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Caring wisely

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https://www.readbyqxmd.com/read/28730751/tuberculosis-and-biologics-in-rheumatology-india-a-special-situation
#1
REVIEW
Rohini Handa, Sundeep Upadhyaya, Sanjiv Kapoor, Ramesh Jois, Bimlesh D Pandey, Anuj K Bhatnagar, Ashwani Khanna, Vishal Goyal, Kamal Kumar
India has a huge patient burden of rheumatic diseases (RDs) including rheumatoid arthritis. The use of biologics has transformed the treatment paradigm for RD; however, biologic treatment-related infections (especially tuberculosis [TB]) are an area of potential concern for TB-endemic nations like India. Anti-tumor necrosis factor (TNF) therapy impairs the physiological TNF-mediated signaling and may cause reactivation and dissemination of latent TB infection (LTBI). Careful screening is, thus, crucial in RD patients who are about to commence anti-TNF treatment...
July 21, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28729776/expenditure-of-hospital-care-on-cancer-in-china-from-2011-to-2015
#2
Yue Cai, Ming Xue, Wanqing Chen, Maogui Hu, Zhiwen Miao, Lan Lan, Rongshou Zheng, Qun Meng
OBJECTIVE: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. METHODS: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces...
June 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28716794/incidence-of-live-attenuated-influenza-vaccine-administration-beyond-expiry-date-in-children-and-adolescents-aged-2-17-years-in-the-uk-a-population-based-cohort-study
#3
Herve Caspard, Robert P Wise, Amy Steffey, Robert S Brody
OBJECTIVES: To estimate the proportion of live-attenuated influenza vaccine (LAIV) doses administered beyond expiry date in children and adolescents during influenza seasons 2013-2014 and 2014-2015 in the UK. DESIGN: This was a retrospective cohort study. Two cohorts of children and adolescents who received LAIV from 1 September 2013 to 31 March 2014 and from 1 September 2014 to 31 March 2015 and aged 2-17 years at time of LAIV administration were identified from the Clinical Practice Research Datalink (CPRD)...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28707960/biofunctionalized-hybrid-magnetic-gold-nanoparticles-as-catalysts-for-photothermal-ablation-of-colorectal-liver-metastases
#4
Sarah B White, Dong-Hyun Kim, Yang Guo, Weiguo Li, Yihe Yang, Jeane Chen, Venkateswara R Gogineni, Andrew C Larson
Purpose To demonstrate that anti-MG1 conjugated hybrid magnetic gold nanoparticles (HNPs) act as a catalyst during photothermal ablation (PTA) of colorectal liver metastases, and thus increase ablation zones. Materials and Methods All experiments were performed with approval of the institutional animal care and use committee. Therapeutic and diagnostic multifunctional HNPs conjugated with anti-MG1 monoclonal antibodies were synthesized, and the coupling efficiency was determined. Livers of 19 Wistar rats were implanted with 5 × 10(6) rat colorectal liver metastasis cell line cells...
July 13, 2017: Radiology
https://www.readbyqxmd.com/read/28706550/effect-of-acupressure-on-early-complications-of-menopause-in-women-referring-to-selected-health-care-centers
#5
Maryam Armand, Gity Ozgoli, Reza Heshmat Giti, Hamid Alavi Majd
BACKGROUND: Menopausal period is accompanied by numerous disorders and complications. Nowadays, hormone therapy is the most effective existing method to treat these complications, but many women cannot undergo that due to the known potentiality of risk. So, the present study aimed to investigate the effect of acupressure on early complications of menopause. MATERIALS AND METHODS: This is a blind random clinical trial conducted on 70 menopaused women referring to selected health care centers in Tehran who were qualified to enter the study...
May 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28701226/the-application-of-geographic-information-systems-gis-in-identifying-the-priority-areas-for-maternal-care-and-services
#6
Fatemeh Salehi, Leila Ahmadian
BACKGROUND: Improving maternal health is globally introduced as an important health priority. The purpose of this study is to identify the high priority areas which require more maternal health services in Kerman, Iran. METHODS: This is a descriptive cross-sectional study, performed in 2015. The literatures were first explored in order to extract geographic indicators and sub indicators relevant to the maternal health. Data were collected by the use of a questionnaire designed on the basis of AHP (Analytic Hierarchy Process) method...
