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A report on the 73th Annual Congress of the Japan Society of Obstetrics and Gynecology International Workshop for Junior Fellows: Risk-reducing surgery for hereditary breast and ovarian cancer.

J Obstet Gynaecol Res 2021 Aug 1. Epub 2021 Aug 1.

Board of education, Japan Society of Obstetrics and Gynecology, Tokyo, Japan.

At the 73rd Annual Congress of the Japan Society of Obstetrics and Gynecology, young doctors from Japan and South Korea made presentations on the present condition of risk-reducing surgery for hereditary breast and ovarian cancer (RRSO) in their respective country. RRSO was insured in Japan in April 2020, whereas in South Korea, it was insured 7 years earlier in 2013. In Japan, certification criteria have been set for facilities that perform RRSO, and the number of facilities is increasing, but regional disparities still exist in its distribution. Read More

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Geographic barriers to achieving universal health coverage: evidence from rural Madagascar.

Health Policy Plan 2021 Jul 31. Epub 2021 Jul 31.

NGO PIVOT, BP23 Ranomafana, 312 Ifanadiana, Madagascar.

Poor geographic access can persist even when affordable and well-functioning health systems are in place, limiting efforts for universal health coverage (UHC). It is unclear how to balance support for health facilities and community health workers in UHC national strategies. The goal of this study was to evaluate how a health system strengthening (HSS) intervention aimed towards UHC affected the geographic access to primary care in a rural district of Madagascar. Read More

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Innovation for improved hand hygiene: Field testing the Autarky handwashing station in collaboration with informal settlement residents in Durban, South Africa.

Sci Total Environ 2021 Jul 14;796:149024. Epub 2021 Jul 14.

Eawag, Swiss Federal Institute of Aquatic Science and Technology, 8600 Dübendorf, Switzerland; ETH Zürich, Institute of Environmental Engineering, 8093 Zürich, Switzerland.

Safe and accessible water services for hand hygiene are critical to human health and well-being. However, access to handwashing facilities is limited in cities in the Global South, where rapid urbanisation, service backlogs, lack of infrastructure and capacity, and water scarcity impact on the ability of local governments to provide them. Community participation and the co-production of knowledge in the development of innovative technologies, which are aligned with Water, Sanitation and Hygiene (WASH) principles, can lead to more sustainable and socially-acceptable hand hygiene systems. Read More

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Innovation of endoscopic management in difficult common bile duct stone in the era of laparoscopic surgery.

World J Gastrointest Endosc 2021 Jul;13(7):198-209

Digestive Disease and GI Oncology Center, Medistra Hospital, Jakarta 12950, DKI, Indonesia.

Common bile duct (CBD) stone is a common biliary problem, which often requires endoscopic approach as the initial treatment option. Roughly, 7%-12% of the subjects who experience cholecystectomy were subsequently referred to biliary endoscopist for further management. In general, there are three classifications of difficult CBD stone, which are based on the characteristics of the stone (larger than 15 mm, barrel or square-shaped stones, and hard consistency), accessibility to papilla related to anatomical variations, and other clinical conditions or comorbidities of the patients. Read More

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Improving Self-Confidence of Military Medical Providers With Joint Procedure Simulation: A Pilot Study.

Mil Med 2021 Jul 28. Epub 2021 Jul 28.

Department of Rheumatology, Tripler Army Medical Center, Honolulu, HI 96859, USA.

Introduction: Military medical providers are a unique population that encounter different environments across the world. From hospital clinics to war zones, these providers must perform procedures and rely on their training and skill to help their patients. This pilot study aimed to assess the self-confidence of military medical providers performing joint aspiration and injection before and after a simulation workshop in both clinical and austere settings. Read More

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Patients' perspectives on the experience of absconding from a psychiatric hospital: a qualitative study.

BMC Psychiatry 2021 Jul 26;21(1):371. Epub 2021 Jul 26.

Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda.

Background: Absconding (i.e., escaping) is common among patients with mental illness admitted to psychiatric hospitals. Read More

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The Impact of an Internet Use Promotion Programme on Communication, Internet Use, and the Extent of Social Networks among Low-Income Older Adults.

