver, Theodore Malmstrom, Nina Tumosa, and John Morley. "P3-094: The Veterans Affairs Medical Center Saint Louis University Mental Status Examination Comparison Study." Alzheimer's & Dementia 8, no. 4S_Part_13 (2012): P485. http://dx.doi.org/10.1016/j.jalz.2012.05.1313.

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Farber, Harrison W., Mark Gladwin, Evelyn M. Horn, and Myung H. Park. "Sickle Cell Disease and Pulmonary Hypertension: Addressing the Mixed Pathology and Special Considerations in Diagnosis and Treatment." Advances in Pulmonary Hypertension 6, no. 1 (2007): 39–44. http://dx.doi.org/10.21693/1933-088x-6.1.39.

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This discussion was moderated by Evelyn M. Horn, MD, Associate Professor of Clinical Medicine and Director, Pulmonary Vascular Disease, Center for Advanced Cardiac Care, Columbia University Medical Center, New York, New York. Panel members included Harrison W. Farber, MD, Director, Pulmonary Hypertension Center, Boston Medical Center, Boston University School of Medicine; Mark Gladwin, MD, Chief, Vascular Medicine Branch, National Heart, Lung, and Blood Institute, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD; Myung H. Park, MD, Director, Pulmonary Vascular Disease Program, University of Maryland School of Medicine.

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Drucker, Mark L. "Public hospitals as competitors for medicaid revenue: the case study of St. Louis regional medical center." International Journal of Public Administration 22, no. 11-12 (1999): 1587–613. http://dx.doi.org/10.1080/01900699908525442.

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Honda, Hitoshi, Jeffrey C. Jones, Martha C. Craighead, Michael N. Diringer, Ralph G. Dacey, and David K. Warren. "Reducing the Incidence of Intraventricular Catheter–Related Ventriculitis in the Neurology-Neurosurgical Intensive Care Unit at a Tertiary Care Center in St Louis, Missouri: An 8-Year Follow-Up Study." Infection Control & Hospital Epidemiology 31, no. 10 (2010): 1078–81. http://dx.doi.org/10.1086/656377.

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We reviewed the effect of 3 interventions to reduce the incidence of intraventricular catheter–related ventriculitis, conducted at a tertiary care center in St Louis, Missouri, during an 8-year period. The incidence density of intraventricular catheter-related ventriculitis decreased substantially after the implementation of standardized management of intraventricular catheters.

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Binder, Louis, Desmond Colohan, Wolfgang Dick, Bernard Nemitz, Yoel Donchin, and Noriyoshi Ohashi. "Pregraduate Training in Emergency Medicine." Prehospital and Disaster Medicine 8, no. 1 (1993): 69–75. http://dx.doi.org/10.1017/s1049023x00040048.

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AbstractA panel session on undergraduate education in Emergency Medicine from a worldwide perspective was conducted at the Seventh World Congress of Emergency and Disaster Medicine in Montreal, in May, 1991. Desmond Colohan MD, of the University of Toronto (Canada) was the panel moderator. Panel speakers were: Louis Binder MD, Texas Tech University Health Services Center (USA); Wolfgang Dick MD, University of Mainz (Germany); Bernard Nemitz MD, Faculty de Medicine d'Ameins (France); Yoel Donchin MD, Hadassa Medical Organization (Israel); and Noriyoshi Ohashi MD, Tsukuba Medical Center (Japan).

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Day, T. Eugene, W. Max Li, Armann Ingolfsson, and Nathan Ravi. "The Use of Queueing and Simulative Analyses to Improve an Overwhelmed Pharmacy Call Center." Journal of Pharmacy Practice 23, no. 5 (2010): 492–95. http://dx.doi.org/10.1177/0897190009358772.

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Like many others, the St. Louis Veterans Administration Medical Center (VAMC) Pharmacy help desk receives far more calls than can be processed by current staffing levels. The objective of the study is to improve pharmaceutical services provided by the call center, by using queueing theory and discrete event dynamic simulation to analyze incoming telephone traffic to the help desk. Queueing and simulation models using both archival and hand-gathered data over a 1-year period were created, compared, and presented in order to determine the minimum quantities of staff needed to reach the desired service threshold. The simulation model was validated in comparison with real-world data. Results suggest that telephone traffic congestion in this setting may be alleviated by increasing the number of staff responsible for telephone services from 2 to 6 throughout the week, with an additional one serving on Monday. Both queueing and simulative models can be used to improve overwhelm pharmacy call centers, by determining the theoretical minimal staff needed to reach a service threshold.

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Sinclair, Paige, Charles John Nock, Chris Burant, and Candice Wenzell. "Immunotherapy for advanced non-small cell lung cancer (NSCLC): Experience at Louis Stokes Cleveland VA Medical Center (LSCVAMC)." Journal of Clinical Oncology 36, no. 15_suppl (2018): e21148-e21148. http://dx.doi.org/10.1200/jco.2018.36.15_suppl.e21148.

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15

Meier, Bernard. "Reply to the letter to the editor “On plaque sealing” by Morton J. Kern, St. Louis University Medical Center." Catheterization and Cardiovascular Diagnosis 38, no. 2 (1996): 227. http://dx.doi.org/10.1002/(sici)1097-0304(199606)38:2<227::aid-ccd26>3.0.co;2-e.

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16

Park, Myung H., Rene Alvarez, Teresa De Marco, Ivan Robbins, and Marc Semigran. "PH and Left Heart Disease: Defining the Clinical Dilemma." Advances in Pulmonary Hypertension 10, no. 1 (2011): 49–56. http://dx.doi.org/10.21693/1933-088x-10.1.49.

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A panel of experts convened by telephone on April 20, 2011 to discuss their experiences and recommendations regarding diagnosis and management of patients with Group 2 PH. The conversation was facilitated by Myung Park, MD, Associate Professor of Medicine and Director, Pulmonary Vascular Disease Program, Division of Cardiology at University of Maryland School of Medicine and guest editor of this issue. The participants were Rene Alvarez, MD, Associate Professor of Medicine and Director, Advanced Heart Failure/Pulmonary Hypertension Outreach Program, University of Pittsburgh School of Medicine; Teresa De Marco, MD, Professor of Medicine, Director, Heart Failure and Pulmonary Hypertension Program and Director, Heart Transplantation, University of California San Francisco Medical Center; Marc Semigran, MD, Medical Director of the Heart Failure and Cardiac Transplant Program at the Massachusetts General Hospital Center and Associate Professor of Medicine at Harvard Medical School; and Ivan Robbins, MD, Assistant Professor of Medicine and Director, Lung Transplant Program, Vanderbilt University Medical Center.

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Ladenson, Jack H., Mitchell G. Scott, Derryck Klarkowski, and Melles Seyoum. "Use of a Major Medical Center Clinical Laboratory as a Reference Laboratory for a Developing Country: Ordering Patterns Help Set Laboratory Priorities." Clinical Chemistry 49, no. 1 (2003): 162–66. http://dx.doi.org/10.1373/49.1.162.

