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https://www.readbyqxmd.com/read/28526169/the-second-victim-a-review
#1
REVIEW
B Coughlan, D Powell, M F Higgins
Amongst the lay and media population there is a perception that pregnancy, labour and delivery is always physiological, morbidity and mortality should be "never events" and that error is the only cause of adverse events. Those working in maternity care know that it is an imperfect art, where adverse outcomes and errors will occur. When errors do occur, there is a domino effect with three groups being involved - the patient (first victim), the staff (second victims) and the organization (third victims). If the perceived expectation of patients on all clinicians is that of perfection, then clinicians may suffer the consequences of adverse outcomes in isolation and silence...
June 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28523700/balancing-medical-accuracy-and-diagnostic-consequences-diagnosing-medically-unexplained-symptoms-in-primary-care
#2
Erik B Rasmussen
Focusing on the case of medically unexplained symptoms (MUS), this article explores diagnostic classification in the absence of biomedical evidence or other strong medical warrants for diagnosis. The data are from three focus group interviews with Norwegian general practitioners (GPs) conducted in 2015, that centred on the issue of what diagnoses to use (or not) for MUS. The qualitative analysis reconstructs the logic underlying GPs' diagnostic accounts, which centred on the meaning of diagnostic categories and on anticipating how 'generalised others' would respond to those meanings (called 'diagnosing by anticipation')...
May 18, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28522182/hodotopy-neuroplasticity-and-diffuse-gliomas
#3
H Duffau
BACKGROUND AND PURPOSE: The historical approach in neurooncology is used to mainly investigate the tumor, with very few considerations regarding the brain itself. Nonetheless, to select the best personalized therapeutic management for each patient with a diffuse glioma, i.e. to optimize the "onco-functional balance", the brain reaction induced by glioma growth and migration should be studied. Indeed, due to strong interactions between the glioma and the brain, cerebral adaptive phenomena often occur in order to maintain neurological and cognitive functions, as well as to compensate glioma spreading...
May 15, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28521554/social-factors-predictive-of-social-integration-for-adults-with-brain-injury
#4
Elisabeth Batchos, Amanda Easton, Christopher Haak, Nicole Ditchman
INTRODUCTION: Individuals with acquired brain injury (ABI) may not only struggle with physical and cognitive impairments, but may also face challenges reintegrating into the community socially. Research has demonstrated that following ABI, individuals' social networks tend to dwindle, support may decline, and isolation increases. This study examined factors impacting social integration in a community-based sample of 102 individuals with ABI. METHODS: Potential predictors included emotional support, instrumental support, problem solving confidence, and approach-avoidance style (AAS) of problem solving, while controlling for age, gender, education, and time since injury...
May 18, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28516993/stable-and-conductive-lead-halide-perovskites-facilitated-by-x-type-ligands
#5
Longfei Ruan, Wei Shen, Aifei Wang, Qingwen Zhou, Huigang Zhang, Zhengtao Deng
Lead halide perovskites exhibit outstanding optoelectronic and optical properties. However, some applications of perovskites are hindered by their instability in polar environments; thus, how to balance stability with conductivity is a great challenge. Here, we report a new approach of using X-type ligands to address this issue. Surface treatments containing multi-step ligand exchanges and ion filling were necessary to obtain X-type ligand-protected perovskites. Performances of this material show that: (1) the crystal structure of perovskites is stable in ethanol; (2) surface defects can be fixed by a photoactivation process and photoluminescence intensity can be enhanced to 136%; and (3) electronic devices fabricated from such materials show stabilility even after washing with ethanol...
May 18, 2017: Nanoscale
https://www.readbyqxmd.com/read/28514873/unpacking-community-mobility-a-preliminary-study-into-the-embodied-experiences-of-stroke-survivors
#6
Christa S Nanninga, Louise Meijering, Klaas Postema, Marleen C Schönherr, Ant T Lettinga
PURPOSE: To enrich the discussion on mobility in stroke rehabilitation by translating theoretical repertoires of mobility from the context of geography to rehabilitation. METHOD: Qualitative research methodology was applied, and included in-depth interviews with stroke survivors. RESULTS: This study revealed: (a) social and material differences in clinical, private and public places; (b) ambivalences and shifting tensions in bodily, family and community life; (c) differences in access to resources to be used for mobility...
