Mohs Micrographic Surgery at the Skin and Cancer Foundation Australia, 20 Years Later (1997-2017).

BACKGROUND: The availability of Mohs micrographic surgery (MMS) in Australia has increased dramatically since its inception in the 1980s. OBJECTIVE: This study aimed to describe the evolution of MMS practices at the Skin and Cancer Foundation Australia (SCFA) over the past 20 years (1997-2017). METHODS: Retrospective analysis of Mohs surgery cases at SCFA in 2017, 2007, and 1997, comparing data on sex, age, tumor type and site, initial tumor and final defect size, number of surgical stages and sections, and closure management. The present study is limited by being a retrospective analysis from a single institution. RESULTS: There was a 415% increase in the number of Mohs surgery cases from 1997 to 2017, and a significant increase in Mohs surgery-treated squamous cell carcinoma. The preoperative tumor and final defect size have decreased. More side-to-side closures and fewer grafts are being performed over time. LIMITATIONS: Retrospective analysis from a single institution. CONCLUSION: Over the last 20 years, MMS has remained appropriate in its application and is being increasingly used for treatment of squamous cell carcinoma suggesting improved access.

Lots of little ones: Analysis of charitable donations to a hospice and palliative care unit in Taiwan.

BACKGROUND: Charitable donations play a major role in the provision of hospice and palliative care (HPC) services, most of which are not reimbursed by health insurance programs. A good understanding of the constitution and use of donations is thus conducive to maintaining a high-quality HPC unit. METHODS: The data sources were the publicly available balance sheet, work report, and donor lists of a foundation exclusively supporting one of the best HPC units in Taiwan in the fiscal year of 2017. The analysis included the donation amounts and frequencies by donor type (individual, corporate, and group) and the categories of expenses. RESULTS: The foundation received 3033 donations worth a total of 7.8 million New Taiwan dollars (NTD) (approximately 258 thousand US dollars) in 2017. Two-thirds of the donations were allocated to the provision of direct care services. Of the 3033 donations, only 11 (0.4%) were worth 100 000 NTD or more, while 108 (3.6%) were valued between 10 000 and 99 999 NTD, 1268 (41.8%) were valued between 1000 and 9999 NTD, and 1646 (54.2%) were worth less than 1000 NTD. Of 1051 donors, 974 (92.7%) were individuals, 378 (36.0%) donated more than once, and 106 (10.1%) donated 12 or more times in one year. CONCLUSION: HPC services in Taiwan are sponsored by lots of individuals and small donations. For sustainability of standards-based and quality HPC services, the benevolence of the public should be thus cherished and adequately responded to.

Funding blood safety in the 21st century.

BACKGROUND: Since 2000, there has been an historic increase in international development assistance, including blood safety projects. The result has been increased blood donations and infectious disease screening in many beneficiary countries. A comprehensive examination of international development assistance for blood safety has yet to be completed. STUDY DESIGN AND METHODS: This report examines publicly available information, including donor agency websites and databases and data from the 2008 and 2012 World Health Organization Global Database on Blood Safety. RESULTS: Between 2000 and 2015, from $602.4 million to $2.1 billion in international development assistance was allocated to blood safety programs worldwide, mostly as part of the global response to the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic. The US President's Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis, and Malaria were responsible for the majority of blood safety funding, which peaked in 2010 and declined through 2015. CONCLUSION: Between 2000 and 2015, countries with high burdens of human immunodeficiency virus/acquired immunodeficiency syndrome received funding and technical assistance to improve national laboratories, increase blood component production, and strengthen clinical practice. Global trends in international development assistance at large, including aid for blood safety, suggest that funding will not rebound.

Diversity dynamics: The experience of male Robert Wood Johnson Foundation nurse faculty scholars.

