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Intuition in medical practice

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https://www.readbyqxmd.com/read/28526721/health-care-resource-utilization-and-associated-costs-among-metastatic-cutaneous-melanoma-patients-treated-with-ipilimumab-intuition-study
#1
Grant A McArthur, Peter Mohr, Paolo Antonio Ascierto, Ana Arance, Ana Banos Hernaez, Peter Kaskel, Michael Weichenthal, Reshma Shinde, Kendall Stevinson
BACKGROUND: There are limited real-world data on health care resource utilization (HCRU) among advanced melanoma patients. The objective of this study was to describe HCRU and health care costs associated with the management of advanced melanoma patients receiving ipilimumab. METHODS: This retrospective multinational, observational study included advanced melanoma patients from Australia, Germany, Italy, and Spain who had received at least 1 dose of ipilimumab. Data extracted from medical charts included inpatient admissions, outpatient visits, surgical procedures, laboratory investigations, radiation therapy, imaging studies, and concomitant medications...
May 19, 2017: Oncologist
https://www.readbyqxmd.com/read/28471111/intelligent-diagnosis-of-jaundice-with-dynamic-uncertain-causality-graph-model
#2
Shao-Rui Hao, Shi-Chao Geng, Lin-Xiao Fan, Jia-Jia Chen, Qin Zhang, Lan-Juan Li
Jaundice is a common and complex clinical symptom potentially occurring in hepatology, general surgery, pediatrics, infectious diseases, gynecology, and obstetrics, and it is fairly difficult to distinguish the cause of jaundice in clinical practice, especially for general practitioners in less developed regions. With collaboration between physicians and artificial intelligence engineers, a comprehensive knowledge base relevant to jaundice was created based on demographic information, symptoms, physical signs, laboratory tests, imaging diagnosis, medical histories, and risk factors...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28464865/empathy-in-psychoanalysis-and-medical-education-what-can-we-learn-from-each-other
#3
Henriette Löffler-Stastka, Felicitas Datz, Karoline Parth, Ingrid Preusche, Xenia Bukowski, Charles Seidman
BACKGROUND: Several research areas, including medical education (ME), focus on empathy as an important topic in interpersonal relationships. This focus is central to the use of communication skills related to empathy and even more crucial to provide information in a way that makes patients feel more involved in the treatment process. Psychoanalysis (PA) provides its initial concept of empathy based on affective aspects including findings from neuroscience and brain research. Enhancing cooperation between ME and PA can help to integrate both aspects of empathy into a longitudinal training program...
May 2, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28460709/assessment-of-knowledge-in-palliative-care-of-physical-therapists-students-at-a-university-hospital-in-brazil
#4
Livia R Zalaf, Mayara S Bianchim, Daniel A Alveno
BACKGROUND: In Brazil there are several challenges to reach a humanized health care. Among them is the well-known lack in academic education and training in palliative care field. This lack is mostly due to the modern medical care culture that prioritize curative medicine ahead of palliative care. As the goal of saving lives is rooted in medical training, death is still confronted as the main enemy of the health professionals. OBJECTIVE: To analyze the knowledge of palliative care among the physical therapists of a University Hospital...
March 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28454581/changing-the-culture-of-assessment-the-dominance-of-the-summative-assessment-paradigm
#5
Christopher J Harrison, Karen D Könings, Lambert W T Schuwirth, Valerie Wass, Cees P M van der Vleuten
BACKGROUND: Despite growing evidence of the benefits of including assessment for learning strategies within programmes of assessment, practical implementation of these approaches is often problematical. Organisational culture change is often hindered by personal and collective beliefs which encourage adherence to the existing organisational paradigm. We aimed to explore how these beliefs influenced proposals to redesign a summative assessment culture in order to improve students' use of assessment-related feedback...
April 28, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28344696/systems-1-and-2-thinking-processes-and-cognitive-reflection-testing-in-medical-students
#6
Shu Wen Tay, Paul Ryan, C Anthony Ryan
BACKGROUND: Diagnostic decision-making is made through a combination of Systems 1 (intuition or pattern-recognition) and Systems 2 (analytic) thinking. The purpose of this study was to use the Cognitive Reflection Test (CRT) to evaluate and compare the level of Systems 1 and 2 thinking among medical students in pre-clinical and clinical programs. METHODS: The CRT is a three-question test designed to measure the ability of respondents to activate metacognitive processes and switch to System 2 (analytic) thinking where System 1 (intuitive) thinking would lead them astray...
October 2016: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28341982/pocket-sized-point-of-care-cardiac-ultrasound-devices-role-in-the-emergency-department
#7
A Colclough, P Nihoyannopoulos
BACKGROUND: Acute breathlessness accounts for 8% of accident and emergency attendances. Point-of-care cardiac ultrasound (US) effectively reduces time to diagnosis. Fast and practical information via pocket-sized cardiac US devices may better the diagnosis in this complex patient group. METHODS: We prospectively enrolled 40 consecutive patients presenting with shortness of breath at the emergency department (ED). Divided into two groups were all adult patients over 18 with acute breathing difficulties (triage category 1-3): 21 patients received a short focused cardiac US scan using a pocket-sized Vscan and 19 patients received no scan...
