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https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#1
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333904/-intestinal-endometriosis-a-case-report
#2
Sławomir Krzemiński
Endometriosis intestines due to its non-specific symptoms can pose diagnostic problems, a lack of or incorrect treatment worsens the quality of life, sometimes leading to serious complications. The differential diagnosis of abdominal pain, especially in patients of reproductive age should be taken disease into account. Often abdominal pain in young women are classified as a functional gastrointestinal disorder, and only carefully collected intelligence allows you to focus on the diagnosis of endometriosis, especially if the symptoms significantly impair quality of life...
March 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28333696/a-universal-freeze-all-strategy-why-it-is-not-warranted
#3
Baris Ata, Emre Seli
PURPOSE OF REVIEW: There's some preclinical evidence of an adverse effect of multifollicular growth on endometrial function in assisted reproductive technology cycles. Universal elective frozen embryo transfer (eFET) in an unstimulated cycle is being promoted as a panacea, regardless of patient, and cycle characteristics. We review the clinical evidence on the effectiveness and safety of eFETs. RECENT FINDINGS: Randomized controlled trials (RCTs) comparing fresh and eFET yield contradictory results in terms of live birth rates...
March 22, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28333688/treatment-planning-of-intensity-modulated-composite-particle-therapy-with-dose-and-linear-energy-transfer-optimization
#4
Taku Inaniwa, Nobuyuki Kanematsu, Koji Noda, Tadashi Kamada
The biological effect of charged-particle beams depends on both dose and radiation quality. The radiation quality of charged-particle beams has been most commonly represented by the linear energy transfer (LET) in radiation biology studies. We investigated a new therapeutic technique using two or more ion species in one treatment session, which we call an Intensity Modulated composite PArtiCle Therapy (IMPACT), for optimizing the physical dose and dose-averaged LET distributions in a patient as its proof of principle...
March 23, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28333292/a-randomized-double-blinded-controlled-trial-of-hcg-as-luteal-phase-support-in-natural-cycle-frozen-embryo-transfer
#5
Vivian Chi Yan Lee, Raymond Hang Wun Li, William Shu Biu Yeung, H O Pak Chung, Ernest Hung Yu Ng
STUDY QUESTION: Does the use of hCG as luteal phase support in natural cycle frozen embryo transfer (FET) increase the ongoing pregnancy rate? STUDY ANSWER: The use of hCG in natural cycle FET did not improve the ongoing pregnancy rate. WHAT IS KNOWN ALREADY: The use of luteal phase support in stimulated cycles has been associated with higher live-birth rates and the results are similar when using hCG or progesterone. STUDY DESIGN SIZE, DURATION: This is a randomized double-blinded controlled trial of 450 women recruited between August 2013 and October 2015...
March 8, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333265/improving-oocyte-quality-by-transfer-of-autologous-mitochondria-from-fully-grown-oocytes
#6
Stine Gry Kristensen, Susanne Elisabeth Pors, Claus Yding Andersen
Older women are often the most challenging group of patients in fertility clinics due to a decline in both number and overall quality of oocytes. The quality of oocytes has been linked to mitochondrial dysfunction. In this mini-review, we discuss this hypothesis and suggest alternative treatment options using autologous mitochondria to potentially augment pregnancy potential in ART. Autologous transfer of mitochondria from the patient's own germline cells has attracted much attention as a possible new treatment to revitalize deficient oocytes...
March 2, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28329244/attrition-from-hiv-treatment-programs-in-africa-a-longitudinal-ecological-analysis-using-data-from-307-144-patients-initiating-antiretroviral-therapy-between-2005-and-2010
#7
Batya Elul, Suzue Saito, Hannah Chung, David Hoos, Wafaa El-Sadr
Background: As access to antiretroviral therapy (ART) in Africa has increased dramatically, concerns have been raised regarding patient attrition, an important measure of program quality. Methods: We examined aggregate data from 307,144 patients initiating ART in 5,638 successive cohorts at 638 facilities in nine African countries from 2005-2010, a period characterized by massive treatment expansion. Poisson regression assessed trends in six- and 12-month cohort attrition (i...
