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https://www.readbyqxmd.com/read/29452361/iui-review-and-systematic-assessment-of-the-evidence-that-supports-global-recommendations
#1
Ben Cohlen, Aartjan Bijkerk, Sheryl Van der Poel, Willem Ombelet
BACKGROUND: IUI with or without ovarian stimulation (OS) has become a first-line treatment option for many infertile couples, worldwide. The appropriate treatment modality for couples and their clinical management through IUI or IUI/OS cycles must consider maternal and perinatal outcomes, most notably the clinical complication of higher-order multiple pregnancies associated with IUI-OS. With a current global emphasis to continue to decrease maternal and perinatal mortality and morbidity, the World Health Organization (WHO) had established a multi-year project to review the evidence for the establishment of normative guidance for the implementation of IUI as a treatment to address fertility problems, and to consider its cost-effectiveness for lower resource settings...
February 14, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29452291/pharmacokinetic-models-to-assist-the-prescriber-in-choosing-the-best-tacrolimus-dose
#2
REVIEW
Jean-Baptiste Woillard, Franck Saint-Marcoux, Jean Debord, Anders Åsberg
Due to a high inter-individual variability in its pharmacokinetics, tacrolimus dose individualization is mandatory. Even though the expert opinion has defined the area under the curve (AUC) as the best marker to use when performing dose adjustment of tacrolimus, most centres only use trough levels. Multiple targets have been proposed for this parameter and physicians rely largely on their personal experience when making a decision about dose adjustment. Several population pharmacokinetics models (POPPK) allowing AUC determination have been developed, but only a few are actually used in routine practice for dose individualization...
February 13, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29451516/-evidence-based-medicine-vs-personalized-medicine
#3
Lucio Capurso
Evidence-based medicine (EBM) and personalized medicine (PM) are driven by two diverse modes of reasoning about «evidence making». EBM has been criticized since his quality mark has been misappropriated by vested interests, the benefits statistically significant may be marginal in clinical practice, rigid rules and technology may produce care that is management driven rather than patient centered. On the contrary PM (or "precision medicine") refers to the tailoring of medical treatment to the specific characteristics of each patient involving the ability to classify individuals into subpopulations that are uniquely susceptible to a specific treatment, sparing expense and side effects and is derived from doubts on the results of subgroup analyses and on non responders in clinical trials typical of EBM...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29450795/ethics-and-confidentiality-for-psychologists-in-academic-health-centers
#4
Kathleen Ashton, Amy Sullivan
Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care...
February 15, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29449241/simplified-guideline-for-prescribing-medical-cannabinoids-in-primary-care
#5
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29447370/management-of-gout-by-uk-rheumatologists-a-british-society-for-rheumatology-national-audit
#6
Edward Roddy, Jon Packham, Karen Obrenovic, Ali Rivett, Joanna M Ledingham
Objectives: To assess the concordance of gout management by UK rheumatologists with evidence-based best-practice recommendations. Methods: Data were collected on patients newly referred to UK rheumatology out-patient departments over an 8-week period. Baseline data included demographics, method of diagnosis, clinical features, comorbidities, urate-lowering therapy (ULT), prophylaxis and blood tests. Twelve months later, the most recent serum uric acid level was collected...
February 13, 2018: Rheumatology
https://www.readbyqxmd.com/read/29447071/a-social-media-intervention-to-improve-hypoglycaemia-management-at-a-multi-centre-hospital-a-quality-improvement-pilot-for-clinical-nurses
#7
Filomena De Sousa, Jennifer Jackson, Ruth Knight, Edith Cloutier, Rosemary Basa, Anne Fourney, Kathleen Devecseri
BACKGROUND: Hypoglycaemia is associated with increased mortality, length of stay, readmission and adverse events. Nursing management of hypoglycaemia is a challenge, despite established best practice guidelines. Social media is an effective tool for sharing information, and had potential to overcome barriers to clinical education at a multi-centre hospital. AIMS: The purpose of this quality improvement intervention was to create and disseminate social media posts about best practices in hypoglycaemia management...
February 15, 2018: Contemporary Nurse
https://www.readbyqxmd.com/read/29446451/practical-data-collection-and-extraction-for-big-data-applications-in-radiotherapy
#8
Todd R McNutt, Michael Bowers, Sierra Cheng, Peijin Han, Xuan Hui, Joseph Moore, Scott Robertson, Charles Mayo, Ranh Voong, Harry Quon
The capture of high quality treatment and outcomes data is necessary in order to learn from our clinical experiences with big data analytics. In radiotherapy, there are several practical challenges to overcome. Practical aspects of data collection are discussed pointing to a need for a culture change in clinical practice to one that captures structured patient related data in routine care in a prospective manner. Radiation dosimetry and the contoured anatomy must also be captured routinely to represent the best estimate of delivered radiation...
