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https://www.readbyqxmd.com/read/28426536/exploring-the-interaction-between-nursing-decision-making-and-patient-outcomes-in-2-european-cancer-centers-a-qualitative-study
#1
Dario Valcarenghi, Annamaria Bagnasco, Giuseppe Aleo, Gianluca Catania, Milko Zanini, Bruno Cavaliere, Franco Carnevale, Loredana Sasso
BACKGROUND: In some clinical settings, nurses have difficulty describing the outcomes of their caring activities. Understanding the reasons for this could help nurse leaders to improve the effectiveness and visibility of nursing practice and safeguard nurses' working conditions. OBJECTIVE: The aims of this study were to understand how nurses working in 2 different adult cancer centers make healthcare decisions and assess the respective outcomes on their patients...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#2
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#3
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#4
Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock, Jean Kutner
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual's acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable...
April 18, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28419657/a-new-approach-to-clinical-research-integrating-clinical-care-quality-reporting-and-research-using-a-wound-care-network-based-learning-healthcare-system
#5
Thomas E Serena, Caroline E Fife, Kristen A Eckert, Raphael A Yaakov, Marissa J Carter
The disparity between ideal evidence from randomized controlled trials and real-world evidence in medical research has prompted the United States Food and Drug Administration to consider the use of real-world data to better understand safety and effectiveness of new devices for a broader patient population and to prioritize real-world data in regulatory decision making. As the healthcare system transitions from volume- to value-based care, there is a growing need to harness the power of real-world data to change the paradigm for wound care clinical research and enable more generalizable clinical trials...
April 17, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28419267/a-national-survey-assessing-the-number-of-records-allowed-open-in-electronic-health-records-at-hospitals-and-ambulatory-sites
#6
Jason S Adelman, Matthew A Berger, Amisha Rai, William L Galanter, Bruce L Lambert, Gordon D Schiff, David K Vawdrey, Robert A Green, Hojjat Salmasian, Ross Koppel, Clyde B Schechter, Jo R Applebaum, William N Southern
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, we conducted an electronic survey via 2 national listservs. Among 167 inpatient and outpatient study facilities using EHR systems designed to open multiple records at once, 44.3% were configured to allow ≥3 records open at once (unrestricted), 38...
April 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28418940/assessment-of-the-albumin-bilirubin-albi-grade-as-a-prognostic-indicator-for-hepatocellular-carcinoma-patients-treated-with-radioembolization
#7
Bin Gui, Ashley A Weiner, John Nosher, Shou-En Lu, Gretchen M Foltz, Omar Hasan, Seung K Kim, Vyacheslav Gendel, Naganathan B Mani, Darren R Carpizo, Nael E Saad, Timothy J Kennedy, Darryl A Zuckerman, Jeffrey R Olsen, Parag J Parikh, Salma K Jabbour
OBJECTIVE: As the utility of Child-Pugh (C-P) class is limited by the subjectivity of ascites and encephalopathy, we evaluated a previously established objective method, the albumin-bilirubin (ALBI) grade, as a prognosticator for yttrium-90 radioembolization (RE) treatment for patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 117 patients who received RE for HCC from 2 academic centers were reviewed and stratified by ALBI grade, C-P class, and Barcelona Clinic Liver Cancer stage...
April 17, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28416138/patient-centered-outcomes-of-breast-reconstruction-in-the-setting-of-post-mastectomy-radiotherapy-a-comprehensive-review-of-the-literature
#8
REVIEW
Bassim El-Sabawi, Adelyn L Ho, Michael Sosin, Ketan M Patel
BACKGROUND: The impact of post-mastectomy radiotherapy (PMRT) on patient-centered outcomes of breast reconstruction remains unclear. This comprehensive review aims to consolidate the available data regarding aesthetic outcomes, patient satisfaction, and the BREAST-Q(©) following breast reconstruction in the setting of PMRT to facilitate the informed consent and shared decision-making process. MATERIALS AND METHODS: A systematic search of the literature published from 2000 to 2016 in the PubMed/MEDLINE database was performed to identify all manuscripts reporting aesthetic outcome, patient satisfaction, or BREAST-Q(©) scores of patients undergoing PMRT and breast reconstruction...
