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https://www.readbyqxmd.com/read/28535332/interventions-for-treating-anxiety-after-stroke
#1
REVIEW
Peter Knapp, C Alexia Campbell Burton, John Holmes, Jenni Murray, David Gillespie, C Elizabeth Lightbody, Caroline L Watkins, Ho-Yan Y Chun, Sharon R Lewis
BACKGROUND: Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with antidepressants or other anxiety-reducing drugs, or both, or they can provide psychological therapy. This review looks at available evidence for these interventions. This is an update of the review first published in October 2011. OBJECTIVES: The primary objective was to assess the effectiveness of pharmaceutical, psychological, complementary, or alternative therapeutic interventions in treating stroke patients with anxiety disorders or symptoms...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28532611/hijacked-evidence-based-medicine-stay-the-course-and-throw-the-pirates-overboard
#2
John P A Ioannidis
The article discusses a number of criticisms that have been raised against evidence-based medicine, such as focusing on benefits and ignoring adverse events; being interested in averages and ignoring the wide variability in individual risks and responsiveness; ignoring clinician-patient interaction and clinical judgement; leading to some sort of reductionism; and falling prey to corruption from conflicts of interest. I argue that none of these deficiencies are necessarily inherent to evidence-based medicine...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28521082/training-doctors-briefly-and-in-situ-to-involve-their-patients-in-making-medical-decisions-preliminary-testing-of-a-newly-developed-module
#3
J├╝rgen Kasper, Katrin Liethmann, Christoph Heesen, Daniel R Reissmann, Friedemann Geiger
OBJECTIVE: To carry out preliminary evaluation of a training module for doctors to enhance their ability to involve their patients in medical decision making. The training refers to the shared decision-making (SDM) communication concept. METHODS: The training module includes a comprehensive manual, a corresponding video tutorial with communication examples and a 15-minute face-to-face feedback session based on an SDM analysis of a consultation recording provided by the trainee...
May 18, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28495818/application-of-minimal-important-differences-in-degenerative-knee-disease-outcomes-a-systematic-review-and-case-study-to-inform-bmj-rapid-recommendations
#4
Tahira Devji, Gordon H Guyatt, Lyubov Lytvyn, Romina Brignardello-Petersen, Farid Foroutan, Behnam Sadeghirad, Rachelle Buchbinder, Rudolf W Poolman, Ian A Harris, Alonso Carrasco-Labra, Reed A C Siemieniuk, Per O Vandvik
OBJECTIVES: To identify the most credible anchor-based minimal important differences (MIDs) for patient important outcomes in patients with degenerative knee disease, and to inform BMJ Rapid Recommendations for arthroscopic surgery versus conservative management DESIGN: Systematic review. OUTCOME MEASURES: Estimates of anchor-based MIDs, and their credibility, for knee symptoms and health-related quality of life (HRQoL). DATA SOURCES: MEDLINE, EMBASE and PsycINFO...
May 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28484636/response-threshold-variance-as-a-basis-of-collective-rationality
#5
Tatsuhiro Yamamoto, Eisuke Hasegawa
Determining the optimal choice among multiple options is necessary in various situations, and the collective rationality of groups has recently become a major topic of interest. Social insects are thought to make such optimal choices by collecting individuals' responses relating to an option's value (=a quality-graded response). However, this behaviour cannot explain the collective rationality of brains because neurons can make only 'yes/no' responses on the basis of the response threshold. Here, we elucidate the basic mechanism underlying the collective rationality of such simple units and show that an ant species uses this mechanism...
April 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28473679/epiploic-appendagitis-an-uncommon-surgical-diagnosis
#6
A Michael, Y Zakry, H Hanif
Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients...
April 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28446185/evidence-based-policymaking-is-not-like-evidence-based-medicine-so-how-far-should-you-go-to-bridge-the-divide-between-evidence-and-policy
#7
EDITORIAL
Paul Cairney, Kathryn Oliver
There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking...
