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https://www.readbyqxmd.com/read/28918412/prediction-of-early-unplanned-intensive-care-unit-readmission-in-a-uk-tertiary-care-hospital-a-cross-sectional-machine-learning-approach
#1
Thomas Desautels, Ritankar Das, Jacob Calvert, Monica Trivedi, Charlotte Summers, David J Wales, Ari Ercole
OBJECTIVES: Unplanned readmissions to the intensive care unit (ICU) are highly undesirable, increasing variance in care, making resource planning difficult and potentially increasing length of stay and mortality in some settings. Identifying patients who are likely to suffer unplanned ICU readmission could reduce the frequency of this adverse event. SETTING: A single academic, tertiary care hospital in the UK. PARTICIPANTS: A set of 3326 ICU episodes collected between October 2014 and August 2016...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28915430/care-interrupted-poverty-in-migration-and-primary-care-in-rural-resource-towns
#2
Kathleen Rice, Fiona Webster
Internationally, rural people have poorer health outcomes relative to their urban counterparts, and primary care providers face particular challenges in rural and remote regions. Drawing on ethnographic fieldnotes and 14 open-ended qualitative interviews with care providers and chronic pain patients in two remote resource communities in Northern Ontario, Canada, this article examines the challenges involved in providing and receiving primary care for complex chronic conditions in these communities. Both towns struggle with high unemployment in the aftermath of industry closure, and are characterized by an abundance of affordable housing...
September 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28914465/exploring-avenues-for-best-use-of-cytotechnologists-in-non-gynaecological-cytology-double-screening-or-independent-sign-out
#3
G Fischer, M Haddad, K Cormier
OBJECTIVE: Cytotechnologist (CT) screening workload has been decreasing due to the falling number of Papanicolaou tests. This continuing trend has prompted exploration of ways to best employ the CT skillset. One potential way of more effective use is by having two CTs double screen non-gynaecological (NGC) cases to assess whether this improves screening quality and concordance with pathologists. Another is evaluating the CT's performance on low-complexity negative NGC cases for a potential independent CT sign-out without pathologist review...
September 15, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/28914264/comprehensive-use-of-extended-exome-analysis-improves-diagnostic-yield-in-rare-disease-a-retrospective-survey-in-1-059-cases
#4
Gaber Bergant, Ales Maver, Luca Lovrecic, Goran Čuturilo, Alenka Hodzic, Borut Peterlin
PurposeWe sought to determine the analytical sensitivity of several extended exome variation analysis approaches in terms of their contribution to diagnostic yield and their clinical feasibility.MethodsWe retrospectively analyzed the results of genetic testing in 1,059 distinct cases referred for exome sequencing to our institution. In these, we routinely employed extended exome analysis approaches in addition to basic variant analysis, including (i) copy-number variation (CNV) detection, (ii) nonconsensus splice defect detection, (ii) genomic breakpoint detection, (iv) homozygosity mapping, and (v) mitochondrial variant analysis...
September 14, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28912954/evaluation-of-the-current-landscape-of-respiratory-nurse-specialists-in-the-uk-planning-for-the-future-needs-of-patients
#5
Janelle Yorke, Sam Prigmore, Matt Hodson, Carol Stonham, Hannah Long, Sarah Bellhouse, Monica Fletcher, Sheila Edwards
INTRODUCTION: The National Health Service currently faces significant challenges and must optimise effective workforce planning and management. There are increasing concerns regarding poor workforce planning for respiratory medicine; a greater understanding of the role of respiratory nurse specialists will inform better workforce planning and management. METHODS: This was a survey study. Two surveys were administered: an organisational-level survey and an individual respiratory nurse survey...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28912726/cardiovascular-and-muscular-consequences-of-work-matched-interval-type-of-concentric-and-eccentric-pedaling-exercise-on-a-soft-robot
#6
Martin Flück, Rebekka Bosshard, Max Lungarella
Eccentric types of endurance exercise are an acknowledged alternative to conventional concentric types of exercise rehabilitation for the cardiac patient, because they reduce cardiorespiratory strain due to a lower metabolic cost of producing an equivalent mechanical output. The former contention has not been tested in a power- and work-matched situation of interval-type exercise under identical conditions because concentric and eccentric types of exercise pose specific demands on the exercise machinery, which are not fulfilled in current practice...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28912712/effect-of-cognitive-demand-on-functional-visual-field-performance-in-senior-drivers-with-glaucoma
#7
Viswa Gangeddula, Maud Ranchet, Abiodun E Akinwuntan, Kathryn Bollinger, Hannes Devos
Purpose: To investigate the effect of cognitive demand on functional visual field performance in drivers with glaucoma. Method: This study included 20 drivers with open-angle glaucoma and 13 age- and sex-matched controls. Visual field performance was evaluated under different degrees of cognitive demand: a static visual field condition (C1), dynamic visual field condition (C2), and dynamic visual field condition with active driving (C3) using an interactive, desktop driving simulator. The number of correct responses (accuracy) and response times on the visual field task were compared between groups and between conditions using Kruskal-Wallis tests...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28912653/validity-of-a-newly-designed-rectilinear-stepping-ergometer-submaximal-exercise-test-to-assess-cardiorespiratory-fitness
#8
Rubin Zhang, Likui Zhan, Shaoming Sun, Wei Peng, Yining Sun
The maximum oxygen uptake (V̇O2 max), determined from graded maximal or submaximal exercise tests, is used to classify the cardiorespiratory fitness level of individuals. The purpose of this study was to examine the validity and reliability of the YMCA submaximal exercise test protocol performed on a newly-designed rectilinear stepping ergometer (RSE) that used up and down reciprocating vertical motion in place of conventional circular motion and giving precise measurement of workload, to determine V̇O2 max in young healthy male adults...
