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https://www.readbyqxmd.com/read/28517988/the-promise-and-the-hype-of-personalised-medicine
#1
Tim Maughan
Personalised medicine is widely considered as the way of the future for medicine. However, progress in cancer, with a few outstanding exceptions, has fallen below expectations because of the challenges of tumour heterogeneity and clonal evolution. In both benign and malignant disease, diseases caused by single genetic alterations are more amenable to precision medicine approaches. However, most common diseases are caused by a complex interplay of multiple genetic and environmental factors making personalised medicine far more challenging...
April 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/28511818/-how-the-other-half-live-lay-perspectives-on-health-inequalities-in-an-age-of-austerity
#2
Kayleigh Garthwaite, Clare Bambra
This paper examines how people living in two socially contrasting areas of Stockton on Tees, North East England experience, explain, and understand the stark health inequalities in their town. Participants displayed opinions that fluctuated between a variety of converging and contrasting explanations. Three years of ethnographic observation in both areas (2014-2017) generated explanations which initially focused closely on behavioural and individualised factors, whilst 118 qualitative interviews subsequently revealed more nuanced justifications, which prioritised more structural, material and psychosocial influences...
May 10, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28507221/allocation-of-antiretroviral-drugs-to-hiv-infected-patients-in-togo-perspectives-of-people-living-with-hiv-and-healthcare-providers
#3
Lonzozou Kpanake, Paul Clay Sorum, Etienne Mullet
AIM: To explore the way people living with HIV and healthcare providers in Togo judge the priority of HIV-infected patients regarding the allocation of antiretroviral drugs. METHOD: From June to September 2015, 200 adults living with HIV and 121 healthcare providers living in Togo were recruited for the study. They were presented with stories of a few lines depicting the situation of an HIV-infected patient and were instructed to judge the extent to which the patient should be given priority for antiretroviral drugs...
May 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28490553/using-a-patient-decision-aid-for-insulin-initiation-in-patients-with-type-2-diabetes-a-qualitative-analysis-of-doctor-patient-conversations-in-primary-care-consultations-in-malaysia
#4
Ayeshah Syed, Zuraidah Mohd Don, Chirk Jenn Ng, Yew Kong Lee, Ee Ming Khoo, Ping Yein Lee, Khatijah Lim Abdullah, Azlin Zainal
OBJECTIVE: To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations. DESIGN: Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin. SETTING: Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28478858/survivorship-care-for-postmenopausal-breast-cancer-patients-in-ireland-what-do-women-want
#5
Elizabeth Meade, Sonja McIlfatrick, Ann Marie Groarke, Eimear Butler, Maura Dowling
PURPOSE: The aim of this study was to identify the concerns of postmenopausal breast cancer patients in Ireland and inform the development of a survivorship care plan. METHOD: A qualitative participatory approach was used. Focus group interviews (n = 6) with 51 women were undertaken. Following analysis of the focus group discussions, two nominal group technique (NGT) (consensus workshops) involving representatives (n = 17) from each of the six focus groups were held...
June 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28453429/anti-microbial-coating-innovations-to-prevent-infectious-diseases-amici-cost-action-ca15114
#6
Colum P Dunne, Minna M Keinänen-Toivola, Anne Kahru, Birgit Teunissen, Hulya Olmez, Isabel Gouveia, Luis Melo, Kazimierz Murzyn, Martina Modic, Merja Ahonen, Pete Askew, Theofilos Papadopoulos, Christian Adlhart, Francy R L Crijns
Worldwide, millions of patients are affected annually by healthcare-associated infection (HCAI), impacting up to 80,000 patients in European Hospitals on any given day. This represents not only public health risk, but also an economic burden. Complementing routine hand hygiene practices, cleaning and disinfection, antimicrobial coatings hold promise based, in essence, on the application of materials and chemicals with persistent bactericidal or -static properties onto surfaces or in textiles used in healthcare environments...