Ageing Int 2021 Jul 21:1-24. Epub 2021 Jul 21.

School of Health Studies, Northern Illinois University, Wirtz Hall 254, DeKalb, Illinois 60115 USA.

We examined whether an internet use promotion intervention influences low-income older adults' communication modes, internet use, and social networks using existing data collected for an intervention. Participants living in public senior housing facilities in the United States ( = 77) completed surveys before and after a 12-week computer and internet training. The six-item Lubben Social Network Scale (LSNS-6) was used to measure the extent of older adults' social networks. Read More

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Estimated Mortality Increases During The COVID-19 Pandemic By Socioeconomic Status, Race, And Ethnicity.

Health Aff (Millwood) 2021 Aug 21;40(8):1252-1260. Epub 2021 Jul 21.

Bhashkar Mazumder is a senior economist in the Economic Research Department, Federal Reserve Bank of Chicago, in Chicago, Illinois.

This article estimates changes in all-cause mortality due to the COVID-19 pandemic by socioeconomic characteristics and occupation for nonelderly adults in the US, using large-scale, national survey data linked to administrative mortality records. Mortality increases were largest for adults living in correctional facilities or in health care-related group quarters, those without health insurance coverage, those with family incomes below the federal poverty level, and those in occupations with limited work-from-home options. For almost all subgroups, mortality increases were higher among non-Hispanic Black respondents than among non-Hispanic White respondents. Read More

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Characteristics of nursing homes associated with COVID-19 outbreaks and mortality among residents in Victoria, Australia.

Australas J Ageing 2021 Jul 19. Epub 2021 Jul 19.

Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Vic., Australia.

Objective: To determine nursing home characteristics associated with COVID-19 outbreak, outbreak size and mortality, during the second wave in Victoria, Australia.

Method: Population-based cross-sectional study of all nursing homes in Victoria between 7 July and 13 November 2020.

Results: There were one or more resident cases of COVID-19 in 9. Read More

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Clinical and technical considerations for mediastinal Hodgkin lymphoma protontherapy based on a single-center early experience.

Cancer Radiother 2021 Jul 15. Epub 2021 Jul 15.

Institut Curie, Department of Radiation Oncology, 75005 Paris, France. Electronic address:

Purpose: Protontherapy for mediastinal Hodgkin lymphoma reduces cardiac, lung and breast exposure, which may limit radiation-induced adverse events. While this technique is already widely implemented in the United-States, clinical experience is still limited in France. This study analyses the practice of mediastinal Hodgkin lymphoma protontherapy at the Institut Curie to implement this technique at a larger scale. Read More

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Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.

PLoS One 2021 16;16(7):e0253927. Epub 2021 Jul 16.

London School of Hygiene and Tropical Medicine, London, United Kingdom.

Introduction: Catastrophic costs incurred by tuberculosis (TB) patients have received considerable attention, however little is known about costs and pathways to care after a negative TB evaluation.

Materials And Methods: We conducted a cross-sectional study of 70 patients with a negative TB evaluation at four community health centres in rural and peri-urban Uganda. Patients were traced 9 months post-evaluation using contact information from TB registers. Read More

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Predictors of Physical Activity Levels in University Physical Education Implementing Sport Education.

J Sports Sci Med 2021 Sep 1;20(3):516-524. Epub 2021 Jul 1.

Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, Chine.

By adopting Sport Education into the university context, this study examined how lesson content and teacher interaction contribute to university students' physical activity levels during physical education lessons. Following a continuing professional development workshop, a 10-week Sport Education season was designed collaboratively and implemented at a university, taking into account the university's facilities. This study used the momentary time sampling tool, System for Observing Fitness Instruction Time, in which eight teachers and 202 students (72% male) were videotaped in 156 lessons. Read More

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September 2021

Larger Nursing Home Staff Size Linked To Higher Number Of COVID-19 Cases In 2020.

