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  1. Article: Sebaceous carcinoma arising within an ovarian mature cystic teratoma: A case report with discussion of clinical management and genetic evaluation.

    Wield, Alyssa / Hodeib, Melissa / Khan, Mohammad / Gubernick, Lindsay / Li, Andrew J / Kandukuri, Shivani

    Gynecologic oncology reports

    2018  Volume 26, Page(s) 37–40

    Abstract: Sebaceous carcinomas are rare tumors, with the majority of described cases occurring within the eyelid. To date, there are nine documented reports of sebaceous carcinoma arising within a mature cystic teratoma of the ovary. Although the majority of cases ...

    Abstract Sebaceous carcinomas are rare tumors, with the majority of described cases occurring within the eyelid. To date, there are nine documented reports of sebaceous carcinoma arising within a mature cystic teratoma of the ovary. Although the majority of cases originate from idiopathic mutations, there exists a strong association between this rare tumor and hereditary syndromes of DNA mismatch repair deficiency, such as Lynch syndrome and the lesser-known Muir-Torre syndrome. Here we present the case of a 67 year-old woman with a longstanding history of a small left ovarian cyst with sonographic features of an ovarian dermoid. After nine years, the left adnexal mass was noted to have enlarged, and she underwent a laparoscopic bilateral salpingo-oophorectomy. The final pathology was reported as sebaceous carcinoma arising within a mature cystic teratoma. The patient underwent subsequent surgical staging and has been followed for eight months without evidence of disease. This report includes a review of the current literature, as well as a brief discussion of the clinical management of women with sebaceous carcinoma arising within a mature teratoma. Additionally, we comment on the broader, hereditary significance of a diagnosis of sebaceous carcinoma, and use this case to demonstrate the thorough histologic and genetic evaluation that is recommended for patients diagnosed with this rare tumor.
    Language English
    Publishing date 2018-08-29
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2818505-5
    ISSN 2352-5789
    ISSN 2352-5789
    DOI 10.1016/j.gore.2018.08.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Child Abuse and Neglect Risk Assessment: Quality Improvement in a Primary Care Setting.

    Chung, Esther K / Gubernick, Ruth S / LaNoue, Marianna / Abatemarco, Diane J

    Academic pediatrics

    2018  Volume 19, Issue 2, Page(s) 227–235

    Abstract: Objectives: Practicing Safety is an American Academy of Pediatrics toolkit to help practices address child abuse and neglect (CAN) risk by increasing screening and providing resources. The objectives in an urban practice serving low-income children were ...

    Abstract Objectives: Practicing Safety is an American Academy of Pediatrics toolkit to help practices address child abuse and neglect (CAN) risk by increasing screening and providing resources. The objectives in an urban practice serving low-income children were to 1) standardize CAN risk assessment and developmental screening, and 2) improve resource provision.
    Methods: A quality improvement initiative to standardize CAN risk assessment, using materials adapted from Practicing Safety, was conducted through the use of SmartTools in an electronic health record. The Edinburgh Postnatal Depression Scale and Parents Evaluation of Developmental Status were used to assess maternal depression and child development, respectively. Charts were reviewed in waves-pre-, immediate post-, and early post-implementation (waves 1 to 3); monthly for 6 months (waves 4 to 9); and quarterly for 12 months (waves 10 to 13)-to assess screening and resource provision for 6 domains: infant crying, maternal depression, development, discipline, temper tantrums, and toilet training.
    Results: A total of 581 charts were reviewed (92, 95, and 94 for waves 1 to 3, respectively; 30 each for waves 4 to 13). Screening for infant crying, maternal depression, development, and discipline rose from 0% pre-implementation to over 50% post-implementation. Screening for temper tantrums and toilet training rose from 6% to 72% and from 36% to 82%, respectively. For all measures, resource provision improved over time, and all improvements were maintained for 1.5 years post-implementation.
    Conclusions: Incorporating an adapted version of Practicing Safety into an electronic health record is a practical and effective approach to improving CAN risk assessment and resource provision. This quality improvement initiative is an example of a practice-wide improvement that resulted in clinical practice change.
    MeSH term(s) Child Abuse/diagnosis ; Child Abuse/statistics & numerical data ; Child Development ; Child, Preschool ; Crying ; Depression, Postpartum/diagnosis ; Depressive Disorder/diagnosis ; Electronic Health Records ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mass Screening ; Mothers ; Parenting ; Primary Health Care ; Quality Improvement ; Risk Assessment ; Toilet Training
    Language English
    Publishing date 2018-09-29
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2483385-X
    ISSN 1876-2867 ; 1876-2859
    ISSN (online) 1876-2867
    ISSN 1876-2859
    DOI 10.1016/j.acap.2018.09.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The HIV therapy market.

