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https://www.readbyqxmd.com/read/27925274/supplementation-of-a-clinical-trial-by-historical-control-data-is-the-prospect-of-dynamic-borrowing-an-illusion
#1
N W Galwey
There are strong arguments, ethical, logistical and financial, for supplementing the evidence from a new clinical trial using data from previous trials with similar control treatments. There is a consensus that historical information should be down-weighted or discounted relative to information from the new trial, but the determination of the appropriate degree of discounting is a major difficulty. The degree of discounting can be represented by a bias parameter with specified variance, but a comparison between the historical and new data gives only a poor estimate of this variance...
December 7, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27925142/dg-connect-funded-projects-on-information-and-communication-technologies-ict-for-old-age-people-beyond-silos-carewell-and-smartcare
#2
W Keijser, E de Manuel-Keenoy, M d'Angelantonio, P Stafylas, P Hobson, G Apuzzo, M Hurtado, J Oates, J Bousquet, A Senn
Information and communication technologies (ICT) are promising for the long-term care of older and frequently frail people. These innovations can improve health outcomes, quality of life and efficiency of care processes, while supporting independent living. However, they may be disruptive innovations. As all European member states are facing an increasing complexity of health and social care, good practices in ICT should be identified and evaluated. Three projects funded by DG CNECT are related to Active and Healthy Ageing (AHA) and frailty: (i) BeyondSilos, dealing with independent living and integrated services, (ii) CareWell, providing integrated care coordination, patient empowerment and home support and (iii) SmartCare, proposing a common set of standard functional specifications for an ICT platform enabling the delivery of integrated care to older patients...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27923860/using-a-domestic-and-sexual-violence-prevention-advocate-to-implement-a-dating-violence-prevention-program-with-athletes
#3
M C D Jaime, M Stocking, K Freire, L Perkinson, S Ciaravino, E Miller
'Coaching Boys into Men' is an evidence-based dating violence prevention program for coaches to implement with male athletes. A common adaptation of this program is delivery by domestic violence and sexual violence prevention advocates instead of coaches. We explored how this implementer adaptation may influence athlete uptake of program messages and outcomes. Randomly, one school received the program delivered by an advocate while another school received the program delivered by coaches. Athletes completed baseline and follow-up surveys (n = 148), and a subset who received the advocate-led program participated in focus groups (four groups; n = 26)...
December 2016: Health Education Research
https://www.readbyqxmd.com/read/27923091/association-between-learning-environment-interventions-and-medical-student-well-being-a-systematic-review
#4
Lauren T Wasson, Amberle Cusmano, Laura Meli, Irene Louh, Louise Falzon, Meghan Hampsey, Geoffrey Young, Jonathan Shaffer, Karina W Davidson
Importance: Concerns exist about the current quality of undergraduate medical education and its effect on students' well-being. Objective: To identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Data Sources: Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and ERIC from database inception dates to October 2016...
December 6, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27922995/integrating-preventive-cardiovascular-healthcare-into-home-health-a-pilot-study
#5
Janet R Lynch, Cynthia K Sun, Stacie Deslich
The viability of measuring and integrating preventive cardiovascular care into home healthcare was investigated through a pilot study fielded during 2013 and 2014. The study tested the feasibility of using a data registry to measure preventive cardiovascular care delivered in home healthcare, examined opportunities for quality improvement, and looked at the association between exposure to evidence-based tools and improvement in aspirin use and blood pressure screening and control among a convenience sample of 20 agencies...
January 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/27922876/mothers-weaning-practices-when-infants-breastfeed-for-more-than-one-year
#6
Addie Cunniff, Diane Spatz
The American Academy of Pediatrics and the World Health Organization recommend that infants receive human milk exclusively for the first 6 months of life and that breastfeeding continue beyond the first or second year of life for as long as a family deems appropriate. More infants in the United States and around the world are meeting this recommendation. As more infants breastfeed beyond the first year of life, best practices for weaning toddlers come into question. Little is known about concerns and practices of breastfeeding mothers weaning their children from feedings...