February 15, 2018: Medical Physics
https://www.readbyqxmd.com/read/29445900/clinical-interpretation-of-pathogenic-atm-and-chek2-variants-on-multigene-panel-tests-navigating-moderate-risk
#9
Allison H West, Kathleen R Blazer, Jessica Stoll, Matthew Jones, Caroline M Weipert, Sarah M Nielsen, Sonia S Kupfer, Jeffrey N Weitzel, Olufunmilayo I Olopade
Comprehensive genomic cancer risk assessment (GCRA) helps patients, family members, and providers make informed choices about cancer screening, surgical and chemotherapeutic risk reduction, and genetically targeted cancer therapies. The increasing availability of multigene panel tests for clinical applications allows testing of well-defined high-risk genes, as well as moderate-risk genes, for which the penetrance and spectrum of cancer risk are less well characterized. Moderate-risk genes are defined as genes that, when altered by a pathogenic variant, confer a 2 to fivefold relative risk of cancer...
February 14, 2018: Familial Cancer
https://www.readbyqxmd.com/read/29444700/pharmacotherapies-for-fatigue-in-chronic-liver-disease-cld-a-systematic-review-and-meta-analysis-protocol
#10
Andem Effiong, Prerna Kumari
BACKGROUND: This is the protocol for a systematic review (and meta-analysis) of an intervention. The primary objective of this systematic review will be to assess the benefits and harms of pharmacological therapies (pharmacotherapies) for the management of fatigue in adults with CLD of any etiology. The effects of pharmacological therapies on fatigue in CLD will be compared against those of placebo, no intervention, or non-pharmacological interventions. Specifically, this review will examine whether pharmacological therapies improve CLD-associated fatigue, and if they do, what key elements are associated with their effectiveness...
February 14, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29444339/nursing-intensive-care-satisfaction-scale-nicss-development-and-validation-of-a-patient-centered-instrument
#11
M Romero-García, L de la Cueva-Ariza, Ll Benito-Aracil, T M Lluch-Canut, J Trujols-Albet, M A Martínez-Momblan, M E Juvé-Udina, P Delgado-Hito
AIM: To develop and validate the Nursing Intensive-Care-Satisfaction-Scale to measures satisfaction with nursing care from the critical care patient's perspective. BACKGROUND: Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units...
February 14, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29444256/dose-effect-of-patient-care-team-communication-via-secure-portal-messaging-on-glucose-and-blood-pressure-control
#12
Eboni G Price-Haywood, Qingyang Luo, Dominique Monlezun
Objectives: Organizational strategies for implementing eHealth tools influence patient and provider use of portal technology. This study examines whether the intensity of bidirectional secure portal messaging is associated with improved clinical outcomes. Material and Methods: This is a retrospective cohort analysis of 101 019 patients with diabetes or hypertension (11 138 active portal users) who received primary care within the Ochsner Health System between 2012 and 2014...
February 9, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29443719/the-time-is-now-using-graduates-practice-data-to-drive-medical-education-reform
#13
Marc M Triola, Richard E Hawkins, Susan E Skochelak
Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both in terms of the quality of the care they provide and the clinical challenges they face, can aid educators in taking an evidence-based approach to medical education...
February 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29441604/national-survey-of-patch-testing-in-the-united-kingdom-and-republic-of-ireland-what-proportion-of-the-population-is-and-should-be-tested
#14
Bevin Bhoyrul, Samantha Keegan, Avad Mughal
BACKGROUND: An initial study of patch testing practices across Wales, United Kingdom, showed wide variation in practice against a standardized set of guidelines and best practice recommendations. OBJECTIVES: To evaluate (i) current patch testing practice on a national level in the United Kingdom and Republic of Ireland (ROI), (ii) compliance with the current published guidelines, and (iii) the proportion of the catchment population tested by patch testing centres...
February 14, 2018: Contact Dermatitis
https://www.readbyqxmd.com/read/29439286/evidence-flowers-an-innovative-visual-method-of-presenting-best-evidence-summaries-to-health-professional-and-lay-audiences
#15
O O Babatunde, V Tan, J L Jordan, K Dziedzic, C A Chew-Graham, C Jinks, J Protheroe, D A van der Windt
BACKGROUND & AIMS: Barriers to dissemination and engagement with evidence pose a threat to implementing evidence-based medicine. Understanding, retention and recall can be enhanced by visual presentation of information. The aim of this exploratory research was to develop and evaluate the accessibility and acceptability of visual summaries for presenting evidence syntheses with multiple exposures or outcomes to professional and lay audiences. METHODS: 'Evidence flowers' were developed as a visual method of presenting data from four case scenarios: two complex evidence syntheses with multiple outcomes, Cochrane reviews and clinical guidelines...
