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https://www.readbyqxmd.com/read/28813512/implementation-of-a-comprehensive-intervention-for-patients-at-high-risk-of-cardiovascular-disease-in-rural-china-a-pragmatic-cluster-randomized-controlled-trial
#1
Xiaolin Wei, John D Walley, Zhitong Zhang, Guanyang Zou, Weiwei Gong, Simin Deng, Anthony D Harries, Joseph P Hicks, Marc K C Chong, James N Newell, Jieming Zhong, Min Yu
OBJECTIVE: This study aims to assess whether a standard intervention package of cardiovascular disease (CVD) care was being delivered effectively, and if it was associated with improved lifestyle and biomedical indicators. METHODS: In rural China, we implemented a pragmatic cluster randomized controlled trial for 12 months, randomized at the township hospital level, and compared with usual care. Intervention case management guideline, training and performance monitoring meeting and patient support activities were designed to fit within the job description of family doctors in the township hospitals and comprised: 1) prescription of a standardised package of medicines targeted at those with hypertension or diabetes; 2) advice about specific lifestyle interventions; and 3) advice about medication adherence...
2017: PloS One
https://www.readbyqxmd.com/read/28812132/bowel-preparation-in-ct-colonography-is-diet-restriction-necessary-a-randomised-trial-dietsan
#2
Davide Bellini, Domenico De Santis, Damiano Caruso, Marco Rengo, Riccardo Ferrari, Tommaso Biondi, Andrea Laghi
OBJECTIVES: To investigate whether diet restriction affects quality of colon cleansing and patient tolerance during reduced bowel preparation for CT colonography (CTC). METHODS: Asymptomatic and symptomatic patients were enrolled in this pragmatic, single-centre, randomised trial. All patients were randomly assigned (1:1 ratio, blocks of ten) to receive a reduced bowel preparation and faecal tagging with (Diet-Restriction-Group [DR]) or without (No-Diet-Restriction-Group [NDR]) dietary restriction...
August 10, 2017: European Radiology
https://www.readbyqxmd.com/read/28811916/drug-information-update-atypical-antipsychotics-and-neuroleptic-malignant-syndrome-nuances-and-pragmatics-of-the-association
#3
Siddharth Sarkar, Nitin Gupta
Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal adverse event associated with the use of antipsychotics. Although atypical antipsychotics were initially considered to carry no risk of NMS, reports have accumulated over time implicating them in NMS causation. Almost all atypical antipsychotics have been reported to be associated with NMS. The clinical profile of NMS caused by certain atypical antipsychotics such as clozapine has been reported to be considerably different from the NMS produced by typical antipsychotics, with diaphoresis encountered more commonly, and rigidity and tremor encountered less frequently...
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28811155/assessing-changes-in-quality-of-life-and-independent-living-and-working-levels-among-agrability-farmers-and-ranchers-with-disabilities
#4
Robert J Fetsch, Danielle M Jackman, Christina L Collins
BACKGROUND: While emerging research has focused on quality of life (QOL) levels among farmers and ranchers with disabilities, much work is still needed on this largely understudied population. The AgrAbility Project, a USDA initiative, offers pragmatic solutions to increase farmers and ranchers with disabilities' QOL and ability to work and live independently (ILW). OBJECTIVES: To assess pretest-posttest changes in farmers and ranchers with disabilities' ILW and QOL levels after participating in AgrAbility, to identify demographic predictors of ILW and QOL (e...
August 8, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28810472/the-rapid-expansion-of-mainstream-health-psychology-in-france-historical-foundations
#5
Marie Santiago-Delefosse, Maria Del Rio Carral
This article traces the historical evolution of ongoing theoretical debates in psychology in France from the 1940s until today. Its aim is to show how the conjunction of certain conditions was determinant for a rapid expansion of American-derived mainstream health psychology during the 1980s. The authors describe the French context in the post-World War II period that made possible the introduction of psychology courses at the university, which included the tensions between two epistemological orientations: experimental psychology and clinical psychology, the latter partly inspired by Politzer's concrete psychology...
June 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810158/a-typology-of-vaping-identifying-differing-beliefs-motivations-for-use-identity-and-political-interest-amongst-e-cigarette-users
#6
Hannah Farrimond
BACKGROUND: The aim of this study was to identify and differentiate socially shared accounts of e-cigarette use (vaping) using Q-methodology, combining factor analysis with qualitative comments. METHODS: Seventy statements on e-cigarettes, drawn from media, academic and online discussions, were sorted by participants along a continuum of agreement/disagreement, commenting on strongly ranked items. Each participant thus created their own 'account' of their vaping...
