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https://www.readbyqxmd.com/read/28330336/postpartum-modern-contraceptive-use-and-associated-factors-in-northern-ethiopia
#1
Teklehaymanot Huluf Abraha, Alemayehu Shimeka Teferra, Abebaw Addis Gelagay
OBJECTIVES: Postpartum period is a critical period to address high unmet needs of family planning and to reduce the risks of closely spaced pregnancies. However, contraception during extended postpartum period has given less emphasis concerning contraceptive practice in Ethiopia. Therefore, this study was aimed to assess postpartum modern contraceptive use and associated factors among postpartum women in Northern Ethiopia. METHODS: A community based cross sectional study was done from March to April, 2015...
March 20, 2017: Epidemiology and Health
https://www.readbyqxmd.com/read/28329439/clinical-intuition-in-the-nursing-process-and-decision-making-a-mixed-studies-review
#2
REVIEW
Christina Melin-Johansson, Rebecca Palmqvist, Linda Rönnberg
AIM AND OBJECTIVES: To review what is characteristic of registered nurses' intuition in clinical settings, in relationships, and in the nursing process. BACKGROUND: Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this...
March 22, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28328942/the-value-of-theory-in-programmes-to-implement-clinical-guidelines-insights-from-a-retrospective-mixed-methods-evaluation-of-a-programme-to-increase-adherence-to-national-guidelines-for-chronic-disease-in-primary-care
#3
Jessica Sheringham, Francesca Solmi, Cono Ariti, Abigail Baim-Lance, Steve Morris, Naomi J Fulop
BACKGROUND: Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in 'real-world' rather than research settings. MATERIALS AND METHODS: This mixed-methods study tested a retrospective theory-based approach to evaluate a 'real-world' programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care...
2017: PloS One
https://www.readbyqxmd.com/read/28327645/a-novel-point-of-care-smartphone-based-system-for-monitoring-the-cardiac-and-respiratory-systems
#4
Kwanghyun Sohn, Faisal M Merchant, Omid Sayadi, Dheeraj Puppala, Rajiv Doddamani, Ashish Sahani, Jagmeet P Singh, E Kevin Heist, Eric M Isselbacher, Antonis A Armoundas
Cardio-respiratory monitoring is one of the most demanding areas in the rapidly growing, mobile-device, based health care delivery. We developed a 12-lead smartphone-based electrocardiogram (ECG) acquisition and monitoring system (called "cvrPhone"), and an application to assess underlying ischemia, and estimate the respiration rate (RR) and tidal volume (TV) from analysis of electrocardiographic (ECG) signals only. During in-vivo swine studies (n = 6), 12-lead ECG signals were recorded at baseline and following coronary artery occlusion...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28327571/insights-from-early-experience-of-a-rare-disease-genomic-medicine-multidisciplinary-team-a-qualitative-study
#5
Elizabeth Ormondroyd, Michael P Mackley, Edward Blair, Jude Craft, Julian C Knight, John Taylor, Jenny C Taylor, Andrew Om Wilkie, Hugh Watkins
Whole-exome/whole-genome sequencing (WES/WGS) has the potential to enhance genetic diagnosis of rare disease, and is increasingly becoming part of routine clinical care in mainstream medicine. Effective translation will require ongoing efforts in a number of areas including: selection of appropriate patients, provision of effective consent, pre- and post-test genetic counselling, improving variant interpretation algorithms and practices, and management of secondary findings including those found incidentally and those actively sought...
March 22, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28327170/critical-attitudes-and-beliefs-towards-guidelines-amongst-palliative-care-professionals-results-from-a-national-survey
#6
Helen Kalies, Rieke Schöttmer, Steffen T Simon, Raymond Voltz, Alexander Crispin, Claudia Bausewein
BACKGROUND: Little is known about palliative care professionals' attitudes towards guidelines. In 2015, the German Association for Palliative Medicine (DGP) published an evidence based guideline for palliative care in adults with incurable cancer. Before publication we conducted a national survey among members of the DGP to detect possible barriers and facilitators for its implementation. The aim of the present publication was to evaluate critical attitudes and beliefs which could hinder the effective implementation of the new guideline and to evaluate differences within professional groups and medical specialisations...
