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https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#1
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28092219/the-21st-century-cures-act-pharmacoeconomic-boon-or-bane
#2
Roger Lee Mendoza
Barriers to entry in healthcare markets constitute one of the overriding concerns of health economists. The recent enactment of the 21st Century Cures Act in the United States is one landmark legislation that reduces statutory entry barriers to the discovery, development, testing and licensing of drugs and medical devices. However, it brings with it many critical challenges concerning the safety, efficacy and value of drugs and devices, along with novel opportunities for medical innovation and faster treatment of diseases...
January 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28092092/domains-of-daily-physical-activity-in-children-with-mitochondrial-disease-a-3d-accelerometry-approach
#3
Saskia Koene, Ilse Dirks, Esmee van Mierlo, Pascal R de Vries, Anjo J W M Janssen, Jan A M Smeitink, Arjen Bergsma, Hans Essers, Kenneth Meijer, Imelda J M de Groot
Feasible, sensitive and clinically relevant outcome measures are of extreme importance when designing clinical trials. For paediatric mitochondrial disease, no robust end point has been described to date. The aim of this study was to select the domains of daily physical activity, which can be measured by 3D accelerometry, that could serve as sensitive end points in future clinical trials in children with mitochondrial disorders.In this exploratory observational study, 17 patients with mitochondrial disease and 16 age- and sex-matched controls wore 3D accelerometers at the upper leg, upper arm, lower arm and chest during one weekend...
January 17, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28091791/a-novel-scalable-robust-downstream-process-for-oncolytic-rat-parvovirus-isoelectric-point-based-elimination-of-empty-particles
#4
Barbara Leuchs, Veronika Frehtman, Markus Riese, Marcus Müller, Jean Rommelaere
The rodent protoparvovirus H-1PV, with its oncolytic and oncosuppressive properties, is a promising anticancer agent currently under testing in clinical trials. This explains the current demand for a scalable, good manufacturing practice-compatible virus purification process yielding high-grade pure infectious particles and overcoming the limitations of the current system based on density gradient centrifugation. We describe here a scalable process offering high purity and recovery. Taking advantage of the isoelectric point difference between full and empty particles, it eliminates most empty particles...
January 14, 2017: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28091698/-clotrimazole-and-ciclopirox-olamine-respectively-in-combination-with-methylprednisolone-aceponate-as-extemporaneous-formulations
#5
J Wohlrab, R H H Neubert, E Sommer, J Michael
The combination of topical fungicide and glucocorticoids has been proven as a successful therapy of cutaneous mycoses with accompanying inflammatory reactions, particularly when used at an early stage. Various national and international therapeutic guidelines recommend this practice. In this context, two individually manufactured formulations have been developed and tested for stability: the combination of methylprednisolone aceponate-a topical glucocorticoid with the therapeutic index of 2.0-with clotrimazole and with ciclopirox olamine, respectively...
January 13, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28089141/stable-emulsion-se-alone-is-an-effective-adjuvant-for-a-recombinant-baculovirus-expressed-h5-influenza-vaccine-in-healthy-adults-a-phase-2-trial
#6
John J Treanor, Laurence Chu, Brandon Essink, Derek Muse, Hana M El Sahly, Ruvim Izikson, Karen L Goldenthal, Peter Patriarca, Lisa M Dunkle
BACKGROUND: Influenza A viruses of the H5 subtype have been identified as important targets for development of vaccines. Achievement of potentially protective antibody responses against pandemic strains has usually required the use of adjuvants. OBJECTIVES: We evaluated a candidate A/Indonesia/05/2005 (H5) vaccine generated by baculovirus expression of recombinant hemagglutinin (HA) protein with or without stable emulsion (SE) as an adjuvant. METHODS: Healthy subjects 18-49years old were randomized (1:1:1:1) to receive two doses of rHA at 7...
January 11, 2017: Vaccine
https://www.readbyqxmd.com/read/28088344/design-control-considerations-for-biologic-device-combination-products
#7
Dave Anderson, Roger Liu, J Anand Subramony, Jon Cammack
Combination products are therapeutic and diagnostic medical products that combine drugs, devices, and/or biological products with one another. Historically, biologics development involved identifying efficacious doses administered to patients intravenously or perhaps by a syringe. Until fairly recently, there has been limited focus on developing an accompanying medical device, such as a prefilled syringe or auto-injector, to enable easy and more efficient delivery. For the last several years, and looking forward, where there may be little to distinguish biologics medicines with relatively similar efficacy profiles, the biotechnology market is beginning to differentiate products by patient-focused, biologic-device based combination products...
