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Usefulness regarding add-on Danhong treatment inside sufferers along with unsound angina pectoris: The double-blind, randomized, placebo-controlled, multicenter clinical study.
Vendor procurement should be viewed not as a process that ends when a vendor is selected but rather as a continuing and evolving relationship. Evaluation should assess the ability and willingness of vendors to support stakeholders and meet their needs, stimulate new ideas and adapt to changing environments and expanding systems. The model enabled recording of factors necessary for successful outcomes and provided a strategy to help select vendors for successful long-term partnerships. Copyright © 2020 Longwoods Publishing.Replacement of an end-of-life cardiac catheterization laboratory ("cath lab") can pose a significant challenge to a hospital, particularly in single-cath-lab institutions. The disruption in patient care requires innovative approaches to minimize the inconvenience and ensure ongoing quality of care. We describe a unique approach whereby Michael Garron Hospital (MGH) "leased" a cath lab within Sunnybrook Health Sciences Centre for a 12-week period during a cath lab replacement project at MGH. The MGH cath lab and patient recovery bay remained a completely separate entity staffed by MGH nurses and physicians, with electronic connection to the home hospital. A total of 420 patients underwent cardiac catheterization with no adverse outcomes while maintaining system efficiency and high patient and staff satisfaction. Cath lab leasing involving two cooperating hospitals is an innovative and safe way to bridge a cath lab replacement. Copyright © 2020 Longwoods Publishing.Cancer Care Ontario developed a diagnostic assessment program (DAP) to improve patients' experience in the diagnostic phase of their cancer journey and improve health system efficiency and effectiveness. MSAB The Stronach Regional Cancer Centre Lung DAP (at Southlake Regional Health Centre) used learnings from a Lean improvement event to increase capacity to meet patient demand for service and to achieve/improve upon the provincial wait time target from consultation to diagnosis for lung cancer patients (65% within 28 days), improving overall patient experience of care. Monthly patient volumes have increased by 65%, and wait time has improved by 60%. Copyright © 2020 Longwoods Publishing.A key goal of programs in health management, policy and research is to transform students into effective leaders. Academic experience can impart knowledge about the skills or competencies required but may not be sufficient to transform students into leaders of health system change. Copyright © 2020 Longwoods Publishing.Recruitment and retention of physicians, especially in rural communities, are severe public health policy problems in Canadian hospitals. This characterizes the situation in Nova Scotia. This study explored the Eastern Zone of the Nova Scotia Health Authority to determine ways to overcome the physician shortage. Six participants, all working in physician recruitment in Nova Scotia, were asked semi-structured, in-depth questions about the current recruitment process in their respective zones. The research participants presented many parallel perspectives on problems and solutions. It was determined that the biggest obstacles faced by recruiters are bureaucracy, a lack of clear communication channels, failure to track return on investment, a lack of community integration (including spousal employment supports) and a lack of clearly defined roles and responsibilities within the Eastern Zone. This study is timely given the salience of the subject, especially on the Canadian public agenda. Copyright © 2020 Longwoods Publishing.The Rural Hastings Health Link coordinates care for the 1-5% of the local population whose complexity represents two-thirds of healthcare spending. Gateway Community Health Centre developed a primary care-led model with local partners in primary care and the broader health and social sector built on four interventions a structure to support integrated system thinking with partners, system navigators embedded in primary care addressing medical and social needs, a digital care-coordination tool and data management supporting accountability. It has altered how providers respond to clients' needs and, as an integrated system of care, created a shared culture of change driven by trust. Copyright © 2020 Longwoods Publishing.The team mapping method engages participants in rapid, facilitated co-creation workshops to help groups explore how to work together in a primary care team. It uses patient personas (local evidence-based simulated cases) to explore team structure through paper prototyping circles of care (the persona's healthcare system). Roles and tasks are collectively defined through the discussion. Team mapping builds on three foundational methods and, through a three-stage process, facilitates the formation and strengthening of new and existing relationships, fostering team development through the process. This paper describes team mapping, outlines when it can be applied and highlights the benefits for teams. Copyright © 2020 Longwoods Publishing.This qualitative study aimed to describe patients' and caregivers' views on referral-consultation communication, how communication impacted their care and their perspectives on the components required in high-quality communication. Purposeful and convenience sampling was used to recruit participants from urban and rural areas who had been referred to Alberta specialists. Twenty participants joined one of four focus groups - two in-person and two teleconferences. Thematic analysis was conducted on the transcripts and field notes using NVivo 12 