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Genotype-based chemotherapy for patients with gastrointestinal tumors: focus on oxaliplatin, irinotecan, and fluoropyrimidines.

Drug Metab Pers Ther 2021 Nov 30. Epub 2021 Nov 30.

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare, Moscow, Russian Federation.

This review aimed to summarize the pharmacogenetic studies of the most commonly used drugs in the chemotherapy of gastrointestinal (GI) tumors: oxaliplatin, irinotecan, and fluoropyrimidines. So far, it has not been possible to develop an effective genotype-based approach for oxaliplatin. More and more evidence is emerging in favor of the fact that the choice of a dose of fluorouracil based on pharmacogenetic testing according to , can be not only effective but also cost-effective. Read More

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November 2021

Connecting the Dots: The State of Arts and Health in Singapore.

Arts Health 2021 Nov 30:1-17. Epub 2021 Nov 30.

RTI International, Duraham, United States.

This article examines the state of the field of arts and health in Singapore and identifies the drivers that have shaped its development to date, adding new insights from Asia to the growing international literature in this area. Various methods, including an online survey and in-depth focus groups were used. We find that the field in Singapore is rapidly growing, with a proliferation of activities across the arts and culture, healthcare, and social care sectors in recent decades fostered by various policy developments, increased funding and new peer-to-peer networking. Read More

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November 2021

Genetic counseling students' and recent graduates' attitudes toward psychiatric illness.

J Genet Couns 2021 Nov 30. Epub 2021 Nov 30.

Sarah Lawrence College, Human Genetics Program, Bronxville, New York, USA.

Due to the high prevalence of mental illness in the general population, genetic counselors are likely to encounter patients with mental illness in practice, regardless of specialty. However, previous studies have shown that recent graduates of genetic counseling programs do not feel comfortable discussing mental illness in clinical encounters. One possible explanation for this discomfort is stigma toward mental illness, a well-documented phenomenon both in society and in the healthcare field. Read More

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November 2021

An Innovative Needs Assessment Approach to Develop Relevant Continuing Professional Development for Psychiatrists.

Acad Psychiatry 2021 Nov 30. Epub 2021 Nov 30.

Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.

Objectives: Gaps in psychiatrists' competence can interfere with the delivery of optimal patient care, particularly when these gaps have not been identified. This study aimed to assess the perceived and unperceived continuing professional development needs of psychiatrists practicing in Quebec, Canada.

Methods: The authors sent an online cross-sectional survey (2018) to members of the 'Association des médecins psychiatres du Québec' and collected data on unperceived needs via the critical incident method (focused on managing challenging clinical cases/situations). Read More

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November 2021

Why Not Home?: A Study of the Impact of an Effort to Reduce Postacute Expenditures.

Prof Case Manag 2022 Jan-Feb 01;27(1):3-11

Kelli A. Chovanec, DNP, RN, NE-BC, is the System Director for Care Navigation at ProMedica Health System, where she drives the care management strategy across the continuum with a focus on integration and population health management. She is a quality-oriented leader with proven expertise in care management, data analysis, and integrated health care delivery.

Purpose Of Study: Accountable Care Organizations (ACOs) aiming to reduce healthcare expenditure adopt strategies targeting costly postacute service utilization, asking "why not home?" as a part of the hospital discharge planning paradigm. This study examined the impact of an interventional approach to implement evidence-based interventions to improve transitions of care to the least restrictive next site of care on the rate of skilled nursing facility (SNF) admissions per 1,000, SNF length of stay (LOS), and total SNF cost.

Primary Practice Setting: The impact of the interventional approach for an ACO-attributed Medicare population, analyzing Medicare Shared Savings Plan Part A and Part B beneficiary claims data, was examined. Read More

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November 2021

How to WHO: lessons from aviation in checklists and debriefs.

Ann R Coll Surg Engl 2021 Nov 30:1-7. Epub 2021 Nov 30.

Portsmouth Hospitals University NHS Trust, UK.

Introduction: The World Health Organization (WHO) surgical safety checklist (SSC) has had an overall positive impact; however, it has not completely prevented adverse events and compliance with the checklist varies. The aviation industry is considered to have better engagement with their safety checklists, reporting not only safety improvements, but also a cultural shift in their checklist philosophy over recent years.

Methods: We explored the personal attitudes of pilots working in the aviation industry to identify principles of an effective checklist philosophy that could be transposed to the healthcare setting to empower more effective, consistent and ultimately successful implementation of the WHO SSC. Read More

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November 2021

Processual Validity in Qualitative Research in Healthcare.

Inquiry 2021 Jan-Dec;58:469580211060750

28122Paraná Federal University, Curitiba, Brazil.