January 11, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28081584/-mini-open-approach-shows-good-results-in-treatment-of-femoroacetabular-impingement
#8
Stephanie Maria Kirschbaum, Frank Sitterlee, Carsten Perka, Michael Müller
Background Femoroacetabular impingement (FAI) describes a painful, abnormal (bony) contact between the femoral neck and acetabulum, which, if left untreated, contributes to early osteoarthritis (OA) of the hip. Despite its flat learning curve and long operation times, hip arthroscopy has been used increasingly often in recent years in the surgery of femoroacetabular impingement. The mini-open technique (MOT) offers a possible alternative that addresses the abnormal morphological prominence and allows minimally invasive clearance of hip motion...
January 12, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28079863/the-modified-patient-enablement-instrument-a-portuguese-cross-cultural-adaptation-validity-and-reliability-study
#9
Mafalda Remelhe, Pedro M Teixeira, Irene Lopes, Luís Silva, Jaime Correia de Sousa
Enabling patients with asthma to obtain the knowledge, confidence and skills they need in order to assume a major role in the management of their disease is cost effective. It should be an integral part of any plan for long-term control of asthma. The modified Patient Enablement Instrument (mPEI) is an easily administered questionnaire that was adapted in the United Kingdom to measure patient enablement in asthma, but its applicability in Portugal is not known. Validity and reliability of questionnaires should be tested before use in settings different from those of the original version...
January 12, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28075620/diagnostic-efficacy-of-structural-mri-in-patients-with-mild-to-moderate-alzheimer-disease-automated-volumetric-assessment-versus-visual-assessment
#10
Jeeyoung Min, Won-Jin Moon, Ji Young Jeon, Jin Woo Choi, Yeon-Sil Moon, Seol-Heui Han
OBJECTIVE: The purpose of this study was to compare the diagnostic efficacies of an automated volumetric assessment tool and visual assessment in the evaluation of medial temporal lobar atrophy in mild-to-moderate Alzheimer disease (AD). MATERIALS AND METHODS: This retrospective study included 30 patients with mild-to-moderate AD and 25 age-matched healthy control subjects undergoing MRI with a 3D fast spoiled gradient recalled-echo sequence at 3 T. The images were processed with fully automated volumetric analysis software...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28075223/the-statistical-crisis-in-science-how-is-it-relevant-to-clinical-neuropsychology
#11
Andrew Gelman, Hilde M Geurts
There is currently increased attention to the statistical (and replication) crisis in science. Biomedicine and social psychology have been at the heart of this crisis, but similar problems are evident in a wide range of fields. We discuss three examples of replication challenges from the field of social psychology and some proposed solutions, and then consider the applicability of these ideas to clinical neuropsychology. In addition to procedural developments such as preregistration and open data and criticism, we recommend that data be collected and analyzed with more recognition that each new study is a part of a learning process...
January 11, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28073792/adult-parenteral-nutrition-in-the-north-of-england-a-region-wide-audit
#12
Jessica K Dyson, Nick Thompson
OBJECTIVES: Parenteral nutrition (PN) is widely used to provide nutritional support to patients with inaccessible or inadequate length of gut or non-functioning gut. The objective was to compare practice in PN administration to results of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report, 'A Mixed Bag', and to establish whether good practice was being followed within this part of the UK. SETTING: Using the Northern Nutrition Network (NNN), we examined the care of adult patients receiving PN in all 10 secondary care hospitals in our region...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28072917/a-provider-based-survey-to-assess-bereavement-care-knowledge-attitudes-and-practices-in-pediatric-oncologists
#13
Jasmin Jensen, Cindy Weng, Holly L Spraker-Perlman
BACKGROUND: Bereavement support is a core tenet of palliative care that may prove difficult for clinicians as it is time-consuming, emotionally charged, and not emphasized in pediatrics training. This project is intended to describe the opinions, knowledge, and practice of bereavement care among pediatric oncologists to identify gaps in clinical care. PROCEDURES: An internet-based survey instrument was pilot tested, refined, and distributed to pediatric oncologists in the United States...
