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https://www.readbyqxmd.com/read/29166352/more-learners-finite-resources-and-the-changing-landscape-of-procedural-training-at-the-bedside
#1
Michael A Gisondi, Linda Regan, Jeremy Branzetti, Laura R Hopson
There is growing competition for non-operative, procedural training in teaching hospitals, due to an increased number of individuals seeking to learn procedures from a finite number of appropriate teaching cases. Procedural training is required by students, post-graduate learners, and practicing providers who must maintain their skills. These learner groups are growing in size as the number of medical schools increase and advance practice providers expand their skills to include complex procedures. These various learner needs occur against a background of advancing therapeutic techniques that improve patient care, but also act to reduce the overall numbers of procedures available to learners...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166331/223ra-therapy-in-patients-with-advanced-castration-resistant-prostate-cancer-with-bone-metastases-lessons-from-daily-practice
#2
Maarten J van der Doelen, Malou C P Kuppen, Marianne A Jonker, Niven Mehra, Marcel J R Janssen, Inge M van Oort, Winald R Gerritsen
PURPOSE: To identify pre-therapeutic variables associated with overall survival (OS) in patients treated with Ra. METHODS: Data from 45 CRPC patients treated with Ra were retrospectively analyzed. All patients who received at least one Ra injection were included in the study. Cox proportional hazard regression models were used to estimate hazard ratio's (HR) and to test for association. RESULTS: Twenty-one patients (47%) received six Ra injections and 24 patients (53%) received one to five Ra injections...
November 22, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29166260/the-development-and-content-validation-of-a-multidisciplinary-evidence-based-wound-infection-prevention-and-treatment-guideline
#3
Sammy A Zakhary, Chris Davey, Rebecca Bari, Jordan Bean, Tyler Reber, Kathy Gallagher, Kara Couch, Jennifer Hurlow, Karen Laforet, Corrine McIssac, Karen Napier, Diana Vilar-Compte, Emily Zakhary, Michel Hermans, Laura Bolton
Acute and chronic wound infections create clinical, economic, and patient-centered challenges best met by multidisciplinary wound care teams providing consistent, valid, clinically relevant, safe, evidence-based management across settings. To develop an evidence-based wound infection guideline, PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched from inception through August 1, 2017 using the terms (or synonyms) wound infection and risk factor, significant, diagnosis, prevention, treatment, or surveillance...
November 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29165776/model-driven-gas-exchange-monitoring-in-the-critically-ill
#4
Cosmin Ion Balan, Adrian View-Kim Wong
Understanding pulmonary gas exchange performance is a dynamic process which, depending on clinical context, exhibits different levels of complexity. Global tools such as tension-based indexes yield clinically crucial information under very specific conditions. Yet, accurate mechanistic insight can only originate in model-based tools. One-parameter models such as shunt or dead space are well established in clinical practice whilst two or three-parameter models have just been advanced and their role is yet to be delineated...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29164552/-the-application-of-grief-theories-to-bereaved-family-members
#5
Lee-Jen Suen Wu, Chuan-Chiang Chou, Yen-Chun Lin
Loss is an inevitable experience for humans for which grief is a natural response. Nurses must have an adequate understanding of grief and bereavement in order to be more sensitive to these painful emotions and to provide appropriate care to families who have lost someone they love deeply. This article introduces four important grief theories: Freud's grief theory, Bowlby's attachment theory, Stroebe and Schuts' dual process model, and Neiyemer's meaning reconstruction model. Freud's grief theory holds that the process of grief adaptation involves a bereaved family adopting alternative ways to connect with the death of a loved one and to restore their self-ego...
December 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29163885/molecular-design-of-upconversion-nanoparticles-for-gene-delivery
#6
REVIEW
Wing-Fu Lai, Andrey L Rogach, Wing-Tak Wong
Due to their large anti-Stokes shifts, sharp emission spectra and long excited-state lifetimes, upconversion nanoparticles (UCNPs) have attracted an increasing amount of research interests, and have shown great potential for enhancing the practical utility of gene therapy, whose versatility has been limited by existing gene delivery technologies that are basically mono-functional in nature. Despite this, up to now in-depth analysis of the development of UCNPs for gene delivery has been scant in the literature, even though there has been an upsurge of reviews on the chemistry of UCNPs and their applications in bioimaging and drug delivery...
