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https://www.readbyqxmd.com/read/29446570/gratitude-protective-buffering-and-cognitive-dissonance-how-families-respond-to-pediatric-whole-exome-sequencing-in-the-absence-of-actionable-results
#1
Allison Werner-Lin, Lori Zaspel, Mae Carlson, Rebecca Mueller, Sarah A Walser, Ria Desai, Barbara A Bernhardt
Clinical genome and exome sequencing (CGES) may identify variants leading to targeted management of existing conditions. Yet, CGES often fails to identify pathogenic diagnostic variants and introduces uncertainties by detecting variants of uncertain significance (VUS) and secondary findings. This study investigated how families understand findings and adjust their perspectives on CGES. As part of NIH's Clinical Sequencing Exploratory Research Consortium, children were recruited from clinics at the Children's Hospital of Pennsylvania (CHOP) and offered exome sequencing...
March 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29443393/parenteral-nutrition-electrolyte-abnormalities-and-associated-factors-before-and-after-nutrition-support-team-initiation
#2
Katie Braun, Anne Utech, Maria Eugenia Velez, Renee Walker
BACKGROUND: Studied since the 1940s, refeeding syndrome still has no universal definition, thus making comparison of studies difficult. Negative outcomes (eg, metabolic abnormalities) may occur with the use of specialized nutrition, such as parenteral nutrition (PN). Less than half of medical institutions have a nutrition support team (NST) managing PN. Interdisciplinary team management of PN may reduce negative outcomes of PN. The objective of this study was to show the value of the NST by measuring differences in PN variables, especially electrolyte abnormalities (EAs), before and after NST initiation at a large medical center and to identify factors associated with EAs among adult subjects receiving PN...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29443076/optimized-management-of-endovascular-treatment-for-acute-ischemic-stroke
#3
Katharina Schregel, Daniel Behme, Ioannis Tsogkas, Michael Knauth, Ilko Maier, André Karch, Rafael Mikolajczyk, Mathias Bähr, Jörn Schäper, José Hinz, Jan Liman, Marios-Nikos Psychogios
This manuscript describes a streamlined protocol for the management of patients with acute ischemic stroke, which aims at the minimization of time from hospital admission to reperfusion. Rapid restoration of cerebral blood flow is essential for the outcomes of patients with acute ischemic stroke. Endovascular treatment (EVT) has become the standard of care to accomplish this in patients with acute stroke due to large vessel occlusion (LVO). To achieve reperfusion of ischemic brain regions as fast as possible, all in-hospital time delays have to be carefully avoided...
January 18, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29440878/functionality-and-outcome-in-older-patients-with-severe-aortic-stenosis-foopas-an-interdisciplinary-study-concept-for-a-prospective-trial
#4
Ferdinand Vogt, Susanne Wicklein, Markus Gosch, Jürgen Jessl, Wolfgang Hitzl, Theodor Fischlein, Matthias Pauschinger, Steffen Pfeiffer, Dennis Eckner
Background: Frailty is a geriatric syndrome that can influence mortality and functional recovery after treatment of severe aortic stenosis (AS). The integration of standardized geriatric assessment (GA) in clinical practice is limited by a lack of consensus on how to measure it. Objectives: This study aims to compare the incremental predictive value of different frailty scales to predict the outcomes following surgical aortic valve replacement, transcatheter aortic valve implantation, and conservative treatment of severe AS...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29440128/a-quality-improvement-intervention-to-improve-inpatient-pediatric-asthma-controller-accuracy
#5
Alexander H Hogan, Deepa Rastogi, Michael L Rinke
OBJECTIVES: Our objective was to investigate if a rigorous quality improvement (QI) intervention could increase accuracy of pediatric asthma controller medications on discharge from an inpatient hospitalization. METHODS: Our interprofessional QI team developed interventions such as improving documentation and creating standardized language to ensure patients were discharged on an appropriate asthma controller medication and improve assessment of asthma symptom control...
February 13, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29438566/a-theoretical-model-of-resource-oriented-music-therapy-with-informal-hospice-caregivers-during-pre-bereavement
#6
Noah Potvin, Joke Bradt, Claire Ghetti
Background: Over the past decade, caregiver pre-bereavement has received increased scholarly and clinical attention across multiple healthcare fields. Pre-bereavement represents a nascent area for music therapy to develop best practices in and an opportunity to establish clinical relevancy in the interdisciplinary team. Objective: This study was an exploratory inquiry into the role of music therapy with pre-bereaved informal hospice caregivers. This study intended to articulate (a) what pre-bereavement needs are present for informal hospice caregivers, (b) which of those needs were addressed in music, and (c) the process by which music therapy addressed those needs...
