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https://www.readbyqxmd.com/read/28938252/emotional-impact-of-end-of-life-decisions-on-professional-relationships-in-the-icu-an-obstacle-to-collegiality
#1
Alexandra Laurent, Magalie Bonnet, Gilles Capellier, Pierre Aslanian, Paul Hebert
OBJECTIVES: End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU. DESIGN: Qualitative study with clinical interviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28936694/evaluating-the-effectiveness-of-physician-counseling-to-promote-physical-activity-in-mexico-an-effectiveness-implementation-hybrid-study
#2
Karla I Galaviz, Paul A Estabrooks, Edtna Jauregui Ulloa, Rebecca E Lee, Ian Janssen, Juan López Y Taylor, Luis Ortiz-Hernández, Lucie Lévesque
Integrating physical activity (PA) counseling in routine clinical practice remains a challenge. The purpose of this study was to evaluate the implementation and effectiveness of a pragmatic strategy aimed to improve physician PA counseling and patient PA. An effectiveness-implementation type-2 hybrid design was used to evaluate a 3-h training (i.e., implementation strategy-IS) to increase physician use of the 5-As (assess, advise, agree, assist, arrange) for PA counseling (i.e., clinical intervention-CI) and to determine if the CI improved patient PA...
September 21, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28932964/treatment-strategies-for-the-opioid-dependent-patient
#3
REVIEW
Shweta Teckchandani, Meredith Barad
PURPOSE OF REVIEW: This review is intended to help the headache physician think through and plan for management issues concerning the use of opioids. We ask the headache physician to consider if there are instances where prescribing or continuing prescriptions of opiates is plausible, and if so, how can the physician proceed as safely as possible. Our goal is to start a conversation regarding the inevitable encounter with a patient on opiates or requesting opiates. RECENT FINDINGS: The use of opiates in our society has reached a crisis in staggering death and addiction rates...
September 20, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28928295/real-time-human-respiration-carbon-dioxide-measurement-device-for-cardiorespiratory-assessment
#4
Om Prakash Singh, Teo Aik Howe, Malarvili Balakrishnan
Development of a human respiration carbon dioxide (CO2) measurement device remains a demanding research to evaluate the cardio-respiratory status of human beings since last decades in and out of hospital. Hence, we report a real time, user operable CO2 measurement device using infrared CO2 sensor, Arduino Mega2560, and thin film transistor (TFT, 3.5"), incorporated with low pass (cut-off frequency,10Hz) and moving average (span,8) filters. The proposed device measures features such as partial end-tidal carbon dioxide (EtCO2), respiratory rate (RR), inspired carbon dioxide (ICO2) and newly proposed feature, Hjorth Activity that annotated with a date and time received from real-time clock and stores into the secure digital (SD) card...
September 20, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28926751/collaboration-of-midwives-in-primary-care-midwifery-practices-with-other-maternity-care-providers
#5
J Catja Warmelink, Therese A Wiegers, T Paul de Cock, Trudy Klomp, Eileen K Hutton
BACKGROUND: Inter-professional collaboration is considered essential in effective maternity care. National projects are being undertaken to enhance inter-professional relationships and improve communication between all maternity care providers in order to improve the quality of maternity care in the Netherlands. However, little is known about primary care midwives' satisfaction with collaboration with other maternity care providers, such as general practitioners, maternity care assistance organisations (MCAO), maternity care assistants (MCA), obstetricians, clinical midwives and paediatricians...
September 6, 2017: Midwifery
https://www.readbyqxmd.com/read/28925073/role-of-cardiopulmonary-exercise-testing-in-clinical-stratification-in-heart-failure-a-position-paper-from-the-committee-on-exercise-physiology-and-training-of-the-heart-failure-association-of-the-european-society-of-cardiology
#6
REVIEW
Ugo Corrà, Pier Giuseppe Agostoni, Stefan D Anker, Andrew J S Coats, Maria G Crespo Leiro, Rudolph A de Boer, Veli-Pekka Hairola, Loreena Hill, Mitja Lainscak, Lars H Lund, Marco Metra, Piotr Ponikowski, Jillian Riley, Petar M Seferović, Massimo F Piepoli
Traditionally, the main indication for cardiopulmonary exercise testing (CPET) in heart failure (HF) was for the selection of candidates to heart transplantation: CPET was mainly performed in middle-aged male patients with HF and reduced left ventricular ejection fraction. Today, CPET is used in broader patients' populations, including women, elderly, patients with co-morbidities, those with preserved ejection fraction, or left ventricular assistance device recipients, i.e. individuals with different responses to incremental exercise and markedly different prognosis...
