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https://www.readbyqxmd.com/read/28929813/limited-english-proficient-patients-perceptions-of-when-interpreters-are-needed-and-how-the-decision-to-utilize-interpreters-is-made
#1
Rebecca J Schwei, Michelle Schroeder, Ifna Ejebe, Maichou Lor, Linda Park, Phia Xiong, Elizabeth A Jacobs
Our objective was to describe when Hmong- and Spanish-speaking limited English proficient (LEP) patients perceive an interpreter was needed and how they perceive the decision to utilize an interpreter is made in a health care encounter. We interviewed a total of 20 LEP patients. We used a number of strategies to recruit LEP patients including posting language-appropriate flyers at clinics, sending letters to LEP patients and asking our participants to refer their family and friends to participate in our study...
September 20, 2017: Health Communication
https://www.readbyqxmd.com/read/28929417/a-metaheuristically-tuned-interval-type-2-fuzzy-system-to-reduce-segmentation-uncertainty-in-brain-mri-images
#2
Abolfazl Taghribi, Saeed Sharifian
Precise segmentation of magnetic resonance image (MRI) seems challenging because of the complex structure of the brain, non-uniform field in images, and noise. As a result, decision-making is associated with uncertainty. Fuzzy based approaches have been developed to overcome this problem, though most of them use fuzzy type 1 method, and sometimes contain a pre-processing step. This paper "modified type 2 fuzzy system" (MT2FS) declares a state-of-the-art method to segment MRI images using interval fuzzy type-2...
September 19, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28928756/prioritizing-crop-management-to-increase-nitrogen-use-efficiency-in-australian-sugarcane-crops
#3
Peter J Thorburn, Jody S Biggs, Jeda Palmer, Elizabeth A Meier, Kirsten Verburg, Danielle M Skocaj
Sugarcane production relies on the application of large amounts of nitrogen (N) fertilizer. However, application of N in excess of crop needs can lead to loss of N to the environment, which can negatively impact ecosystems. This is of particular concern in Australia where the majority of sugarcane is grown within catchments that drain directly into the World Heritage listed Great Barrier Reef Marine Park. Multiple factors that impact crop yield and N inputs of sugarcane production systems can affect N use efficiency (NUE), yet the efficacy many of these factors have not been examined in detail...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28922291/population-based-models-of-planning-for-palliative-care-in-older-people
#4
David C Currow, Jane Phillips, Meera Agar
PURPOSE OF REVIEW: Health service planning requires demographic, clinical, and health systems data and is unique to each health system. Planning for palliative care in older people must include patients and their carers. This review explores literature from the last 24 months. RECENT FINDINGS: The proportion of people living in skilled nursing facilities is increasing and many residents require quality palliative care. Simultaneously, the complexity of care for older people is also increasing...
September 16, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#5
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28903861/a-decision-support-system-and-rule-based-algorithm-to-augment-the-human-interpretation-of-the-12-lead-electrocardiogram
#6
Andrew W Cairns, Raymond R Bond, Dewar D Finlay, Daniel Guldenring, Fabio Badilini, Guido Libretti, Aaron J Peace, Stephen J Leslie
BACKGROUND: The 12-lead Electrocardiogram (ECG) has been used to detect cardiac abnormalities in the same format for more than 70years. However, due to the complex nature of 12-lead ECG interpretation, there is a significant cognitive workload required from the interpreter. This complexity in ECG interpretation often leads to errors in diagnosis and subsequent treatment. We have previously reported on the development of an ECG interpretation support system designed to augment the human interpretation process...
August 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28899412/the-effect-of-information-about-the-benefits-and-harms-of-mammography-on-women-s-decision-making-study-protocol-for-a-randomized-controlled-trial
#7
Misericòrdia Carles, Montserrat Martínez-Alonso, Anna Pons, Maria José Pérez-Lacasta, Lilisbeth Perestelo-Pérez, Maria Sala, Carmen Vidal, Montse Garcia, Ana Toledo-Chávarri, Núria Codern, Maria Feijoo-Cid, Anabel Romero, Roger Pla, Jorge Soler-González, Xavier Castells, Montserrat Rué
BACKGROUND: The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening...
