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https://www.readbyqxmd.com/read/27914156/-intratechal-chemotherapy-treatment-through-an-ommaya-reservoir-catheter-for-meningeal-carcinomatosis-a-single-centre-experience
#1
José Pedro Lavrador, Nuno Simas, Edson Oliveira, Manuel Herculano Carvalho
INTRODUCTION: Meningeal carcinomatosis is defined as tumour cells infiltration of leptomeninges and subarachnoid space. It is normally related with poor survival (2 - 5 months). The best multidisciplinary treatment for this condition is a matter of discussion. Patient's condition and the natural history of the disease should be considered in the decision making process. MATERIAL AND METHODS: Retrospective cohort analysis of patients submitted to Ommaya Reservoir placement due to systemic solid tumour meningeal carcinomatosis between 2006 and 2014...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913961/prediction-of-postoperative-clinical-recovery-of-drop-foot-attributable-to-lumbar-degenerative-diseases-via-a-bayesian-network
#2
Shota Takenaka, Hiroyuki Aono
BACKGROUND: Drop foot resulting from degenerative lumbar diseases can impair activities of daily living. Therefore, predictors of recovery of this symptom have been investigated using univariate or/and multivariate analyses. However, the conclusions have been somewhat controversial. Bayesian network models, which are graphic and intuitive to the clinician, may facilitate understanding of the prognosis of drop foot resulting from degenerative lumbar diseases. QUESTIONS/PURPOSES: (1) To show a layered correlation among predictors of recovery from drop foot resulting from degenerative lumbar diseases; and (2) to develop support tools for clinical decisions to treat drop foot resulting from lumbar degenerative diseases...
December 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27913742/frailty-assessment-in-hospitalized-older-adults-using-the-electronic-health-record
#3
Deborah A Lekan, Debra C Wallace, Thomas P McCoy, Jie Hu, Susan G Silva, Heather E Whitson
INTRODUCTION: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. PURPOSE: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization...
December 2, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#4
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912898/a-clinical-prediction-model-for-prolonged-air-leak-after-pulmonary-resection
#5
Adam Attaar, Daniel G Winger, James D Luketich, Matthew J Schuchert, Inderpal S Sarkaria, Neil A Christie, Katie S Nason
OBJECTIVE: Prolonged air leak increases costs and worsens outcomes after pulmonary resection. We aimed to develop a clinical prediction tool for prolonged air leak using pretreatment and intraoperative variables. METHODS: Patients who underwent pulmonary resection for lung cancer/nodules (from January 2009 to June 2014) were stratified by prolonged parenchymal air leak (>5 days). Using backward stepwise logistic regression with bootstrap resampling for internal validation, candidate variables were identified and a nomogram risk calculator was developed...
October 14, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27912780/the-influence-of-cost-per-daly-information-in-health-prioritisation-and-desirable-features-for-a-registry-a-survey-of-health-policy-experts-in-vietnam-india-and-bangladesh
#6
Yot Teerawattananon, Sripen Tantivess, Inthira Yamabhai, Nattha Tritasavit, Damian G Walker, Joshua T Cohen, Peter J Neumann
BACKGROUND: Economic evaluation has been implemented to inform policy in many areas, including coverage decisions, technology pricing, and the development of clinical practice guidelines. However, there are barriers to evidence-based policy in low- and middle-income countries (LMICs) that include limited stakeholder awareness, resources and data availability, as well as the lack of capacity to conduct country-specific economic evaluations. This study aims to survey health policy experts' opinions on barriers to use of cost-effectiveness data in these settings and to obtain their advice on how to make a new cost-per-DALY database being developed by Tufts Medical Center more relevant to LMICs...
December 3, 2016: Health Research Policy and Systems
https://www.readbyqxmd.com/read/27912776/improving-stroke-prevention-therapy-for-patients-with-atrial-fibrillation-in-primary-care-protocol-for-a-pragmatic-cluster-randomized-trial
#7
Theresa M Lee, Noah M Ivers, Sacha Bhatia, Debra A Butt, Paul Dorian, Liisa Jaakkimainen, Kori Leblanc, Dan Legge, Dante Morra, Alissia Valentinis, Laura Wing, Jacqueline Young, Karen Tu
BACKGROUND: The prevalence of atrial fibrillation (AF) is growing as the population ages, and at least 15% of ischemic strokes are attributed to AF. However, many high-risk AF patients are not offered guideline-recommended stroke prevention therapy due to a variety of system, provider, and patient-level barriers. METHODS: We will conduct a pragmatic, cluster-randomized controlled trial randomizing primary care clinics to test a "toolkit" of quality improvement interventions in primary care...
