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Managing uncertainty

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https://www.readbyqxmd.com/read/29140490/distress-management-through-mind-body-therapies-in-oncology
#1
Linda E Carlson
Distress is highly prevalent in cancer survivors, from the point of diagnosis through treatment and recovery, with rates higher than 45% reported worldwide. One approach for helping people cope with the inherent stress of cancer is through the use of mind-body therapies (MBTs) such as mediation, yoga, hypnosis, relaxation, and imagery, which harness the power of the mind to affect physical and psychological symptoms. One group of MBTs with a growing body of research evidence to support their efficacy focus on training in mindfulness meditation; these are collectively known as mindfulness-based interventions (MBIs)...
November 1, 2017: Journal of the National Cancer Institute. Monographs
https://www.readbyqxmd.com/read/29136338/the-perspectives-of-medical-specialists-from-different-disciplines-on-the-management-of-systemic-lupus-erythematosus-an-interview-study
#2
David J Tunnicliffe, Davinder Singh-Grewal, Jonathan C Craig, Shilpanjali Jesudason, Peter Tugwell, Ming-Wei Lin, Sean G O'Neill, Daniel Sumpton, Allison Tong
OBJECTIVES: Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect multiple organ systems, with specialists from many disciplines often involved, which may lead to inconsistent care. We aimed to describe the attitudes and perspectives of specialists from different medical disciplines on the management of people with SLE. METHODS: Face-to-face, semi-structured interviews were conducted with rheumatologists (n=16), nephrologists (n=16), and immunologists (n=11) providing care to adults with SLE from 19 centers across Australia in 2015...
November 14, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29134456/european-hernia-society-guidelines-on-prevention-and-treatment-of-parastomal-hernias
#3
REVIEW
S A Antoniou, F Agresta, J M Garcia Alamino, D Berger, F Berrevoet, H-T Brandsma, K Bury, J Conze, D Cuccurullo, U A Dietz, R H Fortelny, C Frei-Lanter, B Hansson, F Helgstrand, A Hotouras, A Jänes, L F Kroese, J R Lambrecht, I Kyle-Leinhase, M López-Cano, L Maggiori, V Mandalà, M Miserez, A Montgomery, S Morales-Conde, M Prudhomme, T Rautio, N Smart, M Śmietański, M Szczepkowski, C Stabilini, F E Muysoms
BACKGROUND: International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. METHODS: The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched...
November 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29131846/how-many-species-and-under-what-names-using-dna-barcoding-and-genbank-data-for-west-central-african-amphibian-conservation
#4
Jessica L Deichmann, Daniel G Mulcahy, Hadrien Vanthomme, Elie Tobi, Addison H Wynn, Breda M Zimkus, Roy W McDiarmid
Development projects in west Central Africa are proceeding at an unprecedented rate, often with little concern for their effects on biodiversity. In an attempt to better understand potential impacts of a road development project on the anuran amphibian community, we conducted a biodiversity assessment employing multiple methodologies (visual encounter transects, auditory surveys, leaf litter plots and pitfall traps) to inventory species prior to construction of a new road within the buffer zone of Moukalaba-Doudou National Park, Gabon...
2017: PloS One
https://www.readbyqxmd.com/read/29130378/the-experiences-of-patients-with-advanced-cancer-and-caregivers-presenting-to-emergency-departments-a-qualitative-study
#5
Jennifer Philip, Cheryl Remedios, Sibilah Breen, Tracey Weiland, Lisa Willenberg, Mark Boughey, George Jelinek, Heather Lane, Claudia Marck, Jennifer Weil
BACKGROUND: Despite being a common event in the course of an advanced cancer illness, there is little understanding of patients' perceptions of hospital Emergency Department presentations. AIM: To explore the experiences and perceptions of Emergency Departments held by patients with advanced cancer and their informal caregivers. DESIGN: Cross-sectional study involving semi-structured interviews with advanced cancer patients and their informal caregivers...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29128243/an-empirical-model-to-predict-road-dust-emissions-based-on-pavement-and-traffic-characteristics
#6
Elio Padoan, Franco Ajmone-Marsan, Xavier Querol, Fulvio Amato
The relative impact of non-exhaust sources (i.e. road dust, tire wear, road wear and brake wear particles) on urban air quality is increasing. Among them, road dust resuspension has generally the highest impact on PM concentrations but its spatio-temporal variability has been rarely studied and modeled. Some recent studies attempted to observe and describe the time-variability but, as it is driven by traffic and meteorology, uncertainty remains on the seasonality of emissions. The knowledge gap on spatial variability is much wider, as several factors have been pointed out as responsible for road dust build-up: pavement characteristics, traffic intensity and speed, fleet composition, proximity to traffic lights, but also the presence of external sources...
