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Articoli di riviste sul tema "Multidisciplinary health center (MHC)"

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Montgomery, Kelsey B., Britany A. Hollenquest, Adam T. Lucy, Charles A. Banks, Vanessa Anne Eulo e Kristy Kummerow Broman. "Evaluation of delays to multidisciplinary treatment of soft tissue sarcomas at a tertiary cancer center." JCO Oncology Practice 19, n. 11_suppl (novembre 2023): 62. http://dx.doi.org/10.1200/op.2023.19.11_suppl.62.

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62 Background: Management of soft tissue sarcomas often requires coordinated multidisciplinary care including radiation, medical, and surgical oncology. Delays in the multidisciplinary evaluation and treatment may lead to poorer outcomes. Coordination of care through a multidisciplinary clinic (MDC) offering access to all three specialties during the same clinic visit may reduce time from initial evaluation to treatment. Methods: Adult patients treated for soft tissue sarcoma at an NCI-designated comprehensive cancer center following the opening of a sarcoma MDC in November 2021 to May 2023 were included. Patients were either seen in the sarcoma MDC or separately by oncologic providers (usual care). The primary outcome was delay in treatment initiation, defined as greater than 21 days from initial consultation to first treatment. Reasons for delay were abstracted. Descriptive statistics and bivariate analyses were performed. Results: Among 147 patients, 20 were (13.6%) seen in MDC and 127 (86.4%) by usual care. Initial treatments were surgery (46.9%), radiation (30.6%), or systemic therapy (22.4%). Median time to treatment was 34 days (IQR 14-57 days), which differed by treatment modality (surgery 34 days, radiation 37 days, systemic 18 days). There were no significant differences in time to treatment for MDC patients (33 days, IQR 25-44) versus usual care (34 days, IQR 13-57) (p=0.93). However, a significantly higher proportion of MDC patients received multiple modalities of treatment (75.0% vs 48.8% usual care, p=0.011), with a longer average time to treatment in the multi- versus single-modality groups (41 vs 22 days, p<0.001). Among patients requiring multimodal therapy, median time to treatment was 33 days for MDC patients versus 44 days for usual care (p=0.07). MDC patients were also much more likely to receive radiation (90.0% MDC vs 45.6% usual care, p=0.001). Delays in care (n=76, 51.7% of cohort) were seen in 66.7% (12/18) of MDC patients versus 58.3% (63/108) of usual care patients. The most common reasons for delay were need for additional imaging (29.7%) or preoperative testing (18.8%). Conclusions: In this single-center study, no improvement in time to treatment was seen following the opening of a sarcoma multidisciplinary clinic, likely explained by higher proportion of MDC patients receiving multiple treatment modalities. Primary reasons for delay could be anticipated prior to initial evaluation and represent an opportunity for more active case review prior to in-person evaluation to reduce delays in sarcoma treatment.
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Onukwugha, Eberechukwu, Nicholas J. Petrelli, Kathleen M. Castro, James F. Gardner, Jinani Jayasekera, Olga Goloubeva, Ming T. Tan et al. "ReCAP: Impact of Multidisciplinary Care on Processes of Cancer Care: A Multi-Institutional Study". Journal of Oncology Practice 12, n. 2 (febbraio 2016): 155–56. http://dx.doi.org/10.1200/jop.2015.004200.

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QUESTION ASKED: What is the relationship between the level of implementation of multidisciplinary care (MDC) and various processes of cancer care (eg, time to treatment receipt, evaluation for enrollment onto a clinical trial) among community cancer centers serving patients diagnosed with colon, rectal, or lung cancer? There is limited generalizable evidence on this topic. It is important to answer this question using data that can generalize across cancer patients, the majority of whom receive treatment in a community cancer center. SUMMARY ANSWER: Focusing on the time to receipt of cancer-directed treatment as one key process of cancer care in this patient population, we found that the answer to our question depended on the MDC assessment area and tumor site ( Table 1 ). Among patients with colon cancer, higher MDC levels of physician engagement (ie, a higher level of physician engagement at the institutional level) were associated with a shorter time to treatment receipt, whereas higher MDC levels of case planning were associated with a longer time to treatment receipt. Among patients with rectal cancer, higher MDC levels of physician engagement were associated with a shorter time to cancer-directed treatment receipt, whereas higher MDC levels of evaluation for enrollment onto clinical trials were associated with a longer time to treatment receipt. Among patients with lung cancer, there was no association between the MDC areas of assessment and the time to cancer-directed treatment receipt. [Table: see text] METHODS: We collected data for patients receiving care at 14 National Cancer Institute (NCI) community cancer centers. We characterized the NCI community cancer centers according to their level of MDC implementation across seven MDC assessment areas and over time. Using statistical regression models, we investigated the relationship between the level of MDC implementation and various process measures, including time to treatment receipt, clinical trial evaluation, receipt of multimodality treatment, and adherence to treatment guidelines published by the National Comprehensive Cancer Network. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: In the absence of a validated MDC assessment tool, the NCI community cancer centers used a nonvalidated tool. Additional institutional-level data would have been useful for characterizing norms and practices that may have differed across cancer centers and potentially explained variation in care processes. Although we controlled for patient demographic characteristics, baseline data were not available to document patient comorbidity or performance status level. To the extent that cancer centers at higher levels of MDC implementation may have been more likely to treat clinically complex patients, the inability to control for potential confounding bias caused by patient case mix may have influenced the study results. REAL-LIFE IMPLICATIONS: MDC models are important decision-making forums in current oncology practice. They involve oncologists in generating a comprehensive and coordinated plan of care for patients. Although MDC is purported to offer benefits to patients, there is limited generalizable evidence regarding the benefit to individuals receiving care at community cancer centers in the United States. Across various care processes that are important for characterizing cancer care, this study’s results indicate that changes in the level of MDC implementation could differentially affect the process of care, depending on the MDC area of assessment and the cancer site. In addition, the study results can be used to generate hypotheses for future studies among individuals diagnosed with colon, rectal, or lung cancer.
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Simpong, Nicodemus Larbi, Charity Tenu Afefa, Leander Yimpuri, Betty Akum, Afia Safo, Simon-Junior Edziah, David Larbi Simpong e Patrick Adu. "Establishing pregnancy-specific haematological reference intervals in Ghana; a three-center cross-sectional study". PLOS ONE 18, n. 2 (3 febbraio 2023): e0274422. http://dx.doi.org/10.1371/journal.pone.0274422.