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Abstract Background: The test menus for developed and developing countries may differ, depending on many factors, including the expected volume of testing, disease frequency and therapies available, clinical impact of the test, technical skill and equipment needed, cost, the patient population served, and whether alternative testing sites are available, and some of them may not be exactly known. We assessed test priorities in a developing country by making a broad range of tests available and then assessing which tests were actually used by the physicians in the country for the care of their patients. Methods: The Barnes-Jewish Hospital laboratory and Washington University Medical Center provided patients in the developing country of Eritrea access to the same tests as patients in St. Louis for all analytes that are stable at 4 °C, the lowest temperature that could be used for shipping. Results: The use of the St. Louis laboratories increased steadily from 1998 to 2001. More than one-half of the physicians in Eritrea used the reference laboratories, with requests for thyroid function and female fertility representing 48–71% of the test requests over the 4 years evaluated. The high degree of utilization for these test batteries was not predicted. Testing for thyroid function, female fertility, and lipid panels are now performed, or soon will be performed, in Eritrea based on the experience of the reference laboratory system. The reference laboratory system is continuing so that the test priorities of the country can be evaluated on an ongoing basis and specialized tests can be made available at a low cost. Conclusion: The experiences of a reference laboratory for a developing country can help to identify unanticipated priorities for medical testing within the country.

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Guenter, Peggi. "Effectiveness of pH Measurements in Predicting Feeding Tube Placement NORMA METHENY, PAMELA WILLIAMS, LAUREL WIERSEMA, MARY ANNE WEHRLE, PATRICIA EISENBERG, MARYELLEN McSWEENEY St. Louis University Medical Center, St. Louis, Missouri." Nutrition in Clinical Practice 5, no. 1 (1990): 32–33. http://dx.doi.org/10.1177/088453369000500113.

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19

Murray, Teri A., Richard C. MacIntyre, and Cynthia S. Teel. "An Analysis of Partnership Performance: The St. Johns Mercy Medical Center–Saint Louis University School of Nursing Dedicated Education Unit Project." Journal of Professional Nursing 27, no. 6 (2011): e58-e63. http://dx.doi.org/10.1016/j.profnurs.2011.08.005.

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20

Manochakian, Rami, Stephanie Mervar, Deborah Fox, Yang Liu, Joseph A. Bokar, and Lisa Arfons. "Timeliness of care in patients with non-small cell lung cancer (NSCLC) at the Louis Stokes Veteran Affairs Medical Center (LSVAMC)." Journal of Clinical Oncology 31, no. 31_suppl (2013): 50. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.50.

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50 Background: Timeliness of care in patients with newly diagnosed lung cancer is a controversial topic. Although some studies have concluded that timeliness does not improve clinical outcomes, many experts agree that timeliness is an important aspect of quality care as it leads to shorter duration of emotional distress during the diagnostic process and treatment initiation. Methods: At the LSVAMC, we have established a 60-day time interval from first abnormal radiology to treatment initiation as our institutional standard of care. We have initiated several interventions to improve timeliness of care through our new lung cancer program launched in July 2012. These interventions, which were implemented over a 1 year period, include: 1) Weekly interdisciplinary lung nodule rounds. 2) A cancer care tracking system. 3) A lung cancer-specific case manager who collaborates with all disciplines to expedite workup and treatment initiation. We have retrospectively reviewed all NSCLC cases since the launch of the new lung cancer program (group 1) and compared the timeliness to a sample of patients before the interventions (group 2). Results: 58 patients (group 1) and 107 patients ( group 2) with NSCLC were diagnosed and treated at the LSVAMC from January to July 2011 and July 2012 to May 2013 respectively. Median time from first abnormal radiology to first treatment was 104 days (range 13-375, mean 113.4) in group 1 and 81 days (range 1-261, mean 84.9) in group 2. Median time from diagnostic radiology to tissue diagnosis was 39 days (range 2-226, mean 66) in group 1 and 29 days (range 2-206, mean 42.6) in group 2. Median time from tissue diagnosis to first treatment was 23 days (range 0-177, mean 38) in group 1 and 28 days (range 0-254, mean 36.5) in group 2. Conclusions: Timeliness of care in NSCLC patients at our center has improved. We still have not reached our target. Continued progress is expected as we transition to a multidisciplinary multi specialty care lung cancer program.

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Manochakian, Rami, Jennifer Smith, Stephanie Mervar, et al. "Improving veteran access to lung cancer care (IVaLuCancerCare): A quality improvement project at the Louis Stokes Cleveland VA Medical Center (LSVAMC)." Journal of Clinical Oncology 33, no. 15_suppl (2015): 6530. http://dx.doi.org/10.1200/jco.2015.33.15_suppl.6530.

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Burda, Anthony M., and Natalie M. Burda. "Taking a Stand against Accidental Childhood Poisoning: The Founding of the Nation's First Poison Control Center in Chicago." Journal of Pharmacy Practice 13, no. 1 (2000): 6–13. http://dx.doi.org/10.1177/089719000001300102.

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Prior to the 1950s, there existed no formal system for poison prevention or treatment in the United States. Estimates place the number of pediatric poisoning fatalities at over 400 per year at that time. After World War II, urbanization and modern technological methods brought forth over 250,000 different brand name products on the market. Health care professionals presented with cases of acute poisoning usually had little knowledge of what ingredients were contained in these new products making it difficult, if not impossible, to treat these patients. In the 1930s, decades before the creation of the Chicago Poisoning Control Program, pharmacist Louis Gdalman had already established a poison information service at St. Luke's Hospital. Because of Mr. Gdalman's training in pharmacy and chemistry, physicians throughout the city of Chicago and from around the United States called on him around the clock in search of his assistance. In the late 1940s, Mr. Gdalman began recording information on small cards and developed a standard data collection form. By the 1950s he had established an extensive library on the management of acute and chronic poisoning. The first poison control center in Chicago was described as nothing more than a desk, chair, and a telephone located in the inpatient pharmacy. Reluctance by hospital administrators to designate space, resources, and funds were problems confronted by the first poison control center. Poison centers of the 1990s still experience these same difficulties.

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siddiq, zubair, Chris Veremakis, Steven Trottier, and Robert W. Taylor. "RAPID SHALLOW BREATHING INDEX: A SIMPLIFIED VERSION Z SIDDIQ, C VEREMAKIS, SJ TROTTIER, RW TAYLOR DEPARTMENT OF CRITICAL CARE MEDICINE, ST. JOHN’S MERCY MEDICAL CENTER, SAINT LOUIS UNIVERSITY, ST. LOUIS, MO." Critical Care Medicine 33 (December 2005): A113. http://dx.doi.org/10.1097/00003246-200512002-00401.

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McClellan, Frances, Monique Washington, Robert Ruff, and Stephen M. Selkirk. "Guest Editorial: Developing a system of care for ALS patients at the Louis Stokes Cleveland VA Medical Center, Spinal Cord Injury Division." Journal of Rehabilitation Research and Development 50, no. 2 (2013): vii. http://dx.doi.org/10.1682/jrrd.2012.12.0237.

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Liao, Yi-Lin, Lung-Kun Yeh, Yueh-Ju Tsai, and Shin-Yi Chen. "Colored corn starch dust explosion-related ocular injuries at a Taiwan water park: A preliminary report from a single medical center." Taiwan Journal of Ophthalmology 6, no. 3 (2016): 123–26. http://dx.doi.org/10.1016/j.tjo.2016.05.004.