Pro. Participants reported inadequate communication between patients, family physicians and specialists. They discussed how incomplete information impacted their continuity of care, led to inappropriate referrals and caused delays in timely diagnosis or follow-up, all of which resulted in health consequences. They wanted physicians and healthcare professionals to engage them using a person-centred approach and provide a point of contact and timely updates of their referral statuses. This article includes participant feedback that can be used to improve closed-loop communications for referrals. Copyright © 2020 Longwoods Publishing.This article describes an innovative organization-spanning collaboration between primary care and acute care in Calgary to support continuity of care for patients with complex needs. Mosaic Primary Care Network provides funding for a primary care navigation nurse to work at the Peter Lougheed Centre, an Alberta Health Services hospital. This role supports hospital in-patients with discharge planning, linking to family physicians and connecting to programs that provide support in the community to vulnerable populations. The commitment of leadership from both organizations was critical for getting this unique role implemented. Copyright © 2020 Longwoods Publishing.In Alberta, no standardized processes exist to identify patients with chronic diseases (CDs) who do not have a family physician. This study examined the association between relational continuity (continuity of care) and healthcare utilization patterns in this population. Relational continuity was assessed using health administrative data to calculate a Usual Provider Continuity (UPC) Index. The majority of patients with no or a low UPC Index were male, did not have CD and were healthy or non-users of healthcare. When grouped by UPC Index, regression modelling revealed that emergency department visits and unplanned hospitalization declined with increased continuity of care. Advanced state of disease(s) and location of residence increased the likelihood of utilization of these services in the low- and moderate-continuity groups. Copyright © 2020 Longwoods Publishing.Federal, provincial and territorial governments endorsed agreements in August of 2017 to focus on the shared health priorities of home, community, mental health and addictions care (Government of Canada 2017). The related $11 billion federal investment over a 10-year period aims to improve access for Canadians to effective and appropriate services in these areas (Government of Canada 2019). Copyright © 2020 Longwoods Publishing.Cholesterol-lowering statin medications are a safe and effective therapy to lower cholesterol and reduce the risk of cardiovascular events. Yet physician prescribing patterns and patient adherence remain suboptimal in Canada and the United States, often due to pervasive misconceptions. The Community Heart Outcomes Improvement and Cholesterol Education Study (CHOICES) is a pragmatic, registry-based, cluster randomized controlled trial that aims to improve cholesterol management through appropriate statin use in adults and to ultimately reduce cardiovascular events in high-risk communities across Ontario. The trial uses an innovative, multicomponent intervention and implementation approach that includes audit and feedback reports for family physicians and educational materials and tools for patients. Copyright © 2020 Longwoods Publishing.Legions of people with multiple roles are charged with bringing accessible, high-quality healthcare to Canadians every day. To fulfill this shared responsibility, all participants must contribute. Their success is tied to each other's, and the quality and sustainability of the system depend on their collective performance. The contingencies are diverse and daunting. High-performing health systems yield better care, lower costs, improved outcomes and better patient and provider (Bodenheimer and Sinsky 2014). They have no weak links. Copyright © 2020 Longwoods Publishing.Existential concerns manifest themselves emotionally in patients. Emotions tend to be transferred between patient and doctor but the underlying existential concerns may remain hidden and obscure for both. If doctors understand that there are always existential concerns behind patients' inquiries it becomes easier to relate to the patient's feelings in an interested and curious way. Ultimately this benefits both doctors and patients.We have observed five existential human concerns leads to strong emotions (1. death, 2. thrown-ness, 3. aloneness, 4. choosing (the imperative of choice) and 5. meaninglessness (the absence of objective meaning).Nitrogen forms can regulate soil-borne Fusarium wilt suppression, but the related mechanisms are largely unknown, especially possible action via the rhizospheric microbial community. Soil analysis, MiSeq high-throughput sequencing analysis, community diversity, and network analysis were used to characterize the impact of different nitrogen forms (nitrate and ammonium) on rhizospheric fungal communities and the contribution of nitrate to the suppression to Fusarium oxysporum f. sp. cucumerinum compared with ammonium. Nitrate-grown cucumber showed a lower disease index and F. oxysporum f. sp. cucumerinum abundance in the rhizosphere. In comparisons with ammonium nutrients, nitrate-fed plants maintained a higher soil rhizosphere pH, microbial biomass carbon content, microbial biomass nitrogen content, as well as fungal community richness and diversity following F. oxysporum f. sp. cucumerinum incubation. All these factors were negatively related with disease index. Network analysis showed fewer nodes and edges in the ammonium treatments compared with nitrate treatments.
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