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https://www.readbyqxmd.com/read/28936750/person-centered-care-and-personalized-medicine-irreconcilable-opposites-or-potential-companions
#1
Leila El-Alti, Lars Sandman, Christian Munthe
In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined or if they conflict at fundamental or pragmatic levels...
September 21, 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28936715/comparing-different-partograph-designs-for-use-in-standard-labor-care-a-pilot-randomized-trial
#2
Nigel J Lee, Jeremy Neal, Nancy K Lowe, Sue V Kildea
Backgound Partographs are used in many labour settings to provide a pictorial overview of a woman's cervical dilation pattern in the first stage of labor and to alert clinicians to slow progress possibly requiring intervention. Recent reviews called for large trials to establish the efficacy of partographs to improve birth outcomes whilst highlighting issues of clinician compliance with use. Previous studies have also reported issues with participant recruitment related to concerns regarding the possibility of a longer labour...
September 21, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28936694/evaluating-the-effectiveness-of-physician-counseling-to-promote-physical-activity-in-mexico-an-effectiveness-implementation-hybrid-study
#3
Karla I Galaviz, Paul A Estabrooks, Edtna Jauregui Ulloa, Rebecca E Lee, Ian Janssen, Juan López Y Taylor, Luis Ortiz-Hernández, Lucie Lévesque
Integrating physical activity (PA) counseling in routine clinical practice remains a challenge. The purpose of this study was to evaluate the implementation and effectiveness of a pragmatic strategy aimed to improve physician PA counseling and patient PA. An effectiveness-implementation type-2 hybrid design was used to evaluate a 3-h training (i.e., implementation strategy-IS) to increase physician use of the 5-As (assess, advise, agree, assist, arrange) for PA counseling (i.e., clinical intervention-CI) and to determine if the CI improved patient PA...
September 21, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28934952/post-market-outcome-of-an-extract-of-traditional-cretan-herbs-on-upper-respiratory-tract-infections-a-pragmatic-prospective-observational-study
#4
Marilena Anastasaki, Antonios Bertsias, Stergios A Pirintsos, Elias Castanas, Christos Lionis
BACKGROUND: The beneficial effects of traditional herbs of Crete, Greece for the treatment of upper respiratory tract infections have been reported in observational and laboratory studies. Following a published, double blind, randomized, placebo controlled trial, this study aimed to assess the effectiveness of an extract of three Cretan herbs on the treatment of upper respiratory tract infections, upon its market release. METHODS: An observational study was conducted in Heraklion, Crete, Greece...
September 21, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28934032/relational-inquiry-approach-nursing-practice-in-pakistan-a-case-study
#5
Ahtisham Younas
The relational inquiry approach enables nurses to understand and examine different nursing situations within complex healthcare contexts using the ideologies of pragmatism, critical theory, and hermeneutic phenomenology. In this paper, the author presents the application of the relational inquiry approach using Newman's theory to analyze a case of a man who refused coronary artery bypass surgery in Pakistan. This analysis demonstrates that relational inquiry is useful in examining patients' experiences and related healthcare needs and helps the nurses to perform appropriate actions to produce desirable outcomes...
October 2017: Nursing Science Quarterly
https://www.readbyqxmd.com/read/28933994/decision-making-for-people-living-with-dementia-by-their-carers-at-the-end-of-life-a-rapid-scoping-review
#6
Sue Barker, Mary Lynch, Jane Hopkinson
BACKGROUND: There are an increasing number of people living with dementia, as well as an expectation that care decisions are made collaboratively with those with the disease entering the end stage and their families. This has increased the burden on family carers. AIM: To explore the evidence on the decisional support needs of informal carers of people with end-stage dementia. DESIGN: A rapid scoping review was undertaken of peer-reviewed publications between 2000 and 2016, which included all health-care settings and the person's own home...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28933674/critical-healthcare-management-studies-green-shoots
#7
Martin Kitchener, Aoife M McDermott, Simon Cooper
Purpose While critical approaches have enriched research in proximate fields, their impact has been less marked in studies of healthcare management. In response, the 2016 Organizational Behaviour in Health Care Conference hosted its first-ever session dedicated to the emergent field of critical healthcare management studies (CHMSs). The purpose of this paper is to present five papers selected from that conference. Design/methodology/approach In this introductory paper, the authors frame the contributions as "green shoots" in a field of CHMS which contains four main furrows of activity: questioning the taken-for-granted; moving beyond instrumentalism; reflexivity and meanings in research; and challenging structures of domination (Kitchener and Thomas, 2016)...
