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https://www.readbyqxmd.com/read/28329417/nursing-judgement-and-decision-making-using-the-sedation-withdrawal-score-sws-in-children
#1
Jennie Craske, Bernie Carter, Ian H Jarman, Lyvonne N Tume
AIMS: The aim of the study was to evaluate registered children's nurses' approaches to the assessment and management of withdrawal syndrome in children. BACKGROUND: Assessment of withdrawal syndrome is undertaken following critical illness when the child's condition may be unstable with competing differential diagnoses. Assessment tools aim to standardise and improve recognition of withdrawal syndrome. Making the right decisions in complex clinical situations requires a degree of mental effort and it is not known how nurses make decisions when undertaking withdrawal assessments...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#2
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#3
Anne Hurren, Nick Miller
PURPOSE OF REVIEW: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28303438/using-health-technology-assessment-to-assess-the-value-of-new-medicines-results-of-a-systematic-review-and-expert-consultation-across-eight-european-countries
#4
Aris Angelis, Ansgar Lange, Panos Kanavos
BACKGROUND: Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. OBJECTIVE: To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment...
March 16, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28300480/impossible-decision-an-investigation-of-risk-trade-offs-in-the-intensive-care-unit
#5
Tom W Reader, Geetha Reddy, Stephen J Brett
In the intensive care unit (ICU), clinicians must often make risk trade-offs on patient care. For example, on deciding whether to discharge a patient before they have fully recovered in order to create a bed for another, sicker, patient. When misjudged, these decisions can negatively influence patient outcomes: yet it can be difficult, if not impossible, for clinicians to evaluate with certainty the safest course of action. Using a vignette-based interview methodology, a naturalistic decision-making approach was utilised to study this phenomena...
March 16, 2017: Ergonomics
https://www.readbyqxmd.com/read/28295898/the-program-for-personnel-in-medical-institutions-in-japan-to-combat-child-maltreatment
#6
Koji Tanoue, Masayoshi Senda, Byongmun An, Midori Tasaki, Megumi Taguchi, Kosuke Kobashi, Shinji Oana, Fumitake Mizoguchi, Yuko Shiraishi, Fujiko Yamada, Makiko Okuyama, Kotaro Ichikawa
BACKGROUND: In 2014, we created the training program for personnel in medical institutions in Japan to combat child maltreatment. Our objective was to document the effectiveness of the program for professionals from multiple disciplines working in medical institutions. METHODS: The questionnaire designed for the training program included demographic questions such years of practice and area of specialty, i.e. physician, nurse, social worker, public health nurse, technician, and others, as well as experience with suspected child maltreatment cases and training in dealing with such cases...
March 11, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28290256/preparing-the-sexual-health-workforce-to-deliver-integrated-services-is-education-the-answer-a-qualitative-study-exploring-the-impact-of-sexual-health-education-on-developing-integrated-policy-and-practice
#7
Judy Brook, Debra Salmon, Rachael-Anne Knight
Aim This study aimed to explore the ability of sexual health nurses working in the South West of England, to implement new learning within existing sexual health service delivery models. Drawing on Lipsky's account of street-level bureaucracy to conceptualise policy implementation, the impact of workforce learning on the development of integrated services across this region of the United Kingdom was assessed. BACKGROUND: In order to achieve the United Nations' goal of universal access to sexual health, it is essential for reproductive and sexual health, including HIV provision, to integrate into a single service...
March 14, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28281044/using-patient-reported-outcome-measures-for-quality-improvement-in-clinical-genetics-an-exploratory-study
#8
A Costal Tirado, A M McDermott, C Thomas, D Ferrick, J Harris, A Edwards, Marion McAllister
International advocacy of patient-centred healthcare delivery has led to emphasis on the (re)design and evaluation of healthcare processes and outcomes from a patient perspective. Patient-reported outcome measures (PROMs) have significant potential to inform such attempts. However there is limited understanding of the processes by which this can be achieved. This exploratory study followed attempts to utilise two different PROMs measures to support service quality improvement in clinical genetics. PROMs used were the Genetic Counseling Outcome Scale (GCOS-24), a well-validated clinical genetics-specific PROM and Euroqol (EQ-5D), a generic PROM favoured by the UK National Institute for Health and Excellence (NICE)...
