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https://www.readbyqxmd.com/read/29786861/temporally-feathered-intensity-modulated-radiation-therapy-a-planning-technique-to-reduce-normal-tissue-toxicity
#1
Juan Carlos López Alfonso, Shireen Parsai, Nikhil Joshi, Andrew Godley, Chirag Shah, Shlomo A Koyfman, Jimmy J Caudell, Clifton D Fuller, Heiko Enderling, Jacob G Scott
PURPOSE: Intensity modulated radiation therapy (IMRT) has allowed optimization of three-dimensional spatial radiation dose distributions permitting target coverage while reducing normal tissue toxicity. However, radiation-induced normal tissue toxicity is a major contributor to patients' quality of life and often a dose-limiting factor in the definitive treatment of cancer with radiation therapy. We propose the next logical step in the evolution of IMRT using canonical radiobiological principles, optimizing the temporal dimension through which radiation therapy is delivered to further reduce radiation-induced toxicity by increased time for normal tissue recovery...
May 22, 2018: Medical Physics
https://www.readbyqxmd.com/read/29786592/obstetric-and-gynecological-care-by-family-doctors-in-ukraine-literature-review
#2
Oksana V Bakun, Svitlana Y Karatieieva, Svitlana B Semenenko, Oksana I Yurkiv, Ksenia V Slobodian
OBJECTIVE: Introduction: The analysis of literature on the questions of obstetrical and gynecologic care by general practitioners - family doctors in Ukraine has been presented in the article. Special attention has been paid to the actual problems of primary health care implementation on the basis of family medicine. The aim of the study is to find out the depth of the problem "A female doctor as an obstetrician-gynecologist" by analyzing scientific relevant literature data...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29785938/decision-making-in-end-of-life-care-are-we-really-playing-together-in-the-same-team
#3
M M Lomero-Martínez, M F Jiménez-Herrera, M A Bodí-Saera, M Llauradó-Serra, N Masnou-Burrallo, E Oliver-Juan, A Sandiumenge-Camps
BACKGROUND: Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. OBJECTIVE: To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death...
May 18, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29784566/preoperative-point-of-care-ultrasound-and-its-impact-on-arteriovenous-fistula-maturation-outcomes
#4
Sajjid Hossain, Amit Sharma, Luc Dubois, Guy DeRose, Audra Duncan, Adam H Power
OBJECTIVE: Duplex ultrasound as a preoperative assessment tool in the clinic may help identify anatomic factors predictive of fistula maturation. Preoperative point-of-care ultrasound (POCUS) offers surgeons an alternative to routine formal vein mapping as it can be performed by the operator during the initial clinic visit. We sought to determine the impact of POCUS as an adjunct to physical examination on arteriovenous fistula maturation. METHODS: All consecutive patients undergoing first-time dialysis access creation from December 2007 to December 2014 were retrospectively reviewed...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29784265/don-t-ignore-my-snore-reducing-perioperative-complications-of-obstructive-sleep-apnea
#5
Ludy P Lemus, Betty McMullin, Honorata Balinowski
PURPOSE: Obstructive sleep apnea (OSA), a condition associated with decreased muscle tone in the airway, has been linked to postoperative complications. The purpose of the initiative was to develop and implement a guideline for patients identified as high-risk for OSA to reduce complications related to OSA. DESIGN: A multidisciplinary team developed the guideline utilizing the Iowa Model of Evidence-Based Practice to Promote Quality Care. METHODS: PubMed literature search from 2006-2013 and critique of over 40 articles were completed...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784225/nursing-diagnoses-of-the-homeless-population-in-light-of-self-care-theory
#6
Felicialle Pereira da Silva, Francisco de Assis Siqueira Paiva, Carolina Pereira Guedes, Iracema da Silva Frazão, Selene Cordeiro Vasconcelos, Murilo Duarte da Costa Lima
BACKGROUND: A growing number of people find themselves in conditions of extreme poverty, which often makes living on the streets the only option. Living conditions in this setting exert a direct impact on health and self-care. Health care for the homeless population should be planned in an interdisciplinary and intersectoral manner. In this context, nursing diagnoses constitute an essential part of the systemization of care. OBJECTIVES: The aims of the present study were to identify nursing diagnoses of a homeless population and propose nursing interventions based on the findings in light of the Nursing Outcomes Classification and Nursing Interventions Classification...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29784059/diabetes-intervention-accentuating-diet-and-enhancing-metabolism-diadem-i-a-randomised-controlled-trial-to-examine-the-impact-of-an-intensive-lifestyle-intervention-consisting-of-a-low-energy-diet-and-physical-activity-on-body-weight-and-metabolism-in-early
#7
Shahrad Taheri, Odette Chagoury, Hadeel Zaghloul, Sara Elhadad, Salma Hayder Ahmed, Omar Omar, Sherryl Payra, Salma Ahmed, Neda El Khatib, Rasha Abou Amona, Katie El Nahas, Matthew Bolton, Henem Chaar, Noor Suleiman, Amin Jayyousi, Mahmoud Zirie, Ibrahim Janahi, Wahiba Elhag, Abdulla Alnaama, Abduljaleel Zainel, Dahlia Hassan, Tim Cable, Mary Charlson, Martin Wells, Abdulla Al-Hamaq, Samya Al-Abdulla, Abdul Badi Abou-Samra
BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29784051/contributions-of-a-survey-and-retrospective-cohort-study-to-the-planning-of-a-randomised-controlled-trial-of-corticosteroids-in-the-treatment-of-paediatric-septic-shock
#8
Anna Liu, Kusum Menon
BACKGROUND: Randomised controlled trials (RCTs) are challenging to conduct in a paediatric critical-care environment. Background work, including surveys and observational studies, is often used to determine disease estimates, sample sizes and design protocols when planning such RCTs. Our objective was to determine the necessity of performing a survey or a retrospective chart review or both when planning an RCT on corticosteroids in the treatment of paediatric septic shock. METHODS: We compared information on corticosteroid use for moderate to severe paediatric septic shock obtained from a survey of physician beliefs and stated practices with that obtained from a retrospective cohort study...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29783763/integrated-framework-of-load-monitoring-by-a-combination-of-smartphone-applications-wearables-and-point-of-care-testing-provides-feedback-that-allows-individual-responsive-adjustments-to-activities-of-daily-living
#9
Peter Düking, Silvia Achtzehn, Hans-Christer Holmberg, Billy Sperlich
Athletes schedule their training and recovery in periods, often utilizing a pre-defined strategy. To avoid underperformance and/or compromised health, the external load during training should take into account the individual's physiological and perceptual responses. No single variable provides an adequate basis for planning, but continuous monitoring of a combination of several indicators of internal and external load during training, recovery and off-training as well may allow individual responsive adjustments of a training program in an effective manner...
