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Safer conception

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https://www.readbyqxmd.com/read/28598742/a-call-to-action-the-controversy-of-and-rationale-for-competency-based-medical-education
#1
Eric S Holmboe, Jonathan Sherbino, Robert Englander, Linda Snell, Jason R Frank
Although medical education has enjoyed many successes over the last century, there is a recognition that health care is too often unsafe and of poor quality. Errors in diagnosis and treatment, communication breakdowns, poor care coordination, inappropriate use of tests and procedures, and dysfunctional collaboration harm patients and families around the world. These issues reflect on our current model of medical education and raise the question: Are physicians being adequately prepared for twenty-first century practice? Multiple reports have concluded the answer is "no...
June 2017: Medical Teacher
https://www.readbyqxmd.com/read/28597343/safer-conception-for-couples-affected-by-hiv-structural-and-cultural-considerations-in-the-delivery-of-safer-conception-care-in-uganda
#2
Deborah Mindry, Rhoda K Wanyenze, Jolly Beyeza-Kashesya, Mahlet A Woldetsadik, Sarah Finocchario-Kessler, Kathy Goggin, Glenn Wagner
In countries with high HIV prevalence and high fertility desires, the rights of HIV-affected couples to have children are a pressing issue. Conception among people living with HIV carries risks for both horizontal and vertical HIV transmission. In Uganda ~100,000 HIV-infected women become pregnant annually. Providers face a number of challenges to preventing HIV transmission, reducing unplanned pregnancies, and ensuring safer conception. We report findings from interviews with 27 HIV-affected couples (54 individuals) in Uganda...
June 8, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28595484/kinetic-modelling-and-optimisation-of-antimicrobial-compound-production-by-candida-pyralidae-ku736785-for-control-of-candida-guilliermondii
#3
Maxwell Mewa-Ngongang, Heinrich W du Plessis, Ucrecia F Hutchinson, Lukhanyo Mekuto, Seteno Ko Ntwampe
Biological antimicrobial compounds from yeast can be used to address the critical need for safer preservatives in food, fruit and beverages. The inhibition of Candida guilliermondii, a common fermented beverage spoilage organism, was achieved using antimicrobial compounds produced by Candida pyralidae KU736785. The antimicrobial production system was modelled and optimised using response surface methodology, with 22.5 ℃ and pH of 5.0 being the optimum conditions. A new concept for quantifying spoilage organism inhibition was developed...
June 2017: Food Science and Technology International, Ciencia y Tecnología de Los Alimentos Internacional
https://www.readbyqxmd.com/read/28581409/current-status-of-targeted-radioprotection-and-radiation-injury-mitigation-and-treatment-agents-a-critical-review-of-the-literature
#4
REVIEW
Noah S Kalman, Sherry S Zhao, Mitchell S Anscher, Alfredo I Urdaneta
As more cancer patients survive their disease, concerns about radiation therapy-induced side effects have increased. The concept of radioprotection and radiation injury mitigation and treatment offers the possibility to enhance the therapeutic ratio of radiation therapy by limiting radiation therapy-induced normal tissue injury without compromising its antitumor effect. Advances in the understanding of the underlying mechanisms of radiation toxicity have stimulated radiation oncologists to target these pathways across different organ systems...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28574204/rational-clinical-evaluation-of-suspected-acute-coronary-syndromes-the-value-of-more-information
#5
David G Hancock, Ming-Yu Anthony Chuang, Rebecca Bystrom, Amera Halabi, Rachel Jones, Matthew Horsfall, Louise Cullen, William A Parsonage, Derek P Chew
OBJECTIVE: Many meta-analyses have provided synthesised likelihood ratio data to aid clinical decision-making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome. METHODS: Clinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013...
June 2, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28501964/consensus-statement-supporting-safer-conception-and-pregnancy-for-men-and-women-living-with-and-affected-by-hiv
#6
Lynn T Matthews, Jolly Beyeza-Kashesya, Ian Cooke, Natasha Davies, Renee Heffron, Angela Kaida, John Kinuthia, Okeoma Mmeje, Augusto E Semprini, Shannon Weber
Safer conception interventions reduce HIV incidence while supporting the reproductive goals of people living with or affected by HIV. We developed a consensus statement to address demand, summarize science, identify information gaps, outline research and policy priorities, and advocate for safer conception services. This statement emerged from a process incorporating consultation from meetings, literature, and key stakeholders. Three co-authors developed an outline which was discussed and modified with co-authors, working group members, and additional clinical, policy, and community experts in safer conception, HIV, and fertility...