July 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28699935/use-of-simulation-to-assess-incoming-interns-recognition-of-opportunities-to-choose-wisely
#7
Kathleen Wiest, Jeanne Farnan, Ellen Byrne, Lukas Matern, Melissa Cappaert, Kristen Hirsch, Vineet Arora
BACKGROUND: Despite increasing healthcare costs, training on cost-consciousness is lacking in graduate medical education (GME). Medical centers must consider how best to incorporate value-based training into their GME curricula. OBJECTIVE: To incorporate low-value principles into an existing GME simulation exercise and assess incoming interns' recognition of low-value care. METHODS: Choosing Wisely™ lists were reviewed to identify 4 low-value hazards to be embedded into a simulated hospital room in addition to the 8 patient safety hazards used previously...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#8
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28694677/does-shared-decision-making-results-in-better-health-related-outcomes-for-individuals-with-painful-musculoskeletal-disorders-a-systematic-review
#9
Yannick Tousignant-Laflamme, Shefali Christopher, Derek Clewley, Leila Ledbetter, Christian Jaeger Cook, Chad E Cook
Background: Shared Decision-Making (SDM) is a dynamic process by which the health care professional and the patient influence each other in making health-related choices or decisions. SDM is strongly embedded in today's health care approaches, and is advocated as an ideal model since it renders individuals more control towards the health care they choose to receive, and has been shown to improve patient outcomes. Objectives: The goal of this systematic review was to investigate the added-value of SDM on clinical health-related outcomes in patients with a variety of musculoskeletal conditions...
July 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/28693330/reducing-unnecessary-blood-chemistry-testing-in-the-emergency-department-implementation-of-choosing-wisely
#10
Arjun K Venkatesh, David Hajdasz, Craig Rothenberg, Meir Dashevsky, Vivek Parwani, Mark Sevilla, Marc Shapiro, Ian Schwartz
Point of care (POC) laboratory testing is used to improve emergency department (ED) throughput but often overuses resources by duplicating formal laboratory testing. This study sought to evaluate the effect of a multimodal intervention on duplicate chemistry testing. This pre-post analysis included all visits to 2 urban EDs between June 2014 and June 2016. The multimodal intervention including provider education, signage, electronic health record redesign, and audit and feedback focused on reducing duplicate chemistry testing...
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28689504/a-multinational-and-multidisciplinary-approach-to-treat-chd-in-paediatric-age-in-angola-initial-experience-of-a-medical-surgical-centre-for-children-with-heart-disease-in-angola
#11
Maria Ana S Nunes, Manuel P Magalhães, Miguel S Uva, Patrícia Heitor, Ana Henriques, Valdano Manuel, Gade Miguel, António F Júnior
BACKGROUND: Epidemiological patterns of cardiac disease differ between developed countries and African nations. Despite the collaborative efforts of developed countries, several obstacles hinder the implementation of successful programmes for the management of children with heart disease in Africa. Materials and methods This study is a retrospective analysis of a bi-national two-institution partnership programme for the treatment of children with congenital and acquired heart disease...
July 10, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28680281/choosing-wisely-in-cancer-control-across-canada-a-set-of-baseline-indicators
#12
K Tran, R Rahal, S Fung, G Lockwood, C Louzado, J Xu, H Bryant
Value-based care, which balances high-quality care with the most efficient use of resources, has been considered the next frontier in cancer care and a means to maintain health system sustainability. Created to promote value-based care, Choosing Wisely Canada-modelled after Choosing Wisely in the United States-is a national clinician-driven campaign to identify unnecessary or harmful services that are frequently used in Canada. As part of the campaign, national medical societies have developed recommendations for tests and treatments that clinicians and patients should question...
June 2017: Current Oncology
https://www.readbyqxmd.com/read/28676773/intuitive-face-judgments-rely-on-holistic-eye-movement-pattern
#13
Laura F Mega, Kirsten G Volz
Non-verbal signals such as facial expressions are of paramount importance for social encounters. Their perception predominantly occurs without conscious awareness and is effortlessly integrated into social interactions. In other words, face perception is intuitive. Contrary to classical intuition tasks, this work investigates intuitive processes in the realm of every-day type social judgments. Two differently instructed groups of participants judged the authenticity of emotional facial expressions, while their eye movements were recorded: an 'intuitive group,' instructed to rely on their "gut feeling" for the authenticity judgments, and a 'deliberative group,' instructed to make their judgments after careful analysis of the face...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28675101/tympanoplasty-following-blast-injury
#14
Matthew Keller, Ryan Sload, Justin Wilson, Howard Greene, Peggy Han, Sean Wise
Objectives To assess outcomes following tympanoplasty for blast-induced tympanic membrane perforations in a military population. Study Design Case series with chart review. Setting Tertiary care medical centers. Subjects and Methods Military personnel (N = 254) undergoing tympanoplasty for blast-related tympanic membrane perforations sustained between April 2005 and July 2014 were identified from the Expeditionary Medical Encounter Database. Descriptive statistics were obtained regarding demographics, primary and revision surgery success rates, hearing status pre- and postsurgery, and frequency of ossicular reconstruction...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28673310/the-evaluation-of-enhanced-feedback-interventions-to-reduce-unnecessary-blood-transfusions-affinitie-protocol-for-two-linked-cluster-randomised-factorial-controlled-trials
#15
Suzanne Hartley, Robbie Foy, Rebecca E A Walwyn, Robert Cicero, Amanda J Farrin, Jill J Francis, Fabiana Lorencatto, Natalie J Gould, John Grant-Casey, Jeremy M Grimshaw, Liz Glidewell, Susan Michie, Stephen Morris, Simon J Stanworth
BACKGROUND: Blood for transfusion is a frequently used clinical intervention, and is also a costly and limited resource with risks. Many transfusions are given to stable and non-bleeding patients despite no clear evidence of benefit from clinical studies. Audit and feedback (A&F) is widely used to improve the quality of healthcare, including appropriate use of blood. However, its effects are often inconsistent, indicating the need for coordinated research including more head-to-head trials comparing different ways of delivering feedback...
