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https://www.readbyqxmd.com/read/28102968/thoracic-ultrasound-recognition-of-competence-a-position-paper-of-the-thoracic-society-of-australia-and-new-zealand
#1
Jonathan P Williamson, Scott H Twaddell, Y C Gary Lee, Matthew Salamonsen, Mark Hew, David Fielding, Phan Nguyen, Daniel Steinfort, Peter Hopkins, Nicola Smith, Christopher Grainge
The ability to perform bedside thoracic ultrasound is increasingly recognized as an essential skill for thoracic clinicians, extending the clinical examination and aiding diagnostic and therapeutic procedures. Thoracic ultrasound reduces complications and increases success rates when used prior to thoracentesis or intercostal chest tube insertion. It is increasingly difficult to defend performing these procedures without real or near-real time image guidance. To assist thoracic physicians and others achieve and demonstrate thoracic ultrasound competence, the Interventional Pulmonology Special Interest Group (IP-SIG) of the Thoracic Society of Australia and New Zealand (TSANZ) has developed a new pathway with four components: (i) completion of an approved thoracic ultrasound theory and hands-on teaching course...
February 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28100204/acceptance-and-attitudes-of-healthcare-staff-towards-the-introduction-of-clinical-pharmacy-service-a-descriptive-cross-sectional-study-from-a-tertiary-care-hospital-in-sri-lanka
#2
Lelwala Guruge Thushani Shanika, Chandrani Nirmala Wijekoon, Shaluka Jayamanne, Judith Coombes, Ian Coombes, Nilani Mamunuwa, Andrew Hamilton Dawson, Hithanadura Asita De Silva
BACKGROUND: Multidisciplinary patient management including a clinical pharmacist shows an improvement in patient quality use of medicine. Implementation of a clinical pharmacy service represents a significant novel change in practice in Sri Lanka. Although attitudes of doctors and nurses are an important determinant of successful implementation, there is no Sri Lankan data about staff attitudes to such changes in clinical practice. This study determines the level of acceptance and attitudes of doctors and nurses towards the introduction of a ward-based clinical pharmacy service in Sri Lanka...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28099787/cultural-sensitivity-among-clinical-nurses-a-descriptive-study
#3
Medine Yilmaz, Serap Toksoy, Zübeyde Denizci Direk, Selma Bezirgan, Münevver Boylu
PURPOSE: The purpose of this study was to investigate the cultural sensitivity of nurses working in rural and urban hospitals in Turkey. DESIGN AND METHODS: The sampling of this descriptive and correlational study was composed of only 516 clinical nurses working in inpatient clinics. The data collection tools were the Socio-Demographic Questionnaire and the Intercultural Sensitivity Scale. FINDINGS: A majority of the participating nurses experienced culture-related problems...
January 18, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28099372/effect-of-sequence-of-simulated-and-clinical-practicum-learning-experiences-on-clinical-competency-of-nursing-students
#4
Jamie Hansen, Marilyn Bratt
Two different sequences of blocks of simulated and clinical practicum learning experiences compared the clinical competency development of nursing students using a randomized crossover design. Competency was measured 3 times: after each block of simulated and clinical experiences and after a final simulated experience. No significant differences in competency scores between the 2 groups across the 3 time points were found. Using alternative models of clinical and simulation learning may help address barriers to the delivery of clinical education faced by schools of nursing...
January 18, 2017: Nurse Educator
https://www.readbyqxmd.com/read/28099326/implementation-of-a-needs-based-online-feedback-tool-for-anesthesia-residents-with-subsequent-mapping-of-the-feedback-to-the-acgme-milestones
#5
Pedro Tanaka, Sylvia Bereknyei Merrell, Kim Walker, Jennifer Zocca, Lena Scotto, Alyssa L Bogetz, Alex Macario
BACKGROUND: Optimizing feedback that residents receive from faculty is important for learning. The goals of this study were to (1) conduct focus groups of anesthesia residents to define what constitutes optimal feedback; (2) develop, test, and implement a web-based feedback tool; and (3) then map the contents of the written comments collected on the feedback tool to the Accreditation Council for Graduate Medical Education (ACGME) anesthesiology milestones. METHODS: All 72 anesthesia residents in the program were invited to participate in 1 of 5 focus groups scheduled over a 2-month period...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099309/the-core-competencies-for-general-orthopaedic-surgeons
#6
James F Kellam, Douglas Archibald, James W Barber, Eugene P Christian, Richard J D'Ascoli, Richard J Haynes, Suzanne S Hecht, Shepard R Hurwitz, James F Kellam, Alexander C McLaren, Terrance D Peabody, Stephen R Southworth, Robert W Strauss, Veronica M R Wadey
BACKGROUND: With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. METHODS: Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28099177/medical-students-perspectives-on-implementing-curriculum-change-at-one-institution
#7
Aaron M Yengo-Kahn, Courtney E Baker, Kimberly D Lomis
Training physicians to be effective practitioners throughout their careers begins in undergraduate medical education with particular focus on self-directed inquiry, professional and interprofessional development, and competency-based assessment. A select number of medical schools are restructuring their curricula by placing the student at the center of content delivery to enhance the learning experience. While this restructuring may benefit the adult learner, administrators often make assumptions about how students will perceive and respond to such innovative and unfamiliar educational concepts...
