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Environmental and organizational correlates and motivations for provider-sponsored health plan ownership in the post-reform era.

Health Care Manage Rev 2021 Jul 23. Epub 2021 Jul 23.

Katherine A. Meese, PhD, Assistant Professor and Director of Wellness Research, Department of Health Services Administration, University of Alabama at Birmingham. E-mail: Larry R. Hearld, PhD, Associate Professor and PhD Program Director, Department of Health Services Administration, University of Alabama at Birmingham. Stephen J. O'Connor, PhD, FACHE, Professor, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham. Mary Dale Peterson, MD, MSHCA, Executive Vice President and Chief Operating Officer, Driscoll Health System, Corpus Christi, Texas. Nathan W. Carroll, PhD, MHA, Assistant Professor, Department of Health Services Administration, University of Alabama at Birmingham. Bisakha "Pia" Sen, PhD, Blue Cross Blue Shield Endowed Chair in Health Economics, Department of Healthcare Organization & Policy, School of Public Health, University of Alabama at Birmingham.

Background: The 1980s to 1990s saw many health systems in the United States enter and exit the insurance market in the form of provider-sponsored health plans (PSHPs). Reforms and value-based reimbursement methods have stimulated health care organizations to reconsider PSHP as a logical strategy.

Purpose: The aim of this study was to examine market and organizational factors associated with PSHP ownership and motivations for engaging in PSHP after health care reforms. Read More

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Assessment of Caregiving Burden of Family Caregivers of Advanced Cancer Patients and Their Satisfaction with the Dedicated Inpatient Palliative Care Provided to Their Patients: A Cross-Sectional Study from a Tertiary Care Centre in South Asia.

Asian Pac J Cancer Prev 2021 Jul 1;22(7):2109-2115. Epub 2021 Jul 1.

Department of Pharmacology, All India institute of medical sciences, Jodhpur, Rajasthan, India.

Background And Objectives: Family Caregivers (FCs) of advanced cancer patients often suffer from caregiving burden due to stress arising from the responsibility of caregiving. During the course of their patients palliative therapy, FCs quality of life seems to be influenced by their satisfaction with the quality of patient care. In this study, caregiving burden of FCs and their satisfaction with dedicate Inpatient palliative care (IPC) services provided to their patients  were studied. Read More

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Bracing NK cell based therapy to relegate pulmonary inflammation in COVID-19.

Heliyon 2021 Jul 21:e07635. Epub 2021 Jul 21.

Department of Biotechnology, School of Engineering &Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India.

The contagiosity of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) has startled mankind and has brought our lives to a standstill. The treatment focused mainly on repurposed immunomodulatory and antiviral agents along with the availability of a few vaccines for prophylaxis to vanquish COVID-19. This seemingly mandates a deeper understanding of the disease pathogenesis. Read More

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Prevalence and characteristics of dermatological manifestations in COVID-19 positive dermatologists: Report from a web-based survey in India.

J Eur Acad Dermatol Venereol 2021 Jul 23. Epub 2021 Jul 23.

Department of Dermatology, Saheed Hasan Khan Mewati Government Medical College and Hospital, Nuh, India.

The available literature on dermatological manifestations of COVID-19 indicates a variation in prevalence and characteristics of muco-cutaneous findings among different population groups. An early descriptive Chinese study reported a prevalence of 0.2%, however, a recent Spanish study reported a prevalence of 45. Read More

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Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.

Lancet Reg Health Eur 2021 Jul 19:100180. Epub 2021 Jul 19.

Department of Respiratory Sciences, University of Leicester, United Kingdom.

Background: In most countries, healthcare workers (HCWs) represent a priority group for vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to their elevated risk of COVID-19 and potential contribution to nosocomial SARS-CoV-2 transmission. Concerns have been raised that HCWs from ethnic minority groups are more likely to be vaccine hesitant (defined by the World Health Organisation as refusing or delaying a vaccination) than those of White ethnicity, but there are limited data on SARS-CoV-2 vaccine hesitancy and its predictors in UK HCWs.

Methods: Nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK HCWs. Read More

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Bowling alone or distancing together? The role of social capital in excess death rates from COVID19.

