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Clinical decision making

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https://www.readbyqxmd.com/read/29779182/locator%C3%A2-versus-ceramic-electroplated-double-crown-attachments-a-prospective-study-on-the-intraindividual-comparison-of-implant-supported-mandibular-prostheses
#1
Silvia Brandt, Jan Brandt, Ali-Reza Ketabi, Hans-Christoph Lauer, Anna Kunzmann
OBJECTIVES: Implant-supported overdentures are an established dental treatment mode. The aim of this prospective study was and interindividual comparison of patient satisfaction with restorations retained by a prefabricated and thus inexpensive attachment system (Locator®) or with a technologically complex and thus expensive attachment system (ceramic/electroplated double crowns) with similar retentive performance. MATERIALS AND METHODS: Twelve patients received a Locator and a double-crown prosthesis in a crossover study for test periods of 3 months each...
May 19, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29779085/progressive-grey-matter-volume-changes-in-patients-with-schizophrenia-over-6-weeks-of-antipsychotic-treatment-and-their-relationship-to-clinical-improvement
#2
Xiao Zhang, Yuyanan Zhang, Jinmin Liao, Sisi Jiang, Jun Yan, Weihua Yue, Dai Zhang, Hao Yan
Cross-sectional and longitudinal studies have identified widespread and progressive grey matter volume (GMV) reductions in schizophrenia, especially in the frontal lobe. In this study, we found a progressive GMV decrease in the rostral medial frontal cortex (rMFC, including the anterior cingulate cortex) in the patient group during a 6-week follow-up of 40 patients with schizophrenia and 31 healthy controls well-matched for age, gender, and education. The higher baseline GMV in the rMFC predicted better improvement in the positive score on the Positive and Negative Syndrome Scale (PANSS), and this might be related to the improved reality-monitoring...
May 19, 2018: Neuroscience Bulletin
https://www.readbyqxmd.com/read/29778986/breaking-through-the-dilemma-of-whether-to-continue-nursing-newly-graduated-nurses-experiences-of-work-challenges
#3
Hwey-Fang Liang, Chun-Chih Lin, Kuang-Ming Wu
BACKGROUND: Newly graduated nurses (NGNs) often encounter unique work challenges. PURPOSE: To discover Taiwanese NGNs' experiences of work challenges. METHOD: An interpretive qualitative design was chosen. In-depth interviews were completed with 25 NGNs working in clinical settings in Taiwan. Data were analyzed using content analysis. RESULTS: The essential structure of NGNs' experiences of work challenges was described as struggling and breaking through the dilemma of deciding whether to continue nursing or quit...
May 4, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29778474/a-longitudinal-observational-study-of-the-dynamics-of-mycoplasma-bovis-antibodies-in-naturally-exposed-and-diseased-dairy-cows
#4
Mette B Petersen, Jeanette Pedersen, Dinah L Holm, Matthew Denwood, Liza R Nielsen
Mycoplasma bovis is an important pathogen causing disease and substantial economic losses in cattle. However, knowledge of the dynamics of antibody responses in individual cows in the face of an outbreak is currently extremely limited. The use of commercial antibody tests to support clinical decision-making and for surveillance purposes is therefore challenging. Our objective was to describe the dynamics of M. bovis antibody responses in 4 Danish dairy herds experiencing an acute outbreak of M. bovis-associated disease, and to compare the antibody dynamics between dairy cows with different disease manifestations...
May 16, 2018: Journal of Dairy Science
https://www.readbyqxmd.com/read/29778437/state-level-adoption-of-national-guidelines-for-norovirus-outbreaks-in-health-care-settings
#5
Carl J Grafe, Catherine J Staes, Kensaku Kawamoto, Matthew H Samore, R Scott Evans
BACKGROUND: Clinical decision support (CDS) systems can help investigators use best practices when responding to outbreaks, but variation in guidelines between jurisdictions can make such systems hard to develop and implement. This study aimed to identify (1) the extent to which state-level guidelines adhere to national recommendations for norovirus outbreak response in health care settings and (2) the impact of variation between states on outbreak outcomes. METHODS: State guidelines were obtained from Internet searches and direct contact with state public health officials in early 2016...
May 16, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29778349/a-contemporary-prostate-biopsy-risk-calculator-based-on-multiple-heterogeneous-cohorts
#6
Donna P Ankerst, Johanna Straubinger, Katharina Selig, Lourdes Guerrios, Amanda De Hoedt, Javier Hernandez, Michael A Liss, Robin J Leach, Stephen J Freedland, Michael W Kattan, Robert Nam, Alexander Haese, Francesco Montorsi, Stephen A Boorjian, Matthew R Cooperberg, Cedric Poyet, Emily Vertosick, Andrew J Vickers
BACKGROUND: Prostate cancer prediction tools provide quantitative guidance for doctor-patient decision-making regarding biopsy. The widely used online Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) utilized data from the 1990s based on six-core biopsies and outdated grading systems. OBJECTIVE: We prospectively gathered data from men undergoing prostate biopsy in multiple diverse North American and European institutions participating in the Prostate Biopsy Collaborative Group (PBCG) in order to build a state-of-the-art risk prediction tool...
