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Observed structured clinical exam

Rachel Boxio, Julien Wartelle, Béatrice Nawrocki-Raby, Brice Lagrange, Laurette Malleret, Timothee Hirche, Clifford Taggart, Yves Pacheco, Gilles Devouassoux, Abderrazzaq Bentaher
BACKGROUND: In acutely injured lungs, massively recruited polymorphonuclear neutrophils (PMNs) secrete abnormally neutrophil elastase (NE). Active NE creates a localized proteolytic environment where various host molecules are degraded leading to impairment of tissue homeostasis. Among the hallmarks of neutrophil-rich pathologies is a disrupted epithelium characterized by the loss of cell-cell adhesion and integrity. Epithelial-cadherin (E-cad) represents one of the most important intercellular junction proteins...
October 17, 2016: Respiratory Research
Tomohiro Sonoo, Satoshi Iwai, Ryota Inokuchi, Masataka Gunshin, Yoichi Kitsuta, Susumu Nakajima
Along with article-based checklists, structured template recording systems have been reported as useful to create more accurate clinical recording, but their contributions to the improvement of the quality of patient care have been controversial. An emergency department (ED) must manage many patients in a short time. Therefore, such a template might be especially useful, but few ED-based studies have examined such systems.A structured template produced according to widely used head injury guidelines was used by ED residents for head injury patients...
October 2016: Medicine (Baltimore)
Myrthe van der Ven, Maren C Karreman, Angelique E A M Weel, Ilja Tchetverikov, Marijn Vis, Tamar E C Nijsten, Johanna M W Hazes, Jolanda J Luime
OBJECTIVES: Part of the psoriasis patients with musculoskeletal complaints will have inflammation of the entheses. Entheseal inflammation is difficult to assess by clinical examination only. Therefore, we aimed to determine the frequency of clinically relevant ultrasound inflammation at the most commonly assessed entheses (MASEI; Madrid Sonographic Enthesis Index) in primary care psoriasis patients with one or more tender entheses. METHODS: Adult primary care psoriasis patients with musculoskeletal complaints (tender enthesis or arthritis at physical examination) had an ultrasound examination of seven entheses according to the MASEI...
September 8, 2016: Clinical and Experimental Rheumatology
R Brent Stansfield, Lisa Diponio, Cliff Craig, John Zeller, Edmund Chadd, Joshua Miller, Seetha Monrad
BACKGROUND: Medical students have difficulty performing and interpreting musculoskeletal physical examinations and interpreting the findings. Research has focused on students' knowledge deficits, but there are few direct assessments of students' ability to perform a hypothesis-driven physical examination (HDPE). We developed a novel musculoskeletal Objective Structured Clinical Exam (OSCE) focusing on HDPE skills for disorders of the shoulder, back and knee, and used it to explore medical student diagnostic reasoning...
October 14, 2016: BMC Medical Education
Benard O Botwe, Lawrence Arthur, Michael K K Tenkorang, Samuel Anim-Sampong
INTRODUCTION: It is important that theory is synchronous with clinical practices that students engage in. Lack of congruence between theory and practice presents serious problems to students. This study was therefore conducted to determine if there was a theory-practice gap in chest radiography during clinical rotations, and any associated causes and effects on radiography students. METHOD: A descriptive survey design was used to conduct this study from 2 February to 27 July 2014...
June 11, 2016: Journal of Medical Radiation Sciences
Islay Mactaggart, Hannah Kuper, G V S Murthy, Joseph Oye, Sarah Polack
PURPOSE: To investigate the relationship between two distinct measures of disability: self-reported functional limitations and objectively-screened clinical impairments. METHODS: We undertook an all age population-based survey of disability in two areas: North-West Cameroon (August/October 2013) and Telangana State, India (Feb/April 2014). Participants were selected for inclusion via two-stage cluster randomised sampling (probability proportionate to size cluster selection and compact segment sampling within clusters)...