Soc Sci Med 2021 Jul 19;284:114241. Epub 2021 Jul 19.

Assistant Professor of Human Resilience, Embry-Riddle Aeronautical University, Embry-Riddle Aeronautical University, Dept. of Security and Emergency Services, 1 Aerospace Boulevard, Daytona Beach, FL, 32114, USA. Electronic address:

Much attention on the spread and impact of the ongoing pandemic has focused on institutional factors such as government capacity along with population-level characteristics such as race, income, and age. This paper draws on a growing body of evidence that bonding, bridging, and linking social capital - the horizontal and vertical ties that bind societies together - impact public health to explain why some U.S. Read More

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Constructing high-quality rest facilities to maximise performance and ensure patient safety.

BMJ Open Qual 2021 07;10(3)

Quality Improvement, Kettering General Hospital, Kettering, UK.

Introduction: Junior doctors are working in an increasingly overstretched National Health Service. In 2018, Kettering General Hospital (KGH) was awarded £60 800 of government funds to create high-quality rest facilities and improve junior doctor well-being.

Methods: An audit and survey in KGH identified the structural and functional improvements needed. Read More

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The Role of a Resilient Information Infrastructure in COVID-19 Vaccine Uptake in Ontario.

Healthc Q 2021 Jul;24(2):7-11

A senior scientist and chief science officer at ICES, a clinician scientist at The Hospital for Sick Children and professor of Paediatrics, Health Policy and Public Health at the Dalla Lana School of Public Health at the University of Toronto in Toronto, ON.

The COVID-19 pandemic has highlighted the need for a robust and nimble public health data infrastructure. ICES - a government-sponsored, independent, non-profit research institute in Ontario, Canada - functions as a key component of a resilient information infrastructure and an enabler of data co-production, contributing to Ontario's response to the COVID-19 pandemic as part of a learning health system. Linked data on the cumulative incidence of infection and vaccination at the neighbourhood level revealed disparate uptake between areas with low versus high risk of COVID-19. Read More

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Developing a capacity-building programme to support a mental health service modernisation pilot project in Lviv region of Western Ukraine.

BJPsych Int 2021 May;18(2):40-42

MD, Psychiatrist, Coordinator of Community-Based Mental Health Services Development, Mental Health for Ukraine Project, Ukraine.

This paper reflects on the development of a capacity-building programme to support a mental health service modernisation pilot project based in the Lviv region of Western Ukraine. National programmes that aim to modernise mental health services now have the experience of other countries on which to draw. The challenges faced by such modernisers have much in common. Read More

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Evolving an ethical framework for Covid-19 management in India.

Indian J Med Ethics 2021 Jul-Sep;VI(3):1-20

Director, Professor and Dean, Department of Community Medicine, Maulana Azad Medical College, Delhi, INDIA.

The Covid-19 pandemic has caused millions of cases and deaths worldwide and has caused a massive global economic contraction. Governments, policymakers, and medical professionals have been confronted with several complex bioethical dilemmas during these exceptional circumstances. In developing countries like India, having a large population base, inadequate preexisting public health infrastructure, and a multi-level government system with complex administrative mechanisms imposes enormous barriers and challenges in the effective and ethical management of the pandemic. Read More

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Stakeholder point of view on prescription drug affordability - a systematic literature review and content analysis.

Health Policy 2021 Jul 9. Epub 2021 Jul 9.

Director, Policy Evidence Research CORE, Merck & Co. Inc., Kenilworth, NJ, USA. Electronic address:

Objectives: The objectives of this research were to: 1) understand perspectives on affordability of pharmaceutical drugs from the point of view of stakeholders as reported in published peer-reviewed journals and conferences; 2) evaluate if (and how) perspectives on affordability overlapped across stakeholders.

Methods: The systematic literature review followed Cochrane and PRISMA guidelines. Content analysis with iterative and systematic coding of text was conducted, to identify themes. Read More

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Evaluation of a New Method to Track Changes in Vision at Home for Children Undergoing Amblyopia Treatment.

Br Ir Orthopt J 2021 9;17(1):70-78. Epub 2021 Apr 9.

Kay Pictures, GB.

