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Daniel W Yokom, Shabbir M H Alibhai, Schroder Sattar, Monika K Krzyzanowska, Martine T E Puts
INTRODUCTION: Screening tools in geriatric oncology have traditionally been studied for their ability to identify patients who have abnormal domains on a comprehensive geriatric assessment (CGA). However, an alternative outcome of identifying patients who would receive CGA-based interventions could improve selection of patients whose management will be altered by a CGA. The objective of this study was to assess the performance of three geriatric oncology screening tools for their ability to predict for CGA-based interventions...
March 12, 2018: Journal of Geriatric Oncology
Melissa H Bellin, Angelica Newsome, Cassie Lewis-Land, Joan Kub, Shawna S Mudd, Rachel Margolis, Arlene M Butz
INTRODUCTION: Low-income caregiver perspectives on asthma management are understudied but may illuminate strategies to improve care delivery and child outcomes. METHOD: Purposive sampling methods were used to recruit 15 caregivers of children with frequent asthma emergency department visits. Interviews explored how poverty and stress affect asthma management. Grounded theory coding techniques were used to analyze the data. RESULTS: Participants were the biological mother (100%) and were poor (75% had mean annual income ≤ $30,000)...
March 12, 2018: Journal of Pediatric Health Care
Sumit Agrawal, Nadine Schart-Morén, Wei Liu, Hanif M Ladak, Helge Rask-Andersen, Hao Li
OBJECTIVE: We used synchrotron radiation phase contrast imaging (SR-PCI) to study the 3D microanatomy of the basilar membrane (BM) and its attachment to the spiral ligament (SL) (with a conceivable secondary spiral lamina [SSL] or secondary spiral plate) at the round window membrane (RWM) in the human cochlea. The conception of this complex anatomy may be essential for accomplishing structural preservation at cochlear implant surgery. MATERIAL AND METHODS: Sixteen freshly fixed human temporal bones were used to reproduce the BM, SL, primary and secondary osseous spiral laminae (OSL), and RWM using volume-rendering software...
March 14, 2018: Upsala Journal of Medical Sciences
Mark L Graber, Diana Rusz, Melissa L Jones, Diana Farm-Franks, Barbara Jones, Jeannine Cyr Gluck, Dana B Thomas, Kelly T Gleason, Kathy Welte, Jennifer Abfalter, Marie Dotseth, Kathleen Westerhaus, Josanne Smathers, Ginny Adams, Michael Laposata, Tina Nabatchi, Margaret Compton, Quentin Eichbaum
The National Academy of Medicine (NAM) in the recently issued report Improving Diagnosis in Health Care outlined eight major recommendations to improve the quality and safety of diagnosis. The #1 recommendation was to improve teamwork in the diagnostic process. This is a major departure from the classical approach, where the physician is solely responsible for diagnosis. In the new, patient-centric vision, the core team encompasses the patient, the physician and the associated nursing staff, with each playing an active role in the process...
November 27, 2017: Diagnosis
Kelly T Gleason, Patricia M Davidson, Elizabeth K Tanner, Diana Baptiste, Cynda Rushton, Jennifer Day, Melinda Sawyer, Deborah Baker, Lori Paine, Cheryl R Dennison Himmelfarb, David E Newman-Toker
Nurses have always been involved in the diagnostic process, but there remains a pervasive view across physicians, nurses, and allied health professionals that medical diagnosis is solely a physician responsibility. There is an urgent need to adjust this view and for nurses to take part in leading efforts addressing diagnostic errors. The purpose of this article is to define a framework for nursing engagement in the diagnostic process that can serve as a catalyst for nurses to engage in eliminating preventable harms from diagnostic error...