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Background Abnormal intra-pregnancy haematological variables are associated with adverse feto-maternal outcomes. However, the reference intervals (RIs) employed in sub-Saharan Africa to inform clinical decisions are generally imported. Since RIs are influenced by age, geographical location, and race, we hypothesized that context specific RIs should be established in Ghana to contextualize intra-pregnancy decision making. Methods This cross-sectional study retrospectively retrieved data of 333 pregnant women with no known clinically determined intra-pregnancy complications; 22 participants in their first trimester (T1; 1–13 weeks), 177 in their T2 (14–27 weeks), and 132 in T3 (28–41 weeks). RIs for haematological parameters were non-parametrically determined at 2.5th and 97.5th percentiles in accordance with CLSI guidance document EP28-A3c. Two-sample comparisons were undertaken using Wilcoxon rank-sum tests whereas more than two-sample comparisons were undertaken using Kruskal-Wallis test. Statistical significance was set at p <0.05 under the two-tailed assumptions. Results In accordance with WHO trimester-specific haemoglobin cutoffs, anaemia prevalence was a moderate (T1: 36.4%; 8/22 & T2: 31.6%; 56/177) to severe (T3:68.0%; 90/132) public health problem. Additionally, 9.3% (31/333) individuals had high gestational haemoglobin levels (Hb >13.0 g/dL). Moreover, haemoglobin (T2: 8.6–14.3 vs T3: 7.5–13.6 g/dL), MCH (T2: 22.5–69.8 vs T3: 21.6–31.9 pg), MCHC (T2: 30.2–51.8 g/L vs T3: 30.5–37.9 g/L), TWBC (T2: 4.0–13.4 vs T3: 4.1–13.0 x 109/L) required trimester specific RIs, compared to RBC (2.8–5.1 x 1012/L), MCV (66.2–100.2 fL), and platelet counts (106.3–388.3 x 109/L) that each required combined reference intervals. Conclusions The intra-pregnancy haematological RIs determined have appreciable lower limits; there is the need to determine context-specific thresholds for haematological variables predictive of positive and/or adverse maternal and infant health outcomes.
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McCahill, Laurence E., Sunil Konduri, Alan T. Davis, Mary May, Coralyn Martinez, Wendy K. Taylor e Gerald P. Wright. "Quality of gastrointestinal cancer care at a community hospital under the paradigm of multidisciplinary care." Journal of Clinical Oncology 30, n. 4_suppl (1 febbraio 2012): 133. http://dx.doi.org/10.1200/jco.2012.30.4_suppl.133.

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133 Background: Benefits of MDC have been established for other cancers but not GI malignancies. Benefits of GI NDC cancer care for underserved populations is yet to be quantified. Our GI-MDC was established to provide efficient, evidenced-based, high quality cancer care to patients of all ethnic and socioeconomic backgrounds. Methods: We prospectively identified underserved patients in seven categories. A GI nurse navigator (NN) contacted patients, coordinated appointments /diagnostic studies and prepared for prospective case evaluation and weekly multidisciplinary GI clinic. Health care efficiency/quality data was abstracted by an R.N. quality analyst. Outcomes were compared between underserved and non-underserved populations. Percentages were compared using Chi square and medians by Mann-Whitney U test. Results: From Jan 2010-July 2011, 208 patients were evaluated, with 137 confirmed new cancers, clinically estimated as Stage I=31, II=30, III=26, and IV=47. Among underserved patients, categories included age >80(n=26), public aid (n=28), uninsured (n=12), mental disability/impairment (n=15), incarcerated/institutionalized (n=4), and language barrier (n=2), more then one category could be selected. Outcomes are listed in the Table. Conclusions: A model of GI cancer care including a GI NN, treatment planning conference, and MDC clinic is feasible in a community cancer center. Preliminary data demonstrates small differences between underserved and non underserved patient populations. This model of health care may help to reduce disparities in cancer care. [Table: see text]
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Bomar, Kaitlin, Nicole Vickery, Meagan Duggan, Tina Redenz, Tracey Lukker, Kristin Jensen, Eugene Paciarelli, Terra Dillard, Robert D. Siegel e Hal E. Crosswell. "The Bon Secours St. Francis Cancer Survivorship Program: A model for community-based multidisciplinary survivorship care." Journal of Clinical Oncology 34, n. 3_suppl (20 gennaio 2016): 45. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.45.

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45 Background: In 1974, Giulio D' Angio,MD, stated “Cure Is Not Enough” and the concept of Survivorship was ignited. Multidisciplinary survivorship clinics have since become a mainstay of many pediatric cancer programs; few such clinics exist in adult cancer programs, especially in community practice. We report on the development of a survivorship care plan and a community-based clinic designed to provide guideline-driven after care for cancer survivors. Methods: An overview of the vision and mission of the Bone Secours St. Francis Cancer Center Survivorship Program is provided. Descriptive analysis of the components and metrics of success are provided, in the context of accrediting organizations requirements for current and future goals for survivorship care. Results: BSSF, which is a non-academic, community-based cancer program, and receives over 1300 referrals annually from a referral population of 1.32 million in 10 counties. St. Francis , accredited by both the Commission on Cancer and National Accreditation Program for Breast Centers, has been providing cancer‐related services to the Upstate South Carolina region for a decade. The survivorship program at St. Francis is a STAR‐certified program and is a patient‐centered service provided in a comprehensive and coordinated multidisciplinary team approach, including integrated psychologic care. A custom survivorship care plan was developed and efforts, including successes and barriers, to implementation of plans for all cancer survivors in accordance with CoC and NAPBC goals are addressed. Conclusions: The BSSF Cancer Center Survivorship Program has developed a practical, yet comprehensive SCP, which is risk-adapted and guideline-driven in order to provide customized survivorship education and monitoring. The MDC provides comprehensive evaluations and recommendations in order to maximize health and well-being of patients navigating life after cancer diagnosis and treatment. Our efforts have demonstrated that survivorship clinics of this nature can be established and successful in a non-academic community setting.
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Morel, Adeline, Margaux Jacobs, Angelique Da Silva, Djelila Allouache, Ioana Hrab, Carine Segura, Maud Villemin et al. "Abstract P4-12-05: Benefit of multidisciplinary consultation at initiation of oral antineoplastic agents in metastatic breast cancer patients". Cancer Research 82, n. 4_Supplement (15 febbraio 2022): P4–12–05—P4–12–05. http://dx.doi.org/10.1158/1538-7445.sabcs21-p4-12-05.

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Abstract INTRODUCTION: The management of cancer patients changed in the recent years with increased in the number of oral antineoplastic agents (OANA) prescriptions. Recent guidelines encouraged improvement of information and patient education, and the coordination between health care professionals to secure and optimize the management of these drugs. To cope with current recommendations, a multidisciplinary consultation (MDC) for initiation of OANA was initiated at François Baclesse comprehensive cancer center in Caen, France. OBJECTIVE: The aim of this study was to evaluate the benefit of the MDC before the initiation OANA in patients with metastatic breast cancer. MDC consisted of a medical oncologist, hospital pharmacist, and oncology nurse consultations. Primary endpoint was the rate of hospitalizations. Secondary endpoints were treatment discontinuation and of adverse events rate. MATERIALS AND METHODS: We conducted a retrospective single center study comparing patients receiving MDC to the population with a single medical visit. RESULTS: A total of 482 patients were included in this study between January 2017 and December 2019 (329 patients had only a consultation with a medical oncologist before initiation of OANA and 153 had the MDC). A statistically significant decrease in the rate of hospitalizations for toxicity was found in the group of patients with MDC 3.9% (n=6) vs 18.5% (n = 61) in the group without MDC (p &lt; 0.001). A significant decrease in treatment interruption rate for toxicity was found in the group of patients with MDC 11% (n = 16) vs 26% (n=86) (p &lt; 0.001). Adverse events rate was not statistically significant between the two groups CONCLUSION: A statistically significant decrease in hospitalizations and rate of treatment interruption for toxicity was observed after initiation of MDC in patients with a metastatic breast cancer treated with an OANA. This process should be generalized for a better security in the management of the OANA. Citation Format: Adeline Morel, Margaux Jacobs, Angelique Da Silva, Djelila Allouache, Ioana Hrab, Carine Segura, Maud Villemin, Clémence Boscher, Alison Johnson, Charlotte Ceintre, Rose-Marie Charles, François Lahaye, Justine Lequesne, Fabienne Divanon, Christelle Levy, Georges Emile. Benefit of multidisciplinary consultation at initiation of oral antineoplastic agents in metastatic breast cancer patients [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-12-05.
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Aoyama, Takashi, Osamu Imataki, Akifumi Notsu, Takashi Yurikusa, Koki Ichimaru, Masanori Tsuji, Kanako Yoshitsugu, Masafumi Fukaya, Terukazu Enami e Takashi Ikeda. "Examination of a nutritional treatment pathway according to pretreatment health status and stress levels of patients undergoing hematopoietic stem cell transplantation". PLOS ONE 17, n. 8 (1 agosto 2022): e0271728. http://dx.doi.org/10.1371/journal.pone.0271728.

