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https://www.readbyqxmd.com/read/28647725/percutaneous-coronary-intervention-patients-and-cardiologists-experiences-of-the-informed-consent-process-in-northern-england-a-qualitative-study
#1
Joy Probyn, Joanne Greenhalgh, Janet Holt, Dwayne Conway, Felicity Astin
OBJECTIVE: Informed consent is central to ethical medical practice, but little is known about how the process takes place in clinical practice. Percutaneous coronary intervention (PCI) is a common revascularisation procedure. Studies report that patients overestimate benefits, forget the risks and are unaware of alternative treatments. The aim of this study was to describe PCI patients' and cardiologists' experiences of the informed consent process in acute care settings. DESIGN/SETTING/PARTICIPANTS: A qualitative study with a maximum variation sample of elective and acute PCI patients and cardiologists taking their consent, recruited from a district general hospital and tertiary centre...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644205/the-unrecognized-epidemic-of-electronic-cigarette-burns
#2
Jesus I Ramirez, Catherine A Ridgway, Jeanne G Lee, Bruce M Potenza, Soman Sen, Tina L Palmieri, David G Greenhalgh, Pirko Maguina
Electronic cigarettes (e-cigarettes) are novel battery-operated devices that deliver nicotine as an inhaled aerosol. They originated from China in 2007 and their use has rapidly increased worldwide in the past decade, yet they remain largely unregulated. Reports of injuries associated with their use have appeared as unusual events in the news media and as case reports in the medical literature. This study was undertaken to explore e-cigarettes as a mechanism of burn injury. Referral records to three burn centers from January 2007 to July 2016 were searched to identify patients with injuries caused by e-cigarettes...
July 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28637744/group-clinics-for-young-adults-with-diabetes-in-an-ethnically-diverse-socioeconomically-deprived-setting-together-study-protocol-for-a-realist-review-co-design-and-mixed-methods-participatory-evaluation-of-a-new-care-model
#3
Chrysanthi Papoutsi, Dougal Hargreaves, Grainne Colligan, Ann Hagell, Anita Patel, Desirée Campbell-Richards, Russell M Viner, Shanti Vijayaraghavan, Martin Marshall, Trisha Greenhalgh, Sarah Finer
INTRODUCTION: Young adults with diabetes often report dissatisfaction with care and have poor diabetes-related health outcomes. As diabetes prevalence continues to rise, group-based care could provide a sustainable alternative to traditional one-to-one consultations, by engaging young people through life stage-, context- and culturally-sensitive approaches. In this study, we will co-design and evaluate a group-based care model for young adults with diabetes and complex health and social needs in socioeconomically deprived areas...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615004/understanding-heart-failure-explaining-telehealth-a-hermeneutic-systematic-review
#4
Trisha Greenhalgh, Christine A'Court, Sara Shaw
BACKGROUND: Enthusiasts for telehealth extol its potential for supporting heart failure management. But randomised trials have been slow to recruit and produced conflicting findings; real-world roll-out has been slow. We sought to inform policy by making sense of a complex literature on heart failure and its remote management. METHODS: Through database searching and citation tracking, we identified 7 systematic reviews of systematic reviews, 32 systematic reviews (including 17 meta-analyses and 8 qualitative reviews); six mega-trials and over 60 additional relevant empirical studies and commentaries...
June 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28594637/applying-a-potential-difference-to-minimise-damage-to-carbon-fibres-during-carbon-nanotube-grafting-by-chemical-vapour-deposition
#5
David Benbow Anthony, Hui Qian, Adam Clancy, Alexander Bismarck, Emile Greenhalgh, Milo Shaffer
The application of an in-situ potential difference between carbon fibres and a graphite foil counter electrode (300 V, generating an electric field <i>ca.</i> 0.3 V µm<sup>-1</sup> to 0.7 V µm<sup>-1</sup>) during the chemical vapour deposition synthesis of carbon nanotube (CNT) grafted carbon fibres, significantly improves the uniformity of growth without reducing the tensile properties of the underlying carbon fibres. Grafted carbon nanotubes with diameters around 55 nm and lengths around 10 µm were well attached to the carbon fibre surface, and were grown without the requirement for protective barrier coatings...
June 8, 2017: Nanotechnology
https://www.readbyqxmd.com/read/28567263/non-bonding-1-5-s%C3%A2-%C3%A2-%C3%A2-o-interactions-govern-chemo-and-enantioselectivity-in-isothiourea-catalyzed-annulations-of-benzazoles
#6
Emily R T Robinson, Daniel M Walden, Charlene Fallan, Mark D Greenhalgh, Paul Ha-Yeon Cheong, Andrew D Smith
Isothiourea-catalyzed annulations between 2-acyl benzazoles and α,β-unsaturated acyl ammonium intermediates are selectively tuned to form either lactam or lactone heterocycles in good yields (up to 95%) and high ee (up to 99%) using benzothiazole or benzoxazole derivatives, respectively. Computation gives insight into the significant role of two 1,5-S···O interactions in controlling the structural preorganization and chemoselectivity observed within the lactam synthesis with benzothiazoles as nucleophiles...
