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https://www.readbyqxmd.com/read/27922504/genetic-testing-of-presymptomatic-individuals-at-risk-for-progressive-myopathy
#1
Zachary Simmons
Patients and their family members often ask about genetic testing for asymptomatic individuals who are at risk for developing a genetic disorder. Ordering a genetic test is a complex process involving consideration of many basic ethical principles including autonomy, beneficence, and nonmaleficence, as well as the physician's duty to act in the patient's best interest. Physicians have many choices regarding what tests to order, and they must develop the knowledge and skills to best discuss genetic testing with their patients...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27921276/relationship-between-physician-adjudicated-adverse-events-and-patient-reported-health-related-quality-of-life-in-a-phase-ii-clinical-trial-nct01143402-of-patients-with-metastatic-uveal-melanoma
#2
Thomas M Atkinson, Jennifer L Hay, Alexander Shoushtari, Yuelin Li, Daniel J Paucar, Sloane C Smith, Ragini R Kudchadkar, Austin Doyle, Jeffrey A Sosman, Jorge Fernando Quevedo, Mohammed M Milhem, Anthony M Joshua, Gerald P Linette, Thomas F Gajewski, Jose Lutzky, David H Lawson, Christopher D Lao, Patrick J Flynn, Mark R Albertini, Takami Sato, Karl Lewis, Brian Marr, David H Abramson, Mark Andrew Dickson, Gary K Schwartz, Richard D Carvajal
PURPOSE: Clinical trials commonly use physician-adjudicated adverse event (AE) assessment via the common terminology criteria for adverse events (CTCAE) for decision-making. Patient-reported health-related quality of life (HRQoL) data are becoming more frequent in oncology; however, the relationship between physician-adjudicated AE assessment and HRQoL is understudied. METHODS: Data from a phase II trial (clinicaltrials.gov identifier: NCT01143402) where patients with metastatic uveal melanoma were randomized to receive selumetinib, an oral MEK inhibitor, or chemotherapy were analyzed...
December 5, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27921257/impact-of-community-health-workers-on-use-of-healthcare-services-in-the-united-states-a-systematic-review
#3
Helen E Jack, Sophia D Arabadjis, Lucy Sun, Erin E Sullivan, Russell S Phillips
BACKGROUND: As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. METHODS: We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015...
December 5, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27920012/effect-of-cataract-surgery-volume-constraints-on-recently-graduated-ophthalmologists-a-population-based-cohort-study
#4
Robert J Campbell, Sherif R El-Defrawy, Chaim M Bell, Sudeep S Gill, Philip L Hooper, Marlo Whitehead, Erica de L P Campbell, Robert Nesdole, Daniel Warder, Martin Ten Hove
BACKGROUND: Across Canada, graduates from several medical and surgical specialties have recently had difficulty securing practice opportunities, especially in specialties dependent upon limited resources. In most developed nations, cataract surgery is the most common operation performed, making practice opportunities sensitive to access to health system resources and making this procedure an exemplar of issues facing resource-intensive specialties. METHODS: We used population-based administrative data from Ontario for the period Jan...
