Effectiveness and Challenges: The Current Situation of Electronic Health Records (EHRs) to Improve Health Care Outcomes

Background. In the Philippines, although software for Electronic Health Records (EHRs) is still new, knowledge about EHRs benefits is increasing.Objective: This study investigated the effectiveness of electronic health records to health care outcomes at selected health facilities in the National Capital Region (NCR) and CALABARZON regions of the Philippines. The effectiveness of the current EHRs in government and private health facilities were determined in terms of quality patient care, patient engagement, support team-based care, workload, and data liquidity; and the challenges facing health providers in the implementation of electronic health records were identified.Methods. The research utilized the descriptive, cross-sectional design. Three hundred seven (N=307) health providers from the medical, nursing, and paramedical departments were the study participants. A three-part adapted questionnaire was the main tool used for data collection. Mean, standard deviation, and Mann-Whitney & Kruskal-Wallis’s tests were utilized for data analysis.Results. The results revealed that in the Philippines, EHRs are moderately effective in improving health care outcomes. EHRs effectiveness is primarily achieved through better access and retrieval of health information. EHRs implementation poses major challenges in the Philippines’ health facilities which are central to socio-economic and organizational factors.Conclusions. The more effective the use of EHR systems, the greater the challenges experienced by care providers and health facilities

Detection of SARS-CoV-2 N protein allelic variants by rapid high-throughput CLEIA antigen assay

We report the data obtained using an automated chemiluminescence enzyme immunoassay (CLEIA) for rapid antigen detection of SARS-CoV-2 with a number of variants

ICME international survey on teachers working and learning through collaboration

This article presents preliminary results from a survey commissioned for ICME 13 (2016) focusing on "Teachers Working and Learning Through Collaboration". It takes as a starting point a previous survey, commissioned for ICME 10 in 2004 that focused on Mathematics Teacher Education. The current survey focuses centrally on teachers involved in collaborations, sometimes in formal settings of professional development, but also in a more diverse range of collaborative settings including research initiatives. The roles of teachers involved in the collaboration, survey methods, decisions and limitations are described. While some of the findings to date resonate with those of the earlier survey, other findings highlight characteristics and issues relating to the differing ways in which teachers collaborate, either with other teachers or the various 'others', most notably mathematics teacher educator researchers. The roles and relationships that contribute to learning in such collaborations, as well as theories and methodologies found in survey sources, are a focus of the findings presented here. Studies rarely theorised collaboration, and few of those that did so reported explicitly on how their theoretical frame shaped the design of research methodologies/approaches guiding activities with teachers. One significant outcome has been the difficulty of relating teachers' learning to collaboration within a project, although many initiatives report developments in teaching, teacher learning and students' learning

Rational Use of Monoclonal Antibodies as Therapeutic Treatment in an Oncologic Patient with Long COVID

We present the case of a 76-year-old male patient persistently infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the setting of a stage IIIC cutaneous melanoma and non-Hodgkin’s lymphoma (NHL). Due to the persistent coronavirus disease 19 (COVID-19), all cancer treatments were discontinued. Because of the worsening of his clinical state and the persistence of SARS-CoV-2 positivity for more than six months, the patient was treated with sotrovimab, which was ineffective due to resistance mutations acquired during that time. In order to resume cancer treatment and make the patient free from SARS-CoV-2, an in vitro screening of Evusheld monoclonal antibodies (tixagevumab–cilgavimab) against the viral strains isolated from the subject was performed. The promising results obtained during in vitro testing led to the authorization of the off-label use of Evusheld, which made the patient negative for SARS-CoV-2, thus, allowing him to resume his cancer treatment. This study highlights the Evusheld monoclonal antibodies’ efficacy, not only in prevention but also in successful therapy against prolonged COVID-19. Therefore, testing neutralizing monoclonal antibodies in vitro against SARS-CoV-2 mutants directly isolated from patients could provide useful information for the treatment of people affected by long COVID

