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https://www.readbyqxmd.com/read/28214074/subspecialty-training-and-certification-in-geriatric-psychiatry-a-25-year-overview
#1
Dorthea Juul, Christopher C Colenda, Jeffrey M Lyness, Laura B Dunn, Rita Hargrave, Larry R Faulkner
: The Institute of Medicine estimated that by 2030, from 10.1 to 14.4 million Americans aged 65 years or older will have mental health or substance use disorders. This article reviews the history and current status of training, certification, and practice in geriatric psychiatry against the backdrop of this "silver tsunami." The American Board of Psychiatry and Neurology (ABPN) administered the first subspecialty examination in geriatric psychiatry in 1991, and through 2015 3,329 certificates were awarded...
January 9, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28213598/informing-efficient-randomised-controlled-trials-exploration-of-challenges-in-developing-progression-criteria-for-internal-pilot-studies
#2
Kerry N L Avery, Paula R Williamson, Carrol Gamble, Elaine O'Connell Francischetto, Chris Metcalfe, Peter Davidson, Hywel Williams, Jane M Blazeby
OBJECTIVES: Designing studies with an internal pilot phase may optimise the use of pilot work to inform more efficient randomised controlled trials (RCTs). Careful selection of preagreed decision or 'progression' criteria at the juncture between the internal pilot and main trial phases provides a valuable opportunity to evaluate the likely success of the main trial and optimise its design or, if necessary, to make the decision not to proceed with the main trial. Guidance on the appropriate selection and application of progression criteria is, however, lacking...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28213592/the-evidence-of-benefits-of-exercise-training-in-interstitial-lung-disease-a-randomised-controlled-trial
#3
Leona M Dowman, Christine F McDonald, Catherine J Hill, Annemarie L Lee, Kathryn Barker, Claire Boote, Ian Glaspole, Nicole S L Goh, Anne M Southcott, Angela T Burge, Rebecca Gillies, Alicia Martin, Anne E Holland
BACKGROUND: Uncertainty exists regarding the clinical relevance of exercise training across the range of interstitial lung diseases (ILDs). OBJECTIVE: To establish the impact of exercise training in patients with ILDs of differing aetiology and severity. METHODS: 142 participants with ILD (61 idiopathic pulmonary fibrosis (IPF), 22 asbestosis, 23 connective tissue disease-related ILD (CTD-ILD) and 36 with other aetiologies) were randomised to either 8 weeks of supervised exercise training or usual care...
February 17, 2017: Thorax
https://www.readbyqxmd.com/read/28212633/cooking-smoke-and-respiratory-symptoms-of-restaurant-workers-in-thailand
#4
Chudchawal Juntarawijit, Yuwayong Juntarawijit
BACKGROUND: Restaurant workers are at risk from exposure to toxic compounds from burning of fuel and fumes from cooking. However, the literature is almost silent on the issue. What discussion that can be found in the literature focuses on the potential effects from biomass smoke exposure in the home kitchen, and does not address the problem as occurring in the workplace, particularly in restaurants. METHODS: This was a cross-sectional survey of 224 worker from 142 food restaurants in the Tha Pho sub-district of Phitsanulok, a province in Thailand...
