Pub Date : 2018-10-01DOI: 10.1093/med/9780190617127.003.0001
M. Lark, N. Fujihara, K. Chung
This chapter presents general treatment strategies for carpal tunnel syndrome using a clinical case example. It discusses assessment and planning, diagnostic pearls, decision-making, surgical procedures (open and endoscopic carpal tunnel release), management pearls, aftercare, complications and their management, and evidence and outcomes. Physical exams, such as Phalen’s test or a Tinel sign over the median nerve, are introduced, whereas steps in the surgical procedure are shown with intraoperative photographs. The chapter provides information on modern practices for comprehensive management of carpal tunnel syndrome from start to finish.
{"title":"Median Neuropathy—Carpal Tunnel Syndrome","authors":"M. Lark, N. Fujihara, K. Chung","doi":"10.1093/med/9780190617127.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780190617127.003.0001","url":null,"abstract":"This chapter presents general treatment strategies for carpal tunnel syndrome using a clinical case example. It discusses assessment and planning, diagnostic pearls, decision-making, surgical procedures (open and endoscopic carpal tunnel release), management pearls, aftercare, complications and their management, and evidence and outcomes. Physical exams, such as Phalen’s test or a Tinel sign over the median nerve, are introduced, whereas steps in the surgical procedure are shown with intraoperative photographs. The chapter provides information on modern practices for comprehensive management of carpal tunnel syndrome from start to finish.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77072990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/MED/9780198828761.003.0010
J. Onwumere, E. Kuipers
The development of psychotic illness exerts a significant impact on the affected individual but will also affect, in a variety of ways, their family and social networks. Although psychotic conditions are severe mental health problems, they are treatable, and family care and support play an important role in helping to achieve better recovery outcomes. In its first half, this chapter provides an overview of the impact of psychosis on family carers and the close relationship that exists between family wellbeing and patient outcomes, including the relevance of expressed emotion. The second half of the chapter offers an outline of family interventions—the psychological talking therapies designed to help individuals living with psychosis and their families to improve their understanding of the illness, develop skills in positive communication, problem-solving and coping, and identify appropriate support pathways. The evidence base underpinning the interventions and future developments in working with families is also discussed.
{"title":"Psychosis and the family: the role of family interventions","authors":"J. Onwumere, E. Kuipers","doi":"10.1093/MED/9780198828761.003.0010","DOIUrl":"https://doi.org/10.1093/MED/9780198828761.003.0010","url":null,"abstract":"The development of psychotic illness exerts a significant impact on the affected individual but will also affect, in a variety of ways, their family and social networks. Although psychotic conditions are severe mental health problems, they are treatable, and family care and support play an important role in helping to achieve better recovery outcomes. In its first half, this chapter provides an overview of the impact of psychosis on family carers and the close relationship that exists between family wellbeing and patient outcomes, including the relevance of expressed emotion. The second half of the chapter offers an outline of family interventions—the psychological talking therapies designed to help individuals living with psychosis and their families to improve their understanding of the illness, develop skills in positive communication, problem-solving and coping, and identify appropriate support pathways. The evidence base underpinning the interventions and future developments in working with families is also discussed.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87051053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/med/9780190685157.003.0003
Pilar Mercado, J. E. Eklund, Jennifer L. Anderson
The major diagnostic features of CHARGE syndrome include coloboma of the eyes, choanal atresia or stenosis, distinctive external ears, cranial nerve abnormalities, and absent or small semicircular canals. The mnemonic refers to coloboma of the eye, heart defects, atresia of choanae, retardation of growth and development, cenitalia hypoplasia, and ear abnormalities and deafness. There is no defined etiology, though a de novo mutation on the CHD 7 gene located on Chromosome 8 is responsible for more than 50% of CHARGE cases. The incidence of CHARGE is about 1:10,000 live births with an equal distribution between males and females. The anesthetic implications of this syndrome are many and vary with the patient’s phenotype. A potential difficult airway, congenital heart defects, choanal atresia, and cranial nerve abnormalities present the most significant issues for the anesthesiologist. A multidisciplinary team must be established early to properly care for these complex patients.
