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The implementation of certification procedures across healthcare systems is an essential component of the management process. Several promising approaches were developed toward a successful implementation of such policies; however, a precise adaptation and implementation to each local context was essential. Local activities must be considered in order to generate more pragmatic recommendations for managers. In this study, we built a framework for the implementation of certification procedures at nurse activity level. This was developed using two objectives the identification of key implementation process components, and the integration of these components into a framework which considered the local socio-material context of nurses' work.<br /><br /> We used a two-step mixed approach. The first was inductive and consisted of a qualitative case study conducted between April and December 2019. Here, we analyzed the implementation of certification procedures in a French teaching hospital. Data were collected using semi-srk components took on a transversal aspect which were then adapted by TMT to the local work context.<br /><br /> We successfully generated a framework that supports the implementation of certification procedures at the activity level. Our approach identified a broader vision of the interactions between proximity managers, teams, and contexts during change mobilization, which were not encompassed by transversal framework only, such as QIT. In the future, more empirical studies are needed to test this framework.<br /><br />We successfully generated a framework that supports the implementation of certification procedures at the activity level. Our approach identified a broader vision of the interactions between proximity managers, teams, and contexts during change mobilization, which were not encompassed by transversal framework only, such as QIT. In the future, more empirical studies are needed to test this framework.<br /><br /> Antimicrobial resistance (AMR) is among the gravest threats to human health and food security worldwide. The use of antimicrobials in livestock production can lead to emergence of AMR, which can have direct effects on humans through spread of zoonotic disease. Pigs pose a particular risk as they are a source of zoonotic diseases and receive more antimicrobials than most other livestock. Here we use a large-scale genomic approach to characterise AMR in Streptococcus suis, a commensal found in most pigs, but which can also cause serious disease in both pigs and humans.<br /><br /> We obtained replicated measures of Minimum Inhibitory Concentration (MIC) for 16 antibiotics, across a panel of 678 isolates, from the major pig-producing regions of the world. For several drugs, there was no natural separation into 'resistant' and 'susceptible', highlighting the need to treat MIC as a quantitative trait. We found differences in MICs between countries, consistent with their patterns of antimicrobial usage. AMR levels were higple contributing factors to AMR in S. suis. The high levels of AMR in S. suis that we observe are reflected by antibiotic usage patterns but our results confirm the potential for genomic data to aid in the fight against AMR.<br /><br /> Dendritic cell (DC)-based immunotherapy is capable of activating the immune system and in particular tumor-specific cytotoxic T lymphocytes (CTLs) to eradicate the tumor. However, major limitations are the availability of autologous tumor cells as antigenic source and the selection of antigen that may have potential to activate both CD4<br /><br /> and CD8<br /><br /> T cells in immune-specific manner. Recently, we reported the expression of sperm associated antigen 9 (SPAG9) that is associated with various types of malignancies including cervical cancer. We examined the recombinant human SPAG9 (rhSPAG9) as an antigenic source for generating efficient DCs to stimulate CD4<br /><br /> and CD8<br /><br /> T cell responses for future DCs-based vaccine trials in cervical cancer patients.<br /><br /> Human monocytes derived DCs were pulsed with different concentrations (250ng/ml to 1000ng/ml) of recombinant human SPAG9 (rhSPAG9) and evaluated for their phenotypic and functional ability. The efficacy of DCs primed with 750ng/ml of rhSPAG9 (SPDCs) was compared wionse which, in turn, may help in decreasing the tumor burden when used along with a cisplatin based combinatorial regimen for therapeutic intervention.<br /><br /> Breast cancer incidence rates are increasing in developing countries including India. With 1.3 million new cases of cancer been diagnosed annually, breast cancer is the most common women's cancer in India. India's National Family Health Survey (NFHS-4) data 2015-2016 shows that only 9.8% of women between the ages of 15 and 49 had ever undergone breast examination (BE). Further, access to screening and treatment is unequally distributed, with inequalities by socio-economic status. It is unclear, however, if socio-economic inequalities in breast examination are similar across population subgroups.<br /><br /> We compared BE coverage in population sub-groups categorised by place of residence, religion, caste/tribal groups, education levels, age, marital status, and employment status in their intersection with economic status in India. We analysed data for 699,686 women aged 15-49 using the NFHS-4 data set conducted during 2015-2016. Descriptive (mean, standard errors, and confidence intervals) of women undergoing BE disdia is concentrated among wealthier populations across population groups defined by place of residence, religion, age, employment, and marital status. Apart from this national analysis, subnational analyses may also help identify strategies for programme rollout and ensure equity in women's cancer screening.