May 16, 2018: European Urology
https://www.readbyqxmd.com/read/29778317/appropriate-use-of-noninvasive-ischemia-testing-to-guide-revascularization-decision-making-following-acute-st-elevation-myocardial-infarction-in-latin-american-countries-results-from-an-expert-panel-meeting-of-the-international-atomic-energy-agency
#7
I Berrocal, A Peix, F Mut, L J Shaw, G Karthikeyan, E Estrada Lobato, D Paez
Across Latin American and Caribbean countries, cardiovascular disease and especially ischemic heart disease is currently the main cause of death both in men and in women. For most Latin American and Caribbean countries, public and community health efforts aim to define care strategies which are both clinically and cost effective and promote primary and secondary prevention, resulting in improved patient outcomes. The optimal approach to deal with acute events such as ST-elevation myocardial infarction (STEMI) is a matter of controversy; however, there is an expanding role for assessing residual ischemic burden in STEMI patients following primary percutaneous coronary intervention...
May 16, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/29778122/provider-language-proficiency-and-decision-making-when-caring-for-limited-english-proficiency-children-and-families
#8
Yolanda N Evans, Sarah A Rafton, Eriberto Michel, Beth E Ebel
OBJECTIVE: To examine associations between self-assessed language ability and provision of clinical care without professional interpretation. METHODS: We conducted an anonymous web-based survey of pediatric residents at a large pediatric training program. Respondents self-rated their language ability, and then reported on their willingness to deliver clinical care without professional interpretation in standardized clinical scenarios. RESULTS: All pediatric residents completed the survey (n=81; 100%)...
June 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29778017/the-preconception-care-experiences-of-women-with-epilepsy-on-sodium-valproate
#9
Lorna Lawther, Helen Dolk, Marlene Sinclair, Jim Morrow
PURPOSE: To understand the preconception experiences of women with epilepsy who have been taking the teratogenic drug valproate. METHODS: Seven women were recruited, three from a preconception clinic and four from an antenatal clinic in a region of the UK. All had taken valproate preconceptionally. Three preconception clinic encounters were observed and audio-recorded. Interviews with all women were analysed using Interpretative Phenomenological Analysis (IPA). RESULTS: Women experienced a "trajectory of balance"...
May 16, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29777966/determinants-of-choice-of-delivery-place-testing-rational-choice-theory-and-habitus-theory
#10
Anja Broda, Juliane Krüger, Stephanie Schinke, Andreas Weber
OBJECTIVE: The current study uses two antipodal social science theories, the rational choice theory and the habitus theory, and applies these to describe how women choose between intraclinical (i.e., hospital-run birth clinics) and extraclinical (i.e., midwife-led birth centres or home births) delivery places. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: Data were collected in a cross-sectional questionnaire-based survey among 189 women. A list of 22 determinants, conceptualized to capture the two theoretical concepts, were rated on a 7-point Likert scale with 1 = unimportant to 7 = very important...
May 7, 2018: Midwifery
https://www.readbyqxmd.com/read/29777648/reasons-for-discontinuation-of-implanon-among-users-in-buffalo-city-metropolitan-municipality-south-africa-a-cross-sectional-study
#11
Khungelwa Patricia Mrwebi, Daniel Ter Goon, Eyitayo Omolara Owolabi, Oladele Vincent Adeniyi, Eunice Seekoe, Anthony Idowu Ajayi
Early discontinuation of implanon, a long-acting, reversible contraceptive among reproductive age women in South Africa is a serious public health concern. The aim of this study was to examine the reasons for discontinuation of implanon among its previous users. This descriptive cross-sectional study involved 188 consecutively selected participants in two large family planning clinics in Buffalo Metropolitan Municipality, East London, South Africa. Descriptive statistics was conducted using SPSS version 22...
March 2018: African Journal of Reproductive Health
https://www.readbyqxmd.com/read/29777566/care-provider-allocation-on-admissions-to-acute-mental-health-wards-the-development-and-validation-of-the-admission-team-score-list
#12
Sjobha R N van den Berg, Barbara Stringer, Roland van de Sande, Stasja Draisma
Currently, support tools are lacking to prioritize steps in the care coordination process to enable safe practice and effective clinical pathways in the first phase of acute psychiatric admissions. This study describes the development, validity, and reliability of an acute care coordination support tool, the Admission Team Score List (ATSL). The ATSL assists in care provider allocation during admissions. Face validity and feasibility of the ATSL were tested in 77 acute admissions. Endscores of filled out ATSL's were translated to recommended team compositions...
May 18, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29777464/the-key-features-approach-to-assess-clinical-decisions-validity-evidence-to-date
#13
REVIEW
G Bordage, G Page
The key-features (KFs) approach to assessment was initially proposed during the First Cambridge Conference on Medical Education in 1984 as a more efficient and effective means of assessing clinical decision-making skills. Over three decades later, we conducted a comprehensive, systematic review of the validity evidence gathered since then. The evidence was compiled according to the Standards for Educational and Psychological Testing's five sources of validity evidence, namely, Content, Response process, Internal structure, Relations to other variables, and Consequences, to which we added two other types related to Cost-feasibility and Acceptability...