November 8, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/29127473/colorectal-cancer-and-thrombosis
#7
P A Rees, H W Clouston, S Duff, C C Kirwan
SIGNIFICANCE: Colorectal cancer (CRC), results in a hypercoagulable state which manifests clinically as venous thromboembolism (VTE), often presenting as a deep vein thrombosis (DVT) or pulmonary embolism (PE). The consequences of VTE in CRC can be devastating, resulting in long-term morbidity and are a frequent cause of death, even amongst those who would have otherwise had a favourable cancer prognosis. The incidence of VTE in all cancers is increasing, whilst the exact incidence of VTE in CRC is likely to be underestimated...
November 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29127230/primary-care-management-of-headaches-and-how-direct-access-mri-fits-a-qualitative-study-of-uk-general-practitioners-views
#8
Raphael Underwood, Rachael Kilner, Leone Ridsdale
OBJECTIVES: To develop a better understanding of general practitioners' (GPs) views and experiences of the management of patients with headaches and use of direct-access MRI scans, and observe outcomes of an educational session offered by a GP with a special interest (GPwSI) to GPs. DESIGN: A qualitative study using semistructured interviews, analysed using thematic analysis. A GPwSI in headaches visited practices delivering a talk on headache medication, diagnosis and management...
November 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/29125445/morphometric-and-volumetric-comparison-of-102-children-with-symptomatic-and-asymptomatic-chiari-malformation-type-i
#9
Siri Sahib S Khalsa, Ndi Geh, Bryn A Martin, Philip A Allen, Jennifer Strahle, Francis Loth, Desale Habtzghi, Aintzane Urbizu Serrano, Daniel McQuaide, Hugh J L Garton, Karin M Muraszko, Cormac O Maher
OBJECTIVE Chiari malformation Type I (CM-I) is typically defined on imaging by a cerebellar tonsil position ≥ 5 mm below the foramen magnum. Low cerebellar tonsil position is a frequent incidental finding on brain or cervical spine imaging, even in asymptomatic individuals. Nonspecific symptoms (e.g., headache and neck pain) are common in those with low tonsil position as well as in those with normal tonsil position, leading to uncertainty regarding appropriate management for many patients with low tonsil position and nonspecific symptoms...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29125386/investigating-uncertainty-in-genetic-counseling-encounters-managing-information-about-genetic-cancer-risk
#10
Emily A Rauscher
The Theory of Motivated Information Management (TMIM) was used to investigate how individuals at increased risk of developing hereditary cancer seek information from genetic counselors. Results show the TMIM model fit the data well in predicting participants' intentions to seek information from genetic counselors. Participants felt an uncertainty discrepancy that elicited feelings of anxiety, which in turn negatively predicted both outcome expectancies and efficacy assessments. Efficacy assessments, but not anxiety, significantly predicted participants' intentions to seek information from a genetic counselor in the future...
November 10, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/29124893/ischaemic-colitis-uncertainty-in-diagnosis-pathophysiology-and-management
#11
REVIEW
Amanda L Nikolic, James O Keck
Ischaemic colitis is the most common form of gastrointestinal ischaemia, but may be confused with acute mesenteric ischaemia, inflammatory bowel disease or infectious colitis. This review article outlines the current classification, epidemiology and risk factors, as well as approaches about diagnosis and management to guide clinical practice. It also identifies areas for further research.
November 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29124801/responses-to-clinical-uncertainty-in-australian-general-practice-trainees-a-cross-sectional-analysis
#12
Georga Cooke, Amanda Tapley, Elizabeth Holliday, Simon Morgan, Kim Henderson, Jean Ball, Mieke van Driel, Neil Spike, Rohan Kerr, Parker Magin
CONTEXT: Tolerance for ambiguity is essential for optimal learning and professional competence. General practice trainees must be, or must learn to be, adept at managing clinical uncertainty. However, few studies have examined associations of intolerance of uncertainty in this group. OBJECTIVES: The aim of this study was to establish levels of tolerance of uncertainty in Australian general practice trainees and associations of uncertainty with demographic, educational and training practice factors...
December 2017: Medical Education
https://www.readbyqxmd.com/read/29123913/sex-hormone-status-in-women-with-chronic-kidney-disease-survey-of-nephrologists-and-renal-allied-health-care-providers-perceptions
#13
Sharanya Ramesh, Matthew T James, Jayna M Holroyd-Leduc, Stephen B Wilton, Ellen W Seely, David C Wheeler, Sofia B Ahmed
Background: Chronic kidney disease (CKD) in reproductive-age women is accompanied by menstrual and fertility disorders and premature menopause. Objective: We sought to determine nephrologists' and allied health care providers' perceptions on management of sex hormone status in women with CKD. Methods: An anonymous, Internet-based survey was sent to nephrology society members from Canada, Australia, New Zealand, and the United Kingdom, and the Canadian Association of Nephrology Nurses and Technologists (February-November 2015)...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29121907/-helping-my-neighbour-is-like-giving-a-loan%C3%A2-the-role-of-social-relations-in-chronic-illness-in-rural-uganda
#14
Jovita Amurwon, Flora Hajdu, Dominic Bukenya Yiga, Janet Seeley
BACKGROUND: Understanding individuals' experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. This study explored the impact on households of access to free healthcare and how they managed to meet needs during chronic illness. METHODS: Rich data from the life stories of individuals from 22 households in rural south-western Uganda collected in 2009 were analysed...