Health Aff (Millwood) 2021 Aug 14;40(8):1261-1269. Epub 2021 Jul 14.

Michael Lawrence Barnett is an assistant professor of health policy and management, Harvard T. H. Chan School of Public Health, in Boston, Massachusetts, and an assistant professor of medicine at Harvard Medical School.

Staff in skilled nursing facilities (SNFs) are essential health care workers, yet they can also be a source of COVID-19 transmission. We used detailed staffing data to examine the relationship between a novel measure of staff size (that is, the number of unique employees working daily), conventional measures of staffing quality, and COVID-19 outcomes among SNFs in the United States without confirmed COVID-19 cases by June 2020. By the end of September 2020, sample SNFs in the lowest quartile of staff size had 6. Read More

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No evidence of increased fecal glucocorticoid metabolite levels in capercaillie () due to wind turbines.

Ecol Evol 2021 Jul 2;11(13):8487-8494. Epub 2021 May 2.

Institute of Wildlife Biology and Game Management Department of Integrative Biology and Biodiversity Research University of Natural Resources and Life Science Vienna Austria.

Wind energy facilities (WEFs) are a relatively novel impact on wildlife habitats, and an increasing number of studies show negative effects on wildlife. Increased stress-associated hormone levels are an indicator of disturbance effects, and measuring fecal glucocorticoid metabolite (FCM) levels is an established noninvasive method to study disturbance effects on wildlife. We studied whether FCM levels of capercaillie (), a locally threatened forest bird species with proven behavioral responses to WEF, are affected by WEF. Read More

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Examining the Relationship Between Environmental Factors and Inpatient Hospital Falls: Protocol for a Mixed Methods Study.

JMIR Res Protoc 2021 Jul 13;10(7):e24974. Epub 2021 Jul 13.

Office of Facilities Standards Service/Office of Facilities Planning, Office of Construction and Facilities Management, Department of Veterans Affairs, Washington, DC, United States.

Background: Patient falls are the most common adverse events reported in hospitals. Although it is well understood that the physical hospital environment contributes to nearly 40% of severe or fatal hospital falls, there are significant gaps in the knowledge about the relationship between inpatient unit design and fall rates. The few studies that have examined unit design have been conducted in a single hospital (non-Veterans Health Administration [VHA]) or a small number of inpatient units, limiting generalizability. Read More

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Longitudinal social network analysis of avian mycobacteriosis incidence in a large population of zoo birds.

Prev Vet Med 2021 Aug 23;193:105415. Epub 2021 Jun 23.

Department of Political Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92023, USA. Electronic address:

The goal of this study was to evaluate longitudinal patterns of avian mycobacteriosis spread through a social network. Specifically, we wanted to determine whether the patterns of connectivity over time can predict future infections, and whether this pattern can distinguish between different sources of infection. The study population included 13,409 individuals nested in a larger population of birds that were closely monitored in zoological facilities for over 22 years (1992-2014). Read More

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Rheuma SPACE - Standard Practice Aiming Clinical Excellence: the first Portuguese Rheumatology Department evaluation.

Acta Reumatol Port 2021 Apr-Jun;46(2):140-155

Serviço de Reumatologia, Centro Hospitalar Universitário de Lisboa Norte; Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa.

The Portuguese Rheumatology Society (SPR) embraced quality as a major goal and launched, in early 2015, a program to aim for excellence in global clinical care: Rheuma SPACE - Standard Practice Aiming Clinical Excellence. Evaluating daily reality is the first step in a quality development timeline, ultimately contributing for health gains. Herein we describe the results of the evaluation of the quality indicators defined for this project and the improvement strategies identified. Read More

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Evaluation of Dental Program for Older Adults Living in Long-Term Care Facilities.

Clin Cosmet Investig Dent 2021 29;13:275-281. Epub 2021 Jun 29.

Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.

Introduction: Compared to the general population, older adults living in long-term care facilities have poorer oral health. Also, they seldom have access to dental care services. Given that, a dental health program was initiated by Manipal College of Dental Sciences, Mangalore (MCODSM), to deliver dental care to the residents of St. Read More

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Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis.