Knowledge development has been continuously challenging. Qualitative research seems to be promising; however, there are difficulties and complexities involved, one of which is validity. Qualitative research is based on different paradigms, ontologies, theories, and methods, and validity assessment may vary. Read More

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November 2021

Parental perceptions of bladder dysfunction in children with symptomatic joint hypermobility.

Am J Med Genet C Semin Med Genet 2021 Nov 29. Epub 2021 Nov 29.

UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Children with symptomatic joint hypermobility (SJH) report chronic pain, fatigue, and joint instability as their main symptoms. Symptoms can extend beyond musculoskeletal and include lower urinary tract dysfunction (LUTD). There are no studies exploring parent-perceived quality of life (QoL) in children with LUTD, or strategies used to manage symptoms in this population. Read More

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November 2021

Impact and implementation findings from a cluster randomized trial of a youth relationship education curriculum.

Fam Process 2021 Nov 29. Epub 2021 Nov 29.

Department of Psychology, University of Denver, Denver, CO, US.

The current study presents implementation and impact data from a cluster randomized trial of a youth relationship education curriculum. High school students (n = 1,135) were randomized at the school level to receive curricula-as-usual or a healthy relationships program delivered by facilitators who were not employed by the high schools. Program evaluators reported high engagement and students indicated high satisfaction with the program, but multilevel models showed no statistically significant impacts on healthy relationship skills, attitudes, and behaviors at three and nine months post-intervention. Read More

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November 2021

Recent advances in nanocarriers for nutrient delivery.

Drug Deliv Transl Res 2021 Nov 29. Epub 2021 Nov 29.

Department of Pharmacy, Birla Institute of Technology and Science, Pilani, India, 333031.

For the past few years, there has been a surge in the use of nutraceuticals. The global nutraceuticals market in 2020 was USD 417.66 billion, and the market value is expected to increase by 8. Read More

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November 2021

The Impact of Reconstructive Modality and Postoperative Complications on Decision Regret and Patient-Reported Outcomes following Breast Reconstruction.

Aesthetic Plast Surg 2021 Nov 29. Epub 2021 Nov 29.

Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road, Suite 400, Palo Alto, CA, 94304, USA.

Shared decision-making gives patients greater autonomy in their healthcare decisions; however, decisions that result in negative outcomes may lead to decision regret. The complexity of reconstructive options makes post-mastectomy breast reconstruction particularly prone to decision regret. This study's purpose was to explore the relationship between breast reconstruction modalities and degree of postoperative decision regret. Read More

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November 2021

How Stressed Are They?: Levels and Sources of Stress in Doctor of Physical Therapy Students.

J Allied Health 2021 ;50(4):277-283

St. Catherine University, 2004 Randolph Ave., St. Paul, MN 55105, USA. Tel 651-690-6020.

Purpose: Stress has detrimental effects on psychological well-being, cognitive function, and physiological health. While students in many healthcare programs experience high levels of stress, it is unknown whether this is true for Doctor of Physical Therapy (DPT) students. The purpose of this study was to explore the levels and sources of stress experienced by first- and second-year DPT students. Read More

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January 2021

Medicine and dentistry: Understanding the language of dentistry.

Aust J Gen Pract 2021 12;50(12):950-953

MBBS, FRACGP, FACRRM, PhD, Professor of Health Professional Education, College of Medicine and Dentistry, James Cook University, Qld.

Background: Dental problems are common in general practice and are responsible for many avoidable hospitalisations. Medicine and dentistry are often practised in isolation, with little shared language or understanding.

Objective: The aim of this article is to help general practitioners (GPs) maximise effective dental referral strategies by briefly outlining basic dental nomenclature and describing the roles of different types of oral healthcare providers. Read More

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December 2021

Role of the trace amine associated receptor 5 (TAAR5) in the sensorimotor functions.

Sci Rep 2021 Nov 29;11(1):23092. Epub 2021 Nov 29.

Institute of Translational Biomedicine, Saint Petersburg State University, Saint Petersburg, 199034, Russia.

Classical monoamines are well-known modulators of sensorimotor neural networks. However, the role of trace amines and their receptors in sensorimotor function remains unexplored. Using trace amine-associated receptor 5 knockout (TAAR5-KO) mice, that express beta-galactosidase mapping its localization, we observed TAAR5 expression in the Purkinje cells of the cerebellum and the medial vestibular nucleus, suggesting that TAAR5 might be involved in the vestibular and motor control. Read More

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November 2021

Revealing the efficacy-toxicity relationship of Fuzi in treating rheumatoid arthritis by systems pharmacology.

Sci Rep 2021 Nov 29;11(1):23083. Epub 2021 Nov 29.

State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China.

In recent decades, herbal medicines have played more and more important roles in the healthcare system in the world because of the good efficacy. However, with the increasing use of herbal medicines, the toxicity induced by herbal medicines has become a global issue. Therefore, it is needed to investigate the mechanism behind the efficacy and toxicity of herbal medicines. Read More

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November 2021

Network meta-analysis for comparative effectiveness of treatments for chronic low back pain disorders: systematic review protocol.