December 5, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27919400/a-novel-concept-for-integrating-and-delivering-health-information-using-a-comprehensive-digital-dashboard-an-analysis-of-healthcare-professionals-intention-to-adopt-a-new-system-and-the-trend-of-its-real-usage
#5
Keehyuck Lee, Se Young Jung, Hee Hwang, Sooyoung Yoo, Hyun Young Baek, Rong-Min Baek, Seok Kim
OBJECTIVE: To introduce a new concept of medical dashboard system called BESTBoard. Such a system was implemented in all wards in a tertiary academic hospital to explore the development process, core designs, functions, usability and feasibility. METHODS: The task-force team made user interface designs for 6 months based on a need analysis. Hardware configuration and software development was carried out for 3 months. We conducted a survey of 383 physicians and nurses to determine the usability and feasibility of the system...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27918403/new-hampshire-nurse-practitioners-take-the-lead-in-forming-an-accountable-care-organization
#6
Wendy L Wright
In 2012, New Hampshire nurse practitioners (NPs), along with Anthem Blue Cross/Blue Shield, formed the first Patient Centered Shared Savings Program in the nation, composed of patients managed by nurse practitioners employed within NP-owned and operated clinics. In this accountable care organization (ACO), NP-attributed patients were grouped into one risk pool. Data from the ACO and the NP risk pool, now in its third year, have produced compelling statistics. Nurse practitioners participating in this program have met or exceeded the minimum scores for 29 quality metrics along with a demonstrated cost-savings in the first 2 years of the program...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27917589/the-petale-study-late-adverse-effects-and-biomarkers-in-childhood-acute-lymphoblastic-leukemia-survivors
#7
Sophie Marcoux, Simon Drouin, Caroline Laverdière, Nathalie Alos, Gregor U Andelfinger, Laurence Bertout, Daniel Curnier, Matthias G Friedrich, Ekaterini A Kritikou, Geneviève Lefebvre, Emile Levy, Sarah Lippé, Valérie Marcil, Marie-Josée Raboisson, Frank Rauch, Philippe Robaey, Mariia Samoilenko, Chantal Séguin, Serge Sultan, Maja Krajinovic, Daniel Sinnett
BACKGROUND: Childhood cancer survivorship issues represent an established public health challenge. Most late adverse effects (LAEs) have been demonstrated to be time and treatment dependent. The PETALE study is a multidisciplinary research project aiming to comprehensively characterize LAEs and identify associated predictive biomarkers in childhood acute lymphoblastic leukemia (cALL) survivors. METHODS: cALL survivors treated at Sainte-Justine University Health Center with Dana-Farber Cancer Institution-ALL protocols 87-01 through 2005-01 were eligible...
December 4, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27916027/-current-status-of-lung-transplantation-in-china-problems-and-perspectives
#8
X A Wang, G N Jiang
Despite rapid progress, clinical lung transplantation in China still lags far behind. A great challenge remains in donor lung utilization and perioperative medicine. It's really abnormal that we are so backward in lung transplantation when we have come up with the advanced world levels in thoracic surgery, pulmonology and critical care medicine. Our shortcomings were analyzed by comparing lung transplantation in China and in the advanced countries. The first problem is multidisciplinary teamwork. In the United States, a lung transplant team includes physician specialized in lung transplantation, thoracic surgeons, nurses, respiratory therapists and other specialists possibly needed...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#9
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27914313/requests-for-cesarean-deliveries-the-politics-of-labor-pain-and-pain-relief-in-shanghai-china
#10
Eileen Wang
Cesarean section rates have risen dramatically in China within the past 25 years, particularly driven by non-medical factors and maternal requests. One major reason women request cesareans is the fear of labor pain, in a country where a minority of women are given any form of pain relief during labor. Drawing upon ethnographic fieldwork and in-depth interviews with 26 postpartum women and 8 providers at a Shanghai district hospital in June and July of 2015, this article elucidates how perceptions of labor pain and the environment of pain relief constructs the cesarean on maternal request...
November 24, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27914136/physicians-should-provide-shared-decision-making-for-anti-tnf-therapy-to-inflammatory-bowel-disease-patients
#11
Jae Myung Cha, Dong Il Park, Sang Hyoung Park, Jeong Eun Shin, Wan Soo Kim, Suk Kyun Yang
Shared decision-making may increase the effectiveness of inflammatory bowel disease (IBD) treatment, as different anti-tumor necrosis factor (anti-TNF) administrations may have different effects on the quality of life (QOL). Patient preference is integral to the selection of anti-TNFs and their routes of administration, however, previous studies on the patient preference to anti-TNFs are inconsistent and limited. We evaluated the predictive factors for preferences to anti-TNF administrations in IBD patients between March and August in 2015...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27912963/overcoming-communication-challenges-in-integrative-supportive-cancer-care-the-integrative-physician-the-psycho-oncologist-and-the-patient
#12
Eran Ben-Arye, Efrat Shavit, Haya Wiental, Elad Schiff, Olga Agour, Noah Samuels
BACKGROUND: Complementary/integrative medicine (CIM) services are increasingly being integrated into conventional supportive cancer care, presenting a number of challenges to communication between healthcare professionals (HCPs). The purpose of the present study was to explore the impact of the communication between integrative physicians (IPs) trained in CIM and social workers (SWs) working as psycho-oncologists in the same oncology setting. We examine whether IP-SW communication correlates with the number of patient-SW sessions, as provided within the oncology department...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27911868/design-and-implementation-of-a-mobile-system-for-lung-cancer-patient-follow-up-in-china-and-initial-report-of-the-ongoing-patient-registry
#13
Xiangyun Ye, Jia Wei, Ziming Li, Xiaomin Niu, Jiemin Wang, Yunqin Chen, Zongming Guo, Shun Lu
INTRODUCTION: Management of lung cancer remains a challenge. Although clinical and biological patient data are crucial for cancer research, these data may be missing from registries and clinical trials. Biobanks provide a source of high-quality biological material for clinical research; however, linking these samples to the corresponding patient and clinical data is technically challenging. We describe the mobile Lung Cancer Care system (mLCCare), a novel tool which integrates biological and clinical patient data into a single resource...