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Introduction This study aimed to validate hematopoietic stem cell transplantation (HSCT) treatment via a tailored nutritional pathway in myeloablative conditioning (MAC), determine its efficacy in terms of remission, and explore associations between clinical outcomes and nutritional indicators. Methods We included patients who underwent MAC for HSCT at the Shizuoka Cancer Center Stem Cell Transplantation between 2015 and 2019. We evaluated outcomes from the day before treatment initiation (transplant date: day 0) to day 42. Results Among the 40 MAC cases (participant characteristics: 20/40 males, mean age of 52 years, and mean body mass index of 21.9 kg/m2), we found that the percent loss of body weight and loss of skeletal muscle mass were correlated with the basal energy expenditure rate (BEE rate; r = 0.70, p<0.001 and r = 0.49, p<0.01, respectively). Based on the receiver operating characteristics curves, the cutoff value for the BEE rate in terms of weight loss was 1.1. Salivary amylase levels did not significantly change during the treatment course. Continuous variables, including oral caloric intake and performance status, showed statistically significant correlations with nutrition-related adverse events during treatment (r = −0.93, p<0.01 and r = 0.91, p<0.01, respectively). Skeletal muscle mass before treatment initiation was an independent predictive variable for reduced 2-year survival (p = 0.04). Conclusion Our results support the validity of a safe nutritional pathway with a BEE rate of 1.1 for HSCT patients pretreated with MAC. Specifically, we found that this pathway could prevent weight loss in response to nutrition-related adverse events. Skeletal muscle mass before treatment was identified as an independent risk factor for reduced 2-year survival.
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Lyznicki, James, Italo Subbarao, Georges C. Benjamin e James J. James. "Developing a Consensus Framework for an Effective and Efficient Disaster Response Health System: A National Call to Action". Disaster Medicine and Public Health Preparedness 1, S1 (settembre 2007): S51—S54. http://dx.doi.org/10.1097/dmp.0b013e31814622e2.

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ABSTRACTEighteen national organizations, representing medicine, dentistry, nursing, hospital systems, public health, and emergency medical services, have worked together to create a framework for a national and regional disaster response health system that is scalable, multidisciplinary, and seamless, and based on an all-hazards approach. In July 2005 and June 2006 the American Medical Association (AMA) and the American Public Health Association (APHA) convened the AMA/APHA Linkages Leadership Summit, with funding from the Centers for Disease Control and Prevention under the Terrorism Injuries: Information Dissemination and Exchange (TIIDE) program. As cofacilitators, James J. James, MD, DrPH, MHA, director of the AMA Center for Public Health Preparedness and Disaster Response, and Georges Benjamin, MD, FACP, FACEP(E), APHA executive director, met with leaders from 16 national medical, dental, hospital, nursing, hospital systems, public health, and emergency medical services organizations in Chicago (2005) and New Orleans (2006) to deliberate the deficiencies in the medical and public health disaster response system and the lack of necessary linkages between key components of this system: the health care, emergency medical services, and public health sectors. The goal was to reach consensus on a set of overarching recommendations to improve and sustain health system preparedness and to combine each organization's advocacy expertise and experience to promote a shared policy agenda. The full summit report contains 53 consensus-based recommendations, which will serve as the framework for a coordinated national agenda for strengthening health system preparedness for terrorism and other disasters. The 9 most overarching critical recommendations from the report are highlighted here. Although the summit report presents important perspectives on the subject of preparedness for public health emergencies, we must understand that preparedness is a process and that these recommendations must be reviewed and refined continually over time. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S51–S54)
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Nah, Eun-Hee, Yong Jun Choi, Seon Cho, Hyeran Park, Suyoung Kim, Eunjoo Kwon e Han-Ik Cho. "Changes in nonalcoholic fatty liver disease and M2BPGi due to lifestyle intervention in primary healthcare". PLOS ONE 19, n. 2 (29 febbraio 2024): e0298151. http://dx.doi.org/10.1371/journal.pone.0298151.

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Background A healthy lifestyle is the most important method for managing nonalcoholic fatty liver disease (NAFLD). Mac-2-binding protein glycosylated isomer (M2BPGi) has been suggested as a biomarker for NAFLD. This study aimed to determine the efficacy of personalized lifestyle interventions on NAFLD remission. Methods This single-arm intervention study recruited participants with NAFLD who underwent health checkups at seven health-promotion centers in five South Korean cities. Fatty liver diagnosis was based on ultrasonography (US). The 109 individuals were recruited for personalized lifestyle interventions of hypocaloric diets and exercise. The participants attended the lifestyle intervention programs once per month for the first 3 months, and once every 3 months for the subsequent 6 months. In addition to sessions through center visits, phone-based intervention and self-monitoring at 4-, 5-, 7-, and 8-month were provided during the 9-month intervention period. And phone-based self-monitoring were also provided monthly during the 3-month follow-up period. The primary outcome was NAFLD remission at month 12 as measured on US and magnetic resonance elastography. The secondary outcomes were the changes in metabolic factors and M2BPGi. Results The 108 individuals (62 males and 46 females; age 51.1±12.4 years, mean±standard deviation) were finally analyzed after the 12month intervention. Body mass index, waist circumference (WC), blood pressure, blood lipids (total cholesterol, triglycerides, and HDL-C), and fasting blood sugar levels were improved relative to baseline (all P<0.05). Fatty liver at or above the moderate grade according to US was decreased at month 12 relative to baseline (67.6% vs 50.9%) (P = 0.002). M2BPGi levels decreased during the 12-month study period (P<0.001). M2BPGi levels were moderately correlated with hepatic fat fraction by magnetic resonance imaging (r = 0.33, P = 0.05). WC (OR = 0.82, 95% CI = 0.67–1.00, P = 0.05) and HDL-C (OR = 1.17, 95% CI = 1.03–1.32, P = 0.014) were associated with remission of fatty liver in the multivariate analysis. Conclusion The personalized lifestyle intervention was effective in improving fatty liver and metabolic factors, but not hepatic stiffness, in NAFLD. Trial registration ICTRP, cris.nih.go.kr (KCT0006380).
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Bankole, A., T. Kazmi, A. Strazanac, W. Scheuing e J. Fleming. "AB1559-HPR ESTABLISHING A MULTIDISCIPLINARY CLINIC TO IMPROVE THE QUALITY OF CARE FOR PATIENTS WITH INTERSTITIAL LUNG DISEASE." Annals of the Rheumatic Diseases 81, Suppl 1 (23 maggio 2022): 1879.2–1880. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2477.

