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https://www.readbyqxmd.com/read/27936437/clinical-trial-methodology-to-assess-the-efficacy-effectiveness-of-long-acting-antipsychotics-randomized-controlled-trials-vs-naturalistic-studies
#1
REVIEW
Andrea Fagiolini, Paola Rocca, Serafino De Giorgi, Edoardo Spina, Giovanni Amodeo, Mario Amore
Schizophrenia presents unique difficulties in clinical trial design associated with the condition's variable presentation and clinical course, and multiple features influencing affect, cognition, volition and perception. Randomized controlled trials (RCTs) are explanatory studies using a carefully selected patient population, predefined assessment intervals and, generally, symptom-focused endpoints. Naturalistic studies are pragmatic, with no active intervention, and outcomes that are generally those used in clinical practice (e...
November 28, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27932629/breathlessness-during-daily-activity-the-psychometric-properties-of-the-london-chest-activity-of-daily-living-scale-in-patients-with-advanced-disease-and-refractory-breathlessness
#2
Charles C Reilly, Claudia Bausewein, Rachel Garrod, Caroline J Jolley, John Moxham, Irene J Higginson
BACKGROUND: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. AIM: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. DESIGN: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034)...
December 8, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27931842/quality-end-of-life-cancer-care-an-overdue-imperative
#3
REVIEW
Guy B Faguet
This review assesses the current status of end-of-life care based on large-scale, multiyear nationwide surveys of treatment modality, setting, and cost of care during terminal patients' last months of life. It shows that end-of-life care goals often remain suboptimal. Contributing factors include prioritized life preservation, uneven commitment to palliative care, few palliative care specialists, and perverse financial incentives that encourage costly interventions. Although not determinant per se, these factors coupled to doubts about what constitutes end-of-life can lead to overextended disease treatment and a late implementation of palliative care...
December 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27931214/how-effective-are-volunteers-at-supporting-people-in-their-last-year-of-life-a-pragmatic-randomised-wait-list-trial-in-palliative-care-elsa
#4
Catherine Walshe, Steven Dodd, Matt Hill, Nick Ockenden, Sheila Payne, Nancy Preston, Guillermo Perez Algorta
BACKGROUND: Clinical care alone at the end of life is unlikely to meet all needs. Volunteers are a key resource, acceptable to patients, but there is no evidence on care outcomes. This study aimed to determine whether support from a social action volunteer service is better than usual care at improving quality of life for adults in the last year of life. METHODS: A pragmatic, multi-centre wait-list controlled trial, with participants randomly allocated to receive the volunteer support intervention either immediately or after a 4 week wait...
December 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27930953/adolescent-binge-alcohol-exposure-increases-risk-assessment-behaviors-in-male-wistar-rats-after-exposure-to-an-acute-psychological-stressor-in-adulthood
#5
Audrey Torcaso, AnnaDorothea Asimes, Margaret Meagher, Toni R Pak
Teenage binge drinking is a common practice that has been shown to increase the risk for developing mood disorders in adulthood. The hypothalamo-pituitary-adrenal (HPA) axis is often dysfunctional in mood disorder patients, and animal models of adolescent binge alcohol exposure similarly show disordered HPA axis function, even after long periods of alcohol abstinence. Here, we sought to investigate the anxiety-like behavioral consequences of binge alcohol exposure in a Wistar rat model. Male rats were administered alcohol in a binge pattern during peri-puberty, and one month later, anxiety-like behaviors were measured using the elevated plus maze...
November 30, 2016: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27930399/practical-discourse-revisited-hermeneutics-at-the-intersection-of-philosophy-and-nursing
#6
Stephen M Padgett
Three early papers by Janice Thompson-Practical Discourse, Critical Scholarship, and Hermeneutic Inquiry-are examined in reference to the historical context of the time (1985-1990), and implications for current scholarship. Hermeneutic philosophy has been neglected in recent years, overshadowed by its weaker cousin phenomenology. I argue that renewed attention to hermeneutics would help us focus on the "situatedness" of nursing scholars, the class politics of academia, and a better balance in interpretative work between faith and suspicion...
December 6, 2016: ANS. Advances in Nursing Science
https://www.readbyqxmd.com/read/27928857/further-examination-of-predictors-of-turnover-intention-among-mental-health-professionals
#7
N J Yanchus, D Periard, K Osatuke
: WHAT IS KNOWN ON THE SUBJECT?: When mental health professionals leave organizations, detrimental effects on quality of patient care occur. Reasons for leaving include incivility, lack of autonomy, perceptions of unfair treatment and feeling psychologically unsafe at work. This paper sought to investigate additional reasons why mental health professionals intend to quit or to cognitively withdraw from their jobs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Past research on this topic is limited in its scope and data...
