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Clinical problem solving

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https://www.readbyqxmd.com/read/27924735/-clinical-medication-reviews-in-elderly-patients-with-polypharmacy-a-cross-sectional-study-in-dutch-community-pharmacies
#1
S H Chau, A P D Jansen, P M van de Ven, P Hoogland, P J M Elders, J G Hugtenburg
OBJECTIVE: To investigate the nature and prevalence of drug related problems (DRPs) in older patients with polypharmacy identified by community pharmacists in daily practice through means of a clinical medication review (CMR) and assess the implementation rate of proposed interventions to solve DRPs. DESIGN: A cross-sectional study METHOD: We analysed the CMR data of 3,807 older patients (≥ 65 years) with polypharmacy (≥ 5 drugs) completed in January-August 2012...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27923730/are-neurocognitive-factors-associated-with-repetition-of-self-harm-a-systematic-review
#2
REVIEW
Angharad N de Cates, Karen Rees, Fabrice Jollant, Benjamin Perry, Karina Bennett, Katie Joyce, Eimear Leyden, Catherine Harmer, Keith Hawton, Kees van Heeringen, Matthew R Broome
BACKGROUND: Prediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be established AIMS: Identify neurocognitive factors that may predict repetition of self-harm. METHODS: Systematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015...
December 3, 2016: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/27921218/from-problem-solving-to-problem-definition-scrutinizing-the-complex-nature-of-clinical-practice
#3
Sayra Cristancho, Lorelei Lingard, Glenn Regehr
In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations...
December 5, 2016: Perspectives on Medical Education
https://www.readbyqxmd.com/read/27917564/mind-the-gap-in-clinical-trials-a-participatory-action-analysis-with-citizen-collaborators
#4
Amy Price, Su May Liew, Jo Kirkpatrick, Jazmin Price, Taylor Lopreto, Yasmin Nelken
What are the strengths, gaps, expectations, and barriers to research engagement in clinical trials as communicated through social media? Clinical trials test treatments to provide reliable information for safety and effectiveness. Trials are building blocks in which what is learned in earlier research can be used to improve treatments, compare alternatives, and improve quality of life. For 20 years, the percentages of clinical trials volunteers have decreased whereas the costs of running clinical trials have multiplied...
December 4, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27913545/what-have-we-learned-from-large-population-studies-of-von-willebrand-disease
#5
Robert R Montgomery, Veronica H Flood
Von Willebrand factor (VWF) is a critical regulator of hemostatic processes, including collagen binding, platelet adhesion, and platelet aggregation. It also serves as a carrier protein to normalize plasma factor VIII synthesis, release, and survival. While VWF protein measurements by immunoassay are reasonably comparable between institutions, the measurement of VWF ristocetin cofactor activity (VWF:RCo) has significant variability. Other tests of VWF function, including collagen binding or platelet glycoprotein IIb-IIIa binding, are not universally available, yet these functional defects may cause major bleeding even with normal VWF antigen (VWF:Ag) and VWF:RCo assays...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911004/a-comparison-of-the-neuropsychological-profiles-of-people-living-in-squalor-without-hoarding-to-those-living-in-squalor-associated-with-hoarding
#6
Sook Meng Lee, Matthew Lewis, Deborah Leighton, Ben Harris, Brian Long, Stephen Macfarlane
OBJECTIVE: Squalor affects 1 in 1000 older people and is regarded as a secondary condition to other primary disorders such as dementia, intellectual impairment and alcohol abuse. Squalor frequently is associated with hoarding behaviour. We compared the neuropsychological profile of people living in squalor associated with hoarding to those presenting with squalor only. METHODS: This study is a retrospective case series of hospital inpatient and community healthcare services of 69 people living in squalor (49 from aged care, 16 from aged psychiatry, 3 from acute medical and 1 from a memory clinic)...
December 2, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27904214/results-of-neurolysis-in-established-upper-limb-volkmann-s-ischemic-contracture
#7
Dinesh K Meena, Srikiran Thalanki, Poornima Patni, Ram Khiladi Meena, Dinesh Bairawa, Chirag Bhatia
BACKGROUND: Treatment of established cases of Volkmann's ischemic contracture (VIC) of upper limb is very tedious. Since the period of Volkmann, various experimental works are being performed for its treatment, but none are effective. Disabilities from nerve palsy and hand muscle paralysis are more problematic than any other deformity in VIC. To solve these problems, we conducted a study to see the result of neurolysis of median and ulnar nerve and their subcutaneous placement in established cases of VIC...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27903591/platelet-rich-plasma-powder-a-new-preparation-method-for-the-standardization-of-growth-factor-concentrations
#8
Matthias Kieb, Frank Sander, Cornelia Prinz, Stefanie Adam, Anett Mau-Möller, Rainer Bader, Kirsten Peters, Thomas Tischer
BACKGROUND: Platelet-rich plasma (PRP) is widely used in sports medicine. Available PRP preparations differ in white blood cell, platelet, and growth factor concentrations, making standardized research and clinical application challenging. PURPOSE: To characterize a newly standardized procedure for pooled PRP that provides defined growth factor concentrations. STUDY DESIGN: Controlled laboratory study. METHODS: A standardized growth factor preparation (lyophilized PRP powder) was prepared using 12 pooled platelet concentrates (PCs) derived from different donors via apheresis...
