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https://www.readbyqxmd.com/read/29913434/factors-influencing-child-protection-professionals-decision-making-and-multidisciplinary-collaboration-in-suspected-abusive-head-trauma-cases-a-qualitative-study
#1
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
Clinicians face unique challenges when assessing suspected child abuse cases. The majority of the literature exploring diagnostic decision-making in this field is anecdotal or survey-based and there is a lack of studies exploring decision-making around suspected abusive head trauma (AHT). We aimed to determine factors influencing decision-making and multidisciplinary collaboration in suspected AHT cases, amongst 56 child protection professionals. Semi-structured interviews were conducted with clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
June 15, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29911931/profile-of-roche-s-ariosa-harmony-prenatal-test
#2
Elisa Bevilacqua, Serena Resta, Andrew Carlin, Xin Kang, Teresa Cos Sanchez, Jérôme de Marchin, Jacques C Jani
Roche's Ariosa HarmonyTM Prenatal Test, a noninvasive cfDNA (cell-free DNA) method for major trisomies has been available since January-2013 at the authors unit and tests were sent to California. From July-2017 onwards, prenatal cfDNA has been reimbursed in Belgium for all pregnancies, however since then samples are sent to a local technology transfer center. Little data are available on patient's profile and choices towards cfDNA and on the performance of local technology transfer centers. Areas covered: The profiles and choices of women regarding this test were evaluated...
June 18, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29910113/evaluation-of-the-vasoactive-inotropic-score-mid-regional-pro-adrenomedullin-and-cardiac-troponin-i-as-predictors-of-low-cardiac-output-syndrome-in-children-after-congenital-heart-disease-surgery
#3
J L Pérez-Navero, C Merino-Cejas, I Ibarra de la Rosa, S Jaraba-Caballero, M Frias-Perez, E Gómez-Guzmán, M Gil-Campos, M J de la Torre-Aguilar
OBJECTIVE: To determine the predictive value of the inotropic score (IS) and vasoactive-inotropic score (VIS) in low cardiac output syndrome (LCOS) in children after congenital heart disease surgery involving cardiopulmonary bypass (CPB), and to establish whether mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I), associated to the IS and VIS scores, increases the predictive capacity in LCOS. DESIGN: A prospective observational study was carried out...
June 14, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29909809/the-gap-between-economic-evaluations-and-clinical-practice-a-systematic-review-of-economic-evaluations-on-dabigatran-for-atrial-fibrillation
#4
Herbert J A Rolden, Gert Jan van der Wilt, Angela H E M Maas, Janneke P C Grutters
OBJECTIVES: As model-based economic evaluations (MBEEs) are widely used to make decisions in the context of policy, it is imperative that they represent clinical practice. Here, we assess the relevance of MBEEs on dabigatran for the prevention of stroke in patients with atrial fibrillation (AF). METHODS: We performed a systematic review on the basis of a developed questionnaire, tailored to oral anticoagulation in patients with AF. Included studies had a full body text in English, compared dabigatran with a vitamin K antagonist, were not dedicated to one or more subgroup(s), and yielded an incremental cost-effectiveness ratio...
June 18, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29909110/comprehensive-echocardiographic-assessment-of-normal-transcatheter-valve-function
#5
Rebecca T Hahn, Jonathon Leipsic, Pamela S Douglas, Wael A Jaber, Neil J Weissman, Philippe Pibarot, Philipp Blanke, Jae K Oh
OBJECTIVES: This study aims to establish parameters for identifying normal function for each of the 3 iterations of balloon-expandable valves and 2 iterations of self-expanding valves. BACKGROUND: Expected transthoracic echocardiographic Doppler-derived hemodynamic data for transcatheter aortic valves inform pre-implant decision-making and post-implanted monitoring of longitudinal valve function. METHODS: We collected the Echocardiography Core Lab measured mean gradients and effective orifice area (EOA) from discharge or 30-day echocardiograms from randomized trials; the PARTNER (Placement of Aortic Transcatheter Valves) trials for the balloon-expandable valves and the Medtronic CoreValve US Pivotal trial and Medtronic CoreValve Evolut R United States IDE Clinical Study for the self-expanding valves...
June 8, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29907553/development-and-evaluation-of-an-ethical-guideline-for-decisions-to-limit-life-prolonging-treatment-in-advanced-cancer-protocol-for-a-monocentric-mixed-method-interventional-study
#6
Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29906795/national-survey-of-neonatal-intensive-care-unit-medication-safety-practices
#7
Rachel G Greenberg, P Brian Smith, Carl Bose, Reese H Clark, C Michael Cotten, Chris DeRienzo
OBJECTIVE:  We conducted a detailed survey to identify medication safety practices among a large network of United States neonatal intensive care units (NICUs). METHODS:  We created a 53-question survey to assess 300 U.S. NICU's demographics, medication safety practices, adverse drug event (ADE) reporting, and ADE response plans. RESULTS:  Among the 164 (55%) NICUs that responded to the survey, more than 85% adhered to practices including use of electronic health records, computerized physician order entry, and clinical decision support; fewer reported adopting barcoding, formal safety surveys, and formal culture training; 137 of 164 (84%) developed at least one NICU-specific order-set with a median of 10 order-sets...
