bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organizational and legal basis for aesthetic breast reconstruction in oncological clinic
Authors: Korostelev A. M. , Udovichenko I. V. , Bulinsky D. N. , Zakharova N. V. , Vazhenina I. I. , Samylov V. V. 
Published: July 2021

Introduction. The article reveals the organizational and legal basis for aesthetic reconstruction of the breast in the oncology clinic. The increase of patients' requirements for aesthetic results of the breast cancer treatment is outlined. Judicial practice data from open sources on «medical» cases are presented. Materials of external studies are described, where aesthetic reconstruction is presented as an integral part of rehabilitation, prevention of negative consequences of treatment, including mental disorders. The article defines the place of aesthetic reconstruction after breast cancer surgery, raises the problem of the possibility of symmetrical operations on the healthy contralateral breast, preventive breast and pelvic surgery in women with genetically predisposed forms of oncological diseases, expanding the volume of screening in women with a hereditary anamnesis.The purpose of the study was to compare the requirements for the quality and scope of medical care for breast cancer patients at a state oncology clinic with the professional competencies of the end-doctor oncologist, according to current standards, clinical guidelines, and guidelines for medical care.Materials and methods.The review of current regulations in the field of medical activity in the profile «Oncology» effective in the Russian Federation. Also the data of the judicial practice from open sources for 2012, 2017-2020 are presente. Results. The interpretation of current legal documents of the Russian Federation in the field of medical care in the profile «oncology» gave ambiguous results: probably, there is an intersection of qualification requirements for oncologist and plastic surgeon.Discussion. Possible ways out and suggestions from the current dangerous, from the legal point of view, situation are outlined.
THE EDUCATION SYSTEM IN ROMANIA TODAY
Authors: ȘTEFĂNESCU Anca 
Published: July 2021

Romanian education is a great system that carries out a complex but extremely important process for our society. It seems to work but there is a lot to change even wherethings are seemingly going well. A complete analysis brings to our attention a tumultuous picture of the problems faced by education in Romania in an attempt to fully fulfill the social objective it has assumed. Education is changing with the evolution of technologies, society is changing every day, the global economy needs other skills and the world now needs much more complex things than 20 years ago. The question is, how can education be changed quickly and effectively? In general, the change in education is very difficult, but in order to complete such a process, a real and concrete analysis of what we have now is needed.Keywords: Romania, education, sistem, skills ,economy, educational reforms, Bologna Process, academic mobility, institutional autonomy
Instituciones de protección del patrimonio frente al conflicto armado y el papel de la oralidad como memoria cultural
Authors: Solano-Sanguino Ángel Ricardo 
Published: July 2021

La protección del patrimonio cultural ha sido motivo de creación de derecho internacional, fomentado por organizaciones internacionales que han defendido a naciones vulneradas y afectadas directa o indirectamente por la destrucción, saqueo y tráfico de bienes culturales, así como por la prohibición o imposibilidad de transferencia oral de costumbres. Estos son considerados como daños irreparables para la humanidad, dado que, por una parte, el patrimonio cultural permite restablecer la identidad generando la creación de un vínculo con el pasado, el presente y el futuro y por la otra, la oralidad como memoria cultural es una expresión patrimonial compartida y su archivo corresponde a la memoria colectiva. Se tilizó una metodología de tipo cualitativa, documental y con orientación axiológica, con el fin de explicar las consecuencias del expolio como por ejemplo el nazi, el cual generó además de la pérdida aproximada de 50 millones de vidas, daños al patrimonio cultural material e inmaterial de toda Europa. Se halló que los países en las invasiones son motivados por intereses oscuros como erradicar la presencia histórica, bienes tangibles e intangibles, así como la oralidad y el futuro de la comunidad atacada.
Tres momentos de la oralidad. Una mirada sobre lo escuchado y lo escrito
Authors: Rojas-Álvarez Gloria Mariela 
Published: July 2021

Este artículo de corte ensayístico presentacalgunas reflexiones consideradas desde tres momentos y entornos determinantes de la oralidad. En primer lugar se hace referencia a lo netamente oral. En seguida se menciona un entorno de oralidad secundaria, condicionada por la escritura. En el tercero la oralidad y la escritura se emulsionan con formas propias de la era electrónica, en la que lo audiovisual y lo virtual marcan nuevos rumbos de comprensión e interacción. Esta mirada sobre las variaciones y transformaciones de la oralidad, en esos tres momentos referidos, evidencian que la lectura y la escucha, como procesos de recepción, quedan, generalmente, subsumidos a los procesos de producción: escritura y habla. Por ello, se invita al silencio como camino de la escucha (de sí, los otros y lo otro), que permite que cualquier réplica necesaria y subsiguiente tenga mayor impacto y profundidad.
Outcome of Person-centered Care at a Dynamic-Psychiatric Hospital in Germany
Authors: Ammon Maria , Finke Gisela 
Published: July 2021

