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https://www.readbyqxmd.com/read/28921935/assessing-causal-relationships-using-genetic-proxies-for-exposures-an-introduction-to-mendelian-randomisation
#1
Srinivasa Vittal Katikireddi, Michael Green, Amy E Taylor, George Davey Smith, Marcus R Munafò
BACKGROUND AND AIMS: Studying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research, and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Mendelian randomisation (MR) offers potential solutions to these problems...
September 18, 2017: Addiction
https://www.readbyqxmd.com/read/28921846/improvement-of-polytrauma-management-quality-inspection-of-a-newly-introduced-course-concept
#2
Ingo Gräff, Shahab Ghamari, Sylvia Schacher, Procula Glien, Rolf Fimmers, Torsten Baehner, Se-Chan Kim
RATIONALE, AIMS, AND OBJECTIVES: A systematic literature search for training course concepts for care of severely injured and severely ill patients respecting improvement of process and outcome yielded little data. For several years, the University Hospital of Bonn has hosted a shock-room management course which, on the one hand, communicates human factor aspects and, on the other hand, pursues interdisciplinary and interprofessional team training. The Bonn shock-room management course (BSM-course®) differs from other courses in both format and principles...
September 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28920710/use-of-strong-opioids-for-chronic-pain-in-osteoarthritis-an-insight-into-the-latin-american-reality
#3
Miguel Angel Ruiz Iban, Javier Benavides, Juan Pablo Forero, Sacha Bittelman, Rafael Martinez, Miguel Angel Mite, Jorge Diaz Heredia, Sergio Ulloa, Mauro Marcelo Lizárraga Ferrand
Osteoarthritis is the most common cause of arthritis and one of the principle causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids...
September 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28916186/clinical-immunological-and-genetic-spectrum-of-696-patients-with-combined-immunode%C3%AF-ciency
#4
Hassan Abolhassani, Janet Chou, Wayne Bainter, Craig Platt, Mahmood Tavassoli, Toba Momen, Marzieh Tavakol, Mohammad Hossein Eslamian, Mohammad Gharagozlou, Masoud Movahedi, Mohsen Ghadami, Amir Ali Hamidieh, Gholamreza Azizi, Reza Yazdani, Mohsen Afarideh, Alireza Ghajar, Arash Havaei, Zahra Chavoushzadeh, Seyed Alireza Mahdaviani, Taher Cheraghi, Nasrin Behniafard, Reza Amin, Soheila Aleyasin, Reza Faridhosseini, Farahzad Jabbari-Azad, Mohammamd Nabavi, Mohammad Hassan Bemanian, Saba Arshi, Rasol Molatefi, Roya Sherkat, Mahboubeh Mansouri, Mehrnaz Mesdaghi, Delara Babaie, Iraj Mohammadzadeh, Javad Ghaffari, Alireza Shafiei, Najmeddin Kalantari, Hamid Ahanchian, Maryam Khoshkhui, Habib Soheili, Abbas Dabbaghzadeh, Afshin Shirkani, Rasoul Nasiri Kalmarzi, Seyed Hamidreza Mortazavi, Javad Tafaroji, Abbas Khalili, Javad Mohammadi, Babak Negahdari, Mohammad-Taghi Joghataei, Basel K Al-Ramadi, Capucine Picard, Nima Parvaneh, Nima Rezaei, Talal Chatila, Michel J Massaad, Sevgi Keles, Lennart Hammarström, Raif S Geha, Asghar Aghamohammadi
BACKGROUND: Combined immunodeficiencies (CIDs) are diseases of defective adaptive immunity with diverse clinical phenotypes. Although CIDs are more prevalent in the Middle East than Western countries, the resources for genetic diagnosis are limited. OBJECTIVES: This study aims to characterize the categories of CID patients in Iran clinically and genetically. METHODS: Clinical and laboratory data were obtained from 696 patients with CIDs. Patients were subdivided into those with syndromic (344 patients) and non-syndromic CIDs (352 patients)...
