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https://www.readbyqxmd.com/read/28645125/-epidemiology-of-parkinson-s-disease-and-current-concepts%C3%A2-of-outpatient-care-in-germany
#1
Lars Tönges, Reinhard Ehret, Michael Lorrain, Peter Riederer, Martina Müngersdorf
The ambulatory care of patients with Parkinson's disease (PD) in Germany has been established for a long time. As the prevalence of Parkinson's disease continues to increase, the outpatient neurological sector is becoming more and more important and needs to adapt itself to current needs. This includes an optimization of the care structures for Parkinson's patients as well as adequate concepts for the execution of differentiated diagnostics and therapy. For many patients care is provided by non-specialized neurological practices or general practitioners, without exchange of views with neurologists or a specialized university outpatient clinic for movement disorders...
June 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28644924/intravenous-thrombolysis-for-acute-ischemic-stroke-a-bridge-between-two-centuries
#2
Georgios Tsivgoulis, Odysseas Kargiotis, Andrei Alexandrov
Intravenous tissue-plasminogen activator (tPA) remains the only approved systemic reperfusion therapy suitable for most patients presenting timely with acute ischemic stroke. Accumulating real-word experience for over 20 years regarding tPA safety and effectiveness lead to re-appraisal of original contraindications for intravenous thrombolysis (IVT). Areas covered: This narrative review focuses on fast yet appropriate selection of patients for safe administration of tPA per recently expanded indications. Novel strategies for rapid patient assessment will be discussed...
June 23, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28644789/what-is-the-role-of-ethics-consultation-in-the-moral-habitability-of-health-care-environments
#3
Wendy Austin
Ethics consultation has traditionally focused on the provision of expert guidance to health care professionals when challenging quandaries arise in clinical cases. Its role, however, is expanding as demands on health care organizations are negatively impacting their moral habitability. A sign of this impact can be seen in the moral distress experienced by staff and administrators, such that some leave their positions and their organizations. Ethics consultation, more broadly conceived, can be a major asset in ensuring that ethical practice is meaningfully supported, that moral distress is mitigated, and that the organizational environment is morally habitable...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644360/quality-improvement-in-pediatric-endoscopy-a-clinical-report-from-the-naspghan-endoscopy-committee
#4
Robert E Kramer, Catharine M Walsh, Diana G Lerner, Douglas S Fishman
The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644037/lower-risk-cannabis-use-guidelines-a-comprehensive-update-of-evidence-and-recommendations
#5
Benedikt Fischer, Cayley Russell, Pamela Sabioni, Wim van den Brink, Bernard Le Foll, Wayne Hall, Jürgen Rehm, Robin Room
BACKGROUND: Cannabis use is common in North America, especially among young people, and is associated with a risk of various acute and chronic adverse health outcomes. Cannabis control regimes are evolving, for example toward a national legalization policy in Canada, with the aim to improve public health, and thus require evidence-based interventions. As cannabis-related health outcomes may be influenced by behaviors that are modifiable by the user, evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG)-akin to similar guidelines in other health fields-offer a valuable, targeted prevention tool to improve public health outcomes...
June 23, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28643054/a-structured-extended-training-program-to-facilitate-adoption-of-new-techniques-for-practicing-surgeons
#6
Jacob A Greenberg, Sally Jolles, Sarah Sullivan, Sudha Pavuluri Quamme, Luke M Funk, Anne O Lidor, Caprice Greenberg, Carla M Pugh
INTRODUCTION: Laparoscopic inguinal hernia repair has been shown to have significant benefits when compared to open inguinal hernia repair, yet remains underutilized in the United States. The traditional model of short, hands-on, cognitive courses to enhance the adoption of new techniques fails to lead to significant levels of practice implementation for most surgeons. We hypothesized that a comprehensive program would facilitate the adoption of laparoscopic inguinal hernia repair (TEP) for practicing surgeons...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28641502/ordering-theories-typologies-and-conceptual-frameworks-for-sociotechnical-change
#7
Benjamin K Sovacool, David J Hess
What theories or concepts are most useful at explaining socio technical change? How can - or cannot - these be integrated? To provide an answer, this study presents the results from 35 semi-structured research interviews with social science experts who also shared more than two hundred articles, reports and books on the topic of the acceptance, adoption, use, or diffusion of technology. This material led to the identification of 96 theories and conceptual approaches spanning 22 identified disciplines. The article begins by explaining its research terms and methods before honing in on a combination of fourteen theories deemed most relevant and useful by the material...
