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https://www.readbyqxmd.com/read/28335444/hiv-education-and-welfare-services-in-primary-care-an-empirical-model-of-integration-in-brazil-s-unified-health-system
#1
Rahbel Rahman, Rogério M Pinto, Melanie M Wall
Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil's Unified Health System (UHS)...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28333785/improving-decision-making-for-advanced-heart-failure-patients-and-caregivers
#2
Colleen K McIlvennan
In this month's Magnet® Perspectives column, Colleen K. McIlvennan, DNP, ANP, lead nurse practitioner, Advanced Heart Failure and Transplantation at the University of Colorado, discusses her groundbreaking research encompassing patients' and caregivers' emotional, rational, and fundamental beliefs when considering a left ventricular assist device (LVAD). Results have led to the development of 2 innovative decision aids that are currently in use by LVAD programs across the United States and Canada. Dr McIlvennan's efforts led to a $2 million grant from the Patient-Centered Outcomes Research Institute, as well as national recognition from the American Heart Association and the Heart Failure Society of America...
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28332994/predicting-patient-specific-dosimetric-benefits-of-proton-therapy-for-skull-base-tumors-using-a-geometric-knowledge-based-method
#3
David C Hall, Alexei V Trofimov, Brian A Winey, Norbert J Liebsch, Harald Paganetti
PURPOSE: To predict the organ at risk (OAR) dose levels achievable with proton beam therapy (PBT), solely based on the geometric arrangement of the target volume in relation to the OARs. A comparison with an alternative therapy yields a prediction of the patient-specific benefits offered by PBT. This could enable physicians at hospitals without proton capabilities to make a better-informed referral decision or aid patient selection in model-based clinical trials. METHODS AND MATERIALS: Skull-base tumors were chosen to test the method, owing to their geometric complexity and multitude of nearby OARs...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28330753/rationale-and-study-protocol-for-the-patient-centered-outcome-aid-pcoa-randomized-controlled-trial-a-personalized-decision-tool-for-newly-diagnosed-ovarian-cancer-patients
#4
L Wenzel, D Mukamel, K Osann, L Havrilesky, L Sparks, J Lipscomb, A A Wright, J Walker, R Alvarez, L Van Le, K Robinson, R Bristow, R Morgan, B J Rimel, H Ladd, S Hsieh, A Wahi, D Cohn
No abstract text is available yet for this article.
March 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28330400/academic-responses-to-fukushima-disaster
#5
Kiyotaka Yasui, Yuko Kimura, Kenji Kamiya, Rie Miyatani, Naohiro Tsuyama, Akira Sakai, Koji Yoshida, Shunichi Yamashita, Rethy Chhem, May Abdel-Wahab, Akira Ohtsuru
Since radiation accidents, particularly nuclear disasters, are rarer than other types of disasters, a comprehensive radiation disaster medical curriculum for them is currently unavailable. The Fukushima compound disaster has urged the establishment of a new medical curriculum in preparation for any future complex disaster. The medical education will aim to aid decision making on various health risks for workers, vulnerable people, and residents addressing each phase in the disaster. Herein, we introduce 3 novel educational programs that have been initiated to provide students, professionals, and leaders with the knowledge of and skills to elude the social consequences of complex nuclear disasters...
March 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28329300/personalising-the-decision-for-prolonged-dual-antiplatelet-therapy-development-validation-and-potential-impact-of-prognostic-models-for-cardiovascular-events-and-bleeding-in-myocardial-infarction-survivors
#6
Laura Pasea, Sheng-Chia Chung, Mar Pujades-Rodriguez, Alireza Moayyeri, Spiros Denaxas, Keith A A Fox, Lars Wallentin, Stuart J Pocock, Adam Timmis, Amitava Banerjee, Riyaz Patel, Harry Hemingway
Aims: The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results: Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n = 12 694 patients) and validated (n = 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28327203/an-appraisal-of-analytical-tools-used-in-predicting-clinical-outcomes-following-radiation-therapy-treatment-of-men-with-prostate-cancer-a-systematic-review
#7
Elspeth Raymond, Michael E O'Callaghan, Jared Campbell, Andrew D Vincent, Kerri Beckmann, David Roder, Sue Evans, John McNeil, Jeremy Millar, John Zalcberg, Martin Borg, Kim Moretti
BACKGROUND: Prostate cancer can be treated with several different modalities, including radiation treatment. Various prognostic tools have been developed to aid decision making by providing estimates of the probability of different outcomes. Such tools have been demonstrated to have better prognostic accuracy than clinical judgment alone. METHODS: A systematic review was undertaken to identify papers relating to the prediction of clinical outcomes (biochemical failure, metastasis, survival) in patients with prostate cancer who received radiation treatment, with the particular aim of identifying whether published tools are adequately developed, validated, and provide accurate predictions...
