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https://www.readbyqxmd.com/read/28339685/information-needs-of-generalists-and-specialists-using-online-best-practice-algorithms-to-answer-clinical-questions
#1
David A Cook, Kristi J Sorensen, Jane A Linderbaum, Laurie J Pencille, Deborah J Rhodes
Objective: : To better understand clinician information needs and learning opportunities by exploring the use of best-practice algorithms across different training levels and specialties. Methods: : We developed interactive online algorithms (care process models [CPMs]) that integrate current guidelines, recent evidence, and local expertise to represent cross-disciplinary best practices for managing clinical problems. We reviewed CPM usage logs from January 2014 to June 2015 and compared usage across specialty and provider type...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339637/provider-perspectives-on-the-implementation-of-psychosocial-risk-screening-in-pediatric-cancer
#2
Anne E Kazak, Lamia P Barakat, Martha A Askins, Maureen McCafferty, Alyssa Lattomus, Nicole Ruppe, Janet Deatrick
Objective:  Psychosocial risk screening is an important initial step in delivering evidence-based care. This qualitative descriptive study identified how multidisciplinary pediatric oncology health-care providers perceive psychosocial risk screening to identify factors in uptake and implementation. Methods:  A script guided digitally recorded (transcribed) interviews regarding psychosocial screening and challenges to facilitators of screening. Participants were 15 multidisciplinary staff (physicians, nurses, social workers, psychologists, physician assistant) at nine sites, three using the Psychosocial Assessment Tool© for research and six for clinical care...
February 16, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28337553/early-palliative-care-current-status-of-integration-within-german-comprehensive-cancer-centers
#3
Julia Berendt, Stephanie Stiel, Friedemann Nauck, Christoph Ostgathe
PURPOSE: The aim of this study is to describe how models of early integration (EI) of specialized palliative care (SPC) are applied to German comprehensive cancer center (CCCs). METHODS: Heads of SPC departments of the 15 German CCCs were asked by email to describe the situation of early SPC in their CCC. The responses were analyzed using MAXQDA. RESULTS: Thirteen answers were allowed to be analyzed. Most of the department heads report that EI models of SPC are partially applied in the CCC (responses with "yes" or "partly," n = 10)...
March 23, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28335444/hiv-education-and-welfare-services-in-primary-care-an-empirical-model-of-integration-in-brazil-s-unified-health-system
#4
Rahbel Rahman, Rogério M Pinto, Melanie M Wall
Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil's Unified Health System (UHS)...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28333824/committee-opinion-no-697-planned-home-birth
#5
(no author information available yet)
In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333817/committee-opinion-no-697-summary-planned-home-birth
#6
(no author information available yet)
In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#7
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28329558/integrating-the-integrated-skin-exam-film-into-medical-education
#8
Seth Lofgreen, Michael Lehrer, Paige Bennett, Amit Garg, Cory A Dunnick
AbstractBackgroundThe mortality rate for melanoma continues to rise and the greatest improvement in melanoma survival is attributable to early detection with skin cancer screening exams. However, physicians feel that limited training in the examination of skin and limited clinical time both serve as barriers to adequately assess high-risk lesions.ObjectiveTo test the use of The Integrated Skin Exam film as an instructional tool to teach the examination of skin in a live classroom setting, outside of the purview of the original formal study...
November 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328684/eastern-association-for-the-surgery-of-trauma-society-of-trauma-nurses-advanced-practitioner-position-paper-optimizing-the-integration-of-advanced-practitioners-in-trauma-and-critical-care
#9
Jonathan Messing, Jasmine Garces-King, Dennis Taylor, Jonathan Van Horn, Babak Sarani, A Britton Christmas
Nurse Practitioners and Physician Assistants, collectively known as advanced practitioners (APs), enhance the provision of care for the acutely injured patient. Despite their prevalence, institutions employ, train, and utilize these providers with significant variability. The Eastern Association for the Surgery of Trauma (EAST), the Society of Trauma Nurses (STN), and the American Association of Surgical Physicians Assistants (AASPA) acknowledge the value of APs and support their utilization in the management of injured and critically ill patients...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328391/inpatient-experiences-with-mychart-bedside
#10
Erin L Winstanley, Michelle Burtchin, Yifan Zhang, Paula Campbell, Jodi Pahl, Stephen Beck, Wayne Bohenek
BACKGROUND: As technology is increasingly being integrated into hospital-based care, it is important to assess patient experiences. The purpose of this project was to conduct an evaluation of inpatient experiences with MyChart(®) Bedside. MATERIALS AND METHODS: A convenience sample of patients (n = 88) were included in this study, who responded to a Web-based self-reported survey that was embedded within the MyChart Bedside application. RESULTS: The majority of respondents (78%) reported that MyChart Bedside was easy to use...
February 22, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28327490/integrated-narrative-nursing-a-new-perspective-for-an-advanced-assessment
#11
Giovanna Artioli, Chiara Foà, Chiara Cosentino, Chiara Taffurelli
The assessment is the first of the fundamental nursing processes: it includes data collection, problem identification, and setting of priorities, which all facilitates the process of making a nursing diagnosis. The assessment helps to identify a goal, which, through a decision-making process, orientates the planning as well as the nursing intervention, which will be evaluated at a later stage. It seems that the proposed multidimensional and integrated assessment has a good potential to significantly influence the nursing care...