September 12, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28916019/the-basic-science-of-behavior-change-and-its-application-to-pediatric-providers
#5
REVIEW
Allison R Love, Peter S Jensen, Lisa Khan, Tiffany West Brandt, James Jaccard
Pediatric primary care providers (PPCPs) are increasingly expected to know how to assess, diagnose, and treat a wide range of mental health problems in children and adolescents. For many PPCPs, this means learning and performing new practice behaviors that were not taught in their residency training. Typical continuing education approaches to engage PPCPs in new practices have not yielded the desired changes in provider behavior. This article summarizes behavior change principles identified through basic behavior science, adult education, and communication research, and discusses their application to a patient-centered pediatric primary care mental health curriculum...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28915950/improving-team-performance-through-simulation-based-learning
#6
REVIEW
Mark S Volk
American health care is facing an epidemic of medical errors. A major cause of these errors is poor teamwork. Crisis resource management (CRM) is a set of teamwork principles derived from the airline industry. Medical simulation is an educational tool that affords health care providers a means of improving teamwork by learning and practicing CRM. This article (1) discusses the case for teaching team training, (2) reviews the principles of medical simulation as they pertain to team training, (3) provides practical guidelines for using medical simulation in otolaryngology education, (4) discusses current evidence for the efficacy of medical simulation...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28915842/towards-the-development-of-a-wellbeing-model-for-aboriginal-and-torres-strait-islander-peoples-living-with-chronic-disease
#7
Carol Davy, Elaine Kite, Leda Sivak, Alex Brown, Timena Ahmat, Gary Brahim, Anna Dowling, Shaun Jacobson, Tania Kelly, Kaylene Kemp, Fiona Mitchell, Tina Newman, Margaret O'Brien, Jason Pitt, Kesha Roesch, Christine Saddler, Maida Stewart, Tiana Thomas
BACKGROUND: Re-defining the way in which care is delivered, to reflect Aboriginal and Torres Strait Islander peoples' needs and values, is essential for improving the accessibility of primary healthcare. This study focused on developing a Framework to support the quality of care and quality of life of, as well as treatment for, Aboriginal and Torres Strait Islander peoples living with chronic disease. METHODS: A team of researchers, including thirteen experienced Aboriginal healthcare professionals, came together to undertake this important work...
September 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28915431/ethical-implications-of-location-and-accelerometer-measurement-in-health-research-studies-with-mobile-sensing-devices
#8
Daniel Fuller, Martine Shareck, Kevin Stanley
Quantification of individual behaviours using mobile sensing devices, including physical activity and spatial location, is a rapidly growing field in both academic research and the corporate world. In this case study, we summarize the literature examining the ethical aspects of mobile sensing and argue that a robust discussion about the ethical implications of mobile sensing for research purposes has not occurred sufficiently in the literature. Based on our literature summary and guided by basic ethical principles set out in Canadian, US, and International Ethics documents we propose four areas where further discussion should occur: consent, privacy and confidentiality, mitigating risk, and consideration of vulnerable populations...
September 12, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28914735/palliative-care-in-neuromuscular-diseases
#9
Marianne de Visser, David J Oliver
PURPOSE OF REVIEW: Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. Neuromuscular disorders (NMDs) are characterized by progressive muscle weakness, leading to pronounced and incapacitating physical disabilities. Most NMDs are not amenable to curative treatment and would thus qualify for palliative care. Amyotrophic lateral sclerosis is a relentlessly progressive disease, which leads to death about 2 years after onset due to respiratory muscle weakness...
September 13, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28912836/methods-for-enhancing-the-reproducibility-of-biomedical-research-findings-using-electronic-health-records
#10
REVIEW
Spiros Denaxas, Kenan Direk, Arturo Gonzalez-Izquierdo, Maria Pikoula, Aylin Cakiroglu, Jason Moore, Harry Hemingway, Liam Smeeth
BACKGROUND: The ability of external investigators to reproduce published scientific findings is critical for the evaluation and validation of biomedical research by the wider community. However, a substantial proportion of health research using electronic health records (EHR), data collected and generated during clinical care, is potentially not reproducible mainly due to the fact that the implementation details of most data preprocessing, cleaning, phenotyping and analysis approaches are not systematically made available or shared...
2017: BioData Mining
https://www.readbyqxmd.com/read/28912616/decision-making-in-neonatal-end-of-life-scenarios-in-low-income-settings-1
#11
James McTavish
The challenge of decision making in end-of-life scenarios is exacerbated when the patient is a newborn and in a low-income setting. The principle of proportionate care is a helpful guide but needs to be applied. The complex interplay of benefit, burden, and cost of various treatments all need to be considered. In patients with severe neonatal encephalopathy, prognosis can be hard to determine, and a team approach to decision making can help. In low-income settings, or where there are limited resources, the ideal care needs to be incarnated in the real context...