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BackgroundPatients with interstitial lung disease related to rheumatic disease (ILD-RD) often need to see multiple specialties to establish the diagnosis and for management. Suh care is better provided in a multidisciplinary clinic (MDC) and setting up such a MDC involves significant cost, time and buy in from stakeholders. In our center, we approached starting a MDC as a multiple phased project. Phase 1: confirm improved patient outcomes when multiple specialties are involved in providing care to these patients. Phase 2: application for an internal grant for a prospective pilot clinic and phase 3: the establishment of a permeant MDC. We report the results of our phase 1 analysis.ObjectivesThe primary aim of this study was to determine if involvement of our pulmonary and cardiology colleagues in the care of patients with ILD-RD seen in the rheumatology clinic results in improvement in the evaluation and treatment of these patients.MethodsThis is a retrospective, single center, hospital-affiliated outpatient study. All patients seen in the rheumatology clinic with a diagnosis of ILD-RD between January 1 2018 and December 31 2019 were eligible for enrollment. A list of patients was generated by the technology service group using relevant international classification of diseases codes. These records were reviewed and those meeting the inclusion and exclusion criteria were enrolled.A review of the 1574 charts generated confirmed 41 patients with ILD-RD. Demographic data, as well as disease related data including serological testing, disease manifestation and treatment choices was obtained. Continuous variables were analyzed using T-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-square Tests or Fisher’s exact tests. Statistical analysis was performed using SAS9.4, and p value <0.05 was considered statistically significant.ResultsPatients seen by more than one specialty were more likely to have had a more extensive evaluation for ILD and its complications. The cause of the ILD-RD did not have an impact on the tests performed or the number of specialist seen.There was a significantly more glucocorticoids monotherapy use in scleroderma related ILD, but disease-modifying antirheumatic drugs were more commonly used in non-scleroderma ILD patients.Table 1.DemographicsNon-scleroderma ILD (N = 27)Scleroderma ILD (N = 14)p-valueAge at diagnosis72.8 (10.2)70.5 (13.7)0.55Female70.4% (19/27)71.4% (10/24)0.99Race0.69 Caucasian77.8% (21)85.7% (12) African American22.2% (6)14.3% (14)PAH17.4% (4/23)23.1% (3/13)0.69PFT87.5% (21/24)92.9% (13/14)0.99CT Chest100% (24/24)100% (14/14)Right HCC30.4% (7/23)21.4% (3/14)0.71Number of specialists0.31 18.3% (2)14.3% (2) 237.5% (9)57.1% (8) 34.2% (13)28.6% (4)Medication<0.01 None0% (0)14.3% (2) GC7.4% (2)42.9% (6) GC + DMARDs88.9% (24)42.9% (6) DMARDs3.7% (1)0% (0)ConclusionOur data suggests that a MDC for RD-ILD results in a more thorough investigation and treatment, and this will likely lead to improvements in patient outcomes. Based on these findings, our rheumatology group is seeking internal funding for a pilot clinic evaluating prospectively the benefits of an ILD MDC.References[1]Leeftink AG, Bikker IA, Vliegen IMH, Boucherie RJ. Multi-disciplinary planning in health care: a review. Health Syst (Basingstoke). 2018;9(2):95-118. Published 2018 Feb 27.[2]Chaudhuri N, Spencer L, Greaves M, Bishop P, Chaturvedi A, Leonard C. A Review of the Multidisciplinary Diagnosis of Interstitial Lung Diseases: A Retrospective Analysis in a Single UK Specialist Centre. J Clin Med. 2016;5(8):66.[3]Murali Mohan BV, Tousheed SZ, Manjunath PH, Ravichandra MR, Ranganatha R, Annapandian VM, Kumar MH, Sagar C. Multidisciplinary team obviates biopsy in most patients with diffuse parenchymal lung diseases-A retrospective study from India. Clin Respir J. 2021 Jul;15(7):761-769.Disclosure of InterestsNone declared
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Tesi sul tema "Multidisciplinary health center (MHC)"

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Fruchart, Mathilde. "Réutilisation des données de soins premiers : spécificités, standardisation et suivi de la prise en charge dans les Maisons de Santé Pluridisciplinaires". Electronic Thesis or Diss., Université de Lille (2022-....), 2024. http://www.theses.fr/2024ULILS040.

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Contexte : La réutilisation des données de santé, au-delà de leur usage initial, permet d’améliorer la prise en charge des patients, de faciliter la recherche et d’optimiser le pilotage des établissements de santé. Pour cela, les données sont extraites des logiciels de santé, transformées et stockées dans un entrepôt de données grâce à un processus extract-transform-load (ETL). Des modèles de données communs, comme le modèle OMOP, existent pour stocker les données dans un format homogène,indépendant de la source. Les données de facturation des soins centralisées dans la base nationale (SNDS), les données hospitalières, les données des réseaux sociaux et des forums, et les données de villes ont des sources de données représentatives du parcours de soins des patients. La dernière source de données est encore peu exploitée. Objectif : L’objectif de cette thèse a été d’intégrer les spécificités de la réutilisation des soins premiers pour implémenter un entrepôt de données, tout en montrant la contribution des soins premiers au domaine de la recherche. Méthodes : Dans un premier temps, les données de soins premiers d’une maison de santé ont été extraites du logiciel de soins WEDA. Un entrepôt de données de soins premiers a été implémenté à l’aide d’un processus ETL. La transformation structurelle (harmonisation de la structure de la base de données) et sémantique (harmonisation du vocabulaire utilisé dans les données) ont été mises en place pour aligner les données avec le modèle de données commun OMOP. Pour intégrer les données des médecins généralistes de plusieurs maisons de santé, un outil de généralisation des processus ETL a été développé et testé sur quatre maisons de santé. Par la suite, un algorithme d’évaluation de la persistance à un traitement prescrit et des tableaux de bord ont été développés. Grâce à l’utilisation du modèle OMOP, ces outils sont partageables avec d’autres maisons de santé. Enfin, des études rétrospectives ont été réalisées sur la population de patients diabétiques des quatre maisons de santé. Résultats : Sur plus de 20 ans, les données des 117 005 patients de quatre maisons de santé ont été chargées dans le modèle OMOP, grâce à notre outil d’optimisation des processus ETL. Ces données couvrent les résultats de biologie des laboratoires de ville et les données relatives aux consultations de médecins généralistes. Le vocabulaire propre aux soins premiers a été aligné avec les concepts standards du modèle. Un algorithme pour évaluer la persistance à un traitement prescrit par le médecin généraliste,ainsi qu’un tableau de bord pour le suivi des indicateurs de performance (ROSP) et de l’activité du cabinet ont été développés. Basés sur les entrepôt de données des quatre maisons de santé, nous avons décrit le suivi des patients diabétiques. Ces études utilisent les données de résultats de biologie, les données de consultation et les prescriptions médicamenteuses, au format OMOP. Les scripts de ces études et les outils développés pourront être partagés.Conclusion : Les données de soins premiers représentent un potentiel pour la réutilisation des données à des fins de recherche et d’amélioration de la qualité des soins. Elles complètent les bases de données existantes (hospitalières, nationales et réseaux sociaux) en intégrant les données cliniques de ville. L’utilisation d’un modèle de données commun facilite le développement d’outils et la conduite d’études, tout en permettant leur partage. Les études pourront être répliquées dans différents centres,afin de comparer les résultats
Context : Reusing healthcare data beyond its initial use helps to improve patient care, facilitate research, and optimize the management of healthcare organizations. To achieve this, data is extracted from healthcare software, transformed and stored in a data warehouse through an extract-transform-load(ETL) process. Common data models, such as the OMOP model, exist to store data in a homogeneous,source-independent format. Data from healthcare claims centralized in the national database (SNDS), hospital, social networks and forums, and primary care are different data sources representative of the patient care pathway. The last data source has not been fully exploited. Objective : The aim of this thesis was to incorporate the specificities of primary care data reuse to implement a data warehouse while highlighting the contribution of primary care to the field of research. Methods : The first step was to extract the primary care data of a multidisciplinary health center (MHC) from the WEDA care software. A primary care data warehouse was implemented using an ETL process. Structural transformation (harmonization of the database structure) and semantic transformation (harmonization of the vocabulary used in the data) were implemented to align the data with the common OMOP data model. A process generalization tool was developed to integrate general practitioners (GP) data from multiple care structures and tested on four MHCs. Subsequently, algorithm for assessing the persistence of a prescribed treatment and dashboards were developed. Thanks to the use of the OMOP model, these tools can be shared with other MHCs. Finally, retrospective studies were conducted on the diabetic population of the four MHCs. Results : Over a period of more than 20 years, data of 117,005 patients from four MHCs wereloaded into the OMOP model using our ETL process optimization tool. These data include biological results from laboratories and GP consultation data. The vocabulary specific to primary care was aligned with the standard concepts of the model. An algorithm for assessing persistence with treatment prescribed by the GP and also a dashboard for monitoring performance indicators (ROSP) and practice activity have been developed. Based on the data warehouses of four MHCs, we described the follow-up of diabetic patients. These studies use biological results, consultation and drug prescriptions data in OMOP format. The scripts of these studies and the tools developed can be shared. Conclusion : Primary care data represent a potential for reusing data for research purposes and improving the quality of care. They complement existing databases (hospital, national and social networks) by integrating clinical data from the city. The use of a common data model facilitates the development of tools and the conduct of studies, while enabling their sharing. Studies can be replicated in different centers to compare results
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Libri sul tema "Multidisciplinary health center (MHC)"