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28923056/physicians-perceptions-on-the-impact-of-telemedicine-on-recruitment-and-retention-in-underserved-areas-a-descriptive-study-in-senegal
#7
Birama Apho Ly, Ivy Lynn Bourgeault, Ronald Labonté, Mbayang Ndiaye Niang
BACKGROUND: Similar to many places, physicians in Senegal are unevenly distributed. Telemedicine is considered a potential solution to this problem. This study investigated the perceptions of Senegal's physicians of the impact of telemedicine on their recruitment to and retention in underserved areas. METHODS: We conducted individual interviews with a random sample of 60 physicians in Senegal, including 30 physicians working in public hospitals and 30 physicians working in district health centres between January and June 2014, as part of a mixed methods study...
September 18, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28918910/pet-and-mri-image-fusion-based-on-combination-of-2-d-hilbert-transform-and-ihs-method
#8
Mozhdeh Haddadpour, Sabalan Daneshavar, Hadi Seyedarabi
BACKGROUND: The process of medical image fusion is combining two or more medical images such as Magnetic Resonance Image (MRI) and Positron Emission Tomography (PET) and mapping them to a single image as fused image. So purpose of our study is assisting physicians to diagnose and treat the diseases in the least of the time. METHODS: We used Magnetic Resonance Image (MRI) and Positron Emission Tomography (PET) as input images, so fused them based on combination of two dimensional Hilbert transform (2-D HT) and Intensity Hue Saturation (IHS) method...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28917951/a-spatial-analysis-of-race-local-health-promoting-resources-and-preventable-hospitalizations
#9
Caryn N Bell, Janice V Bowie, Roland J Thorpe, David M Levine
INTRODUCTION: Preventable hospitalizations (PHs) for chronic conditions could have been avoided if treated with primary healthcare. PH rates are higher among African Americans, and in areas with less healthcare. Little is known about the effects of non-healthcare local health-promoting resources (LHPRs). The objective of this study is to determine associations between LHPRs and chronic PH rates in Maryland, and to assess spatial clustering of areas with high PH rates. METHODS: Hospitalizations in 2010 were obtained from the Maryland Health Services Cost Review Commission by zip code of residence...
September 13, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28916930/tongue-image-analysis-and-its-mobile-app-development-for-health-diagnosis
#10
Ratchadaporn Kanawong, Tayo Obafemi-Ajayi, Dahai Liu, Meng Zhang, Dong Xu, Ye Duan
Computer-aided diagnosis provides a medical procedure that assists physicians in interpretation of medical images. This work focuses on computer-aided tongue image analysis specifically, based on Traditional Chinese Medicine (TCM). Tongue diagnosis is an important component of TCM. Computerized tongue diagnosis can aid medical practitioners in capturing quantitative features to improve reliability and consistency of diagnosis. Recently, researchers have started to develop computer-aided tongue analysis algorithms based on new advancement in digital photogrammetry, image analysis, and pattern recognition technologies...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28916030/fellowship-candidate-selection-at-the-best-medical-center-a-novel-process
#11
Philip R Cohen
Dr. Ida Lystic completed her MD degree at the prestigious Harvey Medical School (which has since been renamed the Harvey Provider School) and her residency in internal medicine and gastroenterology fellowship at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. She was subsequently hired as an assistant professor at the BEST (Byron Edwards and Samuel Thompson) Medical Center in 2015. After eventually completing an extensive list of employment requirements, she was able to begin seeing patients...
September 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28915887/professional-fulfillment-and-parenting-work-life-balance-in-female-physicians-in-basic-sciences-and-medical-research-a-nationwide-cross-sectional-survey-of-all-80-medical-schools-in-japan
#12
Yuka Yamazaki, Takanori Uka, Eiji Marui
BACKGROUND: In Japan, the field of Basic Sciences encompasses clinical, academic, and translational research, as well as the teaching of medical sciences, with both an MD and PhD typically required. In this study, it was hypothesized that the characteristics of a Basic Sciences career path could offer the professional advancement and personal fulfillment that many female medical doctors would find advantageous. Moreover, encouraging interest in Basic Sciences could help stem shortages that Japan is experiencing in medical fields, as noted in the three principal contributing factors: premature resignation of female clinicians, an imbalance of female physicians engaged in research, and a shortage of medical doctors in the Basic Sciences...