February 9, 2018: Journal of Music Therapy
https://www.readbyqxmd.com/read/29436434/updates-in-palliative-care-overview-and-recent-advancements-in-the-pharmacological-management-of-cancer-pain
#7
Helen Wood, Andrew Dickman, Angela Star, Jason W Boland
Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29429005/new-frontier-cancer-pain-management-clinical-fellowship
#8
Uri Hochberg, Jordi Perez, Manuel Borod
Cancer pain is a multi-dimensional experience, varies from person to person both physically and psycho-socially, and impacts all aspects of the patients' quality of life. Majority of patients with an advanced or metastatic cancer will experience pain. It is estimated that as many as half of cancer patients are under-treated and as many as 20% experience pain refractory to the conventional WHO ladder of pain management. The McGill University Health Centre (MUHC) Cancer Pain Clinic (CPC) was created to meet the needs of those patients with a diagnosis of cancer whose pain had become a main symptom and those who failed to respond to conventional treatment...
February 10, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29424753/ce-malnutrition-in-older-adults
#9
Ann Reed Mangels
An evidence-based review of risk factors, assessment, and intervention. ABSTRACT: Older adults are at risk for compromised nutritional status because of physical changes associated with aging, as well as cognitive, psychological, and social factors such as dementia, depression, isolation, and limited income. Malnutrition negatively affects quality of life, increases health care costs, and increases the risk of short-term mortality. Nurses and other members of interdisciplinary health care teams play important roles in preventing malnutrition in community-dwelling older adults and in older adults in long-term care settings...
February 8, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29415760/mobile-critical-care-recovery-program-m-ccrp-for-acute-respiratory-failure-survivors-study-protocol-for-a-randomized-controlled-trial
#10
Sikandar Khan, Ashok Biju, Sophia Wang, Sujuan Gao, Omar Irfan, Amanda Harrawood, Stephanie Martinez, Emily Brewer, Anthony Perkins, Frederick W Unverzagt, Sue Lasiter, Ben Zarzaur, Omar Rahman, Malaz Boustani, Babar Khan
BACKGROUND: Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors. METHODS: The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) - m-CCRP intervention versus attention control...
February 7, 2018: Trials
https://www.readbyqxmd.com/read/29413689/germline-bap1-positive-patients-the-dilemmas-of-cancer-surveillance-and-a-proposed-interdisciplinary-consensus-monitoring-strategy
#11
Phoebe Star, Annabel Goodwin, Rony Kapoor, R Max Conway, Georgina V Long, Richard A Scolyer, Pascale Guitera
The germline BAP1 (BRCA1-associated protein-1) mutation and associated cancer pre-disposition syndrome was first described in 2011. Since then, physicians have considered this diagnosis for patients with a characteristic personal or family history of BAP1-associated tumours (mainly uveal and cutaneous melanoma, pleural/peritoneal mesothelioma, renal cell carcinoma and BAP1-deficient melanocytic lesions). However, a positive germline BAP1 mutation detection creates significant uncertainty in terms of appropriate cancer surveillance...
February 2, 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29412098/leadership-in-crisis-situations-merging-the-interdisciplinary-silos
#12
Hugo Paquin, Ilana Bank, Meredith Young, Lily H P Nguyen, Rachel Fisher, Peter Nugus
Purpose Complex clinical situations, involving multiple medical specialists, create potential for tension or lack of clarity over leadership roles and may result in miscommunication, errors and poor patient outcomes. Even though copresence has been shown to overcome some differences among team members, the coordination literature provides little guidance on the relationship between coordination and leadership in highly specialized health settings. The purpose of this paper is to determine how different specialties involved in critical medical situations perceive the role of a leader and its contribution to effective crisis management, to better define leadership and improve interdisciplinary leadership and education...
February 5, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29410749/surgical-treatment-of-a-pattern-i-obstructive-sleep-apnea-syndrome-individual-clinical-case-report
#13
Christiane Cavalcante Feitoza, Matheus Corrêa da-Silva, Yasmim Lima Nascimento, Elaine Sobral Leite, Corintho Viana Pereira, Lucas Gomes Patrocínio
Obstructive Sleep Apnea Syndrome (OSA) is a multifactorial disease that highly alters a persons quality of life. It is characterized by the repeated interruption of breathing during sleep, due to an obstruction or the collapse of the upper airways. Since it is a multifactorial etiological disorder, it requires a thorough diagnosis and treatment with an interdisciplinary team, which comprises several professionals such as a surgical dentist, phonoaudiologist, otorhinolaryngologist, sleep doctor, neurologist and physiotherapist...
October 2017: Sleep Science
https://www.readbyqxmd.com/read/29409043/education-and-training-for-clinical-neuropsychologists-in-integrated-care-settings
#14
Brad L Roper, Cady K Block, Katie Osborn, Rebecca E Ready
The increasing importance of integrated care necessitates that education and training experiences prepare clinical neuropsychologists for competent practice in integrated care settings, which includes (a) general competence related to an integrated/interdisciplinary approach and (b) competence specific to the setting. Formal neuropsychology training prepares neuropsychologists with a wide range of knowledge and skills in assessment, intervention, teaching/supervision, and research that are relevant to such settings...