May 13, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#7
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28426312/safe-sex-in-the-1970s-community-practitioners-on-the-eve-of-aids
#8
Thomas R Blair
In the 1970s, groups of gay and gay-allied health professionals began to formulate guidelines for safer sexual activity, several years before HIV/AIDS. Through such organizations as the National Coalition of Gay Sexually Transmitted Disease Services, Bay Area Physicians for Human Rights, and the Sisters of Perpetual Indulgence, these practitioners developed materials that would define sexual health education for the next four decades, as well as such concepts as "bodily fluids" and the "safe sex hanky." To do so, they used their dual membership in the community and the health professions...
June 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28422301/meeting-the-reproductive-health-needs-of-female-key-populations-affected-by-hiv-in-low-and-middle-income-countries-a-review-of-the-evidence
#9
Nicole B Ippoliti, Geeta Nanda, Rose Wilcher
Female sex workers and other women at high risk of acquiring HIV have the right to sexual and reproductive health, including the right to determine the number and timing of pregnancies. We conducted a literature review to examine the data that exist regarding the family planning and reproductive health needs of female key populations, the underlying determinants of these populations' vulnerability to poor reproductive health outcomes, and the obstacles they face in accessing high-quality reproductive health services...
April 19, 2017: Studies in Family Planning
https://www.readbyqxmd.com/read/28416241/circulating-tumor-dna-from-bench-to-bedside
#10
Joline S J Lim, Filip Janku, Timothy A Yap
In the era of personalized medicine, tumor sampling is paramount to enable the assessment of actionable molecular aberrations to help rationalize and guide treatment decisions. Longitudinal tracking of such aberrations may also be helpful to detect emerging drug resistance and to allow for timely modifications to ongoing therapies to improve patient outcomes. Nevertheless, tumor tissue sampling involves an invasive procedure with potential risks to patients and involves logistical challenges. As such, other less invasive and safer methods such as blood sampling for molecular profiling has been gaining traction...
March 1, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28364968/-sphenopalatine-ganglion-block-for-postdural-puncture-headache-in-ambulatory-setting
#11
José Miguel Cardoso, Miguel Sá, Rita Graça, Hugo Reis, Liliana Almeida, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Postdural puncture headache (PDPH) is a common complication following subarachnoid blockade and its incidence varies with the size of the needle used and the needle design. Supportive therapy is the usual initial approach. Epidural blood patch (EBP) is the gold-standard when supportive therapy fails but has significant risks associated. Sphenopalatine ganglion block (SPGB) may be a safer alternative. CASE REPORT: We observed a 41 year-old female patient presenting with PDPH after a subarachnoid blockade a week before...
March 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28362395/a-novel-technique-for-generating-and-observing-chemiluminescence-in-a-biological-setting
#12
Gabriel E Büchel, Brandon Carney, Jun Tang, Brian M Zeglis, Jörg Eppinger, Thomas Reiner
Intraoperative imaging techniques have the potential to make surgical interventions safer and more effective; for these reasons, such techniques are quickly moving into the operating room. Here, we present a new approach that utilizes a technique not yet explored for intraoperative imaging: chemiluminescent imaging. This method employs a ruthenium-based chemiluminescent reporter along with a custom-built nebulizing system to produce ex vivo or in vivo images with high signal-to-noise ratios. The ruthenium-based reporter produces light following exposure to an aqueous oxidizing solution and re-reduction within the surrounding tissue...