2016: PloS One
Benjamin E Yerys, Jenelle Nissley-Tsiopinis, Ashley de Marchena, Marley W Watkins, Ligia Antezana, Thomas J Power, Robert T Schultz
Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition (ADHD-RS-IV), the relationship of ADHD-RS-IV ratings with participant characteristics and behaviors, and its underlying factor structure in 386, 7-17 year olds with ASD without intellectual disability...
October 13, 2016: Journal of Autism and Developmental Disorders
Christopher A Seid, Kathryn M Jones, Jeroen Pollet, Brian Keegan, Elissa Hudspeth, Molly Hammond, Junfei Wei, C Patrick McAtee, Leroy Versteeg, Amanda Gutierrez, Zhuyun Liu, Bin Zhan, Jonathan L Respress, Ulrich Strych, Maria Elena Bottazzi, Peter J Hotez
A therapeutic vaccine for human Chagas disease is under development by the Sabin Vaccine Institute Product Development Partnership. The aim of the vaccine is to significantly reduce the parasite burden of Trypanosoma cruzi in humans, either as a standalone product or in combination with conventional chemotherapy. Vaccination of mice with Tc24 formulated with monophosphoryl-lipid A (MPLA) adjuvant results in a Th1 skewed immune response with elevated IgG2a and IFNγ levels and a statistically significant decrease in parasitemia following T...
October 13, 2016: Human Vaccines & Immunotherapeutics
Xin Wang, Stephen Birch, Weiming Zhu, Huifen Ma, Mark Embrett, Qingyue Meng
BACKGROUND: Increases in health care utilization and costs, resulting from the rising prevalence of chronic conditions related to the aging population, is exacerbated by a high level of fragmentation that characterizes health care systems in China. There have been several pilot studies in China, aimed at system-level care coordination and its impact on the full integration of health care system, but little is known about their practical effects. Huangzhong County is one of the pilot study sites that introduced organizational integration (a dimension of integrated care) among health care institutions as a means to improve system-level care coordination...
October 12, 2016: BMC Health Services Research
Katarzyna Taran, Tomasz FrÄ Czek, Anita Sikora-Szubert, Anna Sitkiewicz, Wojciech Må Ynarski, Józef Kobos, Piotr Paneth
The paper describes a novel approach to investigating Wilms' tumour (nephroblastoma) biology at the atomic level. Isotope Ratio Mass Spectrometry (IRMS) was used to directly assess the isotope ratios of nitrogen and carbon in 84 Wilms' tumour tissue samples from 28 cases representing the histological spectrum of nephroblastoma. Marked differences in nitrogen and carbon isotope ratios were found between nephroblastoma histological types and along the course of cancer disease, with a breakout in isotope ratio of the examined elements in tumour tissue found between stages 2 and 3...
October 8, 2016: Oncotarget
Daniela Schoberer, Helena Leino-Kilpi, Helga E Breimaier, Ruud Jg Halfens, Christa Lohrmann
PURPOSE OF THE STUDY: Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents. METHODS: A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents...
2016: Clinical Interventions in Aging
Mary de Groot, Kent A Crick, Molly Long, Chandan Saha, Jay H Shubrook
OBJECTIVE: Depression in patients with type 2 diabetes (T2D) is associated with long-term complications, disability, and early mortality. No studies have systematically examined the length of episodes and remission in adults with major depressive disorder (MDD) and T2D. This study examined the course of depressive disorders in patients with T2D and MDD. RESEARCH DESIGN AND METHODS: Participants (N = 50) enrolled in a behavioral intervention for adults with T2D and MDD were interviewed using the Structured Clinical Interview for DSM-IV-TR to assess history of depressive disorders at baseline (lifetime history), postintervention, and 3-month follow-up...
October 11, 2016: Diabetes Care
Abigail R Mayfield, Elyse M Parke, Kimberly A Barchard, RyAnna P Zenisek, Nicholas S Thaler, Lewis M Etcoff, Daniel N Allen
Obtaining data from multiple informants provides a more comprehensive diagnostic picture in the assessment of attention deficit hyperactivity disorder (ADHD). Differences in symptom ratings have been observed between parent- and teacher-report scales, though less information is available regarding differences between mothers and fathers. To address this gap, this study examines the rater agreement between mothers and fathers on the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) ADHD Symptom Rating Scale (DSM-ADHD-SRS)...
