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https://www.readbyqxmd.com/read/27936423/optimising-the-community-based-approach-to-healthcare-improvement-comparative-case-studies-of-the-clinical-community-model-in-practice
#1
Emma-Louise Aveling, Graham Martin, Georgia Herbert, Natalie Armstrong
Community-based approaches to healthcare improvement are receiving increasing attention. Such approaches could offer an infrastructure for efficient knowledge-sharing and a potent means of influencing behaviours, but their potential is yet to be optimised. After briefly reviewing challenges to community-based approaches, we describe in detail the clinical community model. Through exploring clinical communities in practice, we seek to identify practical lessons for optimising this community-based approach to healthcare improvement...
November 22, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27936414/-am-i-too-emotional-for-this-job-an-exploration-of-student-midwives-experiences-of-coping-with-traumatic-events-in-the-labour-ward
#2
Liz Coldridge, Sarah Davies
BACKGROUND: midwifery is emotionally challenging work, and learning to be a midwife brings its own particular challenges. For the student midwife, clinical placement in a hospital labour ward is especially demanding. In the context of organisational tensions and pressures the experience of supporting women through the unpredictable intensity of the labour process can be a significant source of stress for student midwives. Although increasing attention is now being paid to midwives' traumatic experiences and wellbeing few researchers have examined the traumatic experiences of student midwives...
November 28, 2016: Midwifery
https://www.readbyqxmd.com/read/27936348/current-prospects-and-future-challenges-for-nasal-vaccine-delivery
#3
Helmy Yusuf, Vicky Kett
Nasal delivery offers many benefits over traditional approaches to vaccine administration. These include ease of administration without needles that reduces issues associated with needlestick injuries and disposal. Additionally, this route offers easy access to a key part of the immune system that can stimulate other mucosal sites throughout the body. Increased acceptance of nasal vaccine products in both adults and children has led to a burgeoning pipeline of nasal delivery technology. Key challenges and opportunities for the future will include translating in vivo data to clinical outcomes...
December 9, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27936204/serotypes-and-antimicrobial-resistance-in-salmonella-enterica-recovered-from-clinical-samples-from-cattle-and-swine-in-minnesota-2006-to-2015
#4
Samuel Hong, Albert Rovira, Peter Davies, Christina Ahlstrom, Petra Muellner, Aaron Rendahl, Karen Olsen, Jeff B Bender, Scott Wells, Andres Perez, Julio Alvarez
Salmonellosis remains one of the leading causes of foodborne disease worldwide despite preventive efforts at various stages of the food production chain. The emergence of multi-drug resistant (MDR) non-typhoidal Salmonella enterica represents an additional challenge for public health authorities. Food animals are considered a major reservoir and potential source of foodborne salmonellosis; thus, monitoring of Salmonella strains in livestock may help to detect emergence of new serotypes/MDR phenotypes and to gain a better understanding of Salmonella epidemiology...
2016: PloS One
https://www.readbyqxmd.com/read/27936118/challenges-in-evaluating-the-severity-of-fibropapillomatosis-a-proposal-for-objective-index-and-score-system-for-green-sea-turtles-chelonia-mydas-in-brazil
#5
Silmara Rossi, Angélica María Sánchez-Sarmiento, Ralph Eric Thijl Vanstreels, Robson Guimarães Dos Santos, Fabiola Eloisa Setim Prioste, Marco Aurélio Gattamorta, José Henrique Hildebrand Grisi-Filho, Eliana Reiko Matushima
Fibropapillomatosis (FP) is a neoplastic disease that affects marine turtles worldwide, especially green sea turtles (Chelonia mydas). FP tumors can develop on the body surface of marine turtles and also internally in the oral cavity and viscera. Depending on their quantity, size and anatomical distribution, these tumors can interfere with hydrodynamics and the ability to feed, hence scoring systems have been proposed in an attempt to quantify the clinical manifestation of FP. In order to establish a new scoring system adapted to geographic regions, we examined 214 juvenile green sea turtles with FP caught or rescued at Brazilian feeding areas, counted their 7466 tumors and classified them in relation to their size and anatomical distribution...
