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https://www.readbyqxmd.com/read/28532509/barriers-and-facilitators-to-healthcare-professional-behaviour-change-in-clinical-trials-using-the-theoretical-domains-framework-a-case-study-of-a-trial-of-individualized-temperature-reduced-haemodialysis
#1
Justin Presseau, Brittany Mutsaers, Ahmed A Al-Jaishi, Janet Squires, Christopher W McIntyre, Amit X Garg, Manish M Sood, Jeremy M Grimshaw
BACKGROUND: Implementing the treatment arm of a clinical trial often requires changes to healthcare practices. Barriers to such changes may undermine the delivery of the treatment making it more likely that the trial will demonstrate no treatment effect. The 'Major outcomes with personalized dialysate temperature' (MyTEMP) is a cluster-randomised trial to be conducted in 84 haemodialysis centres across Ontario, Canada to investigate whether there is a difference in major outcomes with an individualized dialysis temperature (IDT) of 0...
May 22, 2017: Trials
https://www.readbyqxmd.com/read/28517992/equity-and-value-in-precision-medicine
#2
Muir Gray, Tyra Lagerberg, Viktor Dombrádi
Precision medicine carries huge potential in the treatment of many diseases, particularly those with high-penetrance monogenic underpinnings. However, precision medicine through genomic technologies also has ethical implications. We will define allocative, personal, and technical value ('triple value') in healthcare and how this relates to equity. Equity is here taken to be implicit in the concept of triple value in countries that have publicly funded healthcare systems. It will be argued that precision medicine risks concentrating resources to those that already experience greater access to healthcare and power in society, nationally as well as globally...
April 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/28515182/health-assets-in-older-age-a-systematic-review
#3
Yvonne Claire Hornby-Turner, Nancye May Peel, Ruth Eleanor Hubbard
BACKGROUND: Finding ways to optimise health in older age is key to reducing the impact of population ageing on health and social care systems. A salutogenic approach takes into account an individual's health assets-internal or external strengths or accessible resources which improve and preserve physical, social and mental wellness, independence and quality of life. The aim of this narrative systematic review was to provide a summary and appraisal of the evidence for factors that act as health assets within personal, social, economic and environmental domains...
May 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28496219/the-flipped-classroom-for-pre-clinical-dental-skills-teaching-a-reflective-commentary
#4
A J Crothers, J Bagg, R McKenzie
A Flipped Classroom method for teaching of adult practical pre-clinical dental skills was introduced to the BDS curriculum in Glasgow during the 2015/2016 academic session. This report provides a commentary of the first year of employing this method - from the identification of the need to optimise teaching resources, through the planning, implementation and development of the method, with an early indication of performance.
May 12, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#5
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28488507/how-to-assist-patients-with-sit-stand-transfers
#6
Janice Taylor
Rationale and key points This article discusses optimal methods for assisting patients with sit-stand transfers where moving-and-handling equipment is not required. The article explains the importance of effective mobility care in optimising patients' rehabilitation and enhancing their independence. » The term 'assistance' is used in this article to refer to the support nurses can provide to patients during sit-stand transfers, but excludes manual assistance. Nurses should attempt various 'hands-off' mobility-enhancing strategies to assist the patient, such as the use of verbal, visual or light manual cues...
May 10, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28486846/optimisation-of-chemical-oxygen-demand-removal-from-landfill-leachate-by-sonocatalytic-degradation-in-the-presence-of-cupric-oxide-nanoparticles
#7
Paria Amirian, Edris Bazrafshan, Abolfazl Payandeh
Leachate is the liquid formed when waste breaks down in the landfill and water filters through that waste. This liquid is very toxic and can pollute the land, ground water, and water resources. In most countries, it is mandatory for landfills to be protected against leachate. In addition to all other harms to the environment, disposal of raw landfill leachate can be a major source of hazard to closed water bodies. Hence, treatment of landfill leachate is considered an essential step prior to its discharge from source...
May 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/28479283/web-based-platform-for-patient-dose-surveys-in-diagnostic-and-interventional-radiology-in-bulgaria-functionality-testing-and-optimisation
#8
F Simeonov, N Palov, D Ivanova, D Kostova-Lefterova, E Georgiev, A Zagorska, R Madzharova, J Vassileva
In the period 2013-2016 the National Centre of Radiobiology and Radiation Protection (NCRRP) at the Ministry of Health of Bulgaria has developed a web based platform for performing national patient dose surveys and establishing Diagnostic Reference Levels (DRLs). It is accessible via internet browser, allowing the users to submit data remotely. Electronic questionnaires, specific for radiography, fluoroscopy, image guided interventional procedures, mammography and CT, were provided. Short and clear manuals were added to guide users and minimise human errors...
