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https://www.readbyqxmd.com/read/29771817/high-value-cost-conscious-communication-skills-in-undergraduate-medical-education-validity-evidence-for-scores-derived-from-two-standardized-patient-scenarios
#1
Neena Natt, Stephanie R Starr, Darcy A Reed, Yoon Soo Park, Liselotte N Dyrbye, Andrea N Leep Hunderfund
INTRODUCTION: Training in high-value, cost-conscious care (HVCCC) is increasingly being incorporated into medical school curricula, but students may have limited opportunities to engage patients in HVCCC conversations. The aim of this study was to develop two standardized patient scenarios with associated checklists, hypothesizing that resulting scores would allow for valid formative assessments of HVCCC communication skills. METHODS: Scenarios were designed to generate a less-is-more conversation (in response to a patient requesting an unnecessary test) and a shared decision-making conversation (in response to a patient choosing between multiple effective treatment options)...
May 15, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29768480/internal-medicine-trainees-knowledge-and-confidence-in-using-the-american-society-of-hematology-choosing-wisely-guidelines-in-hemostasis-thrombosis-and-non-malignant-hematology
#2
Ariela L Marshall, Sarah Jenkins, Amy S Oxentenko, Alfred I Lee, Mark D Siegel, Joel T Katz, Jatin M Vyas, John Del Valle, Joseph R Mikhael
BACKGROUND: Several specialty societies participate in the Choosing Wisely (CW) campaign in an attempt to reduce waste in health care spending. We surveyed internal medicine (IM) residents with an objective of classifying knowledge of and confidence in using the American Society of Hematology (ASH) CW principles in hemostasis, thrombosis, and non-malignant hematology. METHODS: Multi-institutional study of IM residents at 5 academic training programs in the United States...
2018: PloS One
https://www.readbyqxmd.com/read/29761337/-psychogenic-non-epileptic-seizures-differential-diagnostic-features
#3
REVIEW
Philipp S Reif, Laurent M Willems, Adam Strzelczyk, Karl Martin Klein, Felix Rosenow
Psychogenic nonepileptic seizures (PNES) are to be considered in the differential diagnosis of a transient loss of consciousness. Their discrimination from syncope, epileptic seizures or vascular events can be difficult and requires profound knowledge about the semiology and clinical presentation of PNES and their differential diagnoses. Erroneous diagnoses and the resulting therapies lead to elevated morbidity, elevated costs and a poorer outcome. The aim of the present article is to provide an overview on PNES and their delineation from the clinical pictures of epilepsy and syncope...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29753518/application-of-the-canadian-computed-tomography-head-rule-to-patients-with-minimal-head-injury
#4
Kevin Davey, Turandot Saul, Geoffrey Russel, Jonathan Wassermann, Joshua Quaas
STUDY OBJECTIVE: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29739427/open-innovation-and-external-sources-of-innovation-an-opportunity-to-fuel-the-r-d-pipeline-and-enhance-decision-making
#5
REVIEW
Alexander Schuhmacher, Oliver Gassmann, Nigel McCracken, Markus Hinder
Historically, research and development (R&D) in the pharmaceutical sector has predominantly been an in-house activity. To enable investments for game changing late-stage assets and to enable better and less costly go/no-go decisions, most companies have employed a fail early paradigm through the implementation of clinical proof-of-concept organizations. To fuel their pipelines, some pioneers started to complement their internal R&D efforts through collaborations as early as the 1990s. In recent years, multiple extrinsic and intrinsic factors induced an opening for external sources of innovation and resulted in new models for open innovation, such as open sourcing, crowdsourcing, public-private partnerships, innovations centres, and the virtualization of R&D...
May 8, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29715607/conscious-motor-control-impairs-attentional-processing-efficiency-during-precision-stepping
#6
Toby J Ellmers, William R Young
BACKGROUND: Current evidence suggests that fall-related anxiety can impair attentional processing efficiency during gait in both young and older adults, reducing the cognitive resources available for carrying out concurrent tasks (i.e., holding a conversation whilst walking or planning the safest route for navigation). RESEARCH QUESTION: It has been suggested that fall-related anxiety may impair processing efficiency by directing attention 'internally', towards consciously controlling and monitoring movement...
April 25, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29700860/summoning-compassion-to-address-the-challenges-of-conservation
#7
Arian D Wallach, Marc Bekoff, Chelsea Batavia, Michael P Nelson, Daniel Ramp
Conservation practice is informed by science, but also reflects ethical beliefs about how we ought to value and interact with the Earth's biota. As human activities continue to drive extinctions and diminish critical life-sustaining ecosystem processes, achieving conservation goals becomes increasingly urgent. In our determination to react decisively, conservation challenges can be handled without due deliberation, particularly when wildlife individuals are sacrificed "for the greater good" of wildlife collectives (populations, species, ecosystems)...