April 26, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28386432/calibration-with-confidence-a-principled-method-for-panel-assessment
#8
R S MacKay, R Kenna, R J Low, S Parker
Frequently, a set of objects has to be evaluated by a panel of assessors, but not every object is assessed by every assessor. A problem facing such panels is how to take into account different standards among panel members and varying levels of confidence in their scores. Here, a mathematically based algorithm is developed to calibrate the scores of such assessors, addressing both of these issues. The algorithm is based on the connectivity of the graph of assessors and objects evaluated, incorporating declared confidences as weights on its edges...
February 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28338533/sepsis-patients-in-the-emergency-department-stratification-using-the-clinical-impression-score-predisposition-infection-response-and-organ-dysfunction-score-or-quick-sequential-organ-failure-assessment-score
#9
Vincent M Quinten, Matijs van Meurs, Anna E Wolffensperger, Jan C Ter Maaten, Jack J M Ligtenberg
OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. PATIENTS AND METHODS: This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included...
May 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28318503/sociotechnical-systems-as-a-framework-for-regulatory-system-design-and-evaluation-using-work-domain-analysis-to-examine-a-new-regulatory-system
#10
Tony Carden, Natassia Goode, Gemma J M Read, Paul M Salmon
Like most work systems, the domain of adventure activities has seen a series of serious incidents and subsequent calls to improve regulation. Safety regulation systems aim to promote safety and reduce accidents. However, there is scant evidence they have led to improved safety outcomes. In fact there is some evidence that the poor integration of regulatory system components has led to adverse safety outcomes in some contexts. Despite this, there is an absence of methods for evaluating regulatory and compliance systems...
March 15, 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28303438/using-health-technology-assessment-to-assess-the-value-of-new-medicines-results-of-a-systematic-review-and-expert-consultation-across-eight-european-countries
#11
Aris Angelis, Ansgar Lange, Panos Kanavos
BACKGROUND: Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. OBJECTIVE: To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment...
March 16, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28290256/preparing-the-sexual-health-workforce-to-deliver-integrated-services-is-education-the-answer-a-qualitative-study-exploring-the-impact-of-sexual-health-education-on-developing-integrated-policy-and-practice
#12
Judy Brook, Debra Salmon, Rachael-Anne Knight
Aim This study aimed to explore the ability of sexual health nurses working in the South West of England, to implement new learning within existing sexual health service delivery models. Drawing on Lipsky's account of street-level bureaucracy to conceptualise policy implementation, the impact of workforce learning on the development of integrated services across this region of the United Kingdom was assessed. BACKGROUND: In order to achieve the United Nations' goal of universal access to sexual health, it is essential for reproductive and sexual health, including HIV provision, to integrate into a single service...
March 14, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28281123/icg-fluorescence-imaging-for-quantitative-evaluation-of-colonic-perfusion-in-laparoscopic-colorectal-surgery
#13
Toshiaki Wada, Kenji Kawada, Ryo Takahashi, Mami Yoshitomi, Koya Hida, Suguru Hasegawa, Yoshiharu Sakai
BACKGROUND: Fluorescence technology with indocyanine green (ICG) provides a real-time assessment of intestinal perfusion. However, a subjective evaluation of fluorescence intensity based on the surgeon's visual judgement is a major limitation. This study evaluated the quantitative assessment of ICG fluorescence imaging in determining the transection line of the proximal colon during laparoscopic colorectal surgery. METHODS: This is a retrospective analysis of a prospectively maintained database of 112 patients who underwent laparoscopic surgery for left-sided colorectal cancers...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28276959/how-should-worsening-in-osteoarthritis-be-defined-development-and-initial-validation-of-preliminary-criteria-for-clinical-worsening-in-knee-and-hip-osteoarthritis
#14
Eam Mahler, A A den Broeder, T G Woodworth, Vjjf Busch, F H van den Hoogen, Jwj Bijlsma, Chm van den Ende
OBJECTIVES: There is a need to define and validate measures of clinical worsening in knee and hip osteoarthritis (OA). The objectives of this exploratory project were: (i) to characterize worsening criteria in knee and hip OA using psychometric methods; (ii) to estimate their sensitivity and specificity; and (iii) to validate and compare these criteria with worsening criteria previously described in the literature. METHOD: An Expert Group reached consensus on 10 sets of worsening criteria to be tested in observational data sets of patients with knee or hip OA who received multimodal conservative treatment...
