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Clinical judgement

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https://www.readbyqxmd.com/read/28210863/healthcare-professionals-response-to-intrapartum-death-a-cross-sectional-study
#1
Karen McNamara, S Meaney, O O'Connell, M McCarthy, R A Greene, K O'Donoghue
BACKGROUND: Exposure to adverse perinatal events can impact on the way healthcare professionals (HCPs) provide patient care. The aim of this study was to document the experiences of HCPs following exposure to intrapartum death (IPD), to identify opinions surrounding education and suitable support strategies, and to ascertain if involvement with an IPD had any impact on clinical practice. METHODS: A questionnaire study, with open and closed questions, was developed and set in a tertiary maternity hospital...
February 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28186914/design-and-validation-of-a-biofeedback-device-to-improve-heel-to-toe-gait-in-seniors
#2
Abhishek Vadnerkar, Sabrina Figueiredo, Nancy Mayo, Robert Kearney
A feature of healthy human walking gait is a clearly defined heel-strike at initial contact, known as heel-to-toe gait. However, a common consequence of ageing is the deterioration of this heel first gait towards a flat foot, or 'shuffling' gait. This leads to a shortened stride length, slowed gait speed, and an increased fall risk. Shuffling gait is normally treated by physiotherapy, however, therapist time is limited and training is restricted to a clinical environment. Gait rehabilitation could be expedited with the use of a device that distinguishes between heel-to-toe and shuffling gait and gives feedback to the user...
February 7, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28186872/acoustic-pattern-evaluation-during-cementless-hip-arthroplasty-surgery-may-be-a-new-method-for-predicting-complications
#3
Itaru Morohashi, Hideaki Iwase, Akio Kanda, Taichi Sato, Yasuhiro Homma, Atsuhiko Mogami, Osamu Obayashi, Kazuo Kaneko
BACKGROUND: Although surgeons must perform implantation of the cementless stem during total hip arthroplasty (THA) without complications, assessment is left to the surgeon's intuitive judgement, which could contain inter/intra-observer bias variety. We therefore asked (1) whether the sound created during the stem implantation could be evaluated objectively and (2) whether those sounds are correlate to the complication specific to the cementless stems. Our hypothesis is that the sounds produced during stem insertion could be quantified and related to the complications...
2017: SICOT-J
https://www.readbyqxmd.com/read/28184087/learning-to-look-from-different-perspectives-what-can-dental-undergraduates-learn-from-an-arts-and-humanities-based-teaching-approach
#4
F Smyth Zahra, K Dunton
By its nature, clinical teaching involves supporting small groups of dental students at the chairside as they treat their own patients. Scaffolding their learning in this way enables observation at close quarters of the various stages of development from early novice, just commencing clinical treatment of patients, to those approaching qualification. The students' main concerns throughout are not primarily with the technical skills required, which they have already been taught in the clinical skills laboratories, but dealing with the complex realities and ambiguities of clinical practice; the 'hidden curriculum' of decision making, judgement calls, issues of communication and what it actually means to be professional...
February 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28181019/evaluating-the-complementary-roles-of-an-sjt-and-academic-assessment-for-entry-into-clinical-practice
#5
Fran Cousans, Fiona Patterson, Helena Edwards, Kim Walker, John C McLachlan, David Good
Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the complementary roles of academic and non-academic selection methods in predicting in-role performance. This is an important area of enquiry as despite it being common practice to use both types of methods within a selection system, there is currently no evidence that this approach translates into increased predictive validity of the selection system as a whole, over that achieved by the use of a single selection method...
February 8, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28169135/case-study-and-case-based-research-in-emergency-nursing-and-care-theoretical-foundations-and-practical-application-in-paramedic-pre-hospital-clinical-judgment-and-decision-making-of-patients-with-mental-illness
#6
Ramon Z Shaban, Julie Considine, Margaret Fry, Kate Curtis
Generating knowledge through quality research is fundamental to the advancement of professional practice in emergency nursing and care. There are multiple paradigms, designs and methods available to researchers to respond to challenges in clinical practice. Systematic reviews, randomised control trials and other forms of experimental research are deemed the gold standard of evidence, but there are comparatively few such trials in emergency care. In some instances it is not possible or appropriate to undertake experimental research...
