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https://www.readbyqxmd.com/read/29649021/impressions-of-early-mobilization-of-critically-ill-children-clinician-patient-and-family-perspectives
#1
Katina Zheng, Aimee Sarti, Sama Boles, Saoirse Cameron, Robert Carlisi, Heather Clark, Adeeb Khawaji, Saif Awladthani, Samah Al-Harbi, Karen Choong
OBJECTIVES: To understand patient, family caregiver, and clinician impressions of early mobilization, the perceived barriers and facilitators to its implementation, and the use of in-bed cycling as a method of mobilization. DESIGN: A qualitative study, conducted as part of the Early Exercise in Critically ill Youth and Children, a preliminary Evaluation (wEECYCLE) Pilot randomized controlled trial. SETTING: McMaster Children's Hospital PICU, Hamilton, ON, Canada...
April 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29627809/antithrombotic-therapy-in-patients-receiving-saphenous-vein-coronary-artery-bypass-grafts-a-protocol-for-a-systematic-review-and-network-meta-analysis
#2
Karla Solo, Janet Martin, Shahar Lavi, Conrad Kabali, Ava John-Baptiste, Immaculate F Nevis, Tawfiq Choudhury, Mamas A Mamas, Rodrigo Bagur
INTRODUCTION: The current evidence for the prevention of saphenous vein graft failure (SVGF) after coronary artery bypass graft (CABG) surgery consists of direct head-to-head comparison of treatments (including placebo) in randomised-controlled trials (RCTs) and observational studies. However, summarising the evidence using traditional pairwise meta-analyses does not allow the inclusion of data from treatments that have not been compared head to head. Exclusion of such comparisons could impact the precision of pooled estimates in a meta-analysis...
April 7, 2018: BMJ Open
https://www.readbyqxmd.com/read/29614138/common-and-not-so-common-comorbidities-of-psoriasis
#3
M Alan Menter, April W Armstrong, Kenneth B Gordon, Jashin J Wu
Plaque psoriasis is increasingly recognized as a multisystemic disease whose most common comorbidities include psoriatic arthritis, cardiovascular disease, metabolic syndrome, overweight/obesity, inflammatory bowel disease, and depression. The presence of such comorbidities affects the therapeutic choices for clinicians. Patients often visit dermatologists more frequently than they do other clinicians, so it is incumbent upon dermatologists to recognize and address early signs of psoriatic comorbidities to prevent further deterioration and improve their patients' quality of life...
February 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29610837/cardiovascular-disease-and-risk-management-review-of-the-american-diabetes-association-standards-of-medical-care-in-diabetes-2018
#4
James J Chamberlain, Eric L Johnson, Sandra Leal, Andrew S Rhinehart, Jay H Shubrook, Lacie Peterson
Description: The American Diabetes Association (ADA) annually updates its Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2018 standards, the ADA Professional Practice Committee searched MEDLINE through November 2017 to add, clarify, or revise recommendations on the basis of new evidence...
April 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29609525/balint-2-0-a-virtual-balint-group-for-doctors-around-the-world
#5
Donald E Nease, Albert Lichtenstein, Luis Pinho-Costa, Kyle Hoedebecke
Objective Balint groups have shown promise in addressing clinician-patient relationships, clinician burnout, referral practices, and psychological mindedness. However, their traditional format of in-person sessions limits their ability to meet the needs of clinicians practicing in locations without trained Balint leaders. We report on a pilot of an international, internet-based Balint group in collaboration between the World Organization of Family Doctors regional Young Doctors Movements and the International Balint Federation...
May 2018: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/29609202/wait-times-are-not-the-problem-detailed-analysis-of-unsolicited-patient-complaints-from-a-metropolitan-australian-emergency-department
#6
Petra Lawrence, Rajeev Jarugula, Sarah Hazelwood, Gavin Fincher, Karen Hay
OBJECTIVE: To describe characteristics of ED admissions that resulted in unsolicited complaints and compare with overall ED admissions. The site utilised is an inner city tertiary hospital, with 630 beds, with approximately 82 600 annual presentations, where 32.5% were children. METHODS: Complaints between the dates of 27 November 2012 and 10 March 2016 were reviewed. Performance indicators and the distribution of presentations by diagnostic code were reviewed. RESULTS: A total of 572 different complaint reasons were found and grouped into 12 categories...
April 2, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29603320/stakeholder-views-of-rural-community-based-medical-education-a-narrative-review-of-the-international-literature
#7
Praphun Somporn, Julie Ash, Lucie Walters
CONTEXT: Rural community-based medical education (RCBME), in which medical student learning activities take place within a rural community, requires students, clinical teachers, patients, community members and representatives of health and government sectors to actively contribute to the educational process. Therefore, academics seeking to develop RCBME need to understand the rural context, and the views and needs of local stakeholders. OBJECTIVES: The aim of this review is to examine stakeholder experiences of RCBME programmes internationally...
