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Practice changing

Rashmi Panda, N B Puhan, Aparna Rao, Debananda Padhy, Ganapati Panda
Retinal nerve fiber layer defect (RNFLD) provides an early objective evidence of structural changes in glaucoma. RNFLD detection is currently carried out using imaging modalities like OCT and GDx which are expensive for routine practice. In this regard, we propose a novel automatic method for RNFLD detection and angular width quantification using cost effective redfree fundus images to be practically useful for computer-assisted glaucoma risk assessment. After blood vessel inpainting and CLAHE based contrast enhancement, the initial boundary pixels are identified by local minima analysis of the 1-D intensity profiles on concentric circles...
March 6, 2018: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
Lisa Blom, Lucie Laflamme, Helle Mölsted Alvesson
BACKGROUND: Image-based teleconsultation between medical experts and healthcare staff at remote emergency centres can improve the diagnosis of conditions which are challenging to assess. One such condition is burns. Knowledge is scarce regarding how medical experts perceive the influence of such teleconsultation on their roles and relations to colleagues at point of care. METHODS: In this qualitative study, semi-structured interviews were conducted with 15 medical experts to explore their expectations of a newly developed App for burns diagnostics and care prior to its implementation...
2018: PloS One
Yefu Zhang, Meimei Ji, Jiaojiao Zou, Tong Yuan, Jing Deng, Lina Yang, Mingzhi Li, Hong Qin, Jihua Chen, Qian Lin
Left-behind children (LBC) are a unique population in China, whose numbers have increased dramatically in recent years. Most caregivers of left-behind children (CLBC) are grandparents who lack knowledge about proper nutrition and food practice, putting LBC at greater risk for malnutrition. A cluster randomized controlled trial was carried to assess the effectiveness of the conditional cash transfer (CCT) program. Forty rural villages from Fenghuang County and Pingjiang County of Hunan province were selected...
March 15, 2018: International Journal of Environmental Research and Public Health
Amy E Vinson, Gail Randel
PURPOSE OF REVIEW: Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. RECENT FINDINGS: As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery...
March 14, 2018: Current Opinion in Anaesthesiology
Marie Fallon, Jane Walker, Lesley Colvin, Aryelly Rodriguez, Gordon Murray, Michael Sharpe
Purpose Pain is suboptimally managed in patients with cancer. We aimed to compare the effect of a policy of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes. Patients and Methods In a two-arm, parallel group, cluster randomized (1:1) trial, we observed pain outcomes in 19 cancer centers in the United Kingdom and then randomly assigned the centers to either implement EPAT or to continue UC...
March 15, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Lu Cai, Kaikai Du, Yurui Qu, Hao Luo, Meiyan Pan, Min Qiu, Qiang Li
Polar crystals can enable strong light-matter interaction at an infrared regime and provide many practical applications including thermal emission. However, the dynamic control of thermal emission based on polar crystals remains elusive as the lattice vibrations are solely determined by the crystal structure. Here, a nonvolatile tunable midinfrared thermal emitter enabled by a phase-changing film Ge2 Sb2 Te5 on silicon carbide polar crystal is demonstrated. By controlling the state of Ge2 Sb2 Te5 from an amorphous to a crystalline state, the emissivity of the thermal emitter is tuned from a low value to near unity with a maximum change in peak emissivity exceeding 10 dB over the Reststrahlen band of SiC (11...
March 15, 2018: Optics Letters
Hui Zhu, Zhixing Li, Jinglei Lv, Renliang Zhao
OBJECTIVE: Cerebral small vessel disease (CSVD) describes a syndrome of neuroimaging, pathological, and associated clinical features caused by small intracranial vascular lesions, which commonly coexists with large artery atherosclerosis (LAA) and has been identified as a major cause of motor impairment over time. In this review, we aim to summarize the relationship between CSVD and LAA, and discuss the effects of CSVD on the clinical outcome of patients with ischemic stroke caused by LAA...
March 15, 2018: Neurological Research
M J Young, M Elmussareh, T Morrison, J R Wilson
Introduction Transurethral resection of the prostate (TURP) is considered the gold standard surgical treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The number of TURPs performed has declined significantly over the last three decades owing to pharmaceutical therapy. TURP data from a single institution for the years 1990, 2000 and 2010 were compared to assess the difference in performance. Methods A retrospective analysis was undertaken of all patients who underwent TURP between January and December 2010...
March 15, 2018: Annals of the Royal College of Surgeons of England
Boon Phiaw Kho, Mohamed Azmi Hassali, Ching Jou Lim, Fahad Saleem
OBJECTIVES: The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. METHODS: Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations...
March 15, 2018: International Journal of Pharmacy Practice
Kyung Duk Min, Sung Il Cho
BACKGROUND: The incidence rate of scrub typhus has been increasing in the Republic of Korea. Previous studies have suggested that this trend may have resulted from the effects of climate change on the transmission dynamics among vectors and hosts, but a clear explanation of the process is still lacking. In this study, we applied mathematical models to explore the potential factors that influence the epidemiology of tsutsugamushi disease. METHODS: We developed mathematical models of ordinary differential equations including human, rodent and mite groups...
