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https://www.readbyqxmd.com/read/28731782/identifiability-of-components-of-complex-interventions-using-factorial-designs
#1
Andreas Gleiss
OBJECTIVE: The aim of this contribution is to demonstrate how the component structure of a complex intervention (CI) can be efficiently exploited for study design and statistical analysis by using concepts of factorial designs. Many studies on CIs in complementary and alternative medicine exhibit the structure of factorial designs, where all possible combinations of the levels of two or more treatments occur together. In this contribution, the treatment arms of CI studies are explicitly viewed as factorial combinations of their components...
July 21, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28731387/a-comparative-analysis-of-pulmonary-and-critical-care-medicine-guideline-development-methodologies
#2
Noah C Schoenberg, Alan F Barker, John Bernardo, Robin R Deterding, Jerrold J Ellner, Dean R Hess, Neil R MacIntyre, Fernando J Martinez, Kevin C Wilson
BACKGROUND: The Institute of Medicine (IOM) standards for guideline development have had unintended negative consequences. A more efficient approach is desirable. OBJECTIVE: To determine whether a modified Delphi process early during guideline development discriminates recommendations that should be informed by a systematic review from those that can be based upon expert consensus. METHODS: The same questions addressed by IOM-compliant pulmonary or critical care guidelines were addressed by expert panels using a modified Delphi process, the Convergence of Opinion on Recommendations and Evidence (CORE) process...
July 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28731361/the-impact-of-teaching-prognostication-at-the-end-of-life-a-pre-post-interventional-study
#3
Alexandria Bear, Tucker Keuter, Jayshil J Patel
BACKGROUND: Providing accurate and valid prognostic information significantly influences end-of-life care. Disclosing a poor prognosis can be among the most difficult of physician responsibilities, thus having appropriate knowledge during training is crucial for appropriate prognostication. OBJECTIVE: To provide internal medicine (IM) house staff with a pre- and posteducational survey to determine their ability to accurately prognosticate 5 common end-stage diseases...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#4
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28729806/evidence-provided-for-the-use-of-oscillating-instruments-in-restorative-dentistry-a-systematic-review
#5
REVIEW
Panagiotis Ntovas, Spyridon Doukoudakis, John Tzoutzas, Panagiotis Lagouvardos
Oscillating diamond instruments are considered gentle sources for the removal of demineralized tooth hard tissues and the preparation of cavity angles and margins needed in minimally invasive dentistry. However, there is a question if literature provides enough evidence for their efficacy in restorative dentistry procedures. A literature search until May 2016 was conducted, using PubMed, Scopus, and The Cochrane Central Register of Controlled Trials databases. The quality of the studies was assessed using the recommendation of the Oxford Centre for Evidence-based Medicine...
April 2017: European Journal of Dentistry
https://www.readbyqxmd.com/read/28728067/an-optimized-hplc-uv-method-for-quantitatively-determining-sesquiterpenes-in-nardostachyos-radix-et-rhizoma
#6
Vu Ngoc Han Le, Trong Quan Khong, Min Kyun Na, Kyung Tae Kim, Jong Seong Kang
Nardostachyos Radix et Rhizoma (NR), the root and rhizome from either Nardostachys jatamansi Batal or Nardostachys jatamansi DC, is known to have biological functions including neuro-protective and anti-pancreatitis activity. The main bioactive compounds within NR are all classified as sesquiterpenes, and include desoxo-narchinol A, nardosinonediol, and nardosinone. Although NR is a valuable herb that is widely used in many Asian countries, robust quality control protocols for NR are still in question, especially those that can analyze the three main active compounds...
July 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28727693/a-cross-disciplinary-assessment-of-student-loans-debt-financial-support-for-study-and-career-preferences-upon-graduation
#7
Craig S Webster, Christopher Ling, Mark Barrow, Phillippa Poole, Marcus Henning
AIM: To explore relationships between student loans debt, financial support and career preferences upon graduation for all healthcare disciplines offered at the Faculty of Medical and Health Sciences, University of Auckland. METHODS: The Faculty Tracking Project is a longitudinal study which invites students to complete a questionnaire at the beginning and end of their educational programmes, including questions on debt, financial support and career preference. Our analysis comprised three phases: (1) a descriptive analysis of data related to debt and financial support; (2) a principal component analysis in order to find related categories of career choice; and (3) logistic regression models to determine how career preference categories could be explained by either levels of student loans debt or financial support...
July 21, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28727667/sleep-apnea-screening-practices-during-department-of-transportation-medical-examinations
#8
Marten R Hawkins, Rasheed Durowoju, Daniel Havlichek, Kenneth D Rosenman
OBJECTIVE: The aim of this study was to examine the practices of Michigan Occupational and Environmental Medicine Association (MOEMA) members regarding screening for sleep apnea during required driver medical examinations. METHODS: A 13-question survey on sleep apnea screening practices was emailed to the MOEMA member. Nonresponders received additional E-mails and calls. RESULTS: The survey response rate was 66%. Fifty-five percent of respondents performed driver examinations and 94% screened for sleep apnea...