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Thistlethwaite, Jill, e Wendy Hawksworth. Handling Ethical Dilemmas in Multidisciplinary Teams. A cura di John Z. Sadler, K. W. M. Fulford e Werdie (C W. ). van Staden. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780198732372.013.41.

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This chapter explores the concept and practice of teamwork and interprofessional collaboration in the support and treatment of clients with mental health problems. Mental health care provision is complex, ethically challenging, and frequently delivered via mental health care teams (MHCT) in both primary and secondary health care settings. We consider how such teams may work together optimally using values-based and client-centered approaches. We discuss the nature of and reasons for conflict arising in multidisciplinary MHCTs, focusing on ethical dilemmas that occur where there is diversity amongst team members in respect of personal, professional, and/or organizational values. The specific ethical issues discussed are: boundary issues; receiving gifts; confidentiality, and involuntary treatment and restraint. Three case studies are used to provide examples of values in action.
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Lamm, Steven, Walsh Thomas J e Joseph P. Alukal. Design and Implementation of the Modern Men's Health Center: A Multidisciplinary Approach. Springer, 2020.

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Lamm, Steven, Walsh Thomas J e Joseph P. Alukal. Design and Implementation of the Modern Men's Health Center: A Multidisciplinary Approach. Springer International Publishing AG, 2021.

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Watson, Maggie, e David Kissane, a cura di. Sexual Health, Fertility, and Relationships in Cancer Care. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190934033.001.0001.

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This book, from the International Psycho-oncology Society, is the second in a series of Companion Guides for Clinicians. The series editors identified a need for a guide to focus on the impact of cancer and oncology treatments on sexual health, fertility, and relationships. This brief manual takes a psycho-oncology perspective, placing the emotional, behavioral, and social elements at the center of the topics covered in the chapters. The aim is to describe approaches and treatments that cancer clinicians, mental health professionals, psycho-oncologists in training, and allied psychosocial oncology professionals can use. It emphasizes the importance of multidisciplinary care. The guide is not intended to replace national clinical guidelines and policies but gives a more generic international overview of factors that need to be considered when dealing with these issues in cancer patients along the treatment trajectory. Topics include management of sexual health, onco-fertility care, and relationship issues. The manual covers standards of good practice across all cancer patients, as well as focusing on the needs of individuals, couples, young people, and LGBT+ groups in a pragmatic format for use in everyday practice. Assessment methods are covered, alongside psychological treatments, encompassing a range of patient ages and cancer types. Policies and service, legal, ethical, confidentiality, and communication issues are covered. This manual can be used for quick reference. This will suit oncology professionals who decide to look further into a topic on a case-by-case or problem-focused basis as they undertake clinical work.
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Capitoli di libri sul tema "Multidisciplinary health center (MHC)"

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Alukal, Joseph P., e Thomas J. Walsh. "The Multidisciplinary Men’s Health Center: A Modern-Day Necessity". In Design and Implementation of the Modern Men’s Health Center, 1–2. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-54482-9_1.

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Borsari, Alice, Patrizia Lombardi e Sara Torabi Moghadam. "Indicators and Scenarios for Sustainable Development at the Local Level". In The Urban Book Series, 61–70. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-33894-6_5.

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AbstractCities around the world have faced the impact of the COVID-19 pandemic with unprecedented speed, due to our hyper-connected society. As history teaches us, epidemics plague society because of the vulnerabilities generated by humans through their relationships with the environment, with other species and with each other. The recent pandemic is a stark reminder that urbanization has changed the way people and communities live, work, and interact, and it is even more necessary than in the past to adopt a multidisciplinary approach to the development of systemic operational skills that can address complex issues within cities. This work showed how many measures adopted during the emergency have now become part of daily life. The lesson of the pandemic is that people’s health is connected to and dependent on the health of the planet, and cities are at the center of this relationship. The objective of the research starts from the need to identify a selection of post-COVID indicators providing an analysis methodology suitable for the creation of its own final set with the identification of specific key performance indicators (KPIs) of the project, replicable in other urban contexts, on which to base the analysis of the level of local sustainability, especially at the neighborhood scale. The proposed methodological framework is developed in two phases: (1) indicator selection and (2) baseline scenario, set out to investigate the existing correlations between the urban environment and the neighborhood level of cities. On the basis of the assessment of the KPIs, selected on the basis of numerous comparisons with the project's internal and external stakeholders, thanks to the creation of an interactive dashboard with Tableau software, it was possible to analyze the basic scenario of proximity at the neighborhood scale for the City of Turin, highlighting weak points and priority areas on which to act, experimenting with the theme “Inhabiting proximity” as an urban response to the pandemic.
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Isaacson, Victoria, e Samantha Ainsworth. "Child Advocacy Center". In Advances in Psychology, Mental Health, and Behavioral Studies, 175–90. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-6684-5097-0.ch008.

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The nature of a visit to a child advocacy center (CAC) following an allegation of child abuse has the potential to be challenging for children and their non-offending caregiver for a variety of reasons. Within a CAC, Certified Child Life Specialists are able to call upon their unique skill set to support children throughout the many elements of a forensic evaluation process. In an effort to reduce anxiety, enhance coping, and provide developmentally appropriate play and education opportunities for children in this setting, child life specialists serve as integral members of the multidisciplinary team (MDT). In their active role, child life specialists are able to collaborate with community MDT members to creatively and effectively support children throughout the forensic evaluation process. The need for child life involvement in CACs and during the investigative forensic evaluation process is highly valuable when reflecting on the benefit and overall experience for children and their families.
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Souza, Ana Beatriz dos Santos, João Victor Silva Borges, Victor Hugo Martins de Morais, Nonato Márcio Custódio Maia Sá, André Maia Pantoja e Joubert Marinho da Silva Bentes. "Occupational therapeutic interventions with the application of the Exercise Activity Protocol (PAE) for the physical rehabilitation of patients with leprosy sequelae: Experience report". In Challenges and Research in Health Sciences: A Multidisciplinary Approach. Seven Editora, 2024. http://dx.doi.org/10.56238/sevened2024.012-022.

