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https://www.readbyqxmd.com/read/29228200/ect-has-greater-efficacy-than-fluoxetine-in-alleviating-the-burden-of-illness-for-patients-with-major-depressive-disorder-a-taiwanese-pooled-analysis
#1
Ching-Hua Lin, Chun-Jen Huang, Cheng-Chung Chen
Background: The burden of major depressive disorder (MDD) includes suffering due to symptom severity, functional impairment, and quality of life (QOL) deficits. The aim of this study was to compare the differences between ECT and pharmacotherapy in reducing such burdens. Methods: This was a pooled analysis study including two open-label trials for MDD inpatients receiving either standard bitemporal and modified ECT with a maximum of 12 sessions, or 20 mg/d of fluoxetine for 6 weeks...
December 8, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29209252/role-of-a-semiotics-based-curriculum-in-empathy-enhancement-a-longitudinal-study-in-three-dominican-medical-schools
#2
Montserrat San-Martín, Roberto Delgado-Bolton, Luis Vivanco
Background: Empathy in the context of patient care is defined as a predominantly cognitive attribute that involves an understanding of the patient's experiences, concerns, and perspectives, combined with a capacity to communicate this understanding and an intention to help. In medical education, it is recognized that empathy can be improved by interventional approaches. In this sense, a semiotic-based curriculum could be an important didactic tool for improving medical empathy. The main purpose of this study was to determine if in medical schools where a semiotic-based curriculum is offered, the empathetic orientation of medical students improves as a consequence of the acquisition and development of students' communication skills that are required in clinician-patient encounters...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29197378/informed-consent-for-clinical-treatment-in-low-income-setting-evaluating-the-relationship-between-satisfying-consent-and-extent-of-recall-of-consent-information
#3
Ikenna I Nnabugwu, Fredrick O Ugwumba, Emeka I Udeh, Solomon K Anyimba, Oyiogu F Ozoemena
BACKGROUND: Treatment informed consent aims to preserve the autonomy of patients in the clinician - patient relationship so as to ensure valid consent. An acceptable method of evaluating understanding of consent information is by assessing the extent of recall by patients of the pieces information believed to have been passed across. When concerns are not satisfactorily addressed from the patients' perspective, recall of consent information may be low. METHODS: This study is a questionnaire - based cross - sectional interview of consecutive adult surgical patients who could give their respective medical histories and who were booked for elective major surgical procedures over a period of 7 months in a tertiary health institution in southeastern Nigeria...
December 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29193265/substance-use-disorder-and-compulsory-commitment-to-care-a-care-ethical-decision-making-framework
#4
Marie Nicolini, Joris Vandenberghe, Chris Gastmans
In the era of deinstitutionalisation of psychiatric patients, steady or even increasing rates of compulsory commitment to care (CCC) are an intriguing phenomenon to analyse. From a clinical, legal and ethical perspective, CCC continues to be a controversial practice in psychiatry, and perhaps even more so when applied to patients with severe substance use disorder (SUD). Several reasons make it controversial. The lack of consensus about the benefits of CCC and professional disagreement about what mental illness and autonomy mean in the case of SUD make it difficult to apply ethically sound clinical decision-making in CCC...
November 29, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29187237/-it-wasn-t-as-bad-as-i-thought-it-would-be-a-qualitative-study-of-early-stage-non-small-cell-lung-cancer-patients-after-treatment
#5
Sara E Golden, Charles R Thomas, Mark E Deffebach, Mithran S Sukumar, Paul H Schipper, Brandon H Tieu, Andrew Y Kee, Andrew C Tsen, Christopher G Slatore
OBJECTIVE: While surgical resection is recommended for most patients with early stage lung cancer, stereotactic body radiotherapy (SBRT) is being increasingly utilized. Provider-patient communication regarding risks/benefits of each approach may be a modifiable factor leading to improved patient-centered outcomes. Our objective was to determine a framework and recommended strategies on how to best communicate with patients with early stage non-small cell lung cancer (NSCLC) in the post-treatment setting...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29177522/nurses-role-in-managing-the-fit-of-older-adults-in-skilled-nursing-facilities
#6
Jacqueline Jones, Emily Lawrence, Amy Ladebue, Chelsea Leonard, Roman Ayele, Robert E Burke
Post-acute care for older adults often involves transfer to a skilled nursing facility (SNF) following hospital discharge. This transition is often poorly coordinated and leaves older adults at risk for poor health outcomes, but new payment models offer opportunities to align improved care practices with payments. There is a dearth of evidence regarding the role of nursing and its potential to improve hospital to SNF care transitions. Ninety-nine semi-structured interviews were conducted with clinicians, patients, and caregivers from three hospitals and three SNFs...
