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Clinical governance

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https://www.readbyqxmd.com/read/29334523/not-a-straight-line-patient-s-experiences-of-prostate-cancer-and-their-journey-through-the-healthcare-system
#1
Kristina Schildmeijer, Oscar Frykholm, Åsa Kneck, Mirjam Ekstedt
BACKGROUND: Cancer and its treatment can severely impact quality of life, giving rise to complex needs with respect to follow-up care. To support patient needs and increase efficiency of care with limited resources, the Swedish government has launched national reforms to redesign cancer care pathways. OBJECTIVE: The aim of this study was to explore how prostate cancer patients experience their journey through the healthcare system when their care is provided according to the standardized care pathway, as described in healthcare policy documents...
January 12, 2018: Cancer Nursing
https://www.readbyqxmd.com/read/29333499/sick-note-to-fit-note-one-trust-s-project-to-improve-usage-by-hospital-clinicians
#2
Amy Moran, Cathryn Mainwaring, Oliver Keane, Thomas Sanctuary, Kathryn Watson, Tunji Lasoye
Introduction: In April 2010, the government introduced a new Statement of Fitness to Work or 'Fit Note' for patients requiring time off of work or adaptations to their work due to illness. Responsibility to issue these documents has shifted from primary to secondary care. Hospital clinicians are required to issue for inpatients and for outpatients where clinical responsibility has not been taken over by the general practitioner (GP). However, awareness of this change is lacking. Misdirecting patients to their GP for the sole purpose of receiving a 'Fit Note' is an unnecessary use of appointment time and negatively impacts on patients...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332145/the-experiences-and-beliefs-of-older-people-in-scottish-very-sheltered-housing-about-using-multi-compartment-compliance-aids
#3
Derek Stewart, Kathrine Gibson Smith, Joan MacLeod, Alison Strath, Vibhu Paudyal, Katrina Forbes-McKay, Scott Cunningham, Katie MacLure
Background Multi-compartment compliance aids (MCAs) are promoted as a potential solution to medicines non-adherence despite the absence of high quality evidence of effectiveness of MCA use impacting medicines adherence or any clinical outcomes. Furthermore, there is a lack of qualitative research which focuses on the perspectives of older people receiving MCAs. Objectives To describe experiences and beliefs surrounding very sheltered housing (VSH) residents' use of MCAs with emphasis on issues of personalisation, reablement, shared decision-making, independence and support...
January 13, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29331395/tyrosine-hydroxylase-as-a-sentinel-for-central-and-peripheral-tissue-responses-in-parkinson-s-progression-evidence-from-clinical-studies-and-neurotoxin-models
#4
REVIEW
M E Johnson, M F Salvatore, S A Maiolo, L Bobrovskaya
Parkinson's disease (PD) is a common neurodegenerative disease worldwide. While the typical motor symptoms of PD are well known, the lesser known non-motor symptoms can also greatly impact the patient's quality of life. These symptoms often appear before motor impairment, therefore identifying biomarkers that may predict PD risk or pathology has been a major and challenging endeavour. Given that the loss of dopamine, and its rate-limiting enzyme tyrosine hydroxylase (TH) occurs in PD, the expression and accompanying post-translational changes in TH during PD progression could yield insight into the disruption of cellular signalling occurring in the CNS, and also in peripheral tissues wherein catecholamine function plays a role...
January 10, 2018: Progress in Neurobiology
https://www.readbyqxmd.com/read/29331212/prion-protein-as-a-toxic-acceptor-of-amyloid-%C3%AE-oligomers
#5
REVIEW
Silvia A Purro, Andrew J Nicoll, John Collinge
The initial report that cellular prion protein (PrPC) mediates toxicity of amyloid-β species linked to Alzheimer's disease was initially treated with scepticism, but growing evidence supports this claim. That there is a high-affinity interaction is now clear, and its molecular basis is being unraveled, while recent studies have identified possible downstream toxic mechanisms. Determination of the clinical significance of such interactions between PrPC and disease-associated amyloid-β species will require experimental medicine studies in humans...
February 15, 2018: Biological Psychiatry
https://www.readbyqxmd.com/read/29330996/missed-immunization-opportunities-among-children-under-5-years-of-age-dwelling-in-karachi-city
#6
Asif Khaliq, Sayeeda Amber Sayed, Syed Abdullah Hussaini, Kiran Azam, Mehak Qamar
BACKGROUND: Immunization is the safest and effective measure for preventing and eradicating various communicable diseases. A glaring immunization gap exists between developing and industrialized countries towards immunization, because the developing countries including Pakistan are still striving to provide basic immunization to their children. The purpose of this study was to access the prevalence and factors of missing immunization among under 5-year children of Karachi.. METHODS: A cross sectional study was conducted from June 2015 to October 2015 among different outpatient clinics of Karachi...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330544/perceptions-of-legislation-relating-to-the-sharing-of-genomic-biobank-results-with-donors-a-survey-of-bbmri-eric-biobanks
#7
Minna Brunfeldt, Harriet Teare, Sirpa Soini, Helena Kääriäinen
Biobanks accumulate huge amounts of research findings, including participants' genomic data. Increasingly this leads to biobanks receiving research results that could be of clinical significance to biobank participants. The EU Horizon 2020 Project 'Genetics Clinic of the Future' surveyed European biobanks' perceptions of the legal and regulatory requirements for communicating individual research results to donors. The goal was to gain background knowledge for possible future guidelines, especially relating to the consent process...