February 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28412049/more-than-a-destination-contraceptive-decision-making-as-a-journey
#9
Margaret Mary Downey, Stephanie Arteaga, Elodia Villaseñor, Anu Manchikanti Gomez
BACKGROUND: Contraceptive use is widely recognized as a means of reducing adverse health-related outcomes. However, dominant paradigms of contraceptive counseling may rely on a narrow definition of "evidence" (i.e., scientifically accurate but exclusive of individual women's experiences). Given increased enthusiasm for long-acting, reversible contraceptive methods, such paradigms may reinforce counseling that overprivileges effectiveness, particularly for groups considered at high risk of unintended pregnancy...
April 12, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28411260/the-fast-ed-app-a-smartphone-platform-for-the-field-triage-of-patients-with-stroke
#10
Raul G Nogueira, Gisele S Silva, Fabricio O Lima, Yu-Chih Yeh, Carol Fleming, Daniel Branco, Arthur H Yancey, Jonathan J Ratcliff, Robert Keith Wages, Earnest Doss, Mehdi Bouslama, Jonathan A Grossberg, Diogo C Haussen, Teppei Sakano, Michael R Frankel
BACKGROUND AND PURPOSE: The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical Services professionals with the field assessment and destination triage of patients with acute ischemic stroke. METHODS: Review of the application's platform and its development as well as the different variables, assessments, algorithms, and assumptions involved...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28410649/incident-dialysis-access-in-patients-with-end-stage-kidney-disease-what-needs-to-be-improved
#11
REVIEW
Louise M Moist, Charmaine E Lok
The initiation of dialysis is a challenging time of transition for patients, families, and their supporters. Patients with exposure to a comprehensive chronic kidney disease clinic may have had education and subsequent decision making regarding dialysis modality and access; however, many patients with or without prior education will require an urgent start to dialysis, requiring quick decisions regarding dialysis modality and access. In many countries, hemodialysis (HD) using a central venous catheter (CVC) is the most common initial renal replacement modality and dialysis access...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410343/patient-understanding-of-the-risks-and-benefits-of-biologic-therapies-in-inflammatory-bowel-disease-insights-from-a-large-scale-analysis-of-social-media-platforms
#12
Bibiana Martinez, Francis Dailey, Christopher V Almario, Michelle S Keller, Mansee Desai, Taylor Dupuy, Sasan Mosadeghi, Cynthia Whitman, Karen Lasch, Lyann Ursos, Brennan M R Spiegel
BACKGROUND: Few studies have examined inflammatory bowel disease (IBD) patients' knowledge and understanding of biologic therapies outside traditional surveys. Here, we used social media data to examine IBD patients' understanding of the risks and benefits associated with biologic therapies and how this affects decision-making. METHODS: We collected posts from Twitter and e-forum discussions from >3000 social media sites posted between June 27, 2012 and June 27, 2015...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28409293/defining-the-need-for-surgery-in-small-bowel-obstruction
#13
Florian Kuehn, Malte Weinrich, Sarah Ehmann, Katja Kloker, Ilaria Pergolini, Ernst Klar
BACKGROUND: Small-bowel obstruction is a frequent disorder in emergency medicine and represents a major burden for patients and health care systems worldwide. Within the past years, progress has been made regarding the management of small-bowel obstructions, including the use of contrast agent swallow as a tool in the decision-making process. OBJECTIVES: This is a prospective controlled study investigating the central role of contrast agent swallow in the diagnostic and treatment algorithm for small-bowel obstruction at a university department of surgery...
April 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28406863/fluid-overload-and-kidney-injury-score-a-multidimensional-real-time-assessment-of-renal-disease-burden-in-the-critically-ill-patient
#14
Ayse Akcan-Arikan, Daniel J Gebhard, Megan A Arnold, Laura L Loftis, Curtis E Kennedy
OBJECTIVE: Interruptive acute kidney injury alerts are reported to decrease acute kidney injury-related mortality in adults. Critically ill children have multiple acute kidney injury risk factors; although recognition has improved due to standardized definitions, subtle changes in serum creatinine make acute kidney injury recognition challenging. Age and body habitus variability prevent a uniform maximum threshold of creatinine. Exposure of nephrotoxic medications is common but not accounted for in kidney injury scores...
