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https://www.readbyqxmd.com/read/29792979/immune-checkpoint-inhibitor-toxicity-review-for-the-palliative-care-clinician
#1
Eric D Hansen, Xiao Wang, Amy A Case, Igor Puzanov, Tom Smith
Immune checkpoint inhibitors (ICI) have opened an exciting chapter in the treatment of patients with advanced cancer. For the palliative care clinician, however, ICI present several new challenges, including new ways to define treatment success, as well as treatment-related toxicities which differ in nature and timing from traditional chemotherapy. In this article, we review the mechanism of action of immune checkpoint inhibitors, as well as selected published data supporting the efficacy of ICI in patients with advanced cancer...
May 21, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29792465/team-development-interventions-evidence-based-approaches-for-improving-teamwork
#2
Christina N Lacerenza, Shannon L Marlow, Scott I Tannenbaum, Eduardo Salas
The rate of teamwork and collaboration within the workforce has burgeoned over the years, and the use of teams is projected to continue increasing. With the rise of teamwork comes the need for interventions designed to enhance teamwork effectiveness. Successful teams produce desired outcomes; however, it is critical that team members demonstrate effective processes to achieve these outcomes. Team development interventions (TDIs) increase effective team competencies and processes, thereby leading to improvements in proximal and distal outcomes...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792459/teamwork-in-healthcare-key-discoveries-enabling-safer-high-quality-care
#3
Michael A Rosen, Deborah DiazGranados, Aaron S Dietz, Lauren E Benishek, David Thompson, Peter J Pronovost, Sallie J Weaver
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#4
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789628/targetable-vulnerabilities-in-t-and-nk-cell-lymphomas-identified-through-preclinical-models
#5
Samuel Y Ng, Noriaki Yoshida, Amanda L Christie, Mahmoud Ghandi, Neekesh V Dharia, Joshua Dempster, Mark Murakami, Kay Shigemori, Sara N Morrow, Alexandria Van Scoyk, Nicolas A Cordero, Kristen E Stevenson, Maneka Puligandla, Brian Haas, Christopher Lo, Robin Meyers, Galen Gao, Andrew Cherniack, Abner Louissaint, Valentina Nardi, Aaron R Thorner, Henry Long, Xintao Qiu, Elizabeth A Morgan, David M Dorfman, Danilo Fiore, Julie Jang, Alan L Epstein, Ahmet Dogan, Yanming Zhang, Steven M Horwitz, Eric D Jacobsen, Solimar Santiago, Jian-Guo Ren, Vincent Guerlavais, D Allen Annis, Manuel Aivado, Mansoor N Saleh, Amitkumar Mehta, Aviad Tsherniak, David Root, Francisca Vazquez, William C Hahn, Giorgio Inghirami, Jon C Aster, David M Weinstock, Raphael Koch
T- and NK-cell lymphomas (TCL) are a heterogenous group of lymphoid malignancies with poor prognosis. In contrast to B-cell and myeloid malignancies, there are few preclinical models of TCLs, which has hampered the development of effective therapeutics. Here we establish and characterize preclinical models of TCL. We identify multiple vulnerabilities that are targetable with currently available agents (e.g., inhibitors of JAK2 or IKZF1) and demonstrate proof-of-principle for biomarker-driven therapies using patient-derived xenografts (PDXs)...
May 22, 2018: Nature Communications
https://www.readbyqxmd.com/read/29789300/teamwork-on-rounds-on-an-inpatient-ward-team-an-ethnographic-study
#6
Carla Falco, Dorene Balmer
BACKGROUND AND OBJECTIVES: Pediatric hospitalists are expected to be adept at effective teamwork; yet, studies in which researchers describe teamwork practices in general pediatric inpatient settings are lacking. Our aim in this study was to examine the roles that general pediatric team members assume in real-life settings and how team members conduct teamwork practices on family-centered rounds. METHODS: In the ethnographic tradition, we observed a general pediatric team on a hospitalist service, focusing on family-centered rounds, and conducted in-depth interviews with interns, senior residents, and faculty...