February 7, 2017: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/28268493/automatic-seizure-detection-using-correlation-integral-with-nonlinear-adaptive-denoising-and-kalman-filter
#15
Hongda Wang, Chiu-Sing Choy
The ability of correlation integral for automatic seizure detection using scalp EEG data has been re-examined in this paper. To facilitate the detection performance and overcome the shortcoming of correlation integral, nonlinear adaptive denoising and Kalman filter have been adopted for pre-processing and post-processing. The three-stage algorithm has achieved 84.6% sensitivity and 0.087/h false detection rate, which are comparable to many machine learning based methods, but at much lower computational cost...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28248575/ten-principles-to-guide-health-reform
#16
Joe K Gerald
Americans face inevitable trade-offs between health care affordability, accessibility, and innovation. Although numerous reforms have been proposed, universal principles to guide decision-making are lacking. Solving the challenges that confront us will be difficult, owing to intense partisan divisions and a dysfunctional political process. Nevertheless, we must engage in reasoned debate that respects deeply held differences of opinion regarding our individual and collective obligations to promote healthy living and ensure affordable access to health care...
March 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230235/seeing-overweight-adults-as-babies-physical-cues-and-implications-for-stigmatization
#17
Anton J M Dijker, Rutger DeLuster, Nicolas Peeters, Nanne K de Vries
Human babies not only are reliable triggers of tender feelings and protective tendencies, they also happen to be exceptionally fat compared to the newborns of most other species. These two facts are used to formulate a hypothesis predicting that overweight males, due to their great physical resemblance to babies, not only are perceived as cute, but also are associated with negatively evaluated traits (e.g., immaturity, lack of willpower) that are saliently inconsistent with traits required for adults. In this study, a great many physical features of adult males varying widely in weight were measured and correlated with subjective judgements...
February 23, 2017: British Journal of Psychology
https://www.readbyqxmd.com/read/28226667/automatic-seizure-detection-using-correlation-integral-with-nonlinear-adaptive-denoising-and-kalman-filter
#18
Hongda Wang, Chiu-Sing Choy, Hongda Wang, Chiu-Sing Choy, Hongda Wang, Chiu-Sing Choy
The ability of correlation integral for automatic seizure detection using scalp EEG data has been re-examined in this paper. To facilitate the detection performance and overcome the shortcoming of correlation integral, nonlinear adaptive denoising and Kalman filter have been adopted for pre-processing and post-processing. The three-stage algorithm has achieved 84.6% sensitivity and 0.087/h false detection rate, which are comparable to many machine learning based methods, but at much lower computational cost...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225495/the-multimorbidity-interaction-severity-index-misi-a-proof-of-concept-study
#19
Dimitri Gassmann, Marcus Cheetham, Klarissa Siebenhuener, Barbara M Holzer, Claudine Meindl-Fridez, Florian F Hildenbrand, Vanessa Virgini, Mike Martin, Edouard Battegay
Therapeutic decision-making for patients with multimorbidity (MM) is challenging. Clinical practice guidelines inadequately address harmful interactions and resulting therapeutic conflicts within and among diseases. A patient-specific measure of MM severity that takes account of this conflict is needed.As a proof of concept, we evaluated whether the new Multimorbidity Interaction Severity Index (MISI) could be used to reliably differentiate patients in terms of lower versus higher potential for harmful interactions...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28220518/describing-student-performance-a-comparison-among-clinical-preceptors-across-cultural-contexts
#20
Kerry Wilbur, Noha Hassaballa, Omaima S Mahmood, Emily K Black
CONTEXT: Health professional student evaluation during experiential training is notably subjective and assessor judgements may be affected by socio-cultural influences. OBJECTIVES: This study sought to explore how clinical preceptors in pharmacy conceptualise varying levels of student performance and to identify any contextual differences that may exist across different countries. METHODS: The qualitative research design employed semi-structured interviews...
February 20, 2017: Medical Education
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