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https://www.readbyqxmd.com/read/28110223/guilt-without-fault-a-qualitative-study-into-the-ethics-of-forgiveness-after-traumatic-childbirth
#1
Katja Schrøder, Karen la Cour, Jan Stener Jørgensen, Ronald F Lamont, Niels Christian Hvidt
When a life is lost or severely impaired during childbirth, the midwife and obstetrician involved may experience feelings of guilt in the aftermath. Through three empirical cases, the paper examines the sense of guilt in the context of the current patient safety culture in healthcare where a blame-free approach is promoted in the aftermath of adverse events. The purpose is to illustrate how healthcare professionals may experience guilt without being at fault after adverse events, and Gamlund's theory on forgiveness without blame is used as the theoretical framework for this analysis...
January 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28109680/-why-do-generic-drugs-fail-to-achieve-an-adequate-market-share-in-greece-empirical-findings-and-policy-suggestions
#2
T Balasopoulos, A Charonis, K Athanasakis, J Kyriopoulos, E Pavi
OBJECTIVES: Since 2010, the memoranda of understanding were implemented in Greece as a measure of fiscal adjustment. Public pharmaceutical expenditure was one of the main focuses of this implementation. Numerous policies, targeted on pharma spending, reduced the pharmaceutical budget by 60.5%. Yet, generics' penetration in Greece remained among the lowest among OECD countries. This study aims to highlight the factors that affect the perceptions of the population on generic drugs and to suggest effective policy measures...
January 9, 2017: Health Policy
https://www.readbyqxmd.com/read/28109160/antibiotics-for-infection-prevention-after-excision-of-the-cervical-transformation-zone
#3
REVIEW
Chumnan Kietpeerakool, Bandit Chumworathayi, Jadsada Thinkhamrop, Butsakorn Ussahgij, Pisake Lumbiganon
BACKGROUND: Excision of the transformation zone of the cervix is the most commonly used approach to treat cervical precancerous lesions (cervical intraepithelial neoplasia (CIN)) to reduce the risk of developing cervical cancer. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk of infection following the procedure. The incidence of infection after cold knife conization (CKC) is 36%, whereas the incidence for large loop excision of the transformation zone (LLETZ, also known as loop electrical excision procedure (LEEP)) is much lower (0...
January 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28108819/preemptive-treatment-with-xonrid%C3%A2-a-medical-device-to-reduce-radiation-induced-dermatitis-in-head-and-neck-cancer-patients-receiving-curative-treatment-a-pilot-study
#4
Nicola Alessandro Iacovelli, Simona Naimo, Francesca Bonfantini, Anna Cavallo, Paolo Bossi, Carlo Fallai, Emanuele Pignoli, Salvatore Alfieri, Cristiana Bergamini, Federica Favales, Ester Orlandi
PURPOSE: The purpose of this study was to investigate efficacy, safety and tolerability of Xonrid®, a new medical device, in preventing radiation dermatitis associated with head and neck cancer (HNC) radiotherapy (RT). METHODS: In this monocentric, prospective pilot study, adult consecutive HNC patients who were planned to receive curative RT with or without chemotherapy were enrolled. Patients were instructed to apply Xonrid® on the irradiated area during treatment continuing until 2 weeks after the completion of RT or the development of severe skin toxicity...
January 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28108735/fertility-sparing-uterine-lesion-resection-for-young-women-with-gestational-trophoblastic-neoplasias-single-institution-experience
#5
Xiaoyu Wang, Junjun Yang, Jie Li, Jun Zhao, Tong Ren, Fengzhi Feng, Xirun Wan, Yang Xiang
PURPOSE: To evaluate the oncological safety and pregnant outcomes of fertility-sparing uterine lesion resection in treating gestational trophoblastic neoplasias. RESULTS: After the treatment of surgery and chemotherapy, all the patients achieved complete remission. With a median follow-up time of 44 months (range, 6-188), 3 patients (3.85%) relapsed within 3-26 months. Multivariate analysis showed that tumor size was the independent risk factor of recurrence and the cutoff value was 4...
