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https://www.readbyqxmd.com/read/28434142/cancer-genetic-counseling-and-testing-in-an-era-of-rapid-change
#1
Gillian W Hooker, Keelia Rhoads Clemens, John Quillin, Kristen J Vogel Postula, Pia Summerour, Rebecca Nagy, Adam H Buchanan
The impacts of the Association for Molecular Pathology vs. Myriad Supreme Court decision regarding patenting DNA segments and multi-gene testing on cancer genetic counseling practice have not been well described. We aimed to assess genetic counselors' perceptions of how their genetic testing-related practices for hereditary breast and/or ovarian cancer (HBOC) changed after these events. One-hundred fifty-two genetic counselors from the National Society of Genetic Counselors Cancer Special Interest Group completed an anonymous, online, mixed-methods survey in November 2013...
April 22, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28433408/don-t-need-help-don-t-want-help-can-t-get-help-how-patients-with-brain-tumors-account-for-not-using-rehabilitation-psychosocial-and-community-services
#2
Danette Langbecker, Stuart Ekberg, Patsy Yates
OBJECTIVE: To understand why some adults with primary brain tumors do not use support services despite indications of a need for help. METHODS: Nineteen adults recently diagnosed with primary brain tumors participated in semi-structured interviews. Thematic analysis was used to identify recurrent ways participants explained their non-use of support services. RESULTS: Some patients indicated that they did not use support services as they did not need help, in particular reporting positive experiences relative to their expectations or to others, that their needs were met, or difficulties recognizing their needs...
April 14, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28433224/the-importance-of-age-on-short-term-outcomes-associated-with-repair-of-giant-paraesophageal-hernias
#3
Mustapha A El Lakis, Stephen J Kaplan, Michal Hubka, Kamran Mohiuddin, Donald E Low
BACKGROUND: Older patients have an increased incidence of paraesophageal hernia (PEH) and can be denied surgical assessment due to the perception of increased complications and mortality. This study examines the influence of age and comorbidities on early complications and other short-term outcomes of PEH repair. METHODS: From 2000 to 2016, data of surgically treated patients with PEH were prospectively recorded in an Institutional Review Board-approved database...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28432961/diurnal-patterns-and-relationships-between-physiological-and-self-reported-stress-in-patients-with-epilepsy-and-psychogenic-non-epileptic-seizures
#4
Barbora Novakova, Peter R Harris, Markus Reuber
PURPOSE: Patients with epilepsy and those with psychogenic non-epileptic seizures (PNES) experience high levels of stress and stress is one of the most frequently self-identified seizure precipitants. Although stress is a multifaceted phenomenon, few studies have systematically examined its different components in patients with seizures. The aim of this study was therefore to describe diurnal patterns of psychological and physiological measures of stress in patients with epilepsy and patients with PNES, and explore their relationships to each other in order to improve our understanding of the mechanisms underlying stress and seizure occurrence in these patients...
April 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28432710/medical-students-perceptions-of-the-importance-of-exercise-and-their-perceived-competence-in-prescribing-exercise-to-older-people
#5
Agathe Daria Jadczak, Khai Loon Tam, Solomon Yu, Renuka Visvanathan
OBJECTIVE: To determine the effects of a 4.5-week geriatric medicine course on fifth year medical students' perception of the importance of and their competence in prescribing exercise to older people. METHODS: The modified Exercise and Physical Activity Competence Questionnaire was administered to 81 students before and after the course. Scores ranged from 0 to 6. One open-ended question about perceived barriers to exercise prescription was asked. RESULTS: Students' perceptions of the importance of designing an exercise prescription (P = 0...
April 22, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28432639/measuring-patient-experience-in-dialysis-a-new-paradigm-of-quality-assessment
#6
REVIEW
Connie M Rhee, Steven M Brunelli, Lalita Subramanian, Francesca Tentori
Patients' experience of care (PEC) is as an important dimension in quality of care. As a distinct entity from patient satisfaction and patient health-related quality of life, PEC is defined as patients' perceptions of the range of interactions they have with the health care system, including care from providers, facilities, and health plans. While traditionally PEC may be ascertained via informal assessments, in recent years, especially in the United States, there has been a shift towards standardized surveillance of PEC amongst dialysis patients in order to: (1) set a normative expectation regarding the importance of PEC; (2) standardize the components of patients' experience that are assessed to minimize potential "blind spots"; (3) provide a direct "voice" to the patient in communicating perceptions of their care; (4) facilitate comparisons of quality across facilities; and (5) broaden accountability for PEC to the entire multidisciplinary dialysis care team...