December 3, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#8
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27911088/african-american-women-s-perspectives-on-donating-healthy-breast-tissue-for-research-implications-for-recruitment
#9
Katherine E Ridley-Merriweather, Katharine J Head
African American women die of breast cancer at a higher rate than any other racial group. The Komen Tissue Bank (KTB) is an ongoing clinical trial that collects healthy breast tissue from women of all racial groups to use as controls in research and represents a critical tool in efforts to treat and prevent breast cancer; however, African Americans display reticence toward donating breast tissue to the KTB. Through the lens of the Integrated Behavioral Model, this study recruited African American women to share their perspectives on donating breast tissue for research purposes...
December 2, 2016: Health Communication
https://www.readbyqxmd.com/read/27910719/artifacts-in-multimodal-imaging-of-titanium-zirconium-and-binary-titanium-zirconium-alloy-dental-implants-an-in-vitro-study
#10
Ralf Smeets, Maximilian Schöllchen, Tobias Gauer, Gahzal Aarabi, Alexandre T Assaf, Carsten Rendenbach, Benedicta Beck-Broichsitter, Jan Semmusch, Jan Sedlacik, Max Heiland, Jens Fiehler, Susanne Siemonsen
OBJECTIVES: To analyze and evaluate imaging artifacts induced by zirconium, titanium and titanium-zirconium alloy dental implants. METHODS: Zirconium, titanium and titanium-zirconium alloy implants were embedded in gelatin and MRI, CT and CBCT were performed. Standard-protocols were used for each modality. For MRI, line-distance-profiles were plotted to quantify the accuracy of size-determination. For CT and CBCT, six shells surrounding the implant were defined every 0...
December 2, 2016: Dento Maxillo Facial Radiology
https://www.readbyqxmd.com/read/27910189/a-qualitative-investigation-into-the-hiv-disclosure-process-within-an-intimate-partnership-the-moment-i-realized-that-our-relationship-was-developing-into-something-serious-i-just-had-to-tell-him
#11
Charlotte Smith, Rachel Cook, Poul Rohleder
OBJECTIVES: This study sought to elucidate the process through which people living with HIV (PLWH) in the United Kingdom disclose their status to an intimate partner (IP). DESIGN: A qualitative cross-sectional survey design was used. METHOD: A total of 95 PLWH took part. They were presented with a series of open-ended questions enquiring into their last experience of disclosing to an IP. The data were analysed using thematic analysis. RESULTS: Disclosure became a salient issue when the discloser acknowledged their relationship as meaningful...
December 2, 2016: British Journal of Health Psychology
https://www.readbyqxmd.com/read/27910173/facilitators-and-barriers-to-person-centred-care-in-child-and-young-people-mental-health-services-a-systematic-review
#12
Dawid Gondek, Julian Edbrooke-Childs, Tjasa Velikonja, Louise Chapman, Felicity Saunders, Daniel Hayes, Miranda Wolpert
: Implementation of person-centred care has been widely advocated across various health settings and patient populations, including recent policy for child and family services. Nonetheless, evidence suggests that service users are rarely involved in decision-making, whilst their preferences and goals may be often unheard. The aim of the present research was to systematically review factors influencing person-centred care in mental health services for children, young people and families examining perspectives from professionals, service users and carers...
December 2, 2016: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/27909972/can-we-estimate-short-and-intermediate-term-survival-in-patients-undergoing-surgery-for-metastatic-bone-disease
#13
Jonathan A Forsberg, Rikard Wedin, Patrick J Boland, John H Healey
BACKGROUND: Objective means of estimating survival can be used to guide surgical decision-making and to risk-stratify patients for clinical trials. Although a free, online tool ( www.pathfx.org ) can estimate 3- and 12-month survival, recent work, including a survey of the Musculoskeletal Tumor Society, indicated that estimates at 1 and 6 months after surgery also would be helpful. Longer estimates help justify the need for more durable and expensive reconstructive options, and very short estimates could help identify those who will not survive 1 month and should not undergo surgery...