November 30, 2016: Oncotarget
https://www.readbyqxmd.com/read/27909799/thyroid-gland-visualization-with-3d-4d-ultrasound-integrated-hands-on-imaging-in-anatomical-dissection-laboratory
#14
John L Carter, Ankura Patel, Gabriel Hocum, Brion Benninger
PURPOSE: In teaching anatomy, clinical imaging has been utilized to supplement the traditional dissection laboratory promoting education through visualization of spatial relationships of anatomical structures. Viewing the thyroid gland using 3D/4D ultrasound can be valuable to physicians as well as students learning anatomy. The objective of this study was to investigate the perceptions of first-year medical students regarding the integration of 3D/4D ultrasound visualization of spatial anatomy during anatomical education...
December 1, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27905907/addressing-asthma-and-obesity-in-children-with-community-health-workers-proof-of-concept-intervention-development
#15
Molly A Martin, Steven K Rothschild, Elizabeth Lynch, Katherine Kaufer Christoffel, Militza M Pagán, Jose Luis Rodriguez, Anna Barnes, Kelly Karavolos, Antonieta Diaz, Lucretia M Hoffman, Diana Plata, Sandra Villalpando
BACKGROUND: The objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity. METHODS: Using a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5-12 years old with physician-diagnosed asthma and body mass index (BMI) > 85%...
December 1, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27900744/-developing-and-verifying-the-validity-and-reliability-of-the-electronic-menopausal-health-screen-system
#16
Pei-Shan Lee, Chyi-Long Lee, Chieh-Yu Liu, Wen-Chin Chen, Yen-Yen Yu, Lee-Ing Tsao
BACKGROUND: Menopausal women are in a transitional phase between health and sickness. Although the highest standards of menopausal care include clinical assessment and patient education on menopausal symptoms, current practices lack integrated care that aim to prevent chronic diseases for which menopause is a predisposing factor. PURPOSE: To integrate menopausal disturbances; to evaluate the risk factors for osteoporosis, cardiovascular disease, and diabetes; and to create a reliable and effective electronic menopausal health screen system (EMHSS)...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27899153/can-integrated-health-services-delivery-have-an-impact-on-hypertension-management-a-cross-sectional-study-in-two-cities-of-china
#17
Haitao Li, Ying Sun, Dongfu Qian
BACKGROUND: Policy makers require information regarding performance of different primary care delivery models in managing hypertension, which can be helpful for better hypertension management. This study aims to compare continuity of care among hypertensive patients between Direct Management (DM) Model of community health centers (CHCs) in Wuhan and Loose Collaboration (LC) Model in Nanjing. METHODS: A cross-sectional questionnaire survey was conducted. Four CHCs in each city were randomly selected as study settings...
November 30, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27896407/mixed-methods-assessment-of-trauma-and-acute-care-surgical-quality-improvement-programs-in-peru
#18
Lacey N LaGrone, Amy K Fuhs, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Roberto Valderrama, Leah N Isquith-Dicker, Jaime Herrera-Matta, Charles N Mock
BACKGROUND: Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. METHODS: This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27893953/leveraging-telehealth-to-bring-volunteer-physicians-into-underserved-communities
#19
Lori Uscher-Pines, Robert Rudin, Ateev Mehrotra
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute...
November 28, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#20
Julia Warner, Mary Ann Raible, Gina Hajduk, Jacqueline Collavo
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent...
January 2017: Critical Care Nursing Quarterly
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