2016: PloS One
https://www.readbyqxmd.com/read/27936033/automated-detection-of-cancer-associated-genes-using-a-combined-fuzzy-rough-set-based-f-information-and-water-swirl-algorithm-of-human-gene-expression-data
#6
Pugalendhi Ganesh Kumar, Muthu Subash Kavitha, Byeong-Cheol Ahn
This study describes a novel approach to reducing the challenges of highly nonlinear multiclass gene expression values for cancer diagnosis. To build a fruitful system for cancer diagnosis, in this study, we introduced two levels of gene selection such as filtering and embedding for selection of potential genes and the most relevant genes associated with cancer, respectively. The filter procedure was implemented by developing a fuzzy rough set (FR)-based method for redefining the criterion function of f-information (FI) to identify the potential genes without discretizing the continuous gene expression values...
2016: PloS One
https://www.readbyqxmd.com/read/27936016/a-tool-for-investigating-asthma-and-copd-exacerbations-a-newly-manufactured-and-well-characterised-gmp-wild-type-human-rhinovirus-for-use-in-the-human-viral-challenge-model
#7
Daniel J Fullen, Bryan Murray, Julie Mori, Andrew Catchpole, Daryl W Borley, Edward J Murray, Ganesh Balaratnam, Anthony Gilbert, Alex Mann, Fiona Hughes, Rob Lambkin-Williams
BACKGROUND: Human Rhinovirus infection is an important precursor to asthma and chronic obstructive pulmonary disease exacerbations and the Human Viral Challenge model may provide a powerful tool in studying these and other chronic respiratory diseases. In this study we have reported the production and human characterisation of a new Wild-Type HRV-16 challenge virus produced specifically for this purpose. METHODS AND STOCK DEVELOPMENT: A HRV-16 isolate from an 18 year old experimentally infected healthy female volunteer (University of Virginia Children's Hospital, USA) was obtained with appropriate medical history and consent...
2016: PloS One
https://www.readbyqxmd.com/read/27935990/hyperalgesia-and-persistent-pain-after-breast-cancer-surgery-a-prospective-randomized-controlled-trial-with-perioperative-cox-2-inhibition
#8
Noud van Helmond, Monique A Steegers, Gertie P Filippini-de Moor, Kris C Vissers, Oliver H Wilder-Smith
BACKGROUND: Persistent pain is a challenging clinical problem after breast cancer treatment. After surgery, inflammatory pain and nociceptive input from nerve injury induce central sensitization which may play a role in the genesis of persistent pain. Using quantitative sensory testing, we tested the hypothesis that adding COX-2 inhibition to standard treatment reduces hyperalgesia after breast cancer surgery. A secondary hypothesis was that patients developing persistent pain would exhibit more postoperative hyperalgesia...
2016: PloS One
https://www.readbyqxmd.com/read/27935861/microrna-203-predicts-human-survival-after-resection-of-colorectal-liver-metastasis
#9
T Peter Kingham, Hoang C B Nguyen, Jian Zheng, Ioannis T Konstantinidis, Eran Sadot, Jinru Shia, Deborah Kuk, Steven Zhang, Leonard Saltz, Michael I D'Angelica, William R Jarnagin, Hani Goodarzi, Sohail F Tavazoie
BACKGROUND: Resection of colorectal liver metastasis (CRLM) can be curative. Predicting which patients may benefit from resection, however, remains challenging. Some microRNAs (miRNAs) become deregulated in cancers and contribute to cancer progression. We hypothesized that miRNA expression can serve as a prognostic marker of survival after CRLM resection. RESULTS: MiR-203 was significantly overexpressed in tumors of short-term survivors compared to long-term survivors...
December 7, 2016: Oncotarget
https://www.readbyqxmd.com/read/27935623/reducing-blood-volume-requirements-for-clinical-pathology-testing-in-toxicologic-studies-points-to-consider
#10
Florence Poitout-Belissent, Adam Aulbach, Niraj Tripathi, Lila Ramaiah
In preclinical safety assessment, blood volume requirements for various endpoints pose a major challenge. The goal of this working group was to review current practices for clinical pathology (CP) testing in preclinical toxicologic studies, and to discuss advantages and disadvantages of methods for reducing blood volume requirements. An industry-wide survey was conducted to gather information on CP instrumentation and blood collection practices for hematology, clinical biochemistry, and coagulation evaluation in laboratory animals involved in preclinical studies...