March 9, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28276959/how-should-worsening-in-osteoarthritis-be-defined-development-and-initial-validation-of-preliminary-criteria-for-clinical-worsening-in-knee-and-hip-osteoarthritis
#9
Eam Mahler, A A den Broeder, T G Woodworth, Vjjf Busch, F H van den Hoogen, Jwj Bijlsma, Chm van den Ende
OBJECTIVES: There is a need to define and validate measures of clinical worsening in knee and hip osteoarthritis (OA). The objectives of this exploratory project were: (i) to characterize worsening criteria in knee and hip OA using psychometric methods; (ii) to estimate their sensitivity and specificity; and (iii) to validate and compare these criteria with worsening criteria previously described in the literature. METHOD: An Expert Group reached consensus on 10 sets of worsening criteria to be tested in observational data sets of patients with knee or hip OA who received multimodal conservative treatment...
February 7, 2017: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/28268493/automatic-seizure-detection-using-correlation-integral-with-nonlinear-adaptive-denoising-and-kalman-filter
#10
Hongda Wang, Chiu-Sing Choy
The ability of correlation integral for automatic seizure detection using scalp EEG data has been re-examined in this paper. To facilitate the detection performance and overcome the shortcoming of correlation integral, nonlinear adaptive denoising and Kalman filter have been adopted for pre-processing and post-processing. The three-stage algorithm has achieved 84.6% sensitivity and 0.087/h false detection rate, which are comparable to many machine learning based methods, but at much lower computational cost...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28251119/fibrosis-assessment-in-patients-with-chronic-hepatitis-b-virus-hbv-infection
#11
REVIEW
Pathik Parikh, John D Ryan, Emmanuel A Tsochatzis
Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide. While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28247246/appropriate-use-criteria-for-echocardiography-in-the-netherlands
#12
B J Bouma, R Riezenbos, A J Voogel, M H Veldhorst, W Jaarsma, J Hrudova, B Cernohorsky, S Chamuleau, R B A van den Brink, R Breedveld, C Reichert, O Kamp, R Braam, J P van Melle
INTRODUCTION: Appropriate use criteria (AUC) for echocardiography based on clinical scenarios were previously published by an American Task Force. We determined whether members of the Dutch Working Group on Echocardiography (WGE) would rate these scenarios in a similar way. METHODS: All 32 members of the WGE were invited to judge clinical scenarios independently using a blanked version of the previously published American version of AUC for echocardiography. During a face-to-face meeting, consensus about the final rating was reached by open discussion for each indication...
February 28, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28246008/compliance-of-systematic-reviews-articles-in-brain-arteriovenous-malformation-with-prisma-statement-guidelines-review-of-literature
#13
REVIEW
T Akhigbe, A Zolnourian, D Bulters
BACKGROUND: The knowledge of reporting compliance of systematic reviews with PRISMA guidelines may assist in improving the quality of secondary research in brain AVM management and subsequently application to patient population and clinical practice. This may allow researchers and clinicians to be equipped to appraise existing literatures based on known deficit to look for or expect. The objective of this study was to assess the compliance of systematic reviews and meta-analysis in the management of brain AVM...
February 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28244558/assessing-the-appropriateness-of-oral-anticoagulation-for-atrial-fibrillation-in-advanced-frailty-use-of-stroke-and-bleeding-risk-prediction-models
#14
R O'Caoimh, E Igras, A Ramesh, B Power, K O'Connor, R Liston
BACKGROUND: Atrial fibrillation (AF) is common among frail older adults. Oral anticoagulation (OAC) is particularly challenging for these due to overlapping stroke and bleeding risk factor profiles. OBJECTIVE: To compare the utility of stroke and haemorrhage risk-prediction instruments in the treatment of AF among frail older adults. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: Frail residents in four nursing homes with a Clinical Frailty Scale score ≥5 (median 7±0)...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28239024/in-practical-training-a-questionnaire-survey-and-analysis-to-pharmacy-students-of-the-utilization-situation-of-the-course-contents-of-pharmacy-school
#15
Masato Okubo, Yuka Takahashi, Jun Yamashita, Hideyo Takahashi, Okiko Miyata, Takaaki Suzuki, Itsuko Ishii
  Pharmacy education comprises basic pharmacy (organic chemistry, biochemistry, and physical chemistry) and applied pharmacy (clinical pharmacy, pharm aceutics, and chemical hygiene). Students are expected to apply these subjects studied in pharmacy school during their practical pharmacy training. However, knowledge gained in university does not appear to be fully utilized in practice. We hypothesized that this is due to a lack of connection between pre-practical training education and actual practical training...