November 1, 2017: Chemical Science
https://www.readbyqxmd.com/read/29162949/neuromuscular-electrical-stimulation-for-treatment-of-muscle-impairment-critical-review-and-recommendations-for-clinical-practice
#7
Ethne L Nussbaum, Pamela Houghton, Joseph Anthony, Sandy Rennie, Barbara L Shay, Alison M Hoens
Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/29162753/assessment-of-pain-in-the-elderly-a-literature-review
#8
REVIEW
Yoon-Sook Kim, Jae-Min Park, Yeon-Sil Moon, Seol-Heui Han
BACKGROUND: Pain perception is highly subjective, and effective pain management can be challenging in the elderly. We aimed to identify a set of practical measures that could be used to assess pain in elderly patients with or without cognitive impairment, as the first step towards effectively managing their pain. METHODS: We used the PRISMA guidelines for this literature review. Two reviewers independently assessed titles, abstracts and full-text articles, and a third reviewer resolved any disagreements...
July 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/29162320/controlled-human-infections-a-report-from-the-controlled-human-infection-models-workshop-leiden-university-medical-centre-4-6-may-2016
#9
Meta Roestenberg, Annie Mo, Peter G Kremsner, Maria Yazdanbakhsh
The principle of deliberately infecting humans with infectious agents in a controlled setting, so-called controlled human infections (CHI), is not novel. Many CHI models have a long history and were established decades ago such as the intentional exposure to yellow fever and dengue performed in the 1900's (Reed, 1902) [2]. In these times bioethics and scientific reasoning were in their infancy. Nowadays, clinical trials are highly regulated and CHI are executed worldwide. Controlled human malaria infections and influenza infections are the two most frequently practiced...
November 18, 2017: Vaccine
https://www.readbyqxmd.com/read/29162150/a-content-analysis-of-dissemination-and-implementation-science-resource-initiatives-what-types-of-resources-do-they-offer-to-advance-the-field
#10
Doyanne Darnell, Caitlin N Dorsey, Abigail Melvin, Jonathan Chi, Aaron R Lyon, Cara C Lewis
BACKGROUND: The recent growth in organized efforts to advance dissemination and implementation (D & I) science suggests a rapidly expanding community focused on the adoption and sustainment of evidence-based practices (EBPs). Although promising for the D & I of EBPs, the proliferation of initiatives is difficult for any one individual to navigate and summarize. Such proliferation may also result in redundant efforts or missed opportunities for participation and advancement. A review of existing D & I science resource initiatives and their unique merits would be a significant step for the field...
November 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29162081/self-management-support-and-ehealth-for-patients-and-informal-caregivers-confronted-with-advanced-cancer-an-online-focus-group-study-among-nurses
#11
Vina N Slev, H Roeline W Pasman, Corien M Eeltink, Cornelia F van Uden-Kraan, Irma M Verdonck-de Leeuw, Anneke L Francke
BACKGROUND: Self-management by patients and informal caregivers confronted with advanced cancer is not self-evident. Therefore they might need self-management support from nurses. This article reports on nurses' perspectives on self-management support for people confronted with advanced cancer, and nurses' experiences with eHealth in this context. METHODS: Six online focus groups were organized, with a total of 45 Dutch nurses with different educational levels and working in different care settings...
November 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29162024/modern-fixed-imaging-systems-reduce-radiation-exposure-to-patients-and-providers
#12
Lars Stangenberg, Fahad Shuja, I Martijn J van der Bom, Martine H G van Alfen, Allen D Hamdan, Mark C Wyers, Raul J Guzman, Marc L Schermerhorn
High-definition fluoroscopic imaging is required to perform endovascular procedures safely and precisely, especially in complex cases, resulting in longer procedures and increased radiation exposure. This is of importance for training institutions as trainees, even with sound instruction in as low as reasonably achievable (ALARA) principles, tend to have high radiation exposures. Recently, there was an upgrade in the imaging system allowing for comparison of radiation exposure to patients and providers. We performed an analysis of consecutive endovascular aneurysm repair (EVAR) and superficial femoral artery (SFA) interventions in the years 2013 to 2014...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29161885/critical-limb-ischemia-a-practical-up-to-date-review
#13
Iacopo Fabiani, Enrico Calogero, Nicola Riccardo Pugliese, Rossella Di Stefano, Irene Nicastro, Flavio Buttitta, Marco Nuti, Caterina Violo, Danilo Giannini, Alessandro Morgantini, Lorenzo Conte, Valentina Barletta, Raffaella Berchiolli, Daniele Adami, Mauro Ferrari, Vitantonio Di Bello
Critical limb ischemia (CLI) is the most advanced form of peripheral artery disease. It is associated with significant morbidity and mortality and high management costs. It carries a high risk of amputation and local infection. Moreover, cardiovascular complications remain a major concern. Although it is a well-known entity and new technological and therapeutic advances have been made, this condition remains poorly addressed, with significantly heterogeneous management, especially in nonexperienced centers...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29161824/special-issue-on-erice-mathcompepi-2015-proceedings
#14
Alberto d'Onofrio, Paola Cerrai, Piero Manfredi
The mathematical and computational modelling of the spread of infectious diseases is a research field in applied mathematics that in the same time was both able to give an impetum to various areas of the dynamical systems theory and mathematical analysis, and to give an important contribution to the biological and epidemiological understanding of the spread of these diseases. National as well as Inter-National health authorities adopt routinely in the practice methodologies and concept that were born in the field of Mathematical and Computational Epidemiology (MCE) for assisting public Health decisions and policies...