December 9, 2016: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/27935555/algoplus%C3%A2-scale-in-older-patients-with%C3%A2-dementia-a-reliable-real-world-pain%C3%A2-assessment-tool
#11
Fiammetta Monacelli, Alessio Signori, Laura Roffredo, Katiuscia Pace, Alessio Nencioni, Gisele Pickering, Macian Nicolas, Patrizio Odetti
Pain is still a neglected clinical issue in elderly people with dementia and/or communicative disorders, with an unacceptable higher rate of under diagnosis and under treatment. Cognitive deficit and emotional and psychological disturbances entangle pain symptoms, affecting patient self-report. So far, observational pain tools do not have fully adequate clinimetric properties and quality requirements for easy-to-use daily rating. Older patients with dementia represent a clinical challenge. The assessment of pain is important for improving clinical outcomes, such as functional status, frailty trajectories, comorbidity, and quality of life...
December 5, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27935536/evaluation-of-a-12-month-pilot-of-long-term-and-temporary-assisted-peritoneal-dialysis
#12
Micheli U Bevilacqua, Linda Turnbull, Sushila Saunders, Lee Er, Helen Chiu, Penny Hill, Rajinder S Singh, Adeera Levin, Michael A Copland, Abeed Jamal, Catherine Brumby, Orla Dunne, Paul A Taylor
♦ Background: Peritoneal dialysis (PD) is challenging for patients with functional limitations, and assisted PD can support these patients, but previous reports of assisted PD have not examined the role of temporary assisted PD and had difficulty identifying adequate comparator cohorts. ♦ Methods: Peritoneal Dialysis Assist (PDA), a 12-month pilot of long-term and temporary assisted PD was completed in multiple PD centers in British Columbia, Canada. Continuous cycler PD (CCPD) patients were identified for PDA by standardized criteria, and service could be long-term or temporary/respite...
December 1, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27935476/assessing-the-mechanism-and-therapeutic-potential-of-modulators-of-the-human-mediator-complex-associated-protein-kinases
#13
Paul Andrew Clarke, Maria-Jesus Ortiz-Ruiz, Robert TePoele, Olajumoke Adeniji-Popoola, Gary Box, Will Court, Stefanie Czasch, Samer El Bawab, Christina Esdar, Ken Ewan, Sharon Gowan, Alexis De Haven Brandon, Phllip Hewitt, Stephen M Hobbs, Wolfgang Kaufmann, Aurélie Mallinger, Florence Raynaud, Toby Roe, Felix Rohdich, Kai Schiemann, Stephanie Simon, Richard Schneider, Melanie Valenti, Stefan Weigt, Julian Blagg, Andree Blaukat, Trevor C Dale, Suzanne A Eccles, Stefan Hecht, Klaus Urbahns, Paul Workman, Dirk Wienke
Mediator-associated kinases CDK8/19 are context-dependent drivers or suppressors of tumorigenesis. Their inhibition is predicted to have pleiotropic effects, but it is unclear whether this will impact on the clinical utility of CDK8/19 inhibitors. We discovered two series of potent chemical probes with high selectivity for CDK8/19. Despite pharmacodynamic evidence for robust on-target activity, the compounds exhibited modest, though significant, efficacy against human tumor lines and patient-derived xenografts...
December 9, 2016: ELife
https://www.readbyqxmd.com/read/27935442/psychosis-after-switch-in-opioid-maintenance-agonist-and-risperidone-induced-pisa-syndrome-two-critical-incidents-in-the-treatment-of-a-patient-with-dual-diagnosis
#14
Manuel Sutter, Marc Walter, Kenneth M Dürsteler, Johannes Strasser, Marc Vogel
BACKGROUND AND AIMS: Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case which illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature. CASE DESCRIPTION: We report on a 56-year old patient diagnosed with schizophrenia and opioid dependence that suffered both from a risperidone-induced Pisa syndrome and, three years later, an acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT-prolongation...
