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Whole person care

Arno K Kumagai, Lisa Richardson, Sarah Khan, Ayelet Kuper
Given the constant pressures of overflowing clinics, hospital wards, and emergency departments; shortened duty hours; and increased accreditation requirements, over-burdened clinician teachers ask, "how does one teach for humanism and justice?" How does one step away-even momentarily-and focus teaching on the individual in front of us, the person who requires our attention and care? This approach must not only involve content (the patient's perspective of illness, social context, and life story) but it also must be tightly linked with the ways in which these lessons in living are learned and taught...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Kate Shafto, Suzanne Gouda, Kris Catrine, Melanie L Brown
Pediatric palliative care is a field which focuses on caring for and treating the symptoms and distress typically associated with life-limiting illness. Integrative medicine is supported by evidence and aims to heal the whole person, including all aspects of one’s lifestyle. Therapies offered by integrative medicine often empower patients and families, allowing for a sense of control. This review addresses the merging of integrative medicine philosophy and modalities with the care given to children with life-limiting illness...
June 13, 2018: Children
Ana Stoilkova-Hartmann, Frits M E Franssen, Ingrid M L Augustin, Emiel F M Wouters, Katharine D Barnard
BACKGROUND: The art of medicine is undergoing a dramatic shift in focus, evolving to focus on patient involvement as partners in care, transforming the traditional, prescriptive, reactive practice of healthcare into a proactive discipline. The personal and societal burden of chronic diseases is burgeoning and unsustainable in current systems, novel approaches are required to address this. DISCUSSION: Although considerable progress has been made in the development of diagnostics, therapeutics and care guidelines for patients with chronic obstructive pulmonary disease (COPD), questions remain surrounding the implementation of best practice education and support...
June 1, 2018: Patient Education and Counseling
Dzmitry Krupchanka, Karolína Mladá, Petr Winkler, Yasser Khazaal, Emiliano Albanese
BACKGROUND: The region of central and eastern Europe is estimated to have high rates of premature mortality due to mental disorders. However, epidemiological evidence is scarce and insufficient to inform policy actions and health system development. We aimed to assess mortality associated with mental disorders in the Czech Republic. METHODS: We did a nationwide, register-based, retrospective cohort study using routinely collected health data from two nationwide registries in the Czech Republic: the register of inpatient discharges (from Jan 1, 1994, to Dec 31, 2013) and the causes of death registry (from Jan 1, 1994, to Dec 31, 2014)...
June 2018: Lancet. Public Health
C Del Rincon-Fernandez
In palliative care it is necessary to evaluate and respond to the psychological and spiritual needs of the participants in order to achieve the maximum possible well-being for both the patient and his/her family. Coping with one's own death, the loss of a loved one or the loss of some significant aspect in a person's life is one of the most difficult challenges that human beings have to face. Death, as the maximum expression of loss, is experienced as a threat, as one of the most difficult events to cope with and with the greatest psychological impact...
June 5, 2018: Revista de Neurologia
M Halbach, S Baldus
Certification is a critical component of quality assurance in medicine. From the certification of individual persons, through units and up to whole hospitals, certification stimulates testing and optimization of treatment processes, thereby improving the quality of care. Minimum case numbers needed to acquire a certificate are an important and objective attribute of quality. Advantages of certification include an improved treatment of patients, structured training of new employees and enhanced cost efficiency...
June 6, 2018: Herz
Ryuichi Ohta, Daisuke Son
Objective: Community-based medical education (CBME) serves as a complement to university medical education, and it is practiced in several urban undergraduate and postgraduate curriculums. However, there are few reports on CBME learning content in rural Japanese settings. Materials and Methods: This research aimed to clarify learning content through semi-structured interviews and qualitative analysis of second-year residents who studied on a remote, rural island located 400 km from the mainland of Okinawa, Japan...
May 2018: Journal of Rural Medicine: JRM
Jane Trinh, Nicholas Turner
Background: Hepatitis C (HCV) is a viral liver disease that can result in cirrhosis, hepatocellular carcinoma, liver transplantation or death. The Centers for Disease Control (CDC) estimates that 2.7-3.9 million Americans are living with HCV, yet the majority are unaware. Starting in 2013, both CDC and US Preventative Services Task Force guidelines agreed in recommending HCV screening for all those born between 1945 and 1965 yet many clinics have been slow to adopt screening. Objective: We designed a quality improvement project seeking to improve HCV screening rates among patients seen for new or annual visits to ≥90% over a 3-year period in an academic primary care clinic...
