Klinegunn6319

We propose the following EHR design principles to address these needs enhance the flexibility of EHR documentation workflows; expand the ability to exchange information within teams and between systems; balance innovation and standardization of health information technology systems; organize and simplify information displays; and prioritize and reduce information. CONCLUSION Developing EHR tools that are simple, accessible, easy to use, and able to be updated by a range of professionals is critical. The identified information needs and design principles should inform developers and implementers working in community health centers and other settings where complex patients receive care. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email journals.permissions@oup.com.The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. see more GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies. © The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.BACKGROUND It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of .05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of less then 10 minutes were 0.86 (0.81-0.92) and 0.96 (0.93-0.99), respectively. CONCLUSIONS Higher MVPA, regardless accumulation patterns, or LPA in bouts of less then 10 minutes was associated with lower risk of functional disability in a linear dose-response manner in older adults. © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.BACKGROUND Prior research demonstrated statistically significant racial disparities related to lung cancer treatment and outcomes. We examined differences in initial imaging and survival between Blacks, Hispanics and non-Hispanic Whites. METHODS The linked Surveillance, Epidemiology, and End Results-Medicare database between 2007 and 2015 was used to compare initial imaging modality for patients with lung cancer. Participants included 28,881 non-Hispanic Whites, 3,123 Black, and 1,907 Hispanics, patients age ≥66 years who were enrolled in Medicare fee-for-service and diagnosed with lung cancer. The primary outcome was comparison of PET/CT utilization between groups. A secondary outcome was 12-month cancer specific survival. Information on stage, treatment, and treatment facility were included in the analysis. Chi-Square test and logistic regression were used to evaluate factors associated with imaging utilization. Kaplan-Meier method and Cox proportional hazards regression were used to calculate adjust hazard ratios and survival. All statistical tests were two-sided. RESULTS After adjusting for demographic, community, and facility characteristics, Blacks were less likely to undergo PET/CT imaging at diagnosis compared to non-Hispanic Whites odds ratio (OR) 0.54; 95% CI 0.50, 0.59; P  less then  0.001). Hispanics were also less likely to receive PET/CT imaging (OR 0.72; 95% CI 0.65, 0.81 P  less then  0.001). PET/CT was associated with improved survival (HR = 0.61; 95% CI 0.57, 0.65, P  less then  0.001). CONCLUSION Blacks and Hispanics are less likely to undergo guideline recommended PET/CT imaging at diagnosis of lung cancer, which may partially explain differences in survival. Awareness of this issue will allow for future interventions aimed at reducing this disparity. © The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email journals.permissions@oup.com.Perioperative treatment for locally advanced gastric cancer has been inconsistent between Japan and the Western countries. In Japan, D2 gastrectomy followed by adjuvant chemotherapy is regarded as standard treatment, while neoadjuvant or perioperative chemotherapy is considered to be a standard in the Western countries. Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG) has conducted many perioperative chemotherapy trials. After the publishing of positive results of ACTS-GC trial, stage-specific adjuvant chemotherapy protocols are planned. JCOG1104 was conducted as to demonstrate the non-inferiority of four courses of S-1 to standard eight courses of S-1, because the efficacy of S-1 appears to be sufficient in stage II. The trial failed to demonstrate the non-inferiority of four courses of S-1. S-1 for 1 year is still recognized to be a standard for stage II gastric cancer. For stage III, studies with more intensive treatments were planned as the efficacy of S-1 monotherapy seems to be insufficient. As in the Western countries, JCOG planned the perioperative chemotherapy. However, the clinical staging is a serious issue to select optimal patients for perioperative chemotherapy. JCOG conducted a prospective cohort study to evaluate the validity of clinical staging in JCOG1302A. From the results of this study, cT3-4 and cN1-3 are selected as optimal candidate for perioperative chemotherapy. JCOG1509 was conducted to demonstrate the superiority of perioperative chemotherapy to adjuvant chemotherapy in these cohorts. Perioperative chemotherapy for marginally resectable tumours such as linitis plastica or extensive nodal disease and special type of cancer like HER2 positive are also conducted. © The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.