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https://www.readbyqxmd.com/read/28092814/a-participatory-action-research-study-exploring-women-s-understandings-of-the-concept-of-informed-choice-during-pregnancy-and-childbirth-in-ireland
#1
Denise O'Brien, Michelle M Butler, Mary Casey
OBJECTIVE: to explore women's understandings and definitions of the concept of informed choice during pregnancy and childbirth. METHODS: a three-phase action research approach. In the first phase of the study (reported in this paper), fifteen women were interviewed to establish their understandings and experiences of informed choice. SETTING: Dublin, Ireland in a large maternity hospital. PARTICIPANTS: fifteen postnatal women who gave birth to a live healthy infant, women attended obstetric or midwifery-led care...
January 4, 2017: Midwifery
https://www.readbyqxmd.com/read/28092738/hearing-children-s-voices-including-children-s-perspectives-on-their-experiences-of-domestic-violence-in-welfare-reports-prepared-for-the-english-courts-in-private-family-law-proceedings
#2
Gillian S Macdonald
This research examined Children and Family Court Advisory and Support Service (Cafcass) reports prepared for private family court proceedings in domestic violence cases in England. The research found that in cases where children's accounts identified them as victims of violence, these disclosures regularly disappeared from report recommendations. Particular discourses regarding 'child welfare' and 'contact' were identified, which routinely impacted on the ways in which children's voices were taken into account...
January 13, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28092685/precision-oncology-for-acute-myeloid-leukemia-using-a-knowledge-bank-approach
#3
Moritz Gerstung, Elli Papaemmanuil, Inigo Martincorena, Lars Bullinger, Verena I Gaidzik, Peter Paschka, Michael Heuser, Felicitas Thol, Niccolo Bolli, Peter Ganly, Arnold Ganser, Ultan McDermott, Konstanze Döhner, Richard F Schlenk, Hartmut Döhner, Peter J Campbell
Underpinning the vision of precision medicine is the concept that causative mutations in a patient's cancer drive its biology and, by extension, its clinical features and treatment response. However, considerable between-patient heterogeneity in driver mutations complicates evidence-based personalization of cancer care. Here, by reanalyzing data from 1,540 patients with acute myeloid leukemia (AML), we explore how large knowledge banks of matched genomic-clinical data can support clinical decision-making. Inclusive, multistage statistical models accurately predicted likelihoods of remission, relapse and mortality, which were validated using data from independent patients in The Cancer Genome Atlas...
January 16, 2017: Nature Genetics
https://www.readbyqxmd.com/read/28092195/serum-bdnf-levels-in-patients-with-gambling-disorder-are-associated-with-the-severity-of-gambling-disorder-and-iowa-gambling-task-indices
#4
Sam-Wook Choi, Young-Chul Shin, Jung Yeon Mok, Dai-Jin Kim, Jung-Seok Choi, Samuel Suk-Hyun Hwang
Background and aims Gambling disorder (GD) shares many similarities with substance use disorders (SUDs) in clinical, neurobiological, and neurocognitive features, including decision-making. We evaluated the relationships among, GD, decision-making, and brain-derived neurotrophic factor (BDNF), as measured by serum BDNF levels. Methods Twenty-one male patients with GD and 21 healthy sex- and age-matched control subjects were evaluated for associations between serum BDNF levels and the Problem Gambling Severity Index (PGSI), as well as between serum BDNF levels and Iowa Gambling Task (IGT) indices...
March 2016: Journal of Behavioral Addictions
https://www.readbyqxmd.com/read/28092113/hemodialysis-treatment-time-as-important-as-it-seems
#5
John T Daugirdas
Hemodialysis treatment time and Kt/V can both be considered to be primary measures of hemodialysis adequacy, because when either goes to zero, mortality is certain in patients without residual kidney function. Treatment time is important, but it needs to be adjusted based on surface-area-normalized Kt/V, residual kidney function, and expected ultrafiltration rate. Rescaling dose of dialysis measured as Kt/V to body surface area prevents ultrashort dialysis in small patients, women, and children with minimal residual kidney function...
