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Matthias Oelke, Peter Anderson, Robert Wood, Tove Holm-Larsen
AIMS: The aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real-life practice in European and US-American patients to obtain better insights into the management of nocturia in different Western healthcare systems. METHODS: Data were drawn from the "LUTS Disease Specific Programme," a real-life survey of physicians and patients in France, Germany, Spain, UK and the USA. Physicians completed a patient record form for lower urinary tract symptoms (LUTS) patients...
October 17, 2016: International Journal of Clinical Practice
Choung Ah Lee, Joon Pil Cho, Sang Cheon Choi, Hyuk Hoon Kim, Ju Ok Park
OBJECTIVE: Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. METHODS: We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group...
June 2016: Clin Exp Emerg Med
Julie Latimer, Stephen Ling, Ian Flaherty, Marianne Jauncey, Allison M Salmon
BACKGROUND: Fentanyl is a powerful analgesic, the prescription of which has increased markedly in recent years. The emergence of the drug at the Sydney Medically Supervised Injecting Centre (MSIC) warranted a retrospective clinical audit to assess the risk of fentanyl overdose in comparison with other opioids, in the context of a drug consumption room. METHOD: Heroin, fentanyl or other prescription opioids (PO) injections resulting in overdose were audited (September 1, 2012 and August 31, 2015)...
October 14, 2016: International Journal on Drug Policy
Mohamed M Abd El-Mawgod, Arwa S Alshaibany, Aeshah M Al-Anazi
BACKGROUND: Dysmenorrhea is one of the most common and important health problems, especially among young girls. It results in absence from school and work. It has some negative effects on the daily activities of patients. Because of cultural problems, patients ordinarily do not seek help from others in this situation. Identification of abnormal menstrual patterns during adolescence may permit early prevention of potential health concerns in adulthood. OBJECTIVES: The aim of this study was to determine the prevalence, severity, and impact of dysmenorrhea in secondary-school students and its association with school absenteeism in Arar city...
September 2016: Journal of the Egyptian Public Health Association
Alexander K Leung, Shawn D Whatley, Dechang Gao, Marko Duic
OBJECTIVE: To study the operational impact of process improvements on emergency department (ED) patient flow. The changes did not require any increase in resources or expenditures. METHODS: This was a 36-month pre- and post-intervention study to evaluate the effect of implementing process improvements at a community ED from January 2010 to December 2012. The intervention comprised streamlining triage by having patients accepted into internal waiting areas immediately after triage...
October 17, 2016: CJEM
Peter Kieseberg, Bernd Malle, Peter Frühwirt, Edgar Weippl, Andreas Holzinger
The "doctor in the loop" is a new paradigm in information-driven medicine, picturing the doctor as authority inside a loop supplying an expert system with information on actual patients, treatment results, and possible additional (side-)effects, including general information in order to enhance data-driven medical science, as well as giving back treatment advice to the doctor himself. While this approach can be very beneficial for new medical approaches like P4 medicine (personal, predictive, preventive, and participatory), it also relies heavily on the authenticity of the data and thus increases the need for secure and reliable databases...
March 19, 2016: Brain Informatics
Amanda Bye, Jill Shawe, Judith Stephenson, Debra Bick, Nataliya Brima, Nadia Micali
OBJECTIVE: Being underweight at pregnancy commencement is associated with a range of adverse maternal and infant outcomes, as is being overweight or obese, yet it is an aspect of maternal health which has been relatively neglected by healthcare professionals and researchers. We aimed to investigate differences in pre-pregnancy and pregnancy healthy lifestyle advice routinely offered by relevant healthcare professionals, including midwives and GPs, to women across three different BMI categories - underweight, normal, and overweight or obese...
September 23, 2016: Midwifery
Ronald Ching Wan Ma, Maria Ines Schmidt, Wing Hung Tam, Harold David McIntyre, Patrick M Catalano
The global epidemic of obesity has led to an increasing number of obese women of reproductive age. Obesity is associated with reduced fertility, and pregnancies complicated by maternal obesity are associated with adverse outcomes, including increased risk of gestational diabetes, pre-eclampsia, preterm birth, instrumental and caesarean births, infections, and post-partum haemorrhage. The medical and obstetric management of obese women is focused on identifying, addressing, and preventing some of these associated complications, and is a daunting challenge given the high percentage of patients with obesity and few therapeutic options proven to improve outcomes in this population...
October 10, 2016: Lancet Diabetes & Endocrinology
Samuel A Wells
Most endocrine tumors are benign, and afflicted patients usually seek medical advice because of symptoms caused by too much, or too little, native hormone secretion or the impingement of their tumor on a vital structure. Malignant endocrine tumors represent a more serious problem, and patient cure often depends on early diagnosis and treatment. The recent development of novel molecular therapeutics holds great promise for the treatment of patients with locally advanced or metastatic endocrine cancer. In this CCR Focus, expert clinical investigators describe the molecular characteristics of various endocrine tumors and discuss the current status of diagnosis and treatment...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Severin Pinilla, Leo Nicolai, Maximilian Gradel, Tanja Pander, Martin R Fischer, Philip von der Borch, Konstantinos Dimitriadis
BACKGROUND: Peer mentoring is a powerful pedagogical approach for supporting undergraduate medical students in their learning environment. However, it remains unclear what exactly peer mentoring is and whether and how undergraduate medical students use social media for peer-mentoring activities. OBJECTIVE: We aimed at describing and exploring the Facebook use of undergraduate medical students during their first 2 years at a German medical school. The data should help medical educators to effectively integrate social media in formal mentoring programs for medical students...