April 28, 2017: Bioengineered
https://www.readbyqxmd.com/read/28449018/accuracy-of-ethnicity-data-recorded-in-hospital-based-patient-clinical-records-and-the-australia-and-new-zealand-dialysis-and-transplant-registry
#7
COMPARATIVE STUDY
Matthew Page, Emma H Wyeth, Ari Samaranayaka, Bronwen McNoe, Rachael Walker, John Schollum, Mark Marshall, Robert Walker, Sarah Derrett
AIM: Sustained health inequities are experienced by indigenous and minority populations. Accurate ethnicity data are fundamental to healthcare planning and provision and monitoring of health outcomes to address such inequities. This study investigated the accuracy of ethnicity data in a large clinical registry of end-stage kidney disease patients (the Australia and New Zealand Dialysis and Transplant Registry; ANZDATA) and hospital-based patient clinical records compared with self-reported ethnicity data collected in the 'Dialysis Outcomes in those aged ≥65 years' (DOS65+) study...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28391102/contributions-of-specific-causes-of-death-to-lost-life-expectancy-in-severe-mental-illness
#8
N Jayatilleke, R D Hayes, R Dutta, H Shetty, M Hotopf, C-K Chang, R Stewart
The life expectancy gap between people with severe mental illness (SMI) and the general population persists and may even be widening. This study aimed to estimate contributions of specific causes of death to the gap. Age of death and primary cause of death were used to estimate life expectancy at birth for people with SMI from a large mental healthcare case register during 2007-2012. Using data for England and Wales in 2010, death rates in the SMI cohort for each primary cause of death category were replaced with gender- and age-specific norms for that cause...
March 17, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28386399/development-of-research-priorities-in-paediatric-pain-and-palliative-care
#9
Christina Liossi, Anna-Karenia Anderson, Richard F Howard
Priority setting for healthcare research is as important as conducting the research itself because rigorous and systematic processes of priority setting can make an important contribution to the quality of research. This project aimed to prioritise clinical therapeutic uncertainties in paediatric pain and palliative care in order to encourage and inform the future research agenda and raise the profile of paediatric pain and palliative care in the United Kingdom. Clinical therapeutic uncertainties were identified and transformed into patient, intervention, comparison and outcome (PICO) format and prioritised using a modified Nominal Group Technique...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28373250/standards-for-reporting-implementation-studies-stari-explanation-and-elaboration-document
#10
Hilary Pinnock, Melanie Barwick, Christopher R Carpenter, Sandra Eldridge, Gonzalo Grandes, Chris J Griffiths, Jo Rycroft-Malone, Paul Meissner, Elizabeth Murray, Anita Patel, Aziz Sheikh, Stephanie J C Taylor
OBJECTIVES: Implementation studies are often poorly reported and indexed, reducing their potential to inform the provision of healthcare services. The Standards for Reporting Implementation Studies (StaRI) initiative aims to develop guidelines for transparent and accurate reporting of implementation studies. METHODS: An international working group developed the StaRI guideline informed by a systematic literature review and e-Delphi prioritisation exercise. Following a face-to-face meeting, the checklist was developed iteratively by email discussion and critical review by international experts...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28364118/enablers-and-determinants-of-the-provision-of-written-action-plans-to-patients-with-asthma-a-stratified-survey-of-canadian-physicians
#11
Fabienne Djandji, Alexandrine J Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
Despite national recommendations, most patients with asthma are not given a written action plan . The objectives were to ascertain physicians' endorsement of potential enablers to providing a written action plan, and the determinants and proportion, of physician-reported use of a written action plan. We surveyed 838 family physicians, paediatricians, and emergency physicians in Quebec. The mailed questionnaire comprised 102 questions on asthma management, 11 of which pertained to written action plan and promising enablers...
March 31, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28342891/cost-utility-of-group-acceptance-and-commitment-therapy-for-fibromyalgia-versus-recommended-drugs-an-economic-analysis-alongside-a-6-month-randomised-controlled-trial-conducted-in-spain-effigact-study
#12
Juan V Luciano, Francesco D'Amico, Albert Feliu-Soler, Lance M McCracken, Jaume Aguado, María T Peñarrubia-María, Martin Knapp, Antoni Serrano-Blanco, Javier García-Campayo
The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively...
