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https://www.readbyqxmd.com/read/27892845/learning-together-1-an-educational-model-for-training-gps-paediatricians-initial-findings
#1
Chloe Macaulay, John Spicer, Wendy Riches, Monica Lakhanpaul
Learning Together is primarily an educational intervention, where paediatric registrars [SpRs] and General Practice (GP) registrars [GPSTs] see children together in a primary care setting. Over a six month period in 2013/2014, 44 learning pairs were set up mainly in North East and Central London. Proof of concept for the model at scale was achieved. Reported learning demonstrated: clinical learning themes of new knowledge, skill and communication skills; and collaborative themes of ongoing collaboration, satisfaction with team working and change in attitudes...
November 28, 2016: Education for Primary Care
https://www.readbyqxmd.com/read/27885750/they-re-nice-and-neat-but-are-they-useful-a-grounded-theory-of-clinical-psychologists-beliefs-about-and-use-of-nice-guidelines
#2
Alex John Court, Anne Cooke, Amanda Scrivener
Guidelines are ubiquitous but inconsistently used in UK mental health services. Clinical psychologists are often influential in guideline development and implementation, but opinion within the profession is divided. This study utilized grounded theory methodology to examine clinical psychologists' beliefs about and use of NICE guidelines. Eleven clinical psychologists working in the NHS were interviewed. The overall emerging theme was; NICE guidelines are considered to have benefits but to be fraught with dangers...
November 25, 2016: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/27884150/identifying-and-prioritizing-lower-value-services-from-dutch-specialist-guidelines-and-a-comparison-with-the-uk-do-not-do-list
#3
Joost Johan Godert Wammes, M Elske van den Akker-van Marle, Eva W Verkerk, Simone A van Dulmen, Gert P Westert, Antoinette D I van Asselt, R B Kool
BACKGROUND: The term 'lower value services' concerns healthcare that is of little or no value to the patient and consequently should not be provided routinely, or not be provided at all. De-adoption of lower value care may occur through explicit recommendations in clinical guidelines. The present study aimed to generate a comprehensive list of lower value services for the Netherlands that assesses the type of care and associated medical conditions. The list was compared with the NICE do-not-do list (United Kingdom)...
November 25, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27884018/blood-transfusion-during-radical-chemo-radiotherapy-does-not-reduce-tumour-hypoxia-in-squamous-cell-cancer-of-the-head-and-neck
#4
Liam Welsh, Rafal Panek, Angela Riddell, Kee Wong, Martin O Leach, Mahvash Tavassoli, Durdana Rahman, Maria Schmidt, Tara Hurley, Lorna Grove, Thomas Richards, Dow-Mu Koh, Christopher Nutting, Kevin Harrington, Kate Newbold, Shreerang Bhide
BACKGROUND: Patients with head and neck squamous cell carcinoma (HNSCC) undergoing radical chemo-radiation (CRT) frequently receive transfusion with packed red cells (PRCT) during radiotherapy on the basis that PRCT increases tumour oxygenation and overcomes hypoxia-induced radio-resistance. This is likely to be a significant oversimplification given the fact that tumour hypoxia is the result of several intrinsic and extrinsic factors, including many that are not directly related to serum haemoglobin (Hb)...
November 24, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27881363/association-between-prediabetes-and-risk-of-cardiovascular-disease-and-all-cause-mortality-systematic-review-and-meta-analysis
#5
Yuli Huang, Xiaoyan Cai, Weiyi Mai, Meijun Li, Yunzhao Hu
OBJECTIVES:  To evaluate associations between different definitions of prediabetes and the risk of cardiovascular disease and all cause mortality. DESIGN:  Meta-analysis of prospective cohort studies. DATA SOURCES:  Electronic databases (PubMed, Embase, and Google Scholar). SELECTION CRITERIA:  Prospective cohort studies from general populations were included for meta-analysis if they reported adjusted relative risks with 95% confidence intervals for associations between the risk of composite cardiovascular disease, coronary heart disease, stroke, all cause mortality, and prediabetes...