May 17, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28514392/-direct-oral-anticoagulants-in-atrial-fibrillation-patients-aged-75-years-or-older-efficacy-and-safety-balance
#7
V V Fomin, A A Svistunov, D A Napalkov, A A Sokolova, M A Gabitova
Atrial fibrillation (AF) is one of the most common heart rhythm disorders in the population. Researchers revealed a direct relationship between their incidence and a patient's age long ago. One of the most challenging issues of clinical practice in patients with AF is anticoagulant therapy used in the so-called very elderly patients aged 75 years and older when age itself is a risk factor for developing both thromboembolic and hemorrhagic events due to anticoagulants, regardless of the mechanism of action of the latter...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28507231/biological-modelling-of-a-computational-spiking-neural-network-with-neuronal-avalanches
#8
Xiumin Li, Qing Chen, Fangzheng Xue
In recent years, an increasing number of studies have demonstrated that networks in the brain can self-organize into a critical state where dynamics exhibit a mixture of ordered and disordered patterns. This critical branching phenomenon is termed neuronal avalanches. It has been hypothesized that the homeostatic level balanced between stability and plasticity of this critical state may be the optimal state for performing diverse neural computational tasks. However, the critical region for high performance is narrow and sensitive for spiking neural networks (SNNs)...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28507228/understanding-principles-of-integration-and-segregation-using-whole-brain-computational-connectomics-implications-for-neuropsychiatric-disorders
#9
REVIEW
Louis-David Lord, Angus B Stevner, Gustavo Deco, Morten L Kringelbach
To survive in an ever-changing environment, the brain must seamlessly integrate a rich stream of incoming information into coherent internal representations that can then be used to efficiently plan for action. The brain must, however, balance its ability to integrate information from various sources with a complementary capacity to segregate information into modules which perform specialized computations in local circuits. Importantly, evidence suggests that imbalances in the brain's ability to bind together and/or segregate information over both space and time is a common feature of several neuropsychiatric disorders...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28507227/when-two-wrongs-make-a-right-synchronized-neuronal-bursting-from-combined-electrical-and-inhibitory-coupling
#10
Reimbay Reimbayev, Kevin Daley, Igor Belykh
Synchronized cortical activities in the central nervous systems of mammals are crucial for sensory perception, coordination and locomotory function. The neuronal mechanisms that generate synchronous synaptic inputs in the neocortex are far from being fully understood. In this paper, we study the emergence of synchronization in networks of bursting neurons as a highly non-trivial, combined effect of electrical and inhibitory connections. We report a counterintuitive find that combined electrical and inhibitory coupling can synergistically induce robust synchronization in a range of parameters where electrical coupling alone promotes anti-phase spiking and inhibition induces anti-phase bursting...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28505266/guidance-for-modifying-the-definition-of-diseases-a-checklist
#11
Jenny Doust, Per O Vandvik, Amir Qaseem, Reem A Mustafa, Andrea R Horvath, Allen Frances, Lubna Al-Ansary, Patrick Bossuyt, Robyn L Ward, Ina Kopp, Laragh Gollogly, Holger Schunemann, Paul Glasziou
Importance: No guidelines exist currently for guideline panels and others considering changes to disease definitions. Panels frequently widen disease definitions, increasing the proportion of the population labeled as unwell and potentially causing harm to patients. We set out to develop a checklist of issues, with guidance, for panels to consider prior to modifying a disease definition. Observations: We assembled a multidisciplinary, multicontinent working group of 13 members, including members from the Guidelines International Network, Grading of Recommendations Assessment, Development and Evaluation working group, and the World Health Organisation...
May 15, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28504070/adverse-effects-on-health-and-wellbeing-of-working-as-a-doctor-views-of-the-uk-medical-graduates-of-1974-and-1977-surveyed-in-2014
#12
Fay Smith, Michael J Goldacre, Trevor W Lambert
Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'...
May 2017: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28503449/feasibility-of-rehabilitation-training-with-a-newly-developed-portable-gait-assistive-robot-for-balance-function-in-hemiplegic-patients
#13
Junhyun Sung, Sehoon Choi, Hyunbae Kim, Gyuhan Lee, Changsoo Han, Younghoon Ji, Dongbin Shin, Seunghoon Hwang, Deokwon Yun, Hyeyoun Jang, Mi Jung Kim
OBJECTIVE: To investigate the clinical feasibility of a newly developed, portable, gait assistive robot (WA-H, 'walking assist for hemiplegia') for improving the balance function of patients with stroke-induced hemiplegia. METHODS: Thirteen patients underwent 12 weeks of gait training on the treadmill while wearing WA-H for 30 minutes per day, 4 days a week. Patients' balance function was evaluated by the Berg Balance Scale (BBS), Fugl-Meyer Assessment Scale (FMAS), Timed Up and Go Test (TUGT), and Short Physical Performance Battery (SPPB) before and after 6 and 12 weeks of training...