January 16, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28092062/-it-s-a-very-big-burden-on-me-women-s-experiences-using-insulin-for-gestational-diabetes
#6
Marlaine Figueroa Gray, Clarissa Hsu, Linda Kiel, Sascha Dublin
Objectives Gestational Diabetes Mellitus (GDM) affects hundreds of thousands of women each year. Many require medications to manage their blood glucose levels. Only insulin is approved by the U.S. Food and Drug Administration for use in pregnancy. While other medications can be used, their safety remains controversial. Few studies have examined women's lived experience of using insulin for GDM. Our objective in this study was to foreground the voices of women speaking about their treatment experience. Methods We conducted two focus groups including 16 women treated for GDM with medications, primarily insulin...
January 13, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28091867/arterial-aortic-stiffness-in-patients-with-resistant-hypertension-from-assessment-to-treatment
#7
REVIEW
James E Sharman, Pierre Boutouyrie, Stéphane Laurent
PURPOSE OF REVIEW: The purpose of the review is to examine whether measurement of aortic stiffness could be especially value-adding for risk stratification and treatment among patients with resistant hypertension (RH). RECENT FINDINGS: Adverse arterial remodeling and increased aortic stiffness is associated with RH, and it may be of additional clinical benefit to measure aortic stiffness in these patients. However, there is insufficient evidence to determine whether aortic stiffness is excessively high relative to the level of blood pressure (BP) among people with RH...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28090403/a-review-of-the-relationship-of-atrial-fibrillation-and-acute-coronary-syndrome
#8
Bory Kea, Tahroma Alligood, Vincent Manning, Merritt Raitt
Atrial fibrillation (AF) is the most common arrhythmia encountered by clinicians. Clinical decision-making focuses on reducing ischemic stroke risk in AF patients; however, AF is also associated with an increased risk of acute coronary syndromes (ACS). Patients with ACS and concurrent AF are less likely to receive appropriate therapies and more likely to experience adverse outcomes than ACS patients in sinus rhythm (SR). Clinicians may be able to stratify ACS patients at increased risk of AF development based on clinical characteristics...
September 2016: Current Emergency and Hospital Medicine Reports
https://www.readbyqxmd.com/read/28090159/transition-from-paper-to-computerized-pharmacist-clinical-decision-support
#9
Albert D Stewart
No abstract text is available yet for this article.
January 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28089913/physicians-perception-of-alternative-displays-of-clinical-research-evidence-for-clinical-decision-support-a-study-with-case-vignettes
#10
Stacey L Slager, Charlene R Weir, Heejun Kim, Javed Mostafa, Guilherme Del Fiol
OBJECTIVE: To design alternate information displays that present summaries of clinical trial results to clinicians to support decision-making; and to compare the displays according to efficacy and acceptability. METHODS: A 6-between (information display presentation order) by 3-within (display type) factorial design. Two alternate displays were designed based on Information Foraging theory: a narrative summary that reduces the content to a few sentences; and a table format that structures the display according to the PICO (Population, Intervention, Comparison, Outcome) framework...
January 13, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28089673/the-value-of-participatory-development-to-support-antimicrobial-stewardship-with-a-clinical-decision-support-system
#11
Nienke Beerlage-de Jong, Jobke Wentzel, Ron Hendrix, Lisette van Gemert-Pijnen
BACKGROUND: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily practice. Our aim was to demonstrate why and how participatory development (involving end-users and other stakeholders) can contribute to the success of CDSSs in ASPs. METHODS: A mixed-methods approach was applied, combining scenario-based prototype evaluations (to support verbalization of work processes and out-of-the-box thinking) among 6 medical resident physicians with an online questionnaire (to cross-reference findings of the prototype evaluations) among 54 Dutch physicians...
January 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28089532/refining-health-risk-assessment-by-incorporating-site-specific-background-concentration-and-bioaccessibility-data-of-nickel-in-soil
#12
Mao-Sheng Zhong, Lin Jiang
Risk assessment of Nickel (Ni) in a brownfield site contaminated was refined by incorporating the site-specific background level (SSBL) derived using multiple lines of evidence technology and bioaccessibility measured by the Unified Bioaccessibility Method (UBM) and Inhalation Bioaccessibility Method (IBM). The results revealed that the SSBL was 80mg/kg, which was much higher than the general soil screening value (GSSL) (50mg/kg) and more than two times regional background level reported for Tianjing (33mg/kg)...