<br /><br />Breast examination coverage in India is concentrated among wealthier populations across population groups defined by place of residence, religion, age, employment, and marital status. Apart from this national analysis, subnational analyses may also help identify strategies for programme rollout and ensure equity in women's cancer screening.<br /><br /> Altruism refers to acting in 'the best interest of patients, not self-interest'. With an observed discordance between the concept and practice of altruism, and increasing attention to 'pathologic altruism', the role of altruism is blurred in present day medical care. In this background, the required balance of altruistic attitude which needs to be fostered in medical students needs clarity. This problem may be best addressed by the practicing clinicians. The objectives of this study were to explore clinicians' understanding of altruism in the clinical context and to identify the key concepts of altruism which they felt, must be included in clinical practice.<br /><br /> It was an exploratory qualitative study to identify clinicians' understanding of altruism and the key practice points for altruism. Online semi-structured interviews were conducted from 18 clinicians through Zoom and transcribed using Otter. Open coding of interview transcripts was done using Atlas ti 8 and grouped by commonalities under sub themes anmay be better promoted through organized team-based approach rather than individual efforts.<br /><br /> In the implementation of standardized cancer patient pathways (CPPs), the investigatory units, endoscopy, radiology and pathology, are crucial to ensure an eventual cancer diagnosis. However, when evaluating the implementation of CPPs, little attention has been paid to the healthcare professionals working in these units. The aim of this study was to explore experiences of the implementation of CPPs among health professionals in investigatory units.<br /><br /> This descriptive qualitative study included 55 health professionals working in investigatory units. Participants were interviewed in 2017-2018, and data were analysed using thematic analysis.<br /><br /> The health professionals reported benefits, facilitators and challenges when describing their experiences of implementing CPPs. [https://www.selleckchem.com/products/oleic-acid.html Oleic mouse] Benefits included that CPP improved collaboration and increased focus on the patients. Facilitators in the implementation process included pre-existing well-functioning work processes and having supportive functions (e.g. coordinators). Challenges included the lack of staff and clinical equipment, as well as unjustified time-slots and incorrect referrals.<br /><br /> The findings show that most health professionals working in investigatory units' experience benefits with the implementation of CPP, but the lack of resources was especially hard to overcome.<br /><br />The findings show that most health professionals working in investigatory units' experience benefits with the implementation of CPP, but the lack of resources was especially hard to overcome.<br /><br /> Menstrual symptoms have been identified as a substantial burden among women of reproductive age, affecting their health status and quality of life globally. A range of menstrual symptoms have been studied as they affect the health-related quality of life (HRQoL), showing variations across specific menstrual symptoms and study settings. A major concern is demonstrated due to menstrual symptoms in women's professional and social life, and consequently societal and economic loss for women and the society at large. Yet evidence is scarce that estimates the index form HRQoL score related to menstrual symptoms that is needed for health economic evaluations.<br /><br /> This study aims to investigate the association between menstrual symptoms and the HRQoL among working women in Japan in an index form, using a self-reporting questionnaire (n = 6048). The EQ-5D-3L (EuroQoL 5-dimension 3-level) is used that is a widely used tool to measure health outcomes for health economic evaluations globally. Multivariate regression analye an important area for future research on women's health and health economic evaluations to inform effective and efficient resource allocations for relevant health policies and financing strategies.<br /><br />This study suggests that HRQoL is substantially and negatively affected by menstruation among working women in Japan. Distinct variations of negative influences across menstrual symptoms underscore the multi-dimensional nature of menstruation and consequently the need of collective interventions to address these difficulties. The evidence of HRQoL continues to be an important area for future research on women's health and health economic evaluations to inform effective and efficient resource allocations for relevant health policies and financing strategies.<br /><br /> Residents need to be trained across the boundaries of their own specialty to prepare them for collaborative practice. Intraprofessional learning (i.e. between individuals of different disciplines within the same profession) has received little attention in the postgraduate medical education literature, in contrast to the extensive literature on interprofessional learning between individuals of different professions. To address this gap, we performed a scoping review to investigate what and how residents learn from workplace-related intraprofessional activities, and what factors influence learning.<br /><br /> The PRISMA guidelines were used to conduct a scoping review of empirical studies on intraprofessional workplace learning in postgraduate medical education published between 1 January 2000 to 16 April 2020 in Pubmed, Embase, PsycINFO, ERIC and Web of Science. This study applied 'best fit' framework-based synthesis to map the existing evidence, using the presage-process-product (3P) model developed by Tynjälä (2013).