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https://www.readbyqxmd.com/read/28811919/trainee-experiences-of-intellectual-disability-psychiatry-and-an-innovative-leaderless-support-group-a-qualitative-study
#1
Ross Spackman, Hannah Toogood, Jayne Kerridge, Jon Nash, Elizabeth Anderson, Dheeraj Rai
Aims and method There is very little research into the challenges of training in intellectual disability psychiatry or into interventions which may address these challenges. Using focus groups, we explored the experiences of intellectual disability psychiatry trainees, and evaluated a leaderless trainee support group developed in Bristol. Results Five distinct themes were identified via framework analysis: that trainees felt unprepared for the difference from previous posts; the need for support; the value of the group; that trainees were concerned about judgement in supervision; that the group structure was valued...
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28811768/clinical-predictors-of-an-abnormal-ultrasound-in-patients-presenting-with-suspected-nephrolithiasis
#2
Salman Tahir Shafi, Roshina Anjum, Tahir Shafi
OBJECTIVE: To determine any clinical features associated with an abnormal ultrasound in patients with suspected nephrolithiasis in an out-patient setting. METHODS: The study design was cross-sectional in nature. The study was conducted at an out-patient nephrology department of a tertiary care facility over a 3 month period. Patients included in the study were 18-80 years old, who presented with unilateral flank or costovertebral angle pain with or without other clinical features suggestive of renal or ureteric calculus based on clinician's judgement...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28806711/the-potential-of-an-automated-system-to-identify-the-upper-limb-component-of-a-controlled-sitting-posture
#3
María B Sánchez, Ian Loram, John Darby, Paul Holmes, Penelope B Butler
Full trunk control in sitting is demonstrated only when the head-trunk are aligned and upper limbs remain free of contact from mechanical support. These components represent a Controlled Kinetic Chain and can be evaluated in people with neuromotor disability using the Segmental Assessment of Trunk Control (SATCo) when a therapist provides manual trunk support at different segmental levels. However, the SATCo, as with other clinical assessments of control, is subjective. The SATCo was translated to objective rules relating the position of the hands and elbows to the head-trunk and then tested to determine the extent to which this automated objective method replicated the clinical judgement...
August 8, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28799446/a-simple-method-for-accurate-rotational-positioning-of-the-femoral-component-in-total-knee-arthroplasty
#4
Eirik Aunan, Daniel Østergaard, Arn Meland, Ketil Dalheim, Leiv Sandvik
Background and purpose - There are many techniques for placing the femoral component in correct rotational alignment in total knee arthroplasty (TKA), but only a few have been tested against the supposed gold standard, rotation determined by postoperative computed tomography (CT). We evaluated the accuracy and variability of a new method, the clinical rotational axis (CRA) method, and assessed the association between the CRA and knee function. Patients and methods - The CRA is a line derived from clinical judgement of information from the surgical transepicondylar axis, the anteroposterior axis, and the posterior condylar line...
August 11, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28793970/historical-perspective-the-pros-and-cons-of-conventional-outcome-measures-in-parkinson-s-disease
#5
Shen-Yang Lim, Ai Huey Tan
BACKGROUND: Conventional outcome measures (COMs) in Parkinson's disease (PD) refer to rating scales, questionnaires, patient diaries and clinically-based tests that do not require specialized equipment. METHODS: It is timely at this juncture - as clinicians and researchers begin to grapple with the "invasion" of digital technologies - to review the strengths and weaknesses of these outcome measures. RESULTS: This paper discusses advances (including an enhanced understanding of PD itself, and the development of clinimetrics as a field) that have led to improvements in the COMs used in PD; their strengths and limitations; and factors to consider when selecting and using a measuring instrument...