Expert Rev Anti Infect Ther 2021 Jul 6. Epub 2021 Jul 6.

Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA.

Background: Although most norovirus outbreaks in high-income countries occur in healthcare facilities, information on associations between control measures and outbreak outcomes in these settings are lacking.

Methods: We conducted a systematic review/meta-analysis of published papers to assess associations between norovirus outbreak control measures and outcomes in hospitals and long-term care facilities (LTCFs), globally. Using regression analyses stratified by setting (hospital/LTCF), we compared durations, attack rates and case counts for outbreaks in which control measures were reportedly implemented to those in which they were not. Read More

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Wound Infection Incidence and Obesity in Elective Cesarean Sections in Jordan.

Med Arch 2021 Apr;75(2):138-143

Jordanian Royal Medical Services/ Army Forces, Amman, Jordan.

Background: Wound infection is a challenge that face healthcare facilities.

Objective: The aim of the study was to assess the effect of obesity on wound infection incidence.

Methods: A prospective study involved 127 patients underwent elective Cesarean section surgeries in the first ten months of 2018 with a follow up period of 90 days. Read More

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Characterization of US Hospital Advertising and Association With Hospital Performance, 2008-2016.

JAMA Netw Open 2021 Jul 1;4(7):e2115342. Epub 2021 Jul 1.

Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.

Importance: Hospital advertising has been touted as a tool to improve consumer decision-making, but little is known about its association with objective measures of hospital quality.

Objective: To document recent trends in hospital advertising in the US and examine the association between concurrent measures of hospital advertising and quality.

Design, Setting, And Participants: Retrospective cross-sectional study of all general acute care hospitals operating in the US between January 2008 and December 2016. Read More

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Facilitators and barriers to HIV pre-exposure prophylaxis (PrEP) uptake through a community-based intervention strategy among adolescent girls and young women in Seme Sub-County, Kisumu, Kenya.

BMC Public Health 2021 Jul 1;21(1):1284. Epub 2021 Jul 1.

Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Background: While the introduction of HIV Pre-Exposure Prophylaxis (PrEP) as an HIV prevention strategy has allowed women to exercise more control over the reduction of HIV transmission rates, adolescent girls and young women in Sub-Saharan Africa continue to experience higher rates of HIV infections and bear the greatest disease burden. Understanding progress in PrEP uptake among adolescent girls and young women would enhance risk reduction in this vulnerable population. The Determined, Resilient, AIDS-Free, Mentored and Safe women (DREAMS) Initiative plays a key role in this risk reduction strategy. Read More

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Understanding the Awareness, Knowledge, and Opinion of Dairy Cattle Welfare among Dairy Farmers in Keningau, Sabah.

Animals (Basel) 2021 Jun 11;11(6). Epub 2021 Jun 11.

Department of Farm and Exotic Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400 UPM, Malaysia.

This study aimed to assess the knowledge and opinions about DCW among dairy cattle farmers in Keningau, Sabah. A questionnaire was developed, validated, and administered by hand to 30 farmers. The data collected include farmers' and farm demographics, and opinions regarding the criteria and indicators of DCW. Read More

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Continuous Performance Improvement Framework for Sustainable Wastewater Treatment Facilities in Arid Regions: Case of Wadi Rumah in Qassim, Saudi Arabia.

Int J Environ Res Public Health 2021 06 26;18(13). Epub 2021 Jun 26.

Civil Engineering Department, College of Engineering, Qassim University, Buraydah 51452, Qassim, Saudi Arabia.

In arid regions such as Saudi Arabia, wastewater treatment (WWT) facilities (meeting promulgated standards) need to adapt their continuous performance improvement (CPI) for long-term sustainability. To achieve this, the facilities need to improve their performance to comply with more strict objectives for broader reuse applications of treated effluent. The present research proposes a CPI framework based on performance benchmarking process for the stepwise improvement of WWT facilities. Read More

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A retrospective observational study on the types of anaesthesia in hip fracture surgery.