February 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28209701/patient-and-citizen-innovation-council-in-family-practice
#5
Ron T Garnett, Jane Bowman, Joanne Ganton
PROBLEM ADDRESSED: Patient engagement is integral to the Patient's Medical Home model. Patient-centred care is more than what happens in the examination room. Decisions around clinic processes, work flow, and initiative prioritization also warrant a patient perspective. OBJECTIVE OF PROGRAM: The Academic Family Medicine Clinic at the South Health Campus in Calgary, Alta, identified a need for patient and community advisory expertise regarding clinic initiatives and quality improvement...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28209331/treatment-effectiveness-of-alemtuzumab-compared-with-natalizumab-fingolimod-and-interferon-beta-in-relapsing-remitting-multiple-sclerosis-a-cohort-study
#6
Tomas Kalincik, J William L Brown, Neil Robertson, Mark Willis, Neil Scolding, Claire M Rice, Alastair Wilkins, Owen Pearson, Tjalf Ziemssen, Michael Hutchinson, Christopher McGuigan, Vilija Jokubaitis, Tim Spelman, Dana Horakova, Eva Havrdova, Maria Trojano, Guillermo Izquierdo, Alessandra Lugaresi, Alexandre Prat, Marc Girard, Pierre Duquette, Pierre Grammond, Raed Alroughani, Eugenio Pucci, Patrizia Sola, Raymond Hupperts, Jeannette Lechner-Scott, Murat Terzi, Vincent Van Pesch, Csilla Rozsa, François Grand'Maison, Cavit Boz, Franco Granella, Mark Slee, Daniele Spitaleri, Javier Olascoaga, Roberto Bergamaschi, Freek Verheul, Steve Vucic, Pamela McCombe, Suzanne Hodgkinson, Jose Luis Sanchez-Menoyo, Radek Ampapa, Magdolna Simo, Tunde Csepany, Cristina Ramo, Edgardo Cristiano, Michael Barnett, Helmut Butzkueven, Alasdair Coles
BACKGROUND: Alemtuzumab, an anti-CD52 antibody, is proven to be more efficacious than interferon beta-1a in the treatment of relapsing-remitting multiple sclerosis, but its efficacy relative to more potent immunotherapies is unknown. We compared the effectiveness of alemtuzumab with natalizumab, fingolimod, and interferon beta in patients with relapsing-remitting multiple sclerosis treated for up to 5 years. METHODS: In this international cohort study, we used data from propensity-matched patients with relapsing-remitting multiple sclerosis from the MSBase and six other cohorts...
February 10, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28206830/medical-student-beliefs-about-disclosure-of-mental-health-issues-a-qualitative-study
#7
Peter Winter, Andrew Rix, Andrew Grant
In 2012 the United Kingdom's General Medical Council (GMC) commissioned research to develop guidance for medical schools on how best to support students with mental illness. One of the key findings from medical student focus groups in the study was students' strong belief that medical schools excluded students on mental health grounds. Students believed mental illness was a fitness to practice matter that led to eventual dismissal, although neither personal experience nor empirical evidence supported this belief...
2017: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/28205253/supporting-existential-care-with-protected-mealtimes-patients-experiences-of-a-mealtime-intervention-in-a-neurological-ward
#8
Malene Beck, Regner Birkelund, Ingrid Poulsen, Bente Martinsen
AIM: To explore the experiences of patients who were admitted to the neurological ward during an intervention - inspired by Protected Mealtime - that changed the traditional mealtime practice. BACKGROUND: Mealtimes are busy events in hospitals and patients are often interrupted by high-priority tasks (e.g., taking blood samples) while eating. Protected Mealtimes is a British concept that changes the organizational structure of mealtimes and provides a focus on the mealtime by ceasing all non-acute activities while patients are eating...
February 15, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28203120/international-lessons-in-new-methods-for-grading-and-integrating-cost-effectiveness-evidence-into-clinical-practice-guidelines
#9
REVIEW
Kathryn M Antioch, Michael F Drummond, Louis W Niessen, Hindrik Vondeling
Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28198755/career-development-support-in-pediatric-critical-care-medicine-a-national-survey-of-fellows-and-junior-faculty
#10
Christina L Cifra, Shilpa S Balikai, Tanya D Murtha, Benson Hsu, Carley L Riley
OBJECTIVES: To determine the perceptions of current pediatric critical care medicine fellows and junior faculty regarding the extent and quality of career development support received during fellowship training. DESIGN: Web-based cross-sectional survey open from September to November 2015. SETTING: Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs. SUBJECTS: Pediatric critical care medicine fellows (second yr or higher) and junior faculty (within 5 yr of completing a pediatric critical care medicine fellowship program)...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28196575/workplace-violence-against-nurses-vhembe-district-hospitals-south-africa
#11
Tshifularo Olga Mahani, Henry Abayomi Akinsola, Jabu Mabunda, Helen Tosin Oni
INTRODUCTION: Work-related violence is a common problem worldwide. In South Africa, the Medical Research Council conducted a study on workplace violence in the health care industry and reported that most respondents had experienced it in different forms. PURPOSE: This study aimed to identify the types and causes of workplace violence toward nurses in Thulamela hospitals, Vhembe district. METHODS: The study employed a quantitative approach using a cross-sectional design...
