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Clinical currency

Patrick J Silva, Valerie M Schaibley, Kenneth S Ramos
While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations...
February 15, 2018: Journal of Translational Medicine
Tiuri R van Rossum, Fedde Scheele, Henk E Sluiter, Emma Paternotte, Ide C Heyligers
INTRODUCTION: As competency-based education has gained currency in postgraduate medical education, it is acknowledged that trainees, having individual learning curves, acquire the desired competencies at different paces. To accommodate their different learning needs, time-variable curricula have been introduced making training no longer time-bound. This paradigm has many consequences and will, predictably, impact the organization of teaching hospitals. The purpose of this study was to determine the effects of time-variable postgraduate education on the organization of teaching hospital departments...
January 31, 2018: Medical Teacher
Liza J Seubert, Kerry Whitelaw, Laetitia Hattingh, Margaret C Watson, Rhonda M Clifford
BACKGROUND: Easy access to effective over-the-counter (OTC) treatments allows self-management of some conditions, however inappropriate or incorrect supply or use of OTC medicines can cause harm. Pharmacy personnel should support consumers in their health-seeking behaviour by utilising effective communication skills underpinned by clinical knowledge. OBJECTIVE: To identify interventions targeted towards improving communication between consumers and pharmacy personnel during OTC consultations in the community pharmacy setting...
December 13, 2017: Research in Social & Administrative Pharmacy: RSAP
Meng-Jie Li, Ying-Ning Zheng, Wen-Bin Liang, Ruo Yuan, Ya-Qin Chai
Ultrasensitive and rapid quantification of the universal energy currency adenosine triphosphate (ATP) is an extremely critical mission in clinical applications. In this work, a "signal-off" photoelectrochemical (PEC) biosensor was designed for ultrasensitive ATP detection based on a fullerene (C60 )-decorated Au nanoparticle@MoS2 (C60 -Au NP@MoS2 ) composite material as a signal indicator and a p-type PbS quantum dot (QD) as an efficient signal quencher. Modification of wide band gap C60 with narrow band gap MoS2 to form an ideal PEC signal indicator was proposed, which could significantly improve photocurrent conversion efficiency, leading to a desirable PEC signal...
December 6, 2017: ACS Applied Materials & Interfaces
Jessie Huisinga, Adam Bruetsch, Ayla McCalley, Melissa Currence, Laura Herbelin, Omar Jawdat, Mamatha Pasnoor, Mazen Dimachkie, Richard Barohn, Jeffrey Statland
INTRODUCTION: Instrumenting timed functional motor tasks may reveal a continuum of motor disability that predicts future motor dysfunction. METHODS: We performed a prospective study of the instrumented timed up and go (iTUG) test in genetically confirmed facioscapulohumeral muscular dystrophy (FSHD) participants utilizing a commercially available system of wireless motion sensors. Patients returned within 2 weeks to determine test-retest reliability. Gait parameters in FSHD participants were compared to a normative data base, FSHD clinical severity score, manual muscle testing, and patient-reported functional disability...
September 6, 2017: Muscle & Nerve
Marvellous Akinlotan, Bradley Chen, Tiana M Fontanilla, Annie Chen, Victoria Y Fan
OBJECTIVES: To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants. METHODS: Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school- or clinic-based setting of delivery...
September 6, 2017: Community Dentistry and Oral Epidemiology
Niclas Skyttberg, Rong Chen, Hans Blomqvist, Sabine Koch
BACKGROUND: Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. OBJECTIVES: This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores...
August 30, 2017: Applied Clinical Informatics
Paula Rosales Zubiaurre, Luciana Ribeiro Bahia, Michelle Quarti Machado da Rosa, Roberto Pereira Assumpção, Alexandre Vontobel Padoin, Samanta Pereira Sussembach, Everton Nunes da Silva, Claudio Corá Mottin
BACKGROUND: Obesity is a major global epidemic and a burden to society and health systems. This study aimed to estimate and compare the anual costs of clinical and surgical treatment of severe obesity from the perspective of the Brazilian Public Health System. METHODS: An observational and cross-sectional study was performed in three reference centers. Data collection on health resources utilization and productivity loss was carried out through an online questionnaire...
