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On being a doctor

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https://www.readbyqxmd.com/read/28944220/determinants-for-further-wishes-for-cosmetic-and-reconstructive-interventions-in-1652-patients-with-surgical-treated-carcinomas-of-the-oral-cavity
#1
Henrik Holtmann, Simon Spalthoff, Nils-Claudius Gellrich, Jörg Handschel, Julian Lommen, Norbert R Kübler, Gertrud Krüskemper, Majeed Rana, Karoline Sander
BACKGROUND: The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. METHOD: The desire of patients for CRS (N = 410; 26%) has been acquired in this DÖSAK rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28943929/contrast-enhanced-multiple-phase-imaging-features-of-intrahepatic-mass-forming-cholangiocarcinoma-and-hepatocellular-carcinoma-with-cirrhosis-a-comparative-study
#2
Ying Chen, Yao Pan, Ke-Ren Shen, Xiu-Liang Zhu, Chen-Ying Lu, Qing-Hai Li, Shu-Gao Han, Yan-Biao Fu, Xiu-Fang Xu, Ri-Sheng Yu
The intrahepatic mass-forming cholangiocarcinoma (IMCC) is frequently misdiagnosed as hepatocellular carcinoma (HCC) in patients with cirrhosis, by numerous radiologists and clinical doctors, which results in the incorrect therapeutic treatment. A retrospective case-control study was conducted, and the contrast-enhanced multiple-phase (CEMP) computed tomography (CT) and magnetic resonance imaging (MRI) findings of 22 pathologically confirmed IMCC patients and 22 HCC controls with underlying liver cirrhosis were analyzed at the present hospital, from January 2010 to December 2015...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28942731/factors-influencing-trainee-doctor-emigration-in-a-high-income-country-a-mixed-methods-study
#3
Nicholas Clarke, Sophie Crowe, Niamh Humphries, Ronan Conroy, Simon O'Hare, Paul Kavanagh, Ruairi Brugha
BACKGROUND: The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. METHODS: Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey...
September 25, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28942115/quality-of-life-and-patient-satisfaction-in-patients-with-atrial-fibrillation-on-stable-vitamin-k-antagonist-treatment-or-switched-to-a-non-vitamin-k-antagonist-oral-anticoagulant-during-a-1-year-follow-up-a-prefer-in-af-registry-substudy
#4
Raffaele De Caterina, Bernd Brüggenjürgen, Harald Darius, Sabine Köhler, Markus Lucerna, Ladislav Pecen, Giulia Renda, Richard John Schilling, Tessa Schliephacke, José Luis Zamorano, Jean-Yves Le Heuzey, Paulus Kirchhof
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are being introduced for stroke prevention in non-valvular Atrial Fibrillation (AF), and promise to be accepted better than Vitamin K Antagonists (VKAs) by patients, improving their Quality of Life (QoL). AIM: To assess to what extent patient-related factors influence decisions to switch from a VKA to a NOAC. METHODS: The PREFER in AF Registry collected data at baseline in 2012 - at the beginning of NOAC prescriptions - and at 1-year follow-up, in 6412 patients in seven Western European countries...
September 20, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28941843/antibiotic-optimisation-in-the-bush-local-know-how-and-core-periphery-relations
#5
Alexander Broom, Jennifer Broom, Emma Kirby, Alexandra Gibson, Mark Davis
The growing global concern around antimicrobial mis-use and proliferating resistance has resulted in increasing interest in optimising antibiotics, particularly in hospitals. While the agenda to tighten antibiotic use has been critically explored in metropolitan settings, the dynamics of rural and remote settings have remained largely unexplored. Drawing on 30 interviews with doctors, nurses, and pharmacists in a remote Australian hospital, we focus on the pertinence of setting, and its importance for contextualising and potentially achieving antibiotic optimisation...
September 20, 2017: Health & Place
https://www.readbyqxmd.com/read/28941773/exploring-the-associations-between-parent-reported-biological-indoor-environment-and-airway-related-symptoms-and-allergic-diseases-in-children
#6
Alisa Weber, Nina Fuchs, Susanne Kutzora, Lana Hendrowarsito, Uta Nennstiel-Ratzel, Erika von Mutius, Caroline Herr, Stefanie Heinze
OBJECTIVES: Asthma and allergic rhinitis are diseases which require special attention in childhood. Risk factors for these diseases are manifold and include environmental factors. Previous studies have shown associations between indoor mould and respiratory diseases in children. Besides indoor mould, organic waste storage, potted plants, pets and crowding could influence the microbial indoor environment at home and the respiratory health of children. Our aim was therefore to explore the associations of these factors with airway-related symptoms and respiratory diseases in preschoolers...
September 6, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28941393/mobile-health-application-to-assist-doctors-in-antibiotic-prescription-an-approach-for-antibiotic-stewardship
#7
Felipe Francisco Tuon, Juliano Gasparetto, Luciana Cristina Wollmann, Thyago Proença de Moraes
BACKGROUND: Technologies applied to mobile devices can be an important strategy in antibiotic stewardship programs. OBJECTIVE: The aim of this study was to determine the impact of a decision-making application on antibiotic prescription. METHODS: This was an observational, analytical and longitudinal study on the implementation of an antimicrobial guide for mobile application (app). This study analyzed the period of 12 months before and 12 months after the app implementation at a university hospital based on local epidemiology, avoiding high cost drugs and reducing the potential for drug resistance including carbapenem...
