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https://www.readbyqxmd.com/read/28806026/physician-perceptions-of-barriers-to-advance-care-planning
#1
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/28802910/inter-rater-reliability-of-physical-abuse-determinations-in-young-children-with-fractures
#2
Katherine E Buesser, John M Leventhal, Julie R Gaither, Victoria Tate, Daniel R Cooperman, Rebecca L Moles, Cicero T Silva, Lauren J Ehrlich, Melinda S Sharkey
As there is no "gold standard" in determining whether a fracture is caused by accident or abuse, agreement among medical providers is paramount. Using abstracted medical record data from 551 children <36months of age presenting to a pediatric emergency department, we examined the extent of agreement between specialists who evaluate children with fractures for suspected abuse. To simulate clinical scenarios, two pediatric orthopaedists and two child abuse pediatricians (CAPs) reviewed the full abstraction and imaging, whereas the two pediatric radiologists reviewed a brief history and imaging...
August 10, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28802364/the-reliability-of-flexible-nasolaryngoscopy-in-the-identification-of-vocal-fold-movement-impairment-in-young-infants
#3
Yi-Chun Carol Liu, Tyler McElwee, Mary Musso, Tara L Rosenberg, Julina Ongkasuwan
OBJECTIVE: Flexible nasolaryngoscopy (FNL) is considered the gold standard for evaluation of vocal fold mobility but there has been no data on the reliability of interpretation in the infant population. Visualization may be limited by excessive movement, secretions, or floppy supraglottic structures that prevent accurate diagnosis of vocal fold movement impairment (VFMI). We sought to evaluate the inter- and intra-rater reliability of FNL for the evaluation of VFMI in young infants. STUDY TYPE: Case-control...
September 2017: International Journal of Pediatric Otorhinolaryngology
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
#4
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/28800832/knowledge-of-appropriate-outpatient-pediatric-echocardiogram-ordering-in-primary-care-physicians-and-trainees
#5
Sean M Lang, Joshua A Daily, Micheal R FitzGerald, Xinyu Tang, Thomas H Best, James M Robbins, R Thomas Collins
Appropriate Use Criteria (AUC) for the initial use of outpatient pediatric echocardiography were established to aid all clinicians in the evaluation of children with possible heart disease, and limit low diagnostic yield studies. We sought to (1) assess PCPs' and trainees' awareness of the AUC document; (2) compare their knowledge of appropriate echocardiogram ordering with that of pediatric cardiologists; and (3) identify additional medical and nonmedical factors affecting PCP echocardiogram ordering. An online survey with clinical scenarios derived from the AUC guidelines was distributed to PCPs and trainees in Arkansas, and pediatric cardiologists from Arkansas Children's Hospital and Cincinnati Children's Hospital Medical Center...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28799841/high-usability-of-a-smartphone-application-for-reporting-symptoms-in-adults-with-cystic-fibrosis
#6
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/28794868/feasibility-and-safety-of-surgical-wound-remote-follow-up-by-smart-phone-in-appendectomy-a-pilot-study
#7
Juan José Segura-Sampedro, Inés Rivero-Belenchón, Verónica Pino-Díaz, María Cristina Rodríguez Sánchez, Felipe Pareja-Ciuró, Javier Padillo-Ruiz, Rosa María Jimenez-Rodriguez
INTRODUCTION: The objective of the present study is to assess the safety and feasibility of the use of telemedicine-based services for surgical wound care and to measure patient satisfaction with telemedicine-based follow-up. MATERIAL AND METHODS: 24 patients were included, they were provided with a corporate mail address. On day 7 after surgery patients sent, via email, an image of their surgical wound together with a completed questionnaire in order to obtain an early diagnosis...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28780729/the-impact-of-myeloproliferative-neoplasms-mpns-on-patient-quality-of-life-and-productivity-results-from-the-international-mpn-landmark-survey
#8
Claire N Harrison, Steffen Koschmieder, Lynda Foltz, Paola Guglielmelli, Tina Flindt, Michael Koehler, Jonathan Mathias, Norio Komatsu, Robert N Boothroyd, Amber Spierer, Julian Perez Ronco, Gavin Taylor-Stokes, John Waller, Ruben A Mesa
Myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia (ET) are myeloproliferative neoplasms (MPNs) associated with high disease burden, reduced quality of life (QOL), and shortened survival. To assess how MPNs affect patients, we conducted a global MPN Landmark survey. This online survey of patients with MPNs and physicians was conducted in Australia, Canada, Germany, Japan, Italy, and the United Kingdom. The survey measured MPN-related symptoms and the impact of MPNs on QOL and the ability to work as well as disease-management strategies...
