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https://www.readbyqxmd.com/read/28813717/exploring-the-use-of-a-participative-design-in-the-early-development-of-a-predictive-test-the-importance-of-physician-involvement
#1
Sophie Veilleux, Maude Villeneuve, Nathalie Lachapelle, Rita Kohen, Luc Vachon, Brian White Guay, John D Rioux, Alain Bitton
In this study, we contribute to the personalized medicine and health care management literature by developing and testing a new participative design approach. We propose that involving gastroenterologists in the development of a predictive test to assist them in their clinical decision-making process for the treatment of inflammatory bowel diseases will increase the likelihood of their acceptance of the innovation. Based on data obtained from 6 focus groups across Canada from a total of 28 physicians, analyses reveal that current tools do not enable discriminating between treatment options to find the best fit for each patient...
August 17, 2017: Public Health Genomics
https://www.readbyqxmd.com/read/28812834/cost-effectiveness-of-rural-incentive-packages-for-graduating-medical-students-in-lao-pdr
#2
Eric Keuffell, Wanda Jaskiewicz, Khampasong Theppanya, Kate Tulenko
BACKGROUND: The dearth of health workers in rural settings in Lao People's Democratic Republic (PDR) and other developing countries limits healthcare access and outcomes. In evaluating non-wage financial incentive packages as a potential policy option to attract health workers to rural settings, understanding the expected costs and effects of the various programs ex ante can assist policy-makers in selecting the optimal incentive package. METHODS: We use discrete choice experiments (DCEs), costing analyses and recent empirical results linking health worker density and health outcomes to estimate the future location decisions of physicians and determine the cost-effectiveness of 15 voluntary incentives packages for new physicians in Lao PDR...
October 29, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28810994/comparison-of-point-of-care-versus-laboratory-troponin-testing-in-an-emergency-department-setting
#3
Michael Juliano, Courtney Wason
BACKGROUND: There have been concerns regarding troponin results accuracy between point-of-care (POC) testing preformed in an emergency department (ED) setting and laboratory testing. The purpose of this study was to compare the results of cardiac troponin I testing as concerns POC testing and laboratory analysis as a way to show that these results are interchangeable. METHODS: A retrospective chart review was performed from October 2012 through September 2013 to identify all patients who presented to the ED that received both a POC and laboratory troponin associated with the same blood draw...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28807048/response-to-single-agent-pd-1-inhibitor-after-progression-on-previous-pd-1-pd-l1-inhibitors-a-case-series
#4
Dylan J Martini, Aly-Khan A Lalani, Dominick Bossé, John A Steinharter, Lauren C Harshman, F Stephen Hodi, Patrick A Ott, Toni K Choueiri
BACKGROUND: Monoclonal antibodies targeting the PD-1/PD-L1 axis have gained increasing attention across many solid tumors and hematologic malignancies due to their efficacy and favorable toxicity profile. With more than 1 agent now FDA-approved in a wide variety of tumor types, and with others in clinical trials, it is becoming more common that patients present to clinic for potential treatment with a second PD-1/PD-L1 inhibitor. CASE PRESENTATION: In this report, we present two patients with renal cell carcinoma and one with melanoma who received PD-1/PD-L1 inhibitors...
August 15, 2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28806783/the-utilization-of-critical-care-ultrasound-to-assess-hemodynamics-and-lung-pathology-on-icu-admission-and-the-potential-for-predicting-outcome
#5
Wanhong Yin, Yi Li, Xueying Zeng, Yao Qin, Dong Wang, Tongjuan Zou, Ling Su, Yan Kang
AIM: Critical care ultrasound (CCUS) has been used by many Intensive Care Units(ICUs) worldwide, so as to guiding the diagnosis and the treatment. However, none of the publications currently systematically describe the utilization of CCUS to analyze the characteristics of hemodynamics and lung pathology upon the new admission to ICU and its potential role in patients' prognosis prediction. In this retrospective clinical study, we have demonstrated and analyzed the characteristics of hemodynamics and lung pathology assessed by CCUS and investigated its potential to predict patient outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28803080/palliative-care-development-in-kyrgyzstan
#6
Aibek Mukambetov, Taalaigul Sabyrbekova, Lola Asanalieva, Ilim Sadykov, Alexander Aralbaev, Stephen Connor
Palliative care began in Kyrgyzstan in 2005 as a pilot home based care program in Osh Cancer Center and was supported by a small group of nurses and one physician from Scotland. In 2010, the Soros Foundation-Kyrgyzstan (SFK) and the Open Society Foundation's International Palliative Care Initiative (IPCI) began supporting work on palliative care policy, legislation, essential medicine availability, education, advocacy and implementation. A Ministry of Health working group was established to lead this initiative and technical assistance was provided by an international palliative care consultant...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803076/palliative-care-in-vietnam-long-term-partnerships-yield-increasing-access
#7
Eric L Krakauer, Dang Huy Quoc Thinh, Quach Thanh Khanh, Hoang Thi Mong Huyen, Tran Diep Tuan, Than Ha Ngoc The, Do Duy Cuong, Tran Van Thuan, Nguyen Phi Yen, Pham Van Anh, Nguyen Thi Phuong Cham, Kathleen P Doyle, Nguyen Thi Hai Yen, Luong Ngoc Khue
Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health (MoH), major public hospitals, and medical universities. An empirical analysis of palliative care need by the MoH in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801317/responses-to-assisted-suicide-requests-an-interview-study-with-swiss-palliative-care-physicians
#8
Claudia Gamondi, Gian Domenico Borasio, Pam Oliver, Nancy Preston, Sheila Payne
OBJECTIVES: Assisted suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to assisted suicide, but little is known about palliative care physicians' involvement in assisted suicide practices. This paper aims to describe their perspectives and involvement in assisted suicide practices. METHODS: A qualitative interview study was conducted with 23 palliative care physicians across Switzerland...
