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Outcomes research

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https://www.readbyqxmd.com/read/28817789/teach-our-children-stroke-education-for-indigenous-children-first-nations-ontario-canada-2009-2012
#1
Mary Ellen Hill, Pauline Bodnar, Robert Fenton, Brenda Mason, Grace Bandoh
BACKGROUND: Because of the heightened risk for stroke among indigenous people, we conducted this multiyear community case study from 2009 through 2012 to address stroke education needs among children aged 11 to 13 years residing in northern urban, rural, and remote First Nations in Ontario, Canada. The goal was to determine what young people understand about stroke and to develop an age-appropriate and culturally appropriate educational product. COMMUNITY CONTEXT: This project responded to First Nations requests that we educate their young people about the signs and symptoms of stroke and the need for early response...
August 17, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28817785/diving-into-the-world-of-alcohol-teratogenesis-a-review-of-zebrafish-models-of-fetal-alcohol-spectrum-disorders
#2
Yohaan Fernandes, Desirè M Buckley, Johann K Eberhart
Fetal alcohol spectrum disorders (FASD) refer to the entire suite of deleterious outcomes resulting from embryonic alcohol exposure. Along with other reviews in this edition, we provide insight into how animal models, specifically the zebrafish; have informed our understanding of FASD. We first provide a brief introduction to FASD. We discuss the zebrafish as a model organism and its strengths for alcohol research. We detail how zebrafish has been used to model some of the major defects present in FASD. These include behavioral defects, such as social behavior as well as learning and memory, and structural defects, disrupting organs such as the brain, sensory organs, heart and craniofacial skeleton...
August 17, 2017: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
https://www.readbyqxmd.com/read/28817703/quality-of-life-of-inguinal-hernia-patients-in-taiwan-the-application-of-the-hernia-specific-quality-of-life-assessment-instrument
#3
Chi-Cheng Huang, Feng-Chuan Tai, Tzung-Hsin Chou, Heng-Hui Lien, Jaan-Yeh Jeng, Thien-Fiew Ho, Ching-Shui Huang
BACKGROUND: With the development of prosthetic mesh and tension free techniques, the recurrence rate following inguinal hernia repair has been reduced, and hernia outcomes research should focus on post-operative quality of life and potential complications. STUDY DESIGN: A novel hernia quality of life assessment instrument, HERQL, was developed. The HERQL questionnaire comprises a 4-item summative pain score measuring pain and discomfort resulting from various strenuous activities...
2017: PloS One
https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#4
Thomas R Vetter, Edward J Mascha
Epidemiologists seek to make a valid inference about the causal effect between an exposure and a disease in a specific population, using representative sample data from a specific population. Clinical researchers likewise seek to make a valid inference about the association between an intervention and outcome(s) in a specific population, based upon their randomly collected, representative sample data. Both do so by using the available data about the sample variable to make a valid estimate about its corresponding or underlying, but unknown population parameter...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28817464/biologics-for-idiopathic-inflammatory-myopathies
#5
Siamak Moghadam-Kia, Rohit Aggarwal, Chester V Oddis
PURPOSE OF REVIEW: As treatment of refractory cases of idiopathic inflammatory myopathies (IIMs) has been challenging, there is growing interest in assessing novel biologics that target various pathways implicated in the pathogenesis of IIM. RECENT FINDINGS: In the largest clinical trial in adult and juvenile IIM assessing the effectiveness of rituximab, the primary outcome was not met but 83% of this refractory group of IIM patients met a predefined definition of improvement and rituximab demonstrated a significant glucocorticoid-sparing effect...
August 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28817402/the-importance-of-natural-killer-cell-killer-immunoglobulin-like-receptor-mismatch-in-transplant-outcomes
#6
Kate Stringaris, Austin J Barrett
PURPOSE OF REVIEW: In recent years, the rules of engagement between natural killer (NK) cells and their targets have become better defined with the identification of an array of NK surface molecules, notably the killer immunoglobulin-like (KIR) receptors and their ligands on target cells through which signals of activation or suppression of NK function are mediated. After allogeneic stem cell transplantation (SCT), the opportunity for NK cell activation can occur both in human leucocyte antigen (HLA) matched and HLA mismatched pairs...
August 16, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28817378/health-policy-making-for-street-children-challenges-and-strategies
#7
Fatemeh Abdi, Sara Esmaelzadeh Saeieh, Nasibeh Roozbeh, Mansoureh Yazdkhasti
Background The phenomenon of street children is a bio-psychological and social issue that not only harms children, but also endangers the health of a society. In line with the national programs for the development and promotion of street children's health in Iran, health policy making and essential strategies for this group of children will be presented in this paper. This paper will discuss the main issues and challenges of street children's health and, also, health policy and guidelines for this population...