    Gubernick, Steven I / Félix, Nuno / Lee, Dolim / Xu, Jing J / Hamad, Bashar

    Nature reviews. Drug discovery

    2016  Volume 15, Issue 7, Page(s) 451–452

    MeSH term(s) Anti-HIV Agents/economics ; Anti-HIV Agents/therapeutic use ; Commerce ; HIV/physiology ; HIV Infections/economics ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Humans
    Chemical Substances Anti-HIV Agents
    Language English
    Publishing date 2016-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2062954-0
    ISSN 1474-1784 ; 1474-1776
    ISSN (online) 1474-1784
    ISSN 1474-1776
    DOI 10.1038/nrd.2016.69
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Practicing safety: a quality improvement intervention to test tools to enhance pediatric psychosocial care for children 0-3 years.

    Abatemarco, Diane J / Gubernick, Ruth S / LaNoue, Marianna D / Pohlig, Ryan T / Slovin, Sara R / Healy, Jill A / Kairys, Steven

    Primary health care research & development

    2017  Volume 19, Issue 4, Page(s) 365–377

    Abstract: Background: Child maltreatment is a significant public health issue in the United States. Yet, fewer than half of pediatricians discuss behavioral, developmental, or parenting issues with parents.: Objective: This paper describes the testing of ... ...

    Abstract Background: Child maltreatment is a significant public health issue in the United States. Yet, fewer than half of pediatricians discuss behavioral, developmental, or parenting issues with parents.
    Objective: This paper describes the testing of bundles of tools and processes, part of a larger intervention, Practicing Safety, targeted at changing physician and staff behavior to identify families at risk for child maltreatment, provide anticipatory guidance, refer to community resources, and follow-up and track at-risk families. The intervention was implemented with 14 pediatric primary care practices throughout the United States; the study was completed in 2011.
    Methods: A within-subjects repeated measures pre-post follow-up design was used to evaluate the intervention. Baseline and repeated measurements of pediatric practices' processes were collected using qualitative and quantitative methods. In total, 14 core improvement teams from across the country tested three bundles of tools (maternal, infant, toddler) within a quality improvement framework over seven months.
    Results: Quantitative results showed statistically significant adoption of tools and processes and enhancement of practice behaviors and office environmental supports. The increase in tool use was immediate and was sustained for six months after implementation. Qualitative data provided insight as to how meaningful the intervention was to the core improvement teams, especially with more complicated behaviors (eg, engaging social workers or community agencies for referrals). Barriers included lack of community resources. Findings showed unanticipated outcomes such as helping practices to become medical homes.
    Conclusion: Lessons learned included that practices appreciate and can adopt brief interventions that have meaningful and useful tools and process to enhance psychosocial care for children 0-3 and that do not place a burden on pediatric practice. An innovative, quality improvement strategy, intuitive to pediatricians, with a brief intervention may help prevent child maltreatment.
    MeSH term(s) Adult ; Child Abuse/prevention & control ; Child, Preschool ; Counseling/standards ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Parents/education ; Parents/psychology ; Patient Safety/standards ; Pediatrics/standards ; Practice Guidelines as Topic ; Pregnancy ; Primary Health Care/methods ; United States
    Language English
    Publishing date 2017-12-18
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2027892-5
    ISSN 1477-1128 ; 1463-4236
    ISSN (online) 1477-1128
    ISSN 1463-4236
    DOI 10.1017/S1463423617000810
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Chemical characterization of urinary volatile compounds ofPeromyscus californicus, a monogamous biparental rodent.