November 27, 2017: Diagnosis
Naoki Nakano, Chetan Gohal, Andrew Duong, Olufemi R Ayeni, Vikas Khanduja
OBJECTIVE/PURPOSE: The aim of the study was to assess the options of treatment and their related outcomes for chondral injuries in the hip based on the available evidence whilst highlighting new and innovative techniques. METHODS: A systematic review of the literature from PubMed (Medline), EMBASE, Google Scholar, British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED) was undertaken from their inception to March 2017 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 13, 2018: International Orthopaedics
Nathali Gunawardena, Ghose Bishwajit, Sanni Yaya
Background: For exploring maternal death, supply and demand-side factors can be characterized by the three delays model developed by Thaddeus and Maine (1994). The model comprises delay in deciding to seek care (delay 1), delay in reaching the health facility (delay 2), and delay in receiving quality care once at the health facility (delay 3). Few studies have comprehensively dealt with the health systems delays that prevent the receipt of timely and appropriate obstetric care once a woman reaches a health facility (phase III delays)...
2018: Frontiers in Public Health
R Mezencev, R M Wartell
Cisplatin is an important anticancer drug with a complex mode of action, a variety of possible targets, and numerous resistance mechanisms. While genomic DNA has traditionally been considered to be its most critical anticancer target, several lines of evidence suggest that various RNAs and other biomolecules may play a role in its anticancer mode of action. In this report we demonstrate that cisplatin modifies pre-miR-200b, impairs its processing to mature miRNA, and decreases miR-200b expression in ovarian cancer cells...
2018: Neoplasma
Hermann Blessberger, Juergen Kammler, Hans Domanovits, Oliver Schlager, Brigitte Wildner, Danyel Azar, Martin Schillinger, Franz Wiesbauer, Clemens Steinwender
BACKGROUND: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia...
March 13, 2018: Cochrane Database of Systematic Reviews
Leen Naji, Harkanwal Randhawa, Zahra Sohani, Brittany Dennis, Deanna Lautenbach, Owen Kavanagh, Monica Bawor, Laura Banfield, Jason Profetto
PURPOSE: Although the digital rectal examination (DRE) is commonly performed to screen for prostate cancer, there is limited data to support its use in primary care. This review and meta-analysis aims to evaluate the diagnostic accuracy of DRE in screening for prostate cancer in primary care settings. METHODS: We searched MEDLINE, Embase, DARE (Database of Abstracts of Reviews of Effects), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) from their inception to June 2016...
March 2018: Annals of Family Medicine
Samuel Y S Wong, Yu Ying Sun, Aaroy T Y Chan, Maria K W Leung, David V K Chao, Carole C K Li, King K H Chan, Wai Kwong Tang, Trevor Mazzucchelli, Alma M L Au, Benjamin H K Yip
PURPOSE: We undertook a randomized controlled trial to assess the efficacy of group-based behavioral activation with mindfulness (BAM) for treating subthreshold depression in primary care in Hong Kong. METHODS: We recruited adult patients aged 18 years or older with subthreshold depression from public primary care clinics and randomly assigned them to a BAM intervention group or a usual care group. The BAM group was provided with eight 2-hour weekly BAM sessions by trained allied health care workers...
March 2018: Annals of Family Medicine
Allie J Widman, Lori L McMahon
Low-dose ketamine, an open-channel N -methyl d-aspartate receptor (NMDAR) antagonist, mediates rapid antidepressant effects in humans that are mimicked in preclinical rodent models. Disinhibition of pyramidal cells via decreased output of fast-spiking GABAergic interneurons has been proposed as a key mechanism that triggers the antidepressant response. Unfortunately, to date, disinhibition has not been directly demonstrated. Furthermore, whether disinhibition is a common mechanism shared among other antagonists with rapid antidepressant properties in humans has not been investigated...
March 12, 2018: Proceedings of the National Academy of Sciences of the United States of America
Yuqing Zhang, Xinyu Zhou, Lining Yang, Sarah E Hetrick, John R Weisz, Pim Cuijpers, Jürgen Barth, Cinzia Del Giovane, Shuai Yuan, David Cohen, Donna Gillies, Xiaofeng Jiang, Teng Teng, Peng Xie
INTRODUCTION: Post-traumatic stress disorder (PTSD) is common among children and adolescents who are exposed to trauma, and it is often associated with significant negative impacts on their psychosocial functioning and quality of life. Many types of psychotherapies have been found to be effective for PTSD in children and adolescents. However, due to the lack of direct comparisons between different psychotherapies, the hierarchy of treatment efficacy is still unclear. Therefore, we plan to conduct a systematic review and network meta-analysis to evaluate the efficacy and acceptability of various types of psychotherapies for PTSD in children and adolescents...
