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https://www.readbyqxmd.com/read/29327616/nintedanib-for-the-treatment-of-idiopathic-pulmonary-fibrosis
#1
Francesco Varone, Giacomo Sgalla, Bruno Iovene, Teresa Bruni, Luca Richeldi
Idiopathic Pulmonary Fibrosis (IPF) is an interstitial lung disease characterized by the progressive loss of pulmonary function, ultimately leading to respiratory failure and death. Two novel compounds, nintedanib and pirfenidone, have shown efficacy in reducing the rate of decline of lung function in IPF patients. The multiple tyrosine kinase inhibitor nintedanib has extensively being studied as a potential angiogenesis inhibitor in clinical against various neoplastic disorders. Afterwards, this compound was successfully tested in IPF...
January 12, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29326414/-effect-of-debriefing-based-on-the-clinical-judgment-model-on-simulation-based-learning-outcomes-of-end-of-life-care-for-nursing-students-a-non-randomized-controlled-trial
#2
Kyung In Jeong, Ja Yun Choi
PURPOSE: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. METHODS: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training...
December 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/29326038/a-qualitative-meta-synthesis-of-emergency-department-staff-experiences-of-violence-and-aggression
#3
REVIEW
Rebecca Angharad Ashton, Lucy Morris, Ian Smith
INTRODUCTION: Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. METHOD: A meta-ethnographic approach was used to review papers. RESULTS: Four concepts were identified: 'The inevitability of violence and aggression'; 'Staff judgments about why they face violence and aggression'; 'Managing in isolation'; and 'Wounded heroes'...
January 8, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29315043/how-should-medical-schools-prepare-medical-students-for-leading-the-nhs
#4
F Kazzazi, J Bartlett, E Finnerty
The NHS is an evolving landscape. While the level of clinical knowledge conferred to medical students remains constant, their competence in other skills, such as leadership, needs to be enhanced in order for them to successfully work within the health-care system. The importance of leadership is considered at the start and end of a medical degree - when applying to medical school with various examples of leading a team, and upon balancing scenarios of leadership when sitting the situational judgement test in final year...
January 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29314554/going-from-evidence-to-recommendations-can-grade-get-us-there
#5
Mathew Mercuri, Brian Baigrie, Ross E G Upshur
The evidence based medicine movement has championed the need for objective and transparent methods of clinical guideline development. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was developed for that purpose. Central to this framework is criteria for assessing the quality of evidence from clinical studies and the impact that body of evidence should have on our confidence in the clinical effectiveness of a therapy under examination. Grades of Recommendation, Assessment, Development, and Evaluation has been adopted by a number of professional medical societies and organizations as a means for orienting the development of clinical guidelines...
January 5, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29306883/clinical-decisions-presented-to-patients-in-hospital-encounters-a-cross-sectional-study-using-a-novel-taxonomy
#6
Eirik Hugaas Ofstad, Jan C Frich, Edvin Schei, Richard M Frankel, Jūratė Šaltytė Benth, Pål Gulbrandsen
OBJECTIVE: To identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics. DESIGN: Cross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND SETTING: 372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29306097/cue-acquisition-a-feature-of-malawian-midwives-decision-making-process-to-support-normality-during-the-first-stage-of-labour
#7
Elizabeth Chodzaza, Elaine Haycock-Stuart, Aisha Holloway, Rosemary Mander
OBJECTIVE: to explore Malawian midwives decision making when caring for women during the first stage of labour in the hospital setting. DESIGN AND METHODS: this focused ethnographic study examined the decision making process of 9 nurse-midwives with varying years of clinical experience in the real world setting of an urban and semi urban hospital from October 2013 to May 2014.This was done using 27 participant observations and 27 post-observation in-depth interviews over a period of six months...
December 6, 2017: Midwifery
https://www.readbyqxmd.com/read/29305817/cognitive-load-predicts-point-of-care-ultrasound-simulator-performance
#8
Sara Aldekhyl, Rodrigo B Cavalcanti, Laura M Naismith
INTRODUCTION: The ability to maintain good performance with low cognitive load is an important marker of expertise. Incorporating cognitive load measurements in the context of simulation training may help to inform judgements of competence. This exploratory study investigated relationships between demographic markers of expertise, cognitive load measures, and simulator performance in the context of point-of-care ultrasonography. METHODS: Twenty-nine medical trainees and clinicians at the University of Toronto with a range of clinical ultrasound experience were recruited...