    Jemiolo, B / Gubernick, D J / Catherine Yoder, M / Novotny, M

    Journal of chemical ecology

    2013  Volume 20, Issue 10, Page(s) 2489–2500

    Abstract: The urinary profiles of adult female and male California mice were examined to determine the volatile compounds that may affect reproduction. The urinary volatiles identified by gas chromatography-mass spectrometry (GC-MS) include ketones, pyrazines, ... ...

    Abstract The urinary profiles of adult female and male California mice were examined to determine the volatile compounds that may affect reproduction. The urinary volatiles identified by gas chromatography-mass spectrometry (GC-MS) include ketones, pyrazines, alkanes, nitrile, and aldehyde. None of volatile compounds was specific to males or females. The concentration of urinary volatiles in pregnant and lactating females was significantly higher than in virgin females. Male urinary volatile concentrations were similar to those of pregnant and lactating females. The GC profiles of both sexes were distinguished by a high percentage (36%) of pyrazine derivatives that were also in unusually high concentrations. These compounds may play a wide-ranging role in the control of reproduction in the California mouse.
    Language English
    Publishing date 2013-11-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800130-3
    ISSN 1573-1561 ; 0098-0331
    ISSN (online) 1573-1561
    ISSN 0098-0331
    DOI 10.1007/BF02036186
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Using genograms to understand pediatric practices' readiness for change to prevent abuse and neglect.

    Abatemarco, Diane J / Kairys, Steven / Gubernick, Ruth S / Hurley, Tammy

    Journal of child health care : for professionals working with children in the hospital and community

    2012  Volume 16, Issue 2, Page(s) 153–165

    Abstract: A novel use of genograms in primary care practice is to identify processes and relationships among physicians and staff prior to implementing practice change. The authors hypothesized that the genogram would inform researchers and practice staff, ... ...

    Abstract A novel use of genograms in primary care practice is to identify processes and relationships among physicians and staff prior to implementing practice change. The authors hypothesized that the genogram would inform researchers and practice staff, participating in a child maltreatment prevention study, how practice members function in a practice. They describe the use of genograms and show how the genogram results are associated with intervention uptake. Researchers constructed genograms, collected baseline surveys, and conducted postintervention interviews with physicians. Data were analyzed to determine processes associated with intervention uptake. While survey results supported the relationships and conflicts observed in the genograms, the genogram provided more multilevel information that reflected practices' abilities to implement change. By providing a snapshot of the relationship and organizational dynamics within a practice, genograms can assess culture for practice change. Genograms describe organizational dynamics and are useful tools to use prior to initiating new programs.
    MeSH term(s) Adult ; Aged ; Child ; Child Abuse/prevention & control ; Female ; Humans ; Interprofessional Relations ; Male ; Middle Aged ; Organizational Culture ; Pediatrics/organization & administration ; Primary Health Care/organization & administration ; Qualitative Research ; Young Adult
    Language English
    Publishing date 2012-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2299167-0
    ISSN 1741-2889 ; 1367-4935
    ISSN (online) 1741-2889
    ISSN 1367-4935
    DOI 10.1177/1367493511424888
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Missed opportunities: Genetic counseling and testing among an ethnically diverse cohort of women with endometrial cancer.

    Lee, Jessica / Gubernick, Lindsay R / Brodsky, Allison L / Fehniger, Julia E / Levine, Douglas A / Gerber, Deanna / Asgari, Shabnam A / Cantor, Anna / Martineau, Jessica T / Ginsburg, Ophira M / Smith, Julia A / Pothuri, Bhavana

    Gynecologic oncology

    2018  Volume 151, Issue 1, Page(s) 153–158

    Abstract: Objectives: Lynch syndrome (LS) accounts for the majority of inherited endometrial cancers (EC), and the identification of probands presents a unique opportunity to treat and prevent multiple cancers. The diagnosis of EC can provide the indication for ... ...