February 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28196230/association-between-the-probability-of-autism-spectrum-disorder-and-normative-sex-related-phenotypic-diversity-in-brain-structure
#12
Christine Ecker, Derek S Andrews, Christina M Gudbrandsen, Andre F Marquand, Cedric E Ginestet, Eileen M Daly, Clodagh M Murphy, Meng-Chuan Lai, Michael V Lombardo, Amber N V Ruigrok, Edward T Bullmore, John Suckling, Steven C R Williams, Simon Baron-Cohen, Michael C Craig, Declan G M Murphy
Importance: Autism spectrum disorder (ASD) is 2 to 5 times more common in male individuals than in female individuals. While the male preponderant prevalence of ASD might partially be explained by sex differences in clinical symptoms, etiological models suggest that the biological male phenotype carries a higher intrinsic risk for ASD than the female phenotype. To our knowledge, this hypothesis has never been tested directly, and the neurobiological mechanisms that modulate ASD risk in male individuals and female individuals remain elusive...
February 8, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28195537/-exit-exams-for-medical-graduates-a-guarantee-of-quality
#13
Ranjit Kumar Dehury, Janmejaya Samal
Despite a great deal of opposition from many segments of the medical community, the Medical Council of India (MCI) has proposed to the Ministry of Health and Family Welfare, Government of India that a pan-India exit examination be introduced for graduating MBBS doctors. Whether the proposal should be put forward was considered twice, once in 2010 and again in 2013, and finally the plan was ready to be taken forward seriously in 2015. The proposal has elicited appreciation and criticism from different segments of the medical community...
January 12, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28193242/process-evaluation-of-a-cluster-randomised-trial-testing-a-pressure-ulcer-prevention-care-bundle-a-mixed-methods-study
#14
Shelley Roberts, Elizabeth McInnes, Tracey Bucknall, Marianne Wallis, Merrilyn Banks, Wendy Chaboyer
BACKGROUND: As pressure ulcers contribute to significant patient burden and increased health care costs, their prevention is a clinical priority. Our team developed and tested a complex intervention, a pressure ulcer prevention care bundle promoting patient participation in care, in a cluster-randomised trial. The UK Medical Research Council recommends process evaluation of complex interventions to provide insight into why they work or fail and how they might be improved. This study aimed to evaluate processes underpinning implementation of the intervention and explore end-users' perceptions of it, in order to give a deeper understanding of its effects...
February 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28193109/child-neurology-education-for-pediatric-residents
#15
Dara V F Albert, Anup D Patel, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Nicole Verbeck, Alisa McQueen, H Barrett Fromme, John D Mahan
The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28190762/optimal-fractionation-of-preoperative-radiotherapy-and-timing-to-surgery-for-rectal-cancer-stockholm-iii-a-multicentre-randomised-non-blinded-phase-3-non-inferiority-trial
#16
Johan Erlandsson, Torbjörn Holm, David Pettersson, Åke Berglund, Björn Cedermark, Calin Radu, Hemming Johansson, Mikael Machado, Fredrik Hjern, Olof Hallböök, Ingvar Syk, Bengt Glimelius, Anna Martling
BACKGROUND: Radiotherapy reduces the risk of local recurrence in rectal cancer. However, the optimal radiotherapy fractionation and interval between radiotherapy and surgery is still under debate. We aimed to study recurrence in patients randomised between three different radiotherapy regimens with respect to fractionation and time to surgery. METHODS: In this multicentre, randomised, non-blinded, phase 3, non-inferiority trial (Stockholm III), all patients with a biopsy-proven adenocarcinoma of the rectum, without signs of non-resectability or distant metastases, without severe cardiovascular comorbidity, and planned for an abdominal resection from 18 Swedish hospitals were eligible...