February 13, 2018: Research Synthesis Methods
https://www.readbyqxmd.com/read/29439280/-adherence-to-immunosuppressive-medication-following-organ-transplantation
#16
Mariel Nöhre, Yesim Erim, Frank Vitinius, Felix Klewitz, Mario Schiffer, Martina de Zwaan
Organ transplantation is the best and to some extent only option for many patients with chronic organ failure. Usually after successful transplantation patients experience a significant improvement of their condition. Nevertheless, they are not cured but still chronically ill. Living with an organ transplant requires consequent immunosuppression intake, regular physician visits and following the recommendations regarding infection prevention. These factors are important to secure a long transplant survival...
February 13, 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/29438602/international-consensus-statement-on-allergy-and-rhinology-allergic-rhinitis
#17
Sarah K Wise, Sandra Y Lin, Elina Toskala, Richard R Orlandi, Cezmi A Akdis, Jeremiah A Alt, Antoine Azar, Fuad M Baroody, Claus Bachert, G Walter Canonica, Thomas Chacko, Cemal Cingi, Giorgio Ciprandi, Jacquelynne Corey, Linda S Cox, Peter Socrates Creticos, Adnan Custovic, Cecelia Damask, Adam DeConde, John M DelGaudio, Charles S Ebert, Jean Anderson Eloy, Carrie E Flanagan, Wytske J Fokkens, Christine Franzese, Jan Gosepath, Ashleigh Halderman, Robert G Hamilton, Hans Jürgen Hoffman, Jens M Hohlfeld, Steven M Houser, Peter H Hwang, Cristoforo Incorvaia, Deborah Jarvis, Ayesha N Khalid, Maritta Kilpeläinen, Todd T Kingdom, Helene Krouse, Desiree Larenas-Linnemann, Adrienne M Laury, Stella E Lee, Joshua M Levy, Amber U Luong, Bradley F Marple, Edward D McCoul, K Christopher McMains, Erik Melén, James W Mims, Gianna Moscato, Joaquim Mullol, Harold S Nelson, Monica Patadia, Ruby Pawankar, Oliver Pfaar, Michael P Platt, William Reisacher, Carmen Rondón, Luke Rudmik, Matthew Ryan, Joaquin Sastre, Rodney J Schlosser, Russell A Settipane, Hemant P Sharma, Aziz Sheikh, Timothy L Smith, Pongsakorn Tantilipikorn, Jody R Tversky, Maria C Veling, De Yun Wang, Marit Westman, Magnus Wickman, Mark Zacharek
BACKGROUND: Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR). METHODS: Using previously described methodology, specific topics were developed relating to AR...
February 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29438566/a-theoretical-model-of-resource-oriented-music-therapy-with-informal-hospice-caregivers-during-pre-bereavement
#18
Noah Potvin, Joke Bradt, Claire Ghetti
Background: Over the past decade, caregiver pre-bereavement has received increased scholarly and clinical attention across multiple healthcare fields. Pre-bereavement represents a nascent area for music therapy to develop best practices in and an opportunity to establish clinical relevancy in the interdisciplinary team. Objective: This study was an exploratory inquiry into the role of music therapy with pre-bereaved informal hospice caregivers. This study intended to articulate (a) what pre-bereavement needs are present for informal hospice caregivers, (b) which of those needs were addressed in music, and (c) the process by which music therapy addressed those needs...
February 9, 2018: Journal of Music Therapy
https://www.readbyqxmd.com/read/29438070/successfully-reducing-newborn-asphyxia-in-the-labour-unit-in-a-large-academic-medical-centre-a-quality-improvement-project-using-statistical-process-control
#19
Rikke von Benzon Hollesen, Rie Laurine Rosenthal Johansen, Christina Rørbye, Louise Munk, Pierre Barker, Anette Kjaerbye-Thygesen
BACKGROUND: A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. METHODS: The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network...
February 3, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29437084/increasing-adherence-to-brain-trauma-foundation-guidelines-for-hospital-care-of-patients-with-traumatic-brain-injury
#20
Ali A Saherwala, Mary Kay Bader, Sonja E Stutzman, Stephen A Figueroa, Jamshid Ghajar, April R Gorman, Abu Minhajuddin, DaiWai M Olson
BACKGROUND: The Brain Trauma Foundation has developed treatment guidelines for the care of patients with acute traumatic brain injury. The Adam Williams Initiative is a program established to provide education and resources to encourage hospitals across the United States to incorporate the guidelines into practice. OBJECTIVE: To explore the relationship in hospitals between participation in the Adam Williams Initiative and adherence to the Brain Trauma Foundation guidelines for patients with acute traumatic brain injury...
February 2018: Critical Care Nurse
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