    Abstract Objectives: Lynch syndrome (LS) accounts for the majority of inherited endometrial cancers (EC), and the identification of probands presents a unique opportunity to treat and prevent multiple cancers. The diagnosis of EC can provide the indication for women with specific risk factors to undergo genetic testing (GT). We sought to evaluate genetic counseling referrals (GCR) and subsequent GT rates in an ethnically diverse group of high-risk women.
    Methods: All women diagnosed with EC between 2011 and 2016 were identified. Risk factors for LS including age, family and personal histories of Lynch-related cancers and loss of tumor mismatch repair (MMR) protein expression were identified from laboratory and medical records. Standard two-sided statistical tests were used.
    Results: Of 583 women diagnosed with EC, 184 (31.6%) were found to have at least one high-risk characteristic for LS. Among these high-risk women, 58% were given GCR and resulting in only 35% undergoing GT. Ten of the 65 high-risk women who had GT (15.4%) were diagnosed with Lynch syndrome, and all ten met high-risk criteria. Two women of Asian race had tumors exhibiting retained MMR protein expression despite germline testing demonstrating Lynch syndrome.
    Conclusions: Many high-risk women do not receive GCR despite a high rate of germline mutations among these women. Improving GCR among high-risk women will lead to more subsequent GT to identify more Lynch syndrome families and prevent additional cancers. Among our ethnically diverse cohort, two women diagnosed with LS had retained MMR protein expression. GCR should be offered to women who possess high-risk characteristics despite normal MMR protein expression.
    MeSH term(s) Aged ; Biomarkers, Tumor/genetics ; Cohort Studies ; Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis ; Colorectal Neoplasms, Hereditary Nonpolyposis/ethnology ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; DNA Mismatch Repair/genetics ; Early Detection of Cancer/methods ; Early Detection of Cancer/statistics & numerical data ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/ethnology ; Endometrial Neoplasms/genetics ; Endometrial Neoplasms/prevention & control ; Female ; Genetic Counseling/methods ; Genetic Counseling/statistics & numerical data ; Genetic Predisposition to Disease ; Genetic Testing/methods ; Genetic Testing/statistics & numerical data ; Humans ; Middle Aged ; Predictive Value of Tests ; Referral and Consultation/statistics & numerical data ; Risk Factors
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2018-08-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2018.07.023
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  8. Article: Adaptive significance of male parental care in a monogamous mammal.

    Gubernick, D J / Teferi, T

    Proceedings. Biological sciences

    2000  Volume 267, Issue 1439, Page(s) 147–150

    Abstract: Paternal behaviour presumably evolved because male care of young was critical for offspring survival. We report field evidence indicating that paternal behaviour enhances offspring survival in a monogamous mammal, the biparental California mouse, ... ...

    Abstract Paternal behaviour presumably evolved because male care of young was critical for offspring survival. We report field evidence indicating that paternal behaviour enhances offspring survival in a monogamous mammal, the biparental California mouse, Peromyscus californicus. Male removal resulted in lower offspring survival in father-absent than in father-present families. New males took up residence with widowed females, but usually after females had stopped lactating, suggesting that the importance of the father is not primarily protection against infanticidal intruders but rather direct care of young.
    MeSH term(s) Adaptation, Physiological ; Animals ; Animals, Newborn/growth & development ; Female ; Longitudinal Studies ; Male ; Mice ; Paternal Deprivation ; Peromyscus/growth & development
    Language English
    Publishing date 2000-01-22
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 209242-6
    ISSN 1471-2954 ; 0962-8452 ; 0080-4649 ; 0950-1193
    ISSN (online) 1471-2954
    ISSN 0962-8452 ; 0080-4649 ; 0950-1193
    DOI 10.1098/rspb.2000.0979
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Expanding the pediatrician's black bag: a psychosocial care improvement model to address the "new morbidities".

    Abatemarco, Diane J / Kairys, Steven W / Gubernick, Ruth S / Kairys, Jo Ann

    Joint Commission journal on quality and patient safety

    2008  Volume 34, Issue 2, Page(s) 106–115

    Abstract: Background: Behavioral, developmental, and psychosocial problems ("new morbidities") significantly affect the well-being of children ages 0-3 years. Practices generally fail to deliver consistent anticipatory guidance or counseling to parents. A ... ...

