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https://www.readbyqxmd.com/read/28911963/evolution-of-computed-tomography-imaging-the-first-year-after-endovascular-sealing-of-infrarenal-aortic-aneurysms-using-the-nellix-device
#1
Leo H van den Ham, Thijs G Ter Mors, Johannes T Boersen, Jean Paul P M de Vries, Patrick W Vriens, Jan M Heyligers, Michel M P J Reijnen
INTRODUCTION: The Nellix Endovascular Aneurysm Sealing (EVAS) System is an alternative endovascular treatment option for infrarenal aortic aneurysms (AAA) with a unique appearance on Computed Tomography Angiography (CTA). Normal evolution of post-EVAS CTA appearance follow-up is still largely unknown and important in order to timely detect eventual complications. OBJECTIVE: To assess the normal appearance of CTA images 30 days and 1 year after EVAS in 50 consecutive patients...
September 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28895808/shared-decision-making-after-severe-stroke-how-can-we-improve-patient-and-family-involvement-in-treatment-decisions
#2
Akila Visvanathan, Martin Dennis, Gillian Mead, William N Whiteley, Julia Lawton, Fergus Neil Doubal
People who are well may regard survival with disability as being worse than death. However, this is often not the case when those surviving with disability (e.g. stroke survivors) are asked the same question. Many routine treatments provided after an acute stroke (e.g. feeding via a tube) increase survival, but with disability. Therefore, clinicians need to support patients and families in making informed decisions about the use of these treatments, in a process termed shared decision making. This is challenging after acute stroke: there is prognostic uncertainty, patients are often too unwell to participate in decision making, and proxies may not know the patients' expressed wishes (i...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28891177/cognitive-challenges-to-minimising-low-value-care
#3
Ian A Scott
Clinical decisions often rely on pattern recognition, simple rules of thumb, tacit knowledge and habit. In many instances, such intuitive decisions are fast and accurate, but they can be subject to cognitive biases leading to delivery of care of low value at odds with scientific evidence of best practice. If programmes, such as EVOLVE (Evaluating Evidence, Enhancing Efficiencies) and Choosing Wisely are to have maximal impact in minimising low value care, such biases, and the factors that hide and accentuate them, need to be exposed and addressed in a collegiate and non-judgemental manner...
September 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28858270/how-economic-analysis-can-contribute-to-understanding-the-links-between-housing-and-health
#4
Ralph Chapman, Nicholas Preval, Philippa Howden-Chapman
An economic analysis of housing's linkages to health can assist policy makers and researchers to make better decisions about which housing interventions and policies are the most cost-beneficial. The challenge is to include cobenefits. The adoption in 2015 of the UN Sustainable Development Goals underscores the importance of understanding how policies interact, and the merit of comprehensively evaluating cobenefits. We explain our approach to the empirical assessment of such cobenefits in the housing and health context, and consider lessons from empirical economic appraisals of the impact of housing on health outcomes...
August 31, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28833507/usefulness-of-shear-wave-elastography-as-a-quantitative-diagnosis-of-chronic-pancreatitis
#5
Takamichi Kuwahara, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Takeshi Yamamura, Kazuhiro Furukawa, Kohei Funasaka, Masanao Nakamura, Ryoji Miyahara, Osamu Watanabe, Masatoshi Ishigami, Senju Hashimoto, Hidemi Goto
BACKGROUND AND AIM: Chronic pancreatitis (CP) is sometimes diagnosed at the progressed stage. For the early diagnosis of CP, Endoscopic ultrasonography (EUS) may be a useful method, but its diagnostic criteria are based on subjective judgement. Shear wave elastography (SW-EG) using transabdominal ultrasonography, which quantifies tissue elasticity as an absolute value, may be an objective and non-invasive method for the diagnosis of CP. METHODS: Eighty-five patients with known or suspected CP who underwent both EUS and SW-EG from October 2012 to July 2016 were included in this study...
August 17, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28820018/evidence-based-creativity-working-between-art-and-science-in-the-field-of-fine-dining
#6
Chad Borkenhagen
This article examines how scientific knowledge drives creativity in the small but influential culinary movement of 'modernist cuisine'. Originating in the mid-1990s, modernist cuisine began with a small group of avant-garde chefs using science to produce wildly innovative culinary creations. Since then, many of the movement's innovations, as well as its more general 'science-based' approach to cooking, have gained adoption among a diverse range of culinary professionals. But while science has enabled modernist chefs to produce a wide array of innovations and refinements, the group's embrace of scientific values poses a potential threat to the subjective, intuition-driven logic of culinary creativity...
