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https://www.readbyqxmd.com/read/29329438/patient-perspectives-on-how-physicians-communicate-diagnostic-uncertainty-an-experimental-vignette-study
#1
Viraj Bhise, Ashley N D Meyer, Shailaja Menon, Geeta Singhal, Richard L Street, Traber D Giardina, Hardeep Singh
Objective: We evaluated the effects of three different strategies for communicating diagnostic uncertainty on patient perceptions of physician competence and visit satisfaction. Design/Setting: Experimental vignette-based study design involving pediatric cases presented to a convenience sample of parents living in a large US city. Participants/Intervention(s): Three vignettes were developed, each describing one of three different ways physicians communicated diagnostic uncertainty to parents-(i) explicit expression of uncertainty ('not sure' about diagnosis), (ii) implicit expression of uncertainty using broad differential diagnoses and (iii) implicit expression of uncertainty using 'most likely' diagnoses...
January 10, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29329269/design-synthesis-and-safener-activity-of-novel-methyl-r-n-benzoyl-dichloroacetyl-thiazolidine-4-carboxylates
#2
Li-Xia Zhao, Hao Wu, Yue-Li Zou, Qing-Rui Wang, Ying Fu, Chun-Yan Li, Fei Ye
A series of novel methyl (R)-N-benzoyl/dichloroacetyl-thiazolidine-4-carboxylates were designed by active substructure combination. The title compounds were synthesized using a one-pot route from l-cysteine methyl ester hydrochloride, acyl chloride, and ketones. All compounds were characterized by IR, ¹H NMR, 13C NMR, and HRMS. The structure of 4q was determined by X-ray crystallography. The biological tests showed that the title compounds protected maize from chlorimuron-ethyl injury to some extent. The ALS activity assay showed that the title compounds increased the ALS activity of maize inhibited by chlorimuron-ethyl...
January 12, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29329147/multisource-feedback-and-narrative-comments-polarity-specificity-actionability-and-canmeds-roles
#3
Jocelyn M Lockyer, Joan Sargeant, Suzanne H Richards, John L Campbell, Laura A Rivera
INTRODUCTION: Multisource feedback is a questionnaire-based assessment tool that provides physicians with data about workplace behaviors and may combine numeric and narrative (free-text) comments. Little attention has been paid to wording of requests for comments, potentially limiting its utility to support physician performance. This study tested the phrasing of two different sets of questions. METHODS: Two sets of questions were tested with family physicians, medical and surgical specialists, and their medical colleague and coworker respondents...
January 10, 2018: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29327679/natural-and-artificial-strategies-to-control-the-conjugative-transmission-of-plasmids
#4
María Getino, Fernando de la Cruz
Conjugative plasmids are the main carriers of transmissible antibiotic resistance (AbR) genes. For that reason, strategies to control plasmid transmission have been proposed as potential solutions to prevent AbR dissemination. Natural mechanisms that bacteria employ as defense barriers against invading genomes, such as restriction-modification or CRISPR-Cas systems, could be exploited to control conjugation. Besides, conjugative plasmids themselves display mechanisms to minimize their associated burden or to compete with related or unrelated plasmids...
January 2018: Microbiology Spectrum
https://www.readbyqxmd.com/read/29324604/preterm-birth-and-gestational-length-in-four-race-nativity-groups-including-somali-americans
#5
Emily A Oliver, Mark Klebanoff, Lina Yossef-Salameh, Reena Oza-Frank, Soheil Moosavinasab, Patricia Reagan, Louis Muglia, Catalin S Buhimschi, Irina A Buhimschi
OBJECTIVE: To compare preterm birth rates and gestational length in four race-nativity groups including Somali Americans. METHODS: Using a retrospective cohort study design of Ohio birth certificates, we analyzed all singleton births between 2000 and 2015 from four groups of women categorized as U.S.-born, non-Hispanic white (USBW), U.S.-born, non-Hispanic black (USBB), African-born black (ABB, primarily of West African birth country), and Somalia-born (SB). An algorithm trained on maternal names was used to confirm Somali ethnicity...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324567/electronic-health-record-implementation-findings-at-a-large-suburban-health-and-human-services-department
#6
Kenyon Crowley, Anubhuti Mishra, Raul Cruz-Cano, Robert Gold, Dushanka Kleinman, Ritu Agarwal
OBJECTIVE: Evaluate an electronic health record (EHR) implementation across a large public health department to better understand and improve implementation effectiveness of EHRs in public health departments. DESIGN: A survey based on Consolidated Framework for Implementation Research constructs was administered to staff before and after implementation of an EHR. SETTING: Large suburban county department of health and human services that provides clinical, behavioral, social, and oral health services...
