25,087 results match your criteria changes implementation


Successful implementation of managed alcohol programs in the San Francisco Bay Area during the COVID-19 crisis.

Subst Abus 2021 Apr 13:1-8. Epub 2021 Apr 13.

School of Nursing-Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, San Francisco, CA.

The COVID-19 crisis presents new challenges and opportunities in managing alcohol use disorders, particularly for people unable to shelter in place due to homelessness or other reasons. Requiring abstinence for shelter engagement is impractical for many with severe alcohol use disorders and poses a modifiable barrier to self-isolation orders. Managed alcohol programs (MAPs) have successfully increased housing adherence for those with physical alcohol dependence in Canada, but to our knowledge, they have not been implemented in the United States. Read More

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The internal realities of individuals with type 2 diabetes-Psychological disposition in self-management behaviour via grounded theory approach.

PLoS One 2021 13;16(4):e0249620. Epub 2021 Apr 13.

Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia.

Background: A paradigm shift in the disease management of type 2 diabetes is urgently needed to stem the escalating trends seen worldwide. A "glucocentric" approach to diabetes management is no longer considered a viable option. Qualitative strategies have the potential to unearth the internal psychological attributes seen in people living with diabetes that are crucial to the sustenance of self-management behaviour. Read More

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Multidisciplinary telephone conferences about medication therapy after discharge of older inpatients: a feasibility study.

Int J Clin Pharm 2021 Apr 13. Epub 2021 Apr 13.

Hospital Pharmacy Funen, Odense University Hospital, Solfaldsvej 38, 5000, Odense C, Denmark.

Background Studies have shown poor post-discharge implementation by the general practitioner of changes made to patients' medication during admission. Objective To assess the feasibility of conducting telephone conferences delivering information about changes in older patients' medications from hospital to general practitioners. Setting Two departments of geriatric medicine in a Danish routine healthcare setting. Read More

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Prevalence and risk factors for obesity among elderly patients living with HIV/AIDS in a low-resource setting.

Medicine (Baltimore) 2021 Apr;100(15):e25399

Institute of Human Virology, Federal Capital Territory, Abuja, Nigeria.

Abstract: Obesity is associated with detrimental changes in cardiovascular and metabolic parameters, including blood pressure, dyslipidemia, markers of systemic inflammation, and insulin resistance. In the elderly living with the human immunodeficiency virus (EPLHIV), and being treated with antiretroviral medications, the obesity complications escalate and expose the elderly to the risk of noncommunicable diseases. Given that over 3 million EPLHIV in sub-Sahara Africa, we assessed the prevalence of obesity and its associated factors among EPLHIV in a low-resource setting. Read More

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Quantitative and qualitative evaluation of the COMPASS mobile app: a citizen science project.

Inform Health Soc Care 2021 Apr 13:1-13. Epub 2021 Apr 13.

Cardiovascular Epidemiology and Genetics, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain.

To evaluate the usability of the COMPASS application with mixed-methodology, using a citizen science approach. Parents/tutors of 10-11 years old children attending a primary school in Barcelona, Spain, were invited to take part in the study. We conducted semi-structured interviews on a subset (n = 7) of participants, two weeks after using the app for the first time. Read More

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COVID-19, community response, public policy, and travel patterns: A tale of Hong Kong.

Transp Policy (Oxf) 2021 Apr 8. Epub 2021 Apr 8.

Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.

The COVID-19 outbreak has necessitated a critical review of urban transportation and its role in society against the backdrop of an exogenous shock. This article extends the transportation literature regarding community responses to the COVID-19 pandemic and what lessons can be obtained from the case of Hong Kong in 2020. Individual behavior and collective responsibility are considered crucial to ensure both personal and community wellbeing in a pandemic context. Read More

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Effect of a multimethod quality improvement intervention on antipsychotic medication use among residents of long-term care.

BMJ Open Qual 2021 Apr;10(2)

Seniors Health Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada.

Background: Antipsychotic medications are used to address neuropsychiatric symptoms associated with dementia. Evidence suggests that among older adults with dementia, their harms outweigh their benefits. A quality improvement initiative was conducted to address inappropriate antipsychotic medication use in long-term care (LTC) in the province of Alberta. Read More

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[Impact of an elective course in evidence-based clinical decision-making on competencies and attitudes of medical students: A pilot study].

Z Evid Fortbild Qual Gesundhwes 2021 Apr 9. Epub 2021 Apr 9.

Allgemeinmedizinisches Institut, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland.

Background: Evidence-based medicine (EbM) as a teaching subject is increasingly taken into account in the Master Plan 2020. To date, neither theoretical requirements nor practical applications of EbM have been consistently implemented in the clinical curriculum. To fill this gap, a digital and tutor-based EbM course has been developed. Read More

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OPTIMIZING THE POTENTIAL FOR TELEHEALTH IN CARDIOVASCULAR CARE (IN THE ERA OF COVID-19): TIME WILL TELL.