March 9, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28361508/delivering-safer-conception-services-to-hiv-serodiscordant-couples-in-kenya-perspectives-from-healthcare-providers-and-hiv-serodiscordant-couples
#13
Kenneth Ngure, Grace Kimemia, Kristin Dew, Njambi Njuguna, Nelly Mugo, Connie Celum, Jared M Baeten, Renee Heffron
INTRODUCTION: For HIV serodiscordant couples in resource-limited settings, pregnancy is common despite the risk of sexual and/or perinatal HIV transmission. Some safer conception strategies to reduce HIV transmission during pregnancy attempts are available but often not used for reasons including knowledge, accessibility, preference and others. We sought to understand Kenyan health providers' and HIV serodiscordant couples' perspectives and experiences with safer conception. METHODS: Between August 2015 and March 2016, we conducted key informant interviews (KIIs) with health providers from public and private HIV care and fertility clinics and in-depth interviews (IDIs) and focus group discussions (FGDs) with HIV serodiscordant couples participating in an open-label study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) for HIV prevention (the Partners Demonstration Project)...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361507/client-uptake-of-safer-conception-strategies-implementation-outcomes-from-the-sakh-umndeni-safer-conception-clinic-in-south-africa
#14
Sheree R Schwartz, Jean Bassett, Charles B Holmes, Nompumelelo Yende, Rebecca Phofa, Ian Sanne, Annelies Van Rie
INTRODUCTION: Implementation of safer conception services for HIV-affected couples within primary healthcare clinics in resource-limited settings remains limited. We review service utilization and safer conception strategy uptake during the first three years of Sakh'umndeni, which is a safer conception clinic in South Africa. METHODS: Sakh'umndeni is located at Witkoppen Health and Welfare Centre, a high-volume primary healthcare clinic in northern Johannesburg...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361506/supporting-hiv-prevention-and-reproductive-goals-in-an-hiv-endemic-setting-taking-safer-conception-services-from-policy-to-practice-in-south-africa
#15
Natasha E C G Davies, Lynn T Matthews, Tamaryn L Crankshaw, Di Cooper, Sheree R Schwartz
INTRODUCTION: Safer conception care encompasses HIV care, treatment and prevention for persons living with HIV and their partners who desire children. In 2012, South Africa endorsed a progressive safer conception policy supporting HIV-affected persons to safely meet reproductive goals. However, aside from select research-supported clinics, widespread implementation has not occurred. Using South Africa as a case study, we identify key obstacles to policy implementation and offer recommendations to catalyse expansion of these services throughout South Africa and further afield...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361503/offering-pre-exposure-prophylaxis-for-hiv-prevention-to-pregnant-and-postpartum-women-a-clinical-approach
#16
REVIEW
Dominika L Seidman, Shannon Weber, Deborah Cohan
INTRODUCTION: HIV prevention during pregnancy and lactation is critical for both maternal and child health. Pregnancy provides a critical opportunity for clinicians to elicit women's vulnerabilities to HIV and offer HIV testing, treatment and referral and/or comprehensive HIV prevention options for the current pregnancy, the postpartum period and safer conception options for future pregnancies. In this commentary, we review the safety of oral pre-exposure prophylaxis with tenofovir/emtricitabine in pregnant and lactating women and suggest opportunities to identify pregnant and postpartum women at substantial risk of HIV...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361502/achieving-pregnancy-safely-for-hiv-serodiscordant-couples-a-social-ecological-approach
#17
REVIEW
Haneefa T Saleem, Manjulaa Narasimhan, Julie A Denison, Caitlin E Kennedy
The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361500/the-role-of-family-planning-in-achieving-safe-pregnancy-for-serodiscordant-couples-commentary-from-the-united-states-government-s-interagency-task-force-on-family-planning-and-hiv-service-integration
#18
REVIEW
Jennifer Mason, Amy Medley, Sarah Yeiser, Vienna R Nightingale, Nithya Mani, Tabitha Sripipatana, Andrew Abutu, Beverly Johnston, D Heather Watts
INTRODUCTION: People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361324/coffee-the-key-to-safer-image-guided-surgery-a-granular-jamming-cap-for-non-invasive-rigid-fixation-of-fiducial-markers-to-the-patient
#19
Patrick S Wellborn, Neal P Dillon, Paul T Russell, Robert J Webster
PURPOSE: Accurate image guidance requires a rigid connection between tracked fiducial markers and the patient, which cannot be guaranteed by current non-invasive attachment techniques. We propose a new granular jamming approach to firmly, yet non-invasively, connect fiducials to the patient. METHODS: Our granular jamming cap surrounds the head and conforms to the contours of the patient's skull. When a vacuum is drawn, the device solidifies in a manner conceptually like a vacuum-packed bag of ground coffee, providing a rigid structure that can firmly hold fiducial markers to the patient's skull...
March 30, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28345750/subway-emergency-preparedness-in-shanghai-a-focused-group-and-interview-study-exploring-the-perceived-experiences-of-senior-citizens-and-the-disabled
#20
Benjamin Ohene Kwapong Baffoe, Zheng Shiyuan
As Shanghai's population increases and currently being boosted by an influx of foreigners, there has been pressure on the subway system and this has led to a great concern for the aged and disabled people (including foreigners) who use the subway during emergency situations. The present study uses an exploratory research approach including a focus group discussion (FGD) and interviews to uncover the experiences, safety concerns, and challenges that the aged and disabled faces when using the subway. A total of 38 participants were involved in the study, which comprises of three FGDs and interviews conducted in the city of Shanghai...
January 2017: Journal of Emergency Management: JEM
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