November 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29120241/communication-and-the-appraisal-of-uncertainty-exploring-parents-communication-with-credible-authorities-in-the-context-of-chronic-childhood-illness
#15
Anna M Kerr, Nancy Grant Harrington, Allison M Scott
Individuals with chronic illnesses must manage long-term uncertainty as they cope with the ways the illness influences their lives. In the context of pediatric illnesses, parents must manage uncertainty during the diagnosis and treatment of their child's illness. It is common for children with complex chronic illnesses to see multiple specialists for the treatment of their condition. While previous research has explored parents' uncertainty during a child's diagnosis and during end-of-life care, less is known about these experiences when the child is referred to a team of specialists for treatment...
November 9, 2017: Health Communication
https://www.readbyqxmd.com/read/29117993/an-update-on-the-bleeding-risks-associated-with-doacs
#16
(no author information available yet)
The direct oral anticoagulants (DOACs), also referred to as novel (or non-vitamin K antagonist) oral anticoagulants (NOACs), represent a major development in anticoagulation therapy due to their rapid onset of action, predictable dose-response with fixed doses and limited interactions with food and drugs.(1,2) However, these agents have been in widespread clinical use for less than a decade and, compared with extensive experience with warfarin, there is uncertainty relating to optimal laboratory monitoring of anticoagulation, perioperative management and treatment of bleeding...
November 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29116489/long-term-survival-according-to-histology-and-radiologic-response-to-preoperative-chemotherapy-in-126-patients-undergoing-resection-of-non-gist-sarcoma-liver-metastases
#17
Claire Goumard, Leonardo P Marcal, Wei-Lien Wang, Neeta Somaiah, Masayuki Okuno, Christina L Roland, Ching-Wei D Tzeng, Yun Shin Chun, Barry W Feig, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: Non-gastrointestinal stromal tumor sarcomas (NGSs) have heterogeneous histology, and this heterogeneity may lead to uncertainty regarding the prognosis of patients with liver metastases from NGS (NGSLM) and decision regarding their surgical management. Furthermore, the role of preoperative chemotherapy in treatment of NGSLM remains poorly defined. We investigated long-term survival and its correlation to response to preoperative chemotherapy in patients with NGSLM. PATIENTS AND METHOD: Patients who underwent liver resection for NGSLM during 1998-2015 were identified...
November 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29114589/long-term-economic-value-of-hypofractionated-prostate-radiation-secondary-analysis-of-a-randomized-trial
#18
K Ranh Voong, Lincy S Lal, Deborah A Kuban, Thomas J Pugh, J Michael Swint, Joy Godby, Seungtaek Choi, Andrew K Lee, Pamela J Schlembach, Steven J Frank, Sean E McGuire, Karen E Hoffman
Purpose: Moderately hypofractionated intensity modulated radiation therapy (HIMRT) for prostate cancer shortens the treatment course while providing outcomes comparable with those of conventional intensity modulated radiation therapy (CIMRT). To determine the long-term economic value of HIMRT, including the costs of managing long-term radiation toxicities, a cost minimization analysis compared CIMRT with dose-escalated HIMRT using patient-level data from a randomized trial. Methods and materials: Men with localized prostate cancer were randomized to CIMRT (75...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29114113/managing-information-in-health-informatics
#19
REVIEW
Rodolfo A Fiorini, Izet Masic
Only once we agree upon our understanding of what words really mean can we debate whether a concept, represented by those words, is or not well represented significantly in specific application. Conceptual clarity and predicative/impredicative competence are the fundamental components for managing information more effectively in Health Informatics, Healthcare and Medicine applications, while promoting innovation and creativity. Medicine was always the art and science of healing. The science became more and more a mechanistic technology in Healthcare; the art was dropped altogether...
September 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29107527/communication-concerns-when-transitioning-to-cancer-survivorship-care
#20
REVIEW
Denice Economou, Anne Reb
OBJECTIVES: To discuss communication needs that relate to transitioning care for cancer survivors and strategies to facilitate patient-centered communication. DATA SOURCES: National Cancer Institute monograph and peer reviewed articles related to survivorship and communication. CONCLUSION: Key communication tasks in survivorship include managing uncertainty, exchanging information, and enabling self-management. These tasks inform assessment strategies and interventions in survivorship care planning...
October 26, 2017: Seminars in Oncology Nursing
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