March 14, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#12
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28325441/a-review-of-fuzzy-cognitive-maps-in-medicine-taxonomy-methods-and-applications
#13
REVIEW
Abdollah Amirkhani, Elpiniki I Papageorgiou, Akram Mohseni, Mohammad R Mosavi
BACKGROUND AND OBJECTIVE: A high percentage of medical errors, committed because of physician's lack of experience, huge volume of data to be analyzed, and inaccessibility to medical records of previous patients, can be reduced using computer-aided techniques. Therefore, designing more efficient medical decision-support systems (MDSSs) to assist physicians in decision-making is crucially important. Through combining the properties of fuzzy logic and neural networks, fuzzy cognitive maps (FCMs) are among the latest, most efficient, and strongest artificial intelligence techniques for modeling complex systems...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28325164/development-of-a-decision-making-tool-for-reporting-drivers-with-mild-dementia-and-mild-cognitive-impairment-to-transportation-administrators
#14
Duncan H Cameron, Carla Zucchero Sarracini, Linda Rozmovits, Gary Naglie, Nathan Herrmann, Frank Molnar, John Jordan, Anna Byszewski, David Tang-Wai, Jamie Dow, Christopher Frank, Blair Henry, Nicholas Pimlott, Dallas Seitz, Brenda Vrkljan, Rebecca Taylor, Mario Masellis, Mark J Rapoport
BACKGROUND: Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators...
March 22, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28324932/an-ict-and-mobile-health-integrated-approach-to-optimize-patients-education-on-hypertension-and-its-management-by-physicians-the-patients-optimal-strategy-of-treatment-post-pilot-study
#15
Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati
INTRODUCTION: Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. OBJECTIVE: To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28320788/effectiveness-of-chronic-care-models-for-the-management-of-type-2-diabetes-mellitus-in-europe-a-systematic-review-and-meta-analysis
#16
Brenda W C Bongaerts, Karsten Müssig, Johan Wens, Caroline Lang, Peter Schwarz, Michael Roden, Wolfgang Rathmann
OBJECTIVES: We evaluated the effectiveness of European chronic care programmes for type 2 diabetes mellitus (characterised by integrative care and a multicomponent framework for enhancing healthcare delivery), compared with usual diabetes care. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, CENTRAL and CINAHL from January 2000 to July 2015. ELIGIBILITY CRITERIA: Randomised controlled trials focussing on (1) adults with type 2 diabetes, (2) multifaceted diabetes care interventions specifically designed for type 2 diabetes and delivered in primary or secondary care, targeting patient, physician and healthcare organisation and (3) usual diabetes care as the control intervention...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28319617/biosimilars-in-psoriasis-the-future-or-not
#17
Roselyn Kellen, Gary Goldenberg
As patents for the biologic agents reach their expiration dates, dermatologists must prepare for the coming of biosimilars. These agents have been deemed "highly similar" to their reference products in a process outlined by the US Food and Drug Administration (FDA). In 2016, the FDA approved 3 biosimilars for various indications including plaque psoriasis and psoriatic arthritis. However, biosimilars are not the same as small-molecule generics because they have a complex manufacturing process that makes it impossible to produce identical products to their reference products...
February 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28319427/new-horizons-in-the-imaging-of-perianal-crohn-s-disease-transperineal-ultrasonography
#18
Cristina Bezzio, Robert V Bryant, Gianpiero Manes, Giovanni Maconi, Simone Saibeni
Perianal disease, most commonly manifest as fistula or abscess formation, affects up to 40% of patients with Crohn's disease. Perianal Crohn's disease is disabling, associated with poor outcomes, and represents a therapeutic challenge for physicians. Correct diagnosis and classification of perianal disease is the first crucial step for appropriate multidisciplinary management. Areas covered: A literature search was performed of the PubMed database using the terms "transperineal ultrasonography", "transperineal ultrasound", "perianal disease", "perianal fistula", "perianal abscess", "magnetic resonance", "endoanal ultrasonography", "endoscopic ultrasound" in combination with "Crohn's disease"...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28317473/the-columbia-bronx-va-amalgamative-clerkship-an-effective-12-week-integrated-longitudinal-clinical-experience
#19
Jillian Diuguid-Gerber, Samuel Porter, Samuel C Quiah, Katherine Nickerson, Deborah Jones, Zeena Audi, Boyd F Richards
BACKGROUND: Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students. OBJECTIVE: In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC)...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28306695/lung-ultrasonography-a-practical-guide-for-cardiologists
#20
Francesco Bianco, Valentina Bucciarelli, Fabrizio Ricci, Raffaele De Caterina, Sabina Gallina
Lung ultrasonography is a well established, user-friendly and easy-to-use technique that can be used in the evaluation of several pathological conditions affecting the lung. Adding lung ultrasonography to traditional echocardiography provides an integrated cardiopulmonary ultrasound analysis. The simultaneous collection of information about the heart and the lungs can help physicians to investigate acute and chronic cardio-pulmonary conditions within a noninvasive, single-probe and all-in-one examination, not exposing the patient to the danger of ionizing radiation...
March 16, 2017: Journal of Cardiovascular Medicine
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