August 21, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28933049/pragmatic-combination-of-available-diagnostic-tools-for-optimal-detection-of-intestinal-microsporidia
#8
Stuti Kaushik, Rumpa Saha, Shukla Das, V G Ramachandran, Ashish Goel
Diarrhea is a debilitating condition in HIV infected individuals and with the finding that almost 1/4 cases of diarrhea in HIV are due to microsporidia, there is a dire need to institute measures for its detection on a regular basis. Keeping this in mind the study aims to determine the burden of intestinal microsporidiosis in HIV seropositive patients presenting with and without diarrhea and to compare the ability of microscopy and PCR in its detection.The study group consisted of 120 patients divided into four groups HIV seropositive with/without diarrhea, and HIV seronegative with/without diarrhea...
September 13, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28931531/clinical-and-cost-effectiveness-of-the-lightning-process-in-addition-to-specialist-medical-care-for-paediatric-chronic-fatigue-syndrome-randomised-controlled-trial
#9
Esther M Crawley, Daisy M Gaunt, Kirsty Garfield, William Hollingworth, Jonathan A C Sterne, Lucy Beasant, Simon M Collin, Nicola Mills, Alan A Montgomery
OBJECTIVE: Investigate the effectiveness and cost-effectiveness of the Lightning Process (LP) in addition to specialist medical care (SMC) compared with SMC alone, for children with chronic fatigue syndrome (CFS)/myalgic encephalitis (ME). DESIGN: Pragmatic randomised controlled open trial. Participants were randomly assigned to SMC or SMC+LP. Randomisation was minimised by age and gender. SETTING: Specialist paediatric CFS/ME service. PATIENTS: 12-18 year olds with mild/moderate CFS/ME...
September 20, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#10
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28928680/addressee-identity-and-morphosyntactic-processing-in-basque-allocutive-agreement
#11
Max Wolpert, Simona Mancini, Sendy Caffarra
Information about interlocutor identity is pragmatic in nature and has traditionally been distinguished from explicitly coded linguistic information, including mophosyntax. Study of speaker identity in language processing has questioned this distinction, but addressee identity has been less considered. We used Basque to explore how addressee identity is processed during morphosyntactic analysis. In the familiar register hika, Basque has obligatory allocutive agreement, where verbal morphology represents the gender of a non-argument addressee...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28928192/a-pragmatic-group-sequential-placebo-controlled-randomised-trial-to-determine-the-effectiveness-of-glyceryl-trinitrate-for-retained-placenta-got-it-a-study-protocol
#12
Fiona C Denison, John Norrie, Julia Lawton, Jane E Norman, Graham Scotland, Gladys C McPherson, Alison McDonald, Mark Forrest, Jemma Hudson, Jane Brewin, Mathilde Peace, Cynthia Clarkson, Sheonagh Brook-Smith, Susan Morrow, Nina Hallowell, Laura Hodges, Kathryn F Carruthers
INTRODUCTION: A retained placenta is diagnosed when the placenta is not delivered following delivery of the baby. It is a major cause of postpartum haemorrhage and treated by the operative procedure of manual removal of placenta (MROP). METHODS AND ANALYSIS: The aim of this pragmatic, randomised, placebo-controlled, double-blind UK-wide trial, with an internal pilot and nested qualitative research to adjust strategies to refine delivery of the main trial, is to determine whether sublingual glyceryl trinitrate (GTN) is (or is not) clinically and cost-effective for (medical) management of retained placenta...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28928185/comparative-effectiveness-of-injectable-penicillin-versus-a-combination-of-penicillin-and-gentamicin-in-children-with-pneumonia-characterised-by-indrawing-in-kenya-protocol-for-an-observational-study
#13
Lucas Malla, Rafael Perera-Salazar, Emily McFadden, Mike English
INTRODUCTION: WHO treatment guidelines are widely recommended for guiding treatment for millions of children with pneumonia every year across multiple low-income and middle-income countries. Guidelines are based on synthesis of available evidence that provides moderate certainty in evidence of effects for forms of pneumonia that can result in hospitalisation. However, trials have included fewer children from Africa than other settings, and it is suggested that African children with pneumonia have higher mortality...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28928175/integrated-management-of-atrial-fibrillation-including-tailoring-of-anticoagulation-in-primary-care-study-design-of-the-all-in-cluster-randomised-trial
#14
Carline J van den Dries, Ruud Oudega, Arif Elvan, Frans H Rutten, Sjef J C M van de Leur, Henk J G Bilo, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing
INTRODUCTION: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. However, primary care has not yet played a dominant role in AF management, which has been in fact more fragmented between different healthcare providers...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28926813/risk-assessment-to-groundwater-of-pit-latrine-rural-sanitation-policy-in-developing-country-settings
#15
Jan O Back, Michael O Rivett, Laura B Hinz, Nyree Mackay, Gift J Wanangwa, Owen L Phiri, Chrispine Emmanuel Songola, Mavuto A S Thomas, Steve Kumwenda, Muthi Nhlema, Alexandra V M Miller, Robert M Kalin
Parallel global rise in pit-latrine sanitation and groundwater-supply provision is of concern due to the frequent spatial proximity of these activities. Study of such an area in Malawi has allowed understanding of risks posed to groundwater from the recent implementation of a typical developing-country pit-latrine sanitation policy to be gained. This has assisted the development of a risk-assessment framework approach pragmatic to regulatory-practitioner management of this issue. The framework involves water-supply and pit-latrine mapping, monitoring of key groundwater contamination indicators and surveys of possible environmental site-condition factors and culminates in an integrated statistical evaluation of these datasets to identify the significant factors controlling risks posed...