January 12, 2018: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29330218/a-study-on-pharmacokinetics-of-bosentan-with-systems-modeling-part-1-translating-systemic-plasma-concentration-to-liver-exposure-in-healthy-subjects
#8
Rui Li, Mark Niosi, Nathaniel Johnson, David A Tess, Emi Kimoto, Jian Lin, Xin Yang, Keith A Riccardi, Sangwoo Ryu, Ayman F El-Kattan, Tristan S Maurer, Larry M Tremaine, Li Di
Understanding liver exposure of hepatic transporter substrates in clinical studies is often critical as it typically governs pharmacodynamics, drug-drug interactions, and toxicity for certain drugs. However, this is a challenging task since there is currently no easy method to directly measure drug concentration in the human liver. Using bosentan as an example, a new approach has been demonstrated to estimate liver exposure based on observed systemic pharmacokinetics from clinical studies using physiologically-based pharmacokinetic modeling...
January 12, 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/29328367/tumorigenic-proteins-upregulated-in-the-mycn-amplified-imr-32-human-neuroblastoma-cells-promote-proliferation-and-migration
#9
Hayat Zaatiti, Jad Abdallah, Zeina Nasr, George Khazen, Anthony Sandler, Tamara J Abou-Antoun
Childhood neuroblastoma is one of the most common types of extra-cranial cancer affecting children with a clinical spectrum ranging from spontaneous regression to malignant and fatal progression. In order to improve the clinical outcomes of children with high-risk neuroblastoma, it is crucial to understand the tumorigenic mechanisms that govern its malignant behaviors. MYCN proto-oncogene, bHLH transcription factor (MYCN) amplification has been implicated in the malignant, treatment-evasive nature of aggressive, high-risk neuroblastoma...
January 4, 2018: International Journal of Oncology
https://www.readbyqxmd.com/read/29326146/prior-authorization-requirements-for-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-across-us-private-and-public-payers
#10
Jalpa A Doshi, Justin T Puckett, Michael S Parmacek, Daniel J Rader
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an innovative treatment option for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require further lowering of low-density lipoprotein cholesterol. However, the high costs of these agents have spurred payers to implement utilization management policies to ensure appropriate use. We examined prior authorization (PA) requirements for PCSK9is across private and public US payers...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29325986/the-challenge-of-rare-diseases
#11
James K Stoller
Rare diseases pose particular challenges to patients who are affected, to the clinicians who care for them, and to the investigators who study their conditions. Though individually uncommon, rare diseases are common in the aggregate, with the ∼7000 described rare diseases affecting 25-30 million Americans. Challenges posed to affected individuals and their families largely regard being diagnosed; receiving optimal care; and affording disease-specific medications. Challenges facing clinicians who care for affected individuals include gaining knowledge and experience in caring for such patients, and the availability of local experts and of expert guidelines...
January 8, 2018: Chest
https://www.readbyqxmd.com/read/29325555/the-readiness-of-hospital-pharmacists-in-kuwait-to-practise-evidence-based-medicine-a-cross-sectional-study
#12
Ali Jasem Buabbas, Fatemah Mohammad Alsaleh, Hamza Mohamad Al-Shawaf, Ali Abdullah, Abdullah Almajran
BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators...
January 11, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29325516/brucellosis-remains-a-neglected-disease-in-the-developing-world-a-call-for-interdisciplinary-action
#13
K A Franc, R C Krecek, B N Häsler, A M Arenas-Gamboa
BACKGROUND: Brucellosis is an endemic zoonotic disease in most of the developing world that causes devastating losses to the livestock industry and small-scale livestock holders. Infected animals exhibit clinical signs that are of economic significance to stakeholders and include reduced fertility, abortion, poor weight gain, lost draught power, and a substantial decline in milk production. In humans, brucellosis typically manifests as a variety of non-specific clinical signs. Chronicity and recurring febrile conditions, as well as devastating complications in pregnant women are common sequelae...