October 27, 2015: JMIR Med Educ
M Victoria Salgado, Raúl M Mejía, Celia P Kaplan, Eliseo J Pérez-Stable
BACKGROUND: Physicians in Argentina smoke at rates similar to the general population, and do not have a clear role in tobacco control strategies. OBJECTIVE: To describe the attitudes and knowledge of medical students and recent graduates towards smoking behavior in Argentina. DESIGN: Cross-sectional self-administered online survey conducted in 2011. PARTICIPANTS: Medical students and recent medical graduates from the University of Buenos Aires...
October 11, 2016: Journal of General Internal Medicine
Tomasz Zaleskiewicz, Agata Gasiorowska, Katarzyna Stasiuk, Renata Maksymiuk, Yoram Bar-Tal
The goal of this experimental project was to investigate lay peoples' perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients' expectations (in the case of politicians)...
2016: Frontiers in Psychology
Camille Yip, Nian-Lin Reena Han, Ban Leong Sng
Legal and ethical issues form an important component of modern research, related to the subject and researcher. This article seeks to briefly review the various international guidelines and regulations that exist on issues related to informed consent, confidentiality, providing incentives and various forms of research misconduct. Relevant original publications (The Declaration of Helsinki, Belmont Report, Council for International Organisations of Medical Sciences/World Health Organisation International Guidelines for Biomedical Research Involving Human Subjects, World Association of Medical Editors Recommendations on Publication Ethics Policies, International Committee of Medical Journal Editors, CoSE White Paper, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use-Good Clinical Practice) form the literature that are relevant to the ethical and legal aspects of conducting research that researchers should abide by when conducting translational and clinical research...
September 2016: Indian Journal of Anaesthesia
Grace McCutchan, Fiona Wood, Stephanie Smits, Adrian Edwards, Kate Brain
BACKGROUND: Socioeconomic inequalities in cancer survival can in part be explained by long patient intervals among people from deprived groups; however, the reasons for this are unclear. This qualitative study explores the actual and anticipated barriers to cancer symptom presentation in the context of socioeconomic deprivation. METHODS: Thirty participants were recruited through the International Cancer Benchmarking Partnership Welsh database (n = 20), snowball sampling (n = 8) and community partners (n = 2)...
October 5, 2016: BMC Public Health
Tracy L Schumacher, Tracy L Burrows, Megan E Rollo, Neil J Spratt, Robin Callister, Clare E Collins
Dietary modifications can improve serum lipids and reduce cardiovascular disease (CVD) risk. However, attendance at multiple dietary consultations can be a barrier to achieving behaviour change. This study investigated the effectiveness of a brief dietetic intervention on CVD risk factors in hyperlipidaemic adults. Adults with total cholesterol ≥ 5.0 mmol/L or low density lipoprotein (LDL) cholesterol ≥ 4.0 mmol/L and not currently taking lipid-lowering medication were eligible for a minimum 6-week dietary intervention...
October 11, 2016: Healthcare (Basel, Switzerland)
Gail Ewing, Clarissa Penfold, John Benson, Ravi Mahadeva, Sophie Howson, Julie Burkin, Sara Booth, Roberta Lovick, David Gilligan, Christopher Todd, Morag Farquhar
CONTEXT: Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease which focus on symptoms are scarce and absent for breathlessness. OBJECTIVES: To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness and relevant outcomes for a future randomised controlled trial (RCT) of an educational intervention for carers...
October 7, 2016: Journal of Pain and Symptom Management
Rehana A Salam, Rahat Najam Qureshi, Sana Sheikh, Asif Raza Khowaja, Diane Sawchuck, Marianne Vidler, Peter von Dadelszen, Shujaat Zaidi, Zulfiqar Bhutta
BACKGROUND: An estimated 276 Pakistani women die for every 100,000 live births; with eclampsia accounting for about 10 % of these deaths. Community health workers contribute to the existing health system in Pakistan under the banner of the Lady Health Worker (LHW) Programme and are responsible to provide a comprehensive package of antenatal services. However, there is a need to increase focus on early identification and prompt diagnosis of pre-eclampsia in community settings, since women with mild pre-eclampsia often present without symptoms...
September 30, 2016: Reproductive Health
Debra Betts, Caroline A Smith, Hannah G Dahlen
BACKGROUND: Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a 'watchful waiting' approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage. METHODS: A mixed methods study involving a randomised controlled trial and semi structured interviews...
October 7, 2016: BMC Pregnancy and Childbirth
C S Moore, T J Wood, G Avery, S Balcam, L Needler, H Joshi, J R Saunderson, A W Beavis
The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range...
October 7, 2016: Physics in Medicine and Biology
Valeria Markova, Gro M Sandal
Objective: Refugees are at high risk of experiencing mental health problems due to trauma in their pasts and to acculturation stress as they settle in a new country. To develop efficient health services that meet the needs of refugees from different regions, an understanding is required of how they make sense of and prefer to cope with mental health problems. This study aims to investigate lay explanatory models of depression and preferred coping strategies among Somali refugees in Norway. Methods: The study used a mixed-method design with a vignette describing a moderately depressed person based on ICD-10 criteria...
2016: Frontiers in Psychology
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