March 30, 2018: Medical Education
https://www.readbyqxmd.com/read/29575484/shared-decision-making-in-tinnitus-care-an-exploration-of-clinical-encounters
#8
Helen Pryce, Amanda Hall, Elizabeth Marks, Beth-Anne Culhane, Sarah Swift, Jean Straus, Rachel L Shaw
OBJECTIVES: This study examined clinical encounters between clinicians and patients to determine current practice for the diagnosis and treatment of tinnitus. The objective was to develop an understanding of the ideal clinical encounter that would facilitate genuine shared decision-making. DESIGN: Video ethnography was used to examine clinical encounters for the diagnosis and treatment of tinnitus. METHODS: Clinical encounters were video-recorded...
March 25, 2018: British Journal of Health Psychology
https://www.readbyqxmd.com/read/29563674/advantages-of-type-and-screen-policy-perspective-from-a-developing-country
#9
Geet Aggarwal, Aseem K Tiwari, Dinesh Arora, Ravi C Dara, Devi P Acharya, Gunjan Bhardwaj, Jyoti Sharma
INTRODUCTION: The authors' center recently changed their pretransfusion testing protocol from "conventional" type and screen (TS) with anti-human globulin (AHG) crossmatch (Policy A) to TS with immediate-spin (IS) crossmatch (Policy B). Red blood cell (RBC) units were issued after compatible IS crossmatch as and when required instead of AHG crossmatch. This study was conducted to compare the effects of change of policy from A to B over 1-year period on crossmatch-to-transfusion (C/T) ratio, RBC issue turnaround time (TAT), outdating of RBC, man-hours consumption, and monetary savings...
January 2018: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/29560051/a-novel-approach-to-addressing-an-unintended-consequence-of-direct-to-room-the-delay-of-initial-vital-signs
#10
Joseph Basile, Elias Youssef, Bartholomew Cambria, Jerel Chacko, Karyn Treval, Barry Hahn, Brahim Ardolic
Introduction: The concept of "direct to room" (DTR) and "immediate bedding" has been described in the literature as a mechanism to improve front-end, emergency department (ED) processing. The process allows for an expedited clinician-patient encounter. An unintended consequence of DTR was a time delay in obtaining the initial set of vital signs upon patient arrival. Methods: This retrospective cohort study was conducted at a single, academic, tertiary-care facility with an annual census of 94,000 patient visits...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29558228/categorisation-of-goals-set-using-goal-attainment-scaling-for-treatment-of-leg-spasticity-a-multicentre-analysis
#11
Stephen Ashford, Heather Williams, Ajoy Nair, Samantha Orridge, Lynne Turner-Stokes
BACKGROUND: Goal-classification of person-centred goals, using Goal Attainment Scaling for leg spasticity treatment. METHODS: The study was conducted in two phases: phase I, a retrospective review to evaluate categories of goal set in routine clinical practice. Findings were used to design a goal classification system. Phase II, a multi-centre study to confirm the goal categories. Goals set (n = 270) were analysed from data collected at three centres in the UK (one centre for phase I)...
March 20, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29550975/the-voice-is-as-mighty-as-the-pen-integrating-conversations-into-advance-care-planning
#12
Kunal Bailoor, Leslie H Kamil, Ed Goldman, Laura M Napiewocki, Denise Winiarski, Christian J Vercler, Andrew G Shuman
Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding of medical options, and cultural disparities...
March 17, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29548061/the-role-of-virtual-rehabilitation-in-total-and-unicompartmental-knee-arthroplasty
#13
Morad Chughtai, John J Kelly, Jared M Newman, Assem A Sultan, Anton Khlopas, Nipun Sodhi, Anil Bhave, Michael C Kolczun, Michael A Mont
This study evaluated the use of telerehabilitation during the postoperative period for patients who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Specifically, this study evaluated the following: (1) patient compliance and adherence to the program, (2) time spent performing physical therapy exercises, (3) the usability of the virtual rehabilitation platform, and (4) clinical outcome scores in a selected primary knee arthroplasty cohort. A total of 157 consecutive patients underwent TKA ( n  = 18) or UKA ( n  = 139)...