April 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28495910/oxidative-imbalance-and-kidney-damage-in-spontaneously-hypertensive-rats-activation-of-extrinsic-apoptotic-pathway
#14
Daniele La Russa, Elvira Brunelli, Daniela Pellegrino
In both humans and animals, essential hypertension acts as a risk factor for subclinical kidney damage and precedes renal dysfunction. Several lines of evidence indicate that hypertension and oxidative stress are closely related. The increase in vascular oxidative stress plays a key role in the pathophysiological consequences of hypertension, including kidney disease. Our study examined this issue in SHR, a reliable model of essential hypertension. We used SHR 20 weeks-old when hypertension is stably developed, vascular remodeling started, but kidney function is preserved...
May 11, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28493654/the-us-food-and-drug-administration-s-perspective-on-the-new-antipsychotic-pimavanserin
#15
Mitchell V Mathis, Brendan M Muoio, Paul Andreason, Amy M Avila, Tiffany Farchione, Aisar Atrakchi, Robert J Temple
OBJECTIVE: To summarize the US Food and Drug Administration's (FDA's) review of the safety and effectiveness for pimavanserin, an atypical antipsychotic, for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. We describe the regulatory and clinical issues important to the FDA's approval of this New Drug Application, with special focus on the risk-benefit balance. We also describe a new labeling feature that presents additional efficacy data to clinicians...
May 9, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28493601/accommodating-interruptions-a-grounded-theory-of-young-people-with-asthma
#16
Mary Hughes, Eileen Savage, Tom Andrews
AIMS AND OBJECTIVES: The aim of this study was to develop an explanatory theory on the lives of young people with asthma, issues affecting them, and the impact of asthma on their day to day lives. BACKGROUND: Accommodating Interruptions is a theory that explains young people's concerns about living with asthma. Although national and international asthma management guidelines exist it is accepted that the symptom control of asthma among the young people population is poor...
May 11, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28486483/insight-into-runoff-characteristics-using-hydrological-modeling-in-the-data-scarce-southern-tibetan-plateau-past-present-and-future
#17
Mingyong Cai, Shengtian Yang, Changsen Zhao, Qiuwen Zhou, Lipeng Hou
Regional hydrological modeling in ungauged regions has attracted growing attention in water resources research. The southern Tibetan Plateau often suffers from data scarcity in watershed hydrological simulation and water resources assessment. This hinders further research characterizing the water cycle and solving international water resource issues in the area. In this study, a multi-spatial data based Distributed Time-Variant Gain Model (MS-DTVGM) is applied to the Yarlung Zangbo River basin, an important international river basin in the southern Tibetan Plateau with limited meteorological data...
2017: PloS One
https://www.readbyqxmd.com/read/28483822/influences-on-gp-coping-and-resilience-a-qualitative-study-in-primary-care
#18
Anna Cheshire, Damien Ridge, John Hughes, David Peters, Maria Panagioti, Chantal Simon, George Lewith
BACKGROUND: 'Neoliberal' work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs. AIM: To explore GPs' experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change. DESIGN AND SETTING: Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews...
May 8, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28474468/the-use-and-design-of-the-bsc-in-the-health-care-sector-a-systematic-literature-review-for-italy-spain-and-portugal
#19
REVIEW
Maria Beatriz Gonzalez-Sanchez, Laura Broccardo, Amélia Maria Martins Pires
The aim of this paper is to gain a better understanding of how the balanced scorecard (BSC) has evolved in Spain, Italy, and Portugal. It reviews all the articles on the BSC in the health care sector written between 1992 and 2015 by Spanish, Italian, or Portuguese authors and published in Spanish, Italian, or Portuguese as well as in English. Our study first shows the state of knowledge on BSC in health care for a homogeneous group of Southern European countries. Second, it uncovers the perspectives, indicators, and generation used in the countries under observation to reveal the extent to which this management tool has evolved...
May 5, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28472568/bidi-smoking-an-underestimated-issue-of-indian-society
#20
Solanki Jitender, Gupta Sarika, Prachi Sharma, Priyanka Mishra
Bidi smoking has always been an under-talked issue of Indian society. Bidis are rolled in tendu leaves which are non porous and have low combustibility due to which they affect the smoker's lungs even more. In spite of the increased toxicology associated with bidis, they are often ignored. The reason for this can be attributed to their home-made production, decreased taxation and the greater prevalence of bidis in rural areas. Since bidis are rolled and packed at home, packaging does not have any warnings about the harmful effects of bidi smoking...
May 2017: Journal of Experimental Therapeutics & Oncology
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