December 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29176497/agreement-among-clinician-patient-and-independent-interviewer-ratings-of-adaptive-functioning
#7
Ora Nakash, Maayan Nagar, Drew Westen
We examined the interrater reliability and diagnostic efficiency of clinician report (both the treating clinician and independent expert clinical interviewer) and patient self-report of clinically meaningful information pertaining to adaptive functioning. A convenience sample of clinicians (N = 80) and patients (N = 170) from eight community mental health clinics in Israel participated in the study. Our findings suggest that clinicians overall reliably report on adaptive functioning of patients (overall correct classification rates range, 0...
November 24, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/29150474/core-outcome-sets-in-miscarriage-trials-cosmist-study-a-study-protocol
#8
Paul Smith, Natalie Cooper, Rima Dhillon-Smith, Emily O'Toole, T Justin Clark, Arri Coomarasamy
INTRODUCTION: 'Core outcome sets' are an agreed, standardised set of outcomes based on what key stakeholders (clinicians, patients, their partners, researchers, service developers, funding organisations and so on) consider the important outcomes in the management or prevention of a condition. This paper describes the rationale and design for the development of Core Outcome Sets for Miscarriage Trials. METHODS AND ANALYSIS: Systematic reviews, interviews and focus groups with patients and their partners will be conducted to identify potential core outcomes that will be introduced into a modified Delphi survey...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29135751/perceptions-experiences-and-preferences-of-patients-receiving-a-clinician-s-touch-during-intimate-care-and-procedures-a-qualitative-systematic-review
#9
Chad O'Lynn, Adam Cooper, Lisa Blackwell
BACKGROUND: Clinical practice frequently involves the practitioner touching patients' bodies in areas that are highly personal. If inappropriately performed, such intimate touch may result in much anxiety, confusion and misinterpretation. Examination of evidence is necessary to guide practice in this area to mitigate risks and foster optimal clinician-patient relations and care. OBJECTIVES: The objective of this qualitative systematic review was to identify and synthesize findings on the perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review considered studies that included patients who had received a clinician's touch during intimate care and procedures...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29133314/decisional-needs-assessment-of-patients-with-complex-care-needs-in-primary-care-a-participatory-systematic-mixed-studies-review-protocol
#10
Mathieu Bujold, Pierre Pluye, France Légaré, Jeannie Haggerty, Genevieve C Gore, Reem El Sherif, Marie-Eve Poitras, Marie-Claude Beaulieu, Marie-Dominique Beaulieu, Paula L Bush, Yves Couturier, Beatrice Débarges, Justin Gagnon, Anik Giguère, Roland Grad, Vera Granikov, Serge Goulet, Catherine Hudon, Bernardo Kremer, Edeltraut Kröger, Irina Kudrina, Bertrand Lebouché, Christine Loignon, Marie-Therese Lussier, Cristiano Martello, Quynh Nguyen, Rebekah Pratt, Benoit Rihoux, Ellen Rosenberg, Isabelle Samson, Nicolas Senn, David Li Tang, Masashi Tsujimoto, Isabelle Vedel, Bruno Ventelou, Michel Wensing
INTRODUCTION: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners)...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29118574/how-is-adult-patient-adherence-recorded-in-orthodontists-clinical-notes-a-mixed-method-case-note-study
#11
Nawaf Al Shammary, Koula Asimakopoulou, Fraser McDonald, Jonathon T Newton, Sasha Scambler
Background: Patient adherence in orthodontic treatment is extremely important as it is linked with better treatment outcomes. Despite its importance, however, there is no shared definition of the concept. This makes the recording of adherence-related behaviors in patient notes difficult. The current study explored how, and to what extent adherence is recorded in adult patients' medical records by orthodontists working in a large National Health Service (NHS) London hospital. Materials and methods: A mixed-methods approach was used...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29114432/eye-related-trauma-and-infection-in-dentistry
#12
REVIEW
Hasan Ekmekcioglu, Meral Unur
Despite numerous technological and medical developments achieved in recent years, a significant amount of occupational health problems still exist in modern dentistry. The risk of eye injury is mostly attributed to the use of high-speed hand pieces and ultrasonic devices. A dental clinic may be the source of eye-related infection and injury because of mechanical, chemical, microbiological and electromagnetic irritants. Accidents may cause facial injuries that involve eyes of the clinicians, patients as well as dental assistants...
2017: Journal of Istanbul University Faculty of Dentistry
https://www.readbyqxmd.com/read/29108840/use-of-the-coronary-artery-calcium-score-in-discussion-of-initiation-of-statin-therapy-in-primary-prevention
#13
Erin D Michos, Michael J Blaha, Roger S Blumenthal
Clinical guidelines for instituting pharmacotherapy for the primary prevention of atherosclerotic cardiovascular disease (ASCVD), specifically lipid management and aspirin, have long been based on absolute risk. However, lipid management in the current era remains challenging to both patients and clinicians in the setting of somewhat discordant recommendations from various organizations. All guidelines endorse the use of statins for primary prevention for those at sufficient absolute risk, and treatment recommendations are generally "risk-based" rather than exclusively targeting specific low-density lipoprotein cholesterol levels...