March 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28327100/impact-of-a-continuing-medical-education-meeting-on-the-use-and-timing-of-urgent-cancer-referrals-among-general-practitioners-a-before-after-study
#7
Berit Skjødeberg Toftegaard, Flemming Bro, Alina Zalounina Falborg, Peter Vedsted
BACKGROUND: Detection of cancer in general practice is challenging because symptoms are diverse. Even so-called alarm symptoms have low positive predictive values of cancer. Nevertheless, appropriate referral is crucial. As 85% of cancer patients initiate their cancer diagnostic pathway in general practice, a Continuing Medical Education meeting (CME-M) in early cancer diagnosis was launched in Denmark in 2012. We aimed to investigate the effect of the CME-M on the primary care interval, patient contacts with general practice and use of urgent cancer referrals...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327076/myocardial-protection-during-minimally-invasive-cardiac-surgery-through-right-mini-thoracotomy
#8
Micaela De Palo, Pietro Guida, Florinda Mastro, Daniela Nanna, Teresa A P Quagliara, Ruggiero Rociola, Giosuè Lionetti, Domenico Paparella
BACKGROUND: Myocardial damage is an independent predictor of adverse outcome following cardiac surgery and myocardial protection is one of the key factors to achieve successful outcomes. Cardioplegia with Custodiol is currently the most used cardioplegia during minimally invasive cardiac surgery (MICS). Different randomized controlled trials compared blood and Custodiol cardioplegia in the context of traditional cardiac surgery. No data are available for MICS. AIM: The aim of this study was to compare the efficacy of cold blood versus Custodiol cardioplegia during MICS...
April 2017: Perfusion
https://www.readbyqxmd.com/read/28326795/digital-health-care-by-in-silico-glycation-of-hba1-blood-cells
#9
James M Minor, Leslie M Rickey, Richard M Bergenstal
BACKGROUND: Diabetes health care relies on the HbA1c (A1c) assay and associated average glucose (AG) to evaluate and control chronic glycemia. However, the A1c assay is plagued with significant noise, lag time, and specificity issues. Current studies support the significant health care advantage of clinical action based on real-time blood glucose (BG) metrics. We seek to improve diabetes management by directly relating such metrics to AG levels as mediated by recently discovered recurrent endocrine cycles...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28326415/help-my-rating-looks-bad-coding-comorbidities-in-arthroplasty
#10
Joseph D Galloway, Frank R Voss
In medicine today, there is a trend toward increasing transparency. Higher quality and better value are being sought, and one of the methods being used is publicly reported health care outcomes. However, there is a problem that comes from our loss of anonymity. Physicians who are being individually watched have to choose between doing what is best for the patient and doing what would look good when it is publicly reported. Often this might mean choosing not to treat a particularly sick patient who is unlikely to have a good outcome...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28325751/smartphone-based-geofencing-to-ascertain-hospitalizations
#11
Kaylin T Nguyen, Jeffrey E Olgin, Mark J Pletcher, Madelena Ng, Leanne Kaye, Sai Moturu, Rachel A Gladstone, Chaitanya Malladi, Amy H Fann, Carol Maguire, Laura Bettencourt, Matthew A Christensen, Gregory M Marcus
BACKGROUND: Ascertainment of hospitalizations is critical to assess quality of care and the effectiveness and adverse effects of various therapies. Smartphones, mobile geolocators that are ubiquitous, have not been leveraged to ascertain hospitalizations. Therefore, we evaluated the use of smartphone-based geofencing to track hospitalizations. METHODS AND RESULTS: Participants aged ≥18 years installed a mobile application programmed to geofence all hospitals using global positioning systems and cell phone tower triangulation and to trigger a smartphone-based questionnaire when located in a hospital for ≥4 hours...
March 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28325711/investigating-the-perceptions-of-care-coordinators-on-using-behavior-theory-based-mobile-health-technology-with-medicaid-populations-a-grounded-theory-study
#12
Brittany Erika Sigler
BACKGROUND: Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting...
March 21, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28323690/organizational-structural-design-in-spine-care
#13
Alok D Sharan, Gregory D Schroeder, Michael E West, Alexander R Vaccaro
For a company to provide high value to its customers, its organization design is critical. As health care transitions to a value-based model, it is critical that spinal care organizations are structured in such a way that they can maximize value to both the patient and the payers. This article will discuss the 3 most common ways that an organization can be structured, and the benefits and problems of each design in spinal care.