BMJ Open 2021 Nov 29;11(11):e057112. Epub 2021 Nov 29.

Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia.

Introduction: Chronic low back pain disorders (CLBDs) present a substantial societal burden; however, optimal treatment remains debated. To date, pairwise and network meta-analyses have evaluated individual treatment modes, yet a comparison of a wide range of common treatments is required to evaluate their relative effectiveness. Using network meta-analysis, we aim to evaluate the effectiveness of treatments (acupuncture, education or advice, electrophysical agents, exercise, manual therapies/manipulation, massage, the McKenzie method, pharmacotherapy, psychological therapies, surgery, epidural injections, percutaneous treatments, traction, physical therapy, multidisciplinary pain management, placebo, 'usual care' and/or no treatment) on pain intensity, disability and/or mental health in patients with CLBDs. Read More

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November 2021

Adherence to antidiabetic treatment and impaired hypoglycemia awareness in type 2 diabetes mellitus assessed in Spanish community pharmacies: the ADHIFAC study.

BMJ Open Diabetes Res Care 2021 Nov;9(2)

Diabetes Group of the Spanish Society of Clinical, Family and Community Pharmacy (SEFAC), Barcelona, Spain.

Introduction: Adherence to treatment and hypoglycemia awareness are strongly linked to glycemic control and hypoglycemia risk in people with type 2 diabetes mellitus (T2DM). Community pharmacies are suitable facilities to detect these conditions, and should be involved in the strategies to minimize the associated risks and burden.

Research Design And Methods: This cross-sectional study conducted at community pharmacies across Spain assessed the prevalence of low adherence to antidiabetic treatments, the frequency of impaired hypoglycemia awareness, and their predictive factors. Read More

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November 2021

Systems engineering analysis of diagnostic referral closed-loop processes.

BMJ Open Qual 2021 Nov;10(4)

Healthcare Systems Engineering Institute, Northeastern University, Boston, Massachusetts, USA

Background: Closing loops to complete diagnostic referrals remains a significant patient safety problem in most health systems, with 65%-73% failure rates and significant delays common despite years of improvement efforts, suggesting new approaches may be useful. Systems engineering (SE) methods increasingly are advocated in healthcare for their value in studying and redesigning complex processes.

Objective: Conduct a formative SE analysis of process logic, variation, reliability and failures for completing diagnostic referrals originating in two primary care practices serving different demographics, using dermatology as an illustrating use case. Read More

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November 2021

A study of the effects of delayed patient presentation on cutaneous SCC progression.

J Plast Reconstr Aesthet Surg 2021 Oct 7. Epub 2021 Oct 7.

St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford CM1 7ET, UK; School of Medicine, Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK; St Andrew's Anglia Ruskin (StAAR) Research Group, Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK. Electronic address:

Background: A cohort study of patients, who underwent cutaneous squamous cell carcinoma (SCC) excision, was undertaken to evaluate the effects of the COVID-19 pandemic on treatment times and histopathological features.

Methods: We identified all patients who had SCCs excised in October 2020 (pandemic group); the control group included all patients who underwent excision of SCCs during October 2019 (pre-pandemic group). Collected data included SCC subtype, thickness, size, clearance margins, referral details, patient comorbidities and operative data. Read More

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October 2021

Promoting adolescent health through integrated human papillomavirus vaccination programs: The experience of Togo.

Vaccine 2021 Nov 26. Epub 2021 Nov 26.

Independent Consultant, Lomé, Togo. Electronic address:

The introduction of the Human papillomavirus (HPV) vaccine has shown potential to not only prevent cervical cancer but also drive adolescents' access to other health care services, even in low-income countries. Few studies have been conducted to date to identify best practices and estimate the acceptance, operational challenges and benefits of including broader adolescent health interventions into immunization efforts, knowledge which is essential to supporting widespread integration. In this paper we review the efforts undertaken by the government of Togo to integrate adolescent health programming with the HPV vaccination roll out. Read More

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November 2021

Process evaluation of a cluster randomised controlled trial to improve bronchiolitis management - a PREDICT mixed-methods study.

BMC Health Serv Res 2021 Nov 29;21(1):1282. Epub 2021 Nov 29.

Children's Emergency Department, Starship Children's Hospital, Private Bag, Auckland, 92019, New Zealand.

Background: Bronchiolitis is the most common reason for hospitalisation in infants. All international bronchiolitis guidelines recommend supportive care, yet considerable variation in practice continues with infants receiving non-evidence based therapies. We developed six targeted, theory-informed interventions; clinical leads, stakeholder meeting, train-the-trainer, education delivery, other educational materials, and audit and feedback. Read More

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November 2021

Interventions for the management of abdominal pain in Crohn's disease and inflammatory bowel disease.

