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https://www.readbyqxmd.com/read/27922781/community-nurse-s-knowledge-confidence-and-experience-of-the-mental-capacity-act-in-practice
#1
Helen Marshall, Sally Sprung
The Mental Capacity Act (MCA) is statutory legislation introduced in 2007 to protect and empower people to make decisions for themselves and those who were deemed as unable to make choices would have decisions made on their behalf, often by health professionals. All health professionals must follow the guiding principles of this legislation. Yet a scrutiny report by the House of Lords concluded this legislation was under-used with a lack of knowledge among professionals regarding applying the legislation in practice...
December 2, 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27922627/blood-based-and-urinary-prostate-cancer-biomarkers-a-review-and-comparison-of-novel-biomarkers-for-detection-and-treatment-decisions
#2
REVIEW
R J Hendriks, I M van Oort, J A Schalken
BACKGROUND: The diagnosis of prostate cancer (PCa) is currently based on serum PSA testing and/or abnormal digital rectal examination and histopathologic evaluation of prostate biopsies. The main drawback of PSA testing is the lack of specificity for PCa. To improve early detection of PCa more specific biomarkers are needed. In the past few years, many new promising biomarkers have been identified; however, to date, only a few have reached clinical practice. METHODS: In this review, we discuss new blood-based and urinary biomarker models that are promising for usage in PCa detection, follow-up and treatment decision-making...
December 6, 2016: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/27922469/sports-and-driving-with-an-implantable-cardioverter-defibrillator
#3
Aileen M Ferrick, Kevin J Ferrick
Many patients with implantable cardioverter-defibrillators (ICD) want to participate in sports and many need or wish to operate a personal motor vehicle. Healthcare providers need to advise patients regarding restrictions related to these activities in the context of the clinical indication for the ICD. Ethical considerations need to be considered when advising ICD patients of restrictions to reduce risk of injury to themselves and to others when participating in either sports or driving. Shared decision-making is necessary to have ICD patients understand and comply with recommended restrictions...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27921276/relationship-between-physician-adjudicated-adverse-events-and-patient-reported-health-related-quality-of-life-in-a-phase-ii-clinical-trial-nct01143402-of-patients-with-metastatic-uveal-melanoma
#4
Thomas M Atkinson, Jennifer L Hay, Alexander Shoushtari, Yuelin Li, Daniel J Paucar, Sloane C Smith, Ragini R Kudchadkar, Austin Doyle, Jeffrey A Sosman, Jorge Fernando Quevedo, Mohammed M Milhem, Anthony M Joshua, Gerald P Linette, Thomas F Gajewski, Jose Lutzky, David H Lawson, Christopher D Lao, Patrick J Flynn, Mark R Albertini, Takami Sato, Karl Lewis, Brian Marr, David H Abramson, Mark Andrew Dickson, Gary K Schwartz, Richard D Carvajal
PURPOSE: Clinical trials commonly use physician-adjudicated adverse event (AE) assessment via the common terminology criteria for adverse events (CTCAE) for decision-making. Patient-reported health-related quality of life (HRQoL) data are becoming more frequent in oncology; however, the relationship between physician-adjudicated AE assessment and HRQoL is understudied. METHODS: Data from a phase II trial (clinicaltrials.gov identifier: NCT01143402) where patients with metastatic uveal melanoma were randomized to receive selumetinib, an oral MEK inhibitor, or chemotherapy were analyzed...
December 5, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27921161/an-international-urogynecological-association-iuga-international-continence-society-ics-joint-report-on-the-terminology-for-the-conservative-and-nonpharmacological-management-of-female-pelvic-floor-dysfunction
#5
Kari Bo, Helena C Frawley, Bernard T Haylen, Yoram Abramov, Fernando G Almeida, Bary Berghmans, Maria Bortolini, Chantale Dumoulin, Mario Gomes, Doreen McClurg, Jane Meijlink, Elizabeth Shelly, Emanuel Trabuco, Carolina Walker, Amanda Wells
INTRODUCTION AND HYPOTHESIS: There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. METHODS: This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees...
December 5, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27921140/cocaine-administration-dose-dependently-increases-sexual-desire-and-decreases-condom-use-likelihood-the-role-of-delay-and-probability-discounting-in-connecting-cocaine-with-hiv
#6
Matthew W Johnson, Evan S Herrmann, Mary M Sweeney, Robert S LeComte, Patrick S Johnson
OBJECTIVES: Although cocaine use has been linked to sexual HIV risk behavior for decades, the direct effects of cocaine on sexual desire and sexual decision-making are unexamined. Research suggests delay discounting (devaluation of future outcomes) and probability discounting (devaluation of uncertain outcomes) play roles in condom use decisions. This study examined the effect of cocaine administration on sexual desire, hypothetical condom use, and discounting tasks. METHODS: This double-blind, within-subjects study compared the effects of 0, 125, and 250 mg/70 kg oral cocaine HCl in 12 cocaine users...