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Morgan, Mark, and Geumchan Hwang. "Perception of Thematic-Based Interpretation at the Jefferson National Expansion Memorial: A Study of Korean Visitors." Journal of Interpretation Research 19, no. 2 (2014): 25–37. http://dx.doi.org/10.1177/109258721401900203.

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The Jefferson National Expansion Memorial (Gateway Arch) is a National Park Service (NPS) monument in St. Louis, Missouri, that serves as a symbol of westward expansion and frontier life in America during the 19th century. Most of the nearly 2.5 million annual visitors are interested in learning about its history and significance. Although the Gateway Arch is an international tourism destination, few attempts have addressed the language requirements of foreign visitors. This study evaluated thematic-based interpretation at the Gateway Arch using a sample of Korean visitors. A total of 148 subjects were recruited from the Asian Affairs Center (AAC) at the University of Missouri (MU) and assigned to one of three conditions: control group (n=42), watching a DVD prior to the visit (n=62), or participating in an on-site, ranger-led tour (n=44). Individuals were asked to evaluate five interpretive themes developed by NPS staff (by condition) using a questionnaire that was translated into Korean and checked for accuracy. Results indicated that theme perception was relatively poor in the control group, but improved significantly ( p < 0.05) after watching a DVD and attending a NPS ranger-led tour. Managerial implications of this study focused on improving visitor experiences for international audiences, especially Koreans.

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Fesler, Mark J., Crystal Weaver, Kimberly McCormick, and Andrew Dwiggins. "A Single Center Survey of Distress Amongst Stem Cell Transplant Recipients." Blood 124, no. 21 (2014): 6006. http://dx.doi.org/10.1182/blood.v124.21.6006.6006.

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Abstract Introduction: According to the Commission on Cancer's 2012 program standards, patients diagnosed with cancer may experience psychological issues that can interfere with patient treatment plans and adversely affect outcomes. To address these issues, the Commission developed the following guidelines to accurately determine patient distress levels: 1) patients with cancer are offered screening for distress at least 1 time during a pivotal medical visit, 2) the mode of administration for the distress screening is to be determined by the program, and 3) facilities select the tool to be administered to screen for distress with preference being given to standardized, validated instruments. To meet this standard and plan future work in distress reduction for stem cell transplant recipients, the St. Louis University Blood and Marrow Transplant Program began implementing The State Trait Anxiety Inventory (STAI) with patients during pivotal medical visits. The STAI is a psychological inventory based on a 4-point Likert scale and consists of 40 questions on a self-report basis. The STAI differentiates between the temporary condition of "state anxiety" and the long-standing quality of "trait anxiety." The essential qualities evaluated by the STAI scale are feelings of apprehension, tension, nervousness, stress, and worry. Scores on the STAI scale increase in response to physical danger and psychological stress and decrease as a result of relaxation training. Average scores for working, male adults are 35.72 (state) and 34.89 (trait). Average scores for working, female adults are 35.20 (state) and 34.79 (trait). After implementing the STAI, it was realized that these screenings could be de-identified and analyzed in groups to determine if patterns emerged regarding patients' perceived anxiety levels throughout the bone marrow transplantation process. Method: The study team received Institutional Review Board approval to perform a retrospective examination of STAIs completed by patients throughout the bone marrow transplantation process at the St. Louis University Blood and Marrow Transplant Program from 03/11/2104 through 06/24/2014. A total of 30 inventories were collected, de-identified, and categorized by the following medical visits: arrival visit (the patient's first visit to the Blood and Marrow Transplant clinic), data review visit (the visit to review transplant related testing and sign consents), start of preparative regimen visit, day 0 visit, day +30 bone marrow biopsy visit for allogenic transplantation, day +30 bone marrow biopsy result visit for allogenic transplantation, and day +100 visit for auto transplantation. Averages for each medical visit category were determined by finding the mean score. Category averages were then compared to determine if a particular pivotal medical visit caused patients to experience an overall increase in anxiety level. Results: Results from the study indicate that patients experience the highest levels of anxiety during the early medical visits of the bone marrow transplantation process. Average state anxiety scores were 46 during the arrival visits, 41 during the data review visits, and 44 during the start of preparative regimen visits. Average trait anxiety scores were 38 during the arrival visits, 45 during the data review visits, and 39 during the start of preparative regimen visits. During the day 0 visits, patients' state anxiety scores decreased to an average of 36 and trait anxiety scores decreased to an average of 35. Day +30 and day +100 visits demonstrated even further decreases in state and trait anxiety scores. Conclusion: The surprising finding of this study was that patients demonstrated a higher level of distress in the period leading up to the transplant which gradually decreased once the preparative regimen was administered. The sample size for this study was small and could possibly skew results. However, this study does provide a starting basis for future study in bone marrow transplant recipient distress, and larger, multi-site studies are being planned to ensure the accuracy of the patterns, which emerged from this study. If patterns could be accurately identified and predicted, the study team may also be able to develop future studies to primitively lower patients' anxiety levels early in the bone marrow transplantation process and thus improve outcomes. Abstract 6006 Figure 1 Abstract 6006 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Sheffer, Christine E., Jeffrey S. Stein, Cara Petrucci, et al. "Tobacco Dependence Treatment in Oncology: Initial Patient Clinical Characteristics and Outcomes from Roswell Park Comprehensive Cancer Center." International Journal of Environmental Research and Public Health 17, no. 11 (2020): 3907. http://dx.doi.org/10.3390/ijerph17113907.

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Despite the importance of smoking cessation to cancer care treatment, historically, few cancer centers have provided treatment for tobacco dependence. To address this gap, the National Cancer Institute (NCI) launched the Cancer Center Cessation Initiative (C3i). As part of this effort, this study examined implementation outcomes in a cohort of cancer survivors (CSs) who smoked cigarettes in the first year of an ongoing process to develop and implement a robust Tobacco Treatment Service at Roswell Park Comprehensive Cancer Center. We provide a comprehensive description of the new tobacco use assessment and referral process, and of the characteristics of cancer survivors who agreed to treatment including traditional tobacco-related psychosocial and cancer treatment-related characteristics and novel characteristics such as delay discounting rates. We also examine characteristic differences among those who agreed to treatment between those who attended and those who did not attend treatment. As the new tobacco assessment was implemented, the number of referrals increased dramatically. The mean number of treatment sessions attended was 4.45 (SD = 2.98) and the six-month point prevalence intention to treat abstinence rate among those who attended was 22.7%. However, only 6.4% agreed to treatment and 4% attended at least one treatment session. A large proportion of cancer survivors who agreed to treatment were women, of older age, of lower socioeconomic status (SES), and who had high levels of depressive symptomology. The findings demonstrate that the implementation of system changes can significantly improve the identification of cancer survivors who use tobacco and are referred to tobacco use treatment. Among those who attend, treatment is effective. However, the findings also suggest that a systematic assessment of barriers to engagement is needed and that cancer survivors may benefit from additional treatment tailoring. We present plans to address these implementation challenges. Systematic electronic medical record (EMR)-sourced referral to tobacco treatment is a powerful tool for reaching cancer survivors who smoke, but more research is needed to determine how to enhance engagement and tailor treatment processes.