BACKGROUND: Managing diversity dynamics in academic or clinical settings for men in nursing has unique challenges resulting from their minority status within the profession. PURPOSE: The purpose of this study was to share challenges and lessons learned identified by male scholars in the Robert Wood Johnson Foundation Nurse Faculty Scholars program and suggest strategies for creating positive organizations promoting inclusive excellence. METHODS: Multiple strategies including informal mentored discussions and peer-to-peer dialogue throughout the program, formal online surveys of scholars and National Advisory Committee members, and review of scholar progress reports were analyzed as part of the comprehensive evaluation plan of the program. DISCUSSION: Diversity dynamic issues include concerns with negative stereotyping, microaggression, gender intelligence, and differences in communication and leadership styles. CONCLUSION: Male nurse faculty scholars report experiencing both opportunities and challenges residing in a predominately female profession. This article attempts to raise awareness and suggest strategies to manage diversity dynamics in service of promoting the development of a culture of health that values diversity and inclusive excellence for both men and women in academic, research, and practice contexts.

The AANA Foundation Malpractice Closed Claims Study: A Descriptive Analysis.

The AANA Foundation Closed Claims Researchers evaluated 245 closed claims spanning from 2003-2012. The majority of claims comprised CRNA providers whom are mainly male, independent contractors, certified between 1980-1999, and with malpractice coverage limits of $1 million/$3 million. The median age for all claimants was 50 years old, and 63.7% of claimants were female. For those claims where race was known, 54% of claimants were Caucasian. Most adverse events occurred in a hospital with an outpatient admission status. The majority of adverse events were identified as intra-anesthesia. The top five surgical procedures associated with these claims were orthopedic general surgery, cosmetic, obstetric, and neurologic procedures. An adverse event leading to death occurred in 35.1% of claims. Regardless of severity of injury, reviewers determined that 45.5% of negative outcomes were preventable, 32.7% of the anesthesia treatment was inappropriate, and 29% of negative outcomes were caused by CRNAs' actions. Reviewers found that no AANA Standards were breached in 45.7% of claims; however, Standards 4, 5, and 3 were the most common standards breached. The most costly severity classification was major permanent injury (ie, paraplegia, blindness, loss of two limbs, or brain ddamage) with a median payment of $299,810.

Evaluation of the impact of National Breast Cancer Foundation-funded research.

OBJECTIVE: To evaluate the impact of the National Breast Cancer Foundation's (NBCF's) research investment. DESIGN AND PARTICIPANTS: Surveys based on the Payback Framework were sent to chief investigators involved in research funded by the NBCF during 1995-2012; a bibliometric analysis of NBCF-funded publications in 2006-2010 was conducted; and a purposive, stratified sample of case studies was obtained. MAIN OUTCOME MEASURES: Research impact on knowledge production, the research system, informing policy, product development and broader health and economic benefits. RESULTS: Of 242 surveys sent, 153 (63%) were returned. The average impact of journals in which NBCF publications appeared was double that of world publications. Seventy surveys (46%) reported career progression, and 185 higher degrees were obtained or expected, including 121 PhDs. One hundred and one grants (66%) produced tools that built capacity across the research system, and research teams leveraged an additional $1.40 in funding for every dollar invested. Fifteen applied grants and one basic grant impacted on policy. Ten basic and four applied grants led to the development of drugs, prognostic tools or diagnostic technologies. Twenty applied and two basic grants led to changes in practice and behaviour of health care staff, consumers and the public, with further impacts anticipated. Case studies provided illustrations of high impact. CONCLUSIONS: NBCF's strategy of investing in a mixed portfolio of research areas and mechanisms encouraged a broad range of impacts across all Payback categories. The impacts from basic research tended to focus on knowledge production and drug development; while applied research generated greater impacts within the other Payback categories. The funding of shared infrastructure stimulated impact across the research system.

[Housing Project 'Living Independently with Intensive Support (WmI)': The View of Foundation and Staff]. / Modellprojekt "Wohnen mit Intensivbetreuung (WmI)": Die Sicht von Stiftung und Mitarbeitenden.

The Fürst Donnersmarck-Foundation (FDSt) initiated the housing projekt 'Living Independently with Intensive Support (WmI)' to show that such a concept is feasible even with persons with severe multiple handicaps. It is reported how financial, organisational and communicative problems can be solved. Overall, the housing project is not much more expensive than inpatient concepts, but a change of traditional concepts of administration was required. The new service mode presupposed a careful preparation and high motivation of the staff. Finally, existing discrepancies between traditional and modern concepts could be resolved.

Model of Success: World Association for the Advancement of Veterinary Parasitology African Foundation (1997-2019).