April 21, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28432607/impact-of-the-medical-specialty-on-knowledge-regarding-multidrug-resistant-organisms-and-strategies-toward-antimicrobial-stewardship
#7
Steffen Lebentrau, Christian Gilfrich, Malte W Vetterlein, Harald Schumacher, Philipp J Spachmann, Sabine D Brookman-May, Hans M Fritsche, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Matthias May
PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties. METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals...
April 21, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28432188/magnetic-resonance-neurography-visualizes-abnormalities-in-sciatic-and-tibial-nerves-in-patients-with-type-1-diabetes-and-neuropathy
#8
Michael Vaeggemose, Mirko Pham, Steffen Ringgaard, Hatice Tankisi, Niels Ejskjaer, Sabine Heiland, Per L Poulsen, Henning Andersen
This study evaluates whether diffusion-tensor-imaging MR-Neurography (DTI-MRN), T2-relaxation-time and proton-spin-density can detect and grade neuropathic abnormalities in patients with type 1 diabetes.Forty-nine patients with type 1 diabetes (11 with severe polyneuropathy (sDPN), 13 with mild polyneuropathy (mDPN) and 25 without polyneuropathy (nDPN)) and 30 healthy controls (HC) were included. Clinical examinations, nerve-conduction-studies and vibratory-perception-thresholds determined the presence and severity of DPN...
April 21, 2017: Diabetes
https://www.readbyqxmd.com/read/28431952/evaluation-of-patient-preparedness-for-surgery-a-randomized-controlled-trial
#9
Kristie A Greene, Allison M Wyman, Lauren A Scott, Stuart Hart, Lennox Hoyte, Renee Bassaly
BACKGROUND: Patient preparedness for pelvic reconstructive surgery has important implications for patient satisfaction and perception of improvement after surgery. The ideal method in which to optimally prepare patients for surgery has not been determined. OBJECTIVE: To evaluate the impact of a preoperative patient education video on patient preparedness prior to sacrocolpopexy as measured by a preoperative preparedness questionnaire (PPQ). STUDY DESIGN: We performed a single-blind, randomized stratified clinical trial at a single academic center evaluating the use of a preoperative patient education video as an adjunct to preoperative counseling on patient preparedness...
April 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28431908/implementation-of-a-person-centered-medical-care-model-in-a-skilled-nursing-facility-a-pilot-evaluation
#10
Kathleen Abrahamson, Jaclyn Myers, Arif Nazir
OBJECTIVES: The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). DESIGN: A mixed-method (qualitative and quantitative) pilot evaluation. SETTING: An 89-bed SNF located within a large midwestern city. PARTICIPANTS: Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431609/benefit-risk-perception-of-natalizumab-therapy-in-neurologists-and-a-large-cohort-of-multiple-sclerosis-patients
#11
Christoph Heesen, Ingo Kleiter, Sven G Meuth, Julia Krämer, Jürgen Kasper, Sascha Köpke, Wolfgang Gaissmaier
BACKGROUND: Natalizumab (NAT) is associated with the risk of progressive multifocal leukoencephalopathy (PML). Risk stratification algorithms have been developed, however, without detectable reduction of PML incidence. OBJECTIVE: To evaluate to which extent patients and physicians understand and accept risks associated with NAT treatment. METHODS: Prospective observational cohort study in German MS centers (n=73) among NAT-treated MS patients (n=801) and their neurologists (n=99)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431536/-popping-nana-back-into-bed-a-qualitative-exploration-of-paramedic-decision-making-when-caring-for-older-people-who-have-fallen
#12
Paul Simpson, Ric Thomas, Jason Bendall, Bill Lord, Stephen Lord, Jacqueline Close
BACKGROUND: Older fallers constitute a large proportion of ambulance work, and as many as 25% are not transported to hospital following paramedic assessment. The objective of this study was to explore the decision making process used by paramedics when caring for older fallers. METHODS: A qualitative study was conducted using constructivist grounded theory methodology. Purposive sampling was used to recruit paramedics to participate in semi-structured interviews and focus groups...
April 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28430890/acceptability-comparison-between-hawley-retainers-and-vacuum-formed-retainers-in-orthodontic-adult-patients-a-single-centre-randomized-controlled-trial
#13
Mohammed Saleh, Mohammad Y Hajeer, Dieter Muessig
Background: Hawley retainers (HRs) and vacuum formed retainers (VFRs) are the most commonly used removable retainers in the orthodontic practice. Patients' cooperation in wearing these appliances is affected by the levels of discomfort and oral impairment. The evidence regarding their acceptably among orthodontic patients is limited. Aims: To compare the acceptability of HRs and VFRs over a 6-month period in a group of fixed orthodontic patients. Trial Design: Two-arm parallel-group randomized controlled trial...