December 2017: Obesity Surgery
Feng Chang, Yue Xi, Jie Zhao, Xiaojian Zhang, Yun Lu
RATIONALE, AIMS, AND OBJECTIVES: Spontaneous reporting of adverse drug reactions (ADRs) in hospitals is often under-reported, which may lead to problems in patient management. This study was aimed to assess the effectiveness of a financial intervention based on a fine and a bonus for improving spontaneous reporting of ADRs by physicians in a hospital setting. METHODS: This study was conducted at the First Affiliated Hospital of Zhengzhou University (China). Starting in 2009, a bonus of 20 RMB (Chinese currency) was given for each spontaneous ADR report, and a fine of 50 RMB was given for any withheld ADR report...
July 4, 2017: Journal of Evaluation in Clinical Practice
Beata Dziki, Izabela Miechowicz, Piotr Iwachów, Michał Kuzemczak, Piotr Kałmucki, Andrzej Szyszka, Artur Baszko, Tomasz Siminiak
BACKGROUND: Costs of percutaneous coronary interventions (PCI) have an important impact on health care expenditures. Despite the present stress upon the cost-effectiveness issues in medicine, few comprehensive data exist on costs and resource use in different clinical settings. AIM: To assess catheterisation laboratory costs related to use of drugs and single-use devices in patients undergoing PCI due to coronary artery disease. METHODS: Retrospective analysis of 1500 consecutive PCIs (radial approach, n = 1103; femoral approach, n = 397) performed due to ST segment elevation myocardial infarction (STEMI; n = 345) and non ST-segment elevation myocardial infarction (NSTEMI; n = 426) as well as unstable angina (UA; n = 489) and stable angina (SA; n = 241) was undertaken...
2017: Kardiologia Polska
Sébastien Hélie, Farzin Shamloo, Keisha Novak, Dan Foti
In neuroeconomics, valuation refers to the process of assigning values to states and actions on the basis of the animal's current representation of the environment, while reward processing corresponds to processing the feedback received from the environment to update the values of states and actions. In this article, we review the brain circuits associated with valuation and reward processing and argue that these are fundamental processes critical to many cognitive functions. Specifically, we focus on the role of valuation and reward processing in attention, memory, decision making, and learning...
May 2017: Annals of the New York Academy of Sciences
Niloufer J Johansen, Christobel M Saunders
Globally, an increasing and aging population is contributing to the prevalence of cancer. To be effective, cancer care needs to involve the coordination of multidisciplinary specialties, and also needs to be affordable, accessible, and capable of producing optimal patient outcomes. Porter and Teisberg (2006) have postulated that shifting current healthcare strategies from volume-based to patient-centric care redirects economic competition to providing treatments which promote the best patient outcomes while driving down costs...
February 17, 2017: Curēus
Jakub Czapiński, Michał Kiełbus, Joanna Kałafut, Michał Kos, Andrzej Stepulak, Adolfo Rivero-Müller
In biological systems, the formation of molecular complexes is the currency for all cellular processes. Traditionally, functional experimentation was targeted to single molecular players in order to understand its effects in a cell or animal phenotype. In the last few years, we have been experiencing rapid progress in the development of ground-breaking molecular biology tools that affect the metabolic, structural, morphological, and (epi)genetic instructions of cells by chemical, optical (optogenetic) and mechanical inputs...
