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https://www.readbyqxmd.com/read/28719395/closing-the-gap-in-cochlear-implant-access-for-african-americans-a-story-of-outreach-and-collaboration-by-our-cochlear-implant-program
#1
Sheree Sims, Lisa Houston, Ivy Schweinzger, Ravi N Samy
PURPOSE OF REVIEW: Minorities often lag behind in hearing loss evaluation and treatment. Our cochlear implant program aimed to identify the socioeconomic and cultural barriers that prevented our African-American cochlear implant candidates from seeking help for their hearing loss, specifically cochlear implant surgery. RECENT FINDINGS: Our pilot study surveyed 11 African-Americans with cochlear implants and identified obstacles that included patient-physician mistrust, social stigma, financial cost, and lack of education about the devices and procedures...
July 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28719236/applying-an-artificial-neural-network-model-for-developing-a-severity-score-for-patients-with-hereditary-amyloid-polyneuropathy
#2
Shenia Novis, Felipe Machado, Victor B Costa, Debora Foguel, Marcia W Cruz, José Manoel de Seixas
Hereditary (familial) amyloid polyneuropathy (FAP) is a systemic disease that includes a sensorimotor polyneuropathy related to transthyretin (TTR) mutations. So far, a scale designed to classify the severity of this disease has not yet been validated. This work proposes the implementation of an artificial neural network (ANN) in order to develop a severity scale for monitoring the disease progression in FAP patients. In order to achieve this goal, relevant symptoms and laboratory findings were collected from 98 Brazilian patients included in THAOS - the Transthyretin Amyloidosis Outcomes Survey...
July 18, 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/28718797/socioeconomic-differences-in-and-predictors-of-home-based-palliative-care-health-service-use-in-ontario-canada
#3
Jiaoli Cai, Denise N Guerriere, Hongzhong Zhao, Peter C Coyte
The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed...
July 18, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28718335/variability-of-performance-status-assessment-between-patients-with-hematologic-malignancies-and-their-physicians
#4
Alexis D Leal, Cristine Allmer, Matthew J Maurer, Tait D Shanafelt, James R Cerhan, Brian K Link, Carrie A Thompson
This study was conducted to determine the incidence of inter-observer variability in Eastern Cooperative Oncology Group (ECOG) performance status (PS) rating between patients with leukemia and lymphoma and their physicians. ECOG PS was assessed at diagnosis by patients and their physicians and stratified by disease subtype, gender, age, disease stage and education. Association between patient- and physician-rated PS and overall survival (OS) was stratified by subtype and prognostic risk score. Overall, 65% of patients and physicians rated PS the same...
July 18, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28718296/real-life-management-of-venous-thromboembolism-with-rivaroxaban-results-from-experience-vte-an-italian-epidemiological-survey
#5
Davide Imberti, Giovanni Barillari
Two large randomized controlled trials examined the efficacy and safety of rivaroxaban for the treatment of venous thromboembolism (VTE). The aim of this epidemiological study was to analyze a cohort of Italian patients affected by VTE who were treated with rivaroxaban in clinical practice. The data were collected by physicians using an online electronic questionnaire. The study was performed during a 6-month period from January to June 2014. We analyzed the clinical characteristics, risk factors for VTE, comorbidities, diagnostic techniques, and treatments in the whole population and in the subgroups with deep vein thrombosis (DVT) only, pulmonary embolism (PE) only, and DVT+PE...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28717929/reduction-in-targeted-potentially-inappropriate-medication-use-in-elderly-inpatients-a-pragmatic-randomized-controlled-trial
#6
Benoit Cossette, Jean-François Éthier, Thomas Joly-Mischlich, Josée Bergeron, Geneviève Ricard, Serge Brazeau, Mathieu Caron, Olivier Germain, Hélène Payette, Janusz Kaczorowski, Mitchell Levine
PURPOSE: The use of potentially inappropriate medications (PIMs) in hospitalized older adults is a complex problem, but the use of computerized alert systems (CAS) has shown some potential. The study's objective is to assess the change in PIM use with a CAS-based pharmacist-physician intervention model compared to usual clinical care. METHODS: Pragmatic single-site randomized controlled trial was conducted at a university teaching hospital. Hospitalizations identified with selected Beers or STOPP criteria were randomized to usual clinical care or to the CAS-based pharmacist-physician intervention...
July 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28717767/breaking-bad-news-in-ethnic-settings-perspectives-of-patients-and-families-in-northern-sri-lanka
#7
Chrishanthi Rajasooriyar, Jenny Kelly, Thanikai Sivakumar, Gowcikan Navanesan, Shahini Nadarasa, Madona Hashanthy Sriskandarajah, Sabe Sabesan
PURPOSE: The discussion of a cancer diagnosis and prognosis often is difficult. This study explored the expectations of Tamil-speaking patients with cancer and their families with respect to receiving their cancer diagnosis in northern Sri Lanka. METHODS: This exploratory, descriptive, qualitative study used semistructured interviews. RESULTS: Thematic analysis identified two major themes: communication and information seeking. The findings illustrate a discrepancy between patient preference for direct disclosure of the diagnosis and that of families...
