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https://www.readbyqxmd.com/read/29159738/prospective-assessment-of-first-year-quality-of-life-after-pelvic-exenteration-for-gynecologic-malignancy-a-french-multicentric-study
#1
A Martinez, T Filleron, P Rouanet, P Méeus, E Lambaudie, J M Classe, F Foucher, F Narducci, S Gouy, F Guyon, F Marchal, E Jouve, P E Colombo, A Mourregot, M Rivoire, N Chopin, G Houvenaeghel, I Jaffre, J Leveque, V Lavoue, E Leblanc, P Morice, E Stoeckle, J L Verheaghe, D Querleu, G Ferron
BACKGROUND: Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent. METHODS: A French multicentric prospective study was performed by including patients who underwent pelvic exenteration...
November 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29155338/financial-toxicity-in-bladder-cancer-patients-reasons-for-delay-in-care-and-effect-on-quality-of-life
#2
Marianne M Casilla-Lennon, Seul Ki Choi, Allison M Deal, Jeannette T Bensen, Gopal Narang, Pauline Filippou, Benjamin McCormick, Raj Pruthi, Eric Wallen, Hung-Jui Tan, Michael Woods, Matthew Nielsen, Angela Smith
PURPOSE: Costly surveillance and treatment of bladder cancer can lead to financial toxicity (FT), a treatment-related financial burden. Our objective was to define the prevalence of FT among bladder cancer patients and identify delays in care and its effect on health-related quality of life (HRQOL). METHODS: We identified bladder cancer patients in the UNC Health Registry/Cancer Survivorship Cohort. FT was defined as agreement with having "to pay more for medical care than you can afford...
November 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29130496/using-smart-design-to-improve-symptom-management-among-cancer-patients-a-study-protocol
#3
Alla Sikorskii, Gwen Wyatt, Rebecca Lehto, David Victorson, Terry Badger, Thaddeus Pace
In this in-progress sequential multiple assignment randomized trial (SMART), dyads of solid tumor cancer patients and their caregivers are initially randomized to 4 weeks of reflexology or meditative (mindfulness) practices provided by/with their caregiver in the patient's home or to a control group. After 4 weeks, intervention group dyads in which patients do not show improvement in fatigue (non-responders) are re-randomized to either receive additional time with the same therapy during weeks 5-8 or to add the other therapy...
November 11, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/29128151/is-the-choosing-wisely-%C3%A2-campaign-model-applicable-to-the-management-of-multiple-sclerosis-in-france-a-gresep-pilot-study
#4
B Trumbic, H Zéphir, J-C Ouallet, E Le Page, D Laplaud, C Bensa, J de Sèze
BACKGROUND: Launched in the US in 2012, Choosing Wisely(®) is a campaign promoted by the American Board of Internal Medicine (ABIM) Foundation with the goal of improving healthcare effectiveness by avoiding wasteful or unnecessary medical tests, treatments and procedures. It uses concise recommendations produced by national medical societies to start discussions between physicians and patients on the relevance of these services as part of a shared decision-making process. The Multiple Sclerosis Focus Group (Groupe de Reflexion Autour de la Sclérose en Plaques; GRESEP) undertook a pilot study to assess the relevance and feasibility of this approach in the management of multiple sclerosis (MS) in France...
November 8, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/29128080/-crossed-perceptions-about-malnutrition-in-patients-and-their-doctors-in-oncology
#5
Bruno Raynard, Xavier Hébuterne, François Goldwasser, Ali Ait Hssain, Pascale Dubray Longeras, Philippe Barthélémy, Edoardo Rosso, Valérie Phoutthasang, Camille Bories, Laurence Digue, David Laharie, Jean-Claude Desport, Sabrina Falkowski, Jean Lacau Saint Guily, Emmanuel Gyan
Malnutrition is common in oncology. However, it is often detected too late and nutritional support is sub-optimal. The patient's opinion, although often sought in therapeutic decisions in oncology, does not appear to be frequently taken into account in dietetic management. In NutriCancer2012 study, we interviewed patients, relatives and doctors about their perceptions of the impact of malnutrition and its quality of care. Of the 2209 patients questioned, majority said they were concerned about nutrition with 75% considering it essential to take appropriate nutritional care but only 19% self-reported link between malnutrition and fatigue...