February 21, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28324982/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#8
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28321004/avj-514-trial%C3%A3-baseline-characteristics-and-30-day-outcomes-following-mitraclip-%C3%A2-treatment-in-a-japanese-cohort
#9
Kentaro Hayashida, Satoshi Yasuda, Takashi Matsumoto, Makoto Amaki, Shingo Mizuno, Tetsuya Tobaru, Kentaro Jujo, Tatsushi Ootomo, Junichi Yamaguchi, Keiichi Fukuda, Shigeru Saito, Elyse Foster, Atif Qasim, Ryohei Yozu, Morimasa Takayama
BACKGROUND: The MitraClip(®)system is a transcatheter-based therapeutic option for patients with chronic mitral regurgitation (MR) who are at high risk for surgery. A prospective, multicenter, single-arm study was initiated to confirm the transferability of this system to Japan.Methods and Results:Patients with symptomatic chronic moderate-to-severe (3+) or severe (4+) functional or degenerative MR with a Society of Thoracic Surgery (STS) score ≥8%, or the presence of 1 predefined risk factor were enrolled...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320482/pressure-relieving-support-surfaces-a-randomised-evaluation-2-pressure-2-photographic-validation-sub-study-study-protocol-for-a-randomised-controlled-trial
#10
Elizabeth McGinnis, Sarah Brown, Howard Collier, Phil Faulks, Rachael Gilberts, Clare Greenwood, Valerie Henderson, Delia Muir, Andrea Nelson, Jane Nixon, Isabelle Smith, Nikki Stubbs, Kay Walker, Lyn Wilson, Susanne Coleman
BACKGROUND: PRESSURE 2 is a randomised evaluation of the clinical and cost effectiveness of two types of pressure relieving mattress for the prevention of pressure ulcers. The primary endpoint is the time to development of a Category ≥2 pressure ulcer. The current 'gold standard' for the identification of a Category ≥2 pressure ulcer is expert clinical assessment. Due to the appearance of the bed, it is not possible to achieve blinding of the endpoint. This therefore poses a risk to the internal validity of the study...
March 20, 2017: Trials
https://www.readbyqxmd.com/read/28315481/a-patient-advocate-to-facilitate-access-and-improve-communication-care-and-outcomes-in-adults-with-moderate-or-severe-asthma-rationale-design-and-methods-of-a-randomized-controlled-trial
#11
Andrea J Apter, Knashawn H Morales, Xiaoyan Han, Luzmercy Perez, Jingru Huang, Grace Ndicu, Anna Localio, Alyssa Nardi, Heather Klusaritz, Marisa Rogers, Alexis Phillips, Zuleyha Cidav, J Sanford Schwartz
Few interventions to improve asthma outcomes have targeted low-income minority adults. Even fewer have focused on the real-world practice where care is delivered. We adapted a patient navigator, here called a Patient Advocate (PA), a term preferred by patients, to facilitate and maintain access to chronic care for adults with moderate or severe asthma and prevalent co-morbidities recruited from clinics serving low-income urban neighborhoods. We describe the planning, design, methodology (informed by patient and provider focus groups), baseline results, and challenges of an ongoing randomized controlled trial of 312 adults of a PA intervention implemented in a variety of practices...
March 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28315047/putting-dementia-awareness-into-general-practice-the-cadif-approach
#12
Michael Pentzek, Horst Christian Vollmar, Stefan Wilm, Verena Leve
BACKGROUND: International studies show that dementia is often recognized at later stages in general practice. Pure knowledge-sharing interventions could not change this in a sustainable manner. Concepts for changing attitudes of general practitioners (GPs) are required. OBJECTIVES: What barriers affect GPs' recognition of and diagnostic approach to dementia? What recommendations for a GP-specific diagnostic procedure can be derived from this? METHODS: Metasynthesis of qualitative studies with GPs on barriers to dementia recognition, explication of the "frailty" concept and the diagnostic approach described therein and the development of an approach in cases of suspected cognitive decline in a multiprofessional team...
March 17, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28304312/cognitive-rehabilitation-in-alzheimer-s-disease-a-controlled-intervention-trial
#13
Katharina Brueggen, Elisabeth Kasper, Sina Ochmann, Henrike Pfaff, Steffi Webel, Wolfgang Schneider, Stefan Teipel
BACKGROUND: Cognitive Rehabilitation for Alzheimer's disease (AD) is an integrative multimodal intervention. It aims to maintain autonomy and quality of life by enhancing the patients' abilities to compensate for decreased cognitive functioning. OBJECTIVE: We evaluated the feasibility of a group-based Cognitive Rehabilitation approach in mild AD dementia and assessed its effect on activities of daily living (ADL). METHODS: We included 16 patients with AD dementia in a controlled partial-randomized design...
March 18, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28302375/risk-factors-for-unplanned-transfer-to-the-intensive-care-unit-after-emergency-department-admission
#14
Lena M Boerma, Eef P J Reijners, Roger A P A Hessels, Martijn A A V Hooft
INTRODUCTION: Unplanned Intensive Care Unit (ICU) admission has been used as a surrogate marker of adverse events, and is used by the Australian Council of Healthcare Accreditation as a reportable quality indicator. If we can identify independent variables predicting deterioration which require ICU transfer within 24h after emergency department (ED) admission, direct ICU admission should be considered. This may improve patient safety and reduce adverse events by appropriate disposition of patients presenting to the ED...
