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https://www.readbyqxmd.com/read/28806791/effect-of-access-to-an-electronic-medical-resource-on-performance-characteristics-of-a-certification-examination-a-randomized-controlled-trial
#1
Rebecca S Lipner, Bradley G Brossman, Kelli M Samonte, Steven J Durning
Background: Electronic resources are increasingly used in medical practice. Their use during high-stakes certification examinations has been advocated by many experts, but whether doing so would affect the capacity to differentiate between high and low abilities is unknown. Objective: To determine the effect of electronic resources on examination performance characteristics. Design: Randomized controlled trial. Setting: Medical certification program...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806026/physician-perceptions-of-barriers-to-advance-care-planning
#2
Lauren Fanta, Jill Tyler
BACKGROUND: Numerous studies have confirmed the importance of advance care planning. Despite the benefits of directed end-of-life discussions, a variety of barriers including discomfort with the topic, physician ideology, lack of time and reimbursement, delaying discussions, and lack of training impede physicians from facilitating these crucial conversations with their patients. This study aims to understand physicians' perceptions to additional barriers to advance care planning with patients and their families...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28805570/swallowing-dysfunctions-in-parkinson-s-disease
#3
Janine A Simons
Dysphagia is a very frequent and highly relevant symptom in Parkinson's disease (PD) for quality of life, morbidity, and remaining lifetime, which is unfortunately widely underdiagnosed and underestimated regarding patients' centered care. Especially in early stages, the causal association between disease and swallowing disabilities remains unnoticed, which may be accounted for by the inability of caregivers and physicians to detect subtle swallowing problems and by the low self-awareness among PD patients...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28803559/rethinking-the-idea-of-late-autism-spectrum-disorder-onset
#4
Elizabeth C Bacon, Eric Courchesne, Cynthia Carter Barnes, Debra Cha, Sunny Pence, Laura Schreibman, Aubyn C Stahmer, Karen Pierce
A common theory of autism spectrum disorder (ASD) symptom onset includes toddlers who do not display symptoms until well after age 2, which are termed late-onset ASD cases. Objectives were to analyze differences in clinical phenotype between toddlers identified as ASD at initial evaluations (early diagnosed) versus those initially considered nonspectrum, then later identified as ASD (late diagnosed). Two hundred seventy-three toddlers recruited from the general population based on a failed developmental screening form or parent or physician concerns were followed longitudinally from 12 months and identified as early- and late-diagnosed cases of ASD, language delayed, or typically developing...
August 14, 2017: Development and Psychopathology
https://www.readbyqxmd.com/read/28803331/impact-of-monitoring-health-related-quality-of%C3%A2-life-in-clinical-practice-in-children-with-type-1-diabetes-mellitus
#5
Marta Murillo, Joan Bel, Jacobo Pérez, Raquel Corripio, Gemma Carreras, Xavier Herrero, Josep-Maria Mengibar, Dolors Rodriguez-Arjona, Ulrike Ravens-Sieberer, Hein Raat, Luis Rajmil
PURPOSE: To test whether the systematic monitoring of health-related quality of life (HRQOL) in clinical practice in Spanish pediatric patients with T1DM helps improve their daily life in a multicenter longitudinal study. METHODS: One hundred thirty-six patients participated, recruited from five centers in Barcelona, Spain (72 girls, mean age 13.4 years). Complete data were collected for 119 patients (85%). Pediatricians were randomly assigned to the HRQOL intervention (n = 70), or control group (n = 49)...
August 12, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28803180/anxiety-contributes-to-poorer-asthma-outcomes-in-inner-city-black-adolescents
#6
Marissa R Shams, Alice C Bruce, Anne M Fitzpatrick
BACKGROUND: The factors associated with poor asthma control, exacerbations, and health care utilization in black adolescents are complex and not well understood. Although psychological comorbidities such as anxiety are common in patients with asthma, these have not been studied in this population. OBJECTIVE: This study characterized anxiety and associated asthma features in a cohort of black inner-city adolescents with persistent asthma and determined the association between anxiety symptoms, persistent uncontrolled asthma, and prospective health care utilization over 1 year...
