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https://www.readbyqxmd.com/read/29453549/the-german-reach-congress-2016-a-workshop-report
#1
Antonia Reihlen, Dirk Jepsen, Lutz Broschinski, Andreas Luch, Agnes Schulte
In October 2016, the German REACH Congress was held at the German Federal Institute for Risk Assessment (BfR) in Berlin. Here, the associated improvement made in the fields of consumer protection and the progress in and experiences gained from the implementation of the authorisation procedure were discussed. Several speakers from EU institutions, German authorities, industry, and civil society organisations were invited to present their views. There was a shared consensus that REACH contributes to the advancement of consumer protection against chemical risks, mainly because more and higher quality information on substance-related hazards and potential exposures becomes available...
February 17, 2018: Archives of Toxicology
https://www.readbyqxmd.com/read/29452858/the-effect-of-being-informed-on-receiving-immediate-breast-reconstruction-in-breast-cancer-patients
#2
K M de Ligt, A C M van Bommel, K Schreuder, J H Maduro, M T F D Vrancken Peeters, M A M Mureau, S Siesling
INTRODUCTION: In previous research from the NABON breast cancer audit, observed hospital variation in immediate breast reconstruction (IBR) rates in the Netherlands could not be fully explained by tumour, patient, and hospital factors. The process of information provision and decision-making may also contribute to the observed variation; the objective of the current study was to give insight in the underlying decision-making process for IBR and to determine the effect of being informed about IBR on receiving IBR...
February 2, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29452582/to-what-extent-can-behaviour-change-techniques-be-identified-within-an-adaptable-implementation-package-for-primary-care-a-prospective-directed-content-analysis
#3
Liz Glidewell, Thomas A Willis, Duncan Petty, Rebecca Lawton, Rosemary R C McEachan, Emma Ingleson, Peter Heudtlass, Andrew Davies, Tony Jamieson, Cheryl Hunter, Suzanne Hartley, Kara Gray-Burrows, Susan Clamp, Paul Carder, Sarah Alderson, Amanda J Farrin, Robbie Foy
BACKGROUND: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages...
February 17, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29452303/effect-of-biologics-on-fatigue-in-psoriatic-arthritis-a-systematic-literature-review-with-meta-analysis
#4
Thomas Reygaerts, Stéphane Mitrovic, Bruno Fautrel, Laure Gossec
OBJECTIVES: Fatigue is a significant issue in psoriatic arthritis. The objective was to assess the effect of biological disease modifying antirheumatic drugs and apremilast on fatigue in psoriatic arthritis randomised controlled trials and to compare this effect with the effect in the same trials, on pain, through a systematic literature review and meta-analysis. METHODS: A systematic literature review was performed up to January 2017 in PubMed, Embase and Cochrane databases...
February 13, 2018: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29452055/feeling-an-invisible-wall-the-experience-of-iranian-women-s-marital-relationship-after-surgical-menopause-a-qualitative-content-analysis-study
#5
Om Salimeh Roudi Rasht Abadi, Mohammad Ali Cheraghi, Batool Tirgari, Nahid Dehaghan Nayeri, Masoud Rayyani
Sexual relationship after surgical menopause matters when talking about sex is taboo and marriage is the only justified way to meet sexual needs. In this qualitative research approach 22 surgical menopausal women shared their experiences of sexual/ marital relationship after surgery through in-depth, face-to-face and semi-structured interviews. Qualitative content analysis technique was used for data analysis. An overarching theme entitled "feeling an invisible wall" reflected this experience. It comprised of three categories: 1) Declined marital intimacy, 2) Disarming, and 3) Transformation of social norms into concerns...
