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https://www.readbyqxmd.com/read/27914313/requests-for-cesarean-deliveries-the-politics-of-labor-pain-and-pain-relief-in-shanghai-china
#1
Eileen Wang
Cesarean section rates have risen dramatically in China within the past 25 years, particularly driven by non-medical factors and maternal requests. One major reason women request cesareans is the fear of labor pain, in a country where a minority of women are given any form of pain relief during labor. Drawing upon ethnographic fieldwork and in-depth interviews with 26 postpartum women and 8 providers at a Shanghai district hospital in June and July of 2015, this article elucidates how perceptions of labor pain and the environment of pain relief constructs the cesarean on maternal request...
November 24, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27914193/coaching-a-new-model-for-academic-and-career-achievement
#2
Nicole M Deiorio, Patricia A Carney, Leslie E Kahl, Erin M Bonura, Amy Miller Juve
BACKGROUND: Individualized education is emerging as an innovative model for physician training. This requires faculty coaching to guide learners' achievements in academic performance, competency development, and career progression. In addition, coaching can foster self-reflection and self-monitoring using a data-guided approach to support lifelong learning. CONTEXT: Coaching differs from mentoring or advising, and its application in medical education is novel. Because of this, definitions of the concept and the constructs of coaching as applied to medical education are needed to accurately assess the coaching relationship and coaching processes...
2016: Medical Education Online
https://www.readbyqxmd.com/read/27914136/physicians-should-provide-shared-decision-making-for-anti-tnf-therapy-to-inflammatory-bowel-disease-patients
#3
Jae Myung Cha, Dong Il Park, Sang Hyoung Park, Jeong Eun Shin, Wan Soo Kim, Suk Kyun Yang
Shared decision-making may increase the effectiveness of inflammatory bowel disease (IBD) treatment, as different anti-tumor necrosis factor (anti-TNF) administrations may have different effects on the quality of life (QOL). Patient preference is integral to the selection of anti-TNFs and their routes of administration, however, previous studies on the patient preference to anti-TNFs are inconsistent and limited. We evaluated the predictive factors for preferences to anti-TNF administrations in IBD patients between March and August in 2015...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#4
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914107/non-paraneoplastic-autoimmune-subepidermal-bullous-disease-associated-with-fatal-bronchiolitis-obliterans
#5
Mari Orime, Katsuhiro Tomiyama, Hideki Hashidate, Satoru Yoshida, Satoshi Hokari, Akiko Tsuda, Hisashi Yokoyama, Jun-Ichi Narita, Youhei Uchida, Takuro Kanekura, Riichiro Abe, Norito Ishii, Takashi Hashimoto, Kazuhiro Kawai
Bronchiolitis obliterans is a small-airway obstructive lung disease for which immunologically mediated pathogenesis is supposed. Frequent association of bronchiolitis obliterans with paraneoplastic pemphigus is well known, but its association with other autoimmune bullous diseases has not been reported except for a case of anti-laminin-332-type mucous membrane pemphigoid in a patient with chronic graft-versus-host disease. We report a case of non-paraneoplastic autoimmune subepidermal bullous disease associated with fatal bronchiolitis obliterans in a patient without transplantation...
December 3, 2016: Journal of Dermatology
https://www.readbyqxmd.com/read/27914088/murine-mycobacterium-marinum-infection-as-a-model-for-tuberculosis
#6
Julia Lienard, Fredric Carlsson
Mycobacteria are a major human health problem globally. Regarding tuberculosis the situation is worsened by the poor efficacy of current vaccine regimens and by emergence of drug-resistant strains (Manjelievskaia J et al, Trans R Soc Trop Med Hyg 110: 110, 2016; Pereira et al., Lancet Infect Dis 12:300-306, 2012; http://www.who.int/tb/publications/global_report/en/) undermining both disease-prevention and available treatments. Thus, increased basic understanding of mycobacterial-and particularly Mycobacterium tuberculosis-virulence strategies and pathogenesis is of great importance...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27913946/diagnostic-reproducibility-what-happens-when-the-same-pathologist-interprets-the-same-breast-biopsy-specimen-at-two-points-in-time
#7
Sara L Jackson, Paul D Frederick, Margaret S Pepe, Heidi D Nelson, Donald L Weaver, Kimberly H Allison, Patricia A Carney, Berta M Geller, Anna N A Tosteson, Tracy Onega, Joann G Elmore
BACKGROUND: Surgeons may receive a different diagnosis when a breast biopsy is interpreted by a second pathologist. The extent to which diagnostic agreement by the same pathologist varies at two time points is unknown. METHODS: Pathologists from eight U.S. states independently interpreted 60 breast specimens, one glass slide per case, on two occasions separated by ≥9 months. Reproducibility was assessed by comparing interpretations between the two time points; associations between reproducibility (intraobserver agreement rates); and characteristics of pathologists and cases were determined and also compared with interobserver agreement of baseline interpretations...