Purpose: A new amblyopia tracker app has been designed to provide parents with a method of monitoring a child's vision by presenting a single optotype size that the tester moves to identify the furthest distance the optotypes can be seen. The aim of this study is to evaluate this methodology in adults, comparing the findings to visual acuity (VA) measured with the iSight app and to determine the test retest variability.

Methods: Adults, aged 18-39 years, with no known eye condition and VA ≤ 0. Read More

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Endorsement of clinical practice guidelines: Criteria from the College of Family Physicians of Canada.

Can Fam Physician 2021 Jul;67(7):499-502

Professor in the Department of Family Practice at the University of British Columbia and Associate Director of the Rural Coordination Centre of BC.

Objective: To refine the process for endorsement of guidelines and establish the expectations of the College of Family Physicians of Canada (CFPC) regarding the quality and relevance of clinical practice guidelines targeting family physicians and their patients.

Composition Of The Committee: Initially, a group of 6 CFPC staff and selected College members reviewed the previous process for endorsement with the aim of providing a new direction, if needed. The work was then assumed by the Guideline and Knowledge Translation Expert Working Group, a purposefully selected group of 9 family physicians from across Canada with expertise in research, evidence, guidelines, knowledge translation, and continuing professional development and education. Read More

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Implementation strategies for the first licensed dengue vaccine: A meeting report.

Vaccine 2021 Jul 9. Epub 2021 Jul 9.

Heidelberg Institute of Global Health, University of Heidelberg, Germany; Institute for Social and Preventive Medicine, University of Bern, Switzerland. Electronic address:

Dengue vaccination would enhance the control of dengue, one of the most frequent vector-borne viral diseases globally. CYD-TDV is the first dengue vaccine to be licensed, but global uptake has been hampered due to its use being limited to seropositive persons aged 9 years and above, and the need for a 3-dose schedule. The Partnership for Dengue Control (PDC) organized a meeting with key opinion leaders and stakeholders to deliberate on implementation strategies for the use of CYD-TDV. Read More

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Needs, gaps and opportunities for standard and e-mental health care among at-risk populations in the Asia Pacific in the context of COVID-19: a rapid scoping review.

Int J Equity Health 2021 07 12;20(1):161. Epub 2021 Jul 12.

Department of Psychiatry, University of British Columbia, Vancouver, Canada.

Background: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. Read More

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The cost-effectiveness of temporary single patient rooms to reduce risks of healthcare associated infection.

J Hosp Infect 2021 Jul 8. Epub 2021 Jul 8.

Introduction: The use of single rooms for patient isolation often forms part of a wider bundle to prevent certain healthcare associated infections in hospitals. Demand for single rooms often exceeds what is available and the use of temporary isolation rooms may help resolve this. Changes to infection prevention practice should be supported by evidence that shows cost-effectiveness is plausible and likely. Read More

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Temporal trends and forecasting of COVID-19 hospitalisations and deaths in Scotland using a national real-time patient-level data platform: a statistical modelling study.

Lancet Digit Health 2021 Jul 5. Epub 2021 Jul 5.

Usher Institute, The University of Edinburgh, Edinburgh, UK; HDR UK BREATHE Hub, Edinburgh, UK.

Background: As the COVID-19 pandemic continues, national-level surveillance platforms with real-time individual person-level data are required to monitor and predict the epidemiological and clinical profile of COVID-19 and inform public health policy. We aimed to create a national dataset of patient-level data in Scotland to identify temporal trends and COVID-19 risk factors, and to develop a novel statistical prediction model to forecast COVID-19-related deaths and hospitalisations during the second wave.

Methods: We established a surveillance platform to monitor COVID-19 temporal trends using person-level primary care data (including age, sex, socioeconomic status, urban or rural residence, care home residence, and clinical risk factors) linked to data on SARS-CoV-2 RT-PCR tests, hospitalisations, and deaths for all individuals resident in Scotland who were registered with a general practice on Feb 23, 2020. Read More

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Immigrant Essential Workers Likely Avoided Medicaid And SNAP Because Of A Change To The Public Charge Rule.

Health Aff (Millwood) 2021 07;40(7):1090-1098

Leah Zallman, who died in November 2020, was director of research at the Institute for Community Health, an assistant professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance, when this research was conducted.