January 17, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28097997/the-4c-framework-for-making-reasonable-adjustments-for-people-with-learning-disabilities
#8
Daniel Marsden, Rachel Giles
Background People with learning disabilities experience significant inequalities in accessing healthcare. Legal frameworks, such as the Equality Act 2010, are intended to reduce such disparities in care, and require organisations to make 'reasonable adjustments' for people with disabilities, including learning disabilities. However, reasonable adjustments are often not clearly defined or adequately implemented in clinical practice. Aim To examine and synthesise the challenges in caring for people with learning disabilities to develop a framework for making reasonable adjustments for people with learning disabilities in hospital...
January 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28096912/mortality-trends-and-the-impact-of-lymphadenectomy-on-survival-for-renal-cell-carcinoma-patients-with-distant-metastasis
#9
Hiten D Patel, Michael A Gorin, Natasha Gupta, Max Kates, Michael H Johnson, Phillip M Pierorazio, Mohamad E Allaf
INTRODUCTION: Current treatment paradigms for metastatic renal cell carcinoma (mRCC) invoke a combination of surgical and systemic therapies. We sought to quantify trends in mortality and performance of lymphadenectomy, as well as impact on survival for patients with mRCC. METHODS: The Surveillance, Epidemiology, and End Results registry (SEER) (1988-2011) identified patients with mRCC. Kaplan-Meier curves and Cox proportional hazards models with competing risks regression were employed to assess survival...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28096666/barriers-and-facilitators-influencing-self-management-among-copd-patients-a-mixed-methods-exploration-in-primary-and-affiliated-specialist-care
#10
Chantal F Hillebregt, Auke J Vlonk, Marc A Bruijnzeels, Onno Cp van Schayck, Niels H Chavannes
Self-management is becoming increasingly important in COPD health care although it remains difficult to embed self-management into routine clinical care. The implementation of self-management is understood as a complex interaction at the level of patient, health care provider (HCP), and health system. Nonetheless there is still a poor understanding of the barriers and effective facilitators. Comprehension of these determinants can have significant implications in optimizing self-management implementation and give further directions for the development of self-management interventions...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28096240/coevolution-of-leukemia-and-host-immune-cells-in-chronic-lymphocytic-leukemia
#11
Noelia Purroy, C J Wu
Cumulative studies on the dissection of changes in driver genetic lesions in cancer across the course of the disease have provided powerful insights into the adaptive mechanisms of tumors in response to the selective pressures of therapy and environmental changes. In particular, the advent of next-generation-sequencing (NGS)-based technologies and its implementation for the large-scale comprehensive analyses of cancers have greatly advanced our understanding of cancer as a complex dynamic system wherein genetically distinct subclones interact and compete during tumor evolution...
January 17, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28095836/physiotherapy-clinical-educators-perceptions-of-student-fitness-to-practise
#12
Kristin Lo, Heather Curtis, Jennifer L Keating, Margaret Bearman
BACKGROUND: Health professional students are expected to maintain Fitness to Practise (FTP) including clinical competence, professional behaviour and freedom from impairment (physical/mental health). FTP potentially affects students, clinicians and clients, yet the impact of supervising students across the spectrum of FTP issues remains relatively under-reported. This study describes clinical educators' perceptions of supporting students with FTP issues. METHODS: Between November 2012 and January 2013 an online survey was emailed to physiotherapy clinical educators from 34 sites across eight health services in Australia...
January 17, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28095811/an-integrated-recovery-oriented-model-irm-for-mental-health-services-evolution-and-challenges
#13
Barry G Frost, Srinivasan Tirupati, Suzanne Johnston, Megan Turrell, Terry J Lewin, Ketrina A Sly, Agatha M Conrad
BACKGROUND: Over past decades, improvements in longer-term clinical and personal outcomes for individuals experiencing serious mental illness (SMI) have been moderate, although recovery has clearly been shown to be possible. Recovery experiences are inherently personal, and recovery can be complex and non-linear; however, there are a broad range of potential recovery contexts and contributors, both non-professional and professional. Ongoing refinement of recovery-oriented models for mental health (MH) services needs to be fostered...
January 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28095268/impact-of-increasing-age-on-cause-specific-mortality-and-morbidity-in-patients-with-stage-i-non-small-cell-lung-cancer-a-competing-risks-analysis
#14
Takashi Eguchi, Sarina Bains, Ming-Ching Lee, Kay See Tan, Boris Hristov, Daniel H Buitrago, Manjit S Bains, Robert J Downey, James Huang, James M Isbell, Bernard J Park, Valerie W Rusch, David R Jones, Prasad S Adusumilli
Purpose To perform competing risks analysis and determine short- and long-term cancer- and noncancer-specific mortality and morbidity in patients who had undergone resection for stage I non-small-cell lung cancer (NSCLC). Patients and Methods Of 5,371 consecutive patients who had undergone curative-intent resection of primary lung cancer at our institution (2000 to 2011), 2,186 with pathologic stage I NSCLC were included in the analysis. All preoperative clinical variables known to affect outcomes were included in the analysis, specifically, Charlson comorbidity index, predicted postoperative (ppo) diffusing capacity of the lung for carbon monoxide, and ppo forced expiratory volume in 1 second...