December 1, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27909516/the-role-of-noacs-in-atrial-fibrillation-management-a-qualitative-study
#14
Katherine Kirley Md Ms, Goutham Rao Md, Victoria Bauer Bs, Christopher Masi Md PhD
Patients with atrial fibrillation (AF) benefit from anticoagulation to reduce stroke risk. However, 30-60% of patients with AF are not anticoagulated. This study explored physicians' reasons for under-treatment of AF, focusing on the role of the novel oral anticoagulants (NOACs). We interviewed primary care physicians and cardiologists involved in AF management in a variety of practice settings. We conducted interviews using a semi-structured format and analyzed the data using the Framework Method. Four themes emerged...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909262/overcoming-the-limits-of-evidence-on-effective-multisectoral-nutrition-policy
#15
Madhu Kumar Marasini, Ssansa Mugenyi
The multisectoral approach has evolved as a popular instrument to attain nutrition goals and targets. But as policy makers, we need timely, relevant, and accurate information in order to effectively support these plans. This commentary comes from the members of the nutrition secretariats at the National Planning Commission in Nepal and the Office of the Prime Minister in Uganda on availability and use of evidence and the nutrition policy cycle. As has been highlighted in this supplement, some of the challenges we have faced include tracking nutrition spending and limited human resource capacity...
December 2016: Food and Nutrition Bulletin
https://www.readbyqxmd.com/read/27909256/optimizing-the-multisectoral-nutrition-policy-cycle-a-systems-perspective
#16
Sascha Lamstein, Amanda Pomeroy-Stevens, Patrick Webb, Eileen Kennedy
Based on the data collected in Uganda, Nepal, and Ethiopia, the papers included in this supplement fill a critical gap in evidence regarding multisectoral National Nutrition Action Plans. The studies offer new data and new thinking on how and why governance, effective financial decentralization, and improved accountability all matter for nutrition actions in low-income countries. This introductory paper offers an overview of the current state of evidence and thinking on the multisectoral nutrition policy cycle, including how governance and financing support that process...
December 2016: Food and Nutrition Bulletin
https://www.readbyqxmd.com/read/27909025/making-the-grade-using-instructional-feedback-and-evaluation-to-inspire-evidence-based-teaching
#17
Peggy Brickman, Cara Gormally, Amedee Marchand Martella
Typically, faculty receive feedback about teaching via two mechanisms: end-of-semester student evaluations and peer observation. However, instructors require more sustained encouragement and constructive feedback when implementing evidence-based teaching practices. Our study goal was to characterize the landscape of current instructional-feedback practices in biology and uncover faculty perceptions about these practices. Findings from a national survey of 400 college biology faculty reveal an overwhelming dissatisfaction with student evaluations, regardless of self-reported teaching practices, institution type, or position...
2016: CBE Life Sciences Education
https://www.readbyqxmd.com/read/27908662/too-cool-symbolic-but-not-iconic-stimuli-impair-4-year-old-children-s-performance-on-the-delay-of-gratification-choice-paradigm
#18
Lisa G Labuschagne, Taylor-Jane Cox, Kaitlyn Brown, Damian Scarf
A common method of improving the performance of children and non-human primates on the delay-of-gratification maintenance paradigm and measures of executive function (e.g., the Less is More task) is to represent the rewards subjects can acquire symbolically. This method, known as symbolic distancing, is thought to lower activation of the "hot" impulsive system and allow the "cool" rational system to dominate processing. Surprisingly, in contrast to its impact on the measures noted above, recent developmental and comparative studies have reported that symbolic distancing has a null or negative impact on performance on the delay-of-gratification choice paradigm...
November 28, 2016: Behavioural Processes
https://www.readbyqxmd.com/read/27908577/the-use-of-predictive-models-to-optimize-risk-of-decisions
#19
József Baranyi, Nathália Buss da Silva
The purpose of this paper is to set up a mathematical framework that risk assessors and regulators could use to quantify the "riskiness" of a particular recommendation (choice/decision). The mathematical theory introduced here can be used for decision support systems. We point out that efficient use of predictive models in decision making for food microbiology needs to consider three major points: (1) the uncertainty and variability of the used information based on which the decision is to be made; (2) the validity of the predictive models aiding the assessor; and (3) the cost generated by the difference between the a-priory choice and the a-posteriori outcome...
October 15, 2016: International Journal of Food Microbiology
https://www.readbyqxmd.com/read/27908534/critical-review-of-the-role-of-intravenous-immunoglobulins-in-idiopathic-inflammatory-myopathies
#20
REVIEW
Sabrina Anh-Tu Hoa, Marie Hudson
OBJECTIVE: The aim of this review was to summarize key findings from the literature concerning the therapeutic role of intravenous immunoglobulins (IVIg) in idiopathic inflammatory myopathies (IIM), dissecting the evidence according to disease subtype and treatment indication, and to review the evidence relating to the mechanism of action of IVIg in IIM to ascertain rationale for continued research. METHODS: Medline (Ovid) and Pubmed databases were searched from inception to July 2016 using relevant keywords...
July 29, 2016: Seminars in Arthritis and Rheumatism
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