February 16, 2018: Journal of Sex & Marital Therapy
https://www.readbyqxmd.com/read/29451515/-promoting-evidence-based-gastroenterology-back-to-the-future
#6
Maurizio Koch
Evidence-based medicine continues to thrive thanks to the publication of a considerable amount of papers focusing on data collection and sharing. Assessment of the accuracy of diagnostic tests still remains highly deficient, often leading to inappropriate clinical decision-making. Like most other doctors, gastroenterologists as well have to face the ever-growing availability of complex and expensive exams, being charged with the task of choosing the best diagnostic option and interpreting test results. It is therefore advisable to provide specialists with the tools they need to evaluate the available literature data...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29450820/overlapping-and-distinct-cognitive-impairments-in-attention-deficit-hyperactivity-and-autism-spectrum-disorder-without-intellectual-disability
#7
Sarah L Karalunas, Elizabeth Hawkey, Hanna Gustafsson, Meghan Miller, Marybeth Langhorst, Michaela Cordova, Damien Fair, Joel T Nigg
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are commonly comorbid, share genetic liability, and often exhibit overlapping cognitive impairments. Clarification of shared and distinct cognitive effects while considering comorbid symptoms across disorders has been lacking. In the current study, children ages 7-15 years assigned to three diagnostic groups:ADHD (n = 509), ASD (n = 97), and controls (n = 301) completed measures spanning the cognitive domains of attention/arousal, working memory, set-shifting, inhibition, and response variability...
February 15, 2018: Journal of Abnormal Child Psychology
https://www.readbyqxmd.com/read/29450795/ethics-and-confidentiality-for-psychologists-in-academic-health-centers
#8
Kathleen Ashton, Amy Sullivan
Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care...
February 15, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29449296/gp-and-parent-dissonance-about-the-assessment-and-treatment-of-childhood-eczema-in-primary-care-a-qualitative-study
#9
Kingsley Powell, Emma Le Roux, Jonathan Banks, Matthew J Ridd
OBJECTIVES: To compare parents' and clinicians' perspectives on the assessment and treatment of children with eczema in primary care. DESIGN: Qualitative interview study with purposive and snowball sampling and thematic analysis. SETTING: 14 general practices in the UK. PARTICIPANTS: 11 parents of children with eczema and 15 general practitioners (GPs) took part in semistructured individual interviews. RESULTS: We identified several areas of dissonance between parents and GPs...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29449241/simplified-guideline-for-prescribing-medical-cannabinoids-in-primary-care
#10
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29447297/development-of-a-decision-aid-for-cardiopulmonary-resuscitation-and-invasive-mechanical-ventilation-in-the-intensive-care-unit-employing-user-centered-design-and-a-wiki-platform-for-rapid-prototyping
#11
Ariane Plaisance, Holly O Witteman, Annie LeBlanc, Jennifer Kryworuchko, Daren Keith Heyland, Mark H Ebell, Louisa Blair, Diane Tapp, Audrey Dupuis, Carole-Anne Lavoie-Bérard, Carrie Anna McGinn, France Légaré, Patrick Michel Archambault
BACKGROUND: Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. OBJECTIVES: To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient's risk factors; and to document the use of a wiki platform for this purpose...
2018: PloS One
https://www.readbyqxmd.com/read/29447193/the-quality-of-instruments-to-assess-the-process-of-shared-decision-making-a-systematic-review
#12
Fania R Gärtner, Hanna Bomhof-Roordink, Ian P Smith, Isabelle Scholl, Anne M Stiggelbout, Arwen H Pieterse
OBJECTIVE: To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. METHODS: In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results...
2018: PloS One
https://www.readbyqxmd.com/read/29446337/a-hierarchical-framework-for-evaluation-and-informed-decision-making-regarding-smartphone-apps-for-clinical-care
#13
John Blake Torous, Steven Richard Chan, Shih Yee-Marie Tan Gipson, Jung Won Kim, Thuc-Quyen Nguyen, John Luo, Philip Wang
With thousands of smartphone apps targeting mental health, it is difficult to ignore the rapidly expanding use of apps in the treatment of psychiatric disorders. Patients with psychiatric conditions are interested in mental health apps and have begun to use them. That does not mean that clinicians must support, endorse, or even adopt the use of apps, but they should be prepared to answer patients' questions about apps and facilitate shared decision making around app use. This column describes an evaluation framework designed by the American Psychiatric Association to guide informed decision making around the use of smartphone apps in clinical care...
February 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29443717/anticipating-and-training-the-physician-of-the-future-the-importance-of-caring-in-an-age-of-artificial-intelligence
#14
S Claiborne Johnston
Artificial intelligence and other forms of information technology are only just beginning to change the practice of medicine. The pace of change is expected to accelerate as tools improve and as demands for analyzing a rapidly growing body of knowledge and array of data increase. The medical students of today will practice in a world where information technology is sophisticated and omnipresent. In this world, the tasks of memorization and analysis will be less important to them as practicing physicians. On the other hand, the non-analytical, humanistic aspects of medicine-most importantly, the art of caring-will remain a critical function of the physician, and facility with improving systems of care will be required...