November 23, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#6
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27869985/agreement-and-accuracy-using-the-figo-acog-and-nice-cardiotocography-interpretation-guidelines
#7
Susana Santo, Diogo Ayres-De-Campos, Cristina Costa-Santos, William Schnettler, Austin Ugwumadu, Luís Mendes Da Graça
INTRODUCTION: One of the limitations reported with cardiotocography (CTG) is the modest interobserver agreement observed in tracing interpretation. This study compared agreement, reliability and accuracy of CTG interpretation using the FIGO, ACOG and NICE guidelines. MATERIAL AND METHODS: A total of 151 tracings was evaluated by 27 clinicians from three centers where FIGO, ACOG and NICE guidelines were routinely used. Interobserver agreement was evaluated using the proportions of agreement (PA) and reliability with the kappa (k) statistic...
November 21, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27869767/clinical-decision-making-in-the-treatment-of-schizophrenia-focus-on-long-acting-injectable-antipsychotics
#8
Ludovic Samalin, Marion Garnier, Candy Auclair, Pierre-Michel Llorca
The purpose of this study was to identify clinician characteristics associated with higher prescription rates of long-acting injectable (LAI) antipsychotics, as well as the sources that influence medical decision-making regarding the treatment of schizophrenia. We surveyed 202 psychiatrists during six regional French conferences (Bordeaux, Lyon, Marseille, Nice, Paris, and Strasbourg). Data on the characteristics of practice, prescription rates of antipsychotic, and information sources about their clinical decisions were collected...
November 19, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27866011/protected-mealtimes-in-hospitals-and-nutritional-intake-systematic-review-and-meta-analyses
#9
REVIEW
Judi Porter, Ella Ottrey, Catherine E Huggins
OBJECTIVES: Protected Mealtimes is an intervention developed to address the problem of malnutrition, particularly in the hospital setting. The intervention aims to provide interruption-free time to eat during a hospital admission, thus supporting increased nutritional intake. This review aimed to determine the impact of Protected Mealtimes on the nutritional intake of hospitalised patients. DESIGN: The review was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42015023423) and followed the PRISMA guidelines...
November 10, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27862982/upper-aerodigestive-tract-cancer-summary-of-the-national-institute-for-health-and-care-excellence-guidelines-for-england-and-wales
#10
V Paleri, C Kerawala, S Winter, M Robinson, D Jarrom, M Prettyjohns
No abstract text is available yet for this article.
November 9, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/27857239/improving-accessibility-to-intravitreal-anti-vascular-endothelial-growth-factor-treatment-for-ophthalmic-patients-in-a-peripheral-centre
#11
Verona E Botha, John J Ah-Chan, Nishan Ramachandran
AIM: An exponential rise in patients requiring intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment has occurred over recent years. We addressed this in Palmerston North by establishing a senior nurse-led macular review clinic. We aimed to determine the current intravitreal service accessibility and compared it to results from 2012. METHODS: Chart analysis. RESULTS: Planned follow-up was aimed for 42 days, near the end of the anti-VEGF therapeutic effect...
November 18, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27830442/venous-thromboembolism-prophylaxis-risk-assessment-in-a-general-surgery-cohort-a-closed-loop-audit
#12
D M McGoldrick, H P Redmond
BACKGROUND AND AIMS: Venous thromboembolism (VTE) is a potential source of morbidity and mortality in surgical in-patients. A number of guidelines exist that advise on prophylactic measures. We aimed to assess VTE prophylaxis prescribing practices and compliance with a kardex-based risk assessment tool in a general surgery population. METHODS: Data on general surgery in-patients were collected on two separate wards on two separate days. Drug kardexes were assessed for VTE prophylaxis measures and use of the risk assessment tool...
November 9, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27830401/investigating-the-prostate-specific-antigen-body-mass-index-and-age-relationship-is-an-age-bmi-adjusted-psa-model-clinically-useful
#13
Sean Harrison, Kate Tilling, Emma L Turner, J Athene Lane, Andrew Simpkin, Michael Davis, Jenny Donovan, Freddie C Hamdy, David E Neal, Richard M Martin
PURPOSE: Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an age-BMI-adjusted PSA model would be clinically useful for detecting prostate cancer. METHODS: Cross-sectional analysis nested within the UK ProtecT trial of treatments for localized cancer...
November 9, 2016: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/27829395/improving-the-care-pathway-for-women-who-request-caesarean-section-an-experience-based-co-design-study
#14
Sara L Kenyon, Nina Johns, Sandhya Duggal, Ruth Hewston, Nicola Gale
BACKGROUND: Maternal request for Caesarean section is controversial and yet the NICE Caesarean section Guideline recommends that that if this is requested, following discussion of the risks and benefits, women should be supported in their choice. There was a desire to improve the pathway at Birmingham Women's NHS Foundation Trust. METHODS: Experience-based co-design methodology uses service user and clinicians experiences collected using qualitative methods to jointly re-design services...