May 19, 2018: Sensors
https://www.readbyqxmd.com/read/29783737/traceability-in-patient-healthcare-through-the-integration-of-rfid-technology-in-an-icu-in-a-hospital
#10
María Martínez Pérez, Carlos Dafonte, Ángel Gómez
Patient safety is a principal concern for health professionals in the care process and it is, therefore, necessary to provide information management systems to each unit of the hospital, capable of tracking patients and medication to reduce the occurrence of adverse events and therefore increase the quality of care received by patients during their stay in hospital. This work presents a tool for the Intensive Care Unit (ICU), a key service with special characteristics, which computerises and tracks admissions, care plans, vital monitoring, the prescription and medication administration process for patients in this service...
May 19, 2018: Sensors
https://www.readbyqxmd.com/read/29783577/re-high-deductible-health-plans-reduce-health-care-cost-and-utilization-including-use-of-needed-preventive-services
#11
Matthew J Resnick
No abstract text is available yet for this article.
June 2018: Journal of Urology
https://www.readbyqxmd.com/read/29783258/-theoretical-grounds-of-a-structural-and-functional-model-for-quality-assurance-of-radiation-diagnostics-under-conditions-of-development-of-the-modern-health-care-system-in-ukraine
#12
Oleg A Korop, Sergiy V Lenskykh
OBJECTIVE: Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783253/planning-of-effective-evaluation-of-the-activities-of-hospital-district-at-the-example-of-poltava-region
#13
Vyacheslav M Zhdan, Valentyn M Dvornyk, Viktor P Lysak, Igor M Skrypnyk, Valeriy I Pokhylko, Iryna A Holovanova, Inna V Bielikova, Maxim V Khorosh, Ludmila M Shylkina, Mariya M Tovstiak
OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783235/-statistical-information-about-the-inflammatory-processes-of-the-jaw-facial-part-in-children
#14
Pavlo I Tkachenko, Serhii O Bilokon, Nataliia M Lokhmatova, Vitalina O Dobroskok, Olha B Dolenko, Nataliia M Korotych, Yuliia V Popelo
OBJECTIVE: Introduction: The acute and chronic inflammatory processes prevail in the structure of the dental surgical diseases in children. Notably, various forms of lymphadenitis, adenophlegmon and odontogenous osteomyelitis dominate in the specialized surgical units; however, it is not possible to resolve a number of organizational problems without clear understanding of the statistical situation. The aim: The paper is aimed at the analysis of the incidence rate of major nosological forms of the acute suppurative inflammations of the maxillofacial area in children for the prospective planning of arrangements to provide them with high-quality specialized care...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#15
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#16
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER: peer-review reports in medical education research
https://www.readbyqxmd.com/read/29782390/suspecting-hyperferritinemic-sepsis-in-iron-deficient-population-do-we-need-a-lower-plasma-ferritin-threshold
#17
Swarup Ghosh, Arun K Baranwal, Prateek Bhatia, Karthi Nallasamy
OBJECTIVES: Hyperferritinemia is being suggested to identify patients with sepsis-induced macrophage activation syndrome for early intervention. However, data among iron-deficient children are scarce. This study was planned to explore the biological behavior of plasma ferritin in children from communities with a high frequency of iron deficiency with septic shock and its association with the outcome. DESIGN: Prospective observational study. SETTING: Tertiary care teaching hospital in a low-middle income economy of South Asia...
May 18, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29782358/neoadjuvant-interdigitated-chemoradiotherapy-using-mesna-doxorubicin-and-ifosfamide-for-large-high-grade-soft-tissue-sarcomas-of-the-extremity-improved-efficacy-and-reduced-toxicity
#18
Mudit Chowdhary, Neilayan Sen, Elizabeth B Jeans, Luke Miller, Marta Batus, Steven Gitelis, Dian Wang, Ross A Abrams
OBJECTIVES: Patients with large, high-grade extremity soft tissue sarcoma (STS) are at high risk for both local and distant recurrence. RTOG 95-14, using a regimen of neoadjuvant interdigitated chemoradiotherapy with mesna, doxorubicin, ifosfamide, and dacarbazine followed by surgery and 3 cycles of adjuvant mesna, doxorubicin, ifosfamide, and dacarbazine, demonstrated high rates of disease control at the cost of significant toxicity (83% grade 4, 5% grade 5). As such, this regimen has not been widely adopted...
May 18, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#19
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#20
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
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