March 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28297333/benchmarking-of-five-commercial-deformable-image-registration-algorithms-for-head-and-neck-patients
#15
Jason Pukala, Perry B Johnson, Amish P Shah, Katja M Langen, Frank J Bova, Robert J Staton, Rafael R Mañon, Patrick Kelly, Sanford L Meeks
Benchmarking is a process in which standardized tests are used to assess system performance. The data produced in the process are important for comparative purposes, particularly when considering the implementation and quality assurance of DIR algorithms. In this work, five commercial DIR algorithms (MIM, Velocity, RayStation, Pinnacle, and Eclipse) were benchmarked using a set of 10 virtual phantoms. The phantoms were previously developed based on CT data collected from real head and neck patients. Each phantom includes a start of treatment CT dataset, an end of treatment CT dataset, and the ground-truth deformation vector field (DVF) which links them together...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297318/a-qualitative-and-quantitative-analysis-of-radiation-dose-and-image-quality-of-computed-tomography-images-using-adaptive-statistical-iterative-reconstruction
#16
Fahad Ahmed Hussain, Noor Mail, Abdulrahman M Shamy, Suliman Alghamdi, Abdelhamid Saoudi
Image quality is a key issue in radiology, particularly in a clinical setting where it is important to achieve accurate diagnoses while minimizing radiation dose. Some computed tomography (CT) manufacturers have introduced algorithms that claim significant dose reduction. In this study, we assessed CT image quality produced by two reconstruction algorithms provided with GE Healthcare's Discovery 690 Elite positron emission tomography (PET) CT scanner. Image quality was measured for images obtained at various doses with both conventional filtered back-projection (FBP) and adaptive statistical iterative reconstruction (ASIR) algorithms...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28291913/a-method-to-reconstruct-and-apply-3d-primary-fluence-for-treatment-delivery-verification
#17
Shi Liu, Thomas R Mazur, Harold Li, Austen Curcuru, Olga L Green, Baozhou Sun, Sasa Mutic, Deshan Yang
MOTIVATION: In this study, a method is reported to perform IMRT and VMAT treatment delivery verification using 3D volumetric primary beam fluences reconstructed directly from planned beam parameters and treatment delivery records. The goals of this paper are to demonstrate that 1) 3D beam fluences can be reconstructed efficiently, 2) quality assurance (QA) based on the reconstructed 3D fluences is capable of detecting additional treatment delivery errors, particularly for VMAT plans, beyond those identifiable by other existing treatment delivery verification methods, and 3) QA results based on 3D fluence calculation (3DFC) are correlated with QA results based on physical phantom measurements and radiation dose recalculations...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28289791/-predictors-of-cognitive-outcome-in-ventilated-early-rehabilitation-patients
#18
M-D Heidler, L Bidu, H Völler, A Salzwedel
BACKGROUND: After weaning failure, patients who are transferred from intensive care units to early rehabilitation centers (ERC) not only suffer from motor deficits but also from cognitive deficits. It is still uncertain which patient factors have an impact on cognitive outcome at the end of early rehabilitation. OBJECTIVE: Investigation of predictors of cognitive performance for initially ventilated early rehabilitation patients. METHODS: A total of 301 patients (mean age 68...
March 13, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28289467/the-development-of-a-consensus-definition-for-healthcare-improvement-science-his-in-seven-european-countries-a-consensus-methods-approach
#19
Brigita Skela-Savič, Rhoda Macrae, Manuel Lillo-Crespo, Kevin D Rooney
INTRODUCTION: There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and 'change making' should become an intrinsic part of everyone's job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy. METHODS: This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques...
June 1, 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28288592/transfer-of-manualized-short-term-psychodynamic-psychotherapy-stpp-for-social-anxiety-disorder-into-clinical-practice-results-from-a-cluster-randomised-controlled-trial
#20
Jörg Wiltink, Christian Ruckes, Jürgen Hoyer, Falk Leichsenring, Peter Joraschky, Frank Leweke, Karin Pöhlmann, Manfred E Beutel
BACKGROUND: Despite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice. This is the first study to examine the effects of an additional training in manualized Short Term Psychodynamic Psychotherapy (STPP) on the outcome in routine psychotherapy for social anxiety disorder (SAD). The study is an extension to a large RCT comparing STPP to Cognitive-Behavioral Therapy of SAD. METHODS: The manualized treatment was designed for a time limited approach with 25 individual sessions of STPP over 6 months...
March 14, 2017: BMC Psychiatry
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