Dynamic psychiatric treatment is a well established therapeutic approach with substantial elements of person-centered care. A study was designed and conducted in order to evaluate the outcome of a person centered dynamic psychiatric inpatient treatment program in Munich, Germany. It was conducted with 792 patients, for whom mean duration of therapy was 65 days. Assessment tools included the Inventory of Interpersonal Problems ( IIP) (a self-report measure of maladaptive relationship behavior), the Ammon Ego Structure Test (ISTA ), the WHO Quality of Life Instrument-Bref, indices of social network extent and depth, and satisfaction with personal communication and care and with concerted treatment planning. The results at discharge and follow up showed that patients had significantly improved concerning all dynamic personality dimensions, interpersonal problems, quality of life, and satisfaction with personalized care. This study offers a measure of validation of person-centered dynamic psychiatric care in terms of relevant outcome measures.
French Roots and Contributions in Person Centered Medicine and the Emergence of a Francophone Observatory
Authors: Kipman Simon-Daniel 
Published: July 2021

There have been significant French roots and contributions in the conceptualization and programmatic development of Person Centered Medicine. A basic and general one is the revolutionary French contributions to the concept of human rights. Broad stimulation has been derived from Paul Tournier’s Medicine de la Personne. Another one, within the framework of health, is the founding of the World Psychiatric Association in Paris in 1950, informed by the articulation of science and humanism, terms that have evolved as key concepts of person centered psychiatry and medicine. To be also recognized are the organization of a pioneering Paris Conference on Psychiatry for the Person in 2008 and the evolving engagement of important French professional societies in support of the development of person centered medicine. A process of annual Geneva Conferences on Person Centered Medicine since 2008, has led to the establishment of an International Network and an International College of Person Centered Medicine (ICPCM). Building on this rich background have appeared in recent years two monographic Manifests in French, one for psychiatry of the person in 2009 and another for medicine of the person in 2012. These book length statements led more recently to the development of L’Observatoire Francophone de la Médecine de la Personne (OFMP) aimed at linking relevant institutions and individuals in addressing the foundations of medicine through experience, reflection and research. The specific goals, approaches and procedures of the OFMP promise to lead the cultivation of person centered medicine to new heights in the francophone world and potentially to new French contributions to person centered medicine across the world.
Ethics in Person Centered Medicine: Conceptual Place and Ongoing Developments
Authors: Mezzich Juan E , Appleyard James , Botbol Michel , Ghebrehiwet Tesfa , Groves Joanna , Salloum Ihsan , Van Dulmen Sandra 
Published: July 2021

Person centered medicine may be defined by its placing the whole person at the center of health and health care. And because of this, ethics seems to be at the core of person centered medicine. The bases for this assertion are briefly delineated in this statement along with a capsular review of the articles in this issue of the International Journal of Person Centered Medicine. These articles encompass, among others, a set of papers on ethical standards for person centered health research as well as on incorporating ethics in medical education curricula and on tracing certain person centered medicine traditions to philosophical and human rights breakthroughs.
Integrated Outpatient Care in Advanced Heart Failure: the Beehive Person-Centered Model
Authors: Stellato Kira , Humar Franco , Montesi Cristina , Radini Donatella , Antonione Raffaella , Sinagra Gianfranco , Di Lenarda Andrea 
Published: July 2021