September 16, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28926526/group-interventions-to-reduce-emotional-distress-and-fatigue-in-breast-cancer-patients-a-9-month-follow-up-pragmatic-trial
#16
Charlotte Grégoire, Isabelle Bragard, Guy Jerusalem, Anne-Marie Etienne, Philippe Coucke, Gilles Dupuis, Dominique Lanctôt, Marie-Elisabeth Faymonville
BACKGROUND: Long-term effects of psychosocial interventions to reduce emotional distress, sleep difficulties, and fatigue of breast cancer patients are rarely examined. We aim to assess the effectiveness of three group interventions, based on cognitive behavioural therapy (CBT), yoga, and self-hypnosis, in comparison to a control group at a 9-month follow-up. METHODS: A total of 123 patients chose to participate in one of the interventions. A control group was set up for those who agreed not to participate...
September 19, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28926014/assessing-the-economic-impact-of-an-endemic-disease-the-case-of-mastitis
#17
H Hogeveen, M Van Der Voort
A large part of the world's resources are used to produce animal products. Efficient use of these resources is important to improve social well-being. Endemic animal diseases decrease production efficiency, because they require a higher level of input to produce the same amount of output or result in a lower output with the same amount of input. The optimal level of production with and without disease differs from farm to farm and depends on varying economic circumstances. Given these difficulties, making an accurate theoretical estimation of the economic impact of endemic diseases is challenging...
April 2017: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/28925019/inclusion-of-pregnant-and-breastfeeding-women-in-research-efforts-and-initiatives
#18
Sílvia M Illamola, Christina Bucci-Rechtweg, Maged M Costantine, Katerina Tsilou, Catherine M Sherwin, Anne Zajicek
Pregnant and breastfeeding women have been rendered therapeutic orphans as they have been historically excluded from clinical trials. Labeling for most approved drugs does not provide information about safety and efficacy during pregnancy. This lack of data is mainly due to ethico-legal challenges that have remained entrenched in the post-diethylstilbestrol and thalidomide era, and that have led to pregnancy being viewed in the clinical trial setting primarily through a pharmacovigilance lens. Policy considerations that encourage and/or require the inclusion of pregnant or lactating women in clinical trials may address the current lack of available information...
September 19, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28923035/comparison-of-volar-flexion-ulnar-deviation-and-functional-position-cast-immobilization-in-the-non-operative-treatment-of-distal-radius-fracture-in-elderly-patients-a-pragmatic-randomized-controlled-trial-study-protocol
#19
Lauri Raittio, Antti Launonen, Teemu Hevonkorpi, Toni Luokkala, Juha Kukkonen, Aleksi Reito, Bakir Sumrein, Minna Laitinen, Ville M Mattila
BACKGROUND: Distal radius fractures (DRFs) are the second most common fractures, after hip fractures, seen in clinical practice. The high incidence of low-energy trauma DRFs in elderly patients raises questions about the best treatment method in terms of function, pain, and quality of life. Although the majority of these fractures are treated non-operatively with cast immobilization, valid scientific evidence of the optimal cast immobilization is lacking. In addition, several publications, including Cochrane review have outlined the need for more evidence to determine the most appropriate method of cast immobilization...
September 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28923013/pragmatic-clinical-trials-embedded-in-healthcare-systems-generalizable-lessons-from-the-nih-collaboratory
#20
Kevin P Weinfurt, Adrian F Hernandez, Gloria D Coronado, Lynn L DeBar, Laura M Dember, Beverly B Green, Patrick J Heagerty, Susan S Huang, Kathryn T James, Jeffrey G Jarvik, Eric B Larson, Vincent Mor, Richard Platt, Gary E Rosenthal, Edward J Septimus, Gregory E Simon, Karen L Staman, Jeremy Sugarman, Miguel Vazquez, Douglas Zatzick, Lesley H Curtis
BACKGROUND: The clinical research enterprise is not producing the evidence decision makers arguably need in a timely and cost effective manner; research currently involves the use of labor-intensive parallel systems that are separate from clinical care. The emergence of pragmatic clinical trials (PCTs) poses a possible solution: these large-scale trials are embedded within routine clinical care and often involve cluster randomization of hospitals, clinics, primary care providers, etc...
September 18, 2017: BMC Medical Research Methodology
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