December 2, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27913942/out-migration-and-attrition-of-physicians-and-dentists-before-and-after-eu-accession-2003-and-2011-the-case-of-hungary
#8
Júlia Varga
This paper employs a large-scale, individual-level, panel dataset to analyse the effect of EU accession on the probability of out-migration on the part of Hungarian physicians and dentists between 2003 and 2011. The study uses event history modelling and competing risk models. The results show that EU accession did not at the time affect the probability of out-migration while after the end of the transitional period of restrictions on the free movement of labour from the new EU member states to Austria and Germany, the probability of doctors' migration increased considerably...
December 2, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27913910/a-randomized-trial-of-displaying-paid-price-information-on-imaging-study-and-procedure-ordering-rates
#9
Alyna T Chien, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Meredith B Rosenthal, Thomas D Sequist
BACKGROUND: Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. OBJECTIVE: To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). DESIGN: Block randomized controlled trial for 1 year...
December 2, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27913903/amyotrophic-lateral-sclerosis-and-myasthenia-gravis-association-or-chance-occurrence
#10
Silvia de Pasqua, Francesco Cavallieri, Roberto D'Angelo, Fabrizio Salvi, Nicola Fini, Roberto D'Alessandro, Rita Rinaldi, Antonio Fasano, Jessica Mandrioli
Very few cases of patients with myasthenia gravis (MG) who later developed amyotrophic lateral sclerosis (ALS) have been described, although some studies showed that significantly more cases than expected have ALS associated with a prior diagnosis of autoimmune diseases. Our aim was to investigate whether the association of ALS and MG was higher than expected in a population-based study and to describe the clinical features characterizing these patients. In Emilia Romagna Region of Italy, a prospective registry has been collecting all incident ALS cases since 1...
December 2, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27913883/on-the-prevalence-of-constipation-and-fecal-incontinence-and-their-co-occurrence-in-the-netherlands
#11
Rob J Meinds, Maxime M van Meegdenburg, Monika Trzpis, Paul M A Broens
PURPOSE: Numerous studies have investigated the prevalence of constipation and fecal incontinence (FI) in the general population and, even though these disorders are known to co-occur, they were studied independently of each other. Our aim was to investigate the prevalence of constipation and FI, and their co-occurrence, in the general population in the Netherlands. METHODS: We studied a cross-section of the Dutch population (N = 1259). All respondents completed the Groningen Defecation & Fecal Continence checklist...
December 2, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27913860/improved-clinical-outcomes-for-multiple-myeloma-patients-treated-at-a-single-specialty-clinic
#12
Ariana Berenson, Suzie Vardanyan, Michael David, James Wang, Nika Manik Harutyunyan, Jillian Gottlieb, Ran Halleluyan, Tanya M Spektor, Kyle A Udd, Shahrooz Eshaghian, Youram Nassir, Benjamin Eades, Regina Swift, James R Berenson
Despite recent advances made in its treatment, multiple myeloma (MM) remains an incurable B cell malignancy. Thus, the objective for treating these patients is to prolong overall survival (OS) and preserve patients' quality of life. We have analyzed data from 264 consecutive MM patients who had their initial visit between July 1, 2004 and December 1, 2014 and have received treatment in a single clinic specializing in MM. We determined their progression-free survival (PFS, OS, and 5-year OS). The PFS for frontline (n = 165 treatments), salvage (n = 980), and all treatments (n = 1145) were 13...