June 1, 2017: Social Studies of Science
https://www.readbyqxmd.com/read/28641324/treatment-preferences-for-decompression-illness-amongst-singapore-dive-physicians
#8
Valerie Huali Tan, Kenneth Chin, Aravin Kumar, Jeremiah Chng, Chai Rick Soh Rick Soh
INTRODUCTION: Owing to the scarcity of randomized controlled trials to guide treatment for decompression illness (DCI), there are many unanswered questions about its management. Apart from reviews and expert opinion, surveys that report practice patterns provide information about useful management strategies. Hence, this study aimed to identify current treatment preferences for DCI amongst diving physicians in Singapore. METHODS: An anonymous web-based questionnaire was sent to known diving physicians in Singapore...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28640027/exploring-integration-in-action-competencies-as-building-blocks-of-expertise
#9
Maria Mylopoulos, Debaroti Tina Borschel, Tara O'Brien, Sofia Martimianakis, Nicole N Woods
PURPOSE: Competency frameworks such as the CanMEDS roles and the ACGME core competencies may lead to the implicit assumption that physicians can learn and practice individual competencies in isolation. In contrast, models of adaptive expertise suggest that the integration of competencies reflects the capabilities of an expert physician. Thus, educational programming aimed at teaching discrete roles or competencies might overlook expert physician capabilities that are central to patient care...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28639837/measuring-cerebrovascular-autoregulation-in-preterm-infants-using-near-infrared-spectroscopy-an-overview-of-the-literature
#10
Elisabeth M W Kooi, Elise A Verhagen, Jan Willem J Elting, Marek Czosnyka, Topun Austin, Flora Y Wong, Marcel J H Aries
The preterm born infant's ability to regulate its cerebral blood flow (CBF) is crucial in preventing secondary ischemic and hemorrhagic damage in the developing brain. The relationship between arterial blood pressure (ABP) and CBF estimates, such as regional cerebral oxygenation as measured by near-infrared spectroscopy (NIRS), is an attractive option for continuous non-invasive assessment of cerebrovascular autoregulation. Areas covered: The authors performed a literature search to provide an overview of the current literature on various current clinical practices and methods to measure cerebrovascular autoregulation in the preterm infant by NIRS...
June 22, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28639605/-the-definition-of-sepsis-25-year-experience-of-concept-development
#11
V P Sazhin, A M Karsanov, S S Maskin, O V Remizov
The review, presented in chronological order the stages of formation of the modern definition of sepsis syndrome, since the recommendations of the conciliation conference ACCP/SCCM (1991), the experience of the practical use of which has been extensively critically assessed in future studies. As a result, it formed a strong opinion that the global challenge of early diagnosis of sepsis, under the previously proposed definitive categories have not been solved, moreover, in the scientific community formed a firm belief in the need to make fundamental changes in the definition of the term 'sepsis'...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28639525/considerations-when-conducting-e-delphi-research-a-case-study
#12
Coleen Toronto
Background E-Delphi is a way to access a geographically dispersed group of experts. It is similar to other Delphi methods but conducted online. E-research methodologies, such as the e-Delphi method, have yet to undergo significant critical discussion. Aim To highlight some of the challenges nurse researchers may wish to consider when using e-Delphi in their research. Discussion This paper provides details about the author's approach to conducting an e-Delphi study in which a group of health literacy nurse experts (n=41) used an online survey platform to identify and prioritise essential health literacy competencies for registered nurses...
June 22, 2017: Nurse Researcher
https://www.readbyqxmd.com/read/28639449/-optic-properties-of-myopic-correction-by-orthokeratology-contact-lenses-a-case-report
#13
M Mýlková, F Pluháček
INTRODUCTION: Orthokeratology lenses present a special type of hard contact lenses, which is used especially for myopic correction. The lenses are applied during the night, when thanks to their special shape cause temporally (reversible) change of the cornea shape. During the day, there is not necessary to wear any other refractive correction. Due to the wearing regimen, there is, comparing to the classical contact lenses, higher risk of health complications. For their safe use, it is necessary to pay attention to the application of lenses of adequate parameters, follow up the care and hygiene precautions, regular controls and early treatment of possible problems...
2017: Ceská a Slovenská Oftalmologie
https://www.readbyqxmd.com/read/28637619/practical-considerations-for-diagnosis-and-management-of-patients-and-carriers
#14
REVIEW
Charlotte M Niemeyer, Cristina Mecucci
Newly diagnosed children and adults with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) need to be screened for presence of a genetic predisposition syndrome because the information on the genetic status is likely to influence clinical care and management of the patient and the family. Scenarios in which genetic counseling is advised include presence of a mutation on somatic screen that can be associated with a germline predisposition, hematologic or cytogenetic characteristics suggestive of an underlying susceptibility syndrome, non-hematological phenotype suspicious for a familial condition, history of previous malignancy, or a family history of cancer, cytopenia, autoimmunity, or organ-system manifestation fitting a predisposition syndrome...