{"title":"Charge Syndrome","authors":"Pilar Mercado, J. E. Eklund, Jennifer L. Anderson","doi":"10.1093/med/9780190685157.003.0003","DOIUrl":"https://doi.org/10.1093/med/9780190685157.003.0003","url":null,"abstract":"The major diagnostic features of CHARGE syndrome include coloboma of the eyes, choanal atresia or stenosis, distinctive external ears, cranial nerve abnormalities, and absent or small semicircular canals. The mnemonic refers to coloboma of the eye, heart defects, atresia of choanae, retardation of growth and development, cenitalia hypoplasia, and ear abnormalities and deafness. There is no defined etiology, though a de novo mutation on the CHD 7 gene located on Chromosome 8 is responsible for more than 50% of CHARGE cases. The incidence of CHARGE is about 1:10,000 live births with an equal distribution between males and females. The anesthetic implications of this syndrome are many and vary with the patient’s phenotype. A potential difficult airway, congenital heart defects, choanal atresia, and cranial nerve abnormalities present the most significant issues for the anesthesiologist. A multidisciplinary team must be established early to properly care for these complex patients.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88028216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/med/9780190685157.003.0029
A. Patil, S. Pestieau
Scoliosis is defined as an abnormal curvature of the spine, which, if severe enough, can affect pulmonary or cardiac function and ultimately require surgical repair. There are 3 well-defined types of scoliosis: idiopathic, neuromuscular, and congenital scoliosis. Anesthetic management of children undergoing posterior spinal fusion can be challenging due to patient comorbidities, the need for neuromonitoring, the potential for significant blood loss, and various perioperative complications. In addition, postoperative pain after spinal fusion is known to be severe and often exceeds those reported in other major surgical procedures. To properly care for these patients, it is vital to be knowledgeable about the anesthetic and pain management considerations of patients undergoing posterior spinal fusion.
{"title":"Anesthetic Management of Scoliosis Surgery in Children","authors":"A. Patil, S. Pestieau","doi":"10.1093/med/9780190685157.003.0029","DOIUrl":"https://doi.org/10.1093/med/9780190685157.003.0029","url":null,"abstract":"Scoliosis is defined as an abnormal curvature of the spine, which, if severe enough, can affect pulmonary or cardiac function and ultimately require surgical repair. There are 3 well-defined types of scoliosis: idiopathic, neuromuscular, and congenital scoliosis. Anesthetic management of children undergoing posterior spinal fusion can be challenging due to patient comorbidities, the need for neuromonitoring, the potential for significant blood loss, and various perioperative complications. In addition, postoperative pain after spinal fusion is known to be severe and often exceeds those reported in other major surgical procedures. To properly care for these patients, it is vital to be knowledgeable about the anesthetic and pain management considerations of patients undergoing posterior spinal fusion.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83931546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/med/9780198797746.003.0009
D. Nutt, L. Nestor
Glutamate is the primary excitatory neurotransmitter in the brain. Glutamate is involved in synaptic plasticity, particularly within dopamine systems of the brain that are involved in reward. Glutamate-dependent plasticity is involved in the development of substance addiction through its actions at NMDA receptors during long-term potentiation (LTP) related learning and memory processes. This plasticity within brain circuitry involved in learning and memory is sustained during substance abstinence and may provide a neural substrate for a vulnerability to addiction relapse. Medications that possess the efficacy to reduce glutamate tone in certain brain circuits may reduce craving, and ultimately, relapse in substance dependence. Further research is required, however, to show that the modulation of glutamate transmission in the brain confers clinical benefits in substance addiction.