February 3, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28167517/the-need-to-optimize-adolescent-immunization
#7
Henry H Bernstein, Joseph A Bocchini
The adolescent period heralds the pediatric patient's transition into adulthood. It is a time of dynamic development during which effective preventive care measures can promote safe behaviors and the development of lifelong health habits. One of the foundations of preventive adolescent health care is timely vaccination, and every visit can be viewed as an opportunity to update and complete an adolescent's immunizations.In the past decade, the adolescent immunization schedule has expanded to include 2 doses of quadrivalent meningococcal conjugate vaccine, 1 dose of tetanus, diphtheria, acellular pertussis, absorbed vaccine, 2 or 3 doses of human papillomavirus vaccine, depending on the child's age, and an annual influenza vaccine...
February 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/28166473/a-retrospective-analysis-of-the-outcomes-of-smoking-cessation-pharmacotherapy-among-persons-with-mental-health-and-substance-use-disorders
#8
Chizimuzo T C Okoli, Vivek Anand, Milan Khara
OBJECTIVES: It is common practice to individualize smoking cessation pharmacotherapy based on clinical judgement and patient response. However, little has been documented about the use and outcomes of smoking cessation pharmacotherapy in 'real world' settings. This study examines factors associated with using smoking cessation pharmacotherapy and related outcomes among smokers with psychiatric and/or substance use disorders who completed an intensive tobacco treatment program within mental health and addictions services settings in Vancouver, Canada...
February 6, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28165847/moving-beyond-routines-in-teaching-and-learning-releasing-the-educative-potential-of-published-eating-disorder-memoirs
#9
Donna Lee Brien, Margaret McAllister
Learning from the lived experience of disordered eating is vital for contemporary mental health practitioners. While mental health practitioners need to understand the psycho-biological issues that impact the person and family with an eating disorder, there is much about this complex condition that eludes and escapes a bio-medical perspective. Use of an aesthetic lens on the issue can illuminate various challenges, tensions and insights that people with disordered eating experience along the journey of their ill-health and on to their recovery, but which often remain unstated in the clinical context...
February 6, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28150267/-the-adaptation-to-an-implantable-cardioverter-defibrillator-in-a-survivor-of-sudden-death-due-to-fatal-arrhythmia
#10
Ching-Yi Chou, Tzu-Yen Chen, Chyi Lo
The purpose of this article was to explore the adaptation to an implantable cardioverter defibrillator (ICD) of a survivor of sudden death due to fatal arrhythmia. Owing to medical urgency, the case patient, a woman, did not have sufficient time to get prepared mentally. Therefore, the case had difficulty coping and ultimately rejected the ICD device. During the period of hospital care (November 10th to 19th, 2015), in-depth interview and clinical observation were used to obtain information from the case. The interview was transcribed and analyzed by repeated reading...
February 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28148572/the-predictive-validity-of-a-situational-judgement-test-a-clinical-problem-solving-test-and-the-core-medical-training-selection-methods-for-performance-in-specialty-training%C3%A2
#11
Fiona Patterson, Safiatu Lopes, Stephen Harding, Emma Vaux, Liz Berkin, David Black
The aim of this study was to follow up a sample of physicians who began core medical training (CMT) in 2009. This paper examines the long-term validity of CMT and GP selection methods in predicting performance in the Membership of Royal College of Physicians (MRCP(UK)) examinations. We performed a longitudinal study, examining the extent to which the GP and CMT selection methods (T1) predict performance in the MRCP(UK) examinations (T2). A total of 2,569 applicants from 2008-09 who completed CMT and GP selection methods were included in the study...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28137432/higher-than-recommended-dosages-of-antipsychotics-in-male-patients-with-schizophrenia-are-associated-with-increased-depression-but-no-major-neurocognitive-side-effects-results-of-a-cross-sectional-pilot-naturalistic-study
#12
Konstantinos N Fountoulakis, Xenia Gonda, Melina Siamouli, Katerina Moutou, Zoe Nitsa, Brian E Leonard, Siegfried Kasper
INTRODUCTION: The current small pilot naturalistic cross-sectional study assesses whether higher dosages of antipsychotics are related to a satisfactory outcome concerning symptoms of schizophrenia but also to a worse outcome in terms of adverse events and neurocognitive function. MATERIAL AND METHODS: 41 male stabilized hospitalized schizophrenic patients were assessed by PANSS, Calgary Depression Rating Scale, UKU and Simpson-Angus Scale and a battery of neurocognitive tests...
January 28, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28133862/nurses-prioritization-of-enteral-nutrition-in-intensive-care-units-a-national-survey
#13
Melissa J Bloomer, Angelique B Clarke, Julia Morphet
BACKGROUND: Enteral nutrition is important in critically ill patients to improve patient outcomes, with nurses playing a pivotal role in the delivery and ongoing care of enteral nutrition. A significant deficit in nurses' knowledge and education relating to enteral nutrition has been identified, leading to iatrogenic malnutrition and potentially compromising patient care. Enteral nutrition appears to be prioritized lower than many other aspects of care. However, there is scant research to show how nurses prioritize enteral nutrition...