July 19, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28727148/treatment-of-intrahepatic-congenital-portosystemic-shunts-in-dogs-a-systematic-review
#9
REVIEW
M S Tivers, V J Lipscomb, D J Brockman
The aim of this study was to establish the evidence base for the treatment of intrahepatic congenital portosystemic shunts in dogs through a systematic review of the pertinent literature. Studies were filtered for evidence to answer the question "Which of the treatment options for intrahepatic CPSS in dogs offers the best short- and long-term outcome?" Studies were assigned a level of evidence based on a system published by the Oxford Centre for Evidence-Based Medicine. Thirty-two studies were included in the review...
July 20, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28724394/development-of-newborn-screening-connect-nbs-connect-a-self-reported-patient-registry-and-its-role-in-improvement-of-care-for-patients-with-inherited-metabolic-disorders
#10
Yetsa Osara, Kathryn Coakley, Aishwarya Devarajan, Rani H Singh
BACKGROUND: Newborn Screening Connect (NBS Connect) is a web-based self-reported patient registry and resource for individuals and families affected by disorders included in the newborn screening panel. NBS Connect was launched in 2012 by Emory University after years of planning and grassroots work by professionals, consumers, and industry. Individuals with phenylketonuria (PKU), maple syrup urine disease (MSUD) or tyrosinemia (TYR) have been recruited through distribution of outreach materials, presentations at parent organization meetings and direct recruitment at clinic appointments...
July 19, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28724151/assessment-of-addiction-medicine-training-in-family-medicine-residency-programs-a-cera-study
#11
Sebastian Tong, Roy Sabo, Rebecca Aycock, Ramakrishna Prasad, Rebecca Etz, Anton Kuzel, Alex Krist
BACKGROUND AND OBJECTIVES: Substance use disorder (SUD) is a widespread problem but physicians may feel inadequately prepared to provide addiction care. We sought to assess current addiction medicine curricula in US family medicine residencies (FMRs) and evaluate barriers to improving or implementing addiction medicine curricula. METHODS: Questions regarding addiction medicine training were added to the December 2015 Council of Academic Family Medicine Educational Research Alliance (CERA) survey to US FMR program directors to evaluate each FMR's curriculum, potential workforce production, perceived barriers to improving or implementing curricula and faculty training in addiction medicine...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28724128/topical-corticosteroid-phobia-in-atopic-dermatitis-a-systematic-review
#12
Alvin W Li, Emily S Yin, Richard J Antaya
Importance: Topical corticosteroid (TCS) phobia refers to the negative feelings and beliefs related to TCSs experienced by patients and patients' caregivers. This phenomenon may be a major contributing factor in treatment failure in patients with atopic dermatitis, yet it has been sparsely described in the literature. Objective: To systematically assess the nomenclature, prevalence, origins, and effect on treatment adherence of TCS phobia in atopic dermatitis. Evidence Review: A literature search was conducted using specific eligibility criteria across electronic databases, including Ovid (MEDLINE, EMBASE), PubMed, and Web of Science, for articles published from January 1, 1946, to October 31, 2016...
July 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28723302/why-use-group-visits-for-opioid-use-disorder-treatment-in-primary-care-a-patient-centered-qualitative-study
#13
Randi Sokol, Chiara Albanese, Deviney Chaponis, Jessica Early, George Maxted, Diana Morrill, Grace Poirier, Fran Puopolo, Zev Schuman-Olivier
BACKGROUND: Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMA). While quantitative research has been previously conducted on SMAs with B/N, we conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients. METHODS: Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two one-hour-long focus groups, which were conducted as actual group visits...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28722755/the-potential-of-anti-infectives-and-immunomodulators-as-therapies-for-asthma-and-asthma-exacerbations
#14
Michael R Edwards, Ross P Walton, David J Jackson, Wojciech Feleszko, Chrysanthi Skevaki, Tuomas Jartti, Heidi Makrinoti, Alexandra Nikonova, Igor Shilovskiy, Jurgen Schwarze, Sebastian L Johnston, Musa Khaitov
Asthma is responsible for approximately 25,000 deaths annually in Europe despite available medicines that maintain asthma control and reduce asthma exacerbations. Better treatments are urgently needed for the control of chronic asthma and reduction of asthma exacerbations, the major cause of asthma mortality. Much research spanning >20 years shows a strong association between microorganisms including pathogens in asthma onset, severity and exacerbation, yet with the exception of antibiotics, few treatments are available that specifically target the offending pathogens...