June 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28717725/minding-the-gaps-in-cancer-pain-management-education-a-multicenter-study-of-clinical-residents-and-fellows-in-a-low-versus-high-resource-setting
#8
Charles Amoatey Odonkor, Ernest Osei-Bonsu, Oswald Tetteh, Andy Haig, Robert Samuel Mayer, Thomas J Smith
PURPOSE: Inadequate pain management training has been reported as a major cause of undertreatment of cancer pain. Yet, past research has not comprehensively compared the quality of cancer pain management education among physicians in training in high-resource countries (HRCs) with those in low-resource countries (LRCs). The purpose of this study was to examine and compare gaps in cancer pain management education among physician trainees in an HRC (United States) versus an LRC (Ghana)...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28717331/knowledge-and-awareness-of-first-aid-of-avulsed-tooth-among-physicians-and-nurses-of-hospital-emergency-department
#9
Sudeep Sreepad Iyer, Antarmayee Panigrahi, Shalini Sharma
INTRODUCTION: Physicians and nurses of emergency department are often the first line of qualified health-care providers attending the patient in person or parent's query over phone reporting immediately following the dental avulsion. Prompt action by them becomes the decisive factor in survival and prognosis of the tooth. Although a few researchers have evaluated knowledge of emergency room physicians, there is scanty of reports concerning nurses who play a climacteric role. MATERIALS AND METHODS: A 10-item questionnaire regarding clinical situation apropos dental injury and tooth avulsion, inquiring knowledge of physicians and nurses was administered to 150 each of nursing professionals and physicians of the emergency department...
April 2017: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28717037/impact-of-a-carbapenem-antimicrobial-stewardship-program-on-patient-outcomes
#10
Valerie Xue Fen Seah, Rina Yue Ling Ong, Ashley Shi Yuan Lim, Chia Yin Chong, Natalie Woon Hui Tan, Koh Cheng Thoon
Antimicrobial stewardship programs (ASPs) aim to improve appropriate antimicrobials use. However, concerns of the negative consequences from accepting ASP interventions exist, particularly when de-escalation or discontinuation of broad-spectrum antibiotics are recommended. Hence, we sought to evaluate the impact on clinical outcomes when ASP interventions for inappropriate carbapenem use were accepted or rejected by primary providers.We retrospectively reviewed all carbapenem prescriptions deemed inappropriate according to institutional guidelines with ASP interventions between July 2011 and December 2014...
July 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28716992/blood-pressure-trajectories-and-the-risk-of-intracerebral-hemorrhage-and-cerebral-infarction-a-prospective-study
#11
Weijuan Li, Cheng Jin, Anand Vaidya, Yuntao Wu, Kathryn Rexrode, Xiaoming Zheng, Mahmut E Gurol, Chaoran Ma, Shouling Wu, Xiang Gao
The association between long-term blood pressure (BP) patterns in community-dwelling adults and risk of intracerebral hemorrhage and cerebral infarction is not well characterized. This prospective study included 79 385 participants, free of stroke, myocardial infarction, and cancer in or before 2010 (baseline). Systolic BP trajectories were identified using latent mixture modeling with data from 2006, 2008, and 2010. Incident cases of intracerebral hemorrhage and cerebral infarction occurred during 2010 to 2014, confirmed by review of medical records, by 3 physicians...
July 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28716704/-psychosocial-working-conditions-of-physician-assistants-results-from-a-qualitative-study-on-occupational-stress-resources-possible-approaches-to-prevention-and-intervention-needs
#12
Patricia Vu-Eickmann, Adrian Loerbroks
BACKGROUND: Numerous studies have documented adverse psychosocial working conditions among health care staff. Working conditions may not only impair the health outcomes of this professional group, but can also affect the quality of care they deliver to patients. Previous work stress research has mainly focused on physicians and nurses. Comparable evidence remains limited, however, for physician assistants (Medizinische Fachangestellte, MFAs), who represent the largest professional group in German primary care...