January 30, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28130975/nursing-students-perceptions-of-using-the-clinical-education-assessment-tool-assce-and-their-overall-perceptions-of-the-clinical-learning-environment-a-cross-sectional-correlational-study
#14
Maria Engström, Anna Löfmark, Karen Johanne Ugland Vae, Gunilla Mårtensson
BACKGROUND: Clinical education is a vital part of nursing students' learning; the importance of assessment tools and feedback in stimulating student learning has been stressed, but this needs to be studied in more detail. OBJECTIVES: To examine relationships between nursing students' perceptions of using an Assessment tool in Clinical Education (AssCE) during their mid-course discussion and final assessment, the content discussed during these meetings between the student, preceptor and nurse teacher and the students' overall perception of the clinical learning environment...
January 22, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28122926/negotiating-explanations-doctor-patient-communication-with-patients-with-medically-unexplained-symptoms-a-qualitative-analysis
#15
Madelon den Boeft, Daniëlle Huisman, LaKrista Morton, Peter Lucassen, Johannes C van der Wouden, Marjan J Westerman, Henriëtte E van der Horst, Christopher D Burton
BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) seek explanations for their symptoms, but often find general practitioners (GPs) unable to deliver these. Different methods of explaining MUPS have been proposed. Little is known about how communication evolves around these explanations. OBJECTIVE: To examine the dialogue between GPs and patients related to explanations in a community-based clinic for MUPS. We categorized dialogue types and dialogue outcomes...
February 2017: Family Practice
https://www.readbyqxmd.com/read/28122906/updated-guideline-on-the-management-of-common-bile-duct-stones-cbds
#16
Earl Williams, Ian Beckingham, Ghassan El Sayed, Kurinchi Gurusamy, Richard Sturgess, George Webster, Tudor Young
Common bile duct stones (CBDS) are estimated to be present in 10-20% of individuals with symptomatic gallstones. They can result in a number of health problems, including pain, jaundice, infection and acute pancreatitis. A variety of imaging modalities can be employed to identify the condition, while management of confirmed cases of CBDS may involve endoscopic retrograde cholangiopancreatography, surgery and radiological methods of stone extraction. Clinicians are therefore confronted with a number of potentially valid options to diagnose and treat individuals with suspected CBDS...
January 25, 2017: Gut
https://www.readbyqxmd.com/read/28114691/-symptom-validation-in-independent-medical-evaluations
#17
Carole Keppler, Andrea Maria Plohmann, Marlon Pflueger, Kristin Rabovsky, Wolf Langewitz, Ralph Mager
High prevalence rates of non-authentic complaints identified by experts in the field of insurance medicine draw attention to the risk of services, which are of limited availability and financially compensated, being used in ways that are not goal-oriented. Therefore, symptom validity testing has become a growing issue to prevent non-targeted monetary compensations. This paper outlines the best-evaluated methods and instruments. Based on the data currently available, their validity, in particular in the context of medico-legal assessment, is assessed...
January 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#18
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28096705/situational-judgment-tests-reliably-measure-professional-attributes-important-for-clinical-practice
#19
EDITORIAL
Katie Petty-Saphon, Kim A Walker, Fiona Patterson, Vicki Ashworth, Helena Edwards
Over the course of more than 40 years, international research has consistently shown situational judgment tests (SJTs) to be a reliable and valid selection method for assessing a range of professional attributes. However, SJTs still represent a relatively new selection method within the medical profession, and as such it is to be expected that applicant reactions will vary. In this Expert Opinion piece, we respond to Najim et al's article "The situational judgement test: a student's worst nightmare" by highlighting three key clarifications...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28092147/should-serum-calcitonin-be-routinely-measured-in-patients-presenting-with-thyroid-nodule
#20
William P Tormey, Brendan Byrne, Arnold D Hill, Mark Sherlock, Christopher J Thompson
BACKGROUND: The European Thyroid Association recommends serum calcitonin measurement in thyroid nodule cases. In contrast, the American Thyroid Association is ambivalent. In this institution, thyroid nodules cases are subject to a multidisciplinary evaluation of the clinical history and examination, ultrasound and scintigraphy, CT scan and sometimes MRI scan, biochemistry and histopathology of biopsies. We report on the current use of plasma calcitonin measurements in the context of changing practice which has not included screening of all thyroid nodules...
January 13, 2017: Minerva Endocrinologica
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