Am J Med 2021 Apr 9. Epub 2021 Apr 9.

Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia. Electronic address:

Before the COVID-19 pandemic, use of telehealth services had been limited in cardiovascular care. Potential benefits of telehealth include improved access to care, more efficient care management, reduced costs, the ability to assess patients within their homes while involving key caretakers in medical decisions, maintaining social distancing, and increased patient satisfaction. Challenges include changes in payment models, issues with data security and privacy, potential depersonalization of the patient-clinician relationship, limitations in the use of digital health technologies, and the potential impact on disparities - socioeconomic, gender, age-related, and access to technology and broadband. Read More

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[Teaching innovation in an undergraduate theoretical medicine course].

Rev Med Chil 2020 Nov;148(11):1659-1667

Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Background: The School of Medicine of the Pontificia Universidad Católica de Chile implemented diverse curricular changes addressing teaching challenges, including those related to generational diversity.

Aim: To describe the implementation and results of curricular innovation in the Theoretic Gastroenterology Course (CTG) imparted between 2008 and 2020.

Materials And Methods: The new teaching methods consisted in the implementation of interactive sessions, research conferences, video-recorded classes, and a learning management/assessment platform. Read More

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November 2020

Blind spot in sepsis management - Tissue level changes in microcirculation.

Physiol Int 2021 Apr 9. Epub 2021 Apr 9.

3Department of Emergency Medicine, Clinical Centre, University of Pécs, Pécs, Hungary.

In sepsis cytokine-mediated inflammation, clotting cascade activation and glycocalyx shedding impair both function and structure of the microcirculation, compromising adequate tissue oxygenation/perfusion. Such mismatch results in "dysoxia", an imbalance in mitochondrial respiration.Microvessel injuries can be grouped into four types: cytotoxic oedema, micro-vessel heterogeneity, sluggish/absent flow, and focal anaemia. Read More

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A Novel Behavioral Intervention for Rural Appalachian Cancer Survivors (weSurvive): Participatory Development and Proof-of-Concept Testing.

JMIR Cancer 2021 Apr 12;7(2):e26010. Epub 2021 Apr 12.

Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA, United States.

Background: Addressing the modifiable health behaviors of cancer survivors is important in rural communities that are disproportionately impacted by cancer (eg, those in Central Appalachia). However, such efforts are limited, and existing interventions may not meet the needs of rural communities.

Objective: This study describes the development and proof-of-concept testing of weSurvive, a behavioral intervention for rural Appalachian cancer survivors. Read More

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Prospective BMI changes in preschool children are not effected by changes in EBRBs but by parental characteristics and body weight perceptions: The ToyBox-study.

Public Health Nutr 2021 Apr 12:1-25. Epub 2021 Apr 12.

Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia.

Objective: To examine the effect of the intervention implemented in the ToyBox study on changes observed in age and sex specific BMI percentile and investigate the role of perinatal factors, parental perceptions and characteristics on this change.

Design: A multicomponent, kindergarten-based, family-involved intervention with a cluster-randomized design. A standardized protocol was used to measure children's body weight and height. Read More

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Restaurant kids' meal beverage offerings before and after implementation of healthy default beverage policy statewide in California compared to citywide in Wilmington, Delaware.

Public Health Nutr 2021 Apr 12:1-23. Epub 2021 Apr 12.

Center for Research in Education and Social Policy, University of Delaware, Pearson Hall, 125 Academy Street, Newark, DE19716.

Objective: In 2019, California and Wilmington, Delaware implemented policies requiring healthier default beverages with restaurant kids' meals. This study assessed restaurant beverage offerings and manager perceptions.

Design: Pre-post menu observations were conducted in California and Wilmington. Read More

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Inpatient Insulin Pen Implementation, Waste, and Potential Cost Savings: A Community Hospital Experience.

J Diabetes Sci Technol 2021 Apr 12:19322968211002514. Epub 2021 Apr 12.

Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: Insulin pen injectors ("pens") are intended to facilitate a patient's self-administration of insulin and can be used in hospitalized patients as a learning opportunity. Unnecessary or duplicate dispensation of insulin pens is associated with increased healthcare costs.

Methods: Inpatient dispensation of insulin pens in a 240-bed community hospital between July 2018 and July 2019 was analyzed. Read More

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Sustainable public procurement in a Brazilian higher education institution.

Environ Dev Sustain 2021 Apr 5:1-32. Epub 2021 Apr 5.

Universidade de Pernambuco (UPE), Avenida Sport Clube do Recife, 252-Madalena, Recife, PE 50750-500 Brasil.