January 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28108641/spinal-cord-stimulation-scs-with-anatomically-guided-3d-neural-targeting-shows-superior-chronic-axial-low-back-pain-relief-compared-to-traditional-scs-lumina-study
#6
Elias Veizi, Salim M Hayek, James North, T Brent Chafin, Thomas L Yearwood, Louis Raso, Robert Frey, Kevin Cairns, Anthony Berg, John Brendel, Nameer Haider, Matthew McCarty, Henry Vucetic, Alden Sherman, Lilly Chen, Nitzan Mekel-Bobrov
: BACKGROUND : The aim of this study was to determine whether spinal cord stimulation (SCS) using 3D neural targeting provided sustained overall and low back pain relief in a broad routine clinical practice population. STUDY DESIGN AND METHODS:  This was a multicenter, open-label observational study with an observational arm and retrospective analysis of a matched cohort. After IPG implantation, programming was done using a patient-specific, model-based algorithm to adjust for lead position (3D neural targeting) or previous generation software (traditional)...
January 20, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28108444/cancer-risk-in-women-treated-with-fertility-drugs-according-to-parity-status-a-registry-based-cohort-study
#7
Marte M Reigstad, Ritsa Storeng, Tor A Myklebust, Nan B Oldereid, Anne K Omland, Trude E Robsahm, Louise A Brinton, Siri Vangen, Kari Furu, Inger K Larsen
Background Long-term safety of assisted reproductive techniques (ART) is of interest as use is increasing. Cancer risk is known to be affected by parity. This study examined risk of cancer after fertility treatment, stratified by women's parity. Methods Data was obtained on all women (n=1 353 724) born in Norway between 1960-1996. Drug exposure data (2004-2014) was obtained from the Norwegian Prescription Database [drugs used in ART and clomiphene citrate (CC)]. The Medical Birth Registry of Norway provided parity status...
January 20, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28108229/vaccine-shot-limiting-estimating-the-prevalence-indicators-and-impact-on-vaccination-status-michigan-2012
#8
Meghan Weinberg, Stephanie Dietz, Rachel Potter, Robert Swanson, Corinne Miller, Jevon McFadden
BACKGROUND: Concerns regarding vaccine safety and pain have prompted certain parents to limit the number of shots their child receives per visit. We estimated the prevalence of shot-limited children in Michigan, described their characteristics, assessed whether shot-limited children were up-to-date on recommended vaccinations, and investigated possible intervention points for vaccination education. METHODS: We analyzed vaccination registry and birth record data of children born in Michigan during 2012 who had ⩾2 vaccination visits, with ⩾1 visits after age 5months...
January 17, 2017: Vaccine
https://www.readbyqxmd.com/read/28108169/learning-to-manage-vasoactive-drugs-a-qualitative-interview-study-with-critical-care-nurses
#9
Marie Häggström, Ann-Christin Bergsman, Ulrika Månsson, Malin Rising Holmström
OBJECTIVE: Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. AIM: To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. RESEARCH METHODOLOGY/SETTING: Twelve critical care nurses from three hospitals in Sweden were interviewed...
January 17, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28107394/quality-of-documentation-as-a-surrogate-marker-for-awareness-and-training-effectiveness-of-phtls-courses-part-of-the-prospective-longitudinal-mixed-methods-epptc-trial
#10
David Häske, Stefan K Beckers, Marzellus Hofmann, Rolf Lefering, Bernhard Gliwitzky, Christoph C Wölfl, Paul Grützner, Ulrich Stöckle, Marc Dieroff, Matthias Münzberg
OBJECTIVE: Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness...
2017: PloS One
https://www.readbyqxmd.com/read/28107373/dexmedetomidine-versus-midazolam-in-procedural-sedation-a-systematic-review-of-efficacy-and-safety
#11
Clemens R M Barends, Anthony Absalom, Baucke van Minnen, Arjan Vissink, Anita Visser
OBJECTIVES: To systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation. MATERIALS AND METHODS: We searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (≥18 years), article written in English, German, French or Dutch, use of study medication for conscious sedation and at least one group receiving dexmedetomidine and one group receiving midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28105882/quality-improvement-in-hospitals-barriers-and-facilitators
#12
Dick E Zoutman, B Douglas Ford
Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105624/-clinical-research-of-delta-shaped-anastomosis-technology-in-laparoscopic-distal-gastrectomy-and-digestive-tract-reconstruction
#13
Bo Gao, Qingxing Huang, Jianhong Dong
OBJECTIVE: To evaluate the feasibility and safety of the delta-shaped anastomosis in laparoscopic distal gastrectomy and digestive tract reconstruction. METHODS: Clinical data of 34 gastric cancer patients undergoing laparoscopic distal gastrectomy with the delta-shaped anastomosis for digestive tract reconstruction (delta-shaped group) and 83 gastric cancer patients undergoing laparoscopic distal gastrectomy with Billroth I( for digestive tract reconstruction (Billroth group) by same surgeon team from July 2013 to July 2015 at the Department of Digestive Surgery, Affiliated Tumor Hospital of Shanxi Medical University were retrospectively analyzed...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105502/transfracture-medial-transposition-of-the-radial-nerve-associated-with-plate-fixation-of-the-humerus
#14
Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
PURPOSE: The aim of this study was to illustrate safety, feasibility and advantages of transfracture medial transposition of the radial nerve during the lateral approach and lateral plating of humeral fractures located in the mid and distal shaft. METHODS: This was a retrospective review and analysis of medical records and radiographs of 19 patients who underwent a transfracture medial transposition of the radial nerve. Fifteen patients were treated for fresh fracture and four for nonunion...