August 5, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28775193/the-american-orthopaedic-foot-and-ankle-society-ankle-hindfoot-scale-translation-and-validation-of-the-dutch-language-version-for-ankle-fractures
#9
A Siebe de Boer, Roderik J C Tjioe, Fleur Van der Sijde, Duncan E Meuffels, Pieter T den Hoed, Cornelis H Van der Vlies, Wim E Tuinebreijer, Michael H J Verhofstad, Esther M M Van Lieshout
OBJECTIVES: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale is among the most commonly used instruments for measuring outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It consists of a patient-reported and a physician-reported part. A validated, Dutch version of this instrument is currently not available. The aim of this study was to translate the instrument into Dutch and to determine the measurement properties of the AOFAS Ankle-Hindfoot Scale Dutch language version (DLV) in patients with a unilateral ankle fracture...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28766306/interpretation-of-brain-ct-scans-in-the-field-by-critical-care-physicians-in-a-mobile-stroke-unit
#10
Maren Ranhoff Hov, Erik Zakariassen, Thomas Lindner, Terje Nome, Kristi G Bache, Jo Røislien, Jostein Gleditsch, Volker Solyga, David Russell, Christian G Lund
BACKGROUND AND PURPOSE: In acute stroke, thromboembolism or spontaneous hemorrhage abruptly reduces blood flow to a part of the brain. To limit necrosis, rapid radiological identification of the pathological mechanism must be conducted to allow the initiation of targeted treatment. The aim of the Norwegian Acute Stroke Prehospital Project is to determine if anesthesiologists, trained in prehospital critical care, may accurately assess cerebral computed tomography (CT) scans in a mobile stroke unit (MSU)...
July 27, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28764924/partial-breast-irradiation-with-interstitial-multi-catheter-high-dose-rate-brachytherapy-long-term-results-of-a-phase-ii-prospective-study
#11
Cynthia Aristei, Ernesto Maranzano, Valentina Lancellotta, Luigia Chirico, Claudio Zucchetti, Marco Italiani, Paola Anselmo, Cristina Mariucci, Elisabetta Perrucci, Fabio Arcidiacono, Fabio Trippa, György Kovacs, Vittorio Bini, Isabella Palumbo
PURPOSE: We report the long-term results of phase II prospective study with accelerated partial breast irradiation (APBI) using interstitial multi-catheter high-dose-rate brachytherapy. METHODS: 240 patients received APBI (4Gy, twice daily; total dose 32Gy). RESULTS: Median follow-up was 96months. Recurrences in the treated breast developed in 8 patients (3.3%) at a median of 73months after APBI. The 5- and 10-year cumulative incidences were respectively, 1...
July 29, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28760793/pim-check-development-of-an-international-prescription-screening-checklist-designed-by-a-delphi-method-for-internal-medicine-patients
#12
Aude Desnoyer, Anne-Laure Blanc, Valérie Pourcher, Marie Besson, Caroline Fonzo-Christe, Jules Desmeules, Arnaud Perrier, Pascal Bonnabry, Caroline Samer, Bertrand Guignard
OBJECTIVES: Potentially inappropriate medication (PIM) occurs frequently and is a well-known risk factor for adverse drug events, but its incidence is underestimated in internal medicine. The objective of this study was to develop an electronic prescription-screening checklist to assist residents and young healthcare professionals in PIM detection. DESIGN: Five-step study involving selection of medical domains, literature review and 17 semistructured interviews, a two-round Delphi survey, a forward/back-translation process and an electronic tool development...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28759272/determination-of-asthma-control-using-administrative-data-regarding-short-acting-beta-agonist-inhaler-purchase
#13
Dekel Shlomi, Irit Katz, Michael J Segel, Bernice Oberman, Nir Peled
BACKGROUND: Symptom control is a primary goal in asthma. We hypothesized that administrative data regarding rescue inhaler purchases may correlate with asthma symptom control. METHODS: We identified all patients who purchased SABA inhalers during the course of one year in the database of an Health Maintenance Organization (HMO). Primary physicians identified asthma patients and classified their asthma symptom control into 3 groups according to GINA guidelines. Asthma patients were asked to answer symptom questionnaires and grade their asthma control...
July 31, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28758230/eyeballing-the-use-of-visual-appearance-to-diagnose-sick
#14
Matthew Sibbald, Jonathan Sherbino, Ian Preyra, Tara Coffin-Simpson, Geoff Norman, Sandra Monteiro
CONTEXT: Prior studies suggest that clinicians can categorise patients in an emergency room as 'sick' or 'not sick' using rapid visual assessment. The rapid nature of these decisions suggests clinicians are relying on pattern recognition or System 1 processing; however, this has not been studied experimentally. In this study, we explore the accuracy of these decisions using patient disposition (discharge, admission to ward or admission to critical care) as an objective outcome, and collect evidence to argue for the use of System 1 processing in the 'sick' or 'not sick' decision process...
