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https://www.readbyqxmd.com/read/29222229/visual-aids-for-patient-family-and-physician-decision-making-about-endovascular-thrombectomy-for-acute-ischemic-stroke
#1
Ivie Tokunboh, Marta Vales Montero, Matheus Fellipe Zopelaro Almeida, Latisha Sharma, Sidney Starkman, Viktor Szeder, Reza Jahan, David Liebeskind, Nestor Gonzalez, Andrew Demchuk, Michael T Froehler, Mayank Goyal, Maarten G Lansberg, Helmi Lutsep, Lee Schwamm, Jeffrey L Saver
BACKGROUND AND PURPOSE: Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential outcomes and can accelerate decision processes. METHODS: From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of endovascular thrombectomy for patients with acute cerebral ischemia and large vessel occlusion using (1) automated (algorithmic) and (2) expert-guided joint outcome table specification...
December 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29221976/modeling-patient-specific-deformable-mitral-valves
#2
REVIEW
Olivia Ginty, John Moore, Terry Peters, Daniel Bainbridge
Medical imaging has advanced enormously over the last few decades, revolutionizing patient diagnostics and care. At the same time, additive manufacturing has emerged as a means of reproducing physical shapes and models previously not possible. In combination, they have given rise to 3-dimensional (3D) modeling, an entirely new technology for physicians. In an era in which 3D imaging has become a standard for aiding in the diagnosis and treatment of cardiac disease, this visualization now can be taken further by bringing the patient's anatomy into physical reality as a model...
September 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29219872/effectiveness-of-decision-aids-on-smoking-cessation-in-adult-patients-a-systematic-review-protocol
#3
Fernea Moyo, Ella Archibald, Jason T Slyer
The objective of this review is to determine the effectiveness of the use of decision aids in a shared decision-making encounter between any healthcare provider and adult patients who smoke, compared to standard education on smoking cessation, in any healthcare setting.Specifically, the review questions are: What is the effectiveness of the use of decision aids in a shared decision-making encounter in any healthcare setting between the healthcare provider and adult patients who smoke compared to standard education, based on the patient's...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29218819/a-conceptual-model-of-the-risk-of-elder-abuse-posed-by-incontinence-and-care-dependence
#4
Joan Ostaszkiewicz
AIMS AND OBJECTIVES: To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. BACKGROUND: Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care...
December 8, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#5
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218777/decision-making-in-pediatric-hematopoietic-cell-transplantation-influential-factors-vary-among-diseases
#6
REVIEW
Ginny L Schulz, Katherine P Kelly, Megan Holtmann, Michelle M Doering, Jane M Armer
Hematopoietic cell transplantation (HCT) is not a trivial treatment decision in pediatrics. We sought to understand what influences this decision-making process from the perspectives of the pediatric patients, their family, and physicians. Using integrative review methods, we identified 19 relevant studies: six qualitative, ten quantitative, and three mixed methods. Synthesis of the results revealed six themes describing patient, family, and provider decision-making processes with distinct subthemes contrasting influential factors among malignant and nonmalignant diseases...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29218267/radiomics-in-precision-medicine-for-lung-cancer
#7
REVIEW
Julie Constanzo, Lise Wei, Huan-Hsin Tseng, Issam El Naqa
With the improvement of external radiotherapy delivery accuracy, such as intensity-modulated and stereotactic body radiation therapy, radiation oncology has recently entered in the era of precision medicine. Despite these precise irradiation modalities, lung cancers remain one of the most aggressive human cancers worldwide, possibly because of diverse genotypic alterations that drive and maintain lung tumorigenesis. It has been long recognized that imaging could aid in the diagnosis, tumor delineation, and monitoring of lung cancer...
December 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/29212765/changes-in-the-fluid-volume-balance-between-intra-and-extracellular-water-in-a-sample-of-japanese-adults-aged-15-88-years-old-a-cross-sectional-study
#8
Yasushi Ohashi, Nobuhiko Joki, Keisuke Yamazaki, Takeshi Kawamura, Reibin Tai, Hideyo Oguchi, Rena Yuasa, Ken Sakai
The fluid volume balance between intracellular water (ICW) and extracellular water (ECW) gradually changes with age and various medical conditions. Comprehension of these physiological changes would aid in clinical decision-making related to body fluid assessments. A total of 1,992 individuals (753 men and 1,239 women) aged ≥15 years included in this study had their body composition measurements performed at training gyms in 2014. We developed a regression formula to assess the association of age with the ratio of ECW to ICW in these subjects...