No abstract available.

The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: development and descriptive data.

BACKGROUND: Case registers have been used extensively in mental health research. Recent developments in electronic medical records, and in computer software to search and analyse these in anonymised format, have the potential to revolutionise this research tool. METHODS: We describe the development of the South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre (BRC) Case Register Interactive Search tool (CRIS) which allows research-accessible datasets to be derived from SLAM, the largest provider of secondary mental healthcare in Europe. All clinical data, including free text, are available for analysis in the form of anonymised datasets. Development involved both the building of the system and setting in place the necessary security (with both functional and procedural elements). RESULTS: Descriptive data are presented for the Register database as of October 2008. The database at that point included 122,440 cases, 35,396 of whom were receiving active case management under the Care Programme Approach. In terms of gender and ethnicity, the database was reasonably representative of the source population. The most common assigned primary diagnoses were within the ICD mood disorders (n = 12,756) category followed by schizophrenia and related disorders (8158), substance misuse (7749), neuroses (7105) and organic disorders (6414). CONCLUSION: The SLAM BRC Case Register represents a 'new generation' of this research design, built on a long-running system of fully electronic clinical records and allowing in-depth secondary analysis of both numerical, string and free text data, whilst preserving anonymity through technical and procedural safeguards.

Transplant coordinators and communication with potential organ donor migrant families in France: an exploratory qualitative study.

Donor transplant coordinators often face organ donation refusals by migrant families in France. A multidisciplinary Working Group was asked by "Fondation Greffe de Vie" and Roche Company, in collaboration with the French national agency "Agence de la Biomédecine," to design a support program to improve communication between coordinators and families from other cultures upon the death of a family member who could be a potential donor. CerPhi was asked to conduct a survey of 30 coordinators in 22 French establishments. Most of the interviewed coordinators indicated that cultural differences complicate communication with families, leading to a higher proportion of organ donation refusals than among the local population. Coordinators are looking for a better knowledge of cultural and religious patterns as well as pertinent transcultural behaviors to improve their communication with families in the painful moment of raising the question of organ consent.

Research misconduct, NSF v NIH: Its nature and prevalence and the impact of their respective methods of investigation and adjudication.

The National Science Foundation (NSF) and the National Institutes of Health (NIH) have established separate administrative mechanisms for investigation and adjudication of alleged research misconduct. This report compares research misconduct at NSF and NIH and the possible effects of their respective methods of investigation and adjudication. Notable and paradoxical findings were identified: NIH supported four times the number of grants as NSF, yet NSF reviewed 2.5 times the number of research misconduct reports. NSF faculty were two-times more likely to be found guilty (88%) than faculty at NIH (42%). 83.6% of NSF offenders were guilty of plagiarism, vs. 4.8% at NIH. NSF trainees made up 6% of the guilty, vs. 42% at NIH. These findings are most likely related to the nature of their respective sciences, scientists, and the nature of their publications. Investigative policies and procedures are quite similar at these two agencies with the exception of the subpoena power available to the NSF's Office of the Inspector General (OIG) where it would be infrequently utilized in investigations of its predominant offense, plagiarism. However, it could prove useful if made available to the NIH Office of Research Integrity (ORI) for investigations of fabrication/falsification, its most common offense. Federal criteria for prosecution should be modified to increase the likelihood of prosecution of serious offenders referred by ORI.

Primary care. Open all hours.

The Department of Health has commissioned the Primary Care Foundation to benchmark out of hours care providers. The benchmark has revealed startling differences around the UK. Services, call handling methods and software all vary, so comparisons are difficult.

On the advancement of highly cited research in China: An analysis of the Highly Cited database.

This study investigates the progress of highly cited research in China from 2001 to 2016 through the analysis of the Highly Cited database. The Highly Cited database, compiled by Clarivate Analytics, is comprised of the world's most influential researchers in the 22 Essential Science Indicator fields as catalogued by the Web of Science. The database is considered an international standard for the measurement of national and institutional highly cited research output. Overall, we found a consistent and substantial increase in Highly Cited Researchers from China during the timespan. The Chinese institutions with the most Highly Cited Researchers- the Chinese Academy of Sciences, Tsinghua University, Peking University, Zhejiang University, the University of Science and Technology of China, and BGI Shenzhen- are all top ten universities or primary government research institutions. Further evaluation of separate fields of research and government funding data from the National Natural Science Foundation of China revealed disproportionate growth efficiencies among the separate divisions of the National Natural Science Foundation. The most development occurred in the fields of Chemistry, Materials Sciences, and Engineering, whereas the least development occurred in Economics and Business, Health Sciences, and Life Sciences.