Cochrane Database Syst Rev 2021 Nov 29;11:CD013531. Epub 2021 Nov 29.

College of Health, Medicine and Life Sciences, Brunel University London, London, UK.

Background: Crohn's disease is a remitting and relapsing disorder that can affect the whole gastrointestinal tract. Active disease symptoms include abdominal pain, fatigue, weight loss, and diarrhoea. There is no known cure; however, the disease can be managed, and therefore places a huge financial burden on healthcare systems. Read More

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November 2021

Adopting Andersen's behavior model to identify factors influencing maternal healthcare service utilization in Bangladesh.

Authors:
Md Ruhul Kabir

PLoS One 2021 29;16(11):e0260502. Epub 2021 Nov 29.

School of Communication, Hong Kong Baptist University, Kowloon Tong, Hong Kong.

Background: Equitable maternal healthcare service access and it's optimum utilization remains a challenge for many developing countries like Bangladesh, and different predisposing, enabling, and need-based factors affect the level of maternal healthcare use. The evidently poor maternal healthcare service utilization and disparities among groups in Bangladesh are concerning considering its effect on maternal health outcomes. The study aimed to identify the factors that influence maternal healthcare service (MHS) utilization in Bangladesh by adopting Andersen's behavior model of health service use as the theoretical framework. Read More

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November 2021

Providers' mediating role for medication adherence among cancer survivors.

PLoS One 2021 29;16(11):e0260358. Epub 2021 Nov 29.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.

Background: We conducted a mediation analysis of the provider team's role in changes to chronic condition medication adherence among cancer survivors.

Methods: We used a retrospective, longitudinal cohort design following Medicare beneficiaries from 18-months before through 24-months following cancer diagnosis. We included beneficiaries aged ≥66 years newly diagnosed with breast, colorectal, lung or prostate cancer and using medication for non-insulin anti-diabetics, statins, and/or anti-hypertensives and similar individuals without cancer from Surveillance, Epidemiology, and End Results-Medicare data, 2008-2014. Read More

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November 2021

Change in treatment burden among people with multimorbidity: Protocol of a follow up survey and development of efficient measurement tools for primary care.

PLoS One 2021 29;16(11):e0260228. Epub 2021 Nov 29.

School of Primary Care, Population Sciences, and Medical Education, University of Southampton, Southampton, United Kingdom.

Background: Treatment burden is the effort required of patients to look after their health and the impact this has on their functioning and wellbeing. It is likely treatment burden changes over time as circumstances change for patients and health services. However, there are a lack of population-level studies of treatment burden change and factors associated with this change over time. Read More

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November 2021

Causes of early postpartum complications that result in visits to the emergency department.

PLoS One 2021 29;16(11):e0260101. Epub 2021 Nov 29.

Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Objective: This study aimed to review the reasons why postpartum women present to the emergency department (ED) over a short term (≤10 days post-delivery) and to identify the risk factors associated with early visits to the ED.

Methods: This retrospective chart review included all women who delivered at a regional health system (William Osler Health System, WOHS) in 2018 and presented to the WOHS ED within 10 days after delivery. Baseline descriptive statistics were used to examine the patient demographics and identify the timing of the postpartum visit. Read More

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November 2021

A qualitative exploration of obesity bias and stigma in Irish healthcare; the patients' voice.

PLoS One 2021 29;16(11):e0260075. Epub 2021 Nov 29.

School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.

Background: Current data indicates 70% of adults with obesity report experiencing bias and stigmatisation when engaging with healthcare. Most studies to date, have focused on weight bias from a healthcare professional's perspective. Few have explored weight bias from the perspective of the individual living with obesity and no study has conducted this research in the Irish context. Read More

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November 2021

Levels and predictors of anxiety, depression, and stress during COVID-19 pandemic among frontline healthcare providers in Gurage zonal public hospitals, Southwest Ethiopia, 2020: A multicenter cross-sectional study.

PLoS One 2021 29;16(11):e0259906. Epub 2021 Nov 29.

Department of Pediatric and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Introduction: The provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. However, healthcare providers as the frontline caregivers dealing with infected patients, are more vulnerable to mental health problems. Despite this fact, there is scarce information regarding the mental health impact of COVID-19 among frontline health care providers in South-West Ethiopia. Read More

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November 2021

Developing a research agenda on exercise and physical activity for people with limb loss in Canada.

Disabil Rehabil 2021 Nov 29:1-9. Epub 2021 Nov 29.

Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Purpose: There is a lack of high-quality evidence about the effects of exercise or physical activity interventions for adults with lower limb amputations (LLAs). A planning meeting involving stakeholders (i.e. Read More

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November 2021