November 3, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29067338/patients-and-caregivers-views-on-conversations-and-shared-decision-making-in-diagnostic-testing-for-alzheimer-s-disease-the-abide-project
#14
Marleen Kunneman, Ruth Pel-Littel, Femke H Bouwman, Freek Gillissen, Niki S M Schoonenboom, Jules J Claus, Wiesje M van der Flier, Ellen M A Smets
INTRODUCTION: This study aims to assess patients' and caregivers' views on and experiences with (1) decisions about diagnostic testing for Alzheimer's disease (AD) and (2) receiving test results. METHODS: We conducted separate focus groups with patients from three hospitals who underwent diagnostic testing for AD (N = 11) and their caregivers (N = 11). Audio recordings were transcribed verbatim and analyzed using MaxQDA. RESULTS: Patients and caregivers preferred and perceived active involvement in decision making, but the decision to initiate diagnostic testing seems to be made before the clinician-patient encounter...
September 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/29036540/tackling-anti-microbial-resistance-ethical-framework-for-rational-antibiotic-use
#15
Jasper Littmann, Annette Rid, Alena Buyx
Background: To reduce the effect of antimicrobial resistance and to preserve antibiotic effectiveness, clinical guidelines and health policy documents call for the rational use of antibiotics, which aims to reduce unnecessary or minimally effective antibiotic use. Methods: Through ethical analysis, we show that rational use programmes can lead to ethical conflicts, because they sometimes place patients at risk of harm-for example, a delayed switch to second-line antibiotics for community-acquired pneumonia can lead to substantial increases in mortality...
October 5, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#16
REVIEW
M Leya, N J Stone
PURPOSE OF REVIEW: Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug-drug interactions before prescribing statin therapy as well as determining the intensity in older individuals...
October 11, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28991954/tools-clinical-prediction-rules-and-algorithms-for-the-insertion-of-peripheral-intravenous-catheters-in-adult-hospitalized-patients-a-systematic-scoping-review-of-literature
#17
Peter J Carr, Niall S Higgins, Marie L Cooke, James Rippey, Claire M Rickard
BACKGROUND: First-time peripheral intravenous catheter (PIVC) insertion success is dependent on patient, clinician, and product factors. Failed PIVC insertion are an under-recognized clinical phenomenon. OBJECTIVE: To provide a scoping review of decision aids for PIVC insertion including tools, clinical prediction rules, and algorithms (TRAs) and their findings on factors associated with insertion success. METHODS: In June 2016, a systematic literature search was performed using the medical subject heading of peripheral catheterization and tool* or rule* or algorithm*...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28976070/palliative-and-end-of-life-care-in-solid-organ-transplantation
#18
REVIEW
K Wentlandt, A Weiss, E O'Connor, E Kaya
Palliative care is an interprofessional approach that focuses on quality of life of patients who are facing life-threatening illness. Palliative care is consistently associated with improvements in advance care planning, patient and caregiver satisfaction, quality of life, symptom burden, and lower healthcare utilization. Most transplant patients have advanced chronic disease, significant symptom burden, and mortality awaiting transplant. Transplantation introduces new risks including perioperative death, organ rejection, infection, renal insufficiency, and malignancy...
December 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28958987/tablet-based-patient-centered-decision-support-for-minor-head-injury-in-the-emergency-department-pilot-study
#19
Navdeep Singh, Erik Hess, George Guo, Adam Sharp, Brian Huang, Maggie Breslin, Edward Melnick
BACKGROUND: The Concussion or Brain Bleed app is a clinician- and patient-facing electronic tool to guide decisions about head computed tomography (CT) use in patients presenting to the emergency department (ED) with minor head injury. This app integrates a patient decision aid and clinical decision support (using the Canadian CT Head Rule, CCHR) at the bedside on a tablet computer to promote conversations around individualized risk and patients' specific concerns within the ED context...
September 28, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28948466/coronary-artery-calcium-scoring-in-current-clinical-practice-how-to-define-its-value
#20
REVIEW
Sina Kianoush, Mohammadhassan Mirbolouk, Raghavendra Charan Makam, Khurram Nasir, Michael J Blaha
Detecting subclinical atherosclerosis with coronary artery calcium (CAC) is promising for identifying individuals at risk for cardiovascular events and appears to be a robust tool for guiding initiation of appropriate and timely primary prevention strategies. However, how do we best determine its clinical value? It is clear that traditional risk prediction models based primarily on age, gender, and risk factors are insufficient for ideal personalization of risk estimation. It is now well established from epidemiologic studies that CAC adds to traditional risk scores for a more accurate risk prediction...
September 25, 2017: Current Treatment Options in Cardiovascular Medicine
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