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https://www.readbyqxmd.com/read/28102961/assessing-the-use-of-4dct-ventilation-in-pre-operative-surgical-lung-cancer-evaluation
#1
Yevgeniy Vinogradskiy, Matthew Jackson, Leah Schubert, Bernard Jones, Richard Castillo, Edward Castillo, Thomas Guerrero, John Mitchell, Chad Rusthoven, Moyed Miften, Brian Kavanagh
PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28102928/reduction-in-colposcopy-workload-and-associated-clinical-activity-following-hpv-catch-up-vaccination-programme-in-scotland-an-ecological-study
#2
M E Cruickshank, J Pan, S C Cotton, K Kavanagh, C Robertson, K Cuschieri, H Cubie, T Palmer, K G Pollock
OBJECTIVE: To measure patterns of clinical activity at colposcopy before and after vaccinated women entered the Scottish Cervical Screening Programme (SCSP). DESIGN: Population-based observational study using nationally collected data. SETTING: Scottish colposcopy clinics. SAMPLE: All women with a date of birth on or after 1 January 1985 who attended colposcopy in Scotland between 2008-2014. METHODS: Routinely collected data from the Scottish National Colposcopy Clinical Information Audit System (NCCIAS) was extracted, including: referral criteria, referral cervical cytology, colposcopic findings, clinical procedures and histology results...
January 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28101983/working-to-define-professionalism-in-pediatric-anesthesiology-a-qualitative-study-of-domains-of-the-expert-pediatric-anesthesiologist-as-valued-by-interdisciplinary-stakeholders
#3
Justin L Lockman, Alan Jay Schwartz, Peter F Cronholm
BACKGROUND: Unprofessional behavior is a significant problem throughout graduate medical education programs and medical centers. Some authors have suggested that professionalism curricula should be focused toward faculty, not trainees, to interrupt the modeling of unprofessionalism. Developing such curricula requires a needs assessment and is challenging given data indicating that the definition of professionalism varies based on medical specialty. Thus, a specialty-specific definition of professionalism is needed as a first step in any curriculum development...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28101699/humanity-at-the-edge-the-moral-laboratory-of-feeding-precarious-lives
#4
Mette N Svendsen, Iben M Gjødsbøl, Mie S Dam, Laura E Navne
At the heart of anthropology and the social sciences lies a notion of human existence according to which humans and animals share the basic need for food, but only humans have the capacity for morality. Based on fieldwork in a pig laboratory, a neonatal intensive care unit (NICU), and a dementia nursing home, we follow practices of feeding precarious lives lacking most markers of human personhood, including the exercise of moral judgment. Despite the absence of such markers, laboratory researchers and caregivers in these three sites do not abstain from engaging in questions about the moral status of the piglets, infants, and people with dementia in their care...
January 18, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28100293/psychiatric-rehabilitation-in-europe
#5
W Rössler, R E Drake
To describe the core elements of modern psychiatric rehabilitation. Based on selected examples we describe the discussion about values in mental health care with focus on Europe. We present outcome data from studies, which have tried to implement care structures based on this value discussion. In the second half of the 20th century, mental health care in all European and other high-income countries changed conceptually and structurally. Deinstitutionalisation reduced the number of psychiatric beds and transferred priority to outpatient care and community-based services, but community mental health programs developed differently across and within these countries...
January 19, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28100141/caring-to-learn-and-learning-to-care
#6
Kristin G Cloyes, Susan J Rosenkranz, Katherine P Supiano, Patricia H Berry, Meghan Routt, Sarah M Llanque, Kathleen Shannon-Dorcy
The increasing numbers of aging and chronically ill prisoners incarcerated in Western nations is well-documented, as is the growing need for prison-based palliative and end-of-life care. Less often discussed is specifically how end-of-life care can and should be provided, by whom, and with what resources. One strategy incorporates prisoner volunteers into end-of-life services within a peer-care program. This article reports on one such program based on focused ethnographic study including in-depth interviews with inmate hospice volunteers, nursing staff, and corrections officers working in the hospice program...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28100086/tracking-down-a-solution-exploring-the-acceptability-and-value-of-wearable-gps-devices-for-older-persons-individuals-with-a-disability-and-their-support-persons
#7
Brittany Williamson, Tammy Aplin, Desleigh de Jonge, Matthew Goyne
PURPOSE: To explore the acceptability and value of three wearable GPS devices for older persons and individuals with a disability and safety concerns when accessing the community. METHODS: This pilot study explored six wearers' and their support persons' experience of using three different wearable GPS devices (a pendant, watch, and mini GPS phone), each for a two-week period. RESULTS: Participants identified safety as the main value of using a wearable GPS device...