January 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28071843/automated-measurement-of-pressure-injury-through-image-processing
#14
Dan Li, Carol Mathews
AIMS AND OBJECTIVES: Develop an image processing algorithm to automatically measure pressure injuries using electronic pressure injury images stored in nursing documentation. BACKGROUND: Photographing pressure injuries and storing the images in the electronic health record is standard practice in many hospitals. However, the manual measurement of pressure injury is time-consuming, challenging, and subject to intra-inter-reader variability with complexities of the pressure injury and the clinical environment...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28069521/validity-of-simplified-versus-standard-self-report-measures-of-pain-intensity-in-preschool-aged-children-undergoing-venipuncture
#15
Anthony Emmott, Nicholas West, Guohai Zhou, Dustin Dunsmuir, Carolyne J Montgomery, Gillian R Lauder, Carl L von Baeyer
: There is inadequate age-specific data to support the use of current self-report pain scales in 3- and 4-year-old children. Most preschool-aged children also lack the necessary cognitive development to use standard scales. We aimed to evaluate the validity and feasibility of two novel simplified scales (Simplified Faces Pain Scale, S-FPS; Simplified Concrete Ordinal Scale, S-COS) for preschool-aged children. These simplified scales used a two-step self-report method: children were first asked whether they have pain (yes/no); only if yes, then pain intensity was self-reported using a 3-point scale with visual aids signifying mild/moderate/severe...
January 6, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28069151/development-and-validation-of-the-daily-fatigue-cancer-scale-dfcs-single-item-questions-for-clinical-practice
#16
Louise Baussard, Anne Stoebner-Delbarre, Laurence Bonnabel, Marie-Eve Huteau, Aurélie Gastou, Florence Cousson-Gélie
PURPOSE: Cancer-Related Fatigue (CRF), subjective symptom, is considered the most prevalent and disabling in cancer. To help caregivers better understand it, we developed and evaluated the psychometric properties of a visual analog scale to assess daily CRF. METHOD: In our qualitative study, we conducted interviews with caregivers, patients and scientists (N = 30) to generate items and select the scale's format. We then administered the final scale to a sample of 104 patients hospitalized for cancer surgery...
February 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28065474/a-single-low-dose-of-a-cgmp-recombinant-bcg-vaccine-elicits-protective-t-cell-immunity-against-the-human-respiratory-syncytial-virus-infection-and-prevents-lung-pathology-in-mice
#17
Pablo F Céspedes, Emma Rey-Jurado, Janyra A Espinoza, Claudia A Rivera, Gisela Canedo-Marroquín, Susan M Bueno, Alexis M Kalergis
Human respiratory syncytial virus (hRSV) is a major health burden worldwide, causing the majority of hospitalizations in children under two years old due to bronchiolitis and pneumonia. HRSV causes year-to-year outbreaks of disease, which also affects the elderly and immunocompromised adults. Furthermore, both hRSV morbidity and epidemics are explained by a consistently high rate of re-infections that take place throughout the patient life. Although significant efforts have been invested worldwide, currently there are no licensed vaccines to prevent hRSV infection...
January 5, 2017: Vaccine
https://www.readbyqxmd.com/read/28064252/philosophical-provocation-the-lifeblood-of-clinical-ethics
#18
Laurence B McCullough
The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation...
February 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28064209/efficacy-and-effectiveness-of-tumour-necrosis-factor-inhibitors-in-the-treatment-of-rheumatoid-arthritis-in-randomized-controlled-trials-and-routine-clinical-practice
#19
Kalle J Aaltonen, Suvi Ylikylä, Jaana Tuulikki Joensuu, Pia Isomäki, Laura Pirilä, Markku Kauppi, Tuomas Rannio, Kari Eklund, Marja Blom, Dan Nordström
OBJECTIVE: Efficacy of TNF inhibitors in the treatment of RA assessed in randomized controlled trials (RCTs) may not be fully comparable to routine care owing to the stringent inclusion criteria. The objective of this study was to observe the effectiveness of TNF inhibitors in real-world patients and assess the patients' potential eligibility for the RCTs. METHODS: RA patients starting a TNF-inhibitor treatment between 2004 and 2014 were identified from the National Register for Biologic Treatment in Finland, which is a longitudinal observational cohort study...
January 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/28063544/the-prevention-of-early-onset-neonatal-group-b-streptococcal-disease
#20
Deborah Money, Victoria M Allen
OBJECTIVE: To review the evidence in the literature and to provide recommendations on the management of pregnant women in labour for the prevention of early-onset neonatal group B streptococcal disease. The key revisions in this updated guideline include changed recommendations for regimens for antibiotic prophylaxis, susceptibility testing, and management of women with pre-labour rupture of membranes. OUTCOMES: Maternal outcomes evaluated included exposure to antibiotics in pregnancy and labour and complications related to antibiotic use...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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