September 20, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28941189/efficacy-of-a-work-disability-prevention-program-for-people-with-rheumatic-and-musculoskeletal-conditions-the-work-it-study-trial
#8
Julie J Keysor, Michael P LaValley, Carrie Brown, David T Felson, Rawan A AlHeresh, Molly W Vaughan, Robert Yood, John I Reed, Saralynn J Allaire
OBJECTIVE: Work disability rates are high among people with rheumatic and musculoskeletal conditions. Effective disability preventive programs are needed. We examined the efficacy of a modified vocational rehabilitation approach delivered by trained occupational therapists and physical therapists on work limitation and work loss over two years among people with rheumatic and musculoskeletal conditions. METHODS: Eligibility criteria for this single-blind parallel-arm randomized trial included 21-65 years of age, 15 or more hours/week employment, self-reported doctor-diagnosed rheumatic or musculoskeletal condition, and concern about staying employed...
September 21, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28939342/the-effect-of-nurse-prescribers-on-glycaemic-control-in-type-2-diabetes-a-systematic-review-and-meta-analysis
#9
REVIEW
Maryam Tabesh, Dianna J Magliano, Digsu N Koye, Jonathan E Shaw
BACKGROUND: The creation of advanced nursing roles in diabetes management, with specific skills such as nurse prescribing, has resulted in nurses taking on roles that have traditionally been associated with doctors. OBJECTIVES: We aimed to examine the effectiveness of nurse-led clinics, in which nurses were involved in prescribing, on haemoglobin A1c (HbA1c) among people with type 2 diabetes. METHODS: We systematically searched the literature, Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Allied Health Literature database guide (CINAHL) databases, to identify randomised controlled trials (RCTs) assessing the effect of nurse prescribers on HbA1c...
August 31, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28938895/-it-is-good-to-take-her-early-to-the-doctor-mothers-understanding-of-childhood-pneumonia-symptoms-and-health-care-seeking-in-kilimanjaro-region-tanzania
#10
Florida Muro, Judith Meta, Jenny Renju, Adiel Mushi, Hilda Mbakilwa, Raimos Olomi, Hugh Reyburn, Helena Hildenwall
BACKGROUND: Pneumonia is among the leading causes of avoidable deaths for young children globally. The main burden of mortality falls on children from poor and rural families who are less likely to obtain the treatment they need, highlighting inequities in access to effective care and treatment. Caretakers' illness perceptions and care-seeking practices are of major importance for children with pneumonia to receive adequate care. This study qualitatively explores the caretaker concepts of childhood pneumonia in relation to treatment seeking behaviour and health worker management in Moshi urban district, Tanzania...
September 22, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28937790/the-doctor-of-philosophy-experience-of-athletic-trainers-facilitators-and-barriers-to-anticipatory-faculty-socialization
#11
Thomas Bowman, Joanne Klossner, Stephanie Mazerolle
CONTEXT:   It is important to understand the process whereby athletic trainers learn about their future roles, particularly when the roles can be complex and demanding. Little is known about the experiences of athletic training doctoral students, including facilitators and barriers to socialization as aspiring faculty members. OBJECTIVE:   To investigate factors influencing the anticipatory socialization of athletic training doctoral students into future faculty roles...
September 22, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28937005/quota-in-specialty-and-super-specialty-courses-what-does-the-judiciary-say
#12
Mukul Chandra Kapoor, Shubhendu Anand
Reservations in super-specialty courses have been controversial for decades. A number of practising doctors, medical students and others in society have wanted to do away with reservations in specialty and super-specialty courses, while there are others in favour of persisting with reservations. Article 15 (4) of the Constitution of India states that nothing shall prevent the State from making any special provision for the advancement of any socially and educationally backward classes of citizens or for the Scheduled Castes/Tribes...
May 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28936996/caregiver-perceptions-on-intensive-care-a-qualitative-study-from-southern-india
#13
Shuba Kumar, Jony Christina, Anna Revathi Jagadish, John Victor Peter, Kurien Thomas, Thambu David Sudarsanam
BACKGROUND: Admission of a patient to an intensive care unit (ICU) can result in tremendous stress to family caregivers not only because of the need to provide physical and emotional support to the sick relative, but also due to the burden of decision-making on behalf of the critically ill person. We enquired about family caregivers' perspectives on intensive care, the challenges they faced with decision-making and their perceptions on the nature of their interactions with healthcare providers...
