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https://www.readbyqxmd.com/read/28930815/variability-in-usual-care-mechanical-ventilation-for-pediatric-acute-respiratory-distress-syndrome-time-for-a-decision-support-protocol
#1
Christopher J L Newth, Katherine A Sward, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Richard Holubkov, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930362/rapid-development-of-specialty-population-registries-and-quality-measures-from-electronic-health-record-data-an-agile-framework
#2
Vaishnavi Kannan, Jason S Fish, Jacqueline M Mutz, Angela R Carrington, Ki Lai, Lisa S Davis, Josh E Youngblood, Mark R Rauschuber, Kathryn A Flores, Evan J Sara, Deepa G Bhat, DuWayne L Willett
BACKGROUND: Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch...
June 14, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28930235/current-usage-of-traditional-chinese-medicine-for-breast-cancer-a-narrative-approach-to-the-experiences-of-women-with-breast-cancer-in-australia-a-pilot-study
#3
Dianna Porter, Suzanne Cochrane, Xiaoshu Zhu
Background: The use of Traditional Chinese Medicine (TCM) by breast cancer patients is growing. Few studies have examined the complexity of breast cancer survivors' attitudes, lived experiences, barriers, and perceptions in using TCM as part of their treatment journey. This article examines breast cancer survivors' experiences, perceptions of, and benefits (or not) in using TCM. Methods: Qualitative research, using semi-structured interviews, was the chosen methodology. Results: Participants used TCM as a form of self-help and as a complement, not an alternative, to standard care...
April 21, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28929855/the-patients-as-partners-movement-and-the-emerging-health-leader
#4
Melinda Young
Over the past decade, the Patients as Partners Movement has spread throughout healthcare systems across Canada. This movement aims to overcome the paternalistic approach, where the system and its providers act for or deliver services to the patient. Instead, decision-making at all levels is to be shared with the patient. Delivering patient- and family-centred care is the goal of the Patients as Partners Movement and authentic engagement is at its core. This article aims to explore the link between the Patients as Partners Movement and authentic engagement...
May 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929818/improving-accountability-in-vaccine-decision-making
#5
James Kenneth Timmis, Steven Black, Rino Rappuoli
Introduction Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures...
September 20, 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/28929797/automated-early-detection-of-drops-in-commercial-egg-production-using-neural-networks
#6
I Ramírez-Morales, E Fernández-Blanco, D Rivero, A Pazos
1. The purpose of this work was to support decision making in poultry farms by performing automatic early detection of anomalies in egg production. 2. Unprocessed data were collected from a commercial egg farm on a daily basis over 7 years. Records from a total of 24 flocks, each with approximately 20 000 laying hens, were studied. 3. Other similar works have required a prior feature extraction by a poultry expert, and this method is dependent on time and expert knowledge. 4. The present approach reduces the dependency on time and expert knowledge because of the automatic selection of relevant features and the use of artificial neural networks capable of cost-sensitive learning...
September 20, 2017: British Poultry Science
https://www.readbyqxmd.com/read/28929478/defining-a-risk-informed-framework-for-whole-of-government-lessons-learned-a-canadian-perspective
#7
Shaye K Friesen, Shelley Kelsey, J A Jim Legere
Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations...
July 2017: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28929413/accessing-support-before-or-after-a-parent-dies-from-cancer-and-young-people-s-current-wellbeing
#8
A Varathakeyan, F E J McDonald, P Patterson, K Nicholson Perry, K R Allison
PURPOSE: To examine differences in distress and unmet needs between bereaved adolescent and young adult (AYA) offspring who accessed support before and after being bereaved by parental cancer, and to explore aspects of their cancer experience that influenced their help-seeking. METHODS: Phase 1: Surveys completed by AYAs (11-26 years) bereaved by parental cancer were subjected to analysis of covariance examining differences in distress and unmet needs between those who accessed support before (n = 159) and after (n = 212) parental bereavement...