August 11, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28800276/enhancing-informed-consent-for-physician-aid-in-dying-potential-role-of-handout-on-possible-benefits-of-palliative-care
#9
Harry Peled, Kathleen E Bickel, Christina Puchalski
In the United States, physician aid in dying (PAD) is now legal in several states. However, neither a requirement for a palliative care (PC) consultation nor a defined education in PC exists for physicians participating in PAD or patients requesting assistance. Patients with advanced chronic and serious illness often experience complex physical, psychosocial, and spiritual distress. PC focuses on relieving this distress and improving patient quality of life through early identification and intervention in all domains of suffering, including physical, psychological, social, and spiritual...
August 11, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28797848/development-of-palliative-care-pc-in-armenia
#10
Anahit Papikyan, Stephen R Connor, Davit Amiryan
In the last seven years, considerable progress has been made in palliative care in Armenia but many problems remain unresolved. Policies developed include completion of a national needs assessment, a recognized working group on palliative care formed, national standards approved, a concept paper on palliative care approved, resolutions on palliative care as a specialized service approved, palliative care became a subspecialty in medicine, palliative care qualifications developed, and a social assistance package approved...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28796651/ultrasound-assisted-reduction-of-displaced-and-shortened-fractures-by-pediatric-emergency-physicians
#11
Eric Scheier, Uri Balla
Pediatric emergency physicians at Kaplan Medical Center regularly reduce forearm fractures under point-of-care ultrasound guidance in the pediatric emergency department. We present 3 children who arrived at our department with shortened, angulated forearm fractures within the span of a single week. We report on the successful reduction of these fractures under point-of-care ultrasound and on the maintenance of anatomic alignment at follow-up 1 week postreduction.
August 7, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28795264/decreasing-patient-length-of-stay-via-new-flexible-exam-room-allocation-policies-in-ambulatory-care-clinics
#12
Vahab Vahdat, Jacqueline Griffin, James E Stahl
To address prolonged lengths of stay (LOS) in ambulatory care clinics, we analyze the impact of implementing flexible and dynamic policies for assigning exam rooms to providers. In contrast to the traditional approaches of assigning specific rooms to each provider or pooling rooms among all practitioners, we characterize the impact of alternate compromise policies that have not been explored in previous studies. Since ambulatory care patients may encounter multiple different providers in a single visit, room allocation can be determined separately for each encounter accordingly...
August 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28794895/-smartscopy-as-an-alternative-device-for-cervical-cancer-screening-a-pilot-study
#13
Yusuke Tanaka, Yutaka Ueda, Akiko Okazawa, Mamoru Kakuda, Shinya Matsuzaki, Eiji Kobayashi, Kiyoshi Yoshino, Tadashi Kimura
The use of smartphones, mobile networks and associated health applications (known as apps) is now almost universal. Countries with low medical resources need assistance in their delivery of healthcare. This is particularly true where there are limited numbers of specialised physicians or nurses with respect to cancer screening. As smartphones become more universal, real-time and near-real-time expert medical consultations and telediagnosis are becoming more common. This leads us to believe that there will soon be a demand for mobile cancer screening services, which will be particularly useful for women living in rural areas or doctor-less inner city communities...