Public policies have required public agencies to adopt sustainable public procurement. It is necessary to understand the importance of the requirement for sustainable purchases to happen. Thus, this study aims to examine the main difficulties in adopting SPP at a public university in Brazil. Read More

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Can the Brain Do Backpropagation? -Exact Implementation of Backpropagation in Predictive Coding Networks.

Adv Neural Inf Process Syst 2020 ;33:22566-22579

MRC Brain Network Dynamics Unit, University of Oxford, UK.

Backpropagation (BP) has been the most successful algorithm used to train artificial neural networks. However, there are several gaps between BP and learning in biologically plausible neuronal networks of the brain (learning in the brain, or simply BL, for short), in particular, (1) it has been unclear to date, if BP can be implemented exactly via BL, (2) there is a lack of local plasticity in BP, i.e. Read More

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January 2020

Economic evidence with respect to cost-effectiveness of the transitional care model among geriatric patients discharged from hospital to home: a systematic review.

Eur J Health Econ 2021 Apr 10. Epub 2021 Apr 10.

Medical Faculty of the Friedrich-Alexander University of Erlangen-Nuremberg, Institute for Biomedicine of Aging, Kobergerstr. 60, 90408, Nuremberg, Germany.

Background: The German hospital-to-home discharge management of geriatric patients has long been criticized. The implementation of the American Transitional Care Model (TCM) could help to reduce readmissions and costs. The objective of this review was to check the scientific evidence of the cost-effectiveness of the TCM. Read More

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Changes in beverage purchases following the announcement and implementation of South Africa's Health Promotion Levy: an observational study.

Lancet Planet Health 2021 Apr;5(4):e200-e208

Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA. Electronic address:

Background: In 2016, South Africa announced an intention to levy a tax on sugar-sweetened beverages (SSBs). In 2018, the country implemented an SSB tax of approximately 10%, known as the Health Promotion Levy (HPL). We aimed to assess changes in the purchases of beverages before and after the HPL announcement and implementation. Read More

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Supporting Parents & Kids Through Lockdown Experiences (SPARKLE): A digital parenting support app implemented in an ongoing general population cohort study during the COVID-19 pandemic: A structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Apr 10;22(1):267. Epub 2021 Apr 10.

Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Objectives: The COVID-19 related lockdowns and distancing measures have presented families with unprecedented challenges. A UK-wide cohort study tracking changes in families' mental health since early lockdown (Co-SPACE) found a significant rise in primary school-aged children's behaviour problems and associated family-related stress. Three-quarters of parents in Co-SPACE also reported wanting extra support. Read More

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Implementation of Genetic Engineering and Novel Omics Approaches to Enhance Bioremediation: A Focused Review.

Bull Environ Contam Toxicol 2021 Apr 10. Epub 2021 Apr 10.

Department of Botany, St. John's College, Agra, U.P, India.

Bioremediation itself is considered to be a cost effective soil clean-up technique and preferred over invasive physical and chemical treatments. Besides increasing efficiency, application of genetic engineering has led to reduction in the time duration required to achieve remediation, overcoming the so called 'Achilles heel' of Bioremediation. Omics technologies, namely genomics, transcriptomics, proteomics, and metabolomics, are being employed extensively to gain insights at genetic level. Read More

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Trends in mortality due to pressure ulcers in Spain, over the period 1999-2016.

J Tissue Viability 2021 Apr 3. Epub 2021 Apr 3.

Clinical Medicine Department, Miguel Hernández University, Carretera Nacional, N-332 S/n, 03550, Sant Joan, Alicante, Spain. Electronic address:

Aim: to analyse trends in mortality by Pressure Ulcers (PU) in Spain, between 1999 and 2016.

Methods: Mortality due to PU in residents in Spain over 65, where a PU was underlying/basic cause of death, was analysed. Data for populations and deaths were gathered from the Spanish National Statistics Institute. Read More

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Re-initiation of CT colonography services during the COVID-19 pandemic: Preliminary evaluation of safety.

Br J Radiol 2021 Apr 9:20201316. Epub 2021 Apr 9.

Gastrointestinal Imaging Group, University Hospitals Leicester NHS Trust, Leicester, United Kingdom.

Objective: The COVID-19 pandemic has led to cancellation and deferral of many cancer investigations, including CT colonography (CTC). In May 2020, BSGAR and SCoR issued guidelines outlining steps for conduct of CTC in the early recovery phase. We evaluated the implementation of these in four English hospital trusts. Read More

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Biosensing human blood clotting factor by dual probes: Evaluation by deep LSTM networks in time series forecasting.

Biotechnol Appl Biochem 2021 Apr 9. Epub 2021 Apr 9.