August 1, 2017: Social Studies of Science
https://www.readbyqxmd.com/read/28814931/prediction-of-histological-grade-and-completeness-of-resection-of-intracranial-meningiomas-role-of-peritumoural-brain-edema
#7
Kamalanathan Palaniandy, Mohammad Saffari Mohammad Haspani, Norzaini Rose Mohd Zain
BACKGROUND: Meningioma is the commonest primary intracranial tumour in adults. Excision is curative for low grade meningioma, whereas high-grade meningioma requires adjuvant therapy following surgery. Several studies have examined the association between peritumoural brain Edema - a common feature in meningioma - and histological grading with mixed results. The present study attempted to elucidate this association and if peritumoural brain Edema affects the intra-operative judgement of surgeons on the completeness of resection...
May 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28811919/trainee-experiences-of-intellectual-disability-psychiatry-and-an-innovative-leaderless-support-group-a-qualitative-study
#8
Ross Spackman, Hannah Toogood, Jayne Kerridge, Jon Nash, Elizabeth Anderson, Dheeraj Rai
Aims and method There is very little research into the challenges of training in intellectual disability psychiatry or into interventions which may address these challenges. Using focus groups, we explored the experiences of intellectual disability psychiatry trainees, and evaluated a leaderless trainee support group developed in Bristol. Results Five distinct themes were identified via framework analysis: that trainees felt unprepared for the difference from previous posts; the need for support; the value of the group; that trainees were concerned about judgement in supervision; that the group structure was valued...
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28806711/the-potential-of-an-automated-system-to-identify-the-upper-limb-component-of-a-controlled-sitting-posture
#9
María B Sánchez, Ian Loram, John Darby, Paul Holmes, Penelope B Butler
Full trunk control in sitting is demonstrated only when the head-trunk are aligned and upper limbs remain free of contact from mechanical support. These components represent a Controlled Kinetic Chain and can be evaluated in people with neuromotor disability using the Segmental Assessment of Trunk Control (SATCo) when a therapist provides manual trunk support at different segmental levels. However, the SATCo, as with other clinical assessments of control, is subjective. The SATCo was translated to objective rules relating the position of the hands and elbows to the head-trunk and then tested to determine the extent to which this automated objective method replicated the clinical judgement...
August 8, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28804806/how-biological-background-assumptions-influence-scientific-risk-evaluation-of-stacked-genetically-modified-plants-an-analysis-of-research-hypotheses-and-argumentations
#10
Elena Rocca, Fredrik Andersen
Scientific risk evaluations are constructed by specific evidence, value judgements and biological background assumptions. The latter are the framework-setting suppositions we apply in order to understand some new phenomenon. That background assumptions co-determine choice of methodology, data interpretation, and choice of relevant evidence is an uncontroversial claim in modern basic science. Furthermore, it is commonly accepted that, unless explicated, disagreements in background assumptions can lead to misunderstanding as well as miscommunication...
August 14, 2017: Life Sciences, Society and Policy
https://www.readbyqxmd.com/read/28797859/valuing-attributes-of-home-palliative-care-with-service-users-a-pilot-discrete-choice-experiment
#11
Barbara Gomes, Maja de Brito, Vera P Sarmento, Deokhee Yi, Duarte Soares, Jacinta Fernandes, Bruno Fonseca, Edna Gonçalves, Pedro L Ferreira, Irene J Higginson
CONTEXT: Discrete choice experiment (DCE) is a quantitative method that helps determine which service attributes are most valued by people and consequently improve their well-being. OBJECTIVES: To test a new DCE on home palliative care (HPC). METHODS: Cross-sectional survey using the DCE method with adult patients and their family caregivers, users of three HPC services in Portugal. Service attributes were based on a Cochrane review, a meta-ethnography, and the few existing DCEs on HPC: 1) team's availability, 2) support for family caregivers, 3) homecare support, 4) information and planning, and 5) waiting time...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797706/prioritisation-of-specialist-health-care-services-not-nice-not-easy-but-it-can-be-done
#12
Pippa Anderson, Philip Webb, Sam Groves
The challenges of delivering healthcare within budget constraints are ever present. Highly specialised technologies (HSTs) have high costs of provision inevitably contributing to NHS cost pressures. Between 2012-2015 the Welsh Health Specialised Services Committee (WHSSC) developed prioritisation methods to make recommendations for HST funding in Wales. Methods adapted as the process continued but was always evidence based and supported by a prioritisation panel of stakeholders. Methods changed from discreet choice to the Portsmouth Score Card, a simple multi-criteria decision analysis (MCDA) method...