January 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28095168/does-having-a-culturally-competent-healthcare-provider-affect-the-patients-experience-or-satisfaction-a-critically-appraised-topic
#15
Miranda Brunett, René Revis Shingles
Clinical Scenario: The level of cultural competence of healthcare providers has been studied. However, limited scholarship has examined whether the cultural competence of the healthcare provider affects patient satisfaction. Focused Clinical Question: Does cultural competence of healthcare providers influence patient satisfaction with their experience with their provider? Summary of Key Findings: Having a culturally competent healthcare provider, or one who a patient perceives as culturally competent, does increase patient satisfaction...
January 17, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28095160/minimal-loss-of-lifetime-for-patients-with-diffuse-large-b-cell-lymphoma-in-remission-and-event-free-24-months-after-treatment-a-danish-population-based-study
#16
Lasse Hjort Jakobsen, Martin Bøgsted, Peter de Nully Brown, Bente Arboe, Judit Jørgensen, Thomas Stauffer Larsen, Maja Bech Juul, Lene Schurmann, Linda Højberg, Olav Jonas Bergmann, Therese Lassen, Pär Lars Josefsson, Paw Jensen, Hans Erik Johnsen, Tarec Christoffer El-Galaly
Purpose The general outlook for patients with diffuse large B-cell lymphoma (DLBCL) in first remission is important information for patients and for planning post-treatment follow-up. The purpose of this study was to evaluate the survival of patients with DLBCL in remission compared with a matched general population. Methods A total of 1,621 patients from the Danish Lymphoma Registry who were newly diagnosed with DLBCL between 2003 and 2011 were included in this study. All patients were ≥ 16 years of age at diagnosis and had achieved complete remission or complete remission unconfirmed after first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or R-CHOP-like therapy...
January 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28095147/management-of-small-renal-masses-american-society-of-clinical-oncology-clinical-practice-guideline
#17
Antonio Finelli, Nofisat Ismaila, Bill Bro, Jeremy Durack, Scott Eggener, Andrew Evans, Inderbir Gill, David Graham, William Huang, Michael A S Jewett, Sheron Latcha, William Lowrance, Mitchell Rosner, Bobby Shayegan, Houston R Thompson, Robert Uzzo, Paul Russo
Purpose To provide recommendations for the management options for patients with small renal masses (SRMs). Methods By using a literature search and prospectively defined study selection, we sought systematic reviews, meta-analyses, randomized clinical trials, prospective comparative observational studies, and retrospective studies published from 2000 through 2015. Outcomes included recurrence-free survival, disease-specific survival, and overall survival. Results Eighty-three studies, including 20 systematic reviews and 63 primary studies, met the eligibility criteria and form the evidentiary basis for the guideline recommendations...
January 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28094638/how-to-remove-an-indwelling-urinary-catheter-in-female-patients
#18
Alison Bardsley
Rationale and key points This article aims to assist nurses to undertake the removal of an indwelling urinary catheter in female patients in a safe, timely, effective and patient-centred manner, while maintaining the patient's privacy and dignity. It is important for the nurse to be competent in undertaking this procedure, and to be aware of local and national policies on catheter removal. » Indwelling urinary catheters should be changed only when clinically necessary, or according to the manufacturer's guidelines...
January 4, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28093867/paramedic-resuscitation-competency-a-survey-of-australian-and-new-zealand-emergency-medical-services
#19
Kylie Dyson, Janet E Bray, Karen Smith, Stephen Bernard, Lahn Straney, Judith Finn
OBJECTIVE: We have previously established that paramedic exposure to out-of-hospital cardiac arrest (OHCA) is relatively rare, therefore clinical exposure cannot be relied on to maintain resuscitation competency. We aimed to identify the current practices within emergency medical services (EMS) for developing and maintaining paramedic resuscitation competency. METHODS: We developed and conducted an online cross-sectional survey of Australian and New Zealand EMS in 2015...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28093700/postdiagnostic-use-of-%C3%AE-blockers-and-other-antihypertensive-drugs-and-the-risk-of-recurrence-and-mortality-in-head-and-neck-cancer-patients-an-observational-study-of-10-414-person-years-of-follow-up
#20
S-A Kim, H Moon, J-L Roh, S-B Kim, S-H Choi, S Y Nam, S Y Kim
INTRODUCTION: Growing evidence indicates that norepinephrine promotes cancer growth and metastasis whereas β-blockers decrease these risks. This study aimed to examine the clinical impact of β-blockers and other hypertensive drugs on disease recurrence and survival in patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: This study analyzed a cohort of 1274 consecutive patients who received definitive treatments for previously untreated HNSCC at our tertiary referral center between January 2001 and December 2012...
January 16, 2017: Clinical & Translational Oncology
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