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Introduction: Leprosy is an infectious disease, of slow and progressive evolution and with high disabling power, which can result in temporary and/or permanent physical deformities. This study aimed to report the experience of students from the State University of Pará (UEPA) of the Occupational Therapy course in interventions with the application of the Exercise Activity Protocol (EAP) in patients with leprosy sequelae in the hands. Method: This is an experience report, elaborated through occupational therapeutic care from the extension project "Rehabilitation and Assistive Technology: Exercise Activity Protocol for patients with disability due to leprosy", carried out at the Specialized Rehabilitation Center (CER III)/Teaching and Assistance Unit of Physical Therapy and Occupational Therapy (UEAFTO)/Laboratory of Assistive Technology (LABTA), located at the Center for Biological and Health Sciences (CCBS) of UEPA. Results: A significant muscle strength deficit was observed, characterized by difficulties in performing Activities of Daily Living and Instrumental Activities of Daily Living. Discussion: The activities carried out aimed to ensure comprehensive health care for patients with leprosy sequelae by associating rehabilitation and assistive technology. Final considerations: The experience provided a better understanding of leprosy and its biopsychosocial consequences, causing deformities and physical disabilities, which contributed to the professional development and academic training of the students.
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da Cruz, Renatha Cândida, Juliana Leme Faleiros e Isabella Christina da Mota Bolfarini. "Social inequalities and access to rights of black women in Brazil: An intersectional analysis". In Challenges and Research in Health Sciences: A Multidisciplinary Approach. Seven Editora, 2024. http://dx.doi.org/10.56238/sevened2024.012-046.

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This article aims to analyze the access to social rights of black women in contemporary Brazil, considering the intersectionality of race and gender. The rationale for this study lies in the need to understand the structural inequalities faced by this population group, as well as the urgency of promoting equity and social justice. The problem addressed involves the barriers faced by black women in accessing health, education, work and housing services, due to structural racism and gender discrimination. The methodology adopted includes the analysis of statistical data from the 2022 Demographic Census, official documents from the Ministry of Health, and works that address intersectionality and structural racism. The results highlight the need for concrete actions to ensure equity in access to social rights, aiming to combat structural inequalities and promote the inclusion and well-being of black women in Brazil. We also highlight that the study is part of a set of actions of the Observatory for Combating Violence against Women and Girls in Latin America organized by the State University of Goiás North Campus, Uruaçu Headquarters, in partnership with the Center for Legal Practices of the Faculty of Law of the same university, with the Autonomous Faculty of Law (FADISP) and the Federal Institute of Goiás Campus Uruaçu.
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Baars, I. J., e G. G. van Merode. "Planning and Control and the Use of Information Technology in Mental Health Care Organizations". In Encyclopedia of Healthcare Information Systems, 1068–73. IGI Global, 2008. http://dx.doi.org/10.4018/978-1-59904-889-5.ch133.

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This article reports the results of two studies on the use of standard care processes and IT for planning and control of mental healthcare processes. The results give insight in the needed functionalities of IT and planning and control of mental healthcare processes. The first study is a case study in a center for multidisciplinary (mental) youth care. This center implemented care programs and an automated planning tool. We studied the success of this implementation and particularly the fit between the care programs and the planning tool. In the second study we studied the characteristics of ambulant mental healthcare processes and the actual and preferable use of planning and control models and IT.
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Ribeiro, Francisca Faustilene da Silva, Antônio Celso da Silva Alves, Millena Raimunda Martins de Almeida Carvalho, José Fernando Santos Rodrigues Junior, Sumaia Almeida Ramos, Elisângela Soares Ribeiro, Anderlyvia Nunes Franklin e Gualberto de Abreu Soares. "Teaching vaccination and vaccine: An experience report during the COVID-19 pandemic". In Communication and Culture: Multidisciplinary Perspectives. Seven Editora, 2024. http://dx.doi.org/10.56238/sevened2024.014-008.

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Vaccination is a public health action that has a good impact on individual and collective health (MALAGUTTI, 2011). When a person is vaccinated, the population is also protected. The general objective of this paper is to present an experience report on the development of an Investigative Teaching Sequence (SEI) with key concepts about vaccine and vaccination, developed with students of the second year of High School Integrated with Health Professional in the PROEJA modality. The experiment took place in two classes of 50 minutes each, with students from the second year of the High School Integrated to the Health Professional of the PROEJA modality. The classes took place during the second semester of 2020 and remotely, through an instant messaging application WhatsApp group. The topic covered in the classes was Immune System and the content was vaccine and Covid19 vaccine. The theme and content were developed in the classes of the Biology discipline. A total of 17 students participated. And for the development of these classes, notebooks, smartphones and textbooks were used. At the end of the process of applying SEI to the development of teaching by inquiry, we can infer that placing the student at the center of the process is a challenging task and because of two variables that are difficult to manage, which are: 1st - The student away from the school floor has difficulty interacting with his peers and with the teacher and this creates a natural resistance to new ways of learning. 2nd - Innovative actions that take the student out of their comfort zone are always rejected at first.
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Mudrey, Patricia, e Lara Simone Messias Floriano. "COVID-19: A STUDY OF THE STRATEGIES OF THE MULTIPROFESSIONAL TEAM FOR PSYCHOSOCIAL REHABILITATION IN A PSYCHOSOCIAL CARE CENTER". In The Impact of Innovation: Navigating Through Multidisciplinary Research. Seven Editora, 2024. https://doi.org/10.56238/sevened2024.031-070.

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This research investigated the adaptation strategies of the multiprofessional team of the Psychosocial Care Center (CAPS II) for psychosocial rehabilitation during the COVID-19 pandemic. Using a qualitative approach and the dialectical critical method, a literature review and semi-structured interviews were conducted. The data were analyzed using the methodology of Bardin (1977), processed in the IRAMUTEQ software, and categorized for interpretation. The results showed that the CAPS team implemented strategies focused on psychosocial rehabilitation, highlighting the importance of innovative and adaptable practices in critical moments and in the continuous routine. The research highlighted the need for robust public policies that support these practices with adequate resources, continuous training, and an institutional environment that promotes creativity and flexibility. Incorporating reinvention into the daily practices of the CAPS, supported by public policies, can avoid setbacks and promote advances in mental health care, benefiting professionals and users. The research underlines the importance of these strategies and the need to discuss mental health and public policies aimed at the citizenship of people with mental health problems.
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Souza, Bruno Gabriel Rodrigues, Hávila Pacífico Sodré, Maria Antônia Zeri de Sousa Silva e Nínive Andreia Garcia Moura. "Menstrual dignity project: Guaranteeing access to menstrual health to the community of the São Carlos do Jamari district, Rondônia". In THE BEST ARTICLES OF THE II SEVEN MULTIDISCIPLINARY CONGRESS. Seven Editora, 2023. http://dx.doi.org/10.56238/thebestiimulti2022-005.

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Menstruation is a physiological and cyclical process that occurs during the woman's reproductive period and results in endometrial shedding and bleeding. It is a natural process of the female organism and can represent a social and public health problem when a portion of women do not have access to hygiene products necessary to control menstrual flow, such as a simple intimate absorbent. Menstrual poverty reflects, among other reasons, the lack of financial resources that make it difficult to acquire these products as well as the lack of information about the menstrual cycle. The negligence of the State, in providing resources or the free distribution of these items, encourages voluntary social projects, such as the one carried out by students from the Pharmacy course at the São Lucas University Center. On the occasion, intimate pads were distributed to women from the riverine community located in the São Carlos do Jamari district.
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Alves, Sonáli Amaral de Lima, Greyce Kelly Marins de Castro, Marcela Muniz Lima, Thaynara da Silva Alvarenga, Tainá da Silva Batista, Thanielly Bernardo Sipriano e Ely Eduardo Saranz Camargo. "ANALYSIS OF VACCINE ACCEPTANCE AMONG THE ELDERLY AT THE "VIVER BEM" COMMUNITY CENTER, IN THE CITY OF JI-PARANÁ/RO". In The Impact of Innovation: Navigating Through Multidisciplinary Research. Seven Editora, 2024. http://dx.doi.org/10.56238/sevened2024.031-068.