    Abstract Background: Behavioral, developmental, and psychosocial problems ("new morbidities") significantly affect the well-being of children ages 0-3 years. Practices generally fail to deliver consistent anticipatory guidance or counseling to parents. A multifaceted intervention was designed to increase the capacity of three very different practice types to adopt and implement Practicing Safety, a child abuse and neglect prevention program.
    Methods: Using a feasibility intervention study, a combination of organizational change approaches, including complexity science principles--self-organization, emergence, and co-evolution--were tested. The multimethod assessment process (MAP) was employed to understand the unique characteristics of each practice that could impede or promote innovation. Findings guided a facilitated, team-based change intervention, the Reflective Adaptive Process (RAP) to restructure psychosocial care.
    Findings: Each practice demonstrated fundamental changes in decision making, developmental assessment, and parent education processes. Practicing Safety tools were adopted and incorporated into daily routines. RAP team members exhibited new patterns of communication and relationships that supported organizationwide preventive service innovations.
    Discussion: The MAP and RAP interventions enabled study practices to integrate novel methods for prevention of child abuse and neglect into daily routines.
    MeSH term(s) Child ; Child Abuse/prevention & control ; Child Abuse/psychology ; Child, Preschool ; Feasibility Studies ; Humans ; Infant ; Infant, Newborn ; Models, Organizational ; Parent-Child Relations ; Pediatrics ; Physicians' Offices/organization & administration ; Primary Health Care ; Psychology
    Language English
    Publishing date 2008-01-31
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1189890-2
    ISSN 1938-131X ; 1549-425X ; 1553-7250 ; 1070-3241 ; 1549-3741
    ISSN (online) 1938-131X ; 1549-425X
    ISSN 1553-7250 ; 1070-3241 ; 1549-3741
    DOI 10.1016/s1553-7250(08)34013-6
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  10. Article ; Online: A Quality Improvement Collaborative to Improve Pediatric Primary Care Genetic Services.

    Rinke, Michael L / Driscoll, Amy / Mikat-Stevens, Natalie / Healy, Jill / Colantuoni, Elizabeth / Elias, Abdallah F / Pletcher, Beth A / Gubernick, Ruth S / Larson, Ingrid / Chung, Wendy K / Tarini, Beth A

    Pediatrics

    2016  Volume 137, Issue 2, Page(s) e20143874

    Abstract: Objective: To investigate if a national pediatric primary care quality improvement collaborative (QIC) could improve and sustain adherence with process measures related to diagnosis and management of children with genetic disorders.: Methods: ... ...

    Abstract Objective: To investigate if a national pediatric primary care quality improvement collaborative (QIC) could improve and sustain adherence with process measures related to diagnosis and management of children with genetic disorders.
    Methods: Thirteen practices in 11 states from the American Academy of Pediatrics' Quality Improvement Innovation Networks participated in a 6-month QIC that included regular educational opportunities, access to genetic professionals, and performance feedback. The QIC identified 11 aims related to improving diagnosis and management of children with genetic disorders. The practices evaluated adherence by reviewing patient records at baseline, monthly for 6 months (active improvement period), and then once 6 months after the QIC's conclusion to check for sustainability. Random intercept binomial regression models with practice level random intercepts were used to compare adherence over time for each aim.
    Results: During the active improvement period, statistically significant improvements in adherence were observed for 4 of the 7 aims achieving minimal data submission levels. For example, adherence improved for family histories created/maintained at health supervision visits documenting all components of the family history (6% vs 60%, P < .001), and for patients with specific genetic disorders who received recommended care (58% vs 85%, P < .001). All 4 of these aims also demonstrated statistically significant improvements during the sustainability period.
    Conclusions: A national QIC reveals promise in improving and sustaining adherence with process measures related to the diagnosis and management of genetic disorders. Future research should focus on patient outcome measures and the optimal number of aims to pursue in QICs.
    MeSH term(s) Child ; Cooperative Behavior ; Genetic Diseases, Inborn/diagnosis ; Genetic Diseases, Inborn/therapy ; Genetic Services/organization & administration ; Genetic Services/standards ; Guideline Adherence/statistics & numerical data ; Guideline Adherence/trends ; Humans ; Outcome and Process Assessment (Health Care) ; Pediatrics/organization & administration ; Pediatrics/standards ; Practice Guidelines as Topic ; Primary Health Care/organization & administration ; Primary Health Care/standards ; Quality Improvement/organization & administration ; United States
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2014-3874
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