July 29, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28793390/interventions-for-maintaining-nasogastric-feeding-after-stroke-an-integrative-review-of-effectiveness-and-acceptability
#6
REVIEW
Catherine Mahoney, Linda Veitch
AIMS AND OBJECTIVES: To investigate the effectiveness and acceptability of interventions for maintaining nasogastric tubes (NGT) in adult stroke patients. BACKGROUND: Internationally, incidence of Cerebral Vascular Disease (CVD) continues to increase and stroke is the largest cause of complex disability in adults. Dysphagia is common following a stroke which necessitates feeding via a NGT. NGT are not well tolerated by stroke patients and may be frequently dislodged...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28780556/evaluation-of-dementianet-a-network-based-primary-care-innovation-for-community-dwelling-patients-with-dementia-protocol-for-a-longitudinal-mixed-methods-multiple-case-study
#7
Anke Richters, Minke S Nieuwboer, Marieke Perry, Marcel G M Olde Rikkert, Rene J F Melis, Marjolein A van der Marck
INTRODUCTION: Primary healthcare professionals will increasingly be required to manage and optimise their treatment for patients with dementia. With DementiaNet, we aim to reduce the burden of dementia on healthcare services and society through implementation and facilitation of integrated network-based care with increased dementia expertise. DementiaNet is designed as a stepwise approach including clinical leadership, quality improvement cycles and interprofessional training, which are tailor-made to the local context...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28776324/maternal-and-foetal-outcomes-following-natural-vaginal-versus-caesarean-section-c-section-delivery-in-women-with-bleeding-disorders-and-carriers
#8
REVIEW
Laxminarayan Karanth, Sachchithanantham Kanagasabai, Adinegara Bl Abas
BACKGROUND: Bleeding disorders are uncommon but may pose significant bleeding complications during pregnancy, labour and following delivery for both the woman and the foetus. While many bleeding disorders in women tend to improve in pregnancy, thus decreasing the haemorrhagic risk to the mother at the time of delivery, some do not correct or return quite quickly to their pre-pregnancy levels in the postpartum period. Therefore, specific measures to prevent maternal bleeding and foetal complications during childbirth, are required...
August 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28771918/effects-of-cognitive-behavioural-therapy-cbt-and-positive-psychological-intervention-ppi-on-female-offenders-with-psychological-distress-in-hong-kong
#9
Vivian W M Mak, Calais K Y Chan
BACKGROUND: Despite rapid growth in the female prison population, there is little research on effectiveness of psychological interventions for them. AIMS: To test the hypotheses that (1) each of two psychological interventions administered separately - cognitive behavioural therapy (CBT) or positive psychology intervention (PPI) - would be more effective than 'treatment-as-usual' alone in reducing psychological distress and enhancing psychological well-being; (2) outcomes would differ according to intervention; and (3) combining the interventions would be more effective than delivering either alone...
August 2, 2017: Criminal Behaviour and Mental Health: CBMH
https://www.readbyqxmd.com/read/28771756/visiting-nurses-posthospital-medication-management-in-home-health-care-an-ethnographic-study
#10
Mette Geil Kollerup, Tine Curtis, Birgitte Schantz Laursen
BACKGROUND: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care...
August 3, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28750092/cost-effectiveness-of-molecular-point-of-care-testing-for-influenza-viruses-in-elderly-patients-at-ambulatory-care-setting
#11
Joyce H S You, Lok-Pui Tam, Nelson L S Lee
BACKGROUND: Early initiation of antiviral therapy in elderly patients with influenza is associated with reduced risk of extra clinic visit, hospitalization and death. This study examined the cost-effectiveness of molecular POCT for detection of influenza viruses in Hong Kong elderly patients with influenza-like illness (ILI) in the outpatient clinics. METHODS: A decision analytic model was used to simulate outcomes of a hypothetical cohort of elderly patients presented with ILI at outpatient clinics during peak season of influenza with two diagnostic approaches: Rapid molecular assay (POCT-PCR group) and clinical judgement with no POCT...
2017: PloS One
https://www.readbyqxmd.com/read/28747258/confidence-and-clinical-judgement-in-community-nurses-managing-venous-leg-ulceration-a-judgement-analysis
#12
Una J Adderley, Carl Thompson
BACKGROUND: The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned. OBJECTIVES: To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration. DESIGN: Judgement Analysis. SETTING: UK community and primary care nursing services...
July 19, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28741976/fampridine-response-in-ms-patients-with-gait-impairment-in-a-real-world-setting-need-for-new-response-criteria
#13
Francisco Alejandro Rodriguez-Leal, Rocco Haase, Katja Thomas, Judith Christina Eisele, Undine Proschmann, Thorsten Schultheiss, Raimar Kern, Tjalf Ziemssen
OBJECTIVE: The primary objective of this real-world study was to describe the response to fampridine and changes of gait parameters in multiple sclerosis (MS) patients' walking disability (Expanded Disability Status Scale (EDSS): 4-7) after treatment with fampridine for 2 weeks as recommended by the European Medicines Agency (EMA) and compare it with the overall physician's judgement. METHODS: A total of 211 adult MS patients were analyzed using a multimodal gait assessment including the timed 25-foot walk test (T25FW), 2-minute walking test (2-MWT), 12-item Multiple Sclerosis Walking Scale (MSWS-12), the GAITRite electronic walkway system, and the patients' clinical global impression (CGI)...