November 30, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27899826/an-elective-course-in-cardiovascular-electrophysiology-for-pharmacy-learners
#9
Diptiman D Bose
Objective. To implement an integrated, comprehensive, and learner-centered elective course focused at exposing learners to the interpretation of electrocardiograms and highlighting the mechanisms underlining the abnormal electrophysiological events. Design. Learners were presented with foundational information on the mechanisms underlying electrophysiological changes associated with the development of arrhythmias. They then discussed the interpretation of electrocardiogram (ECG) recordings and diagnosis of cardiovascular events...
October 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/27896390/-assisted-suicide-in-the-movies-what-is-not-shown
#10
Kurt W Schmidt
Whereas changes to the existing legal situation regarding assisted suicide have been a topic of controversial debate in Germany for the last few years, this issue has long been of interest for international film-makers. Since the mid-1980s, the theme of assisted suicide has repeatedly been taken up by cinema, predominantly as central to a relationship drama. A sick person asks somebody close to them for help. Often this somebody is a physician or a nurse, ultimately an obvious way of solving the practical problem of how the assistant is to gain access to a lethal substance...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27894678/a-simple-orthosis-solves-a-problem-in-a-patient-with-a-dystonic-finger-after-stroke
#11
Stefano Vercelli, Giorgio Ferriero, Elisabetta Bravini, Wafa Al Yazeedi, Ludovit Salgovic, Marco Caligari, Francesco Sartorio
These authors use a custom-fabricated orthotic device to improve hand motion and function for a client with hand dystonia after stroke. Clinical observation and reasoning resulted in an effective solution to control the dystonia that was acceptable to the client. - Kristin Valdes, OTD, OT, CHT, Practice Forum Editor.
November 25, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/27894227/multidisciplinary-teams-involved-detection-of-drug-related-problems-through-continuity-of-care
#12
Elena Yaiza Romero-Ventosa, Marisol Samartín-Ucha, Alicia Martín-Vila, María Lucía Martínez-Sánchez, Isabel Rey Gómez-Serranillos, Guadalupe Pineiro-Corrales
OBJECTIVE: To quantify Drug-Related problems (DRPs) by establishing a Strategic Continuity of Care Program (e-Conecta- Concilia Program; e-CC) focused on the drug therapy of patients within an Integrated Management Structure, in order to guarantee the therapeutical efficiency, safety and traceability of patients. METHOD: A prospective study at 8 months. The project included 22 Hospital Pharmacists and 12 Primary Care Pharmacists. Electronic clinical records were used, which can be accessed by all healthcare levels...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27893903/to-blog-or-not-to-blog-what-do-nursing-faculty-think
#13
Krista Jones, Mary Kate Garrity, Kathryn J VanderZwan, Iris Epstein, Arlene Burla de la Rocha
BACKGROUND: Nurse educators find themselves tasked with developing content that both is aesthetically appealing and engages today's technological learners while empowering them to apply their knowledge in clinical and classroom settings. Students engaging with social networking systems reported increased satisfaction with collaborative peer-to-peer learning experiences, socialization, self-reflection, peer critique, problem-solving skills, collation of evidence-based resources, and instructor performance...
December 1, 2016: Journal of Nursing Education
https://www.readbyqxmd.com/read/27886387/coping-strategies-alexithymia-and-anxiety-in-young-patients-with-food-allergy
#14
Laura Polloni, Audrey DunnGalvin, Emilia Ferruzza, Roberta Bonaguro, Francesca Lazzarotto, Alice Toniolo, Nicolò Celegato, Antonella Muraro
BACKGROUND: Food allergy is major public health concern affecting nearly 15 million Americans and 80 million Europeans. Risk of anaphylaxis and implications for social activities affect patients' quality of life and psychological wellbeing. We previously found that young patients reported higher levels of alexithymia (difficulty in recognizing and expressing emotions) compared to healthy peers, and may influence affect, management style and clinical outcomes. This study aimed to explore links between coping strategies, alexithymia and anxiety among food-allergic adolescents and young adults...
