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Principles of care

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https://www.readbyqxmd.com/read/28212951/priority-to-end-of-life-treatments-views-of-the-public-in-the-netherlands
#1
Sofie Wouters, Job van Exel, Rachel Baker, Werner B F Brouwer
OBJECTIVES: Recent debates in the Netherlands on health care priority setting have focused on the relative value of gains generated by life-extending medicines for people with a terminal illness, mostly new cancer drugs. These treatments are generally expensive, provide relatively small health gains, and therefore usually do not meet common cost per QALY thresholds. Nevertheless, these drugs may be provided under the assumption that there is public support for making a special case for treatments for people with a terminal illness...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212735/elimination-of-the-unnecessary-intra-and-extracellular-signaling-by-anionic-phospholipids
#2
REVIEW
Valerian E Kagan, Hülya Bayır, Yulia Y Tyurina, Sergey B Bolevich, John J Maguire, Bengt Fadeel, Krishnakumar Balasubramanian
High fidelity of biological systems is frequently achieved by duplication of the essential intracellular machineries or, removal of the entire cell, which becomes unnecessary or even harmful in altered physiological environments. Carefully controlled removal of these cells, without damaging normal cells, requires precise signaling, and is critical to maintaining homeostasis. This review describes how two anionic phospholipids - phosphatidylserine (PS) and cardiolipin (CL) - residing in distinct compartments of the cell, signal removal of "the unnecessary" using several uniform principles...
January 15, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28210760/-risk-management-in-anesthesia-and-critical-care-medicine
#3
C Eisold, A R Heller
Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture...
February 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28209705/patients-experiences-of-diabetes-education-teams-integrated-into-primary-care
#4
Barbara Grohmann, Sherry Espin, Enza Gucciardi
OBJECTIVE: To explore patients' perspectives on care received from diabetes education teams (a registered nurse and a registered dietitian) integrated into primary care. DESIGN: Qualitative study using semistructured, one-on-one interviews. SETTING: Three diabetes education programs operating in 11 primary care sites in one region of Ontario. PARTICIPANTS: Twenty-three patients with diabetes. METHODS: Purposeful sampling was used to recruit participants from each site for interviews...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28209325/japanese-guidelines-for-atopic-dermatitis-2017
#5
REVIEW
Ichiro Katayama, Michiko Aihara, Yukihiro Ohya, Hidehisa Saeki, Naoki Shimojo, Shunsuke Shoji, Masami Taniguchi, Hidekazu Yamada
Given the importance of appropriate diagnosis and appropriate assessment of cutaneous symptoms in treatment of atopic dermatitis, the basics of treatment in this guideline are composed of (1) investigation and countermeasures of causes and exacerbating factors, (2) correction of skin dysfunctions (skin care), and (3) pharmacotherapy, as three mainstays. These are based on the disease concept that atopic dermatitis is an inflammatory cutaneous disease with eczema by atopic diathesis, multi-factorial in onset and aggravation, and accompanied by skin dysfunctions...
February 10, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28206996/the-quest-for-sustained-multiple-morbidity-reduction-in-very-low-birth-weight-infants-the-antifragility-project
#6
J W Kaempf, N M Schmidt, S Rogers, C Novack, M Friant, L Wang, N Tipping
OBJECTIVE: Can a comprehensive, explicitly directive evidence-based guideline for all therapies that might affect the major morbidities of very low-birth-weight (VLBW) infants help a neonatal intensive care unit (NICU) further improve generally favorable morbidity rates? Can Antifragility principles of provider adaptive growth from stressors, enhanced infant risk assessment and adherence to effective therapies minimize unproven treatments and reduce all morbidities? STUDY DESIGN: Prospectively planned observational trial in VLBW infants: control group born October 2011 to September 2013 and study group October 2013 to September 2015...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28204949/caregiver-burden-and-the-medical-ethos
#7
Karsten Witt, Johanne Stümpel, Christiane Woopen
Are physicians sometimes morally required to ease caregiver burden? In our paper we defend an affirmative answer to this question. First, we examine the well-established principle that medical care should be centered on the patient. We argue that although this principle seems to give physicians some leeway to lessen caregivers' suffering, it is very restrictive when spelled out precisely. Based on a critical analysis of existing cases for transcending patient-centeredness we then go on to argue that the medical ethos should indeed contain a rule requiring physicians to alleviate caregiver burden under certain circumstances...