January 5, 2018: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29288137/a-prospective-cohort-and-extended-comprehensive-cohort-design-provided-insights-about-the-generalizability-of-a-pragmatic-trial-the-protect-prostate-cancer-trial
#9
Jenny L Donovan, Grace J Young, Eleanor I Walsh, Chris Metcalfe, J Athene Lane, Richard M Martin, Marta K Tazewell, Michael Davis, Tim J Peters, Emma L Turner, Nicola Mills, Hanan Khazragui, Tarnjit K Khera, David E Neal, Freddie C Hamdy
OBJECTIVES: Randomized controlled trials (RCTs) deliver robust internally valid evidence but generalizability is often neglected. Design features built into the ProtecT RCT of treatments for localized prostate cancer (PCa) provided insights into its generalizability. STUDY DESIGN AND SETTING: Population-based cluster-randomization created a prospective study of PSA-testing and a comprehensive-cohort study including groups choosing treatment or excluded from the RCT, as well as those randomized...
December 26, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29282523/amiodarone-associated-bilateral-vestibulopathy
#10
Robert Gürkov, Leonardo Manzari, Alexander Blödow, Angela Wenzel, Dusan Pavlovic, Leonal Luis
BACKGROUND: Bilateral vestibulopathy (BVP) is a debilitating disorder characterized by the hypofunction of both vestibular end organs or nerves. The most frequent identifiable causes of BVP are ototoxic drug effects, infectious and autoimmune disorders. The majority of cases, however, remain idiopathic. METHODS: Medical records of patients diagnosed with idiopathic BVP were examined in five dizziness clinics. RESULTS: We identified 126 patients with "idiopathic" BVP...
December 27, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29278981/delivering-occupational-therapy-hand-assessment-and-treatment-sessions-via-telehealth
#11
Tess Worboys, Melinda Brassington, Elizabeth C Ward, Petrea L Cornwell
Introduction Telehealth offers a solution to assist delivery of occupational therapy (OT) services for hand therapy in rural and remote locations. However, there is currently no evidence to validate this service model. The aim of this study was to examine the validity of clinical decisions made during hand therapy sessions conducted via telehealth compared to a traditional clinical model (TCM) assessment, and explore patient and clinician satisfaction. Methods Eighteen patients referred for hand therapy to a rural/remote hospital-based outpatient service were assessed simultaneously via telehealth and a TCM assessment...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29273843/estimating-the-reference-incremental-cost-effectiveness-ratio-for-the-australian-health-system
#12
Laura Catherine Edney, Hossein Haji Ali Afzali, Terence Chai Cheng, Jonathan Karnon
BACKGROUND: Spending on new healthcare technologies increases net population health when the benefits of a new technology are greater than their opportunity costs-the benefits of the best alternative use of the additional resources required to fund a new technology. OBJECTIVE: The objective of this study was to estimate the expected incremental cost per quality-adjusted life-year (QALY) gained of increased government health expenditure as an empirical estimate of the average opportunity costs of decisions to fund new health technologies...
December 22, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29260399/stigma-perceived-and-experienced-by-adults-with-type-1-diabetes-linguistic-adaptation-and-psychometric-validation-of-the-danish-version-of-the-type-1-diabetes-stigma-assessment-scale-dsas-1-dk
#13
Ulla Møller Hansen, Ingrid Willaing, Adriana D Ventura, Kasper Olesen, Jane Speight, Jessica L Browne
OBJECTIVES: We aimed to (a) culturally and linguistically adapt the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) from English (for Australia) into Danish and (b) examine psychometric properties of the measure among Danish adults with type 1 diabetes. METHODS: We performed a forward-backward translation, face validity interviews with experts and cognitive debriefing of the Danish version (DSAS-1 DK) with ten adults from the target group. The DSAS-1 DK was then completed by 1594 adults with type 1 diabetes...