Rationale: Cardiovascular disease (CVD) is one of the leading causes of chronic care needs. According to the World Health Organization, by 2030 the number of people dying from CVD is expected to reach 23.3 million. Heart failure is a chronic, progressive, incurable condition which poses a substantial physical, psychological, spiritual and social burden on patients, families as well as formal and informal carers. The complex needs of these patients require the planning and implementation of a new, revisited approach to disease management. Methods: In Trieste, Italy, the long-standing integrated outpatient approach to care has been recently integrated by a dedicated Advanced Heart Failure Clinic (AHFC) for the identification of holistic needs and the provision of multidisciplinary, multidimensional supportive and palliative care to patients with advanced HF and their families. Emphasis is being laid not only on the diseased care recipient but on the ‘person’ who attends and is being attended to, who empowers and is being empowered by through an integrated process of care.Results: The integration of outpatient care services is challenging for all the stakeholders involved. A multidisciplinary, multidimensional, person-centered integrated model of care (the beehive person-centered model) might improve heart failure awareness and knowledge and would help structure better territorial outpatient pathways for patients and families, while enhancing formal and informal carers’ individual roles and general wellbeing.Discussion: The need for interconnectedness in the Beehive Person-Centered Model requires for all stakeholders to view each other as symmetrical allies, which may be utopist at best. Flexibility to adapt to individual, organizational and environmental changes may pose challenges to the long-term sustainability of integrated pathways and bring about conforming behaviors rather than proactive ones, which may jeopardize individual accountability. However, an empowered team may provide short and long term benefits to its members such as clarity of vision, greater self-awareness, self-monitoring and adapatability to changes. Conclusions: A Beehive Person-Centered Model of integrated, multidisciplinary and multidimensional evidence and values-based care may prove useful to reconcile clinical, emotional, spiritual and social needs of all stakeholders involved in the cure/care process and ensure sustainable, efficient and effective long-term care. Further qualitative/quantitative research is needed to confirm its efficacy and effectiveness and cultural transferability.
A neo-pragmatist view of evidence-based medicine (EBM)
Authors: Walsh Brian 
Published: July 2021

In contrast to previous papers in which Evidence Based Medicine (EBM) is faulted for not checking its conceptual structure against philosophy, this paper excuses EBM. Philosophy was based on essentialism, objectivity, and the Cartesian divide between the mind inside and the world outside. Knowledge was a representation of reality, inspected for accuracy by the retina, and polished from time to time. Some post-Kantian philosophers have abandoned this set-up, regarding it as just one image, accompanied by pretensions to a superior understanding of truth, the mind and knowledge. EBM, in this paper, is forgiven for not trying to square off with this traditional image, rather noticing that people are suffering, seeking a method of coping with illness, and asking, “Does it work?” This paper, drawing on the thought of Richard Rorty, views EBM as having capitalized on the development of such contingencies as statistics and the world wide web, and having provided another description of patients, in terms of “the evidence”, rather than focusing on discovering what patients are “really like”. In its search for knowledge, EBM has changed the definition of “objectivity” to agreement among qualified people. Even so, clinical research, although “useful”, does tend to hark back to ascertaining what really is the case, whatever that means. It is hard to see what EBM can do about this since most patients seek this kind of bio-medical knowledge when consulting a doctor (although some consult alternative health practitioners, who often use a different model).
A Time for Action on Health Inequities: Foundations of the 2014 Geneva Declaration on Person- and People-centered Integrated Health Care for All
Authors: Cloninger C. Robert , Salvador-Carulla Luis , Kirmayer Laurence J. , Schwartz Michael A. , Appleyard James , Goodwin Nick , Groves JoAnna , Hermans Marc H. M. , Mezzich Juan E. , Van Staden C. W. , Rawaf Salman 
Published: July 2021

Global inequalities contribute to marked disparities in health and wellness of human populations. Many opportunities now exist to provide health care to all people in a person- and people-centered way that is effective, equitable, and sustainable. We review these opportunities and the scientific, historical, and philosophical considerations that form the basis for the International College of Person-centered Medicine’s 2014 Geneva Declaration onPerson- and People-centered Integrated Health Care for All. Using consistent time-series data, we critically examine examples of universal healthcare systems in Chile, Spain, and Cuba. In a person-centered approach to public health, people are recognized to have intrinsic dignity and are treated with respect to encourage their developing health and happiness. A person-centered approach supports the freedom and the responsibility to develop one’s life in ways that are personally meaningful and that are respectful of others and the environment in which we live together. Evidence suggests that health care organizations function well when they operate in a person-and people-centered way because that stimulates better coordination, cooperation, and social trust. Health care coverage must be integrated at several interconnected levels in order to be effective, efficient, and fair. To reduce the burden of disease, integration is needed between the people seeking and delivering care, within the social network of each person, across the trajectory of each person’s life, among primary caregivers and specialists, and across multiple sectors of society. For integration to succeed across all these levels, it must foster common values and a shared vision of the future.
Person-Centered and Integrated Care across the Life-Cycle
Authors: Appleyard James 
Published: July 2021

The health and wellbeing of a person are complex adaptive processes related to the consequences of genetic, biological, social, cultural, behavioral, and economic determinants throughout the life course. Circumstances change as the person develops with accumulative risk and protective factors especially during critical and sensitive periods. A life course perspective offers a more joined up approach with significant implications for long term health gain. There is an emphasis on an integrated continuum of early intervention and education rather than of disconnected and unrelated stages. Each stage in the life of a person exerts influence on the next.Disparities in health outcomes and in the psychosocial factors contributing to them are present early in life and are expressed and compounded during a person's lifetime. Risk factors are embedded in a person's biological makeup, manifested in the disparities in a population's health, and maintained by social, cultural, and economic forces. Research on health disparities has demonstrated the effect of many determinants interacting in various contexts at developmentally sensitive points. We need an integrated conceptual approach to translate this knowledge into effective health and social care
Inter-Professional Education for Collaborative Practice in Health Care
Authors: Ghebrehiwet Tesfamicael 
Published: July 2021