March 21, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28327157/factors-influencing-implementation-of-a-patient-decision-aid-in-a-developing-country-an-exploratory-study
#8
Wen Ting Tong, Yew Kong Lee, Chirk Jenn Ng, Ping Yein Lee
BACKGROUND: Most studies on barriers and facilitators to implementation of patient decision aids (PDAs) are conducted in the west; hence, the findings may not be transferable to developing countries. This study aims to use a locally developed insulin PDA as an exemplar to explore the barriers and facilitators to implementing PDAs in Malaysia, an upper middle-income country in Asia. METHODS: Qualitative methodology was adopted. Nine in-depth interviews (IDIs) and three focus group discussions (FGDs) were conducted with policymakers (n = 6), medical officers (n = 13), diabetes educators (n = 5) and a nurse, who were involved in insulin initiation management at an academic primary care clinic...
March 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28327125/facilitating-informed-decisions-about-breast-cancer-screening-development-and-evaluation-of-a-web-based-decision-aid-for-women-in-their-40s
#9
Elena B Elkin, Valerie H Pocus, Alvin I Mushlin, Tessa Cigler, Coral L Atoria, Margaret M Polaneczky
BACKGROUND: Expert groups and national guidelines recommend individualized decision making about screening mammography for women in their 40s at low-to-average risk of breast cancer. We created Breast Screening Decisions (BSD), a personalized, web-based decision aid, to help women decide when to start and how often to have routine screening mammograms. We evaluated BSD in a large, prospective pilot trial of women and their clinicians. METHODS: Women ages 40-49 were invited to use BSD before a scheduled preventive care visit...
March 21, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28325441/a-review-of-fuzzy-cognitive-maps-in-medicine-taxonomy-methods-and-applications
#10
REVIEW
Abdollah Amirkhani, Elpiniki I Papageorgiou, Akram Mohseni, Mohammad R Mosavi
BACKGROUND AND OBJECTIVE: A high percentage of medical errors, committed because of physician's lack of experience, huge volume of data to be analyzed, and inaccessibility to medical records of previous patients, can be reduced using computer-aided techniques. Therefore, designing more efficient medical decision-support systems (MDSSs) to assist physicians in decision-making is crucially important. Through combining the properties of fuzzy logic and neural networks, fuzzy cognitive maps (FCMs) are among the latest, most efficient, and strongest artificial intelligence techniques for modeling complex systems...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28325164/development-of-a-decision-making-tool-for-reporting-drivers-with-mild-dementia-and-mild-cognitive-impairment-to-transportation-administrators
#11
Duncan H Cameron, Carla Zucchero Sarracini, Linda Rozmovits, Gary Naglie, Nathan Herrmann, Frank Molnar, John Jordan, Anna Byszewski, David Tang-Wai, Jamie Dow, Christopher Frank, Blair Henry, Nicholas Pimlott, Dallas Seitz, Brenda Vrkljan, Rebecca Taylor, Mario Masellis, Mark J Rapoport
BACKGROUND: Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators...
March 22, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28323611/the-role-of-universal-health-literacy-precautions-in-minimizing-medspeak-and-promoting-shared-decision-making
#12
Lara Killian, Margo Coletti
Shared decision making (SDM), a collaborative process whereby patients and professionals make health care decisions together, is a cornerstone of ethical patient care. The patient-clinician communication necessary to achieve SDM depends on many factors, not the least of which is a shared language (sometimes with the aid of a medical interpreter). However, even when a patient and clinician are speaking the same mother tongue, the use of medical jargon can pose a large and unnecessary barrier. This article discusses how health care professionals can use "universal health literacy precautions" as a legal, practical, and ethical means to enhance SDM and improve health care outcomes...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323052/multi-locus-phylogeny-reveals-instances-of-mitochondrial-introgression-and-unrecognized-diversity-in-kenyan-barbs-cyprininae-smiliogastrini
#13
Ray C Schmidt, Henry L Bart, Wanja Dorothy Nyingi
The phylogenetics and taxonomic status of small African barbs (Cyprininae: Smiliogastrini) remains unresolved despite the recent decision to elevate the genus name Enteromius for the group. The main barrier to understanding the origin of African small barbs and evolutionary relationships within the group is the poor resolution of phylogenies published to date. These phylogenies usually rely on mitochondrial markers and have limited taxon sampling. Here we investigate the phylogenetic relationships of small barbs of Kenya utilizing cytochrome b, Growth Hormone intron 2, and RAG1 markers from multiple populations of many species in the region...