May 17, 2018: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29777418/earliest-radiological-progression-in-glioblastoma-by-multidisciplinary-consensus-review
#14
Roelant S Eijgelaar, Anna M E Bruynzeel, Frank J Lagerwaard, Domenique M J Müller, Freek R Teunissen, Frederik Barkhof, Marcel van Herk, Philip C De Witt Hamer, Marnix G Witte
BACKGROUND: Detection of glioblastoma progression is important for clinical decision-making on cessation or initiation of therapy, for enrollment in clinical trials, and for response measurement in time and location. The RANO-criteria are considered standard for the timing of progression. To evaluate local treatment, we aim to find the most accurate progression location. We determined the differences in progression free survival (PFS) and in tumor volumes at progression (Vprog) by three definitions of progression...
May 18, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29777334/patient-engagement-in-community-health-center-leadership-how-does-it-happen
#15
Anjana E Sharma, Beatrice Huang, Margae Knox, Rachel Willard-Grace, Michael B Potter
Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs...
May 18, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29777306/respiratory-manifestations-in-lps-responsive-beige-like-anchor-lrba-protein-deficient-patients
#16
Oded Shamriz, Bella Shadur, Adeeb NaserEddin, Irina Zaidman, Natalia Simanovsky, Orly Elpeleg, Eitan Kerem, Joel Reiter, Polina Stepensky
Lipopolysaccharide (LPS)-responsive beige-like anchor (LRBA) protein deficiency is a rare syndrome of primary immune deficiency and immune dysregulation. In this study, we sought to summarize our experience with respiratory manifestations in LRBA-deficient patients. We conducted a retrospective analysis of the medical records of LRBA-deficient patients treated at Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Data retrieved included pulmonary workup, disease course, treatment, and outcome. Ten patients were included...
May 18, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29777291/growth-of-asymptomatic-intracranial-fusiform-aneurysms-incidence-and-risk-factors
#17
Jusun Moon, Young Dae Cho, Dong Hyun Yoo, Jeongjun Lee, Hyun-Seung Kang, Won-Sang Cho, Jeong Eun Kim, Li Zhang, Moon Hee Han
PURPOSE: Growth of intracranial fusiform aneurysms (IFA) may become clinically problematic through a mass effect or rupture. We investigated the growth rate and factors contributing to growth in asymptomatic untreated IFA. METHOD: As a retrospective review, we assessed patients diagnosed with asymptomatic IFA between August 2000 and September 2014, all untreated. No acute or symptomatic dissecting lesions were considered. Clinical and serial angiographic follow-up data were analyzed, defining growth as expansion > 2 mm in one or more dimensions...
May 18, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29777106/clinical-prediction-models-to-support-the-diagnosis-of-asthma-in-primary-care-a-systematic-review-protocol
#18
L Daines, S McLean, A Buelo, S Lewis, A Sheikh, H Pinnock
Substantial over-diagnosis and under-diagnosis of asthma in adults and children has recently been reported. As asthma is mostly diagnosed in non-specialist settings, a clinical prediction model (CPM) to aid the diagnosis of asthma in primary care may help improve diagnostic accuracy. We aim to systematically identify, describe, compare, and synthesise existing CPMs designed to support the diagnosis of asthma in children and adults presenting with symptoms suggestive of the disease, in primary care settings or equivalent populations...
May 18, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29776847/a-comparative-evaluation-of-spectrophotometric-intracutaneous-analysis-and-laser-doppler-imaging-in-the-assessment-of-adult-and-paediatric-burn-injuries
#19
Somy Charuvila, Masha Singh, Declan Collins, Isabel Jones
INTRODUCTION: Clinical assessment of mid-dermal burns can be challenging. Currently, laser Doppler imaging (LDI) is the gold standard adjunct in the assessment of burn injuries. Although LDI has demonstrated reliable accuracy, it poses various limitations in routine use including cost and ease of use. In comparison, spectrophotometric intracutaneous analysis (SIA) is a relatively cheaper technique, which can be carried out using a modified digital camera that enables easy image acquisition...
March 29, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29776669/-the-role-of-end-of-life-palliative-sedation-medical-and-ethical-aspects-review
#20
REVIEW
Miriam S Menezes, Maria das Graças Mota da Cruz de Assis Figueiredo
BACKGROUND AND OBJECTIVE: Palliative sedation is a medical procedure that has been used for more than 25 years to relieve refractory symptoms not responsive to any previous treatment in patients with no possibility of cure and near the end of life. Many uncertainties persist on the issue regarding definition, indications, decision making, most appropriate place to perform the procedure, most used drugs, need for monitoring, fluids and nutritional support, and possible ethical dilemmas...
May 15, 2018: Revista Brasileira de Anestesiologia
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