July 3, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28669451/cancer-incidence-and-mortality-are-associated-with-human-development-index-and-health-setups-in-africa
#16
Ruqiya Pervaiz, Faisal Faisal
BACKGROUND: This study aimed to analyse the correlation between cancer incidence and mortality and the Human Development Index (HDI) in Africa. Furthermore, to analyse the variations in cancer Mortality to Incidence Ratio (MIR) based on health care systems in African countries. MATERIAL AND METHODS: Cancer incidence and mortality data for 53 countries were obtained from GLOBOCAN database. Country-wise data on National-HDI were obtained from Human Development Report 2015...
June 29, 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/28663352/a-high-value-care-curriculum-for-interns-a-description-of-curricular-design-implementation-and-housestaff-feedback
#17
Jason Hom, Andre Kumar, Kambria H Evans, David Svec, Ilana Richman, Daniel Fang, Andrea Smeraglio, Marisa Holubar, Tyler Johnson, Neil Shah, Cybele Renault, Neera Ahuja, Ronald Witteles, Stephanie Harman, Lisa Shieh
PURPOSE: Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns. DESIGN: Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford. Curricular topics were inspired by the American Board of Internal Medicine's Choosing Wisely campaign, Alliance for Academic Internal Medicine, American College of Physicians and Society of Hospital Medicine...
June 29, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28657766/a-suspected-delayed-hemolytic-transfusion-reaction-mediated-by-anti-joa
#18
Ryan P Jajosky, Wendy C Lumm, Scott C Wise, Roni J Bollag, James F Shikle
A 32-year-old African-American woman with a history of sickle cell disease presented for surgical evaluation of left total hip arthroplasty due to avascular necrosis of the femoral head. In anticipation of a complex orthopedic procedure, pre-surgical blood work was ordered. The patient's Fenwal blood sample typed as group O, D+. Although the patient had a history of anti-Fya, the antibody identification was inconclusive, so the workup was sent to a reference laboratory. The patient was last transfused with red blood cells (RBCs) 2 years earlier, but had no history of transfusion reactions...
June 2017: Immunohematology
https://www.readbyqxmd.com/read/28655848/traces-of-surfactants-can-severely-limit-the-drag-reduction-of-superhydrophobic-surfaces
#19
François J Peaudecerf, Julien R Landel, Raymond E Goldstein, Paolo Luzzatto-Fegiz
Superhydrophobic surfaces (SHSs) have the potential to achieve large drag reduction for internal and external flow applications. However, experiments have shown inconsistent results, with many studies reporting significantly reduced performance. Recently, it has been proposed that surfactants, ubiquitous in flow applications, could be responsible by creating adverse Marangoni stresses. However, testing this hypothesis is challenging. Careful experiments with purified water already show large interfacial stresses and, paradoxically, adding surfactants yields barely measurable drag increases...
July 11, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28651901/benchmarking-numerical-codes-for-tracer-transport-with-the-aid-of-laboratory-scale-experiments-in-2d-heterogeneous-porous-media
#20
Fadji Hassane Maina, Philippe Ackerer, Anis Younes, Alberto Guadagnini, Brian Berkowitz
We present a combined experimental and numerical modeling study that addresses two principal questions: (i) is any particular Eulerian-based method used to solve the classical advection-dispersion equation (ADE) clearly superior (relative to the others), in terms of yielding solutions that reproduce BTCs of the kind that are typically sampled at the outlet of a laboratory cell? and (ii) in the presence of matches of comparable quality against such BTCs, do any of these methods render different (or similar) numerical BTCs at locations within the domain? To address these questions, we obtained measurements from carefully controlled laboratory experiments, and employ them as a reference against which numerical results are benchmarked and compared...
June 7, 2017: Journal of Contaminant Hydrology
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