February 2, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29406125/technique-adaptation-strategic-replanning-and-team-learning-during-implementation-of-mr-guided-brachytherapy-for-cervical-cancer
#15
Julia Skliarenko, Marco Carlone, Kari Tanderup, Kathy Han, Akbar Beiki-Ardakani, Jette Borg, Kitty Chan, Jennifer Croke, Alexandra Rink, Anna Simeonov, Reem Ujaimi, Jason Xie, Anthony Fyles, Michael Milosevic
PURPOSE: MR-guided brachytherapy (MRgBT) with interstitial needles is associated with improved outcomes in cervical cancer patients. However, there are implementation barriers, including magnetic resonance (MR) access, practitioner familiarity/comfort, and efficiency. This study explores a graded MRgBT implementation strategy that included the adaptive use of needles, strategic use of MR imaging/planning, and team learning. METHODS AND MATERIALS: Twenty patients with cervical cancer were treated with high-dose-rate MRgBT (28 Gy in four fractions, two insertions, daily MR imaging/planning)...
January 2018: Brachytherapy
https://www.readbyqxmd.com/read/29405141/incidence-of-ventilator-associated-pneumonia-and-impact-of-multidrug-resistant-infections-on-patient-s-outcome-experience-at-an-apex-trauma-centre-in-north-india
#16
Surbhi Khurana, Purva Mathur, Subodh Kumar, Kapil Dev Soni, Richa Aggrawal, Priyam Batra, Nidhi Bhardwaj
INTRODUCTION: Ventilator-associated pneumonia (VAP) remains one of the most common nosocomial infections in the Intensive Care Unit. In the face of extremely high rates of antimicrobial resistance, it is essential to gauge the clinical significance of isolation of multidrug-resistant (MDR) pathogens from clinical samples. This study details the trend of VAP and the clinical significance of isolation of MDR pathogens from respiratory samples at an Indian tertiary care hospital. METHODS: The study was conducted over a 5-year period...
October 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29403619/national-survey-of-availability-of-physical-rehabilitation-services-in-iran-a-mixed-methods-study
#17
Marzieh Shirazikhah, Arash Mirabzadeh, Homeira Sajadi, Mohammad Taghi Joghataei, Akbar Biglarian, Tahmineh Mousavi, Farahnaz Mohammadi Shahboulaghi
Background: The prevalence of disability in Iran has increased due to ageing of the population and the presence of chronic diseases. However, little is known about the availability of rehabilitation services in Iran. Objective: To study the availability of physical rehabilitation services in Iran. Methods: This was a mixed method study. In the first phase, a qualitative design was conducted for designing an instrument with focus groups based on Service Availability and Readiness Assessment (SARA) instrument (developed by World Health Organization)...
November 2017: Electronic Physician
https://www.readbyqxmd.com/read/29403331/we-re-the-eyes-and-the-ears-but-we-don-t-have-a-voice-perspectives-of-hospice-aides
#18
Djin Lai, Kristin G Cloyes, Margaret F Clayton, Katherine Doyon, Maija Reblin, Anna C Beck, Lee Ellington
Hospice aides are integral to the delivery of home hospice care and play an essential role in the effective communication and collaboration of the hospice interdisciplinary team. Despite their critical role, little is known about hospice aides' perceptions of their role in providing hospice services. This qualitative study explores hospice aides' perspectives of their work, their relationships with patients, families and interdisciplinary team members, and their contributions to end-of-life care. Two focus groups of hospice aides (N = 13), and 16 hours of observation of in-home caregiving were conducted...
February 2018: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/29400348/creative-construction-crafting-negotiating-and-performing-urban-food-sharing-landscapes
#19
Anna R Davies, Ferne Edwards, Brigida Marovelli, Oona Morrow, Monika Rut, Marion Weymes
Activities utilising online tools are an increasingly visible part of our everyday lives, providing new subjects, objects and relationships - essentially new landscapes - for research, as well as new conceptual and methodological challenges for researchers. In parallel, calls for collaborative interdisciplinary, even transdisciplinary, research are increasing. Yet practical guidance and critical reflection on the challenges and opportunities of conducting collaborative research online, particularly in emergent areas, is limited...
December 2017: Area (Oxf)
https://www.readbyqxmd.com/read/29400143/overcoming-challenges-in-primary-care-in-brazil-successful-experiences-in-family-medicine-education
#20
Pablo González Blasco, Francisco Lamus, Graziela Moreto, Marco Aurelio Janaudis, Marcelo R Levites, Pedro S de Paula
Since 1988, Brazil has built a national health system procuring a response that meets universal health care. The government created the Family Health Strategy (FHS) to help improve access to health services through primary health care teams developing interdisciplinary actions. Scarcity of doctors with family medicine (FM) competencies in Brazil limits the FHS effectiveness. The lack of family physicians can be traced primarily to the medical schools where training supports other specialties besides FM. Innovation is required to bring students to the specialty and medical marketplace...
February 5, 2018: Education for Primary Care
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