October 11, 2016: Child Neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence
Guia Guffanti, Lupo Geronazzo-Alman, Bin Fan, Cristiane S Duarte, George J Musa, Christina W Hoven
Patients with a posttraumatic stress disorder (PTSD) diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) will very likely not share all of the same symptoms, a consequence of the polythetic approach used in the DSM. We examined heterogeneity in the latent structure of PTSD symptoms using data from a previously published sample of 8,236 youth a subset of which had been exposed to the September 11, 2001 attacks (N = 6,670; Hoven et al...
October 2016: Journal of Traumatic Stress
Richard R Reich, Cecile A Lengacher, Carissa B Alinat, Kevin E Kip, Carly Paterson, Sophia Ramesar, Heather S Han, Roohi Ismail-Khan, Versie Johnson-Mallard, Manolete Moscoso, Pinky Budhrani-Shani, Steve Shivers, Charles E Cox, Matthew Goodman, Jong Park
CONTEXT: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biological and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters. OBJECTIVES: The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program...
October 5, 2016: Journal of Pain and Symptom Management
Maude Schneider, Marco Armando, Maria Pontillo, Stefano Vicari, Martin Debbané, Frauke Schultze-Lutter, Stephan Eliez
The 22q11.2 deletion syndrome (22q11DS) is characterized by high rates of psychotic symptoms and schizophrenia, making this condition a promising human model for studying risk factors for psychosis. We explored the predictive value of ultra high risk (UHR) criteria in a sample of patients with 22q11DS. We also examined the additional contribution of socio-demographic, clinical and cognitive variables to predict transition to psychosis within a mean interval of 32.5 ± 17.6 months after initial assessment...
October 2016: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
Edwine W Barasa, Susan Cleary, Mike English, Sassy Molyneux
BACKGROUND: Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya...
September 30, 2016: BMC Health Services Research
Chunping Du, Jiadan Yu, Jiaqi Zhang, Jiaojiao Jiang, Huabin Lai, Wei Liu, Yang Liu, Hao Li, Pu Wang
OBJECTIVE: To investigate relevant aspects of functioning and disability, and environmental factors in people with adolescent idiopathic scoliosis according to patients' self-reports based on the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). DESIGN: Multicentre, empirical, cross-sectional study. SETTING: Four departments of orthopaedics in 4 hospitals, and 5 departments of rehabilitation medicine in 5 hospitals...
October 12, 2016: Journal of Rehabilitation Medicine
Thomas W Allan, Julien Besle, Dave R M Langers, Jeff Davies, Deborah A Hall, Alan R Palmer, Peyman Adjamian
Previous studies of anatomical changes associated with tinnitus have provided inconsistent results, with some showing significant cortical and subcortical changes, while others have found effects due to hearing loss, but not tinnitus. In this study, we examined changes in brain anatomy associated with tinnitus using anatomical scans from 128 participants with tinnitus and hearing loss, tinnitus with clinically normal hearing, and non-tinnitus controls with clinically normal hearing. The groups were matched for hearing loss, age and gender...
2016: Frontiers in Aging Neuroscience
Narelle Borrott, Sharon Kinney, Fiona Newall, Allison Williams, Noel Cranswick, Ian Wong, Elizabeth Manias
AIMS AND OBJECTIVES: To examine how communication between nurses and doctors occurred for managing medications in inpatient paediatric settings. BACKGROUND: Communication between health professionals influences medication incidents' occurrence and safe care. DESIGN: An ethnographic study was undertaken. METHODS: Semi-structured interviews, observations and focus groups were conducted in three clinical areas of an Australian tertiary paediatric hospital...
October 5, 2016: Journal of Clinical Nursing
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