Centre for Artificial Intelligence and Robotics, Universiti Teknologi Malaysia, Jalan Sultan Yahya Petra, Kuala Lumpur, 54100, Malaysia.

Artificial intelligent of things (AIoT) has become a potential tool to be implemented in a wide range of fields and expanding with interdisciplinary sciences. On the other hand, in clinical scenario human blood clotting disease (Royal disease) detection has been considered as an urgent issue to be solved. This study uses AIoT with deep long short-term memory (LSTM) networks for biosensing application. Read More

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Implementation of a Software Distribution Intervention to Improve Workload Balance in an Academic Pediatric Radiology Department.

J Digit Imaging 2021 Apr 9. Epub 2021 Apr 9.

Texas Children's Hospital, Singleton Department of Pediatric Radiology, 6107 Fannin Street, Suite 470, 77030, Houston, TX, USA.

In our pediatric radiology department, radiographs (XR) are the shared responsibility of the body section and interpreted in addition to modality or site-specific assignments. Given an unequal contribution amongst radiologists to the XR workload, a software solution was developed to distribute radiographs and improve workload balance. Metrics to evaluate the intervention's effectiveness were compared before and after the intervention. Read More

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Applying A/B Testing to Clinical Decision Support: Rapid Randomized Controlled Trials.

J Med Internet Res 2021 Apr 9;23(4):e16651. Epub 2021 Apr 9.

Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States.

Background: Clinical decision support (CDS) is a valuable feature of electronic health records (EHRs) designed to improve quality and safety. However, due to the complexities of system design and inconsistent results, CDS tools may inadvertently increase alert fatigue and contribute to physician burnout. A/B testing, or rapid-cycle randomized tests, is a useful method that can be applied to the EHR in order to rapidly understand and iteratively improve design choices embedded within CDS tools. Read More

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The Initial Impact of the Coronavirus Disease 2019 Pandemic on ICU Family Engagement: Lessons Learned From a Collaborative of 27 ICUs.

Crit Care Explor 2021 Apr 2;3(4):e0401. Epub 2021 Apr 2.

Society of Critical Care Medicine, Mount Prospect, IL.

Objectives: To describe the impact of coronavirus disease 2019 on family engagement among ICUs participating in a multicenter collaborative promoting implementation of family-centered care projects and to report sites' experiences with the collaborative itself prior to its cancelation due to the pandemic in March 2020.

Design: Cross-sectional survey.

Setting: Twenty-seven academic and community ICUs in the United States and South Korea. Read More

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Effects of sediment replenishment on riverbed environments and macroinvertebrate assemblages downstream of a dam.

Sci Rep 2021 Apr 8;11(1):7525. Epub 2021 Apr 8.

Water Environment Research Group, Public Works Research Institute, 1-6 Minami-hara, Tsukuba, 305-8516, Japan.

Riverbeds downstream of dams are starved of sediment, impacting habitat structure and ecological function. Despite the implementation of sediment management techniques, there has been no evaluation of their conservational effectiveness; the impacts on high trophic level organisms remain unknown. This study examined the effects of sediment replenishment on riverbeds and macroinvertebrates in a dammed river before and after sediment replenishment. Read More

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Why is Quality Improvement so Challenging? A Viable Systems Model Perspective to Understand the Frustrations of Healthcare Quality Improvement Managers.

Health Policy 2021 Apr 3. Epub 2021 Apr 3.

Centre for Health Systems and Technology, Otago Business School, University of Otago, 60 Clyde Street, Dunedin 9016, New Zealand.

The challenges facing Quality Improvement Managers (QIMs) are often understood and addressed in isolation from wider healthcare organisation within which quality improvement initiatives are embedded. We draw on Stafford Beer's Viable System Model (VSM) to shed light on how the viability of quality improvement depends on the effective functioning of five critical quality improvement systems and the extent to which these systems are integrated within the healthcare organisation. These systems are System 1 (Operations), System 2 (Coordination), System 3 (Operational Control), System 4 (Development) and System 5 (Policy). Read More

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How COVID-19 lockdown measures could impact patients with bulimia nervosa: Exploratory results from an ongoing experience sampling method study.

Eat Behav 2021 Mar 29;41:101505. Epub 2021 Mar 29.

Mind-body Research, Biomedical Sciences Group, KU Leuwven, Belgium.

Objective: The impact of COVID-19 lockdown measures on patients with an eating disorder remains unclear, but preliminary results indicate that some patients could be more vulnerable to experience an increase in eating disorder pathology than others. To provide possible directions for future research, this report explored the impact of the Belgian COVID-19 lockdown measures on patients with bulimia nervosa (BN).

Methods: The data of 15 female patients with BN from an ongoing experience sampling method study were analyzed. Read More

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