June 15, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29904596/scepticaemia-the-impact-on-the-health-system-and-patients-of-delaying-new-treatments-with-uncertain-evidence-a-case-study-of-the-sepsis-bundle
#8
Robin Blythe, David Cook, Nicholas Graves
BACKGROUND: A sepsis care bundle of intravenous vitamin C, thiamine, and hydrocortisone was reported to improve treatment outcomes. The data to support it are uncertain and decision makers are likely to be cautious about adopting it. The objective of this study was to model the opportunity costs in dollars and lives of waiting for better information before adopting the bundle. METHODS: A decision tree was built using information from the literature. We modelled the impact of bundle adoption under three scenarios using a simulation in which the bundle was effective as reported in the primary trial, less effective based on other information, and ineffective...
2018: F1000Research
https://www.readbyqxmd.com/read/29904575/recent-advances-in-transfusions-in-neonates-infants
#9
REVIEW
Ruchika Goel, Cassandra D Josephson
Transfusions of red blood cells (RBCs), platelets, and plasma are critical therapies for infants and neonates (particularly preterm neonates) in the neonatal intensive care unit, who are the most frequently transfused subpopulation across all ages. Although traditionally a significant gap has existed between the blood utilization and the evidence base essential to adequately guide transfusion practices in infants and neonates, pediatric transfusion medicine is evolving from infancy and gradually coming of age...
2018: F1000Research
https://www.readbyqxmd.com/read/29902555/inter-rater-agreement-of-intensivists-evaluating-the-goal-concordance-of-preference-sensitive-icu-interventions
#10
Alison E Turnbull, Sarina K Sahetya, Elizabeth Colantuoni, Josephine Kweku, Roozbeh Nikooie, J Randall Curtis
CONTEXT: Goal-concordant care has been identified as an important outcome of advance care planning and shared decision-making initiatives. However validated methods for measuring goal-concordance are needed. OBJECTIVES: To estimate the inter-rater reliability of senior critical care fellows rating the goal-concordance of preference-sensitive interventions performed in intensive care units (ICUs) while considering patient-specific circumstances as described in a previously-proposed methodology...
June 11, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29902464/does-race-influence-risk-assessment-and-recommendations-for-lung-resection-a-randomized-trial
#11
Mark K Ferguson, Carley Demchuk, Kristen Wroblewski, Megan Huisingh-Scheetz, Katherine Thompson, Jeanne Farnan, Julissa Acevedo
BACKGROUND: Racial disparities in utilization of surgical therapy for lung cancer exist in the United States. Videos of standardized patients (SPs) can help identify factors that influence physicians' surgical risk estimation. We hypothesized that physician race and SP race in videos influence surgeon decision making. METHODS: Four race-neutral clinical vignettes representing lung resection candidates were paired with risk-level concordant short silent videos of SPs...
June 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29902283/botulinum-toxin-chemodenervation-for-childhood-strabismus-in-england-national-and-local-patterns-of-practice
#12
Ameenat Lola Solebo, Anne-Marie Austin, Maria Theodorou, Chris Timms, Joanne Hancox, Gillian G W Adams
BACKGROUND: Botulinum toxin injection chemodenervation is a well-established intervention for adult strabismus, and has also been recognised as an effective alternative to routine incisional surgery for paediatric disease. We aimed to investigate the temporal patterns of practice, indications and outcomes of chemodenervation for paediatric strabismus at national and tertiary centre level. METHODS: Retrospective study using routinely collected patient data: Hospital Episode Statistics (HES) data were used to identify children undergoing non-incisional strabismus procedures in England from 2007 to 2016...
2018: PloS One
https://www.readbyqxmd.com/read/29901231/a-qualitative-study-of-midwives-perceptions-on-using-video-calling-in-early-labor
#13
Helen Spiby, Mary Ann Faucher, Gina Sands, Julie Roberts, Holly Powell Kennedy
BACKGROUND: Decisions made in early labor influence the outcomes of childbirth for women and infants. Telephone assessment during labor, the current norm in many settings, has been found to be a source of dissatisfaction for women and can present challenges for midwives. The aim of this qualitative study was to explore midwives' views on the potential of video-calling as a method for assessing women in early labor. METHODS: A series of 8 midwife focus groups (n = 45) and interviews (n = 4) in the Midlands region of England and the mid-South and Northeast regions of the United States were completed...