January 18, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28099667/clinical-functional-vulnerability-index-20-ivcf-20-rapid-recognition-of-frail-older-adults
#8
Edgar Nunes de Moraes, Juliana Alves do Carmo, Flávia Lanna de Moraes, Raquel Souza Azevedo, Carla Jorge Machado, Dalia Elena Romero Montilla
OBJECTIVE: To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS: The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults...
December 22, 2016: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28099286/multicenter-study-validating-accuracy-of-a-continuous-respiratory-rate-measurement-derived-from-pulse-oximetry-a-comparison-with-capnography
#9
Sergio D Bergese, Michael L Mestek, Scott D Kelley, Robert McIntyre, Alberto A Uribe, Rakesh Sethi, James N Watson, Paul S Addison
BACKGROUND: Intermittent measurement of respiratory rate via observation is routine in many patient care settings. This approach has several inherent limitations that diminish the clinical utility of these measurements because it is intermittent, susceptible to human error, and requires clinical resources. As an alternative, a software application that derives continuous respiratory rate measurement from a standard pulse oximeter has been developed. We sought to determine the performance characteristics of this new technology by comparison with clinician-reviewed capnography waveforms in both healthy subjects and hospitalized patients in a low-acuity care setting...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099192/aerobic-exercise-training-in-very-severe-chronic-obstructive-pulmonary-disease-a-systematic-review-and-meta-analysis
#10
Mara Paneroni, Carla Simonelli, Michele Vitacca, Nicolino Ambrosino
OBJECTIVE: To evaluate the effectiveness of exercise training in patients with very severe chronic obstructive pulmonary disease (COPD). DESIGN: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature databases using the following as search terms: COPD, Chronic Obstructive Pulmonary Disease, Exercise, and Pulmonary Rehabilitation. We included randomized controlled trials (RCTs) of subjects with forced expiratory volume in the first second of less than 35% of the predicted normal value enrolled in in-patient, outpatient, or home- or community-based training programs lasting at least 4 weeks with respect to usual care...
January 17, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28099106/costing-in-radiology-and-health-care-rationale-relativity-rudiments-and-realities
#11
Geoffrey D Rubin
Costs direct decisions that influence the effectiveness of radiology in the care of patients on a daily basis. Yet many radiologists struggle to harness the power of cost measurement and cost management as a critical path toward establishing their value in patient care. When radiologists cannot articulate their value, they risk losing control over how imaging is delivered and supported. In the United States, recent payment trends directing value-based payments for bundles of care advance the imperative for radiology providers to articulate their value...
February 2017: Radiology
https://www.readbyqxmd.com/read/28099059/family-physician-readiness-for-value-based-payments-does-ownership-status-matter
#12
Heidy Robertson-Cooper, Bradley Neaderhiser, Laura E Happe, Roy A Beveridge
Value-based payments are rapidly replacing fee-for-service arrangements, necessitating advancements in physician practice capabilities and functions. The objective of this study was to examine potential differences among family physicians who are owners versus employed with respect to their readiness for value-based payment models. The authors surveyed more than 550 family physicians from the American Academy of Family Physician's membership; nearly 75% had made changes to participate in value-based payments...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28098944/validation-of-a-smartphone-based-point-of-care-hemoglobin-assay-for-use-in-dogs
#13
Kate S Farrell, Phillip L Chapman, Lauren A Sullivan
OBJECTIVE: To validate a smartphone-based spectrophotometric assay for point-of-care (POC) measurement of hemoglobin (Hgb) concentration against the standard measurement method in dogs without increases in serum lipemia, hemolysis, or bilirubin. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: One hundred thirty-nine dogs that had a CBC and corresponding biochemical profile submitted to the clinical pathology laboratory...