July 14, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#13
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28714833/patients-expectations-and-solutions-for-improving-primary-diabetes-care
#14
Brigitte Vachon, Ai-Thuy Huynh, Mylaine Breton, Louise Quesnel, Michel Camirand, Jeannette Leblanc, Sylvie Tardif
Purpose The purpose of this paper is to document health care needs expressed by people living with diabetes, describe the solutions they envisaged for improving the quality of primary care (PC) services and empower them to make better use of PC services. Design/methodology/approach A participatory research approach was used. Six workshops were organised to provide diabetes patients with knowledge on available services and to engage them in sharing their experience. Group discussions were recorded. Data were analysed using the thematic analysis method...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28714497/admitting-deserving-medical-students-from-rural-and-disadvantaged-patan-academy-of-health-sciences-approach
#15
S K Upadhyay, S Bhandary, D B Bhandari, R K Dulal, K P Baral, R N Gongal, P K Acharya, S Shrestha, J N Shah, A Karki
BACKGROUND: Patan Academy of Health Sciences (PAHS) aims to produce physicians who would be able and willing to serve in the rural areas. Recognizing the critical importance of student selection strategy, among others, in achieving the program goals, it has adopted an innovative scheme for selecting medical students. This paper describes PAHS medical student selection scheme that favors enrollment of deserving applicants from rural and disadvantaged groups so as to help improve distribution of physicians in rural Nepal...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28714343/a-randomized-controlled-trial-of-a-combined-self-management-and-exercise-intervention-for-elderly-people-with-osteoarthritis-of-the-knee-the-ple-2-no-program
#16
Priscila Marconcin, Margarida Espanha, Júlia Teles, Paulo Bento, Pedro Campos, Rui André, Flávia Yázigi
OBJECTIVE: To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE(2)NO program) in elderly individuals with knee osteoarthritis. DESIGN: Randomized controlled trial. SETTING: Four different community settings. SUBJECTS: Eighty individuals aged 60 years or older with clinical and radiographic knee osteoarthritis enrolled in the study. INTERVENTION: A combined self-management and exercise intervention (treatment group) and an educational intervention (control group)...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28714314/management-of-myocardial-infarction-in-the-elderly-insights-from-spanish-minimum-basic-data-set
#17
Albert Ariza-Solé, Oriol Alegre, Francisco J Elola, Cristina Fernández, Francesc Formiga, Manuel Martínez-Sellés, José L Bernal, José V Segura, Andrés Iñíguez, Vicente Bertomeu, Joel Salazar-Mendiguchía, José C Sánchez Salado, Victòria Lorente, Angel Cequier
BACKGROUND: We aimed to assess the impact of implementation of reperfusion networks, the type of hospital and specialty of the treating physician on the management and outcomes of ST segment elevation myocardial infarction in patients aged ⩾75 years. METHODS: We analysed data from the Minimum Basic Data Set of the Spanish public health system, assessing hospital discharges between 2004 and 2013. Discharges were distributed in three groups depending on the clinical management: percutaneous coronary intervention, thrombolysis or no reperfusion...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28714287/bacteremia-prediction-model-for-community-acquired-pneumonia-external-validation-in-a-multicenter-retrospective-cohort
#18
Byunghyun Kim, Jungho Choi, Kyuseok Kim, Sujin Jang, Tae Gun Shin, Won Young Kim, Jung-Youn Kim, Yoo Seok Park, Soo Hyun Kim, Hui Jai Lee, Jonghwan Shin, JeSung You, Kyung Su Kim, Sung Phil Chung
OBJECTIVE: Many studies have described constructing a prediction model for bacteremia in community-acquired pneumonia (CAP), but these studies were not validated in external heterogeneous groups. The objective of this study was to test the generalizability of a previous bacteremia prediction model for CAP by external validation. METHODS: This multicenter retrospective cohort analysis was performed in eight tertiary urban hospital emergency departments (ED). We reviewed adult patients who were hospitalized after presentation to the ED with CAP...
July 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28714180/tofacitinib-for-the-treatment-of-moderate-to-severe-chronic-plaque-psoriasis-in-japanese-patients-subgroup-analyses-from-a-randomized-placebo-controlled-phase-3-trial
#19
Masatoshi Abe, Chikako Nishigori, Hideshi Torii, Hironobu Ihn, Kei Ito, Makoto Nagaoka, Naoki Isogawa, Isao Kawaguchi, Yukiko Tomochika, Mihoko Kobayashi, Anna M Tallman, Kim A Papp
Tofacitinib is an oral Janus kinase inhibitor. These post-hoc analyses assessed tofacitinib efficacy and safety in Japanese patients with psoriasis enrolled in a 52-week global phase 3 study. Patients received tofacitinib 5 mg, tofacitinib 10 mg or placebo twice daily (b.i.d.); placebo-treated patients advanced to tofacitinib at week 16. Primary efficacy end-points were the proportions of patients with 75% or more reduction from baseline Psoriasis Area and Severity Index (PASI-75) and Physician's Global Assessment (PGA) of "clear" or "almost clear" (PGA response) at week 16...
July 17, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28713663/correlation-between-glycated-hemoglobin-and-triglyceride-level-in-type-2-diabetes-mellitus
#20
Syeda Naqvi, Shabnam Naveed, Zeeshan Ali, Syed Masroor Ahmad, Raad Asadullah Khan, Honey Raj, Shoaib Shariff, Chintan Rupareliya, Fatima Zahra, Saba Khan
CONTEXT: Dyslipidemia is quite prevalent in non-insulin dependent diabetes mellitus. Maintaining tight glycemic along with lipid control plays an essential role in preventing micro- and macro-vascular complications associated with diabetes. PURPOSE: The main purpose of the study was to highlight the relationship between glycosylated hemoglobin (HbA1c) and triglyceride levels. This may in turn help in predicting the triglyceride status of type 2 diabetics and therefore identifying patients at increased risk from cardiovascular events...
June 13, 2017: Curēus
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