December 5, 2016: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/27922563/-sign-here-nursing-value-and-the-process-of-informed-consent
#7
Wesley E Cook
Protecting patient autonomy is a key nursing role. The Code of Ethics (American Nurses Association, 2010), contextualizes the nurse's call to advocacy within the doctrine of informed consent. This article offers a primer on the legal, ethical, and practical aspects of procedural informed consent and examines the value of nursing's role within the process. The theory of nursing's value is sound, but the literature lacks data. Higher levels of evidence are necessary to make sound decisions about best practice for the process of informed consent...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27922462/fostering-evidence-based-quality-improvement-for-patient-centered-medical-homes-initiating-local-quality-councils-to-transform-primary-care
#8
Susan E Stockdale, Jessica Zuchowski, Lisa V Rubenstein, Negar Sapir, Elizabeth M Yano, Lisa Altman, Jacqueline J Fickel, Skye McDougall, Timothy Dresselhaus, Alison B Hamilton
BACKGROUND: Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation...
December 3, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27921195/new-developments-in-the-pharmacodynamics-and-pharmacokinetics-of-combination-of-chinese-medicine-and-western-medicine
#9
REVIEW
Di Liu, Xiao-Chun Liang
It is very common to use Chinese medicine (CM) combined with Western medicine (WM) in clinical practice. The appropriate combination of CM with WM can reduce toxicity and enhance effects in order to make the best use of advantages and bypass the disadvantages. However, an inappropriate combination can not only affect the curative effect but even cause death. Therefore, strengthening the complementary advantages of the CM and WM to improve the therapeutic efficacy and reduce side effects has become an important research topic of clinical medicine and pharmacy...
December 5, 2016: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/27920164/epistemic-injustice-in-healthcare-encounters-evidence-from-chronic-fatigue-syndrome
#10
Charlotte Blease, Havi Carel, Keith Geraghty
Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker's concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of treatments...
December 5, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27919864/taxonomy-for-the-rehabilitation-of-knee-conditions-trak-a-digital-intervention-to-support-the-self-care-components-of-anterior-cruciate-ligament-rehabilitation-protocol-of-a-feasibility-study
#11
Emma Dunphy, Fiona L Hamilton, Kate Button
BACKGROUND: Rupture of the anterior cruciate ligament (ACL) is common, especially in the active population. In defining the problem of ACL rehabilitation, this study draws from the knowledge that improved self-care, strength, and fitness are associated with better outcomes. Traditional rehabilitation involves regular physiotherapy, but it is not clear what the optimal way for delivering rehabilitation is, and it varies widely across the world. Evidence for treatments are discussed in the literature, however standard length of rehabilitation and frequency of appointments are unknown...
December 5, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27918399/the-evolution-of-the-new-provider-team-driving-cultural-change-through-data
#12
Trish Anen, Debra McElroy
Nursing executives are continually challenged to address a rapidly evolving health care system. Every aspect of care delivery is being scrutinized, yet the constant requirement remains assurance of high-quality, highly reliable care that is cost-effective and easily accessible. The nursing workforce remains visible in traditional roles as well as in new and innovative capacities, whereas nurse executives experience expanded realms of focus and responsibility. As health systems continue to adapt to the changing environment, the ability to leverage the role and scope of the advanced practice registered nurse (APRN) as a health care provider is emerging as an essential business and care strategy...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918253/placental-growth-factor-alone-or-in-combination-with-soluble-fms-like-tyrosine-kinase-1-as-an-aid-to-the-assessment-of-women-with-suspected-pre-eclampsia-systematic-review-and-economic-analysis
#13
Geoff K Frampton, Jeremy Jones, Micah Rose, Liz Payne
BACKGROUND: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27917777/the-identification-and-treatment-of-women-with-hyperglycaemia-in-pregnancy-an-analysis-of-individual-participant-data-systematic-reviews-meta-analyses-and-an-economic-evaluation