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Introduction: In recent years, Brazil has advanced in the protection of the elderly population, especially after the implementation of the Statute of the Elderly in 2003, which ensures fundamental rights for people aged 60 years or older. This progress is evidenced by the increase in life expectancy, which in 2023 exceeded 76 years, reflecting improvements in living conditions and public health, including vaccination. Adherence to vaccination among the elderly still faces challenges such as misinformation and difficulties in accessing health services. The acceptance of vaccines at the "Viver Bem" Community Center in Ji-Paraná/RO is relevant, considering it an essential strategy for the prevention of severe diseases in this vulnerable population. Materials and Methods: The research involved 38 older adults, analyzing their vaccination cards and acceptance of vaccines such as influenza, hepatitis B, diphtheria, tetanus, pneumonia, and COVID-19. Demographic factors, reasons for acceptance or refusal of immunization, and prevalent chronic diseases were also investigated. Results: Most respondents were female (84.2%), and the most common chronic conditions were hypertension (61.3%) and diabetes (22.6%). Only 77.8% were vaccinated against influenza and 43.2% against hepatitis B, while adherence to the COVID-19 vaccine was 97.4%. Fear of side effects was reported by 50% of participants. Final Consideration: Educational campaigns are essential to increase vaccination adherence, since all interviewees showed interest in informative events about vaccination, reinforcing the importance of these initiatives.
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Atti di convegni sul tema "Multidisciplinary health center (MHC)"

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Stepanova, Natalya, Tansu Gazieva, Natalya Arkhipova, Samir Elbahnasawy e Suryana Fomina. "RISK ASSESSMENT OF CHEMICAL SUBSTANCES IN THE ATMOSPHERIC AIR AS INDICATOR OF THE ROAD TRAFFIC IMPACT ON THE CHILDREN?S HEALTH IN THE CITY OF KAZAN". In 24th SGEM International Multidisciplinary Scientific GeoConference 2024, 229–36. STEF92 Technology, 2024. https://doi.org/10.5593/sgem2024/5.1/s20.31.

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Assessment of non-carcinogenic risk for the child population health from chemical substances taken with the motor vehicle exhaust gases in 4 districts of the city of Kazan based on the monitoring data from FSFHI �The Center of Hygiene and Epidemiology in the Republic of Tatarstan� for the period from 2015 to 2021 was carried out. The average annual concentrations of chemical substances exceeded the allowable level of standards (MAC) from 2.32 to 9.96 of MAC in all zones. The value of the total daily dose on the inhalation route of the substances� intake with atmospheric air (I) made 1.09 � 10.33 mg/(kg x day) depending on the zone. An unacceptable level of non-carcinogenic risk (HI>3.0) was determined in all zones. In zones 2 and 4, the major impact on the RS was made by soot (HI 13.1), in zone 1 � by complex intake of all fractions of suspended particulate matters, with maximal level of PM 2,5 (HI =5.98), in zone 3 � by intake of �� 10 (HI 7.83). Black carbon (�C) was found to be an important indicator, as well as PM 2,5 and PM 10, for assessing the road traffic impact on the air quality and health. The children living in zones 2 and 4 are most vulnerable to non-carcinogenic risk as far as the respiratory system, which is formed due to complex intake of �C, �� 10 and �� 2,5. Transition to a complex assessment of risk from chemical substances with the account of contribution of certain substances is an important decision in determining the priority actions for minimizing the children�s health risk at regional level.
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Pilecka-Ulcugaceva, Jovita, Anda Bakute, Oskars Purmalis, Kristaps Siltumens e Inga Grinfelde. "BIOMONITORING OF HEAVY METALS IN THE CITY OF JELGAVA, LATVIA USING LICHEN, XANTHORIA PARIETINA". In 24th SGEM International Multidisciplinary Scientific GeoConference 24, 381–88. STEF92 Technology, 2024. https://doi.org/10.5593/sgem2024/4.1/s19.50.

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In urban environments, human health is increasingly affected by air quality, particularly air pollution with particulate matter (PM), which contains various toxic chemical elements. Car traffic is one of the main sources of air pollution in urban areas, which not only raises dust from roadways but also emits micro particles from diesel engines and tire wear containing heavy metals. The aim of the study is to evaluate the ability of the lichen species Xanthoria parietina, commonly found in Latvia, to biomonitor and bioaccumulate various heavy metals (As, Cd, Cu, Cr, Mn, Ni, Pb, Zn, V), and to use this lichen to determine the risk pollution zones in the city of Jelgava. In this study, the epiphytic lichen Xanthoria parietina was used as an air pollution biomonitor to assess long-term air pollution in Jelgava. Lichen samples of Xanthoria parietina were collected on February 14, 2017. In total, 60 samples were collected from 20 monitoring points, and 3 samples from one monitoring point outside the city center of Jelgava, approximately 7 km away. The lichen samples were analyzed using ICP-OES. Analyzing the results, five pollution groups could be identified - the first group reflected parks, while the remaining groups indicated the influence of car traffic with various metal footprints. The average element content in the samples, in descending order, was Mn>Zn>Cu>Pb>Cr>V>Ni>As>Cd. Our results indicate that heavy metals come from vehicles and fossil fuel combustion processes, such as As (0.4 ?g/l � 1.9 ?g/l), Cr (2.1 ?g/l � 13.8 ?g/l), Cu (5.7 ?g/l � 40.2 ?g/l), Ni (1.1 ?g/l � 6.8 ?g/l) and V (0.9 ?g/l � 10.0 ?g/l).
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Hartatiyanto, Gafar, Ahmad Redi e Herman Bakir. "Public Health Services by the Community Health Center Reviewed According to Law Number 25 of 2009 Concerning Public Services". In Proceedings of the 2nd Multidisciplinary International Conference, MIC 2022, 12 November 2022, Semarang, Central Java, Indonesia. EAI, 2023. http://dx.doi.org/10.4108/eai.12-11-2022.2327272.

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Ostroukh, Andrey. "CONCEPT OF THE MACHINE HEALTH MONITORING CENTER". In 18th International Multidisciplinary Scientific GeoConference SGEM2018. Stef92 Technology, 2018. http://dx.doi.org/10.5593/sgem2018/2.1/s07.031.

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Haerani, Farida, e Dicky Yulius. "Juridical Review of the Implementation of Health Services to the Society by Community Health Centers". In Proceedings of the 3rd Multidisciplinary International Conference, MIC 2023, 28 October 2023, Jakarta, Indonesia. EAI, 2023. http://dx.doi.org/10.4108/eai.28-10-2023.2341710.

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Marques, Ketlyn Miranda, Julia Saraiva Rocha, Natália Rocha de Almeida, Vinicius da Cruz Tigre, Karolina de Melo Nogueira, Hortencia Carrafa Esteves e Juliana Santiago de Souza. "Vaginosis and female intimate health: A study in Manhuaçu (MG)". In V Seven International Multidisciplinary Congress. Seven Congress, 2024. http://dx.doi.org/10.56238/sevenvmulti2024-071.