September 2017: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/28911142/deficient-endogenous-glucose-production-during-exercise-after-total-pancreatectomy-islet-autotransplantation
#9
Lindsey D Bogachus, Elizabeth Oseid, Melena Bellin, Adrian Vella, R Paul Robertson
Context: Total pancreatectomy followed by intrahepatic islet autotransplantation (TP/IAT) is performed to alleviate severe, unrelenting abdominal pain caused by chronic pancreatitis, to improve quality of life, and to prevent diabetes. Objective: To determine the cause of exercise-induced hypoglycemia that is a common complaint in TP/IAT recipients. Design: Participants completed 1 hour of steady-state exercise. Setting: Hospital research unit...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28906347/exercise-induced-bronchoconstriction-with-firefighting-contained-breathing-apparatus
#10
Leigh M Seccombe, Lachlan Buddle, John D Brannan, Matthew J Peters, Claude S Farah
PURPOSE: Protective self-contained breathing apparatus (SCBA) used for firefighting delivers decompressed (cold), dehumidified air that may enhance the severity of exercise-induced bronchoconstriction (EIB) in those susceptible. We investigated the effect of SCBA during exercise on airway caliber in people with asthma and healthy controls. METHODS: Two exercise challenges (EC) designed to elicit EIB were performed on separate days within one week. The initial challenge was breathing room air (ECRA) with workload titrated to elicit >60% estimated maximum voluntary ventilation...
September 12, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28905367/nursing-care-disparities-in-neonatal-intensive-care-units
#11
Eileen T Lake, Douglas Staiger, Erika Miles Edwards, Jessica G Smith, Jeannette A Rogowski
OBJECTIVES: To describe the variation across neonatal intensive care units (NICUs) in missed nursing care in disproportionately black and non-black-serving hospitals. To analyze the nursing factors associated with missing nursing care. DATA SOURCES/STUDY SETTING: Survey of random samples of licensed nurses in four large U.S. states. STUDY DESIGN: This was a retrospective, secondary analysis of 1,037 staff nurses in 134 NICUs classified into three groups based on their percent of infants of black race...
September 14, 2017: Health Services Research
https://www.readbyqxmd.com/read/28904647/measuring-and-advancing-experimental-design-ability-in-an-introductory-course-without-altering-existing-lab-curriculum
#12
Ryan A Shanks, Chuck L Robertson, Christian S Haygood, Anna M Herdliksa, Heather R Herdliska, Steven A Lloyd
Introductory biology courses provide an important opportunity to prepare students for future courses, yet existing cookbook labs, although important in their own way, fail to provide many of the advantages of semester-long research experiences. Engaging, authentic research experiences aid biology students in meeting many learning goals. Therefore, overlaying a research experience onto the existing lab structure allows faculty to overcome barriers involving curricular change. Here we propose a working model for this overlay design in an introductory biology course and detail a means to conduct this lab with minimal increases in student and faculty workloads...
2017: Journal of Microbiology & Biology Education: JMBE
https://www.readbyqxmd.com/read/28904325/new-medical-education-reform-in-china-towards-healthy-china-2030
#13
Peipei Song, Chunlin Jin, Wei Tang
On July 11, 2017, the State Council of China issued a bold plan to revolutionize medical education and promote collaboration between medical education and practice. The cornerstone of the plan is training more qualified medical professionals to improve public healthcare on the path to Healthy China 2030. According to this plan, a "5+3" training system will be instituted to train medical professionals in China, and top medical colleges will be encouraged to recruit more students. However, given the less-than-ideal professional status of Chinese doctors, the frequent incidents of violence against them, long working hours and a heavy workload, and an unsatisfactory income, attracting personnel to work in medicine and health care has become a challenge...