March 16, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29535244/humor-during-clinical-practice-analysis-of-recorded-clinical-encounters
#14
Kari A Phillips, Naykky Singh Ospina, Rene Rodriguez-Gutierrez, Ana Castaneda-Guarderas, Michael R Gionfriddo, Megan Branda, Victor Montori
OBJECTIVE: Little is known about humor's use in clinical encounters, despite its many potential benefits. We aimed to describe humor during clinical encounters. DESIGN: We analyzed 112 recorded clinical encounters. Two reviewers working independently identified instances of humor, as well as information surrounding the logistics of its use. RESULTS: Of the 112 encounters, 66 (59%) contained 131 instances of humor. Humor was similarly frequent in primary care (36/61, 59%) and in specialty care (30/51, 59%), was more common in gender-concordant interactions (43/63, 68%), and was most common during counseling (81/112, 62%)...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29533091/inclusion-and-exclusion-in-the-globalisation-of-genomics-the-case-of-rare-genetic-disease-in-brazil
#15
Sahra Gibbon, Waleska Aureliano
Within the context of a globalising agenda for genetic research where 'global health' is increasingly seen as necessarily informed by and having to account for genomics, the focus on rare genetic diseases is becoming prominent. Drawing from ethnographic research carried out separately by both authors in Brazil, this paper examines how an emerging focus on two different arenas of rare genetic disease, cancer genetics and a class of degenerative neurological diseases known as Ataxias, is subject to and a product of the dynamics of inclusion and exclusion as this concerns participation in research and access to health care...
April 2018: Anthropology & Medicine
https://www.readbyqxmd.com/read/29528204/functional-gastrointestinal-disorders-approach-to-patients-with-functional-gastrointestinal-disorders
#16
Samiullah Samiullah, Michael Malone, Abdul Waheed
Functional gastrointestinal disorders (FGIDs) are among the most challenging conditions to diagnose and manage. FGIDs are a heterogeneous group of conditions with varying and sometimes vague symptomatology. The Rome IV classification is the most comprehensive resource on FGIDs. FGIDs are common and are associated with significant social and economic burdens. The patient perspective includes anxiety, emotional distress, and mistrust of health care. Psychological stressors and concomitant psychiatric illness are common but not always present...
March 2018: FP Essentials
https://www.readbyqxmd.com/read/29526389/facilitating-collaborative-and-effective-family-involvement-in-the-cancer-setting-guidelines-for-clinicians-trio-guidelines-1
#17
REVIEW
Rebekah Laidsaar-Powell, Phyllis Butow, Frances Boyle, Ilona Juraskova
OBJECTIVE: Family caregivers regularly attend medical consultations and are often involved in decision-making; however, there are few practical strategies to guide effective communication for the clinician-patient-family trio. We aimed to develop and evaluate the first comprehensive guidelines for oncology physicians and nurses, on how to positively and effectively involve family caregivers of adult patients in consultations and patient care (TRIO Guidelines-1) and how to manage challenging interactions with family caregivers (TRIO Guidelines-2)...
January 31, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29525394/a-population-based-cohort-study-defines-prognoses-in-severe-chronic-kidney-disease
#18
Marcello Tonelli, Natasha Wiebe, Matthew T James, Scott W Klarenbach, Braden J Manns, Pietro Ravani, Giovanni F M Strippoli, Brenda R Hemmelgarn
In older people with chronic kidney disease (CKD) and comorbidities, the risk of death or disability may overshadow the risk of kidney failure. To help refine this we did a retrospective population-based cohort study to evaluate the relative likelihood of adverse outcomes as functions of age and comorbidity burden among 47,228 adults with severe non-dialysis dependent CKD. We identified comorbidities using 29 validated algorithms applied to administrative data and assessed death, end-stage renal disease (ESRD), cardiovascular disease (CVD) events, and long-term care...
March 7, 2018: Kidney International
https://www.readbyqxmd.com/read/29524996/preliminary-development-of-the-food-allergy-coping-and-emotions-questionnaires-for-children-adolescents-and-young-people-qualitative-analysis-of-data-on-ige-mediated-food-allergy-from-five-countries
#19
Audrey DunnGalvin, Laura Polloni, Jennifer Le Bovidge, Antonella Muraro, Matthew Greenhawt, Steve Taylor, Joseph Baumert, Wesley Burks, Anna Trace, Gillian DunnGalvin, Lisa Forristal, Laura McGrath, Jennifer White, Marta Vasquez, Katrina Allen, Aziz Sheikh, Jonathan Hourihane, Mimi L K Tang
BACKGROUND: We have previously developed a food allergy-specific developmental model, that explained emotions and coping styles, among children aged 6 to 15years in Ireland. OBJECTIVE: The objective of this study was to investigate the usefulness of the developmental model in a large multicountry data set, including any mediators of coping style, and to use the findings to generate an item pool that will form the basis for 3 age-appropriate self-report questionnaires to measure coping and emotions...
March 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29523756/resuscitation-decisions-at-the-end-of-life-medical-views-and-the-juridification-of-practice
#20
Fiona Ma MacCormick, Charlotte Emmett, Paul Paes, Julian C Hughes
BACKGROUND: Concerns about decision making related to resuscitation have led to two important challenges in the courts resulting in new legal precedents for decision-making practice. Systematic research investigating the experiences of doctors involved in decisions about resuscitation in light of the recent changes in law remains lacking. AIM: To analyse the practice of resuscitation decision making on hospital wards from the perspectives of doctors. DESIGN: The data presented in this paper were collected as part of a wider research study of end-of-life care in an acute hospital setting...
March 9, 2018: Journal of Medical Ethics
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