December 6, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29212699/rapid-microarray-based-detection-of-rifampicin-isoniazid-and-fluoroquinolone-resistance-in-mycobacterium-tuberculosis-using-a-single-cartridge
#9
Juliane Havlicek, Beatrice Dachsel, Peter Slickers, Sönke Andres, Patrick Beckert, Silke Feuerriegel, Stefan Niemann, Matthias Merker, Ines Labugger
Rapid and robust identification of mutations in Mycobacterium tuberculosis complex (MTBC) strains mediating multidrug and extensively drug-resistant (M/XDR) phenotypes is crucial to combat the MDR tuberculosis (TB) epidemic. Currently available molecular TB drug susceptibility tests are either restricted to single targets/drugs (i.e. Xpert MTB/RIF) or aid the risk of cross-contaminations due to the design limitations of the open platform (i.e. line probe assays).With a good understanding of the technical and commercial boundaries we designed a test cartridge with an introduction of dried reagents, based on an oligonucleotide array, which has the ability to identify MTBC strains resistant to isoniazid, rifampicin and the fluoroquinolones...
December 6, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29212487/recognizing-difficult-trade-offs-values-and-treatment-preferences-for-end-of-life-care-in-a-multi-site-survey-of-adult-patients-in-family-practices
#10
Michelle Howard, Nick Bansback, Amy Tan, Doug Klein, Carrie Bernard, Doris Barwich, Peter Dodek, Aman Nijjar, Daren K Heyland
BACKGROUND: Decisions about care options and the use of life-sustaining treatments should be informed by a person's values and treatment preferences. The objective of this study was to examine the consistency of ratings of the importance of the values statements and the association between values statement ratings and the patient's expressed treatment preference. METHODS: We conducted a multi-site survey in 20 family practices. Patients aged 50 and older self-completed a questionnaire assessing the importance of eight values (rated 1 to 10), and indicated their preference for use of life-sustaining treatment (5 options)...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29212475/implementation-of-shared-decision-making-in-oncology-development-and-pilot-study-of-a-nurse-led-decision-coaching-programme-for-women-with-ductal-carcinoma-in-situ
#11
Birte Berger-Höger, Katrin Liethmann, Ingrid Mühlhauser, Anke Steckelberg
BACKGROUND: To implement informed shared decision-making (ISDM) in breast care centres, we developed and piloted an inter-professional complex intervention. METHODS: We developed an intervention consisting of three components: an evidence-based patient decision aid (DA) for women with ductal carcinoma in situ, a decision-coaching led by specialised nurses (breast care nurses and oncology nurses) and structured physician encounters. In order to enable professionals to gain ISDM competencies, we developed and tested a curriculum-based training programme for specialised nurses and a workshop for physicians...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29211861/spontaneous-microguidewire-extrusion-from-the-foot-following-cerebral-aneurysm-treatment-first-case-report
#12
Kurdow Nader, Saleh Lamin, Joseph Leyon, Swarupsinh Chavda, Allan Thomas, Sarin Kuruvath
BACKGROUND AND IMPORTANCE: Microguidewire entrapment and failure related to endovascular therapy is a rare complication with limited case reports available, most of which are from cardiac endovascular intervention. Migration of the microguidewire has been reported in coronary intervention with some resulting in severe complications, but there are no reported cases of spontaneous extrusion of wire fragment following a neurointerventional procedure. We report the first case of a microguidewire entrapment with subsequent fracture, followed by spontaneous extrusion of the wire fragment...
November 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29210892/physiologically-triggered-digital-cognitive-aid-facilitates-crisis-management-in-a-simulated-operating-room-a-randomized-controlled-study
#13
Jonathan Lipps, Lori Meyers, Scott Winfield, Michael Durda, Vedat Yildiz, Michael Kushelev
INTRODUCTION: Although the benefits of using cognitive aids in anesthesia care have previously been demonstrated, several challenges remain. It must be presented in a timely manner, and providers must be amenable to using the tool once it is available. We hypothesized that anesthesia residents would perform superiorly when presented with a digital cognitive aid (DCogA) that is automatically triggered by a set vital sign aberration. METHODS: Thirty anesthesia residents were randomized to either control (with access to hard copy of the cognitive aid) or receive a DCogA projected on their anesthesia information management system with the onset of heart block and associated hypotension...
November 28, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29209897/adaptation-of-couples-living-with-a-high-risk-of-breast-ovarian-cancer-and-the-association-with-risk-reducing-surgery
#14
Rachel Shapira, Erin Turbitt, Lori H Erby, Barbara B Biesecker, William M P Klein, Gillian W Hooker
Women who carry BRCA1/2 mutations have a significantly elevated risk for breast and ovarian cancer. The positive test result and subsequent decisions about risk reducing behaviors can evoke distress, anxiety and worry. Psychological adaptation, or the process of coming to terms with the implications of a health threat, is an understudied construct in BRCA1/2 carriers. Little is known about adaptation and how it relates to other aspects of living at high risk for cancer. Even less is understood about adaptation among partners of BRCA1/2 carriers, and its relationship to adaptation in high risk individuals...