{"title":"The glutamate system and addiction","authors":"D. Nutt, L. Nestor","doi":"10.1093/med/9780198797746.003.0009","DOIUrl":"https://doi.org/10.1093/med/9780198797746.003.0009","url":null,"abstract":"Glutamate is the primary excitatory neurotransmitter in the brain. Glutamate is involved in synaptic plasticity, particularly within dopamine systems of the brain that are involved in reward. Glutamate-dependent plasticity is involved in the development of substance addiction through its actions at NMDA receptors during long-term potentiation (LTP) related learning and memory processes. This plasticity within brain circuitry involved in learning and memory is sustained during substance abstinence and may provide a neural substrate for a vulnerability to addiction relapse. Medications that possess the efficacy to reduce glutamate tone in certain brain circuits may reduce craving, and ultimately, relapse in substance dependence. Further research is required, however, to show that the modulation of glutamate transmission in the brain confers clinical benefits in substance addiction.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82605827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/med/9780190696696.003.0026
P. Klimo, N. Shimony
Pediatric posterior fossa tumors are usually ependymoma, pilocytic astrocytoma, or medulloblastoma. Ependymoma appears well-demarcated with heterogeneous enhancement on magnetic resonance imaging (MRI). Full neural axis MRI is indicated to assess for metastatic disease. Management is typically surgical resection of the tumor, with consideration for cerebrospinal fluid diversion if patients present with severe hydrocephalus. Extent of resection of the tumor is the most important factor in predicting recurrence and overall survival, and gross total resection is ideal. Infratentorial ependymomas have 2 molecular subtypes, which has implications for responsiveness to adjuvant therapy and prognosis. Infratentorial ependymomas are biologically different from supratentorial ependymomas. Postoperative radiation improves local control.
{"title":"Ependymomas","authors":"P. Klimo, N. Shimony","doi":"10.1093/med/9780190696696.003.0026","DOIUrl":"https://doi.org/10.1093/med/9780190696696.003.0026","url":null,"abstract":"Pediatric posterior fossa tumors are usually ependymoma, pilocytic astrocytoma, or medulloblastoma. Ependymoma appears well-demarcated with heterogeneous enhancement on magnetic resonance imaging (MRI). Full neural axis MRI is indicated to assess for metastatic disease. Management is typically surgical resection of the tumor, with consideration for cerebrospinal fluid diversion if patients present with severe hydrocephalus. Extent of resection of the tumor is the most important factor in predicting recurrence and overall survival, and gross total resection is ideal. Infratentorial ependymomas have 2 molecular subtypes, which has implications for responsiveness to adjuvant therapy and prognosis. Infratentorial ependymomas are biologically different from supratentorial ependymomas. Postoperative radiation improves local control.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91459899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/MED/9780199362318.003.0011
P. Soloff, C. Schmahl
This chapter reviews current data on the prevalence of suicidal behavior and non-suicidal self-injury (NSSI) in patients with PDs; the characteristics of attempters versus completers; and the epidemiology of NSSI in borderline personality disorder (BPD). In addition, it presents explanatory models for suicide and NSSI. Also, there are comprehensive discussions of the neurobiological mechanisms involved in both suicidality and NSSI focusing on the structural and functional neuroimaging of emotion dysregulation, impulsivity, executive cognitive deficits, affective interference and cognitive function, and the Endogenous Opioid System. The chapter concludes with a detailed description of pain processing as it interacts with NSSI.