2018: BMJ Open Quality
Stefan Janssen, Heinke C Hansen, Steven E Schild, Dirk Rades
BACKGROUND/AIM: Patients with cerebral metastases from gynecological cancer who receive whole-brain irradiation (WBI) alone require personalized therapy. This study contributes to personalized care by creating an instrument to predict 6-month survival probability. PATIENTS AND METHODS: In 49 patients, six pre-treatment variables, namely age, Eastern Cooperative Oncology Group performance score (ECOG-PS), primary tumor type, number of cerebral metastases, metastasis outside the brain, and interval between diagnosis of gynecological cancer and WBI, were analyzed for survival...
June 2018: Anticancer Research
Suzanne M Dyer, Enwu Liu, Emmanuel S Gnanamanickam, Rachel Milte, Tiffany Easton, Stephanie L Harrison, Clare E Bradley, Julie Ratcliffe, Maria Crotty
OBJECTIVE: To compare the outcomes and costs of clustered domestic and standard Australian models of residential aged care. DESIGN: Cross-sectional retrospective analysis of linked health service data, January 2015 - February 2016. SETTING: 17 aged care facilities in four Australian states providing clustered (four) or standard Australian (13) models of residential aged care. PARTICIPANTS: People with or without cognitive impairment residing in a residential aged care facility (RACF) for at least 12 months, not in palliative care, with a family member willing to participate on their behalf if required...
June 4, 2018: Medical Journal of Australia
Mats Eliasson, Marie Eriksson, Robert Lundqvist, Patrik Wennberg, Stefan Söderberg
Background The effect of primary prevention of cardiovascular disease is debated. The Västerbotten Intervention Programme (VIP) is an individual and community-based public health programme that comprises the whole county of Västerbotten (VB). In the neighbouring county of Norrbotten (NB), no programmes have been implemented. Method Between 1994 and 2014, five surveys were performed in the two counties on persons aged 40 to 75 years within the Northern Sweden MONICA Study. The number of subjects participating was 6600 (75...
January 1, 2018: European Journal of Preventive Cardiology
Xiaonan Liu, Chao Zhang, Mengye Zhao, Kewu Liu, Hang Li, Ningning Li, Linlin Gao, Xuemin Yang, Ting Ma, Juanli Zhu, Wenli Hui, Kai Hua, Yali Cui
Genotyping of single nucleotide polymorphisms (SNPs) in point-of-care (POC) settings could be further improved through simplifying the treatment of samples. In this study, we devised an accurate, rapid and easy-to-use SNP detection system based on direct loop-mediated isothermal amplification (LAMP) without DNA extraction, known as Direct-LAMP. Samples from various sources (including whole blood, dried blood spot, buccal swab and saliva), treated with NaOH, can be used directly in amplification. The turnaround time was about 30 min from sample collection to provision of results...
May 11, 2018: Biosensors & Bioelectronics
Deydre S Teyhen, Stephen L Goffar, Scott W Shaffer, Kyle Kiesel, Robert J Butler, Ann-Maree Tedaldi, Jennifer C Prye, Daniel I Rhon, Phillip J Plisky
Study Design A prospective observational cohort. Background Musculoskeletal injuries during military service are a primary source of disability resulting in 2.4 million annual health care visits and 25 million limited-duty days. While the injury incidence during basic training is well documented there is little understanding of injury distribution by organization type in the Army following initial training. Objective Compare injury incidence, distribution, and impact across various military units. Methods Comprehensive injury data from subject questionnaires and medical chart reviews were collected for 1430 initially healthy Army personnel representing combat, combat support, combat service support, and ranger units over 12 months...
May 22, 2018: Journal of Orthopaedic and Sports Physical Therapy
Renata Welc-Falęciak, Justyna D Kowalska, Małgorzata Bednarska, Magdalena Szatan, Agnieszka Pawełczyk
BACKGROUND: The studies on the occurrence and diversity of tick-borne infections in HIV-infected individuals have been few, and the subject has been relatively neglected when compared with other common infections associated with HIV. In HIV-positive patients in whom a serological diagnostics is complicated due to reduced positive predictive value, a method where the microorganism is detected directly is of great value. Therefore, we performed a molecular study to ascertain the prevalence and incidence of tick-borne infections in HIV-infected persons in Poland, an endemic area for Ixodes ricinus ticks...