May 22, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29789054/applying-developmentally-supportive-principles-to-diapering-in-the-nicu-what-we-know
#7
Media Esser, Sharon Dore, Felicia Fitzgerald, Kelli Kelley, Joanne Kuller, Sue Ludwig, Debianne Peterman
Developmental care measures are integrated in the NICU, but these measures are largely overlooked when it comes to standard care activities such as diapering. This general review of developmental care in the NICU discusses how caregivers can apply appropriate, individualized developmental care measures to diapering regimens. Numerous opportunities to expand developmental care measures into diapering care are identified; these opportunities can protect and promote sleep for hospitalized infants, enhance the diapering environment, minimize stress that infants may experience with diapering, improve infant skin health outcomes through use of evidence-based skin care practices, and foster family involvement during diapering care in the NICU...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29788460/general-principles-for-pial-synangiosis-in-pediatric-moyamoya-patients-2-dimensional-operative-video
#8
David L Penn, Kyle C Wu, Kayla R Presswood, Coleman P Riordan, R Michael Scott, Edward R Smith
Pial synangiosis is a method of indirect surgical revascularization developed at our institution for the treatment of moyamoya disease in pediatric patients. Similar surgical principles are employed in adult cases, often performed because of lack of an adequate donor vessel. Standardized protocols, including preadmission for preoperative intravenous hydration and aspirin administration, as well as intraoperative electroencephalography, are routinely employed to minimize operative risk. Perioperative heparinization is not required...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788147/will-the-eu-data-protection-regulation-2016-679-inhibit-critical-care-research
#9
Marjolein Timmers, Evert-Ben Van Veen, Andrew I R Maas, Erwin J O Kompanje
There is an inherent tension between critical care research and data protection. Because of their condition it is not possible to ask for the patients' informed consent to be enrolled in observational research at the point of admission to the hospital. Often this is not possible at a later moment either. Yet informed consent is the baseline to be enrolled in research with personal data and exceptions must be allowed for by national legislation. This was the case under Directive 95/96/EC and will be the case under the General Data Protection Regulation (GDPR, Regulation 2016/679 EU) which will replace the Directive from 25 May 2018 onwards...
May 17, 2018: Medical Law Review
https://www.readbyqxmd.com/read/29786861/temporally-feathered-intensity-modulated-radiation-therapy-a-planning-technique-to-reduce-normal-tissue-toxicity
#10
Juan Carlos López Alfonso, Shireen Parsai, Nikhil Joshi, Andrew Godley, Chirag Shah, Shlomo A Koyfman, Jimmy J Caudell, Clifton D Fuller, Heiko Enderling, Jacob G Scott
PURPOSE: Intensity modulated radiation therapy (IMRT) has allowed optimization of three-dimensional spatial radiation dose distributions permitting target coverage while reducing normal tissue toxicity. However, radiation-induced normal tissue toxicity is a major contributor to patients' quality of life and often a dose-limiting factor in the definitive treatment of cancer with radiation therapy. We propose the next logical step in the evolution of IMRT using canonical radiobiological principles, optimizing the temporal dimension through which radiation therapy is delivered to further reduce radiation-induced toxicity by increased time for normal tissue recovery...
May 22, 2018: Medical Physics
https://www.readbyqxmd.com/read/29785172/graft-versus-host-disease-from-basic-pathogenic-principles-to-dna-damage-response-and-cellular-senescence
#11
REVIEW
Adam Kuba, Ludek Raida
Graft versus host disease (GVHD), a severe immunogenic complication of allogeneic hematopoietic stem cell transplantation (HSCT), represents the most frequent cause of transplant-related mortality (TRM). Despite a huge progress in HSCT techniques and posttransplant care, GVHD remains a significant obstacle in successful HSCT outcome. This review presents a complex summary of GVHD pathogenesis with focus on references considering basic biological processes such as DNA damage response and cellular senescence.
2018: Mediators of Inflammation
https://www.readbyqxmd.com/read/29784444/enacting-high-reliability-principles-while-caring-for-people-with-ebola-virus-disease
#12
Bonnie Mowinski Jennings, Katherine A Yeager, Nancye R Feistritzer, Mary M Gullatte, Kristy K Martyn
BACKGROUND: Fear surrounds Ebola Virus Disease (EVD) because it is highly infectious. Yet members of the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital (EUH) had to overcome that fear when caring for patients with EVD. PURPOSE: The analysis reported here illustrates how the members of EUH's SCDU tacitly enacted high reliability (HR) principles while caring for patients with EVD. METHODS: A qualitative study was conducted to describe the experience of members of the EUH SCDU who worked with EVD patients in 2014...