February 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29441035/decision-making-strategy-and-the-simultaneous-processing-of-syntactic-dependencies-in-language-and-music
#15
M P Roncaglia-Denissen, Fleur L Bouwer, Henkjan Honing
Despite differences in their function and domain-specific elements, syntactic processing in music and language is believed to share cognitive resources. This study aims to investigate whether the simultaneous processing of language and music share the use of a common syntactic processor or more general attentional resources. To investigate this matter we tested musicians and non-musicians using visually presented sentences and aurally presented melodies containing syntactic local and long-distance dependencies...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29440123/portrait-patient-centered-outcomes-related-to-treatment-practices-in-peripheral-arterial-disease-investigating-trajectories-overview-of-design-and-rationale-of-an-international-prospective-peripheral-arterial-disease-study
#16
REVIEW
Kim G Smolderen, Kensey Gosch, Manesh Patel, W Schuyler Jones, Alan T Hirsch, John Beltrame, Rob Fitridge, Mehdi H Shishehbor, Johan Denollet, Patrick Vriens, Jan Heyligers, Nancy Stone MEd, Herbert Aronow, J Dawn Abbott, Clementine Labrosciano, Rudolf Tutein-Nolthenius, John A Spertus
BACKGROUND: Health status outcomes, including symptoms, functional status, and quality of life, are critically important outcomes from patients' perspectives. The PORTRAIT study (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) was designed to prospectively define health status outcomes and examine associations between patients' characteristics and care to these outcomes among those presenting with new-onset or worsened claudication...
February 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29438606/experience-and-context-shape-patient-and-clinician-goals-for-treatment-of-rheumatoid-arthritis-a-qualitative-study
#17
Jennifer L Barton, Elizabeth Hulen, Allison Schue, Edward H Yelin, Sarah S Ono, Anais Tuepker, Christopher J Koenig
OBJECTIVE: Patient and clinician goal alignment, central to effective patient-centered care, has been linked to improved patient experience and outcomes, but has not been explored in rheumatoid arthritis (RA). This study aimed to explore goal conceptualization among RA patients and clinicians. METHODS: Seven focus groups and one semi-structured interview were conducted with RA patients and clinicians recruited from four rheumatology clinics. An interview guide was developed to explore goal concordance related to RA treatment...
February 13, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29438512/patients-and-surgeons-perceptions-of-social-media-s-role-in-the-decision-making-for-primary-aesthetic-breast-augmentation
#18
Paolo Montemurro, Mubashir Cheema, Per Hedén
Background: Social media (SoMe) has evolved to be a platform that patients use to seek information prior to an operation, share perioperative and postoperative journey, provide feedback, offer and receive support. While there have been studies looking at the evolution and usage of SoMe either by patients or by surgeons, there is no information that compares its usefulness for both the groups. Objective: The aim of this study was to compare the view held by patients and surgeons, towards social media and other internet resources, in relation to one commonly performed operation...
February 9, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29438140/cost-effectiveness-of-a-ceramide-infused-skin-barrier-versus-a-standard-barrier-findings-from-a-long-term-cost-effectiveness-analysis
#19
Ariel Berger, Gary Inglese, George Skountrianos, Tonny Karlsmark, Mustafa Oguz
PURPOSE: To assess the cost-effectiveness of a ceramide-infused skin barrier (CIB) versus other skin barriers (standard of care) among patients who have undergone ostomy creation. DESIGN: Cost-effectiveness analysis, based on a decision-analytic model that was estimated using data from the ADVOCATE (A Study Determining Variances in Ostomy Skin Conditions And The Economic Impact) trial, which investigated stoma-related healthcare costs over 12 weeks among patients who recently underwent fecal ostomy, and from other sources...
February 12, 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29438070/successfully-reducing-newborn-asphyxia-in-the-labour-unit-in-a-large-academic-medical-centre-a-quality-improvement-project-using-statistical-process-control
#20
Rikke von Benzon Hollesen, Rie Laurine Rosenthal Johansen, Christina Rørbye, Louise Munk, Pierre Barker, Anette Kjaerbye-Thygesen
BACKGROUND: A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. METHODS: The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network...
February 3, 2018: BMJ Quality & Safety
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