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Ngoubangoye, Barthelemy, Gael Darren Maganga, Larson Boundenga, et al. "Absence of paramyxovirus RNA in non-human primate sanctuaries and a primatology center in Gabon." Journal of Epidemiological Research 5, no. 2 (2019): 6. http://dx.doi.org/10.5430/jer.v5n2p6.

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The viruses of the Paramyxoviridae family are known to infect a wide range of animals, including primates, birds, rodents,carnivores, bats, ungulates, snakes, cetaceans and humans. This study aims to investigate the circulation of paramyxoviruses in five potential host species groups (humans, non-human primates, rodents, shrews, and bats) living in the same environments in three conservation programs dedicated to non-human primates, namely the Lékédi park, the primatology center of the International Center for Medical Research of Franceville and the Gorilla Protection Program, located in Gabon. We tested 35 workers, 343 NHPs (8 species), 141 bats (4 species), 420 rodents (5 species) and 10 shrews, sampled between 2013 and 2014. Faecal and organ samples were analyzed using three heminested reverse transcription-PCR (hnRT-PCR). All the 1884 samples tested were negative for PV detection. Further studies spanning a greater period of time are needed to investigate PV circulation patterns in theseconservation programs.

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KOST’, Mariya, Halyna MEDVID, Vasyl HARASYMCHUK, Olha TELEGUZ, Iryna SAKHNYUK, and Orysia MAJKUT. "GEOCHEMICAL PECULIARITIES OF NATURAL WATERS OF SE “SANATORIUM-RESORT MEDICAL CENTER “SHKLO” (LVIV REGION)." Geology and Geochemistry of Combustible Minerals 1, no. 178 (2019): 74–82. http://dx.doi.org/10.15407/ggcm2019.01.074.

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The geochemical features of natural waters of the SE “Sanatorium-resort medical center “Shklo” are established by researches of their ecological-geochemical composition and anthropogenic influence. The mineral water “Naftusya-Shklo” from the pump room in the territory of the sanatorium is selected and analyzed, which is recognized as an analogous to water “Naftusya” by the biological action. The composition of water is hydrocarbonate sodium, having mine-ralization of 0.76 g/dm3, the total hardness of 0.55 mg-eq/dm3, sulfate content of 0.64 g/dm3, and Eh – −79 mV. The sample of water from baths, which is fed from a depth of 129.0 m, is investigated. Therapeutic hydrogen sulfide water is classified as sodium salt-calcium sulfate with mineralization of 2.97 g/dm3 and high sulfate content (1.76 g/dm3). The balneological active component of the therapeutic water is hydrogen sulfide, the content of which is set at 101.75 mg/dm3. The common feature of these waters is the negative values of the oxidation-reduction potential, which is due to the presence of relatively high content of H2S and HS−. In addition to the mineral, a sample of water from the water pipe (drinking water from the Opillia suite of the Lower Neogene) was studied. According to the salt composition, it refers to sulfate-hydrocarbonate sodium-calcium with mineralization of 0.53 g/dm3. The content of the determined macro- and microcomponents do not exceed the maximum permissible concentrations for drinking water, which indicates the absence of influence of the lower horizons. The water sample was also selected from the largest lake of the park, the sanatorium “Shklo”, which is not related to reservoirs with a special regime of protection, therefore access to it is free. The salinity of water refers to chloride-sulfate-hydro carbonate sodium-calcium with mineralization of 0.35 g/dm3. Two samples of water from the Shklo River after its leak from Yavoriv lake showed that these waters are weakly mineralized, weakly alkaline, calcium hydro carbonate sulfate or sulfate calcium. Quantitatively, sulfate ions are 2–3 times more than hydrocarbons. The content of sulfates, Sodium, Calcium, Magnesium is also high, indicating their contamination. Further down the salt content decreases as a result of mixing with the water of droplets. Several sources of supply of sulfate-ion can be named: karst waters formed on gypsum anhydrite; reservoir waters of the Upper Badenian limestones, hydrogen sulfur of the formation waters of the Badenian horizon; hydrogensulfur, formed as a result of reduction of sulfate at the bottom of Yavoriv lake. Ecological and geochemical parameters of water of surface water reservoirs and watercourses generally also correspond to state standards for their use as recreational.

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Flanagan-Kaminsky, Donnamarie. "Intentional Anticipatory Mourning, Caregiver and Bereavement Support Program for Terminally Ill Veterans, Their Families & Caregivers in the VA Contract Home Hospice Program." OMEGA - Journal of Death and Dying 67, no. 1-2 (2013): 69–77. http://dx.doi.org/10.2190/om.67.1-2.h.

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As a response to the increasing numbers of Veterans utilizing the Veterans Affairs (VA) Contract Home Hospice Program, and with growing awareness of the increased stress at end-of-life, the social work leadership of the Louis Stokes Cleveland VA Medical Center implemented a unique approach to support Veterans and their families. The role of a grief/bereavement counselor was added to enhance the VA Contract Home Hospice Program, to assess the needs of the Veterans and family caregivers, and to create a program in response to these findings. A three-prong module evolved encompassing: Anticipatory Mourning Support for both the Veteran and caregiver/family; Caregiver Support; and Bereavement Support. The components of this module are described along with findings in each module.

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Scheuer, James. "The Department of Medicine at the Albert Einstein College of Medicine, 1980-1999." Einstein Journal of Biology and Medicine 20, no. 2 (2016): 59. http://dx.doi.org/10.23861/ejbm200420430.

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Beginning in 1977, the leaders at the Albert Einstein College of Medicine (AECOM) and Montefiore Medical Center (MMC) began to develop unifieddepartments combining the strengths at both campuses under a single department chair. The unification of the Department of Medicine was carried out under the leadership of Dr. Louis M. Sherwood in 1980. This step built upon the strength of the two Departments that had developed separately at MMC and AECOM during the previous era. During the 1980s and the 1990s, the subspecialty divisions, along with their training and research programs, were merged. Other changes evolved though that period, so that by the turn of the century many aspects of the Department of Medicine differed from its structure and function in 1980.

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Muntasib, Harini, Tri Rahayuningsih, and Anisaulhaq Aminsyah. "IDENTIFICATION OF STAKEHOLDERS AND THEIR ROLES IN ECOTOURISM HAZARD MANAGEMENT IN MOUNT RINJANI NATIONAL PARK." Media Konservasi 26, no. 1 (2021): 28–35. http://dx.doi.org/10.29244/medkon.26.1.28-35.