July 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28740510/hematopoietic-stem-cell-transplantation-a-bioethical-lens
#14
REVIEW
Arcangelo Liso, Margherita Neri, Francesca Maglietta, Raffaele La Russa, Emanuela Turillazzi
Hematopoietic stem cell transplantation (HSCT) is one of a range of therapeutic options available to patients suffering from various diseases. HSCT procedure involves important ethical and legal aspects that can occur at every phase of the procedure: the clinical choice of whether to perform the procedure, pretransplantation preparation regimens, donor selection, stem cell harvest procedure, transplantation phase, and short-term and long-term follow-up care. In this discussion paper, we outline the ethical issue-facing physicians involved in HSCT...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28735820/evaluation-of-complementary-alternative-medicine-cam-questionnaire-development-for-indonesian-clinical-psychologists-a-pilot-study
#15
Andrian Liem, Peter A Newcombe, Annie Pohlman
This study aimed to evaluate questionnaire development to measure the knowledge of Complementary-Alternative Medicine (CAM), attitudes towards CAM, CAM experiences, and CAM educational needs of clinical psychologists in Indonesia. A 26-item questionnaire was developed through an extensive literature search. Data was obtained from provisional psychologists from the Master of Professional Clinical Psychology programs at two established public universities in urban areas of Indonesia. To validate the questionnaire, panel reviews by executive members of the Indonesian Clinical Psychology Association (ICPA), experts in health psychology, and experts in public health and CAM provided their professional judgements...
August 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28733440/dose-transition-pathways-the-missing-link-between-complex-dose-finding-designs-and-simple-decision-making
#16
Christina Yap, Lucinda J Billingham, Ying Kuen Cheung, Charlie Craddock, John O'Quigley
The ever increasing pace of development of novel therapies mandates efficient methodologies for assessment of their tolerability and activity. Evidence increasingly support the merits of model-based dose-finding designs in identifying the recommended Phase II dose compared to conventional rule-based designs such as the 3+3 but despite this, their use remains limited. Here, we propose a useful tool, Dose Transition Pathways (DTP), which helps overcome several commonly-faced practical and methodological challenges in the implementation of model-based designs...
July 21, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28729755/social-cognition-deficits-current-position-and-future-directions-for-neuropsychological-interventions-in-cerebrovascular-disease
#17
REVIEW
Progress Njomboro
Neuropsychological assessments of cognitive dysfunction in cerebrovascular illness commonly target basic cognitive functions involving aspects of memory, attention, language, praxis, and number processing. Here, I highlight the clinical importance of often-neglected social cognition functions. These functions recruit a widely distributed neural network, making them vulnerable in most cerebrovascular diseases. Sociocognitive deficits underlie most of the problematic social conduct observed in patients and are associated with more negative clinical outcomes (compared to nonsocial cognitive deficits)...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28727184/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-systematic-realist-review
#18
REVIEW
Jennifer McGaughey, Peter O'Halloran, Sam Porter, Bronagh Blackwood
AIM: To determine the Rapid Response System programme theory and investigate how the mechanisms of implementation and the characteristics of context combine to enable or constrain the implementation of Rapid Response Systems and the achievement of desired outcomes. BACKGROUND: Rapid Response Systems have been implemented internationally to improve the recognition and management of patient deterioration, reduce the need for cardiopulmonary resuscitation and improve patient outcomes...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28723476/charting-recent-progress-and-challenges-in-metastatic-castration-resistant-prostate-cancer-is-there-an-optimal-treatment-sequence
#19
REVIEW
Stéphane Oudard, Pablo Maroto, Gaston Demonty, Winald R Gerritsen
CONTEXT: Recent developments in the treatment of metastatic castration-resistant prostate cancer (mCRPC) have led to uncertainty about the optimal sequence of agents. OBJECTIVE: To review and assess treatment options and sequence in patients with mCRPC. EVIDENCE ACQUISITION: To identify data on the optimal use of approved treatments, we searched PubMed for studies on the use of recently approved agents for men with mCRPC published before March 2015...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28716994/diagnosis-and-management-of-perinatal-depression-and-anxiety-in-general-practice-a-meta-synthesis-of-qualitative-studies
#20
Elizabeth Ford, Suzanne Lee, Judy Shakespeare, Susan Ayers
BACKGROUND: Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. AIM: This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. DESIGN AND SETTING: Meta-synthesis of the available published qualitative evidence on GPs' recognition and management of perinatal anxiety and depression...
August 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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