February 15, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28199800/preventive-biomechanics
#8
Timothy E Hewett, Nathaniel A Bates
BACKGROUND: Preventive medicine techniques have alleviated billions of dollars' worth of the economic burden in the medical care system through the implementation of vaccinations and screenings before the onset of disease symptoms. Knowledge of biomechanical tendencies has progressed rapidly over the past 20 years such that clinicians can identify, in healthy athletes, the underlying mechanisms that lead to catastrophic injuries such as anterior cruciate ligament (ACL) ruptures. As such, preventive medicine concepts can be applied to noncontact musculoskeletal injuries to reduce the economic burden of sports medicine treatments and enhance the long-term health of athletes...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28199291/distal-radius-fractures-in-the-elderly
#9
L Scott Levin, Joshua C Rozell, Nicholas Pulos
Distal radius fractures are common in elderly patients, and the incidence continues to increase as the population ages. The goal of treatment is to provide a painless extremity with good function. In surgical decision making, special attention should be given to the patient's bone quality and functional activity level. Most of these fractures can be treated nonsurgically, and careful closed reduction should aim for maintenance of anatomic alignment with a focus on protecting fragile soft tissues. Locked plating is typically used for fracture management when surgical fixation is appropriate...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28199265/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#10
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28198998/physical-activity-counseling-in-primary-care-insights-from-public-health-and-behavioral-economics
#11
REVIEW
Kerem Shuval, Tammy Leonard, Jeffrey Drope, David L Katz, Alpa V Patel, Melissa Maitin-Shepard, On Amir, Amir Grinstein
Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle...
February 15, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28196828/systematic-review-of-the-effectiveness-barriers-and-facilitators-to-general-practitioner-engagement-with-specialist-secondary-services-in-integrated-palliative-care
#12
REVIEW
Sue-Ann Carmont, Geoffrey Mitchell, Hugh Senior, Michele Foster
: The general practitioner (GP) has a critical role in an integrated model of palliative care as they often know the patient and carer well, are experts in generalist care and have knowledge of health and social services in the community. Specialist palliative services have insufficient capacity to meet demand and those with non-cancer terminal conditions and those from rural and remote areas are underserved. Research has focused on improving access to palliative care by engaging the GP with specialist secondary services in integrated palliative care...
February 14, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28196705/an-exploration-of-emergency-nurses-perceptions-attitudes-and-experience-of-teamwork-in-the-emergency-department
#13
Elise Grover, Joanne E Porter, Julia Morphet
BACKGROUND: Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. METHOD: A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim...
February 11, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28194961/universal-dynamic-dna-assembly-programmed-surface-hybridization-effect-for-single-step-reusable-and-amplified-electrochemical-nucleic-acid-biosensing
#14
Shufeng Liu, Li Fang, Yanqun Wang, Li Wang
The traditional sensitive electrochemical biosensors are commonly confronted with the cumbersome interface operation and washing procedures and the inclusion of extra exogenous reagents, which impose the challenge on the detection simplicity, reliability, and reusability. Herein, we present the proof-of-principle of a unique biosensor architecture based on dynamic DNA assembly programmed surface hybridization, which confers the single-step, reusable, and enzyme-free amplified electrochemical nucleic acid analysis...
February 10, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28194353/labia-majora-share
#15
Hanjing Lee, Yan Lin Yap, Jeffrey Jen Hui Low, Jane Lim
Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28192554/using-patient-centered-care-after-a-prenatal-diagnosis-of-trisomy-18-or-trisomy-13-a-review
#16
Shelly Haug, Mitchell Goldstein, Denise Cummins, Elba Fayard, T Allen Merritt
Importance: Patient-centered care (PCC) has been advocated by the Institute of Medicine to improve health care in the United States. Four concepts of PCC align with clinical ethics principles and are associated with enhanced patient/parent satisfaction. These concepts are dignity and respect, information sharing, participation, and collaboration. The objective of this article is to use the PCC approach as a framework for an extensive literature review evaluating the current status of counseling regarding prenatal diagnosis of trisomy 18 (T18) or trisomy 13 (T13) and to advocate PCC in the care of these infants...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28192033/seven-foundational-principles-of-population-health-policy
#17
Dru Bhattacharya, Jay Bhatt
In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels...
February 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28190946/effects-of-pmto-in-foster-families-with-children-with-behavior-problems-a-randomized-controlled-trial
#18
Anne M Maaskant, Floor B van Rooij, Geertjan J Overbeek, Frans J Oort, Maureen Arntz, Jo M A Hermanns
The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4-12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children's behavior problems are challenging for foster parents and increase the risk of placement breakdown. There is little evidence for the effectiveness of established interventions to improve child and parent functioning in foster families. The goal of Parent Management Training Oregon, a relatively long and intensive (6-9 months, with weekly sessions) parent management training, is to reduce children's problem behavior through improvement of parenting practices...
2017: Journal of Child and Family Studies
https://www.readbyqxmd.com/read/28190696/ethical-issues-in-research
#19
REVIEW
Raul Artal, Sheldon Rubenfeld
Biomedical research is currently guided by ethical standards that have evolved over many centuries. Historical and political events, social and legal considerations, and continuous medical and technological advances have led to the prevailing research ethics and practice. Currently, patients and research subjects have complete autonomy while under medical care or when volunteering as research subjects. Enrolling volunteers in human subjects research includes a detailed and meaningful informed consent process that follows the cardinal principles of ethics: autonomy, beneficence, nonmaleficence, and justice...
January 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28190542/principles-of-effective-communication-with-patients-who-have-intellectual-disability-among-primary-care-physicians
#20
S Werner, S Yalon-Chamovitz, M Tenne Rinde, A D Heymann
OBJECTIVE: Examine physicians' implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors. METHODS: Focus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID. RESULTS: Subjective knowledge of ID and more patients with ID increased utilization of effective communication principles...
February 2, 2017: Patient Education and Counseling
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