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Mount Rinjani is a volcano with hot water, savanna, and other beauty of nature as one of the leading destinations in Lombok. Behind its beauty, Mount Rinjani National Park (TNGR) is in a natural hazard area, making it a disaster-prone area. The objective of this study is to identify the parties and roles of each party involved in the Ecotourism hazard management in TNGR based on their level of interest and influence. Determination of sampling used purposive sampling, as well as semi-structured key informant interviews with snowball sampling using interview guides. The study object of this study were the parties (stakeholders) and the relationship between the parties involved in the hazard management of TNGR ecotourism. The roles of stakeholders in managing the dangers of TNGR Ecotourism were divided into four: support, actors, decision-makers, and infrastructure providers. The key players were TNGR Center and West Nusa Tenggara (NTB) Provincial Tourism Office. The subjects were North Lombok Regency Tourism Office, Central Lombok Regency Tourism Office, East Lombok Culture and Tourism Office, EMHC (Edelweiss Medical Help Center), NTB Provincial Office of Environment and Forestry, Mataram Rescue and Search Office, BPMVG Sembalun, Rinjani Porter Guide Forum, Lombok APGI, Head of Sembalun Subdistrict, Head of Bayan Subdistrict, Sangkreang Nature Lovers Organization, and Tourism Activist Group (Pokdarwis) Rinjani Perkasa. The context setter was Regional Disaster Management Agency (BPBD) of NTB Province. The crowd was NTB Regional Police (Polda), Korem (Subregional Military Command) 162 Wira Bhakti Mataram, Regional Development Planning Agency (Bappeda) of NTB Province, Ministry of Energy and Mineral Resources of NTB Province, NTB Provincial Public Works and Spatial Planning Office, Rinjani Tourism Image Forum, North Lombok TO Association, Central Lombok TO Association, East Lombok TO Association, Daily Executor Board (DPH) Geopark UGG Rinjani Lombok and Grahaphala Unram. Key words: hazard, management, Mount Rinjani, stakeholder

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Grey, Lexie. "Reviewer Acknowledgements for Cancer and Clinical Oncology, Vol. 6, No. 1." Cancer and Clinical Oncology 6, no. 1 (2017): 67. http://dx.doi.org/10.5539/cco.v6n1p67.

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Cancer and Clinical Oncology wishes to acknowledge the following individuals for their assistance with peer review of manuscripts for this issue. Their help and contributions in maintaining the quality of the journal is greatly appreciated.Cancer and Clinical Oncology is recruiting reviewers for the journal. If you are interested in becoming a reviewer, we welcome you to join us. Please find the application form and details at http://www.ccsenet.org/reviewer and e-mail the completed application form to cco@ccsenet.org.Reviewers for Volume 6, Number 1Aditya R Bele, University Of Florida, UsaAnand Kumar, Banaras Hindu University, IndiaDonghui Zhou, Iupui, United StatesHemendra Mod, Aaruni Hospital Pvt Ltd, IndiaJuan Luis Callejas Valera, Ucsd/Moores Cancer Center, United StatesJulita Kulbacka, Wroclaw Medical University, PolandMarco Gambarotti, Rizzoli Orthopaedic Institute, ItalyMohammed Abdelmoneam Osman, General Organization for Teaching Hospitals, EgyptMona Mostafa Mohamed, Cairo University, EgyptNorma Varela, Mcmaster University, CanadaRakesh Ponnala, Zoetis Inc, UsaRuofeng Qiu, University of Texas Health Science Center at San Antonio, United StatesSarandeep S S Boyanapalli, Regeneron Pharmaceuticals, Inc, UsaSoumitra Ghosh, Washington Univ @ St. Louis, United StatesSourav Banerjee, University Of California San Diego, Usa

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Day, T. Eugene, Ajit N. Babu, Steven M. Kymes, and Nathan Ravi. "Discrete Event Simulation and Real Time Locating Systems." International Journal of E-Adoption 4, no. 4 (2012): 16–28. http://dx.doi.org/10.4018/jea.2012100102.

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The Veteran’s Health Administration (VHA) is the largest integrated health care system in the United States, forming the arm of the Department of Veterans Affairs (VA) that delivers medical services. From a troubled past, the VHA today is regarded as a model for healthcare transformation. The VA has evaluated and adopted a variety of cutting-edge approaches to foster greater efficiency and effectiveness in healthcare delivery as part of their systems redesign initiative. This paper discusses the integration of two health care analysis platforms: Discrete Event Simulation (DES), and Real Time Locating systems (RTLS) presenting examples of work done at the St. Louis VA Medical Center. Use of RTLS data for generation and validation of DES models is detailed, with prescriptive discussion of methodologies. The authors recommend the careful consideration of these relatively new approaches which show promise in assisting systems redesign initiatives across the health care spectrum.

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Kotelnikov, GP P., and AV V. Kolsanov. "INNOVATION IN SSMU: INFRASTRUCTURE, TRAINING, DEVELOPMENT OF BREAKTHROUGH PROJECTS, TRANSFER OF TECHNOLOGIES INTO PRACTICE, PUBLIC PARTICIPATION IN RUSSIAN AND REGIONAL INNOVATION ECOSYSTEM." Science and Innovations in Medicine 1, no. 1 (2016): 8–13. http://dx.doi.org/10.35693/2500-1388-2016-0-1-8-13.

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The article focuses on the role of Samara State Medical University in the development of innovative capacity of the Samara region in the sphere of healthcare and medical education. Special attention is given to the multilevel innovative infrastructure of SSMU, which includes such unique departments as the Center for groundbreaking research “IT in medicine”, the scientific and production technology park, scientific-educational centers, small innovative enterprises and others. In particular, this infrastructure is an integrative platform not only for own innovation process at the university, but also for the development of current medical science prospects, for the formation of unique competences in interdisciplinary spheres, for the realization of science-based business, for the organization of innovative educational process (especially in the sphere of simulation technologies), for implementation into clinical practice, and also for successful incorporation into international cooperation.

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Kim, Heung-chul, Chang-uk Park, Miran Kim, et al. "Ticks (Acari: Ixodida: Ixodidae) collected from nest soil and litter of Synthliboramphus antiquus on Chilbal Island, Jeollanam Province, Republic of Korea, with the first Korean record of Ixodes uriae White." Systematic and Applied Acarology 22, no. 7 (2017): 962. http://dx.doi.org/10.11158/saa.22.7.5.

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The 65th Medical Brigade and Medical Department Activity-Korea, in collaboration with the Migratory Birds Research Center, National Park Research Institute, conducted a migratory bird tick-borne disease surveillance program on Chilbal Island during 2016. Chilbal Island is a small, remote, uninhabited government-protected island in southwestern Jeollanam Province, Republic of Korea (ROK). Ticks were collected from nest soil and litter of the Ancient Murrelet, Synthliboramphus antiquus, using Tullgren funnels. A total of 4 Ixodes ticks (3 male Ixodes uriae and 1 female Ixodes signatus) were collected. The principal hosts of I. uriae are pelagic birds that have a largely circumpolar distribution. Ixodes signatus parasitizes other migratory birds in coastal areas of western North America and eastern Asia. This is the first report of I. uriae from the ROK.

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Day, T. Eugene, Anchit Mehrotra, and Nathan Ravi. "A Novel Use for Real Time Locating Systems." International Journal of Healthcare Delivery Reform Initiatives 2, no. 3 (2010): 11–19. http://dx.doi.org/10.4018/jhdri.2010070102.