{"title":"Suicide and Nonsuicidal Self-Injury","authors":"P. Soloff, C. Schmahl","doi":"10.1093/MED/9780199362318.003.0011","DOIUrl":"https://doi.org/10.1093/MED/9780199362318.003.0011","url":null,"abstract":"This chapter reviews current data on the prevalence of suicidal behavior and non-suicidal self-injury (NSSI) in patients with PDs; the characteristics of attempters versus completers; and the epidemiology of NSSI in borderline personality disorder (BPD). In addition, it presents explanatory models for suicide and NSSI. Also, there are comprehensive discussions of the neurobiological mechanisms involved in both suicidality and NSSI focusing on the structural and functional neuroimaging of emotion dysregulation, impulsivity, executive cognitive deficits, affective interference and cognitive function, and the Endogenous Opioid System. The chapter concludes with a detailed description of pain processing as it interacts with NSSI.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83052210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/med/9780190647421.003.0001
David A. Chambers, W. Norton, Cynthia A. Vinson
THE ROOTS of implementation science (IS) in cancer in some sense date back to the earliest days of uncovering cancer’s etiology, diagnosis, prevention, and treatment, although it was not called that. Indeed, unlocking the mysteries of cancer and determining effective ways to intervene began not in the lab but, rather, the clinic. As Mukherjee recounted in the seminal work, The Emperor of All Maladies, 1 cancer had been the subject of clinical examination for centuries, and the drive to optimize care began in those early days. As opposed to the largely separate worlds of research discovery and care delivery that exist today, scientific research and cancer treatment coexisted. In addition, epidemiologic observations of risk factors affecting oncogenesis developed targets for what types of prevention programs needed to be implemented. Naturally, the challenges of what exactly to implement and how best to implement have been with us throughout time.
从某种意义上说，实施科学(IS)在癌症领域的根源可以追溯到发现癌症病因、诊断、预防和治疗的早期，尽管它不被称为实施科学。事实上，揭开癌症的奥秘并确定有效的干预方法并非始于实验室，而是始于临床。正如慕克吉在其开创性著作《万病之王》(the Emperor of All diseases)中所述，几个世纪以来，癌症一直是临床检查的主题，而优化治疗的动力从早期就开始了。与目前存在的研究发现和护理服务的两个截然不同的世界不同，科学研究和癌症治疗是共存的。此外，对影响肿瘤发生的危险因素的流行病学观察为需要实施的预防方案制定了目标。当然，我们一直都面临着具体实施什么以及如何最好地实施的挑战。
{"title":"An Orientation to Implementation Science in Cancer","authors":"David A. Chambers, W. Norton, Cynthia A. Vinson","doi":"10.1093/med/9780190647421.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780190647421.003.0001","url":null,"abstract":"THE ROOTS of implementation science (IS) in cancer in some sense date back to the earliest days of uncovering cancer’s etiology, diagnosis, prevention, and treatment, although it was not called that. Indeed, unlocking the mysteries of cancer and determining effective ways to intervene began not in the lab but, rather, the clinic. As Mukherjee recounted in the seminal work, The Emperor of All Maladies, 1 cancer had been the subject of clinical examination for centuries, and the drive to optimize care began in those early days. As opposed to the largely separate worlds of research discovery and care delivery that exist today, scientific research and cancer treatment coexisted. In addition, epidemiologic observations of risk factors affecting oncogenesis developed targets for what types of prevention programs needed to be implemented. Naturally, the challenges of what exactly to implement and how best to implement have been with us throughout time.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83498519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/MED/9780190685157.003.0020
M. Harvey, I. Ayad
Pierre Robin sequence (PRS) is characterized by micrognathia, glossoptosis, and airway obstruction. Often associated with cleft palate, PRS is usually an isolated finding but is associated with a syndrome one-third of the time. The micrognathia and glossoptosis lead to airway obstruction, respiratory compromise, and feeding difficulties. Severe cases and prolonged and repeated airway obstruction and respiratory distress can lead to failure to thrive, hypoxemia, pulmonary hypertension, cardiac arrest, and death. Treatment options for the management of airway obstruction in PRS depends on the degree of obstruction and any associated comorbidities and range from noninvasive respiratory support to surgical correction of the physical defect. Patients with PRS should be considered as challenging to ventilate and intubate, and the practitioner should be well prepared for the possibility of difficulty with airway management. Anesthetic management is tailored to minimize postoperative upper airway obstruction and avoid disruption of the integrity of the surgical repair.