May 4, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28476988/plants-used-in-folkloric-medicine-of-iran-are-exquisite-bio-resources-in-production-of-silver-nanoparticles
#9
Mohadeseh Hassani Sadi, Gholam Hosein Shahidi Bonjar
This study reports screening of 102 Iranian medicinal plant species belonging to 49 families for the biosynthesis of colloidal silver nanoparticles (AgNPs). Among tested plants, 37 species in 19 plant families are new bio-resources in this regard. Water extracts of macerated plant parts are used in this survey. Six of the bioactive plants are selected for further analysis. They produced amorphous spherical 40-70 nm AgNPs. Biosynthesised colloidal AgNPs are characterised by UV-visible spectroscopy, transmission electron microscopy and scanning electron microscopy...
April 2017: IET Nanobiotechnology
https://www.readbyqxmd.com/read/28469833/use-of-electronic-medical-records-and-biomarkers-to-manage-risk-and-resource-efficiencies
#10
Dermot Ryan, John Blakey, Alison Chisholm, David Price, Mike Thomas, Björn Ställberg, Karin Lisspers, Janwillem W H Kocks
The migration from paper to electronic medical records (EMRs) was motivated by the administrative need to record, retrieve and process increasing amounts of clinical data in the 1980s. In the intervening period, there has been growing recognition of the potential of such records for achieving care efficiencies, informing clinical decision making and real-life research. EMRs can be used to characterise patient groups, management approaches and differential outcomes. Characterisation can also help with identification of potential biomarkers for future risk determination and likely treatment response...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28458122/impact-of-social-prescribing-on-general-practice-workload-and-polypharmacy
#11
A M Loftus, F McCauley, M O McCarron
OBJECTIVES: Social prescribing has emerged as a useful tool for helping patients overcome some of the social and behavioural determinants of poor health. There has been little research on the impact of social prescribing on use of primary healthcare resources. This study sought to determine whether social prescribing activities influenced patient-general practitioner (GP) contacts and polypharmacy. STUDY DESIGN: Quality-improvement design with social prescribing activity interventions from an urban general practice in Northern Ireland...
April 26, 2017: Public Health
https://www.readbyqxmd.com/read/28449648/development-and-evaluation-of-training-resources-to-prepare-health-professionals-for-counselling-pregnant-women-about-non-invasive-prenatal-testing-for-down-syndrome-a-mixed-methods-study
#12
Kerry Oxenford, Rebecca Daley, Celine Lewis, Melissa Hill, Lyn S Chitty
BACKGROUND: The availability of non-invasive prenatal testing (NIPT) for aneuploidies is expanding rapidly throughout the world. Training health professionals to offer NIPT in a way that supports informed choice is essential for implementation. The aim of this study was to develop and evaluate a training package for health professionals to support the introduction of NIPT into clinical practice. METHODS: Training on NIPT was offered to health professionals, primarily midwives, involved in Down syndrome screening and testing in eight hospitals located in England and Scotland as part of a research study evaluating the implementation of NIPT in the UK National Health Service...
April 27, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28436888/neuromorphic-hardware-architecture-using-the-neural-engineering-framework-for-pattern-recognition
#13
Runchun Wang, Chetan Singh Thakur, Gregory Cohen, Tara Julia Hamilton, Jonathan Tapson, Andre van Schaik
We present a hardware architecture that uses the neural engineering framework (NEF) to implement large-scale neural networks on field programmable gate arrays (FPGAs) for performing massively parallel real-time pattern recognition. NEF is a framework that is capable of synthesising large-scale cognitive systems from subnetworks and we have previously presented an FPGA implementation of the NEF that successfully performs nonlinear mathematical computations. That work was developed based on a compact digital neural core, which consists of 64 neurons that are instantiated by a single physical neuron using a time-multiplexing approach...
June 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28412946/big-data-and-data-repurposing-using-existing-data-to-answer-new-questions-in-vascular-dementia-research
#14
Fergus N Doubal, Myzoon Ali, G David Batty, Andreas Charidimou, Maria Eriksdotter, Martin Hofmann-Apitius, Yun-Hee Kim, Deborah A Levine, Gillian Mead, Hermann A M Mucke, Craig W Ritchie, Charlotte J Roberts, Tom C Russ, Robert Stewart, William Whiteley, Terence J Quinn
INTRODUCTION: Traditional approaches to clinical research have, as yet, failed to provide effective treatments for vascular dementia (VaD). Novel approaches to collation and synthesis of data may allow for time and cost efficient hypothesis generating and testing. These approaches may have particular utility in helping us understand and treat a complex condition such as VaD. METHODS: We present an overview of new uses for existing data to progress VaD research. The overview is the result of consultation with various stakeholders, focused literature review and learning from the group's experience of successful approaches to data repurposing...