December 1, 2016: Chemical Science
https://www.readbyqxmd.com/read/28552971/qualitative-analysis-of-how-patients-decide-that-they-want-risk-reducing-mastectomy-and-the-implications-for-surgeons-in-responding-to-emotionally-motivated-patient-requests
#7
Stephen L Brown, Demian Whiting, Hannah G Fielden, Pooja Saini, Helen Beesley, Christopher Holcombe, Susan Holcombe, Lyn Greenhalgh, Louise Fairburn, Peter Salmon
OBJECTIVE: Contemporary approaches to medical decision-making advise that clinicians should respect patients' decisions. However, patients' decisions are often shaped by heuristics, such as being guided by emotion, rather than by objective risk and benefit. Risk-reducing mastectomy (RRM) decisions focus this dilemma sharply. RRM reduces breast cancer (BC) risk, but is invasive and can have iatrogenic consequences. Previous evidence suggests that emotion guides patients' decision-making about RRM...
2017: PloS One
https://www.readbyqxmd.com/read/28508440/has-evidence-based-medicine-ever-been-modern-a-latour-inspired-understanding-of-a-changing-ebm
#8
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trish Greenhalgh
Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals of a changing EBHC. In this paper, we present French philosopher Bruno Latour's vision on modernity as a framework to discuss current changes in the discourse on EBHC/EBM. Drawing on Latour's work, we argue that the early EBM movement had a strong modernist agenda with an aim to "purify" clinical reality into a dichotomy of objective "evidence" from nature and subjective "preferences" from human society and culture...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28498244/identifying-lynch-syndrome-in-women-presenting-with-endometrial-carcinoma-under-the-age-of-50-years
#9
Antonios Anagnostopoulos, Vicky H McKay, Iris Cooper, Fiona Campbell, Lynn Greenhalgh, John Kirwan
BACKGROUND: Lynch syndrome (LS) is an inherited disorder associated with genetic predisposition to endometrial, colorectal, ovarian, and other cancers. There is consensus for the necessity of assessment for LS in view of the established survival benefits for identified patients and affected family members. The debate regarding the best screening policy is far from being concluded. OBJECTIVES: The aim of this study was to evaluate a realistic protocol for identifying LS families by assessing young women with a diagnosis of endometrial cancer (EC)...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28464948/epistatic-and-allelic-interactions-control-expression-of-ribosomal-rna-gene-clusters-in-arabidopsis-thaliana
#10
Fernando A Rabanal, Terezie Mandáková, Luz M Soto-Jiménez, Robert Greenhalgh, David L Parrott, Stefan Lutzmayer, Joshua G Steffen, Viktoria Nizhynska, Richard Mott, Martin A Lysak, Richard M Clark, Magnus Nordborg
BACKGROUND: Ribosomal RNA (rRNA) accounts for the majority of the RNA in eukaryotic cells, and is encoded by hundreds to thousands of nearly identical gene copies, only a subset of which are active at any given time. In Arabidopsis thaliana, 45S rRNA genes are found in two large ribosomal DNA (rDNA) clusters and little is known about the contribution of each to the overall transcription pattern in the species. RESULTS: By taking advantage of genome sequencing data from the 1001 Genomes Consortium, we characterize rRNA gene sequence variation within and among accessions...
May 3, 2017: Genome Biology
https://www.readbyqxmd.com/read/28450337/books-evaluative-research-methods-managing-the-complexities-of-judgment-in-the-field-evaluation-for-social-justice
#11
Trisha Greenhalgh
No abstract text is available yet for this article.
May 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28419552/feasibility-and-utility-of-portable-ultrasound-during-retrieval-of-sick-preterm-infants
#12
Kathryn Browning Carmo, Tracey Lutz, Mark Greenhalgh, Andrew Berry, Martin Kluckow, Nick Evans
AIM: Document the incidence of haemodynamic pathology in critically ill preterm newborns requiring transport. METHOD: A transport neonatologist performed cardiac and cerebral ultrasound before and after transportation of infants born ≤ 30 weeks gestation. RESULTS: 44 newborns were studied 2008 - 2015, 21 transported by road, 19 by helicopter and 4 by fixed wing. Median birth weight 1130g (680-1960g), median gestation 27 weeks (23-30) and 30/44 were male...