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323666/febrile-infant-update
#14
Kate Dorney, Richard G Bachur
PURPOSE OF REVIEW: The approach to febrile young infants remains challenging. This review serves as an update on the care of febrile infants less than 90 days of age with a focus on the changing epidemiology of serious bacterial infection (SBI), refinement of management strategies based on biomarkers, and the development of novel diagnostics. RECENT FINDINGS: There is high variability in the emergency department management of febrile young infants without significant differences in outcomes...
March 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28323533/success-in-weight-management-among-patients-with-type-2-diabetes-do-perceived-autonomy-support-autonomous-motivation-and-self-care-competence-play-a-role
#15
Anne M Koponen, Nina Simonsen, Sakari B Suominen
Based on self-determination theory (SDT), this study investigated whether the three central SDT variables-perceived autonomy support (from a physician), autonomous motivation and self-care competence-were associated with success in weight management (SWM) among primary care patients with type 2 diabetes when the effect of other important life-context factors was controlled for. Patients participated in a mail survey in 2011. Those who had tried to change their health behavior during the past two years in order to lose weight, either with or without success (n = 1433, mean age 63 years, 50% men), were included in this study...
March 21, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28322788/a-recombinant-polypeptide-of-the-megakaryocyte-potentiating-factor-is-a-potential-biomarker-in-plasma-for-the-detection-of-mesothelioma
#16
Irina Raiko, Hans-Peter Rihs, Jan Gleichenhagen, Ingrid Sander, Jens Kollmeier, Martin Lehnert, Thomas Brüning, Georg Johnen
Malignant mesothelioma (MM) is a fatal disease mostly associated with asbestos exposure and difficult to detect by non-invasive methods. This study aimed to use recombinant fragments of the megakaryocyte potentiating factor (MPF) for the development of cost-effective MPF ELISAs. Three polypeptides spanning the MPF region (MPF1-148, MPF 34-288, MPF/MSLN254-400) were produced in E.coli as maltose-binding protein hybrids. After isolation, Factor Xa digest, and purification, the polypeptides were used for the generation of rabbit antibodies and development of ELISAs...
March 17, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28322509/teaching-medical-students-about-cost-effectiveness
#17
Mark Iscoe, Robert Lord, John Schulz, David Lee, Danelle Cayea, Amit Pahwa
BACKGROUND: Rising and burdensome health care costs have driven interest in the practice of high-value care (HVC) and have inspired calls for increased HVC training across all levels of medical education, including among undergraduate medical students. CONTEXT: Classroom-based HVC curricula targeted to medical students have not been previously described in the medical literature. INNOVATION: We developed and evaluated a workshop comprising a lecture, a small-group exercise and a group discussion to instruct medical students on interpreting cost-effectiveness analyses (CEA), applying CEA to patient care and discussing the cost of care with patients...
March 21, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28322487/methodology-for-senior-proof-guidelines-a-practice-example-from-the-netherlands
#18
Barbara C van Munster, Johanna E A Portielje, Andrea B Maier, Arend J Arends, Johannes J A de Beer
RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. METHODS: The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#19
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28320689/use-of-the-total-cancer-care-system-to-enrich-screening-for-cd30-positive-solid-tumors-for-patient-enrollment-into-a-brentuximab-vedotin-clinical-trial-a-pilot-study-to-evaluate-feasibility
#20
Bin Li, Steven A Eschrich, Anders Berglund, Melissa Mitchell, David Fenstermacher, Hadi Danaee, Hongyue Dai, Daniel Sullivan, William L Trepicchio, William S Dalton
BACKGROUND: One approach to identify patients who meet specific eligibility criteria for target-based clinical trials is to use patient and tumor registries to prescreen patient populations. OBJECTIVE: Here we demonstrate that the Total Cancer Care (TCC) Protocol, an ongoing, observational study, may provide a solution for rapidly identifying patients with CD30-positive tumors eligible for CD30-targeted therapies such as brentuximab vedotin. METHODS: The TCC patient gene expression profiling database was retrospectively screened for CD30 gene expression determined using HuRSTA-2a520709 Affymetrix arrays (GPL15048)...
March 20, 2017: JMIR Research Protocols
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