April 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28386403/clinical-benefits-referral-practice-and-cost-implications-of-an-in-hospital-pain-service-results-of-a-service-evaluation-in-a-london-teaching-hospital
#15
Maya Sussman, Elizabeth Goodier, Izabella Fabri, Jessica Borrowman, Sarah Thomas, Charlotte Guest, Carsten Bantel
BACKGROUND: In-hospital pain services (IPS) are commonplace, but evidence of efficacy is inadequate, and patients' pain management in any hospital ward remains problematic. This service evaluation aimed to measure the effect of a contemporary IPS, its appropriate use and cost-efficacy. METHODS: Records of 249 adults reviewed by the IPS in an inner London Teaching Hospital over an 8-month period were analysed for demographic data, interventions, workload and change in pain intensity measured by numerical rating scale (NRS)...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28376293/glucose-6-phosphate-dehydrogenase-g6pd-deficient-infants-enzyme-activity-and-gene-variants-as-risk-factors-for-phototherapy-in-the-first-week-of-life
#16
Fei-Liang Wong, Azlin Ithnin, Ainoon Othman, Fook-Choe Cheah
AIM: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a recognised cause of severe neonatal hyperbilirubinaemia, and identifying which infants are at risk could optimise care and resources. In this study, we determined if G6PD enzyme activity (EA) and certain gene variants were associated with neonatal hyperbilirubinaemia requiring phototherapy during the first week after birth. METHODS: Newborn infants with G6PD deficiency and a group with normal results obtained by the fluorescent spot test were selected for analyses of G6PD EA and the 10 commonly encountered G6PD mutations in this region, relating these with whether the infants required phototherapy before discharge from the hospital in the first week...
April 4, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28373247/practices-and-attitudes-of-doctors-and-patients-to-downward-referral-in-shanghai-china
#17
Wenya Yu, Meina Li, Xin Nong, Tao Ding, Feng Ye, Jiazhen Liu, Zhixing Dai, Lulu Zhang
OBJECTIVES: In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics. METHODS: Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28364649/biochar-and-enhanced-phosphate-capture-mapping-mechanisms-to-functional-properties
#18
Jessica G Shepherd, Stephen Joseph, Saran P Sohi, Kate V Heal
A multi-technique analysis was performed on a range of biochar materials derived from secondary organic resources and aimed at sustainable recovery and re-use of wastewater phosphorus (P). Our purpose was to identify mechanisms of P capture in biochar and thereby inform its future optimisation as a sustainable P fertiliser. The biochar feedstock comprised pellets of anaerobically digested sewage sludge (PAD) or pellets of the same blended in the ratio 9:1 with ochre sourced from minewater treatment (POCAD), components which have limited alternative economic value...
July 2017: Chemosphere
https://www.readbyqxmd.com/read/28345977/spinal-cord-injuries-overcoming-barriers-to-seamless-care-for-patients
#19
Lorraine Donovan, Lee Francis, Paula Muter, Sheila Nevin, Rebecca Warren
Patients with spinal cord injuries (SCIs) often have complex needs that require multidisciplinary support in specialist centres. Optimal management depends on seamless transitions between service providers. Delays at any point potentially compromise clinical outcomes and efficient resource utilisation. The Spinal Advisory Working Group aims to develop and implement practical initiatives to improve SCI care, initially focusing on admission and discharge. A literature review identified few relevant papers. In addition, the generalisability of the findings of these papers to SCI centres in the UK is unclear...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28343451/the-association-between-the-day-of-the-week-of-milestones-in-the-care-pathway-of-patients-with-hip-fracture-and-30-day-mortality-findings-from-a-prospective-national-registry-the-national-hip-fracture-database-of-england-and-wales
#20
Adrian Sayers, Michael R Whitehouse, James R Berstock, Karen A Harding, Michael B Kelly, Timothy J Chesser
BACKGROUND: Recent publications indicate increased mortality in patients admitted to hospital at the weekend, but these findings may be subject to inadequate adjustment for case-mix and the complexities of resource provision. Hip fractures generally occur in a frail comorbid population with a consistent diagnosis precipitating admission as an emergency. We therefore aimed to examine the association between the day of the week of milestones in the care pathway and 30-day mortality in this population...
March 27, 2017: BMC Medicine
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