April 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28370699/guidance-on-guidelines-understanding-the-evidence-on-the-uptake-of-health-care-guidelines
#13
Cathy Brennan, Joanne Greenhalgh, Ray Pawson
RATIONALE: Regardless of health issue, health sector, patient condition, or treatment modality, the chances are that provision is supported by "a guideline" making professionally endorsed recommendations on best practice. Against this background, research has proliferated seeking to evaluate how effectively such guidance is followed. These investigations paint a gloomy picture with many a guideline prompting lip service, inattention, and even opposition. This predicament has prompted a further literature on how to improve the uptake of guidelines, and this paper considers how to draw together lessons from these inquiries...
March 29, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28369935/phase-2-of-catalise-a-multinational-and-multidisciplinary-delphi-consensus-study-of-problems-with-language-development-terminology
#14
Dorothy V M Bishop, Margaret J Snowling, Paul A Thompson, Trisha Greenhalgh
BACKGROUND: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. METHODS: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members...
March 30, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28366351/when-to-pick-the-nose-out-of-hospital-and-emergency-department-intranasal-administration-of-medications
#15
REVIEW
Megan A Rech, Brian Barbas, Whitney Chaney, Elizabeth Greenhalgh, Charles Turck
The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28351391/the-impact-on-healthcare-policy-and-practice-from-36-multi-project-research-programmes-findings-from-two-reviews
#16
REVIEW
Steve Hanney, Trisha Greenhalgh, Amanda Blatch-Jones, Matthew Glover, James Raftery
BACKGROUND: We sought to analyse the impacts found, and the methods used, in a series of assessments of programmes and portfolios of health research consisting of multiple projects. METHODS: We analysed a sample of 36 impact studies of multi-project research programmes, selected from a wider sample of impact studies included in two narrative systematic reviews published in 2007 and 2016. We included impact studies in which the individual projects in a programme had been assessed for wider impact, especially on policy or practice, and where findings had been described in such a way that allowed them to be collated and compared...
March 28, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28346298/defining-sepsis-in-burn-patients-still-a-long-way-to-go
#17
David G Greenhalgh
No abstract text is available yet for this article.
March 24, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328669/burn-state-of-the-science-fluid-resuscitation
#18
Robert Cartotto, David G Greenhalgh, C Cancio
Recognition of fluid creep has driven a large amount of the scientific investigation in the area of acute fluid resuscitation for burn patients. The role of colloids in ameliorating fluid creep is controversial, despite the fact that a fluid-sparing effect of colloids has been recognized for some time. All but one of the available prospective studies using colloids are more than a decade old, and a modern randomized controlled trial (RCT) comparing crystalloids to colloids is long overdue. While urinary output continues to be the main endpoint for fluid titration, there has been a moderate amount of interest in the use of transpulmonary thermodilution to guide fluid resuscitation...
May 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28179367/genomic-rearrangements-in-arabidopsis-considered-as-quantitative-traits
#19
Martha Imprialou, André Kahles, Joshua G Steffen, Edward J Osborne, Xiangchao Gan, Janne Lempe, Amarjit Bhomra, Eric Belfield, Anne Visscher, Robert Greenhalgh, Nicholas P Harberd, Richard Goram, Jotun Hein, Alexandre Robert-Seilaniantz, Jonathan Jones, Oliver Stegle, Paula Kover, Miltos Tsiantis, Magnus Nordborg, Gunnar Rätsch, Richard M Clark, Richard Mott
To understand the population genetics of structural variants and their effects on phenotypes, we developed an approach to mapping structural variants that segregate in a population sequenced at low coverage. We avoid calling structural variants directly. Instead, the evidence for a potential structural variant at a locus is indicated by variation in the counts of short-reads that map anomalously to that locus. These structural variant traits are treated as quantitative traits and mapped genetically, analogously to a gene expression study...
April 2017: Genetics
https://www.readbyqxmd.com/read/28160528/meta-analysis-of-individual-patient-data-from-evar-1-dream-over-and-ace-trials-comparing-outcomes-of-endovascular-or-open-repair-for-abdominal-aortic-aneurysm-over-5-years
#20
REVIEW
J T Powell, M J Sweeting, P Ulug, J D Blankensteijn, F A Lederle, J-P Becquemin, R M Greenhalgh
BACKGROUND: The erosion of the early mortality advantage of elective endovascular aneurysm repair (EVAR) compared with open repair of abdominal aortic aneurysm remains without a satisfactory explanation. METHODS: An individual-patient data meta-analysis of four multicentre randomized trials of EVAR versus open repair was conducted to a prespecified analysis plan, reporting on mortality, aneurysm-related mortality and reintervention. RESULTS: The analysis included 2783 patients, with 14 245 person-years of follow-up (median 5·5 years)...
February 2017: British Journal of Surgery
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