January 10, 2018: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29323529/applying-causal-mediation-analysis-to-personality-disorder-research
#7
Glenn D Walters
This article is designed to address fundamental issues in the application of causal mediation analysis to research on personality disorders. Causal mediation analysis is used to identify mechanisms of effect by testing variables as putative links between the independent and dependent variables. As such, it would appear to have relevance to personality disorder research. It is argued that proper implementation of causal mediation analysis requires that investigators take several factors into account. These factors are discussed under 5 headings: variable selection, model specification, significance evaluation, effect size estimation, and sensitivity testing...
January 2018: Personality Disorders
https://www.readbyqxmd.com/read/29322822/assessment-of-aided-language-comprehension-and-use-in-children-and-adolescents-with-severe-speech-and-motor-impairments
#8
Beata Batorowicz, Kristine Stadskleiv, Gregor Renner, Annika Dahlgren Sandberg, Stephen von Tetzchner
There is limited knowledge about aided language comprehension and use in children who use aided communication and who are considered to have a relatively good comprehension of spoken language. This study's purpose was to assess their aided language skills. The participants were 96 children and adolescents who used communication aids (aided group) and 73 children and adolescents with natural speech (reference group), aged 5 to 15 years. All of the participants who used aided communication were regarded by their teachers or professionals as having age-appropriate language comprehension...
January 11, 2018: Augmentative and Alternative Communication: AAC
https://www.readbyqxmd.com/read/29320778/five-year-recurrence-rate-and-the-predictors-following-stroke-in-the-mashhad-stroke-incidence-study-a-population-based-cohort-study-of-stroke-in-the-middle-east
#9
Maryam Salehi, Amin Amiri, Amanda G Thrift, Moira K Kapral, Luciano Sposato, Réza Behrouz, Jiming Fang, Ali Shoeibi, Peyman Hashemi, Mohammad Taghi Farzadfard, Naghmeh Mokhber, Mahmoud Reza Azarpazhooh
BACKGROUND: Little is known about the risk of recurrent stroke in low- and middle-income countries. This study was designed to identify the long-term risk of stroke recurrence and its associated factors. METHODS: From November 21, 2006 for a period of 1 year, 624 patients with first-ever stroke (FES) were registered from the residents of 3 neighborhoods in Mashhad, Iran. Patients were followed up for the next 5 years after the index event for any stroke recurrence or death...
January 10, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/29320409/evaluating-the-impact-of-a-clinician-improvement-program-for-treating-patients-with-intellectual-and-developmental-disabilities-the-challenging-case-of-mississippi
#10
John P Bartkowski, Janelle Kohler, Craig L Escude, Xiaohe Xu, Stephen Bartkowski
In recent years, people with intellectual and developmental disabilities (IDD) have moved from institutionalized settings to local community residences. While deinstitutionalization has yielded quality of life improvements for people with IDD, this transition presents significant health-related challenges. Community clinicians have typically not been trained to provide sound medical care to people with IDD, a subpopulation that exhibits unique medical needs and significant health disparities. This study reports the results of a comprehensive evaluation of an IDD-focused clinician improvement program implemented throughout Mississippi...