September 2017: Health Policy
https://www.readbyqxmd.com/read/28783607/values-in-evaluation-the-use-of-rubrics
#13
Pauline Dickinson, Jeffery Adams
Rubrics are used by evaluators who seek to move evaluations from being mere descriptions of an evaluand (i.e., the programme, project or policy to be evaluated) to determining the quality and success of the evaluand. However, a problem for evaluators interested in using rubrics is the literature relating to rubric development is scattered and mostly located in the education field with a particular focus on teaching and learning. In this short article we review and synthesise key points from the literature about rubrics to identify best practice...
July 18, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28770229/identifying-high-cost-high-risk-patients-using-administrative-databases-in-tuscany-italy
#14
Irene Bellini, Valentina Barletta, Francesco Profili, Alessandro Bussotti, Irene Severi, Maddalena Isoldi, Maria Bimbi, Paolo Francesconi
OBJECTIVE: (1) Assessing the performance of the algorithm in terms of sensitivity and positive predictive value, considering General Practitioners' (GPs) judgement as benchmark, and (2) describing adverse events (hospitalisation, death, and health services' consumption) of complex patients compared to the general population. DATA SOURCES: (i) Tuscany administrative database containing health data (2013-5); (ii) lists of complex patients indicated by GPs; and (iii) annual health registry of Tuscany...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28764280/content-validation-of-total-knee-replacement-rehabilitation-protocol-in-indian-population
#15
P Antony Leo Aseer, G Arun Maiya, M Mohan Kumar, P V Vijayaraghavan
INTRODUCTION: Total knee replacement (TKR) surgery has become the most successful surgery for patients with severe debilitating arthritis. The guidelines for rehabilitation progression should be tailored respecting the tissue healing parameters. Hence, the current literature states a need for protocol to mitigate these impairments and ultimately result in improved functional outcomes. OBJECTIVE: The present study aimed to validate the content of TKR rehabilitation protocol in Indian population...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28745257/-deciding-on-surgery-for-acute-subdural-haematoma-does-a-neurosurgeon-rather-fill-nursing-homes-or-cemeteries
#16
P van Eijsden
Acute subdural haematoma is a life-threatening condition that can sometimes be mitigated by decompressive craniotomy. However, it can also increase misery when patients survive but are left with severe disabilities. A recent publication shows that neurosurgeons in Belgium and the Netherlands vary considerably in their opinion regarding if, and when, to perform this surgery. This may be due to the fact that this type of intervention asks the question whether the life saved is more favourable than the death averted...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28721107/bite-force-and-dental-implant-treatment-a-short-review
#17
REVIEW
Dennis Flanagan
Dental implants are placed endosseously, and the bone is the ultimate bearer of the occlusal load. Patients are not uniform in the maximum bite force they can generate. The occlusal biting load in the posterior jaw is usually about three times of that found in the anterior. It is possible for supporting implants to be overloaded by the patients' biting force, resulting in bone loss and failure of the fixture. Bite force measurement may be an important parameter when planning dental implant treatment. Some patients can generate extreme biting loads that may cause a luxation of the fixture and subsequent loss of osseointegration...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28710226/evaluating-the-predictive-strength-of-the-lace-index-in-identifying-patients-at-high-risk-of-hospital-readmission-following-an-inpatient-episode-a-retrospective-cohort-study
#18
Sarah Damery, Gill Combes
OBJECTIVE: To assess how well the LACE index and its constituent elements predict 30-day hospital readmission, and to determine whether other combinations of clinical or sociodemographic variables may enhance prognostic capability. DESIGN: Retrospective cohort study with split sample design for model validation. SETTING: One large hospital Trust in the West Midlands. PARTICIPANTS: All alive-discharge adult inpatient episodes between 1 January 2013 and 31 December 2014...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28707532/a-novel-diagnostic-aid-for-intra-abdominal-adhesion-detection-in-cine-mr-imaging-pilot-study-and-initial-diagnostic-impressions
#19
David Randall, Frank Joosten, Richard ten Broek, Richard Gillott, Karna Dev Bardhan, Chema Strik, Wiesje Prins, Harry van Goor, John Fenner
OBJECTIVES: A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI. METHOD: An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices...
July 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28699815/improving-recruitment-to-healthcare-research-studies-clinician-judgements-explored-for-opting-mental-health-service-users-out-of-the-time-to-change-viewpoint-survey
#20
Vanessa Pinfold, Jessica Cotney, Sarah Hamilton, Craig Weeks, Elizabeth Corker, Sara Evans-Lacko, Diana Rose, Claire Henderson, Graham Thornicroft
BACKGROUND: There are significant challenges across the research pathway, including participant recruitment. This paper aims to explore the impact of clinician recruitment decision-making on sampling for a national mental health survey. METHOD: Clinical teams in 20 English mental healthcare provider organisations screened caseload lists, opting-out people whom, in their judgement, should not be approached to participate in a survey about stigma and discrimination...
July 12, 2017: Journal of Mental Health
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