December 5, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27920962/recommendations-for-detecting-and-addressing-barriers-to-successful-supervision
#7
Tyra P Sellers, Linda A LeBlanc, Amber L Valentino
Behavior analysts who supervise staff are responsible for establishing a healthy supervisory relationship and for teaching basic behavior analytic skills (e.g., verbal repertoires, technical repertoires, clinical decision-making). In addition, supervisors should prepare their supervisees to succeed in their subsequent professional activities by developing their interpersonal skills and professionalism repertoires. Difficulties in the supervisor relationship and problematic personal and professional skills often become the focus of targeted supervision efforts after the effects of deficits (e...
December 2016: Behavior Analysis in Practice
https://www.readbyqxmd.com/read/27920623/factors-influencing-decision-making-for-or-against-adjuvant-and-neoadjuvant-chemotherapy-in-postmenopausal-hormone-receptor-positive-breast-cancer-patients-in-the-evaluate-tm-study
#8
Paul Gaß, Peter A Fasching, Tanja Fehm, Johann de Waal, Mahdi Rezai, Bernd Baier, Gerold Baake, Hans-Christian Kolberg, Martin Guggenberger, Mathias Warm, Nadia Harbeck, Rachel Wuerstlein, Jörg-Uwe Deuker, Peter Dall, Barbara Richter, Grischa Wachsmann, Cosima Brucker, Jan W Siebers, Nikos Fersis, Thomas Kuhn, Christopher Wolf, Hans-Walter Vollert, Georg-Peter Breitbach, Wolfgang Janni, Robert Landthaler, Andreas Kohls, Daniela Rezek, Thomas Noesselt, Gunnar Fischer, Stephan Henschen, Thomas Praetz, Volker Heyl, Thorsten Kühn, Thomas Krauss, Christoph Thomssen, Andre Hohn, Hans Tesch, Christoph Mundhenke, Alexander Hein, Claudia Rauh, Christian M Bayer, Adib Jacob, Katja Schmidt, Erik Belleville, Peyman Hadji, Sara Y Brucker, Matthias W Beckmann, Diethelm Wallwiener, Sherko Kümmel, Christian R Löhberg
BACKGROUND: Decision-making for or against neoadjuvant or adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive breast cancer does not follow any clear guidelines, and some patients may unnecessarily undergo chemotherapy and be exposed to the associated toxicity. The aim of this study was to identify the patient population for whom this issue may bear relevance. METHODS: Patients being treated with letrozole in the prospective multicenter noninterventional EvAluate-TM study were recruited...
October 2016: Breast Care
https://www.readbyqxmd.com/read/27920549/management-of-hypoglycemia-in-nondiabetic-palliative-care-patients-a-prognosis-based-approach
#9
REVIEW
Victor C Kok, Ping-Hsueh Lee
Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%-60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode...
2016: Palliative Care
https://www.readbyqxmd.com/read/27920092/definition-discrimination-diagnosis-and-treatment-of-central-breathing-disturbances-during-sleep
#10
Winfried Randerath, Johan Verbraecken, Stefan Andreas, Michael Arzt, Konrad E Bloch, Thomas Brack, Bertien Buyse, Wilfried De Backer, Danny Joel Eckert, Ludger Grote, Lars Hagmeyer, Jan Hedner, Poul Jennum, Maria Teresa La Rovere, Carla Miltz, Walter T McNicholas, Josep Montserrat, Matthew Naughton, Jean-Louis Pepin, Dirk Pevernagie, Bernd Sanner, Dries Testelmans, Thomy Tonia, Bart Vrijsen, Peter Wijkstra, Patrick Levy
The complexity of central breathing disturbances during sleep has become increasingly obvious. They present as central sleep apnoeas (CSAs) and hypopnoeas, periodic breathing with apnoeas, or irregular breathing in patients with cardiovascular, other internal or neurological disorders, and can emerge under positive airway pressure treatment or opioid use, or at high altitude. As yet, there is insufficient knowledge on the clinical features, pathophysiological background and consecutive algorithms for stepped-care treatment...
December 5, 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27919885/-i-have-to-live-with-the-decisions-i-make-laying-a-foundation-for-decision-making-for-children-with-life-limiting-conditions-and-life-threatening-illnesses
#11
REVIEW
Myra Bluebond-Langner, Darren Hargrave, Ellen M Henderson, Richard Langner
The relationship between parents and clinician is critical to the care and treatment of children with life-limiting conditions (LLCs) and life-threatening illnesses (LTIs). This relationship is built and maintained largely in consultations. In this article we lay out factors that bear on the success of clinical consultations and the maintenance of the essential clinician-parent relationship at progression or deterioration of LLCs or LTIs. We suggest an approach to engaging parents in conversations about care and treatment that recognises and appreciates the dilemmas which clinicians and parents face and in so doing provides a way for everyone to live with the decisions that are made...