March 22, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28321589/the-development-of-a-telemedicine-planning-framework-based-on-needs-assessment
#13
Sharifah AlDossary, Melinda G Martin-Khan, Natalie K Bradford, Nigel R Armfield, Anthony C Smith
Providing equitable access to healthcare services in rural and remote communities is an ongoing challenge that faces most governments. By increasing access to specialty expertise, telemedicine may be a potential solution to this problem. Regardless of its potential, many telemedicine initiatives do not progress beyond the research phase, and are not implemented into mainstream practice. One reason may be that some telemedicine services are developed without the appropriate planning to ascertain community needs and clinical requirements...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28320798/interventions-to-improve-the-self-management-support-health-professionals-provide-for-people-with-progressive-neurological-conditions-protocol-for-a-realist-synthesis
#14
Freya Davies, Fiona Wood, Alison Bullock, Carolyn Wallace, Adrian Edwards
INTRODUCTION: Supporting self-management among people with long-term conditions is recognised as an important component of healthcare. Progressive neurological conditions (PNCs), for example, Parkinson's disease and multiple sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28302126/systematic-meta-review-of-supported-self-management-for-asthma-a-healthcare-perspective
#15
Hilary Pinnock, Hannah L Parke, Maria Panagioti, Luke Daines, Gemma Pearce, Eleni Epiphaniou, Peter Bower, Aziz Sheikh, Chris J Griffiths, Stephanie J C Taylor
BACKGROUND: Supported self-management has been recommended by asthma guidelines for three decades; improving current suboptimal implementation will require commitment from professionals, patients and healthcare organisations. The Practical Systematic Review of Self-Management Support (PRISMS) meta-review and Reducing Care Utilisation through Self-management Interventions (RECURSIVE) health economic review were commissioned to provide a systematic overview of supported self-management to inform implementation...
March 17, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28245162/prioritisation-of-future-research-topics-in-paediatric-palliative-care-in-ireland-a-delphi-study
#16
Claire Quinn, Sandra McCarthy, Mary Devins, Maeve O'Reilly, Marie Twomey, Julie Ling
This paper reports the findings from a Delphi Study undertaken to identify the research priorities in children's palliative care in Ireland. Palliative care for children is a small and highly specialised field of healthcare that focuses on improving the quality of life of children living with, or dying from, a life-limiting condition. Ideally, support for children requiring palliative care begins at the time of diagnosis, which for many children with life-limiting conditions can be from birth. There is a notable overlap between the needs of children requiring palliative care and those with disabilities and other complex care needs, resulting in care being provided by a range of voluntary and statutory agencies...
February 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28175979/mind-the-treatment-gap-a-global-perspective-on-current-and-future-strategies-for-prevention-of-fragility-fractures
#17
REVIEW
N C W Harvey, E V McCloskey, P J Mitchell, B Dawson-Hughes, D D Pierroz, J-Y Reginster, R Rizzoli, C Cooper, J A Kanis
This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all...
May 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28173918/rural-and-regional-community-health-service-boards-perceptions-of-community-health-a-delphi-study
#18
Diana Guzys, Guinever Threlkeld, Virginia Dickson-Swift, Amanda Kenny
Much has been written about the composition of health service boards and the importance of recruiting people with skills appropriate for effective and accountable governance of health services. Governance training aims to educate directors on their governance responsibilities; however, the way in which these responsibilities are discharged is informed by board members' understanding of health within their communities. The aim of this study was to identify how those engaged in determining the strategic direction of local regional or rural community health services in Victoria, Australia, perceived the health and health improvement needs of their community...
February 8, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28173749/testing-a-systematic-approach-to-identify-and-prioritise-barriers-to-successful-implementation-of-a-complex-healthcare-intervention
#19
Louise E Craig, Leonid Churilov, Liudmyla Olenko, Dominique A Cadilhac, Rohan Grimley, Simeon Dale, Cintia Martinez-Garduno, Elizabeth McInnes, Julie Considine, Jeremy M Grimshaw, Sandy Middleton
BACKGROUND: Multiple barriers may inhibit the adoption of clinical interventions and impede successful implementation. Use of standardised methods to prioritise barriers to target when selecting implementation interventions is an understudied area of implementation research. The aim of this study was to describe a method to identify and prioritise barriers to the implementation of clinical practice elements which were used to inform the development of the T(3) trial implementation intervention (Triage, Treatment [thrombolysis administration; monitoring and management of temperature, blood glucose levels, and swallowing difficulties] and Transfer of stroke patients from Emergency Departments [ED])...
February 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28159063/-i-don-t-eat-when-i-m-sick-older-people-s-food-and-mealtime-experiences-in-hospital
#20
Kelti Hope, Maree Ferguson, Dianne P Reidlinger, Ekta Agarwal
BACKGROUND: Inadequate dietary intake is a common problem amongst older acute-care patients and has been identified as an independent risk factor for in-hospital mortality. This study aimed to explore whether food and mealtime experiences contribute to inadequate dietary intake in older people during hospitalisation. METHODS: This was a qualitative phenomenological study, data for which were collected using semi-structured interviews over a three-week period. During this time, 26 patients aged 65 years or more, admitted to medical and surgical wards in a tertiary acute-care hospital, were asked to participate if they were observed to eat less than half of the meal offered at lunch...
March 2017: Maturitas
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