During the COVID-19 pandemic in the US, essential workers have provided health care, food, and other necessities, often incurring considerable risk. At the pandemic's start, the federal government was in the process of tightening the "public charge" rule by adding nutrition and health benefits to the cash benefits that, if drawn, could subject immigrants to sanctions (for example, green card denial). Census Bureau data indicate that immigrants accounted for 13. Read More

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COVID-19 appropriate behavior in India: Time to invest for the benefits in future.

J Family Med Prim Care 2021 May 31;10(5):1818-1822. Epub 2021 May 31.

Department of Director and CEO, AIIMS, Jodhpur, Rajasthan, India.

The COVID-19 pandemic gave an opportunity to adopt many appropriate changes in the behavior of the people in India. The major gears of those behavior changes were the enforcement by the government, fear, motivation (self and induced), and self-experiences or realizations with time. If those changes are fitted in the Trans-Theoretical Model, Indian people have passed through the "Pre-Contemplation" to "Action" stage of behavior changes during different phases of this pandemic. Read More

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Decolonizing Health Governance: A Uganda Case Study on the Influence of Political History on Community Participation.

Health Hum Rights 2021 Jun;23(1):259-271

Professor in the Department of Public Health and Primary Care, Ghent University, Belgium.

This paper presents a case study of how colonial legacies in Uganda have affected the shape and breadth of community participation in health system governance. Using Habermas's theory of deliberative democracy and the right to health, we examine the key components required for decolonizing health governance in postcolonial countries. We argue that colonization distorts community participation, which is critical for building a strong state and a responsive health system. Read More

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The Right to Mental Health in Yemen: A Distressed and Ignored Foundation for Peace.

Health Hum Rights 2021 Jun;23(1):43-53

Clinical Professor of Law and Director of the Human Rights Clinic and Institute at Columbia Law School.

Mental health issues are all too common consequences of conflict and atrocity crimes, often causing upwards of one-quarter of the postconflict, post-atrocity population to suffer from physical and mental sequelae that linger long after weapons have been silenced. After more than six years of ongoing conflict, Yemen's already weak health care system is on the brink of collapse, and population resilience has been severely stressed by indiscriminate attacks, airstrikes, torture, food insecurity, unemployment, cholera, and now the COVID-19 pandemic. This paper examines Yemen's responsibilities regarding the right to mental health and details the few actions the government has taken to date toward fulfilling this right. Read More

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An Investigation of MR Imaging Scanner Noise and its Effect on Technologists.

Radiol Technol 2021 Jul;92(6):568-576

Stephanie Smith, MS, R.T.(R)(MR), Alex Wilcher, MS, R.T.(R)(MR), Aurlivia Bibbs, MS, R.T.(R)(MR), and Isaiah Beemon, MS, R.T.(R)(MR), are graduates of the Master of Science in Magnetic Resonance Imaging program at the University of Mississippi Medical Center, School of Health Related Professions in Jackson.

Purpose: To investigate the level of noise that magnetic resonance (MR) technologists are exposed to during daily tasks, and prevalence of hearing loss among MR technologists.

Methods: Decibel levels at the scanner control panel were measured and recorded at clinical facilities. A survey was distributed to MR technologists, which included questions about demographics, workplace habits, and self-reported hearing loss. Read More

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SPIRIT-PRO Extension explanation and elaboration: guidelines for inclusion of patient-reported outcomes in protocols of clinical trials.

BMJ Open 2021 Jun 30;11(6):e045105. Epub 2021 Jun 30.

Value Evidence and Outcomes-Patient Centered Outcomes, GSK, Collegeville, Pennsylvania, USA.

Patient-reported outcomes (PROs) are used in clinical trials to provide valuable evidence on the impact of disease and treatment on patients' symptoms, function and quality of life. High-quality PRO data from trials can inform shared decision-making, regulatory and economic analyses and health policy. Recent evidence suggests the PRO content of past trial protocols was often incomplete or unclear, leading to research waste. Read More

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Changes in children's surgical services during the COVID-19 pandemic at a tertiary-level government hospital in a lower middle-income country.