February 1, 2018: Mathematical Biosciences and Engineering: MBE
https://www.readbyqxmd.com/read/29161398/role-of-gabaa-receptor-subtypes-in-the-behavioural-effects-of-intravenous-general-anaesthetics
#15
C J Weir, S J Mitchell, J J Lambert
Since the introduction of general anaesthetics into clinical practice, researchers have been mystified as to how these chemically disparate drugs act to produce their dramatic effects on central nervous system function and behaviour. Scientific advances, particularly during the last 25 years, have now begun to reveal the molecular mechanisms underpinning their behavioural effects. For certain i.v. general anaesthetics, such as etomidate and propofol, a persuasive case can now be made that the GABAA receptor, a major inhibitory receptor in the mammalian central nervous system, is an important target...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160119/a-review-of-the-infection-pathogenesis-and-prophylaxis-recommendations-in-patients-with-chronic-lymphocytic-leukemia
#16
Tamar Tadmor, Manfred Welslau, Iwoma Hus
The majority of patients with chronic lymphocytic leukemia (CLL) will obtain an infectious complication at some point during their disease, accounting for up to an estimated 60% of deaths in CLL. Patients are predisposed to infection due to inherent immune defects related to the primary disease, and as a result of therapy. The range of infectious complications has evolved alongside therapeutic advances in the treatment of CLL. More recently several novel targeted therapeutic compounds have been introduced in CLL, whose unique safety profiles will probably have an impact on the prophylaxis and management of infectious complications in these patients Areas covered: This review describes the pathogenesis of infections due to intrinsic CLL or therapy-related immunosuppression, and deals with the importance of proactive and reactive infection management as a key focus of patient care...
November 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/29158769/physicians-duty-to-recontact-and-update-genetic-advice
#17
Yvonne A Stevens, Grant D Senner, Gary E Marchant
This perspective addresses whether physicians have a duty to recontact former or current patients to update clinical advice based on newly discovered genomic information. Genetic information is unique compared with other medical data in that the underlying data do not appreciably change during the patients' lifetime, but the clinical significance of that information will continue to evolve. Based on relevant case law and guidelines, there is no general, established legal duty for physicians to affirmatively recontact former or current patients to update clinical advice based on newly discovered genetic information...
2017: Personalized Medicine
https://www.readbyqxmd.com/read/29157567/expanding-collaborative-boundaries-in-nursing-education-and-practice-the-nurse-practitioner-dentist-model-for-primary-care
#18
Maria C Dolce, Jessica L Parker, Chantelle Marshall, Christine A Riedy, Lisa E Simon, Jane Barrow, Catherine R Ramos, John D DaSilva
The purpose of this paper is to describe the design and implementation of a novel interprofessional collaborative practice education program for nurse practitioner and dental students, the Nurse Practitioner-Dentist Model for Primary Care (NPD Program). The NPD Program expands collaborative boundaries in advanced practice nursing by integrating primary care within an academic dental practice. The dental practice is located in a large, urban city in the Northeast United States and provides comprehensive dental services to vulnerable and underserved patients across the age spectrum...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/29157403/spinal-cord-mri-in-multiple-sclerosis
#19
REVIEW
Alexandra Muccilli, Estelle Seyman, Jiwon Oh
Spinal cord (SC) MRI in multiple sclerosis (MS) has significant usefulness in clinical and investigational settings. Conventional MRI of the SC is used in clinical practice, because it has both diagnostic and prognostic value. A number of advanced, quantitative SC MRI measures that assess the structural and functional integrity of the SC have been evaluated in investigational settings. These techniques have collectively demonstrated usefulness in providing insight into microstructural and functional changes relevant to disability in MS...
February 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29157300/prospects-for-combined-use-of-oncolytic-viruses-and-car-t-cells
#20
REVIEW
Adam Ajina, John Maher
With the approval of talimogene laherparepvec (T-VEC) for inoperable locally advanced or metastatic malignant melanoma in the USA and Europe, oncolytic virotherapy is now emerging as a viable therapeutic option for cancer patients. In parallel, following the favourable results of several clinical trials, adoptive cell transfer using chimeric antigen receptor (CAR)-redirected T-cells is anticipated to enter routine clinical practice for the management of chemotherapy-refractory B-cell malignancies. However, CAR T-cell therapy for patients with advanced solid tumours has proved far less successful...
November 21, 2017: Journal for Immunotherapy of Cancer
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