January 10, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29320158/coordination-mediated-synthesis-of-purification-free-bivalent-99mtc-labeled-probes-for-in-vivo-imaging-of-saturable-systems
#11
Yuichiro Taira, Tomoya Uehara, Masao Tsuchiya, Hideaki Takemori, Yuki Mizuno, Shiori Takahashi, Hiroyuki Suzuki, Hirofumi Hanaoka, Hiromichi Akizawa, Yasushi Arano
In the synthesis of technetium-99m (99mTc) labeled target-specific ligands, the presence of a large excess of unlabeled ligands over 99mTc in the injectate hinders target accumulation of 99mTc-labeled ligands by competing for target molecules. To circumvent the problem, we recently developed a concept of the metal coordination-mediated multivalency, and proved the concept with a 99mTc-labeled trivalent compound [99mTc(CO)3(CN-RGD)3]+ In this study, D-penicillamine (Pen) was selected as a chelating molecule and a cyclic RGDfK peptide was conjugated to Pen via a hexanoic linkage (Pen-Ahx-c(RGDfK))...
January 10, 2018: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/29319384/-student-y-or-studious-an-exploration-of-students-perceptions-of-parallel-learning-in-preregistration-physiotherapy-education
#12
James Milligan, Kate Grafton, John A Hammond
BACKGROUND/AIM: Within the United Kingdom (UK), physiotherapy preregistration training is provided at both undergraduate and postgraduate level at 17 higher education institutions (HEIs). Some course teams approach this by teaching preregistration BSc and MSc students simultaneously to meet the same learning outcomes. This is often termed "parallel learning" and it is not known how students perceive this mode of learning. The aim of the study was to explore the perceived benefits and challenges to parallel learning of preregistration BSc and MSc physiotherapy students...
January 10, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29319211/design-and-assembly-of-covalently-functionalized-polyoxofluorovanadate-molecular-hybrids
#13
Maria Nicolaou, Michael Papanikolaou, Athanassios Tsipis, Themistoklis Kabanos, Anastasios Keramidas, Stephen Sproules, Haralampos N Miras
Mixed-valent polyoxometalate (POM) clusters are one of the most interesting host species showing a wide range of structural features and properties. We report the facile preparation and functionalization of a mixed-valent polyoxofluorovanadates where two electrons are trapped to antipodal sites of the clusters. The first members of this family of clusters with the general formula, [VV12VIV2O16(μ-O)10(μ3-O)10(μ3-F)2(L)2]6-, where L: py = pyridine (1); pyr = pyrazine (2); im = imidazole (3), are unique organic-inorganic hybrids with the addition of a N-donor ligand at either end of the polyoxofluorovanadate...
January 10, 2018: Chemistry: a European Journal
https://www.readbyqxmd.com/read/29317909/implementing-the-aseptic-non-touch-technique-antt%C3%A2-clinical-practice-framework-for-aseptic-technique-a-pragmatic-evaluation-using-a-mixed-methods-approach-in-two-london-hospitals
#14
Simon Clare, Stephen Rowley
Background: Aseptic technique is an important infection prevention competency for protecting patients from healthcare-associated infection (HAI). Healthcare providers using the Aseptic Non Touch Technique (ANTT®) aseptic technique have demonstrated reduced variability and improved compliance with aseptic technique. Objectives: The primary aim of this study is to determine whether standardizing aseptic technique for invasive IV procedures, using the ANTT® - Clinical Practice Framework (CPF), increases staff compliance with the infection prevention actions designed to achieve a safe and effective aseptic technique, and whether this is sustainable over time...
January 2018: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29315357/to-increase-trust-change-the-social-design-behind-aggregated-biodiversity-data
#15
Nico M Franz, Beckett W Sterner
Growing concerns about the quality of aggregated biodiversity data are lowering trust in large-scale data networks. Aggregators frequently respond to quality concerns by recommending that biologists work with original data providers to correct errors 'at the source.' We show that this strategy falls systematically short of a full diagnosis of the underlying causes of distrust. In particular, trust in an aggregator is not just a feature of the data signal quality provided by the sources to the aggregator, but also a consequence of the social design of the aggregation process and the resulting power balance between individual data contributors and aggregators...