Today’s health care delivery is increasingly complex and the complex needs of patients demand that health professionals communicate and collaborate to deliver the best care. Governments around the world are looking for innovative solutions that will ensure the appropriate supply, mix and distribution of the health workforce. One of the most promising solutions can be found in inter-professional education (IPE) and collaboration. IPE occurs when students from different professions learn together at some point during their training in order to prepare them to work together in health teams. Unfortunately most health professional training institutions provide little or no opportunity for IPE. Effective inter-professional education (IPE) fosters respect among the health professions, eliminates negative stereotypes, and fosters a team approach in health care. At the same time quality of care is improved when health professionals learn together. These considerations mean that the approach and content of medical, nursing and other curricula must adapt to adequately prepare health professionals to practice within the health team model. This will require the implementation of well-planned educational strategies; so that health professionals learn together in order to work together in coordinated manner to deliver person-centred and team-based health care. The paper highlights key issues in IPE and its benefits in the delivery of quality health care and improved patient safety through collaborative practice.
Applicability, Internal Structure, and basic Patterns of a Multicultural Brief Quality of Life Measure in a Sample of Psychiatric Patients with Comorbid Substance Use Disorders
Authors: Salloum Ihsan M. , Mezzich Juan E. , Kirisci Levent 
Published: July 2021

Background: The measurement of quality of life as estimate of well being is assuming increasing importance in the evaluation of health and treatment efficacy. Objectives: The aim of this study is to evaluate the applicability, internal structure and clinical patterns of the Multicultural Quality of Life Index (MQLI), a brief, self-rated, culturally informed, quality of life scale, in patients experiencing comorbid psychiatric and substance use disorders. Methods: Sixty-two consecutively admitted outpatients completed the MQLI. With this data, the applicability, internal consistency, factorial structure, and prediction of treatment adherence over a three-month period were assessed. Results: It was found that the MQLI was easy to administer. It had good internal consistency (Cronbach’s alpha 0.89). Factor analysis revealed that the first factor explained 53% of the variance, indicating the unidimensionality of the instrument around quality of life. Two MQLI items, interpersonal functioning and the availability of supports, significantly predicted treatment adherence. Conclusions: The MQLI is easy to use, it has a coherent structure, and is clinically useful in psychiatric patients with comorbid substance use disorders.
Enterochromaffin-like Cell Hyperplasia–Associated Gastric Neuroendocrine Tumors May Arise in the Setting of Proton Pump Inhibitor Use
Authors: Rais Rehan , Trikalinos Nikolaos A. , Liu Jingxia , Chatterjee Deyali 
Published: July 2021

Context.—
Hypergastrinemia states such as achlorhydria from gastric mucosal atrophy or a gastrin-producing tumor in humans have been associated with the development of enterochromaffin-like (ECL) cell hyperplasia and gastric neuroendocrine tumors (GNETs). Whether drugs that can elevate serum gastrin levels, such as proton pump inhibitors (PPIs), can produce the same tissue effect is not known, and there is no concrete evidence linking the use of PPIs to GNETs outside animal models and case reports.

Objective.—
To explore the clinicopathologic association for GNETs of presumed ECL cell origin that cannot be reliably placed into any of the 3 established categories currently recognized by the World Health Organization.

Design.—
This is a retrospective clinicopathologic study of GNETs in the body/fundus during a period of 15 years (2005–2019).

Results.—
Of a total of 87 cases, 57 (65.5%) were associated with atrophic gastritis, 2 (2.3%) were associated with Zollinger-Ellison syndrome, and 28 (32.2%) were unclassified. Of the latter, 11 were consistent with true sporadic/type 3 GNETs, while 17 had background mucosal changes of parietal cell and ECL cell hyperplasia but without underlying detectable gastrinoma, and 88.2% (15 of 17) of patients from this group had documented long-term PPI use. This subtype of GNETs was more commonly multifocal and of higher grade (P = .03) than “true” sporadic GNETs.

Conclusions.—
A subset of GNETs arises in the background of gastric mucosal changes suggestive of hypergastrinemia, but without underlying gastrinoma, and could be linked to long-term PPI use.