February 24, 2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28235886/the-pearl-score-predicts-90-day-readmission-or-death-after-hospitalisation-for-acute-exacerbation-of-copd
#16
C Echevarria, J Steer, K Heslop-Marshall, S C Stenton, P M Hickey, R Hughes, M Wijesinghe, R N Harrison, N Steen, A J Simpson, G J Gibson, S C Bourke
BACKGROUND: One in three patients hospitalised due to acute exacerbation of COPD (AECOPD) is readmitted within 90 days. No tool has been developed specifically in this population to predict readmission or death. Clinicians are unable to identify patients at particular risk, yet resources to prevent readmission are allocated based on clinical judgement. METHODS: In participating hospitals, consecutive admissions of patients with AECOPD were identified by screening wards and reviewing coding records...
February 24, 2017: Thorax
https://www.readbyqxmd.com/read/28226667/automatic-seizure-detection-using-correlation-integral-with-nonlinear-adaptive-denoising-and-kalman-filter
#17
Hongda Wang, Chiu-Sing Choy, Hongda Wang, Chiu-Sing Choy, Hongda Wang, Chiu-Sing Choy
The ability of correlation integral for automatic seizure detection using scalp EEG data has been re-examined in this paper. To facilitate the detection performance and overcome the shortcoming of correlation integral, nonlinear adaptive denoising and Kalman filter have been adopted for pre-processing and post-processing. The three-stage algorithm has achieved 84.6% sensitivity and 0.087/h false detection rate, which are comparable to many machine learning based methods, but at much lower computational cost...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225495/the-multimorbidity-interaction-severity-index-misi-a-proof-of-concept-study
#18
Dimitri Gassmann, Marcus Cheetham, Klarissa Siebenhuener, Barbara M Holzer, Claudine Meindl-Fridez, Florian F Hildenbrand, Vanessa Virgini, Mike Martin, Edouard Battegay
Therapeutic decision-making for patients with multimorbidity (MM) is challenging. Clinical practice guidelines inadequately address harmful interactions and resulting therapeutic conflicts within and among diseases. A patient-specific measure of MM severity that takes account of this conflict is needed.As a proof of concept, we evaluated whether the new Multimorbidity Interaction Severity Index (MISI) could be used to reliably differentiate patients in terms of lower versus higher potential for harmful interactions...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28220518/describing-student-performance-a-comparison-among-clinical-preceptors-across-cultural-contexts
#19
Kerry Wilbur, Noha Hassaballa, Omaima S Mahmood, Emily K Black
CONTEXT: Health professional student evaluation during experiential training is notably subjective and assessor judgements may be affected by socio-cultural influences. OBJECTIVES: This study sought to explore how clinical preceptors in pharmacy conceptualise varying levels of student performance and to identify any contextual differences that may exist across different countries. METHODS: The qualitative research design employed semi-structured interviews...
February 20, 2017: Medical Education
https://www.readbyqxmd.com/read/28219209/-value-of-99-tc-m-mdp-spect-ct-in-clinical-decision-making-for-nasopharyngeal-carcinoma-and-a-comparison-of-the-values-of-different-imaging-techniques-for-diagnosing-skull-base-bone-invasion
#20
W Li, R S Zhang, L Q Zhang, B G Lu, W H Fu
Objective: To analyze the clinical value of SPECT/CT in diagnosis of skull base bone invasion and clinical decision-making for nasopharyngeal carcinoma (NPC), and to compare their diagnostic value with SPECT/CT, CT, MRI, and MRI combined with SPECT (MRI-SPECT) for skull base bone invasion. Methods: Before treatment, among 348 newly diagnosed NPC patients, CT scan was performed in 186 patients (group A) and the remaining 162 patients received MRI scan (group B). Clinical doctors then made clinical management decisions according to the CT or MRI results...
February 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
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