December 2, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27913839/the-ability-of-emergency-physicians-to-diagnose-and-score-acute-pancreatitis-on-computed-tomography
#13
A Karagöz, E E Ünlüer, O Oyar, F E Topal, F Topal
PURPOSE: The aim of this study is to determine the ability of emergency physicians' (EP) interpreting contrast-enhanced computed tomographies (CECTs) performed in patients diagnosed or suspected acute pancreatitis (AP), using the modified computed tomography severity index (MCTSI) scoring system. METHODS: This study was conducted in Training and Research Hospital's Emergency Department. From January 1, 2013 to April 30, 2016, patients whom performed CECT within 24 h of admission with diagnosis or suspicion of AP were reviewed retrospectively...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27913799/involvement-of-recipient-transplant-coordinators-in-transplant-outpatient-clinics-in-japan-current-status-and-transplant-physician-s-thoughts-on-follow-up-clinics
#14
Kuniko Hagiwara, Natsuko Seto, Yasuko Shimizu, Shiro Takahara
CONTEXT: Transplant recipients require long-term immunosuppressive therapy, so continued medical follow-up is necessary for long-term survival. OBJECTIVE: To investigate the current role of recipient transplant coordinators (RTCs) in the outpatient care of organ transplant recipients in Japan. METHODS: We sent a questionnaire survey to doctors in transplant facilities affiliated with the Japan Society for Transplantation probing attitudes on the role of RTCs in outpatient clinics...
December 2, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27913762/aspen-felanpe-clinical-guidelines-nutrition-support-of-adult-patients-with-enterocutaneous-fistula
#15
Vanessa J Kumpf, Jose Eduardo de Aguilar-Nascimento, Jose Ignacio Diaz-Pizarro Graf, Amber M Hall, Liam McKeever, Ezra Steiger, Marion F Winkler, Charlene W Compher
BACKGROUND: The management of patients with enterocutaneous fistula (ECF) requires an interdisciplinary approach and poses a significant challenge to physicians, wound/stoma care specialists, dietitians, pharmacists, and other nutrition clinicians. Guidelines for optimizing nutrition status in these patients are often vague, based on limited and dated clinical studies, and typically rely on individual institutional or clinician experience. Specific nutrient requirements, appropriate route of feeding, role of immune-enhancing formulas, and use of somatostatin analogues in the management of patients with ECF are not well defined...
December 2, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27913657/cost-benefit-analysis-of-telehealth-in-pre-hospital-care
#16
James R Langabeer, Tiffany Champagne-Langabeer, Diaa Alqusairi, Junghyun Kim, Adria Jackson, David Persse, Michael Gonzalez
OBJECTIVE: There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. METHODS: Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention...
December 2, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27913569/national-health-spending-faster-growth-in-2015-as-coverage-expands-and-utilization-increases
#17
Anne B Martin, Micah Hartman, Benjamin Washington, Aaron Catlin
Total nominal US health care spending increased 5.8 percent and reached $3.2 trillion in 2015. On a per person basis, spending on health care increased 5.0 percent, reaching $9,990. The share of gross domestic product devoted to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014. Coverage expansions that began in 2014 as a result of the Affordable Care Act continued to affect health spending growth in 2015. In that year, the faster growth in total health care spending was primarily due to accelerated growth in spending for private health insurance (growth of 7...
December 2, 2016: Health Affairs
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#18
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913412/the-impact-of-a-plastic-surgeon-s-gender-on-patient-choice
#19
Eva A Huis In 't Veld, Francisco L Canales, Heather J Furnas
BACKGROUND: In the patient-driven market of aesthetic surgery, an understanding of the factors that patients consider in their choice of surgeon can inform the individual plastic surgeon's marketing strategy. Previous studies have investigated patient gender preferences for physicians in other specialties, but none has investigated whether patients consider gender when choosing a plastic surgeon. OBJECTIVES: The purpose of this study is to determine the impact of a plastic surgeon's gender on patient choice...
December 2, 2016: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/27913367/a-new-method-for-self-estimation-of-the-severity-of-obstructive-sleep-apnea-using-easily-available-measurements-and-neural-fuzzy-evaluation-system
#20
Ming-Feng Wu, Wei-Chang Huang, Chia-Feng Juang, Kai-Ming Chang, Chih-Yu Wen, Yu-Hsuan Chen, Ching-Yi Lin, Yi-Chan Chen, Ching-Cheng Lin
This paper proposes a neural fuzzy evaluation system (NFES) with significant variables selected from stepwise regression to predict apnea-hypopnea index (AHI) for evaluating obstructive sleep apnea (OSA). The variables considered are the change statuses of blood pressure (BP) before going to sleep and early in the morning as well as other five easily available measurements (age, body mass index (BMI) etc.) so that users can use the system for self-evaluation of OSA. A total of 150 subjects are reviewed retrospectively and categorized as training (120 subjects) and validation (30 subjects) sets by a five-fold cross validation scheme with stratified sampling based on the OSA severity...
December 1, 2016: IEEE Journal of Biomedical and Health Informatics
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