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In 2009, the St. Louis Veterans Affairs Medical Center (VAMC) installed a Real Time Locating system (RTLS) in their eye clinic. The system tracks staff and patient movement through a combination of radio-frequency identification and infra-red technology. This system, in addition to its primary purpose as a throughput monitoring system, was used to gather data for the validation of a Discrete Event Simulation (DES) of the eye clinic. Use of the RTLS gathered data greatly diminished the time required to validate the simulation, as well as the cost of labor needed to observe and record the data points necessary. RTLS systems may be employed by operations researchers and systems engineers to assist in patient flow analysis in capacities beyond the ‘Real Time’ aspects of the locating system.

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Molloy, Michael, Ciaran Browne, Tom Horwell, Jason VanDeVelde, and Patrick Plunkett. "Anatomy of a “Mass” Mass Gathering." Prehospital and Disaster Medicine 34, s1 (2019): s38. http://dx.doi.org/10.1017/s1049023x1900092x.

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Introduction:Mass gatherings are growing in frequency. Religious, or in this case, “mass” mass gatherings are also growing in complexity, requiring considerable effort from nations hosting a Papal Mass. Ireland hosted a papal mass in 1979 when the prospect of terrorism at such events was significantly lower. Large high-profile events such as a Papal Mass offer a platform via the media and social media to gain widespread coverage of adverse events. In 2018, a predicted 500,000 guests were scheduled to attend a Papal Mass gathering in Phoenix Park, Dublin, a bounded 1,700-hectare park in the center of Dublin.Aim:To develop a medical plan estimating numbers of people requiring medical attention at a Papal Mass held in Ireland late August 2018, and compare same with actual numbers treated post-event. This study aims to reduce the medical impact of such an event on local receiving hospitals through plans that effectively manage medical- and trauma-related presentations on site.Methods:A literature review of medical reports regarding medical care at Papal Mass gatherings worldwide found a range of predicted medical attendance from 21-61 per 10,000 attendees. On that basis we had prepared on-site facilities, facilities on travel routes and access point system for medical care for a crowd of 500,000 were selected.Results:One of 6 receiving hospitals in Dublin had an increase in average presentations on the day. Attendance was reduced significantly due to weather. 261 patients were treated on site, falling in line with lower rate predicted of 31 patients treated in hospital on site and 17 transports off-site.Discussion:A predictable number of patients presented for medical care. On-site medical services reduced transports to hospital. Reduced attendance ensured facilities were sufficient, but could have been under the pressure of the predicted attendance of 500,000.

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Kim, Heung-Chul, Young-Soo Kwon, Mi-Ran Kim, et al. "Ticks collected from Chilbal Island, Jeollanam Province, Republic of Korea, during 2014–2015." Systematic and Applied Acarology 21, no. 10 (2016): 1641. http://dx.doi.org/10.11158/saa.21.12.5.

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The 65th Medical Brigade and Public Health Command District-Korea, in collaboration with the Migratory Birds Center, National Park Research Institute, conducted a migratory bird tick-borne disease surveillance program on Chilbal Island, a small, remote, uninhabited island in southwestern Jeollanam Province, Republic of Korea (ROK), during 2014–2015. Ticks were collected by dragging vegetation and from nest soil and litter of the Ancient Murrelet, Synthliboramphus antiquus, and Swinhoe’s Storm Petrel, Hydrobates monorhis, using Tullgren funnels. A total of 115 ticks belonging to three genera and three species were collected. Ornithodoros sawaii (98.3%, 113 ticks) was the most frequently collected tick species, followed by Ixodes signatus (0.9%, 1 nymph) collected from nest soil and litter, and Haemaphysalis flava (0.9%, 1 male) collected by tick drag.

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Kipor, Gennady, N. Baranova, N. Pichugina, and S. Goncharov. "The 25 Years of Experience Since Inauguration of All-Russian Center for Disaster Medicine “Zaschia” (Protection)." Prehospital and Disaster Medicine 34, s1 (2019): s99. http://dx.doi.org/10.1017/s1049023x19002024.

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Introduction:Main functions of the Russian Federation in disasters and emergencies are loaded on All-Russian Center for Disaster Medicine of Ministry Health (ARCDM). The principal strategies of the staff are to play leading roles in preparedness, emergency response, evacuation, recovery of health systems, and education.Methods:Our presentation includes selection, classification, analysis, and statistics. There about 80 territorial Disaster Medicine Centers working under the leadership of ARCDM. One experience from the Moscow Territory Disaster Medicine Center will be presented.Results:At the operational and informational department, there are nine special medical emergency teams (three with helicopters). Time of arrival takes between seven and ten minutes, and transport to the hospital takes about five to seven minutes with 33 landing places for helicopters. The operational and control department uses an early warning system. About 1,300 exercises were organized in these centers and hospitals. We will discuss the examples of medical care delivery to the injured in metro Slaviynskie, Basar park Pobedi, Narofominskay, two major fires, and hurricanes. The mobile field hospital worked in more than 12 countries and in many territories in the Russian Federation over 25 years.Discussion:The last year was very difficult due to the Football World Cup, working hard as a collaborating center in emergencies, and working in the framework of a memorandum with China. Preparedness for an international event next May, which includes a field drill with participants from emergency medical teams of Health Ministries of CIS Countries and from State Health of China. We invite others to observe or join this event. Thus, we have some difficulties and problems, but we must increase solidarity and collaboration due to the scale, frequency, and number of losses in emergencies and disasters. Humanity could be able to cope with emergencies if we take into account these issues.

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Jansen, Jeffrey W., and Ryan P. Moenster. "Rate and Incidence of Adverse Reactions Associated With Ceftaroline Exposure: Importance of Cutaneous Manifestations." Annals of Pharmacotherapy 52, no. 3 (2017): 235–39. http://dx.doi.org/10.1177/1060028017735629.

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Background: Ceftaroline is a broad-spectrum, methicillin-resistant Staphylococcus aureus (MRSA)-active β-lactam approved for acute bacterial skin and skin structure infections (ABSSSIs) and community-acquired pneumonia. Because of its favorable spectrum and pharmacokinetics, ceftaroline is frequently utilized for infections such as osteomyelitis and endocarditis. Ceftaroline has been associated with neutropenia, but evaluation of other adverse events remains limited. Objective: To describe the rates and types of ceftaroline-associated adverse events and determine if patients’ baseline allergies affect the rates of an adverse event. Methods: A single-center, retrospective, observational analysis was conducted of all patients who received ceftaroline between November 4, 2011, and March 28, 2017, at the VA Saint Louis Health Care System. The Naranjo algorithm was utilized as a standardized method to evaluate likelihood that the adverse events were caused by ceftaroline therapy. Ceftaroline dose, duration, indication, and baseline allergy information were collected for all patients. Results: There were 75 patients who received 78 courses of ceftaroline identified for inclusion. The most common indications were osteomyelitis (51.3%) and ABSSSI (16.7%). Overall, 13/75 (17.3%) patients developed an adverse event, and 10/75 (13.3%) required discontinuation of ceftaroline. Rash was the most common adverse reaction and occurred in 7/75 (9.3%) patients, followed by neutropenia in 3/75 (4.0%) patients. There were no differences in baseline allergy characteristics between patients who experienced an adverse reaction to ceftaroline and those who did not. Conclusions: When compared with clinical trials, ceftaroline use appears to be associated with an increased rate of overall adverse events, which is driven by cutaneous reactions.

