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Professionalism in the practice of medicine

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https://www.readbyqxmd.com/read/29352526/ectrims-ean-guideline-on-the-pharmacological-treatment-of-people-with-multiple-sclerosis
#1
X Montalban, R Gold, A J Thompson, S Otero-Romero, M P Amato, D Chandraratna, M Clanet, G Comi, T Derfuss, F Fazekas, H P Hartung, E Havrdova, B Hemmer, L Kappos, R Liblau, C Lubetzki, E Marcus, D H Miller, T Olsson, S Pilling, K Selmaj, A Siva, P S Sorensen, M P Sormani, C Thalheim, H Wiendl, F Zipp
BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is a complex disease of the central nervous system. As new drugs are becoming available, knowledge on diagnosis and treatment must continuously evolve. There is therefore a need for a reference tool compiling current data on benefit and safety, to aid professionals in treatment decisions and use of resources across Europe. The European Committee of Treatment and Research in Multiple Sclerosis (ECTRIMS) and the European Academy of Neurology (EAN) have joined forces to meet this need...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29352365/-anesthesia-problem-cards-indispensable-yet-problematic-nationwide-survey-on-experiences-from-clinical-practice
#2
M Schieren, A Böhmer, W Golbeck, J Defosse, F Wappler, H E Marcus
BACKGROUND: Anesthetic procedures may lead to severe and potentially life-threatening complications (e. g. difficult airway, allergic reactions, malignant hyperthermia). Most complications can be avoided in future anesthetic procedures with adequate preparation (e. g. awake intubation, trigger-free anesthesia). In Germany, anesthesia problem cards were introduced two decades ago to identify patients at risk and to increase patient safety by creating a standardized documentation system for anesthesia-related complications...
January 19, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29351363/carers-experiences-of-home-enteral-feeding-a-survey-exploring-medicines-administration-challenges-and-strategies
#3
D Alsaeed, D Furniss, A Blandford, F Smith, M Orlu
WHAT IS KNOWN AND OBJECTIVES: The use of enteral tube feeding at home is becoming more widespread, with patients ranging in age and diseases. Dysphagia and swallowing difficulties can compromise nutritional intake and the administration of oral medications, affecting therapeutic outcomes negatively. Carers' experiences of medicines administration and medicines optimization have not been explored fully. The objectives of this study were to identify issues carers experience in medicines administration; the strategies they have developed to cope; and suggestions to improve the medicines administration process...
January 19, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29349812/drug-promotion-practices-a-review
#4
Nilan T Jacob
Over the years, the pharmaceutical industry has been at the forefront of research and innovation in drug discovery and development. The process of drug discovery extending from pre-clinical studies to multi-centric clinical trials and post-marketing phase is a costly affair running into billions of dollars. On the flip side, not all investigational molecules clear the trial phases and get approved; which puts pressure on the manufacturers to maximise the profit from approved drugs. It is in this key area, the practice of drug promotion plays its role...
January 18, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29346570/implementation-status-of-morbidity-and-mortality-conferences-in-swiss-hospitals-a-national-cross-sectional-survey-study
#5
Isabelle Praplan-Rudaz, Yvonne Pfeiffer, David L B Schwappach
Objective: To determine the implementation status and current practice of morbidity and mortality conferences (M&MCs) in Switzerland. Design: A national cross-sectional online survey was conducted in spring 2017. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Further topics included satisfaction, perceived effectiveness and support requirements. Setting: A total of 913 chief physicians of surgery and internal medicine, and specialist fields of obstetrics and gynaecology, anaesthesiology and intensive care from Swiss acute care hospitals were invited to the survey...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29346354/compassion-from-a-palliative-care-perspective
#6
Antonio Fernando, Conor Rea, Phillipa J Malpas
BACKGROUND: Compassion is a core virtue in medicine and lies at the heart of good medical care. It connects us to each other and reflects our need for relationships with others. AIM: Our aim is to explore how palliative care patients perceive, understand and experience compassion from health professionals, and to inform clinical practice. METHODS: Seven hospice managers in the North Island of New Zealand were contacted and invited to join the study...