2017: Frontiers in Chemistry
Shirley H Bush, Katie L Marchington, Meera Agar, Daniel H J Davis, Lindsey Sikora, Tammy W Y Tsang
OBJECTIVE: To determine the accessibility and currency of delirium guidelines, guideline summary papers and evaluation studies, and critically appraise guideline quality. DESIGN: Systematic literature search for formal guidelines (in English or French) with focus on delirium assessment and/or management in adults (≥18 years), guideline summary papers and evaluation studies.Full appraisal of delirium guidelines published between 2008 and 2013 and obtaining a 'Rigour of Development' domain screening score cut-off of >40% using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument...
March 10, 2017: BMJ Open
Yali Zhong, Xiaoli Li, Yasai Ji, Xiaoran Li, Yaqing Li, Dandan Yu, Yuan Yuan, Jian Liu, Huixiang Li, Mingzhi Zhang, Zhenyu Ji, Dandan Fan, Jianguo Wen, Mariusz Adam Goscinski, Long Yuan, Bin Hao, Jahn M Nesland, Zhenhe Suo
Cells generate adenosine-5'-triphosphate (ATP), the major currency for energy-consuming reactions, through mitochondrial oxidative phosphorylation (OXPHOS) and glycolysis. One of the remarkable features of cancer cells is aerobic glycolysis, also known as the "Warburg Effect", in which cancer cells rely preferentially on glycolysis instead of mitochondrial OXPHOS as the main energy source even in the presence of high oxygen tension. One of the main players in controlling OXPHOS is the mitochondrial gatekeeperpyruvate dehydrogenase complex (PDHc) and its major subunit is E1α (PDHA1)...
February 21, 2017: Oncotarget
Pascalia O Munyewende, Jonathan Levin, Laetitia C Rispel
BACKGROUND: Managerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage. OBJECTIVE: To evaluate the competencies of PHC clinic nursing managers in two South African provinces. DESIGN: A cross-sectional study was conducted in two South African provinces...
2016: Global Health Action
Elise Hindle
Our aim was to institute a system whereby emergency anaesthetic guidelines are available in >90% of appropriate clinical areas throughout each of the acute hospital sites in three health board administrative regions, and whereby >90% of available guidelines are deemed to be in date and fit for purpose. Our objective was to achieve these targets within 6 months. Using quality improvement methodology, we inventoried available emergency anaesthetic guidelines in 132 locations throughout seven acute care hospitals...
2016: BMJ Quality Improvement Reports
Clare F Heal, Jennifer L Banks, Phoebe D Lepper, Evangelos Kontopantelis, Mieke L van Driel
BACKGROUND: Surgical site infections (SSI) can delay wound healing, impair cosmetic outcome and increase healthcare costs. Topical antibiotics are sometimes used to reduce microbial contaminant exposure following surgical procedures, with the aim of reducing SSIs. OBJECTIVES: The primary objective of this review was to determine whether the application of topical antibiotics to surgical wounds that are healing by primary intention reduces the incidence of SSI and whether it increases the incidence of adverse outcomes (allergic contact dermatitis, infections with patterns of antibiotic resistance and anaphylaxis)...
November 7, 2016: Cochrane Database of Systematic Reviews
Keith Harrison, John Peek, Michael Chapman, Mark Bowman
BACKGROUND: Assisted reproductive technology (ART) clinics in Australia and New Zealand are accredited and licensed against a Code of Practice audited by certifying bodies accredited by the Joint Accreditation System for Australia and New Zealand (JAS-ANZ). The system is administered by the Reproductive Technology Accreditation Committee (RTAC) of the Fertility Society of Australia. AIMS: To review the incidence of variances and findings identified by certifying bodies in Australian and New Zealand ART clinics within the currency of a single version of the Code of Practice...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Christine Dennis, Pamela Baxter, Jenny Ploeg, Susan Blatz
AIMS: A discussion of partnership in the context of family-centred care in the acute paediatric setting, through a critical analysis of partnership models. BACKGROUND: Paediatric healthcare practitioners understand the importance of family-centred care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family-centred care, yet less is known about strategies to fully engage or support parents in these partnerships...
October 5, 2016: Journal of Advanced Nursing
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