August 12, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28809179/qualitative-research-for-patient-safety-using-icts-methodological-considerations-in-the-technological-age
#7
Kwang Chien Yee, Ming Chao Wong, Paul Turner
Considerable effort and resources have been dedicated to improving the quality and safety of patient care through health information systems, but there is still significant scope for improvement. One contributing factor to the lack of progress in patient safety improvement especially where technology has been deployed relates to an over-reliance on purely objective, quantitative, positivist research paradigms as the basis for generating and validating evidence of improvement. This paper argues the need for greater recognition and accommodation of evidence of improvement generated through more subjective, qualitative and pragmatic research paradigms to aid patient safety especially where technology is deployed...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28807041/the-feasibility-and-re-aim-evaluation-of-the-tame-health-pilot-study
#8
Zakkoyya H Lewis, Kenneth J Ottenbacher, Steve R Fisher, Kristofer Jennings, Arleen F Brown, Maria C Swartz, Eloisa Martinez, Elizabeth J Lyons
BACKGROUND: Conducting 5 A's counseling in clinic and utilizing technology-based resources are recommended to promote physical activity but little is known about how to implement such an intervention. This investigation aimed to determine the feasibility and acceptability, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, of a pragmatic, primary care-based intervention that incorporated 5 A's counseling and self-control through an activity monitor...
August 14, 2017: International Journal of Behavioral Nutrition and Physical Activity
https://www.readbyqxmd.com/read/28806390/combination-antipsychotic-therapies-an-analysis-from-a-longitudinal-pragmatic-trial
#9
Adriana Foster, Peter Buckley, John Lauriello, Stephen Looney, Nina Schooler
BACKGROUND: Combination antipsychotics (CAs) are prescribed in schizophrenia despite limited evidence of efficacy. To explore the effect of switching from CA to monotherapy, we performed an exploratory analysis of the PROACTIVE (Preventing Relapse in Schizophrenia: Oral Antipsychotics Compared with Injectables: Evaluating Efficacy) study data, in which 305 patients with schizophrenia and schizoaffective disorder were followed for 30 months after randomization to long-acting injectable (LAI) risperidone or second-generation oral antipsychotic (OA)...
August 10, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28806270/new-clinical-paradigms-for-treating-and-preventing-antiplatelet-gastrointestinal-bleeding
#10
Neena S Abraham
PURPOSE OF REVIEW: To quantify antiplatelet-related gastrointestinal bleeding (GIB), characterize patients at greatest risk and summarize risk-management strategies emphasizing evolving knowledge in acute management of antiplatelet-related bleeding. RECENT FINDINGS: New paradigms for acute management of antiplatelet-related GIB exist in the domains of resuscitation and the transfusion of blood products, strategic use of proton pump therapy and identification and eradication of Helicobacter pylori...
August 12, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28805915/selection-on-resilience-improves-disease-resistance-and-tolerance-to-infections
#11
H A Mulder, H Rashidi
Response to infection in animals has 2 main mechanisms: resistance (ability to control pathogen burden) and tolerance (ability to maintain performance given the pathogen burden). Selection on disease resistance and tolerance to infections seems a promising avenue to increase productivity of animals in the presence of disease infections, but it is hampered by a lack of records of pathogen burden of infected animals. Selection on resilience (ability to maintain performance regardless of pathogen burden) may, therefore, be an alternative pragmatic approach, because it does not need records of pathogen burden...
August 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28805718/myoclonic-disorders
#12
REVIEW
Olaf Eberhardt, Helge Topka
Few movement disorders seem to make a straightforward approach to diagnosis and treatment more difficult and frustrating than myoclonus, due to its plethora of causes and its variable classifications. Nevertheless, in recent years, exciting advances have been made in the elucidation of the pathophysiology and genetic basis of many disorders presenting with myoclonus. Here, we provide a review of all of the important types of myoclonus encountered in pediatric and adult neurology, with an emphasis on the recent developments that have led to a deeper understanding of this intriguing phenomenon...
August 14, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28805305/systematic-review-of-provider-involvement-in-heart-failure-self-care-interventions
#13
Rebecca Bryant, Amanda Alonzo, Hanna Schmillen
BACKGROUND AND PURPOSE: Heart failure is a global concern impacting patient outcomes. Self-care interventions improve self-care behaviors in heart failure patients. The impact of direct provider involvement on patient self-care outcomes is unknown in research. The purpose is to review self-care interventions for adults with heart failure and describe direct provider involvement versus no direct provider involvement on patient self-care behaviors. METHODS: Review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28804980/using-bayes-factors-to-evaluate-evidence-for-no-effect-examples-from-the-sips-project
#14
Zoltan Dienes, Simon Coulton, Nick Heather
AIMS: To illustrate how Bayes Factors are important for determining the effectiveness of interventions. METHOD: We consider a case where inappropriate conclusions were publicly drawn based on significance testing, namely the SIPS Project (Screening and Intervention Programme for Sensible drinking), a pragmatic, cluster-randomized controlled trial in each of two healthcare settings and in the criminal justice system. We show how Bayes Factors can disambiguate the non-significant findings from the SIPS Project and thus determine whether the findings represent evidence of absence or absence of evidence...