January 18, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28098629/right-dose-right-now-customized-drug-dosing-in-the-critically-ill
#14
Jason A Roberts, Anand Kumar, Jeffrey Lipman
Drugs are key weapons that clinicians have to battle against the profound pathologies encountered in critically ill patients. Antibiotics in particular are commonly used and can improve patient outcomes dramatically. Despite this, there are strong opportunities for further reducing the persisting poor outcomes for infected critically ill patients. However, taking these next steps for improving patient care requires a new approach to antibiotic therapy. Giving the right dose is highly likely to increase the probability of clinical cure from infection and suppress the emergence of resistant pathogens...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#15
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into 4 cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (N = 1448), acute coronary syndrome (ACS) (N = 602), ischemic stroke (IS) (N = 151), and heart failure (HF) (N = 291) incident cohorts...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#16
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28097288/secondary-analysis-of-an-electronic-surveillance-system-combined-with-multi-focal-interventions-for-early-detection-of-sepsis
#17
Bonnie L Westra, Sean Landman, Pranjul Yadav, Michael Steinbach
: To conduct an independent secondary analysis of a multi-focal intervention for early detection of sepsis that included implementation of change management strategies, electronic surveillance for sepsis, and evidence based point of care alerting using the POC AdvisorTM application. METHODS: Propensity score matching was used to select subsets of the cohorts with balanced covariates. Bootstrapping was performed to build distributions of the measured difference in rates/means...
18, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28095920/accuracy-of-who-immunological-criteria-in-identifying-virological-failure-among-hiv-infected-adults-on-first-line-antiretroviral-therapy-in-mwanza-north-western-tanzania
#18
Daniel W Gunda, Benson R Kidenya, Stephen E Mshana, Semvua B Kilonzo, Bonaventura C T Mpondo
BACKGROUND: Optimal HIV treatment monitoring remains a big challenge in resource limited settings. Guidelines recommend the use of clinical and immunological criteria in resource limited settings due to unavailability of viral load monitoring; however their utility is questionable. This study aimed at assessing the accuracy of immunological criteria in detecting treatment failure among HIV infected Tanzanian adults receiving first line ART. METHODS: A clinic based cross sectional study was conducted between February and July 2011 at Bugando Medical centre (BMC) HIV care and treatment clinic (CTC) involving HIV infected patients aged 18 years and above, receiving first line ART; followed up for at least 1 year...
January 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28095905/imputing-hiv-treatment-start-dates-from-routine-laboratory-data-in-south-africa-a-validation-study
#19
Mhairi Maskew, Jacob Bor, Cheryl Hendrickson, William MacLeod, Till Bärnighausen, Deenan Pillay, Ian Sanne, Sergio Carmona, Wendy Stevens, Matthew P Fox
BACKGROUND: Poor clinical record keeping hinders health systems monitoring and patient care in many low resource settings. We develop and validate a novel method to impute dates of antiretroviral treatment (ART) initiation from routine laboratory data in South Africa's public sector HIV program. This method will enable monitoring of the national ART program using real-time laboratory data, avoiding the error potential of chart review. METHODS: We developed an algorithm to impute ART start dates based on the date of a patient's "ART workup", i...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28095873/physical-integrity-and-residual-bio-efficacy-of-used-llins-in-three-cities-of-the-south-west-region-of-cameroon-4%C3%A2-years-after-the-first-national-mass-distribution-campaign
#20
Stravensky T Boussougou-Sambe, Parfait Awono-Ambene, Geraud C T Tasse, Josiane Etang, Jerome A Binyang, Lynda D Nouage, Gaston Wamba, Peter Enyong, Eric B Fokam
BACKGROUND: Long-lasting insecticidal nets (LLINs) are effective tools at reducing malaria transmission. In Cameroon, following the first national mass distribution campaign in 2011, there has been no follow up on the efficacy of LLINs distributed. The aim of this report is to assess the physical integrity and insecticidal potency of LLINs distributed in three cities with contrasting socio economic status (SES) and to evaluate the use and care for bed nets owned by individuals. METHODS: The study was conducted in Limbe, Tiko and Buea three localities in the Fako division of the South West Region of Cameroon...
January 17, 2017: Malaria Journal
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