Role of Professionalism in Improving the Patient-Centeredness, Timeliness, and Equity of Neurological Care

Franklin, Gary M.; Kaufman, Joel M.; Esper, Gregory J.

doi:10.1001/archneurol.2010.278

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…To improve value, there is increasing recognition that the patients' perspectives should be included in the design and measurement of clinical research and practice 11, 12. In the clinical arena, patient‐centeredness has become a legitimate domain of quality, and economic incentives will exist for hospitals that meet certain quality standards including patient perceptions and satisfaction with care 13.…”

Section: Quality Of Care Researchmentioning

confidence: 99%

Influence of Mesterolone on Satellite Cell Distribution and Fiber Morphology within Maturing Chicken Pectoralis Muscle

Allouh

Aldirawi

2012

The Anatomical Record

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Mesterolone is a synthetic oral anabolic androgenic steroid used to treat hypogonadism. There are frequent reports of mesterolone abuse in human and equine sports to increase muscle mass and strength. However, limited information is available about how this drug exerts its effects on skeletal muscle. Satellite cells (SCs) are mononuclear myogenic stem cells that contribute to postnatal muscle growth and repair. As SC activation and subsequent differentiation to new myonuclei is a major event during muscle hypertrophy, this study investigated the influence of mesterolone on SC distribution within the pectoralis muscle of chickens. Specifically, this study tested the hypotheses that mesterolone induces avian skeletal muscle hypertrophy, and that mesterolone increases the number of SCs in avian skeletal muscle. Robust immunocytochemical techniques and morphometric analyses were used to calculate the numbers of SCs and myonuclei. Also, DNA concentration and Pax7 protein levels were measured to confirm immunocytochemical findings. Mesterolone significantly increased pectoralis mass and fiber size. All SC indices and number of myonuclei increased significantly by mesterolone administration. In addition, greater DNA concentration and Pax7 protein expression were found in mesterolone-treated birds. This study indicates that mesterolone can induce avian skeletal muscle hypertrophy and that this is correlated with increased number of SCs. We suggest that SCs are key cellular intermediaries for mesterolone-induced muscle hypertrophy. Anat Rec,

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Section: Quality Of Care Researchmentioning

confidence: 99%

Influence of Mesterolone on Satellite Cell Distribution and Fiber Morphology within Maturing Chicken Pectoralis Muscle

Allouh

Aldirawi

2012

The Anatomical Record

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“…11,12 In the clinical arena, patient-centeredness has become a legitimate domain of quality, and economic incentives will exist for hospitals that meet certain quality standards including patient perceptions and satisfaction with care. 13 The PPACA codified patient-centeredness into law with the creation of the PCORI and provisions to support interdisciplinary teams within Patient-Centered Medical Homes.…”

Section: Demand For Outcome Measurementmentioning

confidence: 99%

Getting to value in neurological care: A roadmap for academic neurology

Holloway

Ringel²

2011

Annals of Neurology

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Academic neurology is undergoing transformational changes. The public investment in biomedical research and clinical care is enormous and there is a growing perception that the return on this huge investment is insufficient. Hospitals, departments, and individual neurologists should expect more scrutiny as information about their quality of care and financial relationships with industry are increasingly reported to the public. There are unprecedented changes occurring in the financing and delivery of health care and research that will have profound impact on the mission and operation of academic departments of neurology. With the passage of the Patient Protection and Affordable Care Act (PPACA) there will be increasing emphasis on research that demonstrates value and includes the patient's perspective. Here we review neurological investigations of our clinical and research enterprises that focus on quality of care and comparative effectiveness, including cost-effectiveness. By highlighting progress made and the challenges that lie ahead, we hope to create a clinical, educational, and research roadmap for academic departments of neurology to thrive in today's increasingly regulated environment.

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“…In his exposé of the corrupting effects of money and power in medicine, Carl Elliott 33 showed how physicians abetted the process of deprofessionalization through personal profit. 35 Physicians' professional organizations also contribute to deprofessionalization. Other physicians have used their influence as "thought leaders" by serving on pharmaceutical speakers' bureaus.…”

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confidence: 99%

Restoring medical professionalism

Bernat

2012

Neurology

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The essence of medical professionalism is placing dedication to the welfare of patients above physicians' personal or proprietary interests. Medicine has become deprofessionalized as a consequence of socioeconomic factors leading to increasing commercialization and perverse financial incentives converting it into a business, the presence of unmanaged conflicts of interest, challenges to medical authority by insurance companies and the consumerism movement, and by gradual changes in the attitudes of physicians. Organized medicine has responded by making explicit its standards of professionalism and its dedication to preserving them. Medical educators have studied the means to develop professional attitudes and behaviors among medical students and residents. Modeling the characteristics of professional behavior by virtuous physicians remains the most effective method to instill professional behaviors in trainees. Restoring professionalism may be abetted by changes in physicians' financial incentives through innovative models of health care delivery, by physicians reducing their conflicts of interest, and by medical societies rejecting a guild identity.

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Role of Professionalism in Improving the Patient-Centeredness, Timeliness, and Equity of Neurological Care

Cited by 4 publications

References 30 publications

Influence of Mesterolone on Satellite Cell Distribution and Fiber Morphology within Maturing Chicken Pectoralis Muscle

Influence of Mesterolone on Satellite Cell Distribution and Fiber Morphology within Maturing Chicken Pectoralis Muscle

Getting to value in neurological care: A roadmap for academic neurology

Restoring medical professionalism

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