Versión española de la escala job crafting

This paper presents the translation, adaptation and validation of a scale to measure job crafting behaviors (i.e. the Spanish Job Crafting Scale - SJCS; Tims, Bakker, & Derks, 2012). Methods: The scale was applied to a sample of 896 employees in Spain (52.26% women and 47.4% men). We tested the reliability and factorial validity of the 21-item instrument. Results: After confirmatory factor analysis (CFI=.858, TLI= .838, IFI= .860, RMSEA= .067), the results show a structure consisting of four factors: Increasing structural job resources; Decreasing hindering job demands; Increasing social job resources; Increasing challenging job demands. These four factors demonstrate adequate reliability and evidence of validity with others scales that refer to Engagement at Work and Proactivity. Conclusion: The questionnaire may be a useful tool for the assessment of job crafting and for future research in Spanish speaking countries.Este artículo presenta la traducción, adaptación y validación de una escala para medir el comportamiento del job crafting (Spanish Job Crafting Scale -SJCS; Tims, Bakker, & Derks, 2012). Método: la escala fue aplicada a una muestra de 896 empleados (52,6% mujeres y 47,4% hombres). Se han testeado la fiabilidad y la validez factorial de un instrumento con 21 ítems. Resultados: después de realizar análisis confirmatorio (CFI= .858, TLI= .838, IFI= .860, RMSEA= .067), los resultados obtenidos confirman una estructura constituida por cuatro factores: aumento de los recursos estructurales del empleo, Disminución de las demandas de trabajo, aumento de los recursos sociales del empleo, Creciente demanda de desafíos en el trabajo. Estos cuatro factores tienen una fiabilidad adecuada y se constatan evidencias de validez con otras escalas que hacen referencia al Engagement en el trabajo y la Proactividad. Conclusiones: el cuestionario puede ser una herramienta útil para la evaluación del job crafting y para su uso en la investigación en el contexto de los países de lengua española

The route to solve the interplay between inflammation, angiogenesis and anti-cancer immune response

Even though the crucial role played by inflammation in cancer development and progression was first hypothesized by Rudolf Virchow at the beginning of the nineteenth century, only recently inflammation has been recognized as a hallmark of cance

The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases

This guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care. A “Guidance” document is different from a “Guideline.” Guidelines are developed by a multidisciplinary panel of experts and rate the quality (level) of the evidence and the strength of each recommendation using the Grading of Recommendations, Assessment Development, and Evaluation (GRADE) system. A guidance document is developed by a panel of experts in the topic, and guidance statements, not recommendations, are put forward to help clinicians understand and implement the most recent evidence

Obesity-induced insulin resistance in human skeletal muscle is characterised by defective activation of p42/p44 MAP kinase

Insulin resistance (IR), an impaired cellular, tissue and whole body response to insulin, is a major pathophysiological defect of type 2 diabetes mellitus. Although IR is closely associated with obesity, the identity of the molecular defect(s) underlying obesity-induced IR in skeletal muscle remains controversial; reduced post-receptor signalling of the insulin receptor substrate 1 (IRS1) adaptor protein and downstream effectors such as protein kinase B (PKB) have previously been implicated. We examined expression and/or activation of a number of components of the insulin-signalling cascade in skeletal muscle of 22 healthy young men (with body mass index (BMI) range, 20–37 kg/m2). Whole body insulin sensitivity (M value) and body composition was determined by the hyperinsulinaemic (40 mU. min−1.m−2.), euglycaemic clamp and by dual energy X-ray absorptiometry (DEXA) respectively. Skeletal muscle (vastus lateralis) biopsies were taken before and after one hour of hyperinsulinaemia and the muscle insulin signalling proteins examined by western blot and immunoprecipitation assay. There was a strong inverse relationship between M-value and BMI. The most striking abnormality was significantly reduced insulin-induced activation of p42/44 MAP kinase, measured by specific assay, in the volunteers with poor insulin sensitivity. However, there was no relationship between individuals' BMI or M-value and protein expression/phosphorylation of IRS1, PKB, or p42/44 MAP kinase protein, under basal or hyperinsulinaemic conditions. In the few individuals with poor insulin sensitivity but preserved p42/44 MAP kinase activation, other signalling defects were evident. These findings implicate defective p42/44 MAP kinase signalling as a potential contributor to obesity-related IR in a non-diabetic population, although clearly multiple signalling defects underlie obesity associated IR