April 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28405158/patient-experience-with-intravenous-biologic-therapies-for-ankylosing-spondylitis-crohn-s-disease-psoriatic-arthritis-psoriasis-rheumatoid-arthritis-and-ulcerative-colitis
#15
Susan C Bolge, Helen M Eldridge, Jennifer H Lofland, Caitlin Ravin, Philip J Hart, Michael P Ingham
OBJECTIVE: The objective of this study was to describe patient experience with intravenous (IV) biologics for ankylosing spondylitis, Crohn's disease, psoriatic arthritis, psoriasis, rheumatoid arthritis, or ulcerative colitis. METHODS: Semi-structured telephone interviews were conducted in 405 patients with these autoimmune diseases who were receiving an IV biologic to treat their disease. RESULTS: On a 7-point scale (1= not at all satisfied; 7= very satisfied), mean satisfaction with IV medication was rated 6...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28404760/the-21-gene-recurrence-score-assay-for-node-positive-early-stage-breast-cancer-and-impact-of-rxponder-trial-on-chemotherapy-decision-making-have-clinicians-already-decided
#16
Jagar Jasem, Christine M Fisher, Arya Amini, Elena Shagisultanova, Rachel Rabinovitch, Virginia F Borges, Anthony Elias, Peter Kabos
Background: The 21-gene recurrence score (RS) assay is retrospectively validated for assessing prognosis and benefit from chemotherapy in hormone receptor-positive, early-stage breast cancer (EBC) with low RS. We hypothesized that oncologists have already incorporated the RS assay for decision-making in higher-risk, node-positive disease, despite the lack of prospective data and contrary to NCCN Guideline recommendations. This study provides the first analysis of trends and differences in RS use and therapeutic implications in a population-based data set of patients with node-positive EBC...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28404600/qualitative-interviews-exploring-palliative-care-perspectives-of-latinos-on-dialysis
#17
Lilia Cervantes, Jacqueline Jones, Stuart Linas, Stacy Fischer
BACKGROUND AND OBJECTIVES: Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015...
April 12, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28401396/applying-the-temporal-abstraction-technique-to-the-prediction-of-chronic-kidney-disease-progression
#18
Li-Chen Cheng, Ya-Han Hu, Shr-Han Chiou
Chronic kidney disease (CKD) has attracted considerable attention in the public health domain in recent years. Researchers have exerted considerable effort in attempting to identify critical factors that may affect the deterioration of CKD. In clinical practice, the physical conditions of CKD patients are regularly recorded. The data of CKD patients are recorded as a high-dimensional time-series. Therefore, how to analyze these time-series data for identifying the factors affecting CKD deterioration becomes an interesting topic...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28400933/impact-of-contrast-echocardiography-on-assessment-of-ventricular-function-and-clinical-diagnosis-in-routine-clinical-echocardiography-korean-multicenter-study
#19
Doo-Youp Kim, Jung-Hyun Choi, Geu-Ru Hong, Se-Joong Rim, Jang-Young Kim, Sang-Chol Lee, Il-Suk Sohn, Wook-Jin Chung, Hye-Sun Seo, Se-Jung Yoon, Kyoung-Im Cho, Si-Wan Choi, Kyung-Jin Lee
BACKGROUND: Fundamental echocardiography has some drawbacks in patients with difficult-to-image echocardiograms. The aim of this study is to evaluate impact of contrast echocardiography (CE) on ventricular function assessment and clinical diagnosis in routine clinical echocardiography. METHODS: Two hundred sixty patients were prospectively enrolled over 3 years in 12 medical centers in Korea. General image quality, the number of distinguishable segments, ability to assess regional wall motion, left ventricular (LV) apex and right ventricle (RV) visualization, LV ejection fraction, changes in diagnostic or treatment plan were documented after echocardiography with and without ultrasound contrast agent...
March 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28399985/immunosuppressive-treatment-of-non-infectious-uveitis-history-and-current-choices
#20
Zhao Chan, Zhang Meifen
Non-infectious uveitis is one of the leading causes of preventable blindness worldwide. Long-term immunosuppressive treatment is generally required to achieve durable control of inflammation in posterior and panuveitis. Although systemic corticosteroids have been the gold standard of immunosup- pressive treatment for uveitis since first introduced in 1950s, its side effects of long-term use often warrant an adjuvant treatment to reduce the dosage/duration of corticosteroids needed to maintain disease control...
April 10, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
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