August 17, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28817359/developing-the-storyline-for-an-advance-care-planning-video-for-surgery-patients-patient-centered-outcomes-research-engagement-from-stakeholder-summit-to-state-fair
#8
Rebecca A Aslakson, Anne L R Schuster, Thomas J Lynch, Matthew J Weiss, Lydia Gregg, Judith Miller, Sarina R Isenberg, Norah L Crossnohere, Alison M Conca-Cheng, Angelo E Volandes, Thomas J Smith, John F P Bridges
BACKGROUND: Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. OBJECTIVE: The objective is to develop and test acceptability of an ACP video storyline...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817301/patients-views-of-a-behavioral-intervention-including-financial-incentives
#9
Judy A Shea, Aderinola Adejare, Kevin G Volpp, Andrea B Troxel, Darra Finnerty, Karen Hoffer, Thomas Isaac, Meredith Rosenthal, Thomas D Sequist, David A Asch
OBJECTIVES: Clinical trials are increasingly testing the effectiveness of paying patients' financial incentives for achieving desired clinical outcomes. Some researchers and providers are concerned that patient financial incentives will harm the doctor-patient relationship. How patients feel about these approaches, and these trials, is largely unknown. This study examined patients' perceptions of a compound behavioral and financial incentive intervention used in a large multicenter trial to lower low-density lipoprotein cholesterol (LDL-C), including their perceptions of benefits and challenges and the study's effect on patients' relationship with their primary care physicians (PCPs)...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817199/exposure-response-modeling-and-power-analysis-of-components-of-acr-response-criteria-in-rheumatoid-arthritis-part-1-binary-model
#10
Liang Li, Yi Zhang, Lian Ma, Ping Ji, Sarah Yim, Badrul Chowdhury, Suresh Doddapaneni, Jiang Liu, Yaning Wang, Chandrahas Sahajwalla
American College of Rheumatology (ACR) response criteria is used to assess improvement in tender and swollen joint counts and in 3 of the 5 core measures (acute-phase reactant, physician global assessment, patient global assessment, pain, and physical function). From the clinical trial data on 5 approved biological products for the treatment of rheumatoid arthritis, population pharmacokinetic/pharmacodynamic models were developed to quantitatively describe the relationship between exposure and response rates of 3 individual components of ACR response criteria...
September 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28817185/setting-the-stage-for-universal-financial-distress-screening-in-routine-cancer-care
#11
Nandita Khera, Jimmie C Holland, Joan M Griffin
Financial burden from cancer treatment is increasingly being recognized as a threat to optimal access, quality, and outcomes of cancer care for patients. Although research in the area is moving at a fast pace, multiple questions remain unanswered, such as how to practically integrate the assessment and management of financial burden into routine health care delivery for patients with cancer. Although psychological distress screening for patients undergoing cancer treatment now is commonplace, the authors raise the provocative idea of universal screening for financial distress to identify and assist vulnerable groups of patients...
August 17, 2017: Cancer
https://www.readbyqxmd.com/read/28817182/centralized-patient-reported-outcome-data-collection-in-transplantation-is-feasible-and-clinically-meaningful
#12
Bronwen E Shaw, Ruta Brazauskas, Heather R Millard, Rachel Fonstad, Kathryn E Flynn, Amy Abernethy, Jenny Vogel, Charney Petroske, Deborah Mattila, Rebecca Drexler, Stephanie J Lee, Mary M Horowitz, J Douglas Rizzo
BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) cures many patients, but often with the risk of late effects and impaired quality of life. The value of quantifying patient-reported outcomes (PROs) is increasingly being recognized, but the routine collection of PROs is uncommon. This study evaluated the feasibility of prospective PRO collection by an outcome registry at multiple time points from unselected HCT patients undergoing transplantation at centers contributing clinical data to the Center for International Blood and Marrow Transplant Research (CIBMTR), and then it correlated the PRO data with clinical and demographic data...
August 17, 2017: Cancer
https://www.readbyqxmd.com/read/28817068/a-critical-review-on-the-effect-of-docosahexaenoic-acid-dha-on-cancer-cell-cycle-progression
#13
REVIEW
Marnie Newell, Kristi Baker, Lynne M Postovit, Catherine J Field
Globally, there were 14.1 million new cancer diagnoses and 8.2 million cancer deaths in 2012. For many cancers, conventional therapies are limited in their successes and an improved understanding of disease progression is needed in conjunction with exploration of alternative therapies. The long chain polyunsaturated fatty acid, docosahexaenoic acid (DHA), has been shown to enhance many cellular responses that reduce cancer cell viability and decrease proliferation both in vitro and in vivo. A small number of studies suggest that DHA improves chemotherapy outcomes in cancer patients...