May 18, 2018: BMC Infectious Diseases
Sarah M Bergin, Balamurugan Periaswamy, Timothy Barkham, Hong Choon Chua, Yee Ming Mok, Daniel Shuen Sheng Fung, Alex Hsin Chuan Su, Yen Ling Lee, Ming Lai Ivan Chua, Poh Yong Ng, Wei Jia Wendy Soon, Collins Wenhan Chu, Siyun Lucinda Tan, Mary Meehan, Brenda Sze Peng Ang, Yee Sin Leo, Matthew T G Holden, Partha De, Li Yang Hsu, Swaine L Chen, Paola Florez de Sessions, Kalisvar Marimuthu
OBJECTIVEWe report the utility of whole-genome sequencing (WGS) conducted in a clinically relevant time frame (ie, sufficient for guiding management decision), in managing a Streptococcus pyogenes outbreak, and present a comparison of its performance with emm typing.SETTINGA 2,000-bed tertiary-care psychiatric hospital.METHODSActive surveillance was conducted to identify new cases of S. pyogenes. WGS guided targeted epidemiological investigations, and infection control measures were implemented. Single-nucleotide polymorphism (SNP)-based genome phylogeny, emm typing, and multilocus sequence typing (MLST) were performed...
May 9, 2018: Infection Control and Hospital Epidemiology
Amy Waller, Rob Sanson-Fisher, Nola Ries, Jamie Bryant
BACKGROUND: Advance personal planning is the process by which people consider, document and communicate their preferences for personal, financial and health matters in case they lose the ability to make decisions or express their wishes in the future. DISCUSSION: Advance personal planning is most often undertaken by individuals who are seriously ill, often in the context of a medical crisis and/or at the time of admission to hospital. However, the clinical utility and legal validity of the planning process may be compromised in these circumstances...
May 9, 2018: BMC Public Health
Yirong Wu, Jun Fan, Peggy Peissig, Richard Berg, Ahmad Pahlavan Tafti, Jie Yin, Ming Yuan, David Page, Jennifer Cox, Elizabeth S Burnside
Improved prediction of the "most harmful" breast cancers that cause the most substantive morbidity and mortality would enable physicians to target more intense screening and preventive measures at those women who have the highest risk; however, such prediction models for the "most harmful" breast cancers have rarely been developed. Electronic health records (EHRs) represent an underused data source that has great research and clinical potential. Our goal was to quantify the value of EHR variables in the "most harmful" breast cancer risk prediction...
February 2018: Proceedings of SPIE
Victoria O Shipunova, Ivan V Zelepukin, Oleg A Stremovskiy, Maxim P Nikitin, Andrew Care, Anwar Sunna, Andrei V Zvyagin, Sergey M Deyev
Nanoparticle surface engineering can change its chemical identity to enable surface coupling with functional biomolecules. However, common surface coupling methods such as physical adsorption or chemical conjugation often suffer from the low coupling yield, poorly controllable orientation of biomolecules, and steric hindrance during target binding. These issues limit the application scope of nanostructures for theranostics and personalized medicine. To address these shortfalls, we developed a rapid and versatile method of nanoparticle biomodification...
May 23, 2018: ACS Applied Materials & Interfaces
Sarika Gupta, Ranu Gadi
Phthalic acid esters (PAEs) are a group of chemical species, ubiquitously present in the environment and pose a serious risk to humans. In the present study, the average concentrations of PAEs in PM10 (particulate matter ≤ 10 µm) are reported at a densely populated site in Delhi. The average concentration of PAEs was reported to be 703.1 ± 36.2 ng m-3 with slightly higher concentrations in winter than in summer; suggesting that sources are relatively stable over the whole year. The average concentration of PAEs was 35...
April 26, 2018: Bulletin of Environmental Contamination and Toxicology
Angus Forbes, Trevor Murrells, Henrietta Mulnier, Alan J Sinclair
BACKGROUND: Glycaemic targets for older people have been revised in recent years because of concern that more stringent targets are associated with increased mortality. We aimed to investigate the association between glycaemic control (mean HbA1c ) and variability (variability of HbA1c over time) and mortality in older people with diabetes. METHODS: We did a 5-year retrospective cohort study using The Health Improvement Network database, which includes data from 587 UK primary care practices...
June 2018: Lancet Diabetes & Endocrinology
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