The glaucoma research foundation patient survey: patient understanding of glaucoma and its treatment.

PURPOSE: Determine patients' understanding of glaucoma and its treatment, their sources of information about glaucoma, their preferences for treatment, their experience with medication side effects, and their reasons for changing eye doctors. DESIGN: Prospective, nonrandomized patient survey study. METHODS: A questionnaire was developed and sent to the 22,000 subscribers of the Gleams newsletter who have glaucoma. RESULTS: Questionnaires were returned by 4310 glaucoma patients. Most respondents received glaucoma information from their eye doctor. Only 28% of respondents reported having changed eye doctors for reasons related to their glaucoma. Of those who had, 60% cited poor communication as the reason. When queried about specific side effects associated with their medication, over 85% of responding patients were never or rarely bothered by headaches and eyelid darkening. Most respondents (67% and 55%, respectively) were rarely or never disturbed by red eye or burning and stinging. Most respondents understood the importance of intraocular pressure (IOP) lowering in glaucoma, and of those patients who expressed a preference, 92% reported that they would prefer the medication that lowers IOP the most, even if it caused red eye for a few weeks, over a medication that caused no red eye but did not get IOP as low. CONCLUSIONS: Patients who subscribe to Gleams and responded to the survey rely most on their doctors for information about glaucoma and its treatment. Most understand the importance of maintaining low IOP to decrease the risk of vision loss, and most will tolerate temporary ocular side effects to achieve low IOP.

[Analysis of projects of infectious disease epidemiology sponsored by National Natural Science Foundation of China].

OBJECTIVE: To analyze the projects on the infectious disease epidemiology sponsored by the National Natural Science Foundation of China (NSFC), explore the hotspot and development trend, and offer a reference for researchers in this field. METHODS: Based on the NSFC database, the projects on the infectious disease epidemiology (H2609) sponsored from 1987 to 2014 were analyzed. The changes of fund numbers, amounts and research fields were described. RESULTS: During the study period, NSFC sponsored 373 projects, including 228 general projects (61.1%), 78 youth projects (20.9%) and 67 other projects (18.0%). The average amount of the grant was 358.2 thousand Yuan (20 thousand-8 million). The main sponsored research fields were mechanisms of pathogen and immunity (36.2%) and population-based epidemiological studies (33.0%). The top three diseases were hepatitis, HIV/AIDS and tuberculosis. CONCLUSIONS: The amount of funding on researches of infectious disease epidemiology has increased continuously, which has played an important role in training scientific talents in the field of prevention and control of infectious diseases.

Prizes, lectures, and awards of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors.

An important goal of the Section on Tumors of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) since its founding in 1985 has been to foster both education and research in the field of brain tumor treatment. As one means of achieving this, the Section awards a number of prizes, research grants, and named lectures at the annual meetings of the AANS and CNS. After a brief examination of similar honors that were given in recognition of pioneering work by Knapp, Cushing, and other early brain tumor researchers, the authors describe the various awards given by the AANS/CNS Section on Tumors since its founding, their philanthropic donors, and the recipients of the awards. The subsequent career of the recipients is briefly examined, in terms of the rate of full publication of award-winning abstracts and achievement of grant funding by awardees.

Are foundations overlooking mental health?

Over the past decade philanthropic giving for health has increased dramatically, but giving for mental health has not kept pace. Historically, foundations have been key partners in efforts to improve care for people with mental disorders, and foundation funding has influenced the evolution of U.S. mental health services and systems. Although mental health giving grew in the 1990s, the rate of growth was far below that for total foundation giving or giving for health. The authors suggest possible reasons why mental health funding lost ground and describe promising funding approaches and models for increasing both the amount and the impact of philanthropic giving for mental health.