April 27, 2018: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/29693413/edible-insects-defining-knowledge-gaps-in-biological-and-ethical-considerations-of-entomophagy
#8
Isabella Pali-Schöll, Regina Binder, Yves Moens, Friedrich Polesny, Susana Monsó
While seeking novel food sources to feed the increasing population of the globe, several alternatives have been discussed, including algae, fungi or in vitro meat. The increasingly propagated usage of farmed insects for human nutrition raises issues regarding food safety, consumer information and animal protection. In line with law, insects like any other animals must not be reared or manipulated in a way that inflicts unnecessary pain, distress or harm on them. Currently, there is a great need for research in the area of insect welfare, especially regarding species-specific needs, health, farming systems and humane methods of killing...
April 25, 2018: Critical Reviews in Food Science and Nutrition
https://www.readbyqxmd.com/read/29673140/euthanasia-of-cattle-practical-considerations-and-application
#9
REVIEW
Jan Keith Shearer
Acceptable methods for the euthanasia of cattle include overdose of an anesthetic, gunshot and captive bolt. The use of anesthetics for euthanasia is costly and complicates carcass disposal. These issues can be avoided by use of a physical method such as gunshot or captive bolt; however, each requires that certain conditions be met to assure an immediate loss of consciousness and death. For example, the caliber of firearm and type of bullet are important considerations when gunshot is used. When captive bolt is used, a penetrating captive bolt loaded with the appropriate powder charge and accompanied by a follow up (adjunctive) step to assure death are required...
April 17, 2018: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/29666760/barefoot-running-does-not-affect-simple-reaction-time-an-exploratory-study
#10
Nicholas J Snow, Jason F L Blair, Graham Z MacDonald, Jeannette M Byrne, Fabien A Basset
Background: Converging evidence comparing barefoot (BF) and shod (SH) running highlights differences in foot-strike patterns and somatosensory feedback, among others. Anecdotal evidence from SH runners attempting BF running suggests a greater attentional demand may be experienced during BF running. However, little work to date has examined whether there is an attentional cost of BF versus SH running. Objective: This exploratory study aimed to examine whether an acute bout of BF running would impact simple reaction time (SRT) compared to SH running, in a sample of runners naïve to BF running...
2018: PeerJ
https://www.readbyqxmd.com/read/29661381/a-review-of-the-safety-and-efficacy-of-inhaled-methoxyflurane-as-an-analgesic-for-outpatient-procedures
#11
REVIEW
C Jephcott, J Grummet, N Nguyen, O Spruyt
Methoxyflurane delivered via a hand-held inhaler is a proven analgesic which has been used in Australasia for emergency relief of trauma associated pain since the 1970s. The agent is self-administered by the patient under the supervision of trained personnel. More than 5 million patients have received inhaled methoxyflurane without significant side effects. Methoxyflurane is also licensed in Australasia for the relief of pain in monitored conscious patients requiring analgesia for minor surgical procedures...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29619054/clinical-analysis-of-speculum-based-vaginal-packing-for-high-dose-rate-intracavitary-tandem-and-ovoid-brachytherapy-in-cervical-cancer
#12
Shivani Sud, Toni Roth, Ellen Jones
Purpose: Intra-vaginal packing is used to fix the applicator and displace organs at risk (OAR) during high-dose-rate intracavitary tandem and ovoid brachytherapy (HDR-ICB). We retain the speculum from applicator placement as a dual-function bladder and rectum retractor during treatment. Our objective is to review salient techniques for OAR displacement, share our packing technique, and determine the reduction in dose to OAR and inter-fraction variability of dose to OAR, associated with speculum-based vaginal packing (SBVP) in comparison to conventional gauze packing during HDR-ICB...
February 2018: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29607745/outpatient-diode-laser-treatment-of-intermediate-risk-non-invasive-bladder-tumors-without-sedation-efficacy-safety-and-economic-analysis
#13
Gregers Gautier Hermann, Karin Mogensen, Susanne Rosthøj
OBJECTIVE: This study aimed to validate a new method for outpatient diode laser ablation of bladder tumors without sedation or pain control. METHODS: Twenty-one patients with stage Ta low-grade intermediate-risk bladder tumors underwent photodynamic-guided laser ablation of their bladder tumors and 1 month later follow-up cystoscopy with photodynamic and IMAGE1 S™-guided biopsies. Pain was measured using a visual analog scale (range 0-10). Symptoms and worries about the future disease course were calculated using the Quality of Life Questionnaire for Non-Muscle-Invasive Bladder Cancer (range 0-100, high scores indicating worse symptoms or worry)...
April 1, 2018: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/29571088/over-focused-the-relation-between-patients-inclination-for-conscious-control-and-single-and-dual-task-motor-performance-after-stroke
#14
R P M Denneman, E C Kal, H Houdijk, J van der Kamp
BACKGROUND: Many stroke patients are inclined to consciously control their movements. This is thought to negatively affect patients' motor performance, as it disrupts movement automaticity. However, it has also been argued that conscious control may sometimes benefit motor performance, depending on the task or patientś motor or cognitive capacity. AIM: To assess whether stroke patients' inclination for conscious control is associated with motor performance, and explore whether the putative association differs as a function of task (single- vs dual) or patientś motor and cognitive capacity...