August 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28803073/leadership-development-initiative-growing-global-leaders%C3%A2-advancing-palliative-care
#7
Frank D Ferris, Shannon Y Moore, Mary V Callaway, Kathleen M Foley
The International Palliative Care Leadership Development Initiative (LDI) is a model demonstration project that aimed to expand the global network of palliative care leaders in low and moderate-resource countries who are well positioned to apply their new leadership skills. Thirty-nine palliative medicine physicians from 25 countries successfully completed the 2-year curriculum that included three thematic residential courses, mentorship and site visits by senior global palliative care leaders, and personal projects to apply their new leadership skills...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28802366/formula-for-the-prediction-of-apnea-hypopnea-index-in-children-with-obstructive-sleep-apnea-without-polysomnography-according-to-the-clinical-parameters-is-it-reliable
#8
Zlatko Kljajić, Željka Roje, Kristijan Bečić, Vesna Čapkun, K Vilović, Petar Ivanišević, Eugenija Marušić
PURPOSE OF THE STUDY: The aim of the study was to propose "the risk formula" for obstructive sleep apnea in children according to the general and local clinical parameters and findings relevant for obstructive sleep apnea (OSA) severity. The unmet need for this formula arises from the economic burden of polysomnography (device, staff, training, special sleep centers, etc) as the golden standard for the diagnostics. MATERIALS AND METHODS USED: The study was performed from January 2013 until January 2016 in the Sleep Center, Department for Neuroscience, School of Medicine of the University of Split, Department of Pediatrics, University Hospital Split, Croatia and ENT Dept...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802187/radiotherapy-access-in-belgium-how-far-are-we-from-evidence-based-utilisation
#9
Y Lievens, H De Schutter, K Stellamans, M Rosskamp, L Van Eycken
INTRODUCTION: Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed...
August 9, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28801654/perceptions-of-asthma-control-in-the-united-kingdom-a-cross-sectional-study-comparing-patient-and-healthcare-professionals-perceptions-of-asthma-control-with-validated-act-scores
#10
Andrew Menzies-Gow, Gavin Chiu
Perceptions of asthma control often vary between patients and physicians. This cross-sectional survey provided UK-specific data on actual and perceived asthma control in patients (18-75 years) attending routine asthma reviews in primary, secondary and tertiary settings. Differences between healthcare professionals' (HCP) and patients' perceptions of asthma control were evaluated via an online questionnaire and compared to a control-the validated asthma control test (ACT)-which patients completed. Treated patients (at least a short acting ß-agonist) with a documented diagnosis of asthma were enroled and consented within a month of their last appointment...
August 11, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28801439/validation-of-asthma-recording-in-the-clinical-practice-research-datalink-cprd
#11
Francis Nissen, Daniel R Morales, Hana Mullerova, Liam Smeeth, Ian J Douglas, Jennifer K Quint
OBJECTIVES: The optimal method of identifying people with asthma from electronic health records in primary care is not known. The aim of this study is to determine the positive predictive value (PPV) of different algorithms using clinical codes and prescription data to identify people with asthma in the United Kingdom Clinical Practice Research Datalink (CPRD). METHODS: 684 participants registered with a general practitioner (GP) practice contributing to CPRD between 1 December 2013 and 30 November 2015 were selected according to one of eight predefined potential asthma identification algorithms...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801142/synergistic-experimental-and-numerical-characterization-of-a-dry-heat-fluid-warming-device
#12
Winston Tan, Eph M Sparrow, John M Gorman, Jungwon Ahn
Fluids that are infused into the human body must be at a temperature that is compatible with the internal thermal state of the body. Since infusants are typically stored at temperatures that are too low for compatibility, a heating means is required to achieve the appropriate infusion temperature. This paper sets forth a synergistic investigation involving coupled experimentation and numerical simulation of the characteristics of one of the main categories of body-fluid heating means. The methodology developed here serves equally well as a design optimization tool...
August 8, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28801030/lipoprotein-a-screening-in-patients-with-controlled-traditional-risk-factors-undergoing-percutaneous-coronary-intervention
#13
Matthew C Weiss, Jeffrey S Berger, Eugenia Gianos, Edward Fisher, Arthur Schwartzbard, James Underberg, Howard Weintraub
BACKGROUND: Lipoprotein(a) [Lp(a)] is an inherited atherogenic lipoprotein and an independent risk factor for atherosclerotic cardiovascular disease; however, its clinical role remains limited. OBJECTIVE: We hypothesized that Lp(a) screening in high cardiovascular risk patients could provide insight into disease pathogenesis and modify physician behavior for treatment intensification targeting traditional risk factors when Lp(a)-related risk was identified. METHODS: We screened 113 patients presenting electively for percutaneous coronary intervention (PCI) for Lp(a) who met any of the following criteria: (1) premature coronary artery disease (male age <55 years, female age <65 years); (2) family history of premature coronary artery disease; (3) progression to PCI despite well-controlled traditional risk factors (blood pressure <140/90 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL, and HbA1c <7%, and nonsmoker); or (4) progression to PCI despite at least moderate intensity statin use (simvastatin 40, atorvastatin 40-80, or rosuvastatin 20-40 mg daily)...