March 12, 2018: BMJ Open
David Boulos, Deniz Fikretoglu
OBJECTIVE: The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder. DESIGN: Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629)...
March 12, 2018: BMJ Open
Michael Gottlieb, Joshua M DeMott, Marilyn Hallock, Gary D Peksa
STUDY OBJECTIVE: The addition of antibiotics to standard incision and drainage is controversial, with earlier studies demonstrating no significant benefit. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure rates. METHODS: PubMed, the Cumulative Index of Nursing and Allied Health Literature, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all randomized controlled trials comparing adjuvant antibiotics with placebo in the treatment of drained abscesses, with an outcome of treatment failure assessed within 21 days...
March 9, 2018: Annals of Emergency Medicine
Alexandra B Cooke, Romina Pace, Deborah Chan, Ellen Rosenberg, Kaberi Dasgupta, Stella S Daskalopoulou
AIMS: The integration of pedometers into clinical practice has the potential to enhance physical activity levels in patients with chronic disease. Our SMARTER randomized controlled trial demonstrated that a physician-delivered step count prescription strategy has measurable effects on daily steps, glycemic control, and insulin resistance in patients with type 2 diabetes and/or hypertension. In this study, we aimed to understand perceived barriers and facilitators influencing successful uptake and sustainability of the strategy, from patient and physician perspectives...
March 9, 2018: Diabetes Research and Clinical Practice
Heather deBoer, Matthew Andrews, Stephanie Cudd, Ellie Leung, Alana Petrie, Soo Chan Carusone, Kelly K O'Brien
PURPOSE: To investigate the role of physical therapy in HIV care from the perspective of people living with HIV and health care professionals with expertise in HIV care. METHODS: We conducted a qualitative descriptive study using semistructured interviews (with health care professionals) and focus groups (with people living with HIV). We purposively sampled health care professionals and recruited people living with HIV in collaboration with an HIV-specialty hospital...
March 13, 2018: Disability and Rehabilitation
Isabel Lane, Ashley Bryce, Suzanne M Ingle, Alastair D Hay
Purpose: Antimicrobial resistance is a significant threat to public health. Diagnostic uncertainty is a key driver of antimicrobial prescribing. We sought to determine whether locally relevant, real-time syndromic or microbiological infection epidemiology can improve prescribing by reducing diagnostic uncertainty. Methods: Eligible studies investigated effects on primary care prescribing for common infections in Organisation For Economic Co-Operation And Development countries...
February 26, 2018: Family Practice
Gerry Capatos, Christopher R Burke, Mark T Ogino, Roberto R Lorusso, Thomas V Brogan, D Michael McMullan, Heidi J Dalton
AIM: As experience with extracorporeal life support (ECLS) increases, indications for its use have expanded to diverse patient populations, including those with HIV infection. Pneumocystis jirovecii pneumonia (PJP) is a particularly devastating complication of HIV infections. The objective of this study was to review ECLS use in HIV-positive patients, with particular emphasis on those with concomitant PJP infection. METHODS: All patients were treated by the same ECLS team, consisting of an ECLS specialist intensivist, cardiothoracic surgeon and allied medical professionals at three healthcare institutions...
March 1, 2018: Perfusion
Kellie B Emmerson, Katherine E Harding, Kylee J Lockwood, Nicholas F Taylor
BACKGROUND: Allied health professionals working in rehabilitation often prescribe home exercise programs. Smart technology offers an alternative format for presentation of home exercise programs with potential advantages over traditional paper-based programs, but how do patients feel about this? DESIGN: This qualitative analysis was part of a convergent mixed methods design, using in depth, semi-structured interviews to explore the lived experience of patients utilising touch screen tablets to support an upper limb home exercise program post stroke...
March 11, 2018: Australian Occupational Therapy Journal
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