December 5, 2017: Familial Cancer
https://www.readbyqxmd.com/read/29206816/optimizing-selection-of-biologics-in-inflammatory-bowel-disease-development-of-an-online-patient-decision-aid-using-conjoint-analysis
#15
Christopher V Almario, Michelle S Keller, Michelle Chen, Karen Lasch, Lyann Ursos, Julia Shklovskaya, Gil Y Melmed, Brennan M R Spiegel
OBJECTIVES: Recent drug approvals have increased the availability of biologic therapies for inflammatory bowel disease (IBD), making it difficult for patients with ulcerative colitis (UC) and Crohn's disease (CD) to navigate treatment options. Here we developed a conjoint analysis to examine patient decision-making surrounding biologic medicines for IBD. We used the results to create an online patient decision aid that generates a unique "preferences report" for each patient to assist with shared decision-making with their provider...
December 5, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29206702/challenges-in-clarifying-goals-of-care-in-patients-with-advanced-heart-failure
#16
Patricia H Strachan, Jennifer Kryworuchko, Lin Li
PURPOSE OF REVIEW: Patients with advanced heart failure require communication about goals of care, yet many challenges exist, leaving it suboptimal. High mortality rates and advances in the use of life-sustaining technology further complicate communication and underscore the urgency to understand and address these challenges. This review highlights current research with a view to informing future research and practice to improve goals of care communication. RECENT FINDINGS: Clinicians view patient and family barriers as more impactful than clinician and system factors in impeding goals of care discussions...
November 27, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29205753/prognostic-significance-of-pre-operative-inflammatory-markers-in-resected-gallbladder-cancer-a-systematic-review
#17
REVIEW
Rukhtam Saqib, Samir Pathak, Neil Smart, Quentin Nunes, Jonathan Rees, Margaret Finch Jones, Graeme Poston
BACKGROUND: Neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP) and Glasgow Prognostic Score (GPS) have demonstrated good prognostic value in several cancers but their role in gallbladder cancer (GBC) remains unclear. The aim of this study is to systematically review the current literature to determine their role in predicting survival outcomes in GBC. METHODS: Using a pre-specified inclusive search strategy MEDLINE, EMBASE and CINAHL databases were used to identify studies describing survival in patients after GBC resection with high or low pre-operative CRP, GPS or NLR...
December 3, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29205242/refining-tools-to-bridge-the-gap-between-academia-and-chemical-regulation-perspectives-for-wikireach
#18
Marlene Ågerstrand, Mattheus Brenig, Martin Führ, Julian Schenten
Regulatory hazard and risk assessments of chemical substances have to include all reliable and relevant data to be credible and complete. However, screening the literature for appropriate studies and extracting data is burdensome. Therefore, reducing impediments by making data easily and readily accessible to risk assessors could result in more comprehensive hazard and risk assessments. In this paper, we study WikiPharma, a database that aggregates ecotoxicity data for pharmaceuticals, extracted from peer-reviewed studies...
December 5, 2017: Environmental Science. Processes & Impacts
https://www.readbyqxmd.com/read/29205100/role-of-cortical-auditory-evoked-potentials-in-reducing-the-age-at-hearing-aid-fitting-in-children-with-hearing-loss-identified-by-newborn-hearing-screening
#19
Kinjal Mehta, Peter Watkin, Margaret Baldwin, Josephine Marriage, Merle Mahon, Deborah Vickers
Recording of free-field cortical auditory evoked potential (CAEP) responses to speech tokens was introduced into the audiology management for infants with a permanent childhood hearing impairment (PCHI) during 2011-2015 at a U.K. service. Children with bilateral PCHI were studied from two sequential cohorts. Thirty-four children had followed an audiology pathway prior to CAEP introduction, and 44 children followed a pathway after the introduction of CAEP and were tested with unaided and aided CAEP responses...
January 2017: Trends in Hearing
https://www.readbyqxmd.com/read/29204293/validity-reliability-and-feasibility-of-commercially-available-activity-trackers-in-physical-therapy-for-people-with-a-chronic-disease-a-study-protocol-of-a-mixed-methods-research
#20
Emmylou Beekman, Susy M Braun, Darcy Ummels, Kim van Vijven, Albine Moser, Anna J Beurskens
Background: For older people and people with a chronic disease, physical activity provides health benefits. Patients and healthcare professionals can use commercially available activity trackers to objectively monitor (alterations in) activity levels and patterns and to support physical activity. However, insight in the validity, reliability, and feasibility of these trackers in people with a chronic disease is needed. In this article, a study protocol is described in which the validity, reliability (part A), and feasibility from a patient and therapist's point of view (part B) of commercially available activity trackers in daily life and health care is investigated...
2017: Pilot and Feasibility Studies
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