Using principles of Applied Implementation Science, this paper examines strategies for systematically selecting and operationalising National clinical practice guidelines and intentionally creating implementation supports to ensure high fidelity use and sustainable application and outcomes. In the spirit of participatory action research, key…

Independent academic medical centers (IAMC) are challenged to develop and support a research enterprise and maintain primary goals of healthcare delivery and financial solvency. Strategies for promoting translational research have been shown to be effective at institutions in the top level of federal funding, but not for smaller IAMCs. The…

The keynote address of Vice Admiral Adam Robinson, Surgeon General of the United States Navy, summarizes the integration of healthcare humanitarian assistance as central to the Navy's mission of defending and promoting world peace. Citing various examples of current programs and initiatives, the address explores the critical place of human hope as…

The primary focus in managing asthma is the control of inflammation, as asthma is an inflammatory disease. Because of this chronic airway inflammation, the lungs of asthmatic patients are exposed to oxidative stress due to the generation of reactive oxygen- and nitrogen species (ROS and NOS). Oxidative stress therefore plays an important role in…

Time delays in the treatment and transfer of trauma patients is a contributing factor responsible for many fatalities. Time delays are more characteristic of rural trauma systems due to factors such as greater distance, and delays in accident reporting. Efforts to reduce the trauma transfer process have resulted in many changes in protocol and use…

Research on increased medical care costs associated with posttraumatic sequelae has focused on posttraumatic stress disorder (PTSD). However, the provisional diagnosis of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) encompasses broader trauma-related difficulties and may be uniquely related to medical costs. We investigated whether…

Concerns about the influence of the pharmaceutical and medical device industries on continuing medical education (CME) have been voiced frequently over the past decade. Reliance on industry funding increases the potential for bias. Industry-supported CME often emphasizes conditions that can be treated with newer drugs or devices rather than those…

HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

Advocates, clinicians, policy makers, and survivors frequently cite intimate partner violence (IPV) as an immediate cause of or precursor to housing problems. Research has indicated an association between homelessness and IPV, yet few studies examine IPV and housing instability. Housing instability differs from homelessness, in that someone…

Objective: The authors examined psychiatric residents' perceived needs for education in informed consent, principles of ethics and professionalism, and treating vulnerable populations. Method: A written survey was distributed to psychiatric residents (N = 249) at seven U.S. residency programs in 2005. The survey contained 149 questions in 10…

Infants with congenital heart disease (CHD) that is severe enough to require early surgery are at risk for cognitive and motor delays, as well as musculoskeletal impairments, and are best managed by an interdisciplinary team during their hospital stay and after discharge. The purpose of this article is to review some of the risk factors associated…

Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses, the Diagnostic Interview Schedule for Children…

The most effective ways to promote learning and inspire careers related to science, technology, engineering, and mathematics (STEM) remain elusive. To address this gap, we reviewed the literature and designed and implemented a high-fidelity, medical simulation-based Harvard Medical School MEDscience course, which was integrated into high school…

Community services and supports for children with intellectual disabilities (ID) can ameliorate the negative effects of caregiving and enhance child outcomes. For example, in Central and South America, many children with disabilities are institutionalized with inadequate sanitation and medical care. In the United States, certain demographic…