#14
Diane Farrar, Mark Simmonds, Susan Griffin, Ana Duarte, Debbie A Lawlor, Mark Sculpher, Lesley Fairley, Su Golder, Derek Tuffnell, Martin Bland, Fidelma Dunne, Donald Whitelaw, John Wright, Trevor A Sheldon
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with a higher risk of important adverse outcomes. Practice varies and the best strategy for identifying and treating GDM is unclear. AIM: To estimate the clinical effectiveness and cost-effectiveness of strategies for identifying and treating women with GDM. METHODS: We analysed individual participant data (IPD) from birth cohorts and conducted systematic reviews to estimate the association of maternal glucose levels with adverse perinatal outcomes; GDM prevalence; maternal characteristics/risk factors for GDM; and the effectiveness and costs of treatments...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27917759/south-african-guidelines-excellence-sage-adopt-adapt-or-contextualise
#15
J M Dizon, K Grimmer, Q Louw, T Kredo, T Young, S Machingaidze
Clinical practice guideline (CPG) activities must be planned carefully for efficient use of available resources and evidence-based implementation. De novo development of CPGs may sometimes 'recreate the wheel' and delay implementation. Three innovative alternatives to de novo CPG development (adopt, contextualise or adapt) are outlined, which have greater potential than de novo development to best use the limited available resources, personnel and time in settings such as South Africa.
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917465/warm-reactive-immunoglobulin-g-autoantibodies-and-laboratory-testing-best-practices-review-of-the-literature-and-survey-of-current-practice
#16
REVIEW
Alyssa Ziman, Claudia Cohn, Patricia M Carey, Nancy M Dunbar, Mark K Fung, Andreas Greinacher, Simon Stanworth, Nancy M Heddle, Meghan Delaney
BACKGROUND: Warm-reactive autoantibodies (WAAs) are the most common cause of autoimmune hemolytic anemia (AIHA) and can also be present without clinically significant hemolysis. WAAs complicate immunohematological testing, yet there is no commonly accepted approach to laboratory evaluation and red blood cell (RBC) selection. STUDY DESIGN AND METHODS: We searched PubMed/Cochrane Central for articles that described testing methodology and blood selection for patients with WAAs...
December 4, 2016: Transfusion
https://www.readbyqxmd.com/read/27916431/2016-scct-str-guidelines-for-coronary-artery-calcium-scoring-of-noncontrast-noncardiac-chest-ct-scans-a-report-of-the-society-of-cardiovascular-computed-tomography-and-society-of-thoracic-radiology
#17
Harvey S Hecht, Paul Cronin, Michael J Blaha, Matthew J Budoff, Ella A Kazerooni, Jagat Narula, David Yankelevitz, Suhny Abbara
The Society of Cardiovascular Computed Tomography (SCCT) and the Society of Thoracic Radiology (STR) have jointly produced this document. Experts in this subject have been selected from both organizations to examine subject-specific data and write this guideline in partnership. A formal literature review, weighing the strength of evidence has been performed. When available, information from studies on cost was considered. Computed tomography (CT) acquisition, CAC scoring methodologies and clinical outcomes are the primary basis for the recommendations in this guideline...
November 10, 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27914277/accurate-assessment-of-the-weight-of-evidence-for-dna-mixtures-by-integrating-the-likelihood-ratio
#18
Klaas Slooten
Several methods exist for weight of evidence calculations on DNA mixtures. Especially if dropout is a possibility, it may be difficult to estimate mixture specific parameters needed for the evaluation. For semi-continuous models, the LR for a person to have contributed to a mixture depends on the specified number of contributors and the probability of dropout for each. We show here that, for the semi-continuous model that we consider, the weight of evidence can be accurately obtained by applying the standard statistical technique of integrating the likelihood ratio against the parameter likelihoods obtained from the mixture data...
November 16, 2016: Forensic Science International. Genetics
https://www.readbyqxmd.com/read/27911597/evidence-based-psychosocial-treatments-for-pediatric-elimination-disorders
#19
Jaclyn A Shepard, Joseph E Poler, Jesse H Grabman
Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis...
December 2, 2016: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#20
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
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