December 5, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27919386/donor-s-support-tool-enabling-informed-secondary-use-of-patient-s-biomaterial-and-personal-data
#12
Haridimos Kondylakis, Lefteris Koumakis, Stephanie Hänold, Iheanyi Nwankwo, Nikolaus Forgó, Kostas Marias, Manolis Tsiknakis, Norbert Graf
PURPOSE: Biomedical research is being catalyzed by the vast amount of data rapidly collected through the application of information technologies (IT). Despite IT advances, the methods for involving patients and citizens in biomedical research remain static, paper-based and organized around national boundaries and anachronistic legal frameworks. The purpose of this paper is to study the current practices for obtaining consent for biobanking and the legal requirements for reusing the available biomaterial and data in EU and finally to present a novel tool to this direction enabling the secondary use of data and biomaterial...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919375/software-intelligent-system-for-effective-solutions-for-hearing-impaired-subjects
#13
Rajkumar S, Muttan S, Sapthagirivasan V, Jaya V, Vignesh S S
PURPOSE: The anatomy and physiology of the ear is complex in nature, which makes it a challenge for audiologists to prescribe solutions for varied hearing-impaired subjects. There is a need to increase the satisfaction level of hearing-aid users by adopting better strategies that involve modern technological advancements. AIM: To design and develop a decision support Software Intelligent System (SIS) that performs audiological investigations to assess the degree of hearing loss and to suggest appropriate hearing-aid gain values...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919368/clinical-reasoning-in-the-context-of-active-decision-support-during-medication-prescribing
#14
Jan Horsky, Jos Aarts, Leonie Verheul, Diane L Seger, Heleen van der Sijs, David W Bates
OBJECTIVE: Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. METHODS: Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919275/rayyan-a-web-and-mobile-app-for-systematic-reviews
#15
Mourad Ouzzani, Hossam Hammady, Zbys Fedorowicz, Ahmed Elmagarmid
BACKGROUND: Synthesis of multiple randomized controlled trials (RCTs) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions. Filtering of searches is time consuming, and no single method fulfills the principal requirements of speed with accuracy. Automation of systematic reviews is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making. We developed Rayyan ( http://rayyan...
December 5, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27918399/the-evolution-of-the-new-provider-team-driving-cultural-change-through-data
#16
Trish Anen, Debra McElroy
Nursing executives are continually challenged to address a rapidly evolving health care system. Every aspect of care delivery is being scrutinized, yet the constant requirement remains assurance of high-quality, highly reliable care that is cost-effective and easily accessible. The nursing workforce remains visible in traditional roles as well as in new and innovative capacities, whereas nurse executives experience expanded realms of focus and responsibility. As health systems continue to adapt to the changing environment, the ability to leverage the role and scope of the advanced practice registered nurse (APRN) as a health care provider is emerging as an essential business and care strategy...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918336/resident-physicians-improve-nontechnical-skills-when-on-operating-room-management-and-leadership-rotation
#17
Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918122/an-international-urogynecological-association-iuga-international-continence-society-ics-joint-report-on-the-terminology-for-the-conservative-and-nonpharmacological-management-of-female-pelvic-floor-dysfunction
#18
Kari Bo, Helena C Frawley, Bernard T Haylen, Yoram Abramov, Fernando G Almeida, Bary Berghmans, Maria Bortolini, Chantale Dumoulin, Mario Gomes, Doreen McClurg, Jane Meijlink, Elizabeth Shelly, Emanuel Trabuco, Carolina Walker, Amanda Wells
Introduction and hypothesis There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. Methods This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus)...
December 5, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27917919/niptric-an-online-tool-for-clinical-interpretation-of-non-invasive-prenatal-testing-nipt-results
#19
Birgit Sikkema-Raddatz, Lennart F Johansson, Eddy N de Boer, Elles M J Boon, Ron F Suijkerbuijk, Katelijne Bouman, Catia M Bilardo, Morris A Swertz, Martijn Dijkstra, Irene M van Langen, Richard J Sinke, Gerard J Te Meerman
To properly interpret the result of a pregnant woman's non-invasive prenatal test (NIPT), her a priori risk must be taken into account in order to obtain her personalised a posteriori risk (PPR), which more accurately expresses her true likelihood of carrying a foetus with trisomy. Our aim was to develop a tool for laboratories and clinicians to calculate easily the PPR for genome-wide NIPT results, using diploid samples as a control group. The tool takes the a priori risk and Z-score into account. Foetal DNA percentage and coefficient of variation can be given default settings, but actual values should be used if known...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27917770/evaluating-point-of-care-testing-for-glycosylated-haemoglobin-in-public-sector-primary-care-facilities-in-the-western-cape-south-africa
#20
R Mash, A Ugoagwu, C Vos, M Rensburg, R Erasmus
BACKGROUND: Diabetes mellitus contributes significantly to the burden of disease in South Africa (SA). Monitoring of glycaemic control with glycosylated haemoglobin (HbA1c) is recommended, even though current laboratory-based testing does not support immediate clinical decision-making. OBJECTIVES: To evaluate the costs and consequences for quality of care by introducing point-of-care (POC) testing for HbA1c for patients with type 2 diabetes at community health centres in Cape Town, SA...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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