March 19, 2018: Journal of Korean Medical Science
Junchao Chen, Clara Oromendia, Joshua A Halpern, Karla V Ballman
PURPOSE: Recent years have brought many changes in the management of localized prostate cancer as national screening guidelines have been updated and diagnostic practice patterns evolved. We sought to better understand how the changing landscape influenced treatment utilization in the United States. METHODS: We used the SEER database in this retrospective analysis of patients with clinically localized prostate cancer between 2004 and 2013. We evaluated utilization of primary treatment modalities over time with descriptive and trend analyses, and examined treatment utilization by cancer risk group and age at diagnosis...
March 14, 2018: Prostate
Fred Brouns
In the past, different types of diet with a generally low-carbohydrate content (< 50-< 20 g/day) have been promoted, for weight loss and diabetes, and the effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and to a lesser extent, also protein. Accordingly, using the term "low carb-high fat" (LCHF) diet is most appropriate...
March 14, 2018: European Journal of Nutrition
Michael D Kennedy, Jessie M S Gill, Alastair N H Hodges
Background: Diagnosing Airway hyper-responsiveness (AHR) requires bronchial provocation tests that are performed at rest and after exercise or hyperventilation in either a lab or field setting. Presently, it is unclear whether the proposed AHR field test for swimming induces sufficient provocation due to lack of intensity. Thus we aimed to examine how the 8 minute field swim test compared to all out racing and a lower intensity practice exposure affected AHR. We hypothesized that the race would affect AHR the most thereby highlighting the importance of maximal effort in swim AHR...
June 2017: Journal of Exercise Science and Fitness
Kishore P Madhwani, P K Nag
Background: Use of laptops and hand-held devices increase the risk of musculoskeletal disorders (MSDs). More time spent on this activity adopting faulty postures, higher the risk of developing such injuries. This study addresses training on office ergonomics with emphasis on sustainable behavior change among employees to work in safe postures, as this is a top priority in the corporate environment, today. Aim: To explore training intervention methods that ensure wider coverage of awareness on office ergonomics, thereby promoting safer working and suggesting sustainable programs for behavior change and job enrichment...
May 2017: Indian Journal of Occupational and Environmental Medicine
Hargun Ahluwalia, Tanya Anand, L N Suman
Substance abuse is a family disease that adversely impacts both the user and the user's family. The family can act as a risk factor for the development of substance abuse among children and adults. The family can also be involved in therapy to either help the recovery process or prevent substance abuse. Marital and family therapy have been found to be effective in reducing the severity of substance use, lowering marital and family conflict, improving family communication and cohesion as well as effective parenting practices...
February 2018: Indian Journal of Psychiatry
Yefei Jiang, Shuangge Ma, Ben-Chang Shia, Tian-Shyug Lee
In "classic" biomedical research, diseases have usually been studied individually. The pioneering human disease network (HDN) studies jointly consider a large number of diseases, analyse their interconnections, and provide a more comprehensive description of diseases. However, most of the existing HDN studies are based on molecular information and can only partially describe disease interconnections. Building on the unique Taiwan National Health Insurance Research Database (NHIRD), in this study, we construct the epidemiological HDN (eHDN), where two diseases are concluded as interconnected if their observed probability of co-occurrence deviating that expected under independence...
March 14, 2018: Scientific Reports
Karen J Thorpe, Cassandra L Pattinson, Simon S Smith, Sally L Staton
The majority of preschool children (aged 3-5 years) no longer habitually nap, yet in childcare settings daily mandated naptimes in which children lie down without alternative activity remains a common practice. Mandated naptimes are associated with observed reductions in emotional climate and increased incidence of distress. While intended to be restful, mandatory naptimes may induce stress in those children unable to sleep. To examine this possibility, we applied a 2 (mandated/flexible practice) × 2 (nap/no-nap) design to test group difference in stress responses of children (N = 43, mean age 56...
March 14, 2018: Scientific Reports
Joanne Lello, Susan J McClure, Kerri Tyrrell, Mark E Viney
It is normal for hosts to be co-infected by parasites. Interactions among co-infecting species can have profound consequences, including changing parasite transmission dynamics, altering disease severity and confounding attempts at parasite control. Despite the importance of co-infection, there is currently no way to predict how different parasite species may interact with one another, nor the consequences of those interactions. Here, we demonstrate a method that enables such prediction by identifying two nematode parasite groups based on taxonomy and characteristics of the parasitological niche...
March 14, 2018: Proceedings. Biological Sciences
Pepita Barlow, Paulo Serôdio, Gary Ruskin, Martin McKee, David Stuckler
Critics have long accused food and beverage companies of trying to exonerate their products from blame for obesity by funding organisations that highlight alternative causes. Yet, conclusions about the intentions of food and beverage companies in funding scientific organisations have been prevented by limited access to industry's internal documents. Here we allow the words of Coca-Cola employees to speak about how the corporation intended to advance its interests by funding the Global Energy Balance Network (GEBN)...
March 14, 2018: Journal of Epidemiology and Community Health
Jose Francois, Jeffrey Sisler, Stephanie Mowat
BACKGROUND: The Manitoba Physician Achievement Review (MPAR) is a 360-degree feedback assessment that physicians undergo every 7 years to retain licensure. Deliberate reflection on feedback has been demonstrated to encourage practice change. The MPAR Reflection Exercise (RE), a peer-assisted debriefing tool, was developed whereby the physician selects a peer with whom to review and reflect on feedback, committing to change. This qualitative study explores how physicians who had undergone the MPAR used the RE, what areas of change are identified and committed to, and what they perceived as the role of reflection in the MPAR process...
March 14, 2018: BMC Medical Education
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