February 9, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28190757/consensus-bundle-on-maternal-mental-health-perinatal-depression-and-anxiety
#17
Susan Kendig, John P Keats, M Camille Hoffman, Lisa B Kay, Emily S Miller, Tiffany A Moore Simas, Ariela Frieder, Barbara Hackley, Pec Indman, Christena Raines, Kisha Semenuk, Katherine L Wisner, Lauren A Lemieux
Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue...
February 4, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28190578/quarter-dose-quadruple-combination-therapy-for-initial-treatment-of-hypertension-placebo-controlled-crossover-randomised-trial-and-systematic-review
#18
Clara K Chow, Jay Thakkar, Alex Bennett, Graham Hillis, Michael Burke, Tim Usherwood, Kha Vo, Kris Rogers, Emily Atkins, Ruth Webster, Michael Chou, Hakim-Moulay Dehbi, Abdul Salam, Anushka Patel, Bruce Neal, David Peiris, Henry Krum, John Chalmers, Mark Nelson, Christopher M Reid, Mark Woodward, Sarah Hilmer, Simon Thom, Anthony Rodgers
BACKGROUND: Globally, most patients with hypertension are treated with monotherapy, and control rates are poor because monotherapy only reduces blood pressure by around 9/5 mm Hg on average. There is a pressing need for blood pressure-control strategies with improved efficacy and tolerability. We aimed to assess whether ultra-low-dose combination therapy could meet these needs. METHODS: We did a randomised, placebo-controlled, double-blind, crossover trial of a quadpill-a single capsule containing four blood pressure-lowering drugs each at quarter-dose (irbesartan 37·5 mg, amlodipine 1·25 mg, hydrochlorothiazide 6·25 mg, and atenolol 12·5 mg)...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/28187805/the-history-of-neurocritical-care
#19
E F M Wijdicks
Critical care medicine came into sharp focus in the second part of the 20th century. The care of acutely ill neurologic patients in the USA may have originated in postoperative neurosurgical units, but for many years patients with neurocritical illness were admitted to intensive care units next to patients with general medical or surgical conditions. Neurologists may have had their first exposure to the complexity of neurocritical care during the poliomyelitis epidemics, but few were interested. Much later, the development of neurocritical care as a legitimate subspecialty was possible as a result of a new cadre of neurologists, with support by departments of neurosurgery and anesthesia, who appreciated their added knowledge and expertise in care of acute neurologic illness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186686/combined-bone-marrow-derived-mesenchymal-stromal-cell-therapy-and-one-way-endobronchial-valve-placement-in-patients-with-pulmonary-emphysema-a-phase-i-clinical-trial
#20
Hugo Goulart de Oliveira, Fernanda Ferreira Cruz, Mariana Alves Antunes, Amarilio Vieira de Macedo Neto, Guilherme Augusto Oliveira, Fabio Munhoz Svartman, Tamara Borgonovo, Carmen Lucia Kuniyoshi Rebelatto, Daniel J Weiss, Paulo Roberto Slud Brofman, Marcelo Marcos Morales, José Roberto Lapa E Silva, Patricia Rieken Macedo Rocco
One-way endobronchial valves (EBV) insertion to reduce pulmonary air trapping has been used as therapy for chronic obstructive pulmonary disease (COPD) patients. However, local inflammation may result and can contribute to worsening of clinical status in these patients. We hypothesized that combined EBV insertion and intrabronchial administration of mesenchymal stromal cells (MSCs) would decrease the inflammatory process, thus mitigating EBV complications in severe COPD patients. This initial study sought to investigate the safety of this approach...
December 9, 2016: Stem Cells Translational Medicine
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