July 22, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28800808/legal-and-ethical-challenges-part-1-general-population
#14
REVIEW
Britta Ostermeyer, Anim N Shoaib, Swapna Deshpande
Several federal and state laws and regulations, as well as ethical medical principles, govern the emergency clinician's practice of care. Although some common legal-medical and ethical principles are shared with other medical specialties, emergency medicine and emergency psychiatry have unique legal and ethical challenges. This article presents and discusses these challenges, including the physician-patient relationship, malpractice, confidentiality and privilege, duty to report, decision-making capacity and vicarious decision-making, the Emergency Medical Treatment and Labor Act, right to treatment, hospital admissions, involuntary commitment, forced medication administration, and child and elder abuse...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800795/evaluation-of-depression-and-suicidal-patients-in-the-emergency-room
#15
REVIEW
Shana Coshal, John Saunders, Anu A Matorin, Asim A Shah
Depression is the leading cause of disability globally, and more than one-half of those suffering with depression are not receiving effective treatment. Untreated or undertreated depression poses a significant risk for suicide. Suicide is the 10th leading cause of death in the United States. The emergency room provides an essential opportunity to screen for depression as well as suicide and to provide important and evidence-based interventions. The Basic Suicide Assessment Five-step Evaluation (B-SAFE) model provides a structure for all physicians to assess suicide risk and intervene...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28799976/effect-of-gene-gene-and-gene-environment-interactions-associated-with-antituberculosis-drug-induced-hepatotoxicity
#16
Julián G Chamorro, Jorge P Castagnino, Omar Aidar, Rosa M Musella, Ana Frías, Mabel Visca, Mabel Nogueras, Lucas Costa, Alessandro Perez, Fabio Caradonna, Gabriela F de Larrañaga
OBJECTIVES: This study evaluated the association between environmental factors and genetic variations in enzymes that metabolize antituberculosis (anti-TB) drugs [arylamine N-acetyltransferase 2, cytochrome P450 2E1 (CYP2E1), glutathione S-transferase theta 1 (GSTT1), and glutathione S-transferase mu 1] with antituberculosis drug-induced hepatotoxicity (ATDH). We also investigated the potential gene-gene and gene-environment interactions as well as their association with ATDH development in a population of hospitalized TB patients from Buenos Aires...
August 9, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28799841/high-usability-of-a-smartphone-application-for-reporting-symptoms-in-adults-with-cystic-fibrosis
#17
Jamie Wood, Sue Jenkins, David Putrino, Siobhain Mulrennan, Sue Morey, Nola Cecins, Kylie Hill
Introduction In cystic fibrosis, exacerbations impair lung function and health-related quality of life, increase healthcare costs and reduce survival. Delayed reporting of worsening symptoms can result in more severe exacerbations and worse clinical outcomes; therefore there is a need for a novel approach to facilitate the early identification and treatment of exacerbations in this population. This study investigated the usability of a smartphone application to report symptoms in adults with cystic fibrosis, and the observer agreement in clinical decision-making between senior clinicians interpreting smartphone application responses...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28799705/the-process-of-intrapartum-care-among-skilled-birth-attendants-in-the-dominican-republic-and-maternal-perceptions-of-care-during-labor-and-birth-a-case-report
#18
Peter Schindler, Rosa Burgos, Kimberly Vuong, Hilary Aviela Lerner, Elsa Evangelista, Flor Josefina Rodriguez, Lourdes Peralta Polanco, Jennifer Foster
INTRODUCTION: The World Health Organization calls for situation analyses of maternity settings globally to improve maternal-newborn health. This study evaluated the care processes of skilled birth attendants and women's satisfaction with the care in a public hospital in the Dominican Republic. The purpose of the assessment was to establish a baseline to build quality improvements. METHODS: A cross-sectional, mixed-methods, observational study was conducted by an international team...
August 11, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28799471/pathways-between-combat-stress-and-physical-health-among-portuguese-war-veterans
#19
Paulo Correia Ferrajão
In this study, I explored the experience of both physical and psychological chronic illnesses among a sample of Portuguese war veterans. Twenty suffered from chronic posttraumatic stress disorder (PTSD; unrecovered) and 20 had remission from PTSD (recovered), and all participants suffered from a chronic physician-diagnosed medical disorder. Two semistructured interviews were conducted. Analysis of the interviews was conducted using the Thematic and Categorical Analysis. Unrecovered participants reported higher moral injury, discrepancy between pre- and postwar identity, medication side effects, and lower repertoire of coping strategies, and verbalized that treatment care plan triggers posttraumatic symptoms...
September 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28799307/guiding-principles-for-the-use-of-fluroquinolones-in-out-patient-community-settings-of-india-panel-consensus
#20
Agam Vora, K Krishnaprasad
INTRODUCTION: Respiratory tract infections have been an important cause of morbidity and mortality worldwide that is looming large especially in context of antibiotic resistance that is confronted both by a pulmonologist as well as a general practitioner. A reflection to this trend has been the rising phenomenon of MICs as shown the respiratory pathogens towards conventional antibiotics including macrolides or β lactam/β lactamase inhibitor combinations. Respiratory fluoroquinolones offer broad yet potent cover of respiratory pathogens leading to their obvious choice for empirical therapy for clinical persisters or high risk cases with prior history of antibiotics not-withstanding the clinical concerns in tropical countries...
August 2017: Journal of the Association of Physicians of India
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