August 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28816913/influence-of-written-informed-consent-for-methylphenidate-on-medicine-persistence-rates-in-children-with-attention-deficit-hyperactivity-disorder
#14
Kristian Naenen-Hernani, Antonio Palazón-Bru, Francisco Colomina-Climent, Vicente F Gil-Guillén
OBJECTIVE: To assess the influence of written informed consent on nonpersistence with methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). METHODS: We undertook a cohort study including 141 children with ADHD who started treatment with methylphenidate, with a follow-up of 6 months. The main outcome variable was nonpersistence, defined as discontinuation of treatment by the patient. Two groups were analyzed with and without written informed consent...
August 9, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28816891/computed-tomography-use-plateaus-among-children-with-emergency-visits-for-abdominal-pain
#15
Jahan Fahimi, Aaron E Kornblith, Hemal Kanzaria, Andrew Herring, Ralph C Wang
OBJECTIVES: Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain. METHODS: This is a cross-sectional analysis of ED patients 18 years or younger with chief complaint of abdominal pain in the National Hospital Ambulatory Medical Care Survey from 2008 to 2011...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28816873/the-need-of-validated-disease-specific-outcome-instruments-for-spine-trauma
#16
Cumhur Oner, Said Sadiqi, Anne Mechteld Lehr, Gregory D Schroeder, Alexander R Vaccaro
This article focuses on patient-reported and clinician-reported outcome measures in spine trauma care. The measurement of the quality of care and functional and health-related quality of life outcomes of spine trauma patients has become increasingly important. However, no outcome instrument is specifically designed, validated, or universally adapted for this specific patient population. Issues specific to spinal trauma patients may not be adequately addressed by the instruments that are currently used in the literature and the daily clinical practice...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816851/clinical-practice-guideline-safe-medication-use-in-the-icu
#17
Sandra L Kane-Gill, Joseph F Dasta, Mitchell S Buckley, Sandeep Devabhakthuni, Michael Liu, Henry Cohen, Elisabeth L George, Anne S Pohlman, Swati Agarwal, Elizabeth A Henneman, Sharon M Bejian, Sean M Berenholtz, Jodie L Pepin, Mathew C Scanlon, Brian S Smith
OBJECTIVE: To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. DATA SOURCES: PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015. STUDY SELECTION: Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816837/individualizing-thresholds-of-cerebral-perfusion-pressure-using-estimated-limits-of-autoregulation
#18
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Chiara Robba, Luzius A Steiner, Danilo Cardim, Brenno Cabella, Xiuyun Liu, Ari Ercole, Peter John Hutchinson, David Krishna Menon, Marcel J H Aries, Peter Smielewski
OBJECTIVES: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying "one" autoregulation-guided cerebral perfusion pressure target-called "cerebral perfusion pressure optimal". We investigated whether a cerebral perfusion pressure autoregulation range-which uses a continuous estimation of the "lower" and "upper" cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed with pressure reactivity index)-has prognostic value...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816827/the-relationship-between-fear-avoidance-and-objective-biomechanical-measures-of-function-in-patients-with-adult-degenerative-scoliosis
#19
Ram Haddas, Isador H Lieberman, Andrew Block
STUDY DESIGN: A prospective cohort study. OBJECTIVE: The current study utilized quantitative gait analysis to examine the relationship of fear-avoidance beliefs to gait patterns in patients with adult degenerative scoliosis (ADS). SUMMARY OF BACKGROUND DATA: Among patients with chronic spine pain, fear-avoidance beliefs are predictive of behavioral deficiencies, poor work and surgery outcomes. The impact of such beliefs on patients with major spinal deformity has yet to be investigated...
August 14, 2017: Spine
https://www.readbyqxmd.com/read/28816806/autologous-blood-transfusion-for-postpartum-hemorrhage
#20
Julia A Greenawalt, Denise Zernell
Postpartum hemorrhage (PPH) is a leading contributor to maternal morbidity and mortality in the United States and globally. Although the rate of PPH is generally decreasing nationally, severity of PPH appears to be increasing, potentially related to the various comorbidities associated with women of childbearing age. There is increasing evidence of risks associated with allogeneic blood transfusion, which has historically been the classic therapeutic approach for treatment to PPH. Pregnant women are particularly susceptible to the implications of sensitization to red cell antigens, a common sequela to allogenic blood transfusion...
September 2017: MCN. the American Journal of Maternal Child Nursing
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