November 25, 2016: Allergy
https://www.readbyqxmd.com/read/27884479/a-pilot-training-program-for-people-in-recovery-of-mental-illness-as-vocational-peer-support-workers-in-hong-kong-job-buddies-training-program-jbtp-a-preliminary-finding
#15
Kevin Kei Nang Yam, William Tak Lam Lo, Rose Lai Ping Chiu, Bien Shuk Yin Lau, Charles Ka Shing Lau, Jen Kei Yu Wu, Siu Man Wan
OBJECTIVES: The present study reviews the delivery of a pilot curriculum-mentorship-based peer vocational support workers training in a Hong Kong public psychiatric hospital. The present paper reports (1) on the development of a peer vocational support workers training - Job Buddies Training Program (JBTP) in Hong Kong; and (2) preliminary findings from both quantitative and qualitative perspectives. METHOD: The curriculum consists of 15-session coursework, 8-session storytelling workshop and 50-hour practicum to provide Supported Employment Peer Service (SEPS) under the mentorship of occupational therapists...
October 24, 2016: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/27883365/educational-interventions-for-the-management-of-cancer-related-fatigue-in-adults
#16
REVIEW
Sally Bennett, Amanda Pigott, Elaine M Beller, Terry Haines, Pamela Meredith, Christie Delaney
BACKGROUND: Cancer-related fatigue is reported as the most common and distressing symptom experienced by patients with cancer. It can exacerbate the experience of other symptoms, negatively affect mood, interfere with the ability to carry out everyday activities, and negatively impact on quality of life. Educational interventions may help people to manage this fatigue or to cope with this symptom, and reduce its overall burden. Despite the importance of education for managing cancer-related fatigue there are currently no systematic reviews examining this approach...
November 24, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27881121/knowledge-is-not-enough-to-solve-the-problems-the-role-of-diagnostic-knowledge-in-clinical-reasoning-activities
#17
Jan Kiesewetter, Rene Ebersbach, Nike Tsalas, Matthias Holzer, Ralf Schmidmaier, Martin R Fischer
BACKGROUND: Clinical reasoning is a key competence in medicine. There is a lack of knowledge, how non-experts like medical students solve clinical problems. It is known that they have difficulties applying conceptual knowledge to clinical cases, that they lack metacognitive awareness and that higher level cognitive actions correlate with diagnostic accuracy. However, the role of conceptual, strategic, conditional, and metacognitive knowledge for clinical reasoning is unknown. METHODS: Medical students (n = 21) were exposed to three different clinical cases and instructed to use the think-aloud method...
November 24, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27880065/fluctuations-in-the-emotional-intelligence-of-therapy-students-during-clinical-placements-implication-for-educators-supervisors-and-students
#18
Nigel Gribble, Richard K Ladyshewsky, Richard Parsons
This study investigated the changes in emotional intelligence (EI) of occupational therapy, physiotherapy, and speech pathology students (therapy students). Clinical placements have multiple benefits including the development of interprofessional skills, enhancing practice skills and interpersonal skills. Higher EI competencies have been shown to have a positive impact on patient outcomes, teamwork skills, dealing with stress, and patient satisfaction. Data for this study were collected at two time points: before third-year therapy students commenced extended clinical placements (T1 with 261 students) and approximately 7 months later after students had completed one or more clinical placements (T2 with 109 students)...
November 23, 2016: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27879359/effect-of-decide-decision-making-education-for-choices-in-diabetes-everyday-program-delivery-modalities-on-clinical-and-behavioral-outcomes-in-urban-african-americans-with-type-2-diabetes-a-randomized-trial
#19
Stephanie L Fitzpatrick, Sherita Hill Golden, Kerry Stewart, June Sutherland, Sharie DeGross, Tina Brown, Nae-Yuh Wang, Jerilyn Allen, Lisa A Cooper, Felicia Hill-Briggs
OBJECTIVE: To compare the effectiveness of three delivery modalities of Decision-making Education for Choices In Diabetes Everyday (DECIDE), a nine-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training, compared with an enhanced usual care (UC), on clinical and behavioral outcomes among urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS: Eligible participants (n = 182) had a suboptimal CVD risk factor profile (A1C, blood pressure, and/or lipids)...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27877037/acute-and-subacute-toxicity-profiles-of-thymoquinone-loaded-nanostructured-lipid-carrier-in-balb-c-mice
#20
Yong Sze Ong, Latifah Saiful Yazan, Wei Keat Ng, Mustapha M Noordin, Sarah Sapuan, Jhi Biau Foo, Yin Sim Tor
BACKGROUND: Thymoquinone (TQ), the predominant active lipophilic component in Nigella sativa seed oil, has a variety of pharmacological properties such as anticancer activities. However, translation of TQ to clinical phase is still not possible due to its hydrophobic properties. This problem can be solved by encapsulating it in nanoformulations to enhance its pharmacological properties. In our previous study, TQ has been successfully encapsulated in a nanostructured lipid carrier (hereinafter referred to as TQNLC) with excellent physiochemical properties such as high encapsulation efficiency, high drug-loading capacity, particle diameter less than 100 nm, and stability up to 2 years...
2016: International Journal of Nanomedicine
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