November 8, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29127529/the-impact-of-prostate-cancer-diagnosis-and-treatment-decision-making-on-health-related-quality-of-life-before-treatment-onset
#6
Maarten Cuypers, Romy E D Lamers, Erik B Cornel, Lonneke V van de Poll-Franse, Marieke de Vries, Paul J M Kil
OBJECTIVE: The objective of this study is to test if patients' health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and after subsequent treatment decision-making in case Pca is confirmed, and to test whether personality state and traits are associated with these potential changes in HRQoL. METHODS: Patients who were scheduled for prostate biopsy to detect Pca (N = 377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), "big five" personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0)...
November 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29121886/the-strange-case-of-mr-h-starting-dialysis-at-90%C3%A2-years-of-age-clinical-choices-impact-on-ethical-decisions
#7
Giorgina Barbara Piccoli, Andreea Corina Sofronie, Jean-Philippe Coindre
BACKGROUND: Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. CASE PRESENTATION: Mr...
November 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29111627/quantification-of-bowling-workload-and-changes-in-cognitive-function-in-elite-fast-bowlers-in-training-compared-with-twenty20-cricket
#8
Jamie Tallent, Matthew Higgins, Nick Parker, Mark Waldron, Eoin Bradford, James Keenan, Barry V O'Neill
BACKGROUND: Bowling overs are the primary recorded measure for workloads in cricket for youth through to professionals. However, the validity of this measure has never been tested. Additionally, despite the cognitive component of cricket being suggested to be very high, changes in psychomotor processing speed has again not been explored. METHODS: Eight professional English county cricket bowlers participated in the study. Participants wore global positioning systems with a tri-axial accelerometer during a Twenty20 match and training...
November 7, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29110023/-modern-treatment-of-primary-biliary-cholangitis
#9
REVIEW
C P Strassburg
For nearly 30 years ursodeoxycholic acid (UDCA) represented the only pharmacological treatment option available for primary biliary cholangitis (PBC). This changed at the end of 2016 when obeticholic acid was licensed in Europe for PBC patients not responding to UDCA. Novel treatment concepts involving the modulation of nuclear receptor signaling in cholestatic and other liver diseases have led to a host of new potential options, studies and drug candidates for the treatment of PBC. The analysis of large multinational cohorts has additionally confirmed the effectiveness of UDCA in slowing PBC progression, and has led to the development of new definitions for the risk assessment of PBC patients under therapy, which will be an asset for clinical decision making...
November 6, 2017: Der Internist
https://www.readbyqxmd.com/read/29098917/sleep-pattern-and-decision-making-in-physicians-from-mobile-emergency-care-service-with-12-hour-work-schedules
#10
Eleni de Araújo Sales Castro, Katie Moraes de Almondes
INTRODUCTION: Shift work schedules are biological standpoint worse because compel the body to anticipate periods of wakefulness and sleep and thus eventually cause a disruption of biological rhythms. OBJECTIVE: To evaluate the sleep pattern and decision making in physicians working in mobile units of emergency attention undergoing Day Shift and Rotating Shift. METHODS: The study included 26 physicians. The instruments utilized were a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Sleep Habits Questionnaire, the Epworth Sleepiness Scale and Chronotype Identification Questionnaire of Horne-Ostberg, the Iowa Gambling Task (IGT) and hypothetical scenarios of decision-making created according to the Policy-Capturing Technique...
November 3, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29092783/determinants-of-policy-decisions-for-non-commercial-drivers-with-osa-an-integrative-review
#11
REVIEW
Dorrie Rizzo, Eva Libman, Laura Creti, Marc Baltzan, Sally Bailes, Catherine Fichten, Gilles Lavigne
Excessive daytime sleepiness and reduced cognitive functioning secondary to obstructive sleep apnea (OSA) have been identified as an important health-related risk in commercial transportation with, possibly, an increased chance of road accidents. This has resulted in a variety of policies and restrictions imposed on commercial drivers. Here we review current knowledge to assess whether available data are sufficient to guide policy decisions concerning restrictions for non-commercial drivers. The review shows that there is a lack of uniformity among different consensus conferences and guidelines as to how to deal with drivers with OSA...
February 20, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29092059/medication-related-clinical-decision-support-alert-overrides-in-inpatients
#12
Karen C Nanji, Diane L Seger, Sarah P Slight, Mary G Amato, Patrick E Beeler, Qoua L Her, Olivia Dalleur, Tewodros Eguale, Adrian Wong, Elizabeth R Silvers, Michael Swerdloff, Salman T Hussain, Nivethietha Maniam, Julie M Fiskio, Patricia C Dykes, David W Bates
Objective: To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. Materials and Methods: We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons...