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The anatomy of the female genital tract consists of a series of internal cavitary organs that are interconnected with the external environment through the vaginal introitus, located in the center of the urogenital triangle. This structure is responsible for the flow resulting from the physiological menstrual cycle, in addition to allowing sexual intercourse and the passage of the fetus at the time of birth (Moore, 2011). Several pathological processes have this region as a site, both through the entry of pathogenic microorganisms and through the imbalance of the microbiota residing in the genital tract, both harming gynecological health and causing unpleasant symptoms to patients (Berek, 2008).
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Permatasari, Erma Oktania, Vita Ratnasari, I. Nyoman Budiantara, Madu Ratna e Agnes Tuti Rumiati. "Analysis of Patient Satisfaction Levels on the Quality of Health Services in Medical Center ITS". In Brawijaya International Conference on Multidisciplinary Sciences and Technology (BICMST 2020). Paris, France: Atlantis Press, 2020. http://dx.doi.org/10.2991/assehr.k.201021.055.

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Marc, Damjana. "MULTIDISCIPLINARY COLLABORATION IN NURSING CARE IN THE FIELD OF ORAL HEALTH STRENGTHENING". In 14. kongres zdravstvene in babiške nege Slovenije,11. in 12. maj 2023, Kongresni center Brdo, Brdo pri Kranju. Zbornica zdravstvene in babiške nege Slovenije - Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, 2023. http://dx.doi.org/10.14528/asae9754.14.

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Oral health affects the health of the whole body, so it is absolutely necessary that the strengthening of oral health takes place in parallel with health education in patronage care, education of pregnant women in women's dispensaries, children and parents in children's and school dispensaries, in reference clinics and dispensaries for diabetes and lung diseases. The task of the nurse at the primary level is to treat patients holistically. However, since formal education only touches on strengthening oral health, it would be necessary to formulate recommendations for strengthening oral health in all areas of nursing care at the primary level. The oral health group at the National Institute of Public Health plays a major role in the development of these guidelines. The article contains a short survey and explanation of the knowledge of the field of oral health and the implementation of strengthening the oral health of nursing providers at the primary level.
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Stepanova, Natalya, Suryana Fomina, Emiliya Valeeva, Alfiya Ziyatdinova e Galiya Skvortsova. "THE ATMOSPHERIC AIR QUALITY ANALYSIS AND THE HEALTH RISK ASSESSMENT FOR THE KAZAN CITY POPULATION (THE REPUBLIC OF TATARSTAN)". In 22nd SGEM International Multidisciplinary Scientific GeoConference 2022. STEF92 Technology, 2022. http://dx.doi.org/10.5593/sgem2022/5.1/s20.058.

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Monitoring of atmospheric air in the city of Kazan was performed based on average annual concentrations of the Air Pollution Observation Stations (APOS) of three administrations: The Federal Budgetary Healthcare Institution �Center of Hygiene and Epidemiology in RT (Tatarstan)� (FBHI �H&E Center in RT�), Ministry of Environment and Natural Resources of RT (MEPNR of RT) and Federal State Budgetary Institution �Territorial Administration for Hydrometeorological and Environmental Monitoring in RT� (FSBI �TAHEM in RT�). Two Kazan districts with population size equal to one third of the city (the Vakhitovsky and the Sovetsky ones), where APOS of all three administrations were compactly located, were identified for the study. Control data differ in pollutants priority and quantitative estimation of certain pollutants. Non-carcinogenic risk evaluation results on chemical effluence with vehicle emissions had no discrepancies (unacceptably high total risk level in Vakhitovsky and Sovetsky city districts, HI was greater than 6.0); however, danger coefficients obtained from the data of the Federal State-Funded Healthcare Institution �Hygienic and Epidemiological Center in the Republic of Tatarstan� far exceed similar results of other agencies. Verification of the available sampling techniques and development of a single approach to analysis and evaluation of the environmental pollution by harmful substances are required for a consistent risk assessment by monitoring agencies.
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Kleyn, Svetlana, Nina Zaitseva, Irina May e Alena Andrishunas. "EXPERIENCE IN OPTIMIZING PROGRAMS FOR MONITORING AMBIENT AIR QUALITY IN A LARGE INDUSTRIAL CENTER USING HEALTH RISK ASSESSMENT AND GEOINFORMATION TECHNOLOGIES". In 20th International Multidisciplinary Scientific GeoConference Proceedings SGEM 2020. STEF92 Technology, 2020. http://dx.doi.org/10.5593/sgem2020/5.1/s20.044.

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Rapporti di organizzazioni sul tema "Multidisciplinary health center (MHC)"

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Coelho Resende, Noelle, Renata Weber, Jardel Fischer Loeck, Mathias Vaiano Glens, Carolina Gomes, Priscila Farfan Barroso, Janine Targino, Emerson Elias Merhy, Leandro Dominguez Barretto e Carly Machado. Working Paper Series: Therapeutic Communities in Brazil. A cura di Taniele Rui e Fiore Mauricio. Drugs, Security and Democracy Program, Social Science Research Council, giugno 2021. http://dx.doi.org/10.35650/ssrc.2081.d.2021.

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Abstract (sommario):
Spread across Brazil and attaining an unparalleled political force, therapeutic communities are as inescapable in the debate on drug policy as they are complex to define. Although they are not a Brazilian creation, they have been operating in that country for decades, and their dissemination intensified in the 1990s. In 2011, they were officially incorporated into Brazil's Psychosocial Care Network (Rede de Atenção Psicossocial, or RAPS). Since then, therapeutic communities have been at the center of public debates about their regulation; about how they should—or even if they should—be a part of the healthcare system; about the level of supervision to which they should be submitted; about their sources of funding, particularly whether or not they should have access to public funding; and, most importantly, about the quality of the services they offer and the many reports of rights violation that have been made public. However, a well-informed public debate can only flourish if the available information is based on sound evidence. The SSRC’s Drugs, Security and Democracy Program is concerned with the policy relevance of the research projects it supports, and the debate around therapeutic communities in Brazil points to a clear need for impartial research that addresses different cross-cutting aspects of this topic in its various dimensions: legal, regulatory, health, and observance of human rights, among others. It is in this context that we publish this working paper series on therapeutic communities in Brazil. The eight articles that compose this series offer a multidisciplinary view of the topic, expanding and deepening the existing literature and offering powerful contributions to a substantive analysis of therapeutic communities as instruments of public policy. Although they can be read separately, it is as a whole that the strength of the eight articles that make up this series becomes more evident. Even though they offer different perspectives, they are complementary works in—and already essential for—delineating and understanding the phenomenon of therapeutic communities in Brazil.
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Innovative Solutions to Human-Wildlife Conflicts: National Wildlife Research Center Accomplishments, 2014. U.S. Department of Agriculture, Animal and Plant Health Inspection Service, giugno 2015. http://dx.doi.org/10.32747/2015.7206799.aphis.

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The National Wildlife Research Center (NWRC) is the research arm of Wildlife Services (WS), a program within the U.S. Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS). NWRC’s researchers are dedicated to finding biologically sound, practical, and effective solutions to resolving wildlife damage management issues. They seek these solutions using a multiyear, multidisciplinary project management system. NWRC identifies and prioritizes projects based on feedback from WS program leaders, managers, and stakeholders concerning their most pressing wildlife damage management needs. During 2014, five research projects reached the end of their 5-year life cycle. At the final project reviews, project leaders and their staff presented and discussed each project’s accomplishments, challenges, and findings.
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