J Perioper Pract 2021 Jul 1:17504589211006020. Epub 2021 Jul 1.

Geriatric Medicine Department, Northern Adelaide Local Health Network, Modbury Hospital, Modbury, Australia.

Background: There is no specific recommendation regarding the type of anaesthesia in hip fracture surgery.

Objectives: This study sought to examine the current local anaesthetic practice (general anaesthesia versus regional anaesthesia (RA)) in hip fracture surgery and to analyse their associations with perioperative outcomes.

Methodology: A retrospective observational study of hip fracture patients from April to December 2017 was undertaken. Read More

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Using quantitative fetal fibronectin to predict term labour onset in Australian rural women: A pilot study.

Aust N Z J Obstet Gynaecol 2021 Jun 30. Epub 2021 Jun 30.

Research Development Unit, Caboolture Hospital, Queensland Health, Caboolture, Queensland, Australia.

Background: Many women living in rural and remote Australia are required to travel large distances to birth in a hospital with maternity facilities, incurring considerable financial, social and emotional burden for them and their families. No studies to date have investigated the use of quantitative fetal fibronectin (qfFN) to predict term labour in asymptomatic pregnant women. A tool which is able to more accurately predict term labour has the potential to guide informed travel decision-making for women and healthcare professionals in rural and remote Australia. Read More

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Factors that Determine Comprehensive Categorical Classification of EHR Implementation Levels.

Health Serv Insights 2021 15;14:11786329211024788. Epub 2021 Jun 15.

School of Health and Applied Human Sciences, University of North Carolina at Wilmington, Wilmington, NC, USA.

Electronic Health Records (EHRs) have the potential to alleviate patient safety mistakes. Of the various levels of EHR, advanced or higher-level functionalities of EHR are designed to improve patient safety. Certain organizational and environmental factors may pose as barriers toward implementing all of the functionalities, leaving certain hospitals intermediate between basic and comprehensive levels of implementation. Read More

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'Bare-bones' to 'silver linings': lessons on integrating a palliative approach to care in long-term care in Western Canada.

BMC Health Serv Res 2021 Jun 28;21(1):610. Epub 2021 Jun 28.

Institute on Aging and Lifelong Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.

Background: 'Whole-person' palliative approaches to care (PAC) are important for enhancing the quality of life of residents with life-limiting conditions in long-term care (LTC). This research is part of a larger, four province study, the 'SALTY (Seniors Adding Life to Years)' project to address quality of care in later life. A Quality Improvement (QI) project to integrate a PAC (PAC-QI) in LTC was implemented in Western Canada in four diverse facilities that varied in terms of ownership, leadership models, bed size and geography. Read More

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VA Academic Affiliations Matter in the Era of Community Care: A Model From California.

Fed Pract 2021 Apr;38(4):174-182

is a US Department of Veterans Affairs (VA) and University of California, San Francisco (UCSF) Quality Scholar Psychology Fellow. is Associate Chief of Staff for Mental Health, both at the San Francisco VA Health Care System and Vice Chair, Department of Psychiatry Weill Institute of Neuroscience, UCSF.

Background: The Veterans Health Administration (VHA), 1 of 3 administrative branches in the US Department of Veterans Affairs (VA), is the largest integrated health care system in the United States. The VHA has 4 missions: providing health care to eligible veterans; supporting research to benefit veterans and the larger society; providing education for health care trainees; and supporting emergency response.

Observations: In service of these goals, the VA has academic affiliations with training institutions throughout the country, offering unique and extensive training and research opportunities. Read More

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The Veterans Health Administration (VHA) Innovators Network: Evaluation design, methods and lessons learned through an embedded research approach.

Healthc (Amst) 2021 Jun 23;8 Suppl 1:100477. Epub 2021 Jun 23.

Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA; Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.

Background: Collaboration between researchers, implementers and policymakers improves uptake of health systems research. In 2018, researchers and VHA Innovators Network (iNET) leadership used an embedded research model to conduct an evaluation of iNET. We describe our evaluation design, early results, and lessons learned. Read More

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