May 18, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29784222/psychiatric-patients-and-nurses-opinions-about-limit-setting-technique-in-port-said-city
#13
Sonia M El-Sayad
BACKGROUND: Limit setting facilitates the development of a therapeutic, caring and supportive relationships, it can also decrease patients' feelings of anxiety and uncertainty. It is a two-way process that should be delivered professionally by the nurse and perceived therapeutically by the patient, so patient considered a vital participant of the technique. AIM: The present study aimed at exploring psychiatric patients' and nurses' opinions as well as their information about limit setting...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29783259/classifications-of-temporomandibular-disorders-and-patients-examination-protocols-comparative-analysis-by-the-convenience-of-their-daily-use-in-clinical-practice
#14
Ulyana D Telishevska, Oksana D Telishevska
OBJECTIVE: Introduction:The problem of temporomandibular disorders (TMD) is relevant in today's world and is considered one of the most common pathologies causing nonodontogenic pain syndromes of maxillofacial region. The morbidity of temporomandibular disorders is 27 to 76% among patients who seek dental care. There is now a significant number of classifications of TMD, however, clinically convenient, morphologically and pathogenetically substantiated classification of temporomandibular joint's (TMJ) conditions has not yet been developed...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783258/-theoretical-grounds-of-a-structural-and-functional-model-for-quality-assurance-of-radiation-diagnostics-under-conditions-of-development-of-the-modern-health-care-system-in-ukraine
#15
Oleg A Korop, Sergiy V Lenskykh
OBJECTIVE: Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783081/recent-technological-advancements-in-tuberculosis-diagnostics-a-review
#16
REVIEW
Shagun Gupta, Vipan Kakkar
Early diagnosis and on-time effective treatment are indispensable for Tuberculosis (TB) control - a life threatening infectious communicable disease. The conventional techniques for diagnosing TB normally take two to three weeks. This delay in diagnosis and further increase in detection complexity due to the emerging risks of XDR-TB (Extensively drug Resistant-TB) and MDR-TB (Multidrug Resistant-TB) are evoking interest of researchers in the field of developing rapid TB detection techniques such as biosensing and other point-of-care (POC) techniques...
May 11, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#17
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29781968/infusing-social-justice-in-undergraduate-nursing-education-fostering-praxis-through-simulation
#18
Robyn Caldwell, Courtney Cochran
SCOPE OF THE PROBLEM: Forensic clinical experiences are often inconsistent in undergraduate nursing education. Nursing students are not included in the process of forensic evidence collection, often because of the sensitive nature of the situation. Unfortunately, nursing students are forced to rely on theoretical knowledge provided by the nurse educator to understand the complexities of forensic nursing care. Nursing students must be able to identify and provide appropriate nursing care for individuals in all forensic situations...
April 2018: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/29781248/the-role-of-3d-printing-in-treating-craniomaxillofacial-congenital-anomalies
#19
REVIEW
Christopher D Lopez, Lukasz Witek, Andrea Torroni, Roberto L Flores, David B Demissie, Simon Young, Bruce N Cronstein, Paulo G Coelho
Craniomaxillofacial congenital anomalies comprise approximately one third of all congenital birth defects and include deformities such as alveolar clefts, craniosynostosis, and microtia. Current surgical treatments commonly require the use of autogenous graft material which are difficult to shape, limited in supply, associated with donor site morbidity and cannot grow with a maturing skeleton. Our group has demonstrated that 3D printed bio-ceramic scaffolds can generate vascularized bone within large, critical-sized defects (defects too large to heal spontaneously) of the craniomaxillofacial skeleton...
May 20, 2018: Birth Defects Research
https://www.readbyqxmd.com/read/29780789/a-fundamentals-train-the-trainer-approach-to-building-pediatric-critical-care-expertise-in-the-developing-world
#20
Sheri S Crow, Beth A Ballinger, Mariela Rivera, David Tsibadze, Nino Gakhokidze, Nino Zavrashvili, Matthew J Ritter, Grace M Arteaga
Pediatric Fundamental Critical Care Support (PFCCS) is an educational tool for training non-intensivists, nurses, and critical care practitioners in diverse health-care settings to deal with the acute deterioration of pediatric patients. Our objective was to evaluate the PFCCS course as a tool for developing a uniform, reproducible, and sustainable model for educating local health-care workers in the optimal management of critically ill children in the Republic of Georgia. Over a period of 18 months and four visits to the country, we worked with Georgian pediatric critical care leadership to complete the following tasks: (1) survey health-care needs within the Republic of Georgia, (2) present representative PFCCS lectures and simulation scenarios to evaluate interest and obtain "buy-in" from key stakeholders throughout the Georgian educational infrastructure, and (3) identify PFCCS instructor candidates...
2018: Frontiers in Pediatrics
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