October 27, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29068736/emotional-labour-learning-from-the-past-understanding-the-present
#13
Chris Elliott
The number of nurses considering leaving the profession has continued to rise, and in many areas there is a nursing shortfall. For many of those leaving the profession, the decision results from workplace stress. This article examines the concept of emotional labour, which has been linked to compassion fatigue and subsequent burnout. Emotional labour is the term used to describe the process of displaying outward emotion that may not match our internal emotion; this dissonance can lead to highly stressful situations...
October 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29052163/the-use-of-health-state-utility-values-in-decision-models
#14
REVIEW
Roberta Ara, John Brazier, Ismail Azzabi Zouraq
Methodological issues of how to use health state utility values (HSUVs) in decision models arise frequently, including the most appropriate evidence to use as the baseline (e.g. the baseline HSUVs associated with avoiding a particular health condition or event), how to capture changes due to adverse events and how to appropriately capture uncertainty in progressive conditions where the expected change in quality of life is likely to be monotonically decreasing over time. As preference-based measures provide different values when collected from the same patient, it is important to ensure that all HSUVs used within a single model are obtained from the same instrument where ever possible...
October 19, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#15
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29029694/prescriber-response-to-computerized-drug-alerts-for-electronic-prescriptions-among-hospitalized-patients
#16
Yael Zenziper Straichman, Daniel Kurnik, Ilan Matok, Hillel Halkin, Noa Markovits, Amitai Ziv, Ari Shamiss, Ronen Loebstein
BACKGROUND: Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, "alert fatigue", and indiscriminate rejection. OBJECTIVES: To compare acceptance rates of alerts generated by the SafeRx(®) prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine whether alert overrides were justified. METHODS: In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel's largest tertiary care center...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29018561/disturbed-eeg-sleep-paranoid-cognition-and-somatic-symptoms-identify-veterans-with-post-traumatic-stress-disorder
#17
Harvey Moldofsky, Lorne Rothman, Robert Kleinman, Shawn G Rhind, J Donald Richardson
BACKGROUND: Chronic post-traumatic stress disorder (PTSD) behavioural symptoms and medically unexplainable somatic symptoms are reported to occur following the stressful experience of military combatants in war zones. AIMS: To determine the contribution of disordered EEG sleep physiology in those military combatants who have unexplainable physical symptoms and PTSD behavioural difficulties following war-zone exposure. METHOD: This case-controlled study compared 59 veterans with chronic sleep disturbance with 39 veterans with DSM-IV and clinician-administered PTSD Scale diagnosed PTSD who were unresponsive to pharmacological and psychological treatments...
November 2016: BJPsych Open
https://www.readbyqxmd.com/read/29016607/incidence-and-severity-of-self-reported-chemotherapy-side-effects-in-routine-care-a-prospective-cohort-study
#18
Alison Pearce, Marion Haas, Rosalie Viney, Sallie-Anne Pearson, Philip Haywood, Chris Brown, Robyn Ward
AIM: Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. METHODS: We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report...
2017: PloS One
https://www.readbyqxmd.com/read/28983495/effect-of-fatigue-on-reading-computed-tomography-examination-of-the-multiply-injured-patient
#19
Elizabeth A Krupinski, Kevin M Schartz, Mark S Van Tassell, Mark T Madsen, Robert T Caldwell, Kevin S Berbaum
Our goal was to ascertain how fatigue affects performance in reading computed tomography (CT) examinations of patients with multiple injuries. CT images with multiple fractures from a previous study of satisfaction of search (SOS) were read by radiologists after a day of clinical work. Performance in this study with fatigued readers was compared to a previous study in which readers were not fatigued. Detection accuracy for obvious injuries was not affected by fatigue, but accuracy for subtle fractures was reduced ([Formula: see text])...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28976408/real-world-safety-and-patient-profile-of-fingolimod-in-relapsing-remitting-multiple-sclerosis-a-prospective-analysis-in-buenos-aires-argentina
#20
Juan Ignacio Rojas, Liliana Patrucco, Jimena Miguez, Edgardo Cristiano
OBJECTIVE: The aim was to evaluate fingolimod safety and patient profiles in a real-world setting in Buenos Aires, Argentina. METHODS: Relapsing-remitting patients with multiple sclerosis who had been prescribed fingolimod and at least 18 months or more of follow-up were included. Demographic, clinical, and safety issues were described during first dose and follow-up. RESULTS: A total of 145 patients were included, 68% female; mean age, 30 ± 10...
November 2017: Clinical Neuropharmacology
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