January 1, 2018: Database: the Journal of Biological Databases and Curation
https://www.readbyqxmd.com/read/29314366/barriers-to-midwives-and-nurses-addressing-mental-health-issues-with-women-the-mind-mothers-study
#16
Agnes Higgins, Carmel Downes, Mark Monahan, Ailish Gill, Stephen A Lamb, Margaret Carroll
AIM: To explore barriers to midwives and nurses addressing mental health issues with women during the perinatal period. BACKGROUND: Perinatal mental health is considered an important public health issue with health policy internationally identifying the importance of psychological support for women in the perinatal period. Midwives and primary care nurses are ideally positioned to detect mental distress early, but evidence suggests that they are reluctant to discuss mental health issues with women during pregnancy or in the postnatal period...
January 3, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29313124/development-of-a-train-to-proficiency-curriculum-for-the-technical-skills-component-of-the-fundamentals-of-endoscopic-surgery-exam
#17
Susan Gearhart, Michael Marohn, Saowanee Ngamruengphong, Gina Adrales, Oluwafemi Owodunni, Kim Duncan, Emil Petrusa, Pamela Lipsett
BACKGROUND: The demonstration of competency in endoscopy is required prior to obtaining American Board of Surgery Certification. To demonstrate competency, the resident must pass a national high-stakes cognitive test and a technical skills exam on a virtual reality simulator. The purpose of this preliminary study was to design a proficiency-based endoscopy simulation curriculum to meet this competency requirement. METHODS: This is a mixed methods prospective cohort study at a single academic medical institution...
January 8, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29306739/impact-of-enquiry-based-learning-ebl-on-student-midwife-praxis
#18
Anita Byrne, Jennifer McNeill, Katherine Rogers, Sam Porter
Midwifery training in Ireland moved to Higher Education in 2006. This shift established a physical and educational separation of theory and practice. The adoption of Enquiry Based Learning (EBL) by one Irish midwifery education institution attempted to address this division. Enquiry Based Learning (EBL) has the potential to develop student reflexivity and evidence assimilation across the career-span and may therefore enhance student praxis. EBL has been championed as an example of an educational model that supports praxis, helping to create competent practitioners through the use of authentic learning scenarios that address the theory practice divide...
December 28, 2017: Midwifery
https://www.readbyqxmd.com/read/29305720/barriers-for-the-implementation-of-guidelines-in-palliative-care-results-from-a-national-survey-of-professionals
#19
Helen Kalies, Rieke Schöttmer, Steffen T Simon, Raymond Voltz, Alexander Crispin, Claudia Bausewein
BACKGROUND: In 2015, an evidence- and consensus-based palliative care guideline in adults with incurable cancer was published by the German Guideline Program. Barriers and enablers for the guideline implementation of members of the German Association for Palliative Medicine (DGP) were unknown. Therefore, the aims of this study were (1) to evaluate professionals' knowledge, motivation, and outcome expectancy towards already existing recommendations for palliative care and (2) to evaluate the self-experienced competence in five medical key topics presented in the new guideline...
January 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29304360/clinical-trial-design-for-local-therapies-for-brain-metastases-a-guideline-by-the-response-assessment-in-neuro-oncology-brain-metastases-working-group
#20
REVIEW
Brian M Alexander, Paul D Brown, Manmeet S Ahluwalia, Hidefumi Aoyama, Brigitta G Baumert, Susan M Chang, Laurie E Gaspar, Steven N Kalkanis, David R Macdonald, Minesh P Mehta, Riccardo Soffietti, John H Suh, Martin J van den Bent, Michael A Vogelbaum, Jeffrey S Wefel, Eudocia Q Lee, Patrick Y Wen
The goals of therapeutic and biomarker development form the foundation of clinical trial design, and change considerably from early-phase to late-phase trials. From these goals, decisions on specific clinical trial design elements, such as endpoint selection and statistical approaches, are formed. Whereas early-phase trials might focus on finding a therapeutic signal to make decisions on further development, late-phase trials focus on the confirmation of therapeutic impact by considering clinically meaningful endpoints...
January 2018: Lancet Oncology
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