January 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28104709/utility-of-social-media-and-crowd-sourced-data-for-pharmacovigilance-a-scoping-review-protocol
#15
Andrea C Tricco, Wasifa Zarin, Erin Lillie, Ba Pham, Sharon E Straus
INTRODUCTION: Adverse events associated with medications are under-reported in postmarketing surveillance systems. A systematic review of published data from 37 studies worldwide (including Canada) found the median under-reporting rate of adverse events to be 94% in spontaneous reporting systems. This scoping review aims to assess the utility of social media and crowd-sourced data to detect and monitor adverse events related to health products including pharmaceuticals, medical devices, biologics and natural health products...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28104490/increasing-trainee-reporting-of-adverse-events-with-monthly-trainee-directed-review-of-adverse-events
#16
Alla Smith, Jonathan Hatoun, James Moses
OBJECTIVE: Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter "trainee") reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse-event reports, identified system vulnerabilities and designed solutions to those vulnerabilities. METHODS: Monthly conferences over the 22-month study period were led by pediatric trainees, and attended by fellow trainees, departmental leadership, and members of the hospital's quality improvement team...
January 16, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28104438/safety-of-externally-stimulated-intracranial-electrodes-during-functional-mri-at-1-5t
#17
Pallab K Bhattacharyya, Jeffery Mullin, Bryan S Lee, Jorge A Gonzalez-Martinez, Stephen E Jones
Surgical resection of the epileptogenic zone (EZ) is a potential cure for medically refractory focal epilepsy. Proper identification of the EZ is essential for such resection. Synergistic application of functional magnetic resonance imaging (fMRI) simultaneously with stimulation of a single externalized intracranial stereotactic EEG (SEEG) electrode has the potential to improve identification of the EZ. While most EEG-fMRI studies use the electrodes passively to record electrical activity, it is possible to stimulate the brain using the electrodes by connecting them with conducting cables to the stimulation hardware...
January 16, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28104422/tipless-nitinol-stone-baskets-comparison-of-penetration-force-radial-dilation-force-opening-dynamics-and-deflection
#18
Nishant Patel, Arash Akhavein, Bryan Hinck, Rajat Jain, Manoj Monga
OBJECTIVE: To evaluate 5 commercially available tipless nitinol baskets (2.2F) in 4performance factors: penetration force, radial dilation force, opening dynamics and deflection limitation. MATERIAL AND METHODS: The 2.2F Coloplast Dormia No-Tip®, 1.5F Sacred Heart Medical Halo®, 2.2F Cook NCircle Nitinol Tipless Stone Extractor ®, 1.9F Bard SkyLite Tipless Nitinol Basket® and the 1.9F Boston Scientific Zero TipTM baskets were tested for penetration force (safety metric), radial dilation force (functional metric for ureteral calculi), and opening/closing dynamics...
January 16, 2017: Urology
https://www.readbyqxmd.com/read/28103953/microwave-ablation-is-as-effective-as-radiofrequency-ablation-for-very-early-stage-hepatocellular-carcinoma
#19
Yun Xu, Qiang Shen, Neng Wang, Pan-Pan Wu, Bin Huang, Ming Kuang, Guo-Jun Qian
BACKGROUND: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. METHODS: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutaneous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, in Shanghai, China were retrospectively analyzed...
January 19, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28103925/protocol-for-a-realist-review-of-workplace-learning-in-postgraduate-medical-education-and-training
#20
Anel Wiese, Caroline Kilty, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O'Kane, Lucia Prihodova, Dubhfeasa Slattery, Deirdre Bennett
BACKGROUND: Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities...
January 19, 2017: Systematic Reviews
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