December 8, 2016: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/27927817/perioperative-management-of-adult-patients-with-a-history-of-stroke-or-transient-ischaemic-attack-undergoing-elective-non-cardiac-surgery
#8
Zehra Mehdi, Jonathan Birns, Judith Partridge, Ajay Bhalla, Jugdeep Dhesi
It is increasingly common for physicians and anaesthetists to be asked for advice in the medical management of surgical patients who have an incidental history of stroke or transient ischaemic attack (TIA). Advising clinicians requires an understanding of the common predictors, outcomes and management of perioperative stroke. The most important predictor of perioperative stroke is a previous history of stroke, and outcomes associated with such an event are extremely poor. The perioperative management of this patient group needs careful consideration to minimise the thrombotic risk and a comprehensive, individualised approach is crucial...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927658/aneurysmal-subarachnoid-hemorrhage-red-blood-cell-transfusion-and-outcome-sahara-a-pilot-randomised-controlled-trial-protocol
#9
Shane W English, D Fergusson, M Chassé, A F Turgeon, F Lauzier, D Griesdale, A Algird, A Kramer, A Tinmouth, C Lum, J Sinclair, S Marshall, D Dowlatshahi, A Boutin, G Pagliarello, L A McIntyre
INTRODUCTION: Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27925426/the-impact-of-home-fortification-with-multiple-micronutrient-powder-on-vitamin-a-status-in-young-children-a-multicenter-pragmatic-controlled-trial-in-brazil
#10
Lara Livia Santos Silva, Rosângela Aparecida Augusto, Daniela Cardoso Tietzmann, Leopoldina Augusta Souza Sequeira, Maria Claret Costa Monteiro Hadler, Pascoal Torres Muniz, Pedro Israel Cabral de Lira, Marly Augusto Cardoso
Home fortification with multiple micronutrient powder (MNP) is effective in the prevention of anemia in young children. However, the impact on their vitamin A status remains controversial. This study aimed to evaluate the effect of MNP on vitamin A status in young Brazilian children. A multicenter pragmatic, controlled trial was carried out in primary health centers in four Brazilian cities. In the beginning of the study, the control group (CG) consisted of children 11-14 months old (n = 395) attending in routine pediatric health care...
December 7, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27924997/characterization-of-normal-and-freeze-thawed-tissues-in-vitro-through-the-ultrasonic-integrated-backscatter
#11
L Sheng, P Yang, Z He, G Wang, J Luo, J Liu
BACKGROUND: The ultrasound guidance of cryotherapy could be improved if changes of tissue characterization parameters during freezing could be used to monitor freezing patterns and estimate the postoperative effects after surgery. OBJECTIVE: The ultrasonic integrated backscatter analysis holds promise as an effective method for signal analysis and characterization of thawed tissues. MATERIALS AND METHODS: The ultrasonic integrated backscatter has been found to be an important parameter for describing the ultrasonic scattering and characterization of biological tissues...
September 2016: Cryo Letters
https://www.readbyqxmd.com/read/27924467/indian-pediatric-postgraduate-s-perspective-on-future-career-intentions
#12
Latha M Sneha, Manipriya Ravindran, Rekha Kumar, Padmasani Venkatraman, Julius Scott, LakshmiNarayan Kannan
OBJECTIVE: To determine the factors that influence Pediatric residents to pursue a subspecialty career and establish their choice of future workplace. METHODS: The present questionnaire based study was conducted during a National level pediatric post graduate exam refresher course in Chennai, India and involved Pediatric residents from all parts of India. Datas was analysed with the statistical package for social sciences (SPSS, version 18.0). RESULTS: Seventy five respondents participated in the study...
December 7, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27923864/outcomes-of-the-smoker-s-health-project-a-pragmatic-comparative-effectiveness-trial-of-tobacco-dependence-interventions-based-on-self-determination-theory
#13
Geoffrey C Williams, Christopher P Niemiec, Heather Patrick, Richard M Ryan, Edward L Deci
A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory, namely, Intensive Treatment (IT; six contacts over 6 months), Extended Need Support (ENS; eight contacts over 12 months) and Harm Reduction (HR; eight contacts over 12 months with medication use if willing to reduce cigarette use by half)...
December 2016: Health Education Research
https://www.readbyqxmd.com/read/27923694/neuropsychiatric-performance-in-patients-with-cirrhosis-who-is-normal
#14
REVIEW
Sara Montagnese, Michele De Rui, Paolo Angeli, Piero Amodio
Normal neuropsychiatric performance in cirrhosis has been traditionally defined by the absence of any degree of hepatic encephalopathy (HE) and/or the absence of psychometric or neurophysiological abnormalities, by comparison with reference data from the healthy population. It is our impression that as our understanding and management of end-stage liver disease continues to change, the concept of normal neuropsychiatric performance may also need updating. This review explores novel and possibly more pragmatic interpretations of neuropsychiatric "normality" by comparison with top personal performance, in terms of risk of overt HE/brain failure and in relation with events such as liver transplantation, decompensation, acute-on-chronic liver failure (ACLF) and Transjugular Intrahepatic Portal-systemic Shunt (TIPS) placement...