December 9, 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27935199/model-averaging-for-treatment-effect-estimation-in-subgroups
#15
Björn Bornkamp, David Ohlssen, Baldur P Magnusson, Heinz Schmidli
In many clinical trials, biological, pharmacological, or clinical information is used to define candidate subgroups of patients that might have a differential treatment effect. Once the trial results are available, interest will focus on subgroups with an increased treatment effect. Estimating a treatment effect for these groups, together with an adequate uncertainty statement is challenging, owing to the resulting "random high" / selection bias. In this paper, we will investigate Bayesian model averaging to address this problem...
December 9, 2016: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/27935182/pain-management-intervention-targeting-nursing-staff-and-general-practitioners-pain-intensity-consequences-and-clinical-relevance-for-nursing-home-residents
#16
Dagmar Dräger, Andrea Budnick, Ronny Kuhnert, Sonja Kalinowski, Franziska Könner, Reinhold Kreutz
AIM: Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany. METHODS: In a cluster-randomized controlled intervention, 195 residents of 12 Berlin nursing homes who were affected by pain were surveyed at three points of measurement...
December 9, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27934829/does-the-presence-of-klebsiella-pneumoniae-carbapenemase-and-new-delhi-metallo-%C3%AE-lactamase-1-genes-in-pathogens-lead-to-fatal-outcome
#17
P Mathur, S Sagar, S Kumar, V Sharma, D Gupta, S Lalwani, R Rani, A Muruganantham
INTRODUCTION: Infections due to multidrug-resistant (MDR) pathogens are a medical challenge. There is considerable apprehension among clinicians regarding pathogens reported as carrying New Delhi metallo-β-lactamase-1 (NDM) and Klebsiella pneumoniae carbapenemase (KPC) genes from their patients. In the face of extremely high rates of antimicrobial resistance, it is essential to gauge the clinical significance of isolation of pathogens carrying these genes from clinical samples. This study compares the outcome of patients infected with pathogens carrying NDM/KPC genes versus those without these genes...
October 2016: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27934773/are-positive-experiences-of-children-in-non-therapeutic-research-justifiable-research-benefits
#18
Mira S Staphorst, Joke A M Hunfeld, Suzanne van de Vathorst
BACKGROUND: Conducting non-therapeutic research is ethically challenging because participation conveys risks and burden and no health benefit. In this paper, we report the positive experiences of a diverse group of healthy and ill children (6-18 years) who participated in non-therapeutic research studies and discuss whether these positive experiences can justifiably be viewed as benefits. METHODS: We used semistructured interviews from an earlier study about children's experiences in clinical research and did a secondary analysis on the positive experiences of the children in the non-therapeutic studies (N=30)...
December 1, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27934772/the-ethics-liaison-program-building-a-moral-community
#19
Sarah R Bates, Wendy J McHugh, Alexander R Carbo, Stephen F O'Neill, Lachlan Forrow
Ethicists often struggle to maintain institution-wide awareness of and commitment to medical ethics. At Beth Israel Deaconess Medical Center (BIDMC), we created the Ethics Liaison Program to address that challenge by making ethics part of the moral culture of the institution. Liaisons represent clinical and non-clinical areas throughout the medical centre. The liaison has a four-part role: to spread awareness and understanding of Ethics Programs among their coworkers; share information regarding ethical dilemmas in their work area with the members of the Ethics Support Service; review ethics activities and needs within their area; and undertake ethics-related projects...
December 1, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27934670/assessment-of-diagnosed-temporomandibular-disorders-and-orofacial-pain-conditions-by-predoctoral-dental-students-a-pilot-study
#20
Shawn S Adibi, Krishna Kumar Kookal, Nichole M Fishbeck, Chris R Thompson, Muhammad F Walji
Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose for predoctoral dental students due to the multifactorial etiology, complexity, and controversial issues surrounding these conditions. The aim of this study was to determine if patients in the clinic of one U.S. dental school reported existing signs and symptoms of TMD/OFP, whether the dental students diagnosed the condition based on the reported signs and symptoms, and if the condition was then treated. The study was based on a retrospective analysis of electronic health record data over a three-year period...
December 2016: Journal of Dental Education
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