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Kim, Heung-Chul, Chang-Uk Park, Miran Kim, et al. "Ornithodoros sawaii (Acari: Ixodida: Argasidae) collected from nest soil/litter of Synthliboramphus antiquus, Synthliboramphus wumizusume, and nest soil/litter and nestlings of Hydrobates monorhis on Gugul and Sogugul Islands, Jeollanam Province, Republic of Korea." Systematic and Applied Acarology 22, no. 11 (2017): 1959. http://dx.doi.org/10.11158/saa.22.11.13.

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The 65th Medical Brigade and Medical Department Activity-Korea, in collaboration with the Migratory Birds Research Center, National Park Research Institute, conducted a migratory bird tick-borne disease surveillance program on Gugul and Sogugul Islands, two small, remote, uninhabited islands in southwestern Jeollanam Province, Republic of Korea (ROK) from 2015–2016. Ticks were collected from nest soil/litter of the Ancient Murrelet, Synthliboramphus antiquus, Japanese Murrelet, Synthliboramphus wumizusume, and Swinhoe’s Storm Petrel, Hydrobates monorhis, using Tullgren funnels. A total of 100 Ornithodoros sawaii (25 females, 56 males, 17 nymphs, and 2 larvae) were collected from 2/33 (6.1%) Ancient Murrelet, 3/11 (27.3%) Japanese Murrelet, and 23/94 (24.5%) Swinhoe’s Storm Petrel nest sites. In addition, 3 larvae were collected from Swinhoe’s Storm Petrel nestlings. Ticks were identified morphologically and species determination was confirmed using polymerase chain reaction techniques. This is the first record of O. sawaii collected from nest soil/litter of the Japanese Murrelet during this bird’s nesting season in the ROK.

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Ekollo Mbange, Aristid, Abou Abdallah Malick Diouara, Halimatou Diop-Ndiaye, et al. "High HIV-1 Virological Failure and Drug Resistance among Adult Patients Receiving First-Line ART for At least 12 Months at a Decentralized Urban HIV Clinic Setting in Senegal before the Test-and-Treat." Infectious Diseases: Research and Treatment 14 (January 2021): 117863372110145. http://dx.doi.org/10.1177/11786337211014503.

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Background: The feasibility of antiretroviral therapy (ART) monitoring remains problematic in decentralized HIV clinic settings of sub-Saharan Africa. We assessed the rates and correlates of HIV-1 virological failure (VF) and drug resistance (DR) in 2 pre-test-and-treat urban clinic settings of Senegal. Methods: Consenting HIV-1-infected adults (⩾18 years) receiving first-line ART for ⩾12 months were cross-sectionally enrolled between January and March 2015, at the referral outpatient treatment center of Dakar (n = 151) and decentralized regional hospital of Saint-Louis (n = 127). In the 12 months preceding plasma specimens’ collection patients at Saint-Louis had no viral load (VL) testing. Significant predictors of VF (VL ⩾ 1000 copies/ml) and DR (clinically relevant mutations) were determined using binomial logistic regression in R software. Results: Of the 278 adults on EFV-/NVP-based regimens, 32 (11.5% [95%CI: 8.0-15.9]) experienced VF. Failing and non-failing patients had comparable median time [interquartile] on ART (69.5 [23.0-89.5] vs 64.0 [34.0-99.0] months; P = .46, Mann–Whitney U-test). Of the 27 viraemic isolates successfully genotyped, 20 (74.1%) carried DR mutations; most frequent were M184VI (55.6%), K103N (37.1%), thymidine analog mutations (29.6%), Y181CY (22.2%). The pattern of mutations did not always correspond to the ongoing treatment. The adjusted odds of VF was significantly associated with the decentralized clinic site ( P < .001) and CD4 < 350 cells/mm3 ( P < .006). Strong correlates of DR also included Saint-Louis ( P < .009), CD4 < 350 cells/mm3 ( P <. 001), and nevirapine-based therapies (comparator: efavirenz-based therapies; P < .027). In stratification analyses by site, higher rate of VF at Saint-Louis (20.5% [95%CI: 13.8-28.5] vs 4.0% [95%CI: 1.5-8.5] in Dakar) was associated with nevirapine-based therapies (OR = 3.34 [1.07-11.75], P = .038), self-reported missing doses (OR = 3.30 [1.13-10.24], P = .029), and medical appointments (OR = 2.91 [1.05-8.47], P = .039) in the last 1 and 12 months(s), respectively. The higher rate of DR at Saint-Louis (12.9% [95%CI: 7.6-20.1] vs 2.7% [95%CI: 0.7-6.7] in Dakar) was associated with nevirapine-based therapies (OR = 5.13 [1.12-37.35], P = .035). Conclusion: At decentralized urban settings, there is need for enhanced virological monitoring and adherence support. HIV programs in Senegal should intensify early HIV diagnosis for effective test-and-treat. These interventions, in addition to the superiority of efavirenz-based therapies provide a favorable framework for transitioning to the recommended potent drug dolutegravir, thereby ensuring its long-term use.

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Springgate, Benjamin, Lingqi Tang, Michael Ong, et al. "Comparative Effectiveness of Coalitions Versus Technical Assistance for Depression Quality Improvement in Persons with Multiple Chronic Conditions." Ethnicity & Disease 28, Supp (2018): 325–38. http://dx.doi.org/10.18865/ed.28.s2.325.

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Significance: Prior research suggests that Community Engagement and Planning (CEP) for coalition support compared with Resources for Services (RS) for program technical assistance to implement depression quality improvement programs improves 6- and 12-month client mental-health related quality of life (MHRQL); however, effects for clients with multiple chronic medical conditions (MCC) are unknown.Objective: To explore effectiveness of CEP vs RS in MCC and non-MCC subgroups.Design: Secondary analyses of a cluster-randomized trial.Setting: 93 health care and community-based programs in two neighborhoods.Participants: Of 4,440 clients screened, 1,322 depressed (Patient Health Questionnaire, PHQ8) provided contact information, 1,246 enrolled and 1,018 (548 with ≥3 MCC) completed baseline, 6- or 12-month surveys.Intervention: CEP or RS for implementing depression quality improvement programs.Outcomes and Analyses: Primary: depression (PHQ9 ≥10), poor MHRQL (Short Form Health Survey, SF-12<40); Secondary: mental wellness, good physical health, behavioral health hospitalization, chronic homelessness risk, work/workloss days, services use at 6 and 12 months. End-point regressions were used to estimate intervention effects on outcomes for subgroups with ≥3 MCC, non-MCC, and intervention-by- MCC interactions (exploratory).Results: Among MCC clients at 6 months, CEP vs RS lowered likelihoods of depression and poor MHRQL; increased likelihood of mental wellness; reduced work-loss days among employed and likelihoods of ≥4 behavioral-health hospitalization nights and chronic homelessness risk, while increasing faith-based and park community center depression services; and at 12 months, likelihood of good physical health and park community center depression services use (each P<.05). There were no significant interactions or primary outcome effects for non-MCC.Conclusions: CEP was more effective than RS in improving 6-month primary outcomes among depressed MCC clients, without significant interactions.Ethn Dis. 2018;28(Suppl 2):325-338; doi:10.18865/ed.28.S2.325.