January 11, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29324477/assuring-quality-for-non-hospital-based-biologic-infusions-in-pediatric-inflammatory-bowel-disease-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition
#14
Elaine Barfield, Robbyn Sockolow, Edward Hoffenberg, Shehzad Saeed, Sandra Kim, Leah Siebold, Joseph Picoraro, Jonathan Moses, Dana Dykes, Andrew Grossman, Ghassan Wahbeh, K T Park
The primary aim of this Clinical Report by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition is to provide formal guidance to pediatric gastroenterologists and clinicians, health systems, and insurance payers regarding home- and office-based infusions for biologic therapies in pediatric inflammatory bowel disease (IBD). Patients in North America are increasingly denied coverage by payers based on "place of service" codes at hospital-based infusion units where the treating clinicians primarily provide care...
January 10, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29323556/modality-of-primary-hiv-disclosure-and-association-with-mental-health-stigma-and-antiretroviral-therapy-adherence-in-tanzanian-youth-living-with-hiv
#15
Julia V Ramos, Blandina T Mmbaga, Elizabeth L Turner, Leonia L Rugalabamu, Severa Luhanga, Coleen K Cunningham, Dorothy E Dow
Disclosing HIV status to children before adolescence is a major challenge facing families and healthcare providers. This study used a mixed methods approach to explore the youth perspective of how youth living with HIV (YLHIV) found out their status and to quantify the association of disclosure modality with mental health, stigma, adherence, and HIV outcomes in adolescence. Youth 11-24 years of age attending adolescent HIV clinic in Moshi, Tanzania were included. Adolescents answered questions, including when and how they found out they had HIV, mental health surveys (nine-item Patient Health Questionnaire, Strengths and Difficulties Questionnaire, and modified University of California Los Angeles trauma screen), modified Berger's stigma scale, and self-reported adherence...
January 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29322710/etiology-and-outcomes-of-lower-limb-ulcers-in-non-diabetic-patients-an-experience-from-government-hospital-in-western-india
#16
Yojana Gokhale, Amol Raut, Divya Kunal Lala, Rushabh Kothari, Lalana Kalekar, Amol Kamble
Aim: To study the Etiology and Outcomes of Lower Extremity Ulcer in Non- Diabetic Patients. Method: A total number of 40 patients were collected from Rheumatology services (Department of Medicine), Venous Clinic (Department of Surgery) and Dermatology Clinic (Department of Dermatology) of a tertiary care hospital in Mumbai over a period of 48 months from January 2013 to December 2016. The study included serial recruitment of lower limb ulcer fulfilling inclusion criteria...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29322623/clinical-practice-guidelines-in-india-quality-appraisal-and-the-use-of-evidence-in-their-development
#17
Soumyadeep Bhaumik, Soushieta Jagadesh, May Ellatar, Neeraj Kohli, Muhammad Riedha, Monday Moi
BACKGROUND: Guideline development in India has come under increased scrutiny with a growing interest in the use of evidence for guideline development. METHODS: Guidelines on the four leading causes of disability adjusted life years in India (ischemic heart disease, lower respiratory infections, chronic obstructive pulmonary diseases, tuberculosis), published on or after 2010 was searched in electronic databases and by other methods and their quality appraised by using the AGREE-II appraisal tool...
January 11, 2018: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/29321162/risk-of-suicide-attempt-in-poststroke-patients-a-population-based-cohort-study
#18
Tomor Harnod, Cheng-Li Lin, Chia-Hung Kao
BACKGROUND: This nationwide population-based cohort study evaluated the risk of and risk factors for suicide attempt in poststroke patients in Taiwan. METHODS AND RESULTS: The poststroke and nonstroke cohorts consisted of 713 690 patients and 1 426 009 controls, respectively. Adults (aged >18 years) who received new stroke diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM; codes 430-438) between 2000 and 2011 were included in the poststroke cohort...
January 10, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29320541/agent-based-modeling-of-the-interaction-between-cd8-t-cells-and-beta-cells-in-type-1-diabetes
#19
Mustafa Cagdas Ozturk, Qian Xu, Ali Cinar
We propose an agent-based model for the simulation of the autoimmune response in T1D. The model incorporates cell behavior from various rules derived from the current literature and is implemented on a high-performance computing system, which enables the simulation of a significant portion of the islets in the mouse pancreas. Simulation results indicate that the model is able to capture the trends that emerge during the progression of the autoimmunity. The multi-scale nature of the model enables definition of rules or equations that govern cellular or sub-cellular level phenomena and observation of the outcomes at the tissue scale...
2018: PloS One
https://www.readbyqxmd.com/read/29319723/characteristics-and-outcomes-of-intensive-care-unit-survivors-experience-of-a-multidisciplinary-outpatient-clinic-in-a-teaching-hospital
#20
Péricles A D Duarte, Jaquilene Barreto Costa, Silvana Trilo Duarte, Sheila Taba, Claudia Regina Felicetti Lordani, Erica Fernanda Osaku, Claudia Rejane Lima Macedo Costa, Dalas Cristina Miglioranza, Daniela Prochnow Gund, Amaury Cesar Jorge
OBJECTIVES: To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country. METHODS: Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil...
December 2017: Clinics
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