January 12, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28089501/effectiveness-of-conventional-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-a-systematic-review
#13
Jesús Maese, Petra Díaz Del Campo, Daniel Seoane-Mato, Mercedes Guerra, Juan D Cañete
BACKGROUND: Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA. METHODS: Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis...
January 12, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28089317/attitudes-perceptions-and-experiences-of-mealtimes-among-residents-and-staff-in-care-homes-for-older-adults-a-systematic-review-of-the-qualitative-literature
#14
Ross Watkins, Victoria A Goodwin, Rebecca A Abbott, Amy Backhouse, Darren Moore, Mark Tarrant
Addressing problems associated with malnutrition in care home residents has been prioritized by researchers and decision-makers. This review aimed to better understand factors that may contribute to malnutrition by examining the attitudes, perceptions and experiences of mealtimes among care home residents and staff. Five databases were searched from inception to November 2015: Medline, Embase, PsychINFO, AMED, and the Cochrane Database. Forward and backward citation checking of included articles was conducted...
January 12, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#15
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
BACKGROUND: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. METHODS: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28088214/determinants-and-materno-fetal-outcomes-related-to-cesarean-section-delivery-in-private-and-public-hospitals-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis-protocol
#16
Idrissa Beogo, Bomar Mendez Rojas, Marie-Pierre Gagnon
BACKGROUND: Despite the well-established morbidity, mortality, long-term effects, and unnecessary extra-cost burden associated with cesarean section delivery (CSD) worldwide, its rate has grown exponentially. This has become a great topical challenge for the international healthcare community and individual countries. Estimated at three times the acceptable rate as defined by the World Health Organization in 1985, the continued upward trend has been fuelled by higher income countries...
January 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28088171/assessing-the-sustainability-of-daily-chlorhexidine-bathing-in-the-intensive-care-unit-of-a-veteran-s-hospital-by-examining-nurses-perspectives-and-experiences
#17
Jackson S Musuuza, Tonya J Roberts, Pascale Carayon, Nasia Safdar
BACKGROUND: Daily bathing with chlorhexidine gluconate (CHG) of intensive care unit (ICU) patients has been shown to reduce healthcare-associated infections and colonization by multidrug resistant organisms. The objective of this project was to describe the process of daily CHG bathing and identify the barriers and facilitators that can influence its successful adoption and sustainability in an ICU of a Veterans Administration Hospital. METHODS: We conducted 26 semi-structured interviews with a convenience sample of 4 nurse managers (NMs), 13 registered nurses (RNs) and 9 health care technicians (HCTs) working in the ICU...
January 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28088166/impact-of-home-care-versus-alternative-locations-of-care-on-elder-health-outcomes-an-overview-of-systematic-reviews
#18
Laura Boland, France Légaré, Maria Margarita Becerra Perez, Matthew Menear, Mirjam Marjolein Garvelink, Daniel I McIsaac, Geneviève Painchaud Guérard, Julie Emond, Nathalie Brière, Dawn Stacey
BACKGROUND: Many elders struggle with the decision to remain at home or to move to an alternative location of care. A person's location of care can influence health and wellbeing. Healthcare organizations and policy makers are increasingly challenged to better support elders' dwelling and health care needs. A summary of the evidence that examines home care compared to other care locations can inform decision making. We surveyed and summarized the evidence evaluating the impact of home care versus alternative locations of care on elder health outcomes...
January 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#19
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
December 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28087821/selection-of-first-line-therapy-in-multiple-sclerosis-using-risk-benefit-decision-analysis
#20
David Bargiela, Matthew T Bianchi, M Brandon Westover, Lori B Chibnik, Brian C Healy, Philip L De Jager, Zongqi Xia
OBJECTIVE: To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis. METHODS: We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs)...
January 13, 2017: Neurology
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