June 14, 2018: Birth
https://www.readbyqxmd.com/read/29899017/statin-eligibility-coronary-artery-calcium-and-subsequent-cardiovascular-events-according-to-the-2016-united-states-preventive-services-task-force-uspstf-statin-guidelines-mesa-multi-ethnic-study-of-atherosclerosis
#14
Michael D Miedema, Zeina A Dardari, Sina Kianoush, Salim S Virani, Joseph Yeboah, Thomas Knickelbine, Veit Sandfort, Carlos J Rodriguez, Khurram Nasir, Michael J Blaha
BACKGROUND: The potential impact of the 2016 United States Preventive Services Task Force (USPSTF) guidelines on statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) warrants further analysis. METHODS AND RESULTS: We studied participants from MESA (Multi-Ethnic Study of Atherosclerosis) aged 40 to 75 years and not on statins. We compared statin eligibility at baseline (2000-2002) and over follow-up between USPSTF and the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines...
June 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29897473/return-to-duty-practices-of-army-behavioral-health-providers-in-garrison
#15
Coleen Crouch, Justin M Curley, Jamie T Carreno, Joshua E Wilk
Introduction: While combat readiness is a top priority for the U.S. Army, there is concern that behavioral health (BH) return to duty (RTD) practices may under-represent the number of soldiers available for deployment. Profiling, the official administrative process by which medical duty limitations are communicated to commanders, was recently found to be significantly under-reporting BH readiness levels in one Army Division. This is a safety issue in addition to a readiness problem, and underscores the importance of better understanding RTD practices in order to offer solutions...
June 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29896633/screening-for-cardiovascular-disease-risk-with-resting-or-exercise-electrocardiography-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#16
Daniel E Jonas, Shivani Reddy, Jennifer Cook Middleton, Colleen Barclay, Joshua Green, Claire Baker, Gary N Asher
Importance: Cardiovascular disease (CVD) is the leading cause of death in the United States. Objective: To review the evidence on screening asymptomatic adults for CVD risk using electrocardiography (ECG) to inform the US Preventive Services Task Force. Data Sources: MEDLINE, Cochrane Library, and trial registries through May 2017; references; experts; literature surveillance through April 4, 2018. Study Selection: English-language randomized clinical trials (RCTs); prospective cohort studies reporting reclassification, calibration, or discrimination that compared risk assessment using ECG plus traditional risk factors vs traditional risk factors alone...
June 12, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29892980/the-perspective-of-allied-health-staff-on-the-role-of-nurses-in-sub-acute-care
#17
Robin Digby, Danielle Bolster, Andrew Perta, Tracey K Bucknall
AIM: To explore allied health staff perceptions on the role of nurses in sub-acute care wards. BACKGROUND: A consequence of earlier discharge from acute hospitals is higher acuity of patients in sub-acute care. The impact on nurses' roles and required skill mix remains unknown. Similarly, nurses' integration into the rehabilitation team is ambiguous. DESIGN: Descriptive qualitative inquiry. METHODS: Semi-structured interviews conducted with 14 allied health staff from one sub-acute care facility in Melbourne, Australia...
June 12, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29889255/development-and-implementation-of-a-mobile-device-based-pediatric-electronic-decision-support-tool-as-part-of-a-national-practice-standardization-project
#18
Russell J McCulloh, Sarah D Fouquet, Joshua Herigon, Eric A Biondi, Brandan Kennedy, Ellen Kerns, Adrienne DePorre, Jessica L Markham, Y Raymond Chan, Krista Nelson, Jason G Newland
Objective: Implementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project. Materials and Methods: We developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled "Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE)...
June 7, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29888622/how-does-regulatory-practice-create-discrepancies-in-drug-label-information-between-asian-and-western-countries-different-label-information-for-direct-oral-anticoagulants-approved-in-the-united-states-europe-korea-and-japan
#19
Il Young Cho, Ki Hwan Choi, Yhun Yhong Sheen
Globalization of the pharmaceutical industry has continued over the past few decades, and various regulatory authorities have put considerable effort into harmonizing and standardizing drug regulations. However, the regulatory practices of each regulatory authority, in addition to local differences in ethnic, social, and cultural backgrounds, create discrepancies in risk/benefit assessments, regulatory decisions, and drug label information in various countries. This study examines discrepancies in the label information for direct oral anticoagulants approved in the US, Europe, Korea, and Japan and reviews the causes of those discrepancies, focusing on regulatory practices...
January 1, 2018: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/29888322/the-pathology-workforce-and-clinical-licensure-the-role-of-the-phd-clinical-laboratorian-in-the-united-states
#20
Robin G Lorenz, Donald S Karcher, Michael D Gautreaux, Melvin Limson, Dani S Zander
There has been a recent recognition of the need to prepare PhD-trained scientists for increasingly diverse careers in academia, industry, and health care. The PhD Data Task Force was formed to better understand the current state of PhD scientists in the clinical laboratory workforce and collect up-to-date information on the training and certification of these laboratorians. In this report, we summarize the findings of the PhD Data Task Force and discuss the relevance of the data collected to the future supply of and demand for PhD clinical laboratory scientists...
January 2018: Academic Pathology
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