September 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28929097/integrated-clinical-decision-support-systems-promote-absolute-cardiovascular-risk-assessment-an-important-primary-prevention-measure-in-aboriginal-and-torres-strait-islander-primary-health-care
#9
Veronica Matthews, Christopher P Burgess, Christine Connors, Elizabeth Moore, David Peiris, David Scrimgeour, Sandra C Thompson, Sarah Larkins, Ross Bailie
BACKGROUND: Aboriginal and Torres Strait Islander Australians experience a greater burden of disease compared to non-Indigenous Australians. Around one-fifth of the health disparity is caused by cardiovascular disease (CVD). Despite the importance of absolute cardiovascular risk assessment (CVRA) as a screening and early intervention tool, few studies have reported its use within the Australian Indigenous primary health care (PHC) sector. This study utilizes data from a large-scale quality improvement program to examine variation in documented CVRA as a primary prevention strategy for individuals without prior CVD across four Australian jurisdictions...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28928765/emerging-challenges-and-opportunities-for-education-and-research-in-weed-science
#10
REVIEW
Bhagirath S Chauhan, Amar Matloob, Gulshan Mahajan, Farhena Aslam, Singarayer K Florentine, Prashant Jha
In modern agriculture, with more emphasis on high input systems, weed problems are likely to increase and become more complex. With heightened awareness of adverse effects of herbicide residues on human health and environment and the evolution of herbicide-resistant weed biotypes, a significant focus within weed science has now shifted to the development of eco-friendly technologies with reduced reliance on herbicides. Further, with the large-scale adoption of herbicide-resistant crops, and uncertain climatic optima under climate change, the problems for weed science have become multi-faceted...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28928756/prioritizing-crop-management-to-increase-nitrogen-use-efficiency-in-australian-sugarcane-crops
#11
Peter J Thorburn, Jody S Biggs, Jeda Palmer, Elizabeth A Meier, Kirsten Verburg, Danielle M Skocaj
Sugarcane production relies on the application of large amounts of nitrogen (N) fertilizer. However, application of N in excess of crop needs can lead to loss of N to the environment, which can negatively impact ecosystems. This is of particular concern in Australia where the majority of sugarcane is grown within catchments that drain directly into the World Heritage listed Great Barrier Reef Marine Park. Multiple factors that impact crop yield and N inputs of sugarcane production systems can affect N use efficiency (NUE), yet the efficacy many of these factors have not been examined in detail...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28928479/decline-of-long-range-temporal-correlations-in-the-human-brain-during-sustained-wakefulness
#12
Christian Meisel, Kimberlyn Bailey, Peter Achermann, Dietmar Plenz
Sleep is crucial for daytime functioning, cognitive performance and general well-being. These aspects of daily life are known to be impaired after extended wake, yet, the underlying neuronal correlates have been difficult to identify. Accumulating evidence suggests that normal functioning of the brain is characterized by long-range temporal correlations (LRTCs) in cortex, which are supportive for decision-making and working memory tasks. Here we assess LRTCs in resting state human EEG data during a 40-hour sleep deprivation experiment by evaluating the decay in autocorrelation and the scaling exponent of the detrended fluctuation analysis from EEG amplitude fluctuations...
September 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28928350/does-the-early-adopter-catch-the-worm-or-choke-on-it-a-reflective-journey-of-the-challenges-of-technology-adoption-in-a-health-sciences-education-institution
#13
Chrisna Botha-Ravyse, Seugnet Blignaut
BACKGROUND: Early adoption of technology is a struggle well known to early adopters and now to me. Since the demand to use and implement technology in health professions' education has increased, I have been led to adopt various technologies, leading to many headaches. METHODS: This paper addresses my experiences in developing and implementing technology in health science classrooms in a setting not adequately equipped to do so. RESULTS: After reflecting on my experiences, I conclude that it is crucial that systems help innovators and early adopters as they work to develop and implement teaching and learning technology...
May 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/28928111/personalized-hypertension-management-using-patient-generated-health-data-integrated-with-electronic-health-records-empower-h-six-month-pre-post-study
#14
Nan Lv, Lan Xiao, Martha L Simmons, Lisa G Rosas, Albert Chan, Martin Entwistle
BACKGROUND: EMPOWER-H (Engaging and Motivating Patients Online With Enhanced Resources-Hypertension) is a personalized-care model facilitating engagement in hypertension self-management utilizing an interactive Web-based disease management system integrated with the electronic health record. The model is designed to support timely patient-provider interaction by incorporating decision support technology to individualize care and provide personalized feedback for patients with chronic disease...
