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https://www.readbyqxmd.com/read/28530141/decisions-around-long-term-ventilation-for-children-perspectives-of-directors-of-pediatric-home-ventilation-programs
#1
Jeffrey D Edwards, Marilyn C Morris, Judith E Nelson, Howard B Panitch, Rachel L Miller
RATIONALE: The decision of whether to initiate or forgo long-term ventilation for children with life-limiting conditions can be complex and impactful. Providers are responsible for helping families to understand the consequences of their options and guiding them through shared decision-making, but little has been published on how to do this. OBJECTIVES: To assess how directors of pediatric home ventilation programs facilitate shared decision-making with families facing decisions of whether to initiate or forgo long-term ventilation for their children with life-limiting conditions...
May 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28529665/slipped-capital-femoral-epiphysis-a-spectrum-of-surgical-care-and-changes-over-time
#2
R T Loder
PURPOSE: To survey the spectrum of surgical care in children with slipped capital femoral epiphysis (SCFE). This information is valuable in counselling the patient about the future treatment course. METHODS: Data for this study were obtained from the Pediatric Hospital Information System (PHIS) between 2004 and 2015. For all patients with an ICD9 diagnosis of 732.2, gender, ethnicity, hospital, medical record number, date of birth/admission/discharge, type of admission, length of stay, disposition and treatment(s) rendered were collected...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28527934/variability-in-2-year-training-programs-in-vascular-surgery-based-on-results-of-an-association-of-program-directors-in-vascular-surgery-survey
#3
Keith D Calligaro, Danielle M Pineda, Sam Tyagi, Hong Zheng, Douglas A Troutman, Matthew J Dougherty
OBJECTIVE: Although a great deal of attention has recently focused on 5-year integrated (0+5) training programs in vascular surgery, a paucity of data exists concerning variability of daily assignments in 2-year (5+2) vascular fellowships. METHODS: We polled Association of Program Directors in Vascular Surgery members with 2-year vascular fellowships to determine the number of days in a 5-day work week that first- and second-year fellows were assigned to open vascular operations, endovascular procedures (hospital vs nonhospital facility), arterial clinic, venous clinic, noninvasive vascular laboratory (NIVL), and research...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28526538/trastuzumab-emtansine-versus-treatment-of-physician-s-choice-in-patients-with-previously-treated-her2-positive-metastatic-breast-cancer-th3resa-final-overall-survival-results-from-a-randomised-open-label-phase-3-trial
#4
Ian E Krop, Sung-Bae Kim, Antonio Gonzalez Martin, Patricia M LoRusso, Jean-Marc Ferrero, Tanja Badovinac-Crnjevic, Silke Hoersch, Melanie Smitt, Hans Wildiers
BACKGROUND: In the randomised, parallel assignment, open-label, phase 3 TH3RESA study, progression-free survival was significantly longer with trastuzumab emtansine versus treatment of physician's choice in previously treated patients with HER2-positive advanced breast cancer. We report results from the final overall survival analysis of the TH3RESA trial. METHODS: Eligible patients for the TH3RESA trial were men and women (aged ≥18 years) with centrally confirmed HER2-positive advanced breast cancer previously treated with both trastuzumab and lapatinib (advanced setting) and a taxane (any setting) and with progression on two or more HER2-directed regimens in the advanced setting...
May 16, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28525782/the-performativity-of-numbers-in-illness-management-the-case-of-swedish-rheumatology
#5
Anna Essén, Eivor Oborn
While there is a proliferation of numerical data in healthcare, little attention has been paid to the role of numbers in constituting the healthcare reality they are intended to depict. This study explores the performativity of numbers in the microlevel management of rheumatoid disease. We draw on a study of patients' and physicians' use of the numbers in the Swedish Rheumatology Quality Registry, conducted between 2009 and 2014. We show how the numbers performed by constructing the disease across time, and by framing action...
May 10, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28523698/survey-among-critical-care-nurses-and-physicians-about-delirium-management
#6
Peter Nydahl, Michael Dewes, Rolf Dubb, Carsten Hermes, Arnold Kaltwasser, Susanne Krotsetis, Rebecca von Haken
BACKGROUND: Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. AIM: To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. DESIGN: The study used an open online survey with multiple-choice responses...
May 18, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28514230/causes-of-death-of-residents-in-acgme-accredited-programs-2000-through-2014-implications-for-the-learning-environment
#7
Nicholas A Yaghmour, Timothy P Brigham, Thomas Richter, Rebecca S Miller, Ingrid Philibert, DeWitt C Baldwin, Thomas J Nasca
PURPOSE: To systematically study the number of U.S. resident deaths from all causes, including suicide. METHOD: The more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents. The authors aggregated ACGME data on 381,614 residents in training during years 2000 through 2014. Names of residents reported as deceased were submitted to the National Death Index to learn causes of death...