November 9, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27816908/delirium-risk-stratification-in-consecutive-unselected-admissions-to-acute-medicine-validation-of-a-susceptibility-score-based-on-factors-identified-externally-in-pooled-data-for-use-at-entry-to-the-acute-care-pathway
#15
Sarah T Pendlebury, Nicola G Lovett, Sarah C Smith, Rose Wharton, Peter M Rothwell
BACKGROUND: recognition of prevalent delirium and prediction of incident delirium may be difficult at first assessment. We therefore aimed to validate a pragmatic delirium susceptibility (for any, prevalent and incident delirium) score for use in front-line clinical practice in a consecutive cohort of older acute medicine patients. METHODS: consecutive patients aged ≥65 years over two 8-week periods (2010-12) were screened prospectively for delirium using the Confusion Assessment Method (CAM), and delirium was diagnosed using the DSM IV criteria...
November 5, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27811287/impact-of-uk-nice-clinical-guidelines-168-and-social-deprivation-on-access-to-interventional-treatment-for-symptomatic-varicose-vein-and-specialist-referral-for-leg-ulceration
#16
Huw Ob Davies, Matthew Popplewell, Gareth Bate, Lisa Kelly, Andreas Koutsoumpelis, Andrew W Bradbury
BACKGROUND: UK National Institute for Health and Care Excellence (NICE) clinical guidelines (CG) 168, published in July 2013, aimed to improve the management of lower limb venous disease by newly recommending interventional treatment for all people affected by symptomatic varicose veins (VV) and specialist vascular referral for all people suffering from a leg ulcer (LU) that had been present for ≥2 weeks. This study aims to determine if CG168 has increased access to vascular services, particularly for the socially deprived, who might be expected to have greater need for such services...
November 2, 2016: Phlebology
https://www.readbyqxmd.com/read/27795553/intra-gastric-balloon-as-an-adjunct-to-lifestyle-support-in-severely-obese-adolescents-impact-on-weight-physical-activity-cardio-respiratory-fitness-and-psychosocial-wellbeing
#17
L J Reece, N P Wright, P Sachdev, M Thomson, J K Wales, R J Copeland
BACKGROUND: Severe adolescent obesity (BMI>99.6th centile) is a significant public health challenge. Current non-invasive treatments, including community-based lifestyle interventions, are often of limited effectiveness in this population, with NICE guidelines suggesting the use of bariatric surgery as the last line of treatment (NICE, 2013). Health professionals are understandably reluctant to commission bariatric surgery and as an alternative, the use of an intra-gastric balloon as an adjunct to a lifestyle programme might offer a reversible, potentially safer and less invasive option...
October 31, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/27769172/randomized-controlled-trials-vs-observational-studies-why-not-just-live-together
#18
David Faraoni, Simon Thomas Schaefer
Randomized controlled trials (RCTs) are considered the gold standard for clinical research, thus having a high impact on clinical guidelines and our daily patients' care. However, various treatment strategies which we consider "evidence based" have never been subject to a prospective RCT, as we would rate it unethical to withheld an established treatment to individuals in an placebo controlled trial.In a recent BMC Anesthesiology publication, Trentino et al. analyzed the usefulness of observational studies in assessing benefit and risk of different transfusion strategies...
October 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27756146/cancer-associated-thrombosis-and-palliative-care-an-interview-with-simon-noble
#19
Simon Noble
Simon Noble speaks to Sebastian Dennis-Beron, Commissioning Editor: Simon Noble is Clinical Professor in Palliative Medicine at Cardiff University and honorary consultant at the Royal Gwent Hospital in Newport. His main research interests are in the management of venous thromboembolism in advanced cancer, quality of life effects of venous thromboembolism and their therapies, clinical decision-making in venous thromboembolism management and the patient journey. He is involved at a national level in the delivery of evidence-based thromboprophylaxis for hospitalized patients through the All Party Thrombosis Group and sits on the NICE Guideline development group for thromboprophylaxis...
January 2017: Future Oncology
https://www.readbyqxmd.com/read/27754000/db-02-2-strict-control-of-hypertension-in-the-frail-elderly-is-it-beneficial-con
#20
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
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