May 2017: Herz
https://www.readbyqxmd.com/read/28296165/nice-to-watch-students-evaluate-online-lectures
#8
Nancy Sturman, Benjamin Mitchell, Amy Mitchell
BACKGROUND: Many clinical teachers who previously gave face-to-face lectures now record presentations for students to view asynchronously online. These teachers need to understand student expectations of online lectures (OLLs), and their place in the overall 'ecology' of student learning resources, in order to ensure that students watch, and learn from, their lectures. METHODS: We conducted focus groups with a convenience sample of medical students undertaking their general practice placements, exploring student uses, evaluations and expectations of OLLs...
March 14, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28157389/critical-thinking-in-critical-care-five-strategies-to-improve-teaching-and-learning-in-the-intensive-care-unit
#9
Margaret M Hayes, Souvik Chatterjee, Richard M Schwartzstein
Critical thinking, the capacity to be deliberate about thinking, is increasingly the focus of undergraduate medical education, but is not commonly addressed in graduate medical education. Without critical thinking, physicians, and particularly residents, are prone to cognitive errors, which can lead to diagnostic errors, especially in a high-stakes environment such as the intensive care unit. Although challenging, critical thinking skills can be taught. At this time, there is a paucity of data to support an educational gold standard for teaching critical thinking, but we believe that five strategies, routed in cognitive theory and our personal teaching experiences, provide an effective framework to teach critical thinking in the intensive care unit...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28129956/-medically-unexplained-symptoms-care-in-internal-medicine-a-paradigm-of-doctor-patient-relationship-in-situation-of-uncertainty
#10
B Ranque, O Nardon
Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28122614/clinical-decision-making-in-the-recognition-of-dying-a-qualitative-interview-study
#11
Paul Taylor, Dawn Dowding, Miriam Johnson
BACKGROUND: Recognising dying is an essential clinical skill for general and palliative care professionals alike. Despite the high importance, both identification and good clinical care of the dying patient remains extremely difficult and often controversial in clinical practice. This study aimed to answer the question: "What factors influence medical and nursing staff when recognising dying in end-stage cancer and heart failure patients?" METHODS: This study used a descriptive approach to decision-making theory...
January 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28048739/tu-ab-207a-03-image-quality-dose-and-clinical-applications
#12
F Dong
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048020/tu-ab-207a-00-ct-systems-course
#13
Baojun Li
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047355/tu-ab-207a-01-image-acquisition-physics-and-hardware
#14
B Li
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046685/tu-ab-207a-02-image-reconstruction-and-artifact-reduction
#15
J Hsieh
Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality. This course will not focus on the rapid-changing advanced technologies given the two-hour time limit, but the fundamental principles discussed in this course may facilitate better understanding of those more complicated technologies...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031958/life-as-an-early-career-researcher-interview-with-kavita-beri
#16
Kavita Beri
Kavita Beri speaks to Francesca Lake, Managing Editor. Kavita Beri is a board certified Internal Medicine physician in the United States, and is an active member of the American Society of Laser Medicine and Surgery. She is the medical director and owner of BE Skin & Laser Med Spa, an aesthetic medicine practice in NJ, USA. She holds a position as a Visiting Scientist at the Department of Biomaterials and Center for Dermal Research at Rutgers University (NJ, USA) and is an active staff member in the Department of Medicine at Jersey Shore University Medical Center (NJ, USA)...
June 2016: Future Science OA
https://www.readbyqxmd.com/read/27981654/knowing-how-we-know-an-epistemological-rationale-for-the-medical-humanities
#17
Neville Chiavaroli
CONTEXT: Although their inclusion in medical curricula internationally is increasing, the medical humanities still face challenges to their role and place in the curriculum. Justifications supporting the inclusion of humanities content, methods and perspectives in medical curricula have generally been proposed along instrumental, intrinsic and critical lines. However, recent literature in the field has turned to 'ways of knowing' as representing an alternative, essentially epistemological, perspective on the matter...
January 2017: Medical Education
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#18
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27884918/patients-beliefs-on-the-impediments-to-good-diabetes-control-a-mixed-methods-study-of-patients-in-general-practice
#19
Amanda Jane Elliott, Fiona Harris, Sandra G Laird
BACKGROUND: Most people with diabetes are not attaining desirable levels of HbA1c (glycated haemoglobin), or of blood pressure and cholesterol, leaving them at risk of developing complications. AIM: To identify ways of improving diabetes control by gaining insight into patients' attitudes/beliefs. DESIGN AND SETTING: Questionnaires were offered to patients attending for a diabetes review in the 24 GP practices of North East Hampshire and Farnham Clinical Commissioning Group...
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27876238/thermography-examination-of-abdominal-area-skin-temperatures-in-individuals-with-and-without-focal-onset-epilepsy
#20
Hollis H King, Charles Thomas Cayce, Jeph Herrin
Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures...
January 2017: Explore: the Journal of Science and Healing
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