May 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28936233/general-practitioners-experiences-and-perceptions-of-mild-moderate-depression-management-and-factors-influencing-effective-service-delivery-in-rural-australian-communities-a-qualitative-study
#14
Tamishka De Silva, Anjali Prakash, Sandhya Yarlagadda, Marjia Daniella Johns, Kate Sandy, Vibeke Hansen, Sue Phelan, Sabrina Pit
BACKGROUND: Rural communities in Australia face significant disadvantages relating to geographical isolation and limited access to mental health services. Documenting general practitioners' (GP) experiences and perception of mental health services in rural Australia may be useful to gain insight into rural GP management of mild to moderate depression. AIMS: To explore GPs' experience and views on which factors influence access to mental health services for mild to moderate depression...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28934799/factors-influencing-the-application-of-a-biopsychosocial-perspective-in-clinical-judgement-of-chronic-pain-interactive-management-with-medical-students
#15
Christopher P Dwyer, Phoebe E McKenna-Plumley, Hannah Durand, Emer M Gormley, Brian W Slattery, Owen M Harney, Padraig MacNeela, Brian E McGuire
BACKGROUND: Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934403/improving-inpatient-medication-adherence-using-attendant-education-in-a-tertiary-care-hospital-in-uganda
#16
Patricia Alupo, Richard Ssekitoleko, Tracy Rabin, Robert Kalyesubula, Ivan Kimuli, Benjamin E Bodnar
Quality problem: Although widely utilized in resource-rich health care systems, the use of quality improvement (QI) techniques is less common in resource-limited environments. Uganda is a resource-limited country in Sub-Saharan Africa that faces many challenges with health care delivery. These challenges include understaffing, inconsistent drug availability and inefficient systems that limit the provision of clinical care. Initial assessment: Poor adherence to prescribed inpatient medications was identified as a key shortcoming of clinical care on the internal medicine wards of Mulago National Referral Hospital, Kampala, Uganda...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28932935/a-mixed-methods-evaluation-of-paediatric-trainee-preparedness-to-manage-cardiopulmonary-arrests
#17
Órla Walsh, Sinéad Lydon, Paul O'Connor
Paediatric cardiopulmonary arrest (CPA) survival rates are strongly linked to the training of the doctors responding to the event. This study sought to characterise the level of experience in managing CPAs among paediatric trainees and to investigate the nontechnical (NTS) required to effectively lead a paediatric CPA team. A mixed-methods research design was used. For the quantitative phase, a questionnaire was developed to assess training, confidence, and experiences related to CPA management. During the qualitative phase, 17 paediatric trainees participated in a series of critical incident technique (CIT) interviews to explore the NTS used during the management of paediatric CPAs...
September 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28932124/marketed-drugs-used-for-the-management-of-hypercholesterolemia-as-anticancer-armament
#18
REVIEW
Panagiota Papanagnou, Theodora Stivarou, Ioannis Papageorgiou, Georgios E Papadopoulos, Anastasios Pappas
The design of novel pharmacologic agents as well as their approval for sale in markets all over the world is a tedious and pricey process. Inevitably, oncologic patients commonly experience unwanted effects of new anticancer drugs, while the acquisition of clinical experience for these drugs is largely based on doctor-patient partnership which is not always effective. The repositioning of marketed non-antineoplastic drugs that hopefully exhibit anticancer properties into the field of oncology is a challenging option that gains ground and attracts preclinical and clinical research in an effort to override all these hindrances and minimize the risk for reduced efficacy and/or personalized toxicity...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28931509/development-and-validation-of-qmortality-risk-prediction-algorithm-to-estimate-short-term-risk-of-death-and-assess-frailty-cohort-study
#19
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28931394/the-efficacy-of-initial-ventilation-strategy-for-adult-immunocompromised-patients-with-severe-acute-hypoxemic-respiratory-failure-study-protocol-for-a-multicentre-randomized-controlled-trial-venim
#20
Tao Wang, Gang Liu, Kun He, Xin Lu, Xianquan Liang, Meng Wang, Rong Zhu, Zongru Li, Feng Chen, Jun Ke, Qingming Lin, Chuanyun Qian, Bo Li, Jie Wei, Jingjun Lv, Li Li, Yanxia Gao, Guofeng Wu, Xiaohong Yu, Weiqin Wei, Ying Deng, Fengping Wang, Hong Zhang, Yun Zheng, Hong Zhan, Jinli Liao, Yingping Tian, Dongqi Yao, Jingsong Zhang, Xufeng Chen, Lishan Yang, Jiali Wu, Yanfen Chai, Songtao Shou, Muming Yu, Xudong Xiang, Dongshan Zhang, Fengying Chen, Xiufeng Xie, Yong Li, Bo Wang, Wenzhong Zhang, Yongli Miao, Michael Eddleston, Jianqiang He, Yong Ma, Shengyong Xu, Yi Li, Huadong Zhu, Xuezhong Yu
BACKGROUND: Acute respiratory failure (ARF) is still one of the most severe complications in immunocompromised patients. Our previous systematic review showed noninvasive mechanical ventilation (NIV) reduced mortality, length of hospitalization and ICU stay in AIDS/hematological malignancy patients with relatively less severe ARF, compared to invasive mechanical ventilation (IMV). However, this systematic review was based on 13 observational studies and the quality of evidence was low to moderate...
September 20, 2017: BMC Pulmonary Medicine
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