August 13, 2017: Addiction
https://www.readbyqxmd.com/read/28803718/total-neoadjuvant-therapy-a-shifting-paradigm-in-locally-advanced-rectal-cancer-management
#15
REVIEW
Aaron J Franke, Hiral Parekh, Jason S Starr, Sanda A Tan, Atif Iqbal, Thomas J George
Colorectal carcinoma is the second leading cause of cancer-related deaths in the United States, with rectal cancer accounting for approximately one-third of newly diagnosed cases, thus representing a major socioeconomic health burden. Although minimally invasive procedures (ie, transanal excision) may be appropriate for a subset of patients with small, superficially invasive tumors, a more comprehensive trimodality approach with neoadjuvant chemoradiotherapy, total mesorectal excision, and systemic chemotherapy is recommended for medically operable patients with nonmetastatic, locally advanced rectal cancer (LARC)...
June 27, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28802753/challenges-in-immunisation-service-delivery-for-refugees-in-australia-a-health-system-perspective
#16
A Mahimbo, H Seale, M Smith, A Heywood
BACKGROUND: Refugees are at risk of being under-immunised in their countries of origin, in transit and post-resettlement in Australia. Whilst studies have focused on identifying barriers to accessibility of health services among refugees, few focus on providers' perspectives on immunisation service delivery to this group. Health service providers are well placed to provide insights into the pragmatic challenges associated with refugee health service delivery, which can be useful in identifying strategies aimed at improving immunisation coverage among this group...
August 9, 2017: Vaccine
https://www.readbyqxmd.com/read/28802406/real-time-pcr-followed-by-high-resolution-melting-curve-analysis-a-rapid-and-pragmatic-approach-for-screening-of-multidrug-resistant-extrapulmonary-tuberculosis
#17
Kusum Sharma, Megha Sharma, Shreya Singh, Manish Modi, Aman Sharma, Pallab Ray, Subhash Varma
INTRODUCTION: Multidrug resistance (MDR) in extrapulmonary tuberculosis (EPTB) is a diagnostic challenge in an endemic country like India. Timely detection of MDR-TB can contribute to a better patient outcome. OBJECTIVE: To perform real-time PCR (qPCR) using rpoB, mpb64 and IS6110 gene on a variety of EPTB samples and to compare the performance of different gene targets. All qPCR positive samples were subjected to high resolution melt-curve analysis (HRM analysis) for rpoB and katG gene to evaluate its potential for MDR screening among different sample types...
September 2017: Tuberculosis
https://www.readbyqxmd.com/read/28801396/the-sims-trial-adjustable-anchored-single-incision-mini-slings-versus-standard-tension-free-midurethral-slings-in-the-surgical-management-of-female-stress-urinary-incontinence-a-study-protocol-for-a-pragmatic-multicentre-non-inferiority-randomised-controlled
#18
Mohamed Abdel-Fattah, Graeme MacLennan, Mary Kilonzo, R Phil Assassa, Kirsty McCormick, Tracey Davidson, Alison McDonald, James N'Dow, Judith Wardle, John Norrie
INTRODUCTION: Single-incision mini-slings (SIMS) represent the third generation of midurethral slings. They have been developed with the aim of offering a true ambulatory procedure for treatment of female stress urinary incontinence (SUI) with reduced morbidity and earlier recovery while maintaining similar efficacy to standard midurethral slings (SMUS). The aim of this study is to determine the clinical and cost-effectiveness of adjustable anchored SIMS compared with tension-free SMUS in the surgical management of female SUI, with 3-year follow-up...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800001/basic-hemodynamic-monitoring-using-ultrasound-or-electrical-cardiometry-during-transportation-of-neonates-and-infants
#19
Angele Boet, Gilles Jourdain, Serge Demontoux, Sebastien Hascoet, Pierre Tissieres, Catherine Rucker-Martin, Daniele De Luca
OBJECTIVES: Electrical cardiometry and heart ultrasound might allow hemodynamic evaluation during transportation of critically ill patients. Our aims were 1) to test feasibility of stroke volume monitoring using electrical cardiometry or ultrasound during transportation and 2) to investigate if transportation impacts on electrical cardiometry and ultrasound reliability. DESIGN: Prospective, pragmatic, feasibility cohort study. SETTING: Mobile ICUs specialized for neonatal and pediatric transportation...
August 9, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28799452/syncope-current-knowledge-uncertainties-and-strategies-for-management-optimisation-in-the-emergency-department
#20
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
Admission rates and expenditures for syncope remain high. This unsatisfactory management could be due to several factors, including lack of evidence-based strategy, poor accuracy of clinical decision rules, difficulty in disseminating guidelines, as well as uncertainties concerning management of intermediate-risk patients and role of observation protocols and syncope units. To optimise management, it has been proposed to adopt a pragmatic, symptoms-based definition of syncope and a classification related to the underlying mechanism rather than suspected aetiology...
August 11, 2017: Acta Cardiologica
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