March 17, 2017: Molecular Phylogenetics and Evolution
https://www.readbyqxmd.com/read/28320368/use-of-a-decision-aid-did-not-decrease-decisional-conflict-in-patients-with-carpal-tunnel-syndrome
#14
Hyun Sik Gong, Jin Woo Park, Young Ho Shin, Kahyun Kim, Kwan Jae Cho, Goo Hyun Baek
BACKGROUND: Although a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery. METHODS: Eighty patients with CTS were randomized into two groups...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28320334/use-of-a-patient-decision-aid-for-prenatal-screening-for-down-syndrome-what-do-pregnant-women-say
#15
Maria Esther Leiva Portocarrero, Anik M C Giguère, Johanie Lépine, Mirjam M Garvelink, Hubert Robitaille, Agathe Delanoë, Isabelle Lévesque, Brenda J Wilson, François Rousseau, France Légaré
BACKGROUND: Patient decision aids (PtDAs) help people make difficult, values-sensitive decisions. Prenatal screening for assessing the risk of genetic conditions in the fetus is one such decision and patient decision aids are rarely used in this clinical context. We sought to identify factors influencing pregnant women's use of a patient decision aid for deciding about prenatal screening for Down syndrome (DS). METHODS: This qualitative study was embedded in a sequential mixed-methods research program whose main aim is to implement shared decision-making (SDM) in the context of prenatal screening for DS in the province of Quebec, Canada...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28320053/management-of-colorectal-trauma-a-review
#16
REVIEW
Ju Yong Cheong, Anil Keshava
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28317407/using-molecular-diagnostic-testing-to-personalize-the-treatment-of-patients-with-gastrointestinal-stromal-tumors
#17
Amber E Bannon, Lillian R Klug, Christopher L Corless, Michael C Heinrich
The diagnosis and treatment of gastrointestinal stromal tumor (GIST) has emerged as a paradigm for modern cancer treatment ("precision medicine"), as it highlights the importance of matching molecular defects with specific therapies. Over the past two decades, the molecular classification and diagnostic work up of GIST has been radically transformed, accompanied by the development of molecular therapies for specific subgroups of GIST. This review summarizes the developments in the field of molecular diagnosis of GIST, particularly as they relate to optimizing medical therapy...
March 20, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28302644/what-is-an-roc-curve
#18
EDITORIAL
Zhe Hui Hoo, Jane Candlish, Dawn Teare
The paper by Body et al is concerned with the evaluation of decision aids, which can be used to identify potential acute coronary syndromes (ACS) in the ED. The authors previously developed the Manchester Acute Coronary Syndromes model (MACS) decision aid, which uses several clinical variables and two biomarkers to 'rule in' and 'rule out' ACS. However, one of the two biomarkers (heart-type fatty acid bindingprotein, H-FABP) is not widely used so a revised decision aid has been developed (Troponin-only Manchester Acute Coronary Syndromes, T-MACS), which include a single biomarker hs-cTnT...
March 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28300527/the-development-of-an-evacuation-protocol-for-patients-with-ventricular-assist-devices-during-a-disaster
#19
Katherine J Davis, Joseph Suyama, Jennifer Lingler, Michael Beach
Introduction Health care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster. METHODS: This is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol...
March 16, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28297059/preoperative-ultrasound-still-valuable-for-radio-cephalic-arteriovenous-fistula-creation
#20
Jernej Pajek, Marko Malovrh
Radio-cephalic arteriovenous fistula is a prototype hemodialysis access with small incidences of infection and distal ischemia, it spares proximal veins for future access use and it helps in the maturation of veins that may be used for more proximal access creations. This access type is prone to higher early failure rates compared to more proximal fistulas and there are unsolved uncertainties regarding exact ultrasound parameters predictive of fistula outcome. Evolution of ultrasound use has yielded several functional parameters that can be measured in addition to anatomical lumen sizes, which remain core parameters on which the decision to construct fistula in radio-cephalic forearm position is based...
March 6, 2017: Journal of Vascular Access
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