April 2017: BMJ Innovations
https://www.readbyqxmd.com/read/28793317/the-impact-of-the-implementation-of-physician-assistants-in-inpatient-care-a-multicenter-matched-controlled-study
#14
Marijke J C Timmermans, Anneke J A H van Vught, Yvonne A S Peters, Geert Meermans, Joseph G M Peute, Cornelis T Postma, P Casper Smit, Emiel Verdaasdonk, Tammo S de Vries Reilingh, Michel Wensing, Miranda G H Laurant
BACKGROUND: Medical care for admitted patients in hospitals is increasingly reallocated to physician assistants (PAs). There is limited evidence about the consequences for the quality and safety of care. This study aimed to determine the effects of substitution of inpatient care from medical doctors (MDs) to PAs on patients' length of stay (LOS), quality and safety of care, and patient experiences with the provided care. METHODS: In a multicenter matched-controlled study, the traditional model in which only MDs are employed for inpatient care (MD model) was compared with a mixed model in which besides MDs also PAs are employed (PA/MD model)...
2017: PloS One
https://www.readbyqxmd.com/read/28792572/-the-management-of-depression-in-older-adults-and-their-family-caregivers-findings-from-a-research-program-in-quebec
#15
Jane McCusker, Mark Yaffe, Tamara Sussman, Martin Cole, Maida Sewitch, Erin Strumpf, Ellen Freeman, Sylvie Lambert, Manon de Raad
Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Montreal, has conducted a research program over the past two decades that aims to inform improvements in the management of depression in primary care and general medical settings, among older adults. This paper reviews the findings from this research program, discusses the findings in the context of other research, and highlights the implications for practice and health policy.Methods Narrative review and synthesis of 25 published articles, that included: 4 systematic reviews, 10 observational studies, 9 intervention trials, and 2 consensus conference reports...
2017: Santé Mentale Au Québec
https://www.readbyqxmd.com/read/28792563/-initiating-an-antipsychotic-drug-treatment-for-schizophrenia-the-situation-in-quebec-canada-from-1998-to-2006
#16
Jean-Daniel Carrier, Lucie Blais, Alan Cohen, Josiane Courteau, Pasquale Roberge, Annie Larouche, Sylvain Grignon, Marie-Josée Fleury, Alain Lesage, Marie-France Demers, Marc-André Roy, André Delorme, Alain Vanasse
Objectives To describe factors associated with the following characteristics of the first prescription of an antipsychotic drug treatment (ADT): 1) prescribing physician type (psychiatrist vs. general practitioner); 2) second-generation vs. first-generation antipsychotic drug; 3) in conjunction with at least one additional antipsychotic drug (multitherapy); 4) never renewed by the patient.Methods This is a pharmacoepidemiologic study using administrative data from the Régie de l'assurance maladie du Québec (RAMQ), the public healthcare insurer in Quebec, Canada...
2017: Santé Mentale Au Québec
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#17
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28782467/current-and-under-development-treatment-modalities-of-psoriasis-a-review
#18
Abdul Albaghdadi
BACKGROUND AND OBJECTIVE: Psoriasis is a chronic and complex autoimmune inflammatory skin disease that affects over 125 million people worldwide. It can exhibit at any age, in spite of the fact that children are less normally influenced than adults. It is characterized by distinct erythematous plaques shielded with conspicuous silvery scales that shows up in different areas of the skin. Knowledge of pathophysiology, especially the pathogenesis of psoriasis, has significantly progressed in the recent decade...
August 4, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28781898/suicide-by-ingestion-of-caffeine
#19
Frédéric Aknouche, Emilie Guibert, Alison Tessier, Aude Eibel, Pascal Kintz
BACKGROUND: Mr K, aged 48, was found sweating by his partner at home at 11.50 pm. He claimed to have attempted suicide. She immediately called the Emergency Unit to ask for support. At the phone, the physician on duty indicated her to give a pill of Lysanxia (prazepam) to decrease the level of stress of the victim. However, the clinical situation worsened and he was taken to the hospital at 1.00 am. At his arrival at 1.28 am he was in cardiac arrest. Despite intensive resuscitation manoeuvres, death was pronounced at 2...
2017: Egyptian journal of forensic sciences
https://www.readbyqxmd.com/read/28777182/driving-safety-and-fitness-to-drive-in-sleep-disorders
#20
Jon Tippin, Mark Eric Dyken
Driving an automobile while sleepy increases the risk of crash-related injury and death. Neurologists see patients with sleepiness due to obstructive sleep apnea, narcolepsy, and a wide variety of neurologic disorders. When addressing fitness to drive, the physician must weigh patient and societal health risks and regional legal mandates. The Driver Fitness Medical Guidelines published by the National Highway Traffic Safety Administration (NHTSA) and the American Association of Motor Vehicle Administrators (AAMVA) provide assistance to clinicians...
August 2017: Continuum: Lifelong Learning in Neurology
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