September 12, 2017: Trials
https://www.readbyqxmd.com/read/28885933/a-qualitative-study-of-participation-in-cardiac-rehabilitation-programs-in-an-integrated-health-care-system
#8
Nathalie McIntosh, Gemmae M Fix, Kelly Allsup, Martin Charns, Sarah McDannold, Kenneth Manning, Daniel E Forman
INTRODUCTION: Despite strong incentives to use cardiac rehabilitation (CR), patient participation is low in the Veterans Health Administration (VHA). This is paradoxical given that VHA is an integrated health care system that offers a range of CR programs which should logically reduce barriers to access to CR participation. The purpose of this study was to better understand the contextual factors that influence patient participation in CR and how patients consider factors together when making decisions about CR participation...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885238/improving-the-implementation-of-lung-cancer-screening-guidelines-at-an-academic-primary-care-practice
#9
Alison T Brenner, Laura Cubillos, Katherine Birchard, Caleb Doyle-Burr, John Eick, Louise Henderson, Laura Jones, Michael Massaro, Bailey Minish, Paul Molina, Michael Pignone, Shana Ratner, Maria Patricia Rivera, Daniel S Reuland
Expert groups recommend annual chest computed tomography for lung cancer screening (LCS) in high-risk patients. Lung cancer screening in primary care is a complex process that includes identification of the at-risk population, comorbidity assessment, and shared decision making. We identified three key processes required for high-quality screening implementation in our academic primary care practice: (1) systematic collection of lifetime cumulative smoking history to identify potentially eligible patients; (2) visit-based clinical reminders and order sets embedded in the electronic health record (EHR); and (3) tools to facilitate shared decision making and appropriate test ordering...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28883182/it-decision-making-in-german-hospitals-do-ceos-open-the-black-box
#10
Johannes Thye, Ursula Hübner, Jens Hüsers, Birgit Babitsch
Health IT and communication systems are indispensable in German hospitals for clinical as well as administrative process support. However, IT is often regarded as a "black box" for hospital CEOs. Thus, the question arises how can CEOs decide if they do not know what is in the box? In order to answer this question, half-structured interviews with 14 German hospital CEOs were conducted. They revealed three principle decision processes: the supported decision, the joint decision and the corporate level decision...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28881437/older-people-s-experiences-of-nurse-patient-telephone-communication-in-the-primary-health-care-setting
#11
Susan Waterworth, Deborah Raphael, John Parsons, Bruce Arroll, Merryn Gott
AIM: To determine which aspects of primary nurse-patient telephone communication are viewed positively or negatively in terms of meeting the older persons' needs. BACKGROUND: Health professionals are increasingly being called on to develop different ways of working and increase their capacity to meet the needs of an ageing population. In some countries telephone communication between primary nurses and patients in General Practice is already seen as a routine practice, but determining the value of this type of communication as a specific health service needs more understanding...
September 7, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28878809/are-online-prediction-tools-a-valid-alternative-to-genomic-profiling-in-the-context-of-systemic-treatment-of-er-positive-breast-cancer
#12
REVIEW
Umar Wazir, Kinan Mokbel, Amtul Carmichael, Kefah Mokbel
BACKGROUND: Clinicians use clinical and pathological parameters, such as tumour size, grade and nodal status, to make decisions on adjuvant treatments for breast cancer. However, therapeutic decisions based on these features tend to vary due to their subjectivity. Computational and mathematical algorithms were developed using clinical outcome data from breast cancer registries, such as Adjuvant! Online and NHS PREDICT. More recently, assessments of molecular profiles have been applied in the development of better prognostic tools...
2017: Cellular & Molecular Biology Letters
https://www.readbyqxmd.com/read/28877732/ontology-based-specification-identification-and-analysis-of-perioperative-risks
#13
Alexandr Uciteli, Juliane Neumann, Kais Tahar, Kutaiba Saleh, Stephan Stucke, Sebastian Faulbrück-Röhr, André Kaeding, Martin Specht, Tobias Schmidt, Thomas Neumuth, Andreas Besting, Dominik Stegemann, Frank Portheine, Heinrich Herre
BACKGROUND: Medical personnel in hospitals often works under great physical and mental strain. In medical decision-making, errors can never be completely ruled out. Several studies have shown that between 50 and 60% of adverse events could have been avoided through better organization, more attention or more effective security procedures. Critical situations especially arise during interdisciplinary collaboration and the use of complex medical technology, for example during surgical interventions and in perioperative settings (the period of time before, during and after surgical intervention)...