January 19, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#7
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29344003/a-medical-student-in-private-practice-for-a-1-month-clerkship-a-qualitative-exploration-of-the-challenges-for-primary-care-clinical-teachers
#8
Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat
Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Methods: Data were collected via a focus group using a semistructured interview guide...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29340512/articulation-between-health-services-and-indigenous-medicine-anthropological-reflections-on-policies-and-reality-in-brazil
#9
Esther Jean Langdon, Luiza Garnelo
This paper contributes to the dialogue between the social sciences and social medicine in Latin America by exploring therapeutic pluralism in indigenous health policies and services in Brazil. It reviews recent anthropological research, concepts and current debates to critically examine Brazilian indigenous health policy and its concept of "differentiated care," which proposes articulation between official health practices and indigenous therapies. A number of contradictions and tensions are present in the structural organizational of the indigenous health subsystem at the national level and in the daily practices of health teams at the local level...
July 2017: Salud Colectiva
https://www.readbyqxmd.com/read/29336168/dementia-in-eastern-mediterranean-countries-a-systematic-review
#10
Sara Mahmoud Yaghmour, Ruth Bartlett, Tula Brannelly
Globally, there is an increase in the older population, whose lives are affected by local cultural norms. In Eastern Mediterranean countries, dementia is conventionally hidden from view with few dedicated services or recognition for diagnosis. The aim of this systematic review is to explore the limited literature on dementia and cognitive impairment among older people in Eastern Mediterranean countries to present an evaluation of current practices and to consolidate knowledge for future planning. Thirty-three studies were identified for inclusion in the review, and four themes were apparent...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29334913/identifying-enablers-and-barriers-to-individually-tailored-prescribing-a-survey-of-healthcare-professionals-in-the-uk
#11
Joanne Reeve, Nicky Britten, Richard Byng, Jo Fleming, Janet Heaton, Janet Krska
BACKGROUND: Many people now take multiple medications on a long-term basis to manage health conditions. Optimising the benefit of such polypharmacy requires tailoring of medicines use to the needs and circumstances of individuals. However, professionals report barriers to achieving this in practice. In this study, we examined health professionals' perceptions of enablers and barriers to delivering individually tailored prescribing. METHODS: Normalisation Process Theory (NPT) informed an on-line survey of health professionals' views of enablers and barriers to implementation of Individually Tailored Prescribing (ITP) of medicines...
January 15, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29330140/exploring-entertainment-medicine-and-professionalization-of-self-care-interview-study-among-doctors-on-the-potential-effects-of-digital-self-tracking
#12
Katleen Gabriels, Tania Moerenhout
BACKGROUND: Nowadays, digital self-tracking devices offer a plethora of possibilities to both healthy and chronically ill users who want to closely examine their body. This study suggests that self-tracking in a private setting will lead to shifting understandings in professional care. To provide more insight into these shifts, this paper seeks to lay bare the promises and challenges of self-tracking while staying close to the everyday professional experience of the physician. OBJECTIVE: The aim of this study was to (1) offer an analysis of how medical doctors evaluate self-tracking methods in their practice and (2) explore the anticipated shifts that digital self-care will bring about in relation to our findings and those of other studies...
January 12, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29325162/an-analysis-of-adverse-events-in-the-rehabilitation-department-using-the-veterans-affairs-root-cause-analysis-system
#13
Gregory W Hagley, Peter D Mills, Brian Shiner, Robin R Hemphill
Background: Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists...
January 9, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29324559/nurse-experiences-of-medication-administration-to-people-with-swallowing-difficulties-living-in-aged-care-facilities-a-systematic-review-of-qualitative-evidence
#14
Aida Sefidani Forough, Simon Y M Wong, Esther T L Lau, Jose Manuel Serrano Santos, Greg J Kyle, Kathryn J Steadman, Julie A Y Cichero, Lisa M Nissen
OBJECTIVE: To identify nurses' experiences of administering oral medications to residents of aged care facilities (ACFs) with swallowing difficulties. INTRODUCTION: Administering medicines to older people with swallowing difficulties is a challenging task. Nurses frequently modify oral medications e.g. by crushing/splitting tablets or opening capsules, to facilitate the administration process. These practices are associated with an increased risk of medication administration errors...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29323668/professional-responsibilities-regarding-the-provision-publication-and-dissemination-of-patient-phenotypes-in-the-context-of-clinical-genetic-and-genomic-testing-points-to-consider-a-statement-of-the-american-college-of-medical-genetics-and-genomics-acmg
#15
Lynn W Bush, Anita E Beck, Leslie G Biesecker, James P Evans, Ada Hamosh, Ingrid A Holm, Christa L Martin, C Sue Richards, Heidi L Rehm
Disclaimer: This Points to Consider document is designed as an educational resource to provide best practices for medical genetic clinicians, laboratories, and journals regarding the provision, publication, and dissemination of patient phenotypes in the context of genomic testing, clinical genetic practice, and research. While the goal of the document is the improvement of patient care, the considerations and practices described should not be considered inclusive of all proper considerations and practices or exclusive of others that are reasonably directed to obtaining the same goal...