2017: Bioscience Trends
https://www.readbyqxmd.com/read/28904050/defining-high-frequency-emergency-department-use-does-one-size-fit-all-for-urban-and-rural-areas
#14
Cai Lei Matsumoto, Teresa O'Driscoll, Sharen Madden, Brittany Blakelock, Jennifer Lawrance, Len Kelly
OBJECTIVE: To suggest a functional definition for identification of "high-frequency" emergency department (ED) users in rural areas. DESIGN: Retrospective analysis of secondary data. SETTING: Sioux Lookout Meno Ya Win Health Centre in northwestern Ontario. PARTICIPANTS: All ED visitors (N = 7121) in 2014 (N = 17 911 visits) in one rural hospital. MAIN OUTCOME MEASURES: The number of patients and visits identified using different definitions of high-frequency use...
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28903861/a-decision-support-system-and-rule-based-algorithm-to-augment-the-human-interpretation-of-the-12-lead-electrocardiogram
#15
Andrew W Cairns, Raymond R Bond, Dewar D Finlay, Daniel Guldenring, Fabio Badilini, Guido Libretti, Aaron J Peace, Stephen J Leslie
BACKGROUND: The 12-lead Electrocardiogram (ECG) has been used to detect cardiac abnormalities in the same format for more than 70years. However, due to the complex nature of 12-lead ECG interpretation, there is a significant cognitive workload required from the interpreter. This complexity in ECG interpretation often leads to errors in diagnosis and subsequent treatment. We have previously reported on the development of an ECG interpretation support system designed to augment the human interpretation process...
August 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28903843/causes-and-adverse-impact-of-physician-burnout-a-systematic-review
#16
Kamran Azam, Anwar Khan, Muhammad Toqeer Alam
OBJECTIVE: To review the significant causes and effects of physician burnout in published literature. METHODOLOGY: Asystematic review was conducted for searching published literature on the causes and effects of burnout in three online databases. Inclusion and exclusion criteria were developed for final selection of papers. The selected papers were critically appraised and thematic analysis was done to identify major themes related to physician burnout. RESULTS: Thirty-one papers were finally selected among the 2,828 identified studies...
August 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28903627/reliability-and-minimal-detectable-change-of-a-new-treadmill-based-progressive-workload-incremental-test-to-measure-cardiorespiratory-fitness-in-manual-wheelchair-users
#17
Cindy Gauthier, Jasmine Arel, Rachel Brosseau, Audrey L Hicks, Dany H Gagnon
Background Cardiorespiratory fitness training is commonly provided to manual wheelchair users (MWUs) in rehabilitation and physical activity programs, emphasizing the need for a reliable task-specific incremental wheelchair propulsion test. Objective Quantifying test-retest reliability and minimal detectable change (MDC) of key cardiorespiratory fitness measures following performance of a newly developed continuous treadmill-based wheelchair propulsion test (WPTTreadmill). Methods Twenty-five MWUs completed the WPTTreadmill on two separate occasions within one week...
September 13, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28901705/peer-assisted-learning-and-small-group-teaching-to-improve-practice-placement-quality-and-capacity-in-dietetics
#18
Dianne P Reidlinger, Judy Lawrence, Jane E Thomas, Kevin Whelan
AIM: Peer-assisted learning (PAL) has been positively evaluated during practice placements for medical, nursing and some allied health professional students. The aim of this study was to evaluate a PAL and small-group teaching model of dietetic practice placement education implemented in the UK setting as part of a quality improvement process. METHODS: A PAL placement model was adapted from a previously published Australian model, implemented and evaluated among dietetic students at King's College London and with their practice educators...
September 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28900664/-prehospital-care-for-stroke-patients
#19
REVIEW
C H Nolte, H J Audebert
The effectiveness of thrombolysis or mechanical recanalization for acute stroke is higher, the sooner these therapies are started. Therefore, acute stroke patients need to be evaluated by qualified staff for these therapies as soon as possible. Lay persons need to identify the typical symptoms of stroke as an emergency and act accordingly by calling the emergency medical system (EMS). The EMS team reassesses the symptoms and prompts cerebral imaging. Cerebral imaging is performed ideally in hospitals with a stroke unit where subsequent (stroke) treatments occur...
September 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28898958/radiotherapy-for-laryngeal-cancer-technical-aspects-and-alternate-fractionation
#20
Hideya Yamazaki, Gen Suzuki, Satoaki Nakamura, Ken Yoshida, Koji Konishi, Teruki Teshima, Kazuhiko Ogawa
Early laryngeal, especially glottic, cancer is a good candidate for radiotherapy because obvious early symptoms (e.g. hoarseness) make earlier treatment possible and with highly successful localized control. This type of cancer is also a good model for exploring the basic principles of radiation oncology and several key findings (e.g. dose, fractionation, field size, patient fixation, and overall treatment time) have been noted. For example, unintended poor outcomes have been reported during transition from 60Cobalt to linear accelerator installation in the 1960s, with usage of higher energy photons causing poor dose distribution...
July 1, 2017: Journal of Radiation Research
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