August 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28912289/using-best-interests-meetings-for-people-in-a-prolonged-disorder-of-consciousness-to-improve-clinical-and-ethical-management
#12
Derick T Wade
Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of (a) the English Mental Capacity Act 2005 and (b) using time-limited treatment trials could greatly improve patient management and reduce stress on families...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28911349/tuberculosis-human-rights-and-ethics-considerations-along-the-route-of-a-highly-vulnerable-migrant-from-sub-saharan-africa-to-europe
#13
V Wild, D Jaff, N S Shah, M Frick
Migrant health is a critical public health issue, and in many countries attention to this topic has focused on the link between migration and communicable diseases, including tuberculosis (TB). When creating public health policies to address the complex challenges posed by TB and migration, countries should focus these policies on evidence, ethics, and human rights. This paper traces a commonly used migration route from sub-Saharan Africa to Europe, identifying situations at each stage in which human rights and ethical values might be affected in relation to TB care...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28911041/culture-independent-molecular-methods-for-detection-of-antifungal-resistance-mechanisms-and-fungal-identification
#14
David S Perlin, Nathan P Wiederhold
Resistance to azoles and echinocandins has emerged as a significant factor affecting the clinical management of patients with invasive fungal infections. Immunosuppressed patients at high risk for invasive fungal infections often have prolonged or repeated exposure to antifungals resulting in either the well-documented selection of naturally occurring, less susceptible fungal species, or the in situ development of specific resistance mechanisms. Nucleic acid-based molecular diagnostics are particularly well suited for the rapid detection of low-abundance fungal pathogens and identification of the infecting pathogen to the genus and species levels, as well as assessment of resistance mechanisms...
August 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28906423/empowering-parents-of-australian-infants-and-children-in-hospital-translation-cultural-adaptation-and-validation-of-the-empowerment-of-parents-in-the-intensive-care-30-aus-questionnaire
#15
Fenella J Gill, Sally Wilson, Laurene Aydon, Gavin D Leslie, Jos M Latour
OBJECTIVES: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. DESIGN: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire. SETTINGS: Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28905730/how-should-a-health-care-professional-respond-to-an-incarcerated-patient-s-request-for-a-particular-treatment
#16
Tom Peteet, Matt Tobey
Incarceration complicates the ethical provision of clinical care through reduction in access to treatment modalities and institutional cultures that value order over autonomy. Correctional care clinicians should expand their guiding principles to consider autonomy and health justice for their patients, which in turn should prompt development of processes and care plans that are patient-centered and account for the inherent restrictions of the setting.
September 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28905728/what-are-physicians-responsibilities-to-patients-whose-health-conditions-can-influence-their-legal-proceedings
#17
David Beckmann
Correctional populations are disproportionately affected by conditions that affect cognition, such as psychiatric illness and head trauma. Honoring bioethical principles in the care of such patients can be particularly difficult in the correctional setting. However, the approach should not change markedly because a patient is incarcerated. That is, the same standards of respecting patient autonomy and confidentiality should be maintained, and the fact that correctional populations are already marginalized makes it all the more important for clinicians to honor these principles...
September 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28905648/personhood-dementia-policy-and-the-irish-national-dementia-strategy
#18
Niamh Hennelly, Eamon O'Shea
Personhood and its realisation in person-centred care is part of the narrative, if not always the reality, of care for people with dementia. This paper examines how personhood is conceptualised and actualised in Ireland through a content analysis of organisational and individual submissions from stakeholders in the development of the Irish National Dementia Strategy, followed by an examination of the Strategy itself. The organisational submissions are further categorised into dementia care models. A structural analysis of the Strategy examines its principles, actions and outcomes in relation to personhood...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28904846/analyzing-the-historical-development-and-transition-of-the-korean-health-care-system
#19
Sang-Yi Lee, Chul-Woung Kim, Nam-Kyu Seo, Seung Eun Lee
OBJECTIVES: Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system. METHODS: We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power...
August 2017: Osong Public Health and Research Perspectives
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#20
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
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