Pierre Robin序列(PRS)的特征是小颌、光斑下垂和气道阻塞。PRS通常与腭裂有关，通常是孤立的发现，但三分之一的时间与综合征有关。小颌和舌下垂导致气道阻塞、呼吸衰竭和进食困难。严重的病例和长期反复的气道阻塞和呼吸窘迫可导致生长衰竭、低氧血症、肺动脉高压、心脏骤停和死亡。PRS气道阻塞的治疗选择取决于阻塞的程度和任何相关的合并症，范围从无创呼吸支持到物理缺陷的手术矫正。PRS患者应被认为是通气和插管困难的患者，医生应对可能出现的气道管理困难做好充分准备。麻醉管理是量身定制的，以尽量减少术后上气道阻塞，避免破坏手术修复的完整性。
{"title":"Cleft Palate, Cleft Lip, and Pierre Robin Sequence","authors":"M. Harvey, I. Ayad","doi":"10.1093/MED/9780190685157.003.0020","DOIUrl":"https://doi.org/10.1093/MED/9780190685157.003.0020","url":null,"abstract":"Pierre Robin sequence (PRS) is characterized by micrognathia, glossoptosis, and airway obstruction. Often associated with cleft palate, PRS is usually an isolated finding but is associated with a syndrome one-third of the time. The micrognathia and glossoptosis lead to airway obstruction, respiratory compromise, and feeding difficulties. Severe cases and prolonged and repeated airway obstruction and respiratory distress can lead to failure to thrive, hypoxemia, pulmonary hypertension, cardiac arrest, and death. Treatment options for the management of airway obstruction in PRS depends on the degree of obstruction and any associated comorbidities and range from noninvasive respiratory support to surgical correction of the physical defect. Patients with PRS should be considered as challenging to ventilate and intubate, and the practitioner should be well prepared for the possibility of difficulty with airway management. Anesthetic management is tailored to minimize postoperative upper airway obstruction and avoid disruption of the integrity of the surgical repair.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80662206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-01DOI: 10.1093/med/9780190647421.003.0004
T. Skolarus, R. Tabak, A. Sales
This chapter describes implementation theories, models, and frameworks and justifies their systematic use to build understanding of implementation science across the cancer care continuum and, ultimately, facilitate stewardship of effective cancer care and spending across complex clinical and public health contexts. The chapter discusses several previously developed taxonomy and categorization schemes as well as resources to aid implementation researchers and practitioners in their cancer-related implementation science efforts. The importance of precision implementation using systematic theoretical approaches to coincide with precision oncology efforts and funding is also discussed. After providing concrete examples of theory, model, and framework use across the continuum from prevention to palliative care, relevant implementation science opportunities for collaboration, patient-reported outcomes research, de-implementation, and measurement are highlighted as future directions. A case is constructed for the systematic use of theories, models, and frameworks in implementation science and practice.
{"title":"Theories, Frameworks, and Models in Implementation Science in Cancer","authors":"T. Skolarus, R. Tabak, A. Sales","doi":"10.1093/med/9780190647421.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780190647421.003.0004","url":null,"abstract":"This chapter describes implementation theories, models, and frameworks and justifies their systematic use to build understanding of implementation science across the cancer care continuum and, ultimately, facilitate stewardship of effective cancer care and spending across complex clinical and public health contexts. The chapter discusses several previously developed taxonomy and categorization schemes as well as resources to aid implementation researchers and practitioners in their cancer-related implementation science efforts. The importance of precision implementation using systematic theoretical approaches to coincide with precision oncology efforts and funding is also discussed. After providing concrete examples of theory, model, and framework use across the continuum from prevention to palliative care, relevant implementation science opportunities for collaboration, patient-reported outcomes research, de-implementation, and measurement are highlighted as future directions. A case is constructed for the systematic use of theories, models, and frameworks in implementation science and practice.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85323766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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