April 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28637483/analyzing-human-decisions-in-igrt-of-head-and-neck-cancer-patients-to-teach-image-registration-algorithms-what-experts-know
#15
Eva Maria Stoiber, Nina Bougatf, Hendrik Teske, Christian Bierstedt, Dieter Oetzel, Jürgen Debus, Rolf Bendl, Kristina Giske
BACKGROUND: In IGRT of deformable head-and-neck anatomy, patient setup corrections are derived by rigid registration methods. In practice, experienced radiation therapists often correct the resulting vectors, thus indicating a different prioritization of alignment of local structures. Purpose of this study is to transfer the knowledge experts apply when correcting the automatically generated result (pre-match) to automated registration. METHODS: Datasets of 25 head-and-neck-cancer patients with daily CBCTs and corresponding approved setup correction vectors were analyzed...
June 21, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28637234/a-baseline-assessment-by-healthcare-professionals-of-dutch-pharmacotherapeutic-care-for-the-elderly-with-polypharmacy
#16
Lutien Bakker, Peter F Kemper, Cordula Wagner, Gepke O Delwel, Martine C de Bruijne
Polypharmacy is common in the elderly population and is associated with an increased risk of adverse drug events. To diminish this risk, the guideline 'Polypharmacy in the Elderly' has been developed in 2012. This study examines, to what extent Dutch pharmacotherapeutic practice amongst elderly with polypharmacy mirrors the best practice described in this guideline and which barriers threaten it. An observational study was conducted in 2013/14 using a questionnaire distributed amongst Dutch healthcare professionals and elderly patients with polypharmacy...
June 14, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28637156/the-sink-or-swim-hypothesis-a-roadmap-from-pathology-to-work-instability
#17
Bilal Akter Mateen, Catherine Doogan, Kate Hayward, Susan Hourihan, Joanne Hurford, E Diane Playford
PURPOSE: Selecting the most appropriate health-related work outcome to evaluate an intervention can be fraught with difficulty. To aid clinicians in navigating this problem we have developed a model, which illustrates how pathology can affect specific measureable quantities, such as work instability. METHODS: Using a modified-Delphi procedure, a panel of experts met initially to analyze the content of 95 health-related work outcome measures and organize the identified areas of measurement into a coherent model, complemented by a narrative review of the literature...
March 3, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28636480/the-emerging-role-of-pimavanserin-in-the-management-of-parkinson-s-disease-psychosis
#18
Neal Hermanowicz, Gustavo Alva, Fernando Pagan, Alberto J Espay, Amita Patel, Katya Cruz Madrid, Daniel Kremens, Jim Kenney, Sheila Arquette, Gary Tereso, Maria Lopes, Carolyn Farnum
A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key points emerged from the discussion: (1) Because of the nature of Parkinson's disease and PDP, finding appropriate treatment can prove challenging; (2) emerging therapies may present an opportunity for effective disease management; and (3) moving forward, provider and patient education regarding PDP and available treatment options is essential for well-managed symptoms and better quality of life...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28635868/-the-modern-possibilities-for-the-application-of-photogrammetry-in-forensic-medical-traumatology
#19
V A Fetisov, I Yu Makarov, A A Gusarov, A S Lorents, S A Smirenin, V B Stragis
The authors discuss the modern possibilities and prospects for the application of photogrammetry (FM) in forensic medical traumatology based on the results of the analysis of the many-year experience reported in the foreign periodicals with special reference to road traffic injuries, gunshot wounds, and animals' bites. The examples of objective difficulties and promising prospects for the further application of the FM techniques in the practical work of forensic medical experts and medical criminalists are considered with reference to the use of various FM-based methods and equipment including 3D laser scanners, chambers, stereoscopic mounting attachments, etc...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28635066/consensus-development-of-quality-indicators-for-end-of-life-care-for-elders-in-japan
#20
Harue Masaki, Nobuko Kawai, Keiko Matsumoto, Miyoko Kuwata, Sachiko Yoshioka, Midori Nishiyama, Ryoko Uchino, Hiroko Nagae, Megumi Teshima, Sayuri Sakai, Kazuko Endo
AIMS AND OBJECTIVES: Quality indicators for end-of-life care have been published; however, none have been developed specifically for nursing in the cultural and traditional context of Japan. This study aimed to develop and build a consensus of quality indicators for end-of-life care for elders in Japan from the perspective of nursing science. METHODS: To develop the quality indicators, we used a literature review, expert panel process, and the Delphi technique among clinical nurse specialists in geriatrics...
June 2017: International Journal of Nursing Practice
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