July 19, 2017: Allergy
https://www.readbyqxmd.com/read/28721949/rising-to-the-challenge-applying-biofabrication-approaches-for-better-drug-and-chemical-product-development
#15
Anthony M Holmes, Alex Charlton, Brian Derby, Lorna Ewart, Andrew Scott, Wenmiao Shu
Many industrial sectors, from pharmaceuticals to consumer products, are required to provide data on their products to demonstrate their efficacy and that they are safe for patients, consumers and the environment. This period of testing typically requires the use of animal models, the validity of which has been called into question due to the high rates of attrition across many industries. There is increasing recognition of the limitations of animal models and demands for safety and efficacy testing paradigms which embrace the latest technological advances and knowledge of human biology...
July 19, 2017: Biofabrication
https://www.readbyqxmd.com/read/28721683/mesenchymal-stem-progenitor-cells-derived-from-articular-cartilage-synovial-membrane-and-synovial-fluid-for-cartilage-regeneration-current-status-and-future-perspectives
#16
REVIEW
Yi-Zhou Huang, Hui-Qi Xie, Antonietta Silini, Ornella Parolini, Yi Zhang, Li Deng, Yong-Can Huang
Large articular cartilage defects remain an immense challenge in the field of regenerative medicine because of their poor intrinsic repair capacity. Currently, the available medical interventions can relieve clinical symptoms to some extent, but fail to repair the cartilaginous injuries with authentic hyaline cartilage. There has been a surge of interest in developing cell-based therapies, focused particularly on the use of mesenchymal stem/progenitor cells with or without scaffolds. Mesenchymal stem/progenitor cells are promising graft cells for tissue regeneration, but the most suitable source of cells for cartilage repair remains controversial...
July 18, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28721186/factors-driving-the-global-decline-of-cycad-diversity
#17
Ledile T Mankga, Kowiyou Yessoufou
Mounting evidence indicates that we are witnessing the sixth mass extinction period. Given the important goods and services biodiversity delivers to humans, there is a need for a continued commitment to investigate what pre-disposes some taxa to greater risk of extinction. Here, we investigate this question using a phylogenetic comparative method and fitting a cumulative link mixed effect model on biological, ecological and evolutionary data of cycads, the most threatened lineage in the plant kingdom. We identified nine groups of threats to cycads, with habitat loss, over-collection, fire and reproduction failure being the most prominent, but only four of these threats (habitat loss, over-collection, medicinal uses and reproduction failure) clustered on the cycad tree of life...
July 2017: AoB Plants
https://www.readbyqxmd.com/read/28720681/the-eubivas-project-within-and-between-subject-biological-variation-data-for-serum-creatinine-using-enzymatic-and-alkaline-picrate-methods-and-implications-for-monitoring
#18
Anna Carobene, Irene Marino, Abdurrahman Coŝkun, Mustafa Serteser, Ibrahim Unsal, Elena Guerra, William A Bartlett, Sverre Sandberg, Aasne Karine Aarsand, Marit Sverresdotter Sylte, Thomas Røraas, Una Ørvim Sølvik, Pilar Fernandez-Calle, Jorge Díaz-Garzón, Francesca Tosato, Mario Plebani, Niels Jonker, Gerhard Barla, Ferruccio Ceriotti
BACKGROUND: The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) European Biological Variation Study (EuBIVAS) has been established to deliver rigorously determined biological variation (BV) indices. EuBIVAS determined BV for serum creatinine using the enzymatic and alkaline picrate measurement methods. METHOD: In total, 91 healthy individuals (38 males, 53 females; age range, 21-69 years) were bled for 10 consecutive weeks at 6 European laboratories...
July 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28720514/ahrq-series-on-complex-intervention-systematic-reviews-paper-2-defining-complexity-formulating-scope-and-questions
#19
Michael P Kelly, Jane Noyes, Robert L Kane, Christine Chang, Stacey Uhl, Karen A Robinson, Stacey Springs, Mary E Butler, Jeanne-Marie Guise
BACKGROUND: The early stages of a systematic review set the scope and expectations. This can be particularly challenging for complex interventions given their multi-dimensional and dynamic nature. RATIONALE: This paper builds on concepts introduced in Paper 1 of this series. It describes the methodological, practical and philosophical challenges and potential approaches for formulating the questions and scope of systematic reviews of complex interventions. Further it discusses the use of theory to help organize reviews of complex interventions...
June 29, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28717713/breaking-cancer-bad-news-to-patients-with-cancer-a-comprehensive-perspective-of-patients-their-relatives-and-the-public-example-from-a-middle-eastern-country
#20
Jamal Zekri, Syed Mustafa Karim
PURPOSE: Empowering patients with cancer requires that they be continuously informed about their condition. In some Eastern cultures, this concept is often opposed by caregivers. We aim to compare the extent of disclosure desired by actual and presumed patients with cancer and their relatives in our practice. METHODS: Nine questions reflecting possible bad news communication to patients from diagnosis to the end of life were designed to investigate the extent of desired disclosure and were answered by 100 patients (cohort I) and 103 accompanying relatives (cohort II) in an outpatient setting...
October 2016: Journal of Global Oncology
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