BMJ Paediatr Open 2021 31;5(1):e001066. Epub 2021 Mar 31.

Department of Paediatric Surgery, Chittagong Medical College, Chattogram, Bangladesh.

Objective: The aim of this study was to quantify the changes that occurred in the surgical services of children during the COVID-19 pandemic from the perspective of a low/middle-income country.

Design: A case-control study was conducted at a large referral centre in Bangladesh among patients aged ≤12 years. Comparisons were made between cases admitted during a period of 'April to September 2020' () and controls during a similar period in 2019 (). Read More

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General practitioner management of mental health during the COVID-19 pandemic.

Aust J Gen Pract 2021 07;50(7):472-477

AM MBBS (Hons), MD, DCCH, DipRACOG, MCFP, FAHMS, Principal Medical Advisor and Deputy Chief Medical Officer, Australian Government Department of Health, ACT; Professor of Primary Care Reform, Australian National University, ACT; Adjunct Professor, Department of Family and Community Medicine, University of Toronto, Canada; Emeritus Director, World Health Organization Collaborating Centre on Family Medicine and Primary Care, GVA; Professorial Fellow, Murdoch [email protected] Research Institute, The Royal [email protected] Hospital Melbourne, Vic; Honorary Professor of Global Primary Care, Southgate Institute for Health, Society and Equity, Flinders University, SA.

Background: Psychological issues are common presentations in general practice. The COVID-19 pandemic has created a 'perfect storm' for the deterioration of mental health. General practitioners (GPs) are ideally placed to provide supports for people with mental health issues. Read More

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Robustness of differential gene expression analysis of RNA-seq.

Comput Struct Biotechnol J 2021 26;19:3470-3481. Epub 2021 May 26.

Patrick G. Johnson Centre for Cancer Research, Queen's University, Belfast, Northern Ireland, UK.

RNA-sequencing (RNA-seq) is a relatively new technology that lacks standardisation. RNA-seq can be used for Differential Gene Expression (DGE) analysis, however, no consensus exists as to which methodology ensures robust and reproducible results. Indeed, it is broadly acknowledged that DGE methods provide disparate results. Read More

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Polycystic Ovary Syndrome (PCOS) Transition at Menopause.

J Midlife Health 2021 Jan-Mar;12(1):30-32. Epub 2021 Apr 17.

Obstetrics, Gynecology & Reproductive Medicine, Government 43 Medical College, Srinagar, Jammu & Kashmir, India.

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Effect of an online healthy lifestyle psychoeducation programme to improve cardiometabolic outcomes and affective symptoms in youth receiving mental health care: study protocol for a pilot clinical trial.

BMJ Open 2021 Jun 29;11(6):e044977. Epub 2021 Jun 29.

Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia.

Introduction: Worsened cardiometabolic profiles in youth with mental ill health have been associated with a number of modifiable lifestyle risk factors. It is becoming increasingly evident that clinical interventions need to be multimodal in focus to improve mental health symptoms and the physical health symptoms in this already at-risk cohort.

Methods And Analysis: This 12-week pilot clinical trial examines the efficacy, feasibility and acceptability of an adjunctive online psychoeducation programme for improving cardiometabolic risk parameters and affective symptoms in a transdiagnostic sample of at least 44 young people aged 16-25 years presenting for mental healthcare for mood and/or psychotic syndromes (including anxiety, depression, bipolar disorder and psychosis). Read More

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Baseline risk factor prevalence among adolescents aged 15-17 years old: findings from National Non-communicable Disease Monitoring Survey (NNMS) of India.

BMJ Open 2021 Jun 29;11(6):e044066. Epub 2021 Jun 29.

Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Jodphur, Jodhpur, Rajasthan, India.

Objective: To generate national estimates of key non-communicable disease (NCD) risk factors for adolescents (15-17 years) identified in the National NCD Monitoring Framework and, study the knowledge, attitudes and practices towards NCD risk behaviours among school-going adolescents.

Design And Setting: A community-based, national, crosssectional survey conducted during 2017-2018. The survey was coordinated by the Indian Council of Medical Research-National Centre for Disease Informatics and Research with 10 reputed implementing research institutes/organisations across India in urban and rural areas. Read More

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