April 19, 2017: European Journal of Orthodontics
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#14
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28430574/how-navigating-uncertainty-motivates-trust-in-medicine
#15
Jonathan B Imber
Three significant factors in the shaping of modern medicine contribute to broad perceptions about trust in the patient-physician relationship: moral, professional, and epidemiological uncertainty. Trusting a physician depends first on trusting a person, then trusting a person's skills and training, and finally trusting the science that underwrites those skills. This essay, in part based on my book, Trusting Doctors: The Decline of Moral Authority in American Medicine (Princeton University Press, 2008), will address the forms of uncertainty that contribute to the nature of difficult encounters in the patient-physician relationship...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430334/chondro-keratoprosthesis-an-alternative-to-ookp
#16
Louis Hoffart, Laurent Guyot
PURPOSE: To evaluate the use of cartilage as a potential graft material toward osteo-odontal tissue replacement in keratoprosthesis surgery. METHODS: We describe a modification of the osteo-odonto-keratoprosthesis surgery that involves the use of autologous auricular conchal cartilage graft (ACCG). In stage 1a, a full-thickness cheek mucosa graft was performed over the ocular surface. In stage 1b, ACCG was harvested via a retroauricular approach. An optical polymethyl-methacrylate cylinder was embedded into a double-layered fragment of cartilage and secured by cyanoacrylate glue...
April 4, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28430021/family-perspectives-on-telemedicine-for-pediatric-subspecialty-care
#17
Kristin N Ray, Laura Ellen Ashcraft, Ateev Mehrotra, Elizabeth Miller, Jeremy M Kahn
BACKGROUND: Children often have difficulty accessing subspecialty care, and telemedicine may improve access to subspecialty care, but information is lacking on how best to implement telemedicine programs to maximize acceptance and, ultimately, maximize impact for patients and their families. METHODS AND MATERIALS: To understand how subspecialty telemedicine is perceived and to identify design elements with the potential to improve telemedicine uptake and impact, we conducted and analyzed semi-structured interviews with 21 informants, including parents and caregivers of children with subspecialty care needs and adolescent and young adult patients with subspecialty care needs...
April 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28429606/parent-and-patient-perceptions-of-functional-impairment-due-to-tourette-syndrome-development-of-a-shortened-version-of-the-child-tourette-syndrome-impairment-scale
#18
Kara S Francis Barfell, Ryan R Snyder, Kelly M Isaacs-Cloes, Jordan F Garris, Alyssa R Roeckner, Paul S Horn, Michael D Guthrie, Steve W Wu, Donald L Gilbert
The Child Tourette Syndrome Impairment Scale (CTIM) rates 37 problems in school, social, and home domains separately for tics and for comorbid diagnoses. However, a shorter version would be easier to implement in busy clinics. Using published data from 85 children with Tourette syndrome, 92 controls, and parents, factor analysis was used to generate a "mini-CTIM" composed of 12 items applied to tic and comorbid diagnoses. Child- and parent-rated mini-CTIM scores were compared and correlated across raters and accounting for clinician-rated tic severity and presence of attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD)...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28428716/transition-after-pediatric-liver-transplantation-perceptions-of-adults-adolescents-and-parents
#19
Norman Junge, Katarina Migal, Imeke Goldschmidt, Ulrich Baumann
AIM: To develop a locally adapted, patient-focused transition-program, we evaluated the perceptions of adult and adolescent patients and parents regarding transition-programs and transfer. METHODS: We evaluated these perceptions by analyzing the responses of pre-transfer adolescents (n = 57), their parents (n = 57) and post-transfer adults (n = 138) from a cohort of pediatric-liver-transplant-patients using a self-designed questionnaire. Furthermore, we compared a responder group with a non-responder group as well as the provided answers with baseline characteristics and clinical outcomes to exclude selection bias, characterize high-risk patients for non-adherence and test for gender differences...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28428245/thematic-analysis-of-us-stakeholder-views-on-the-influence-of-labour-nurses-care-on-birth-outcomes
#20
Audrey Lyndon, Kathleen Rice Simpson, Joanne Spetz
BACKGROUND: Childbirth is a leading reason for hospital admission in the USA, and most labour care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated nurse-sensitive quality measures for maternity care. We aimed to engage primary stakeholders of maternity care in identifying the aspects of nursing care during labour and birth they believe influence birth outcomes, and how these aspects of care might be measured...
April 20, 2017: BMJ Quality & Safety
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