July 31, 2017: Medical Education
https://www.readbyqxmd.com/read/28756080/-how-to-prescribe-sport-in-patients
#15
François Carré
Physical activity is a non-pharmacological treatment validated by the Haute Autorité de santé since 2011. Since March 2017, a new French law recalls that generalist physicians can prescribe physical activity to their patients suffering from a long-term financial exonerating condition. This physical activity will be adapted to the individual physical capacities and medical risk of the patient. After assessing his/her functional abilities, the attending physician will send the patient, with his or her agreement, to a supervisory structure employing specifically trained professional for physical activity...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28755763/reliability-of-triage-nurses-and-emergency-physicians-for-the-interpretation-of-the-c-3po-rule-for-head-trauma-in-children
#16
Jocelyn Gravel, Serge Gouin, Annie Canuel, Benoît Mâsse
INTRODUCTION: The C-3PO rule has been validated for use by emergency physicians to identify young children at risk of skull fracture following head trauma. The use of the rule by triage nurses could improve patient flow in the emergency department. OBJECTIVES: To evaluate the interobserver agreement of triage nurses and emergency physicians in the interpretation of the C-3PO rule in a pediatric emergency department. METHODS: This was a prospective observational study performed in a consecutive sample of children visiting a single emergency department...
July 26, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28753181/real-life-anti-tumour-necrosis-factor-experience-in-500-paediatric-united-kingdom-inflammatory-bowel-disease-patients
#17
Victoria M Merrick, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus Kh Auth, Mamoun Elawad, John Me Fell, R Mark Beattie, Sabarinathan Loganathan, Franco Torrente, Mary-Anne Morris, Charles Charlton, Nick M Croft, Astor Rodrigues, Mark Furman, Babu Vadamalayan, Huw Jenkins, Veena Zamvar, Sally G Mitton, Sonny Chong, Mike Cosgrove, Anthony Akobeng, David C Wilson, Richard K Russell
OBJECTIVES: To measure the effectiveness, safety and use of anti-Tumour necrosis Factor (TNF) therapy in paediatric inflammatory bowel disease (PIBD) in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment (PGA) +/or the Paediatric Crohn's Disease Activity Index (PCDAI). RESULTS: 37 centres participated (23 of 25 specialist PIBD sites)...
July 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28753052/physicians-and-pharmacists-information-provision-and-patients-psychological-distress
#18
Hiroko Takaki, Takeru Abe, Akihito Hagihara
Providing information related to medication has many benefits for patients. However, patients' conflicting perceptions about medical information provided by physicians and pharmacists may be associated with their psychological distress regarding treatment and medication. This study investigated associations between patients' perceptions of agreement between physicians and pharmacists about medical information and improvements in their psychological distress. It also clarified the specific relationships of their perceptions with psychological distress...
July 28, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28750015/accuracy-of-self-collected-vaginal-dry-swabs-using-the-xpert-human-papillomavirus-assay
#19
Rosa Catarino, Pierre Vassilakos, Aline Bilancioni, Stéphanie Bougel, Meriem Boukrid, Ulrike Meyer-Hamme, Patrick Petignat
BACKGROUND: Polymerase chain reaction-based Xpert human papillomavirus (HPV) assay is a rapid test that detects high-risk HPV (hrHPV) infection. This point-of-care test is usually performed by collecting a cervical specimen in a vial of PreservCyt® transport medium. We compared HPV test positivity and accuracy between self-collected sample with a dry swab (s-DRY) versus physician-collected cervical sampling using a broom like brush and immediate immersion in PreservCyt (dr-WET). METHODS: In this cross-sectional study, we recruited 150 women ≥ 18 years old attending the colposcopy clinic in the University Hospital of Geneva...
2017: PloS One
https://www.readbyqxmd.com/read/28746531/effective-tobacco-control-measures-agreement-among-medical-students
#20
Stella Regina Martins, Renato Batista Paceli, Marco Antônio Bussacos, Frederico Leon Arrabal Fernandes, Gustavo Faibischew Prado, Elisa Maria Siqueira Lombardi, Mário Terra-Filho, Ubiratan Paula Santos
Objective: To determine the level of agreement with effective tobacco control measures recommended by the World Health Organization and to assess the attitudes toward, knowledge of, and beliefs regarding smoking among third-year medical students at University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. Methods: Between 2008 and 2012, all third-year medical students were invited to complete a self-administered questionnaire based on the Global Health Professionals Student Survey and its additional modules...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
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