March 5, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29560814/electrocardiographic-guided-tip-positioning-technique-for-peripherally-inserted-central-catheters-in-a-dutch-teaching-hospital-feasibility-and-cost-effectiveness-analysis-in-a-prospective-cohort-study
#15
Arthur Bloemen, Anne M Daniels, Martine G Samyn, Roel Jl Janssen, Jan-Willem Elshof
INTRODUCTION: Peripherally inserted central catheters are venous devices intended for short to medium periods of intravenous treatment. Positioning of the catheter tip at the cavoatrial junction is necessary for optimum performance of a peripherally inserted central catheter. In this study, safety, effectiveness and cost-effectiveness of electrocardiographic-guided peripherally inserted central catheter positioning in a Dutch teaching hospital were evaluated. METHODS: All patients who received a peripherally inserted central catheter in 2016 using electrocardiographic guidance were compared to those where fluoroscopy guidance was used in a prospective non-randomized cohort study...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29555455/bio-recycling-of-metals-recycling-of-technical-products-using-biological-applications
#16
REVIEW
Katrin Pollmann, Sabine Kutschke, Sabine Matys, Johannes Raff, Gregor Hlawacek, Franziska L Lederer
The increasing demand of different essential metals as a consequence of the development of new technologies, especially in the so called "low carbon technologies" require the development of innovative technologies that enable an economic and environmentally friendly metal recovery from primary and secondary resources. There is serious concern that the demand of some critical elements might exceed the present supply within a few years, thus necessitating the development of novel strategies and technologies to meet the requirements of industry and society...
March 16, 2018: Biotechnology Advances
https://www.readbyqxmd.com/read/29533307/does-continuous-video-eeg-in-patients-with-altered-consciousness-improve-patient-outcome-current-evidence-and-randomized-controlled-trial-design
#17
Andrea O Rossetti, Kaspar Schindler, Vincent Alvarez, Raoul Sutter, Jan Novy, Mauro Oddo, Loane Warpelin-Decrausaz, Stephan Rüegg
Continuous video-EEG is recommended for patients with altered consciousness; as compared to routine EEG (lasting <30 minutes), it improves seizure detection, but is time- and resource-consuming. Although North American centers increasingly implement continuous video-EEG, most other (including European) hospitals have insufficient resources. Only one study suggested that continuous video-EEG could improve outcome in adults, and a recent assessments challenge this view. This article reviews current evidence on the added value for continuous video-EEG in clinical terms and describes a design for a prospective study...
March 8, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29510702/ethical-underpinnings-for-the-development-of-health-literacy-in-schools-ethical-premises-why-orientations-what-and-tone-how
#18
Leena Paakkari, Shanti George
BACKGROUND: Schools are seen as crucial environments to influence and develop the health literacy of new generations, but without sufficient reflection on the ethical underpinnings of intentions and interventions around health literacy. In contrast, we argue here that ethics are fundamental to all education. The article adopts a 'One world' approach that generalizes broadly across the so-called Global North and Global South. It also generalizes across various age groups among school pupils, advocating age appropriate application of the arguments advanced...
March 6, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29499800/patient-costs-associated-with-rosacea
#19
REVIEW
Jackson G Turbeville, Hossein Alinia, Sara Moradi Tuchayi, Naeim Bahrami, Leah A Cardwell, Olabola Awosika, Irma Richardson, Karen E Huang, Steven R Feldman
The recalcitrance of rosacea to many treatment options may prompt patients to spend exorbitant amounts of money on unsubstantiated treatment regimens in an effort to achieve relief. The authors examine the relationship between disease severity and treatment cost across several demographic and socioeconomic strata. Familiarization of evidence-based clinical recommendations and consensus guidelines may equip physicians to educate patients about the most efficacious and cost-effective treatment options to assist patients in making cost-conscious decisions in the management of their rosacea...
April 2018: Dermatologic Clinics
https://www.readbyqxmd.com/read/29487169/predictors-of-symptomatic-intracranial-haemorrhage-in-patients-with-an-ischaemic-stroke-with-neurological-deterioration-after-intravenous-thrombolysis
#20
Brandon James, Andrew D Chang, Ryan A McTaggart, Morgan Hemendinger, Brian Mac Grory, Shawna M Cutting, Tina M Burton, Michael E Reznik, Bradford Thompson, Linda Wendell, Ali Mahta, Matthew Siket, Tracy E Madsen, Kevin N Sheth, Amre Nouh, Karen L Furie, Mahesh V Jayaraman, Pooja Khatri, Shadi Yaghi
OBJECTIVES: Early neurological deterioration prompting urgent brain imaging occurs in nearly 15% of patients with ischaemic stroke receiving intravenous tissue plasminogen activator (tPA). We aim to determine risk factors associated with symptomatic intracranial haemorrhage (sICH) in patients with ischaemic stroke undergoing emergent brain imaging for early neurological deterioration after receiving tPA. METHODS: We abstracted data from our prospective stroke database and included all patients receiving tPA for ischaemic stroke between 1 March 2015 and 1 March 2017...
February 27, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
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