December 19, 2017: Patient
https://www.readbyqxmd.com/read/29251679/morcellation-in-gynecologic-oncology
#14
Eva Chalas
PURPOSE OF REVIEW: Morcellation of uteri with unsuspected malignancies has been the focus of reports for decades. More intensive evaluation of clinical outcomes and evaluation of impact of changes in practice has occurred since the release of FDA statement advising against the use of power morcellators. The review summarizes some of the most relevant publications on this topic. RECENT FINDINGS: The Society of Gynecologic Oncology and the American College of Obstetricians and Gynecologists concur that symptomatic women should undergo appropriate evaluation, morcellation should not be performed whenever malignancy is suspected or diagnosed, and acknowledge the limitations of diagnostic testing currently available to detect leiomyosarcoma...
February 2018: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29251608/manufacturing-the-truth-from-designing-clinical-trials-to-publishing-trial-data
#15
Margaret Whitstock
This paper expands on some of the points made by Deepak Natarajan on techniques used in designing clinical trials of new drugs to ensure favourable outcomes. It also considers the nexus between the manufacturers of new drugs and the publishers of medical journals in which edited versions of these favourable outcomes are presented to the medical fraternity. The argument will be illustrated by referring to the clinical trials of rofecoxib (Vioxx®) and etoricoxib (Arcoxia®). Both these drugs are COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDs) manufactured by Merck and Co...
November 14, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/29251367/thyroid-fna-diagnostics-in-a-real-life-setting-experiences-of-the-implementation-of-the-bethesda-system-in-finland
#16
I Paajanen, S Metso, P Jaatinen, I Kholová
INTRODUCTION: The Bethesda system is widely accepted for thyroid FNA diagnostics, but has scarcely been analysed in relation to clinical background data. Our aim was to analyse the thyroid FNA diagnostic process in view of clinical data, and to assess the validity of the Bethesda system during the first year of implementation. METHODS: There were 415 thyroid FNAs taken from 363 patients during October 2011-September 2012 in the Pirkanmaa Hospital District, Finland...
December 18, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29246213/the-role-of-emotion-in-clinical-decision-making-an-integrative-literature-review
#17
Desirée Kozlowski, Marie Hutchinson, John Hurley, Joanne Rowley, Joanna Sutherland
BACKGROUND: Traditionally, clinical decision making has been perceived as a purely rational and cognitive process. Recently, a number of authors have linked emotional intelligence (EI) to clinical decision making (CDM) and calls have been made for an increased focus on EI skills for clinicians. The objective of this integrative literature review was to identify and synthesise the empirical evidence for a role of emotion in CDM. METHODS: A systematic search of the bibliographic databases PubMed, PsychINFO, and CINAHL (EBSCO) was conducted to identify empirical studies of clinician populations...
December 15, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29241289/-radiology-in-the-light-of-evolutionary-cognitive-theory
#18
Paul Gelinsky
An X-ray photograph is not adapted to the human a priori intuition: it is not colored, it is two-dimensional, has no depth and no perspective. A radiograph is composed by about 100 gradations of grey, of which the human eye cannot resolve more than 30. Projection radiography has a cardinal problem: the superposition of normal and pathological structures. Apart from visual physiology, visual psychology plays an essential role in diagnosis: expectation and stereotyped thinking influence the interpretation of visual perception...
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29240509/mild-bleeding-disorders-what-every-clinician-should-know
#19
H K Hussein, Plr Nicolson, K Fordwor, G C Lowe
Patients with mild bleeding disorders are under-recognized and frequently present to general physicians. The underlying reasons for bleeding are multifactorial. There is little evidence to guide diagnostic and management decision making in patients with mild bleeding disorders. This article outlines different types of mild bleeding disorders, with a particular focus on bleeding associated with low levels of von Willebrand factor and mild platelet defects. It gives practical, evidence-based advice on the investigation and management of patients with a suspected or known mild bleeding disorder, considering the scenarios of an acute bleed, stable outpatient, peri-surgical management and thrombosis...
December 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29237237/clinical-judgement-in-the-era-of-big-data-and-predictive-analytics
#20
Benjamin Chin-Yee, Ross Upshur
Clinical judgement is a central and longstanding issue in the philosophy of medicine which has generated significant interest over the past few decades. In this article, we explore different approaches to clinical judgement articulated in the literature, focusing in particular on data-driven, mathematical approaches which we contrast with narrative, virtue-based approaches to clinical reasoning. We discuss the tension between these different clinical epistemologies and further explore the implications of big data and machine learning for a philosophy of clinical judgement...
December 13, 2017: Journal of Evaluation in Clinical Practice
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