September 6, 2017: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/28875952/role-of-r-e-n-a-l-nephrometry-score-in-laparoscopic-partial-nephrectomy
#14
Hai-Jiang Zhou, Yong Yan, Jian-Zhong Zhang, Li-Rong Liang, Shu-Bin Guo
Background: Preoperative anatomical scoring system is conducive to comparison between treatment options and evaluation of postoperative outcomes in patients with small renal tumors. This study aimed to evaluate the clinical application efficacy of the R.E.N.A.L. nephrometry score (RNS) in predicting perioperative outcomes in patients with renal tumor who underwent laparoscopic partial nephrectomy (LPN). Methods: The clinical data of 139 patients with renal tumors who underwent LPN between 2009 and 2015 were collected and analyzed...
September 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28873246/multicriteria-decision-framework-for-cybersecurity-risk-assessment-and-management
#15
Alexander A Ganin, Phuoc Quach, Mahesh Panwar, Zachary A Collier, Jeffrey M Keisler, Dayton Marchese, Igor Linkov
Risk assessors and managers face many difficult challenges related to novel cyber systems. Among these challenges are the constantly changing nature of cyber systems caused by technical advances, their distribution across the physical, information, and sociocognitive domains, and the complex network structures often including thousands of nodes. Here, we review probabilistic and risk-based decision-making techniques applied to cyber systems and conclude that existing approaches typically do not address all components of the risk assessment triplet (threat, vulnerability, consequence) and lack the ability to integrate across multiple domains of cyber systems to provide guidance for enhancing cybersecurity...
September 5, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28870193/mapping-infectious-disease-hospital-surge-threats-to-lessons-learnt-in-singapore-a-systems-analysis-and-development-of-a-framework-to-inform-how-to-decide-on-planning-and-response-strategies
#16
Shweta R Singh, Richard Coker, Hubertus J-M Vrijhoef, Yee Sin Leo, Angela Chow, Poh Lian Lim, Qinghui Tan, Mark I-Cheng Chen, Zoe Jane-Lara Hildon
BACKGROUND: Hospital usage and service demand during an Infectious Disease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events, to help build appropriately matched responses to future ID surge threats. METHODS: We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners...
September 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28866735/implementation-of-environmental-flows-for-intermittent-river-systems-adaptive-management-and-stakeholder-participation-facilitate-implementation
#17
John Conallin, Emma Wilson, Josh Campbell
Anthropogenic pressure on freshwater ecosystems is increasing, and often leading to unacceptable social-ecological outcomes. This is even more prevalent in intermittent river systems where many are already heavily modified, or human encroachment is increasing. Although adaptive management approaches have the potential to aid in providing the framework to consider the complexities of intermittent river systems and improve utility within the management of these systems, success has been variable. This paper looks at the application of an adaptive management pilot project within an environmental flows program in an intermittent stream (Tuppal Creek) in the Murray Darling Basin, Australia...
September 2, 2017: Environmental Management
https://www.readbyqxmd.com/read/28865706/quantification-and-visualization-of-coordination-during-non-cyclic-upper-extremity-motion
#18
Richard A Fineman, Leia A Stirling
There are many design challenges in creating at-home tele-monitoring systems that enable quantification and visualization of complex biomechanical behavior. One such challenge is robustly quantifying joint coordination in a way that is intuitive and supports clinical decision-making. This work defines a new measure of coordination called the relative coordination metric (RCM) and its accompanying normalization schemes. RCM enables quantification of coordination during non-constrained discrete motions. Here RCM is applied to a grasping task...
August 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28860081/clinical-decision-making-heuristics-and-cognitive-biases-for-the-ophthalmologist
#19
REVIEW
Ahsen Hussain, James Oestreicher
Diagnostic errors have a significant impact on healthcare outcomes and patient care. The underlying causes and development of diagnostic error is complex with flaws in healthcare systems, as well as human error, playing a role. Cognitive biases and a failure of decision-making shortcuts (heuristics) are human factors that can compromise the diagnostic process. We describe these mechanisms, their role with the clinician and provide clinical scenarios to highlight the various points at which biases may emerge...
August 28, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28859864/impaired-decision-making-under-risky-conditions-in-the-acute-phase-of-graves-thyroitoxicosis
#20
Fang Dai, Lili Yuan, Juan Fang, Qiu Zhang, Kai Wang
The patients with Graves' thyroitoxicosis often complain that they have neuropsychiatric symptoms and impaired cognitive function. Decision making is important and complex process involving the interaction and integration of a series of cognitive components. In the 31 newly diagnosed patients with Graves' thyroitoxicosis and 30 healthy controls, we used the Hamilton Anxiety Rating Scale (HAMD), Hamilton Depression Rating Scale (HAMD) and The Game of Dice Task (GDT) to assess the emotion and decision making under risky conditions...
August 28, 2017: Neuroscience Letters
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