September 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28927681/adapting-an-evidence-based-pediatric-acute-asthma-exacerbation-severity-assessment-tool-for-pediatric-primary-care
#15
Anne T Magpuri, Jane K Dixon, Ruth McCorkle, Angela A Crowley
INTRODUCTION: The purposes of this project were (a) to examine criteria derived from evidence-based pediatric acute asthma exacerbation assessment tools, asthma scores, and the acute asthma prediction rule validated and used in the emergency department and (b) to adapt these criteria for pediatric primary care. METHOD: The three stages of the project included (a) identification of criteria in a literature review, (b) validation of the criteria by an expert panel, and (c) adaptation of the criteria in the design of an assessment tool...
September 16, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28927583/differences-in-decision-making-as-a-function-of-drug-of-choice
#16
REVIEW
Joshua L Gowin, Matthew E Sloan, Vijay A Ramchandani, Martin P Paulus, Scott D Lane
Poor decision-making is a central feature of all substance use disorders (SUD), but substances vary in the legal and health consequences associated with their use. For example, while the negative health consequences associated with cigarette smoking are often years away, the consequences of heroin abuse can be fatal in mere hours. It remains unclear if users of these substances show decision-making patterns that differ with the relative riskiness of their drug of choice. To address this question, we reviewed studies that compared decision-making of individuals using different substances...
September 16, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28927507/providing-physical-care-to-persons-with-serious-mental-illness-attitudes-confidence-barriers-and-psychological-empowerment
#17
Margaret Knight, Paula Bolton, Lynne Kopeski
The prevalence of metabolic syndrome (MetS) in people with serious mental illness (SMI) has been well documented in the mental health literature. Despite the adoption of various guidelines for monitoring risk factors for diabetes and cardiovascular risk in this population, limited translation has occurred in actual practice (Hermes, Sernyak, & Rosenheck, 2013). The Institute of Medicine (IoM) (2009) has noted a lag time in the application of knowledge within clinical settings. Evidence-based practice was deemed as a means of improving healthcare outcomes through the use of science supported standards of care...
October 2017: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/28927443/towards-achieving-semantic-interoperability-of-clinical-study-data-with-fhir
#18
Hugo Leroux, Alejandro Metke-Jimenez, Michael J Lawley
BACKGROUND: Observational clinical studies play a pivotal role in advancing medical knowledge and patient healthcare. To lessen the prohibitive costs of conducting these studies and support evidence-based medicine, results emanating from these studies need to be shared and compared to one another. Current approaches for clinical study management have limitations that prohibit the effective sharing of clinical research data. METHODS: The objective of this paper is to present a proposal for a clinical study architecture to not only facilitate the communication of clinical study data but also its context so that the data that is being communicated can be unambiguously understood at the receiving end...
September 19, 2017: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/28927305/discovery-and-application-of-immune-biomarkers-for-hematological-malignancies
#19
Dimitrios Zafeiris, Jayakumar Vadakekolathu, Sarah Wagner, Alan Graham Pockley, Graham Roy Ball, Sergio Rutella
Hematological malignancies originate and progress in primary and secondary lymphoid organs, where they establish a uniquely immune-suppressive tumour microenvironment. Although high-throughput transcriptomic and proteomic approaches are being employed to interrogate immune surveillance and escape mechanisms in patients with solid tumours, and to identify actionable targets for immunotherapy, our knowledge of the immunological landscape of hematological malignancies, as well as our understanding of the molecular circuits that underpin the establishment of immune tolerance, is not comprehensive...
September 19, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28926426/epigenetics-and-precision-oncology
#20
Rachael J Werner, Andrew D Kelly, Jean-Pierre J Issa
Epigenetic alterations such as DNA methylation defects and aberrant covalent histone modifications occur within all cancers and are selected for throughout the natural history of tumor formation, with changes being detectable in early onset, progression, and ultimately recurrence and metastasis. The ascertainment and use of these marks to identify at-risk patient populations, refine diagnostic criteria, and provide prognostic and predictive factors to guide treatment decisions are of growing clinical relevance...
September 2017: Cancer Journal
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