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Berg-Weger, Marla, and Catherine Taylor. "INTEGRATING PRINCIPLES OF VALUE-BASED CARE THROUGH COMMUNITY-BASED ORGANIZATION PARTNERSHIPS." Innovation in Aging 3, Supplement_1 (2019): S372. http://dx.doi.org/10.1093/geroni/igz038.1361.

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Abstract To develop programming consistent with value-based care principles, two GWEPs share strategies and policy implications when partnering with community-based organizations (CBO). Because the aims of value-based care – better patient outcomes and population health, reduced health care costs – cannot be achieved by changing medical practice alone, RI Geriatric Education Center (RIGEC) partners with multiple CBOs to deliver evidence-based patient education programming to empower patients/caregivers to take charge of their health. RIGEC will work directly with physician practices to bring education directly to their high-risk patient census. Saint Louis University CBO partners integrated geriatric assessment into routine care to identify geriatric syndromes. Introduction of protocols for Medicare Annual Wellness Visits, Cognitive Stimulation Therapy and exercise/strengthening enables CBOs to offer interventions. Value-based care is achieved by reducing costs as geriatric syndromes are identified earlier, enabling diagnosis, treatment, and management; improving patient outcomes and satisfaction; and strengthening provider competence in geriatric care.

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Johnstone, Eve C., D. G. C. Owens, and J. Leary. "VI. Comparison of the 1975—85 Cohort with the 1970—75 Cohort." British Journal of Psychiatry 159, S13 (1991): 34–36. http://dx.doi.org/10.1192/s0007125000296347.

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As part of a study of the contribution of institution-alisation to the disabilities of schizophrenia (Johnstone et al, 1985), all patients fulfilling the St Louis criteria (Feighner et al, 1972) for schizophrenia and discharged from Shenley Hospital between 1 January 1970 and 1 January 1975 were followed up five to nine years later (Johnstone et al, 1981, 1984). Until Northwick Park Psychiatric Unit opened in 1975, psychiatric facilities for Harrow patients were all in Shenley Hospital. In the follow-up study the patients were examined in detail and an account of their social circumstances and functioning was obtained. It was considered that the study provided an opportunity to examine the success of community care in a group of schizophrenic patients who left hospital before very active policies of discharge for such patients had been developed. The results had both positive and negative aspects. For example, 18% of the patients examined had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily, but more than 50% had definite psychotic features. No patients and few relatives sought a return to in-patient care, but severe emotional, social and financial difficulties were commonplace. Moreover, 27% of the sample had no contact with the medical or social services.

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Petersen, Jeffrey, Sahil Patel, Sharvari Dalal, and Darshana Jhala. "Laboratory-Diagnosed Gonorrhea and Chlamydia Infection Rate in the Veteran Population: The Corporal Michael J. Crescenz Veteran Affairs Medical Center (CMCVAMC) Experience." American Journal of Clinical Pathology 152, Supplement_1 (2019): S136—S137. http://dx.doi.org/10.1093/ajcp/aqz126.007.

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Abstract Introduction Sexually transmitted infections (STIs) due to gonorrhea and/or chlamydia remain a major public health problem. Previously, it has been documented in the literature that active duty/deployed military personnel may have a higher incidence of STI infections compared with the general population; however, similar studies for the veteran population (after discharge from military service) appear sparse. For facilities that diagnose gonorrhea and chlamydia by a real-time polymerase chain reaction (PCR) assay, an understanding of the expected rate of gonorrhea and chlamydia is helpful for monitoring the assay, both for epidemiological purposes and as a check on assay to detect abnormal trends; therefore, we present the unique experience of the CMCVAMC. Method Quality assurance/improvement quarterly data from October 1, 2013, to December 31, 2018, were reviewed to obtain both the test volume of PCR for gonorrhea and chlamydia as well as the number of positive test results at the CMCVAMC. Testing had been performed using the Abbott m2000 RealTime System (Abbott Park, Illinois). Results A total of 12,856 PCR tests for gonorrhea and chlamydia had been performed on the veteran population; of these, 257 were positive for gonorrhea and 410 were positive for chlamydia. Quarterly percentage rates on a quarterly basis ranged from 1.67% to 5.30% (chlamydia) and 1.01% to 3.25% (gonorrhea) with average rates of 3.29% and 2.01% for chlamydia and gonorrhea, respectively, and expected rates <6% at the CMCVAMC. Conclusions The establishment of the average expected rate of positive laboratory-diagnosed chlamydia and gonorrhea at the CMCVAMC makes a significant contribution to the epidemiological data concerning veterans and provides a valuable benchmark for similar facilities performing quality assurance of their PCR assay for these STIs.

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Srinivasan, Tarika, Erica J. Sutton, Annika T. Beck, et al. "Integrating Genomic Screening into Primary Care: Provider Experiences Caring for Latino Patients at a Community-Based Health Center." Journal of Primary Care & Community Health 12 (January 2021): 215013272110002. http://dx.doi.org/10.1177/21501327211000242.

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Introduction: Minority communities have had limited access to advances in genomic medicine. Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, partnered to assess the feasibility of offering genomic screening to Latino patients receiving care at a community-based health center. We examined primary care provider (PCP) experiences reporting genomic screening results and integrating those results into patient care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other members of the health care team charged with supporting patients who received positive genomic screening results. Interviews were recorded, transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results indicating a genetic variant that warranted clinical management. PCPs felt genomic screening was valuable to patients and their families, and that genomic research should strive to include underrepresented minorities. Providers identified multiple challenges integrating genomic sequencing into patient care, including difficulties maintaining patient contact over time; arranging follow-up medical care; and managing results in an environment with limited genetics expertise. Providers also reflected on the ethics of offering genomic sequencing to patients who may not be able to pursue diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing advances in precision medicine to community-based health centers serving under-resourced populations. By proactively considering patient support needs, and identifying financial assistance programs and patient-referral mechanisms to support patients who may need specialized medical care, PCPs and other health care providers can help to ensure that precision medicine lives up to its full potential as a tool for improving patient care.

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Cohen, Perrin S., and Martin L. Block. "The Use of Animals in Behavioural Science Education in the USA: Finding Alternatives that Address Personal Concerns and Ethical Dilemmas." Alternatives to Laboratory Animals 18, no. 1_part_1 (1990): 51–56. http://dx.doi.org/10.1177/026119299001800108.1.

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Abstract:

In this paper, we describe our efforts to develop a humanitarian approach to the teaching of behavioural science using animals. Reduction, replacement and refinement of animal use in education are most useful if they help reconnect students and teachers with their underlying feelings, attitudes and ethical values related to animal usage. In order to initiate this reconnection process, we established the Northeastern University Center for Science Education (NUCASE) to encourage the dissemination of information and the development of projects that address ethical issues in college science curricula. Two directions that NUCASE has piloted using a humanitarian approach are outlined: an alternative to the traditional animal laboratory course in learning that uses student-run field experiments with feral pigeons in a park; and a conference designed to promote open interchange about personal concerns and ethical dilemmas in the use of animals in education.

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