January 11, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29323667/making-new-genetic-diagnoses-with-old-data-iterative-reanalysis-and-reporting-from-genome-wide-data-in-1-133-families-with-developmental-disorders
#16
Caroline F Wright, Jeremy F McRae, Stephen Clayton, Giuseppe Gallone, Stuart Aitken, Tomas W FitzGerald, Philip Jones, Elena Prigmore, Diana Rajan, Jenny Lord, Alejandro Sifrim, Rosemary Kelsell, Michael J Parker, Jeffrey C Barrett, Matthew E Hurles, David R FitzPatrick, Helen V Firth
PurposeGiven the rapid pace of discovery in rare disease genomics, it is likely that improvements in diagnostic yield can be made by systematically reanalyzing previously generated genomic sequence data in light of new knowledge.MethodsWe tested this hypothesis in the United Kingdom-wide Deciphering Developmental Disorders study, where in 2014 we reported a diagnostic yield of 27% through whole-exome sequencing of 1,133 children with severe developmental disorders and their parents. We reanalyzed existing data using improved variant calling methodologies, novel variant detection algorithms, updated variant annotation, evidence-based filtering strategies, and newly discovered disease-associated genes...
January 11, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29321023/which-risk-understandings-can-be-derived-from-the-current-disharmonized-regulation-of-complementary-and-alternative-medicine-in-europe
#17
Solveig Wiesener, Anita Salamonsen, Vinjar Fønnebø
BACKGROUND: Many European citizens are seeking complementary and alternative medicine (CAM). These treatments are regulated very differently in the EU/EFTA countries. This may demonstrate differences in how risk associated with the use of CAM is perceived. Since most CAM treatments are practiced fairly similarly across Europe, differing risk understandings may influence patient safety for European CAM users. The overall aim of this article is thus to contribute to an overview and awareness of possible differing risk understandings in the field of CAM at a policymaking/structural level in Europe...
January 10, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29316409/exercise-is-medicine-canada-physical-activity-counselling-and-exercise-prescription-training-improves-counselling-prescription-and-referral-practices-among-physicians-across-canada
#18
Jonathon R Fowles, Myles W O'Brien, Kara Solmundson, Paul I Oh, Christopher A Shields
Exercise is Medicine Canada (EIMC) is an initiative that promotes physical activity (PA) counselling and exercise prescription within health care. The purpose of this study was to compare physicians' perceptions and practices around PA counselling and exercise prescription following EIMC training. Physicians (n=46) from 7 different provinces completed questionnaires initially and three-months following an EIMC workshop. Three-months post-intervention, physicians reported greater confidence compared to baseline, for providing physical activity and exercise (PAE) information to patients (79% vs 55%; p<0...
January 9, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29315916/ethical-responsibilities-of-pharmacists-when-selling-complementary-medicines-a-systematic-review
#19
REVIEW
Amber Salman Popattia, Sarah Winch, Adam La Caze
OBJECTIVE: The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines. METHODS: International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017...
January 8, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29314554/going-from-evidence-to-recommendations-can-grade-get-us-there
#20
Mathew Mercuri, Brian Baigrie, Ross E G Upshur
The evidence based medicine movement has championed the need for objective and transparent methods of clinical guideline development. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was developed for that purpose. Central to this framework is criteria for assessing the quality of evidence from clinical studies and the impact that body of evidence should have on our confidence in the clinical effectiveness of a therapy under examination. Grades of Recommendation, Assessment, Development, and Evaluation has been adopted by a number of professional medical societies and organizations as a means for orienting the development of clinical guidelines...
January 5, 2018: Journal of Evaluation in Clinical Practice
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