December 3, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27922448/the-second-randomised-evaluation-of-the-effectiveness-cost-effectiveness-and-acceptability-of-computerised-therapy-reeact-2-trial-does-the-provision-of-telephone-support-enhance-the-effectiveness-of-computer-delivered-cognitive-behaviour-therapy-a-randomised
#15
Sally Brabyn, Ricardo Araya, Michael Barkham, Peter Bower, Cindy Cooper, Ana Duarte, David Kessler, Sarah Knowles, Karina Lovell, Elizabeth Littlewood, Richard Mattock, Stephen Palmer, Jodi Pervin, David Richards, Debbie Tallon, David White, Simon Walker, Gillian Worthy, Simon Gilbody
BACKGROUND: Computerised cognitive behaviour therapy (cCBT) is an efficient form of therapy potentially improving access to psychological care. Indirect evidence suggests that the uptake and effectiveness of cCBT can be increased if facilitated by telephone, but this is not routinely offered in the NHS. OBJECTIVES: To compare the clinical effectiveness and cost-effectiveness of telephone-facilitated free-to-use cCBT [e.g. MoodGYM (National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia)] with minimally supported cCBT...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27921992/the-hubble-trial-haemorrhoidal-artery-ligation-hal-versus-rubber-band-ligation-rbl-for-symptomatic-second-and-third-degree-haemorrhoids-a-multicentre-randomised-controlled-trial-and-health-economic-evaluation
#16
Steven Brown, Jim Tiernan, Katie Biggs, Daniel Hind, Neil Shephard, Mike Bradburn, Allan Wailoo, Abualbishr Alshreef, Lizzie Swaby, Angus Watson, Simon Radley, Oliver Jones, Paul Skaife, Anil Agarwal, Pasquale Giordano, Marc Lamah, Mark Cartmell, Justin Davies, Omar Faiz, Karen Nugent, Andrew Clarke, Angus MacDonald, Phillip Conaghan, Paul Ziprin, Rohit Makhija
BACKGROUND: Optimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious. OBJECTIVE: The comparison of HAL with RBL for the treatment of grade II/III haemorrhoids. DESIGN: A multicentre, parallel-group randomised controlled trial. PERSPECTIVE: UK NHS and Personal Social Services...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27921273/theorizing-language-and-discourse-for-the-interactional-study-of-identities
#17
Neill Korobov
The following commentary critically reflects on the pragmatic and semiotic approach to language and identity articulated by Tapia, Rojas, and Picado (Culture & Psychology, Tapia et al. 2017). The following questions are central: 1) What theoretical position is (tacitly) being articulated regarding the nature of language and discourse? Although the authors admit that an explicit theorization of language and discourse is not their focus, the absence of a clear theoretical position is conspicuously problematic...
December 5, 2016: Integrative Psychological & Behavioral Science
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#18
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27917505/might-constraint-be-compatible-with-care-home-care-as-a-situational-ethics
#19
Antoine Hennion, Pierre A Vidal-Naquet
Respecting the autonomy and will of people has legitimately led to strictly control the use of constraint in care activities, and promote a care ethics centred around people's needs and wills. But constraint is underlying in any action aiming at making people do something, even with their consent, especially when their ability to evaluate what is best for them may be altered. Ceaselessly present in care, this ordinary, silent constraint should not be only deemed as a necessary evil to be prevented. In contrast with this legally-based view, the paper adopts a pragmatic perspective...
December 5, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27917373/are-escherichia-coli-pathotypes-still-relevant-in-the-era-of-whole-genome-sequencing
#20
REVIEW
Roy M Robins-Browne, Kathryn E Holt, Danielle J Ingle, Dianna M Hocking, Ji Yang, Marija Tauschek
The empirical and pragmatic nature of diagnostic microbiology has given rise to several different schemes to subtype E.coli, including biotyping, serotyping, and pathotyping. These schemes have proved invaluable in identifying and tracking outbreaks, and for prognostication in individual cases of infection, but they are imprecise and potentially misleading due to the malleability and continuous evolution of E. coli. Whole genome sequencing can be used to accurately determine E. coli subtypes that are based on allelic variation or differences in gene content, such as serotyping and pathotyping...
2016: Frontiers in Cellular and Infection Microbiology
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