September 15, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28915822/what-hinders-the-uptake-of-computerized-decision-support-systems-in-hospitals-a-qualitative-study-and-framework-for-implementation
#13
Elisa G Liberati, Francesca Ruggiero, Laura Galuppo, Mara Gorli, Marien González-Lorenzo, Marco Maraldi, Pietro Ruggieri, Hernan Polo Friz, Giuseppe Scaratti, Koren H Kwag, Roberto Vespignani, Lorenzo Moja
BACKGROUND: Advanced Computerized Decision Support Systems (CDSSs) assist clinicians in their decision-making process, generating recommendations based on up-to-date scientific evidence. Although this technology has the potential to improve the quality of patient care, its mere provision does not guarantee uptake: even where CDSSs are available, clinicians often fail to adopt their recommendations. This study examines the barriers and facilitators to the uptake of an evidence-based CDSS as perceived by diverse health professionals in hospitals at different stages of CDSS adoption...
September 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28915258/rapid-emergency-medicine-score-a-novel-prognostic-tool-for-predicting-the-outcomes-of-adult-patients-with-hepatic-portal-venous-gas-in-the-emergency-department
#14
Chen-June Seak, David Hung-Tsang Yen, Chip-Jin Ng, Yon-Cheong Wong, Kuang-Hung Hsu, Joanna Chen-Yeen Seak, Hsien-Yi Chen, Chen-Ken Seak
OBJECTIVE: This study aims to evaluate the performance of Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Modified Early Warning Score (MEWS) in ascertaining the severity of illness and predicting the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians (EPs) in risk stratification. METHODS: Data for 66 adult HPVG patients who visited the EDs of 2 research hospitals between October 1999 and April 2016 were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28915075/responding-to-patient-requests-for-hastened-death-physician-aid-in-dying-and-the-clinical-oncologist
#15
Rebecca A Spence, Charles D Blanke, Thomas J Keating, Lynne P Taylor
Physician aid in dying (PAD) or assisted suicide is becoming legal in more US jurisdictions. Meanwhile, the needs of terminally ill patients with cancer are receiving greater attention, including the integration of palliative care into oncology practice. This article highlights a case vignette of a patient with advanced cancer who requests PAD from her oncologist, as a backdrop to help the practicing oncologist examine his or her moral stance regarding participation in aid in dying. The article concludes by offering a framework within which the practicing oncologist can receive and process a patient's request for PAD...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28914678/update-topical-antimicrobial-agents-for-chronic-wounds
#16
R Gary Sibbald, James A Elliott, Luvneed Verma, Alisa Brandon, Reneeka Persaud, Elizabeth A Ayello
GENERAL PURPOSE: To provide information on the use of topical antimicrobial agents for the treatment of chronic wounds. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Examine features of wounds and wound healing as well as the purpose of specific antimicrobial agents...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#17
Benji K Mathews, Michael Zwank
Though the use of point-of-care ultrasound (POCUS) has increased over the last decade, formal hospital credentialing for POCUS may still be a challenge for hospitalists. This document details the Hospital Medicine Department Ultrasound Credentialing Policy from Regions Hospital, which is part of the HealthPartners organization in Saint Paul, Minnesota. National organizations from internal medicine and hospital medicine (HM) have not published recommended guidelines for POCUS credentialing. Revised guidelines for POCUS have been published by the American College of Emergency Physicians, though these are not likely intended to guide hospitalists when working with credentialing committees and medical boards...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913817/return-to-play-in-2017-and-the-role-of-shared-decision-making-in-patients-with-inherited-and-acquired-channelopathies-and-cardiomyopathies
#18
REVIEW
Kia Afshar, T Jared Bunch
Shared decision-making is based upon a physician-patient encounter in which there is adequate education using aids if needed, a mutual discussion of how to assist the patient in weighing risks and benefits, and a supportive environment that allows the patient to deliberate on the clinical decision and make their own choice. This decision-making paradigm centers on the principles of autonomy and self-determination. Physical activity is a critical part of healthy lifestyle choices that helps lower risk of cardiovascular disease or the progression of it...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28912614/spiritual-care-of-the-sick
#19
Fr Juan R Vélez
In the Gospel we see how people bring the sick to Christ to be healed. As physicians, nurses, and chaplains we are God's instruments bringing physical and spiritual healing to the sick. It is important for those of us who care for the sick to ask them about their religious affiliation and spiritual needs, and then following their cues and in a respectful way to encourage them to pray and, in the case of Catholics, to receive the sacraments. We should also pray for our patients, and when we think they would like it, to pray with them...
August 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28910992/physician-assisted-suicide-a-clean-bill-of-health
#20
Robert Preston
Background: Physician-assisted suicide (PAS) laws have been enacted in five US States and, along with physician-administered euthanasia, in Canada and the Netherlands. Sources of data: Annual reports of the Oregon Health Authority and published research papers. Areas of agreement: Not all recipients of lethal drugs use them to end their lives. Improvements in palliative care provision. Areas of controversy: Rising numbers of deaths from PAS...
September 1, 2017: British Medical Bulletin
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