May 9, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28507515/reusable-client-side-javascript-modules-for-immersive-web-based-real-time-collaborative-neuroimage-visualization
#8
Jorge L Bernal-Rusiel, Nicolas Rannou, Randy L Gollub, Steve Pieper, Shawn Murphy, Richard Robertson, Patricia E Grant, Rudolph Pienaar
In this paper we present a web-based software solution to the problem of implementing real-time collaborative neuroimage visualization. In both clinical and research settings, simple and powerful access to imaging technologies across multiple devices is becoming increasingly useful. Prior technical solutions have used a server-side rendering and push-to-client model wherein only the server has the full image dataset. We propose a rich client solution in which each client has all the data and uses the Google Drive Realtime API for state synchronization...
2017: Frontiers in Neuroinformatics
https://www.readbyqxmd.com/read/28506134/efficacy-and-safety-of-etanercept-in-psoriasis-and-psoriatic-arthritis-in-the-presta-study-analysis-in-patients-from-central-and-eastern-europe
#9
Nemanja Damjanov, Sarolta Karpati, Lajos Kemeny, Noemi Bakos, Branislav Bobic, Maria Majdan, Witold Tlustochowicz, Petr Vitek, Eva Dokoupilova, Emre Aldinc, Annette Szumski
BACKGROUND: Data are limited on the effectiveness of anti-TNF and other biologics on psoriatric arthritis (PsA) in Central and Eastern Europe (CEE). The objective of this analysis was to evaluate the efficacy of etanercept (ETN) in PsA patients from CEE. METHODS: In PRESTA, patients were randomised to receive ETN 50 mg BIW or 50 mg QW for 12 weeks (double-blind phase), and ETN 50 mg QW for 12 additional weeks (open-label). In this analysis only patients from Czech Republic, Hungary, Poland, and Serbia were included...
May 16, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28504894/preventing-burdensome-transitions-of-nursing-home-residents-with-advanced-dementia-it-s-more-than-advance-directives
#10
Ruth Palan Lopez, Susan L Mitchell, Jane L Givens
BACKGROUND: Although a palliative approach to care is recommended for people with advanced dementia, many nursing home (NH) residents with dementia experience burdensome interventions such as hospital transfers at the end of life. OBJECTIVE: The goal of this study was to examine how decisions to transfer NH residents with advanced dementia are made, from the perspective of NH nurses and physicians. METHODS: A qualitative, descriptive method was used...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28502545/durability-of-iliac-artery-preservation-associated-with-endovascular-repair-of-infrarenal-aortoiliac-aneurysms
#11
Behzad S Farivar, Mohammad N Abbasi, Agenor P Dias, Yuki Kuramochi, Corey S Brier, F Ezequiel Parodi, Matthew J Eagleton
OBJECTIVE: This study evaluated and compared the long-term clinical outcomes of endovascular repair of infrarenal aortoiliac aneurysms (EVAR) vs EVAR with preservation of antegrade internal iliac artery (IIA) perfusion using iliac branched devices (EVAR-IBDs). METHODS: From October 1998 to August 2015, patients with infrarenal aortoiliac aneurysmal (AIA) disease at high risk for conventional open surgery were enrolled in a prospective physician-sponsored investigational device exemption trial...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502311/tracheotomy-related-deaths
#12
Eckart Klemm, Andreas Karl Nowak
BACKGROUND: Tracheotomies are frequently performed on ventilated patients in intensive care and sometimes lead to fatal complications. In this article, we discuss the causes and frequency of death associated with open surgical tracheotomy (OST) and percutaneous dilatational tracheotomy (PDT) on the basis of a review of the pertinent literature. METHODS: We systematically searched the PubMed, EMBASE, and Cochrane Library databases and the Karlsruhe Virtual Catalog for publications (1990-2015) on tracheotomy-related deaths in adults, using the search terms "tracheotomy" and "tracheostomy...
April 21, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28498292/the-effects-of-conflicts-of-interest-on-practice-patterns-and-complication-rates-in-spine-surgery
#13
Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Danielle S Chun, Kathryn A Barth, Sameer K Singh, Wellington K Hsu
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: We sought to determine whether financial relationships with industry had any impact on operative and/or complication rates of spine surgeons performing fusion surgeries. SUMMARY OF BACKGROUND DATA: Recent actions from Congress and the Institute of Medicine have highlighted the importance of conflicts of interest among physicians. Orthopaedic surgeons and neurosurgeons have been identified as receiving the highest amount of industry payments among all specialties...
May 11, 2017: Spine
https://www.readbyqxmd.com/read/28498034/assessment-of-resident-physicians-communicator-and-collaborator-competencies-by-interprofessional-clinicians-a-mixed-methods-study
#14
Lyn K Sonnenberg, Lesley Pritchard-Wiart, Carol S Hodgson, YongQiang Yu, Sharla King
Phenomenon: As we move toward competency-based medical education, greater emphasis is being placed on assessing a more comprehensive skill set, including the ability to communicate and collaborate effectively in the workplace. Nonphysician members on interprofessional (IP) teams have valuable perspectives on actual resident performance and are often not adequately engaged in the provision of feedback to residents. Based on the educational theories of collaborative evaluation and social constructivism, this research examined the ability of IP clinicians to provide feedback to residents...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28490204/exploring-participatory-behaviour-of-disability-benefit-claimants-from-an-insurance-physician-s-perspective
#15
Christiaan Sjobbema, Sijrike van der Mei, Bert Cornelius, Jac van der Klink, Sandra Brouwer
PURPOSE: In the Dutch social security system, insurance physicians (IPs) assess participatory behaviour as part of the overall disability claim assessment. This study aims to explore the views and opinions of IPs regarding participatory behaviour as well as factors related to inadequate participatory behaviour, and to incorporate these factors in the International Classification of Functioning, Disability and Health (ICF) biopsychosocial framework. METHOD: This qualitative study collected data by means of open-ended questions in 10 meetings of local peer review groups (PRGs) which included a total of 78 IPs of the Dutch Social Security Institute...
May 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28485838/involvement-and-comfort-of-gynecologic-oncologists-in-the-treatment-of-pediatric-adolescent-and-young-adult-patients-with-gynecologic-malignancies
#16
Ira Winer, Divya Patel, Vanessa Dalton, Carolyn Johnston, Elisabeth H Quint, Melissa Zochowski, Adnan Munkarah, Robert Morris, Hope Haefner
OBJECTIVE: To investigate the provision of care for pediatric and adolescent patients by gynecologic oncologists. METHODS: The present prospective cross-sectional study enrolled attending physicians and fellows specializing in gynecologic oncology from the USA during December 2012 and January 2013. A 33-question survey collecting demographic data and details of participant opinions on existing practices was distributed to potential respondents. Survey responses were aggregated and descriptive analyses were performed...
May 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28479409/-i-just-felt-like-i-was-stuck-in-the-middle-physician-assistants-experiences-communicating-with-terminally-ill-patients-and-their-families-in-the-acute-care-setting
#17
Elizabeth Chuang, Richard Lamkin, Aluko A Hope, Gina Kim, Jean Burg, Michelle Ng Gong
CONTEXT: Terminally ill hospitalized patients and their families consistently rank effective communication and shared decision-making among their top priorities. Advance Practice Providers such as Physician Assistants (PAs) are increasingly providing care in the hospital setting and are often called to communicate with patients and families. A first step to improving PA communication is to better understand PAs' current experiences in their daily practices. OBJECTIVES: This study aimed to explore: 1) roles PAs serve in communicating with terminally ill patients/families; 2) PAs' attitudes and opinions about communication roles and 3) perceived barriers and facilitators of communication with patients/families in the hospital setting...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28471816/organ-support-after-death-by-neurologic-criteria-in-pediatric-patients
#18
Ariane Lewis, Nellie Adams, Arun Chopra, Matthew P Kirschen
OBJECTIVES: We sought to 1) evaluate how pediatricians approach situations in which families request continuation of organ support after declaration of death by neurologic criteria and 2) explore potential interventions to make these situations less challenging. DESIGN: A survey on management and personal experience with death by neurologic criteria was distributed electronically to pediatric intensivists and neurologists. We compared responses from individuals who practice in states with accommodation exceptions (accommodation states where religious or moral beliefs must be taken into consideration when declaring death: California, Illinois, New Jersey, New York) to those from non-accommodation states...
April 29, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28464430/patient-and-physician-views-of-shared-decision-making-in-cancer
#19
Nina P Tamirisa, James S Goodwin, Arti Kandalam, Suzanne K Linder, Susan Weller, Stella Turrubiate, Colleen Silva, Taylor S Riall
CONTEXT: Engaging patients in shared decision making involves patient knowledge of treatment options and physician elicitation of patient preferences. OBJECTIVE: Our aim was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. DESIGN: Patients and physicians were asked open-ended questions regarding their perceptions of shared decision making throughout their cancer care. Transcripts of interviews were coded and analysed for shared decision-making themes...
May 2, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28464140/types-and-distribution-of-payments-from-industry-to-physicians-in-2015
#20
Kathryn R Tringale, Deborah Marshall, Tim K Mackey, Michael Connor, James D Murphy, Jona A Hattangadi-Gluth
Importance: Given scrutiny over financial conflicts of interest in health care, it is important to understand the types and distribution of industry-related payments to physicians. Objective: To determine the types and distribution of industry-related payments to physicians in 2015 and the association of physician specialty and sex with receipt of payments from industry. Design, Setting, and Participants: Observational, retrospective, population-based study of licensed US physicians (per National Plan & Provider Enumeration System) linked to 2015 Open Payments reports of industry payments...
May 2, 2017: JAMA: the Journal of the American Medical Association
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