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https://www.readbyqxmd.com/read/28551862/delivery-of-community-based-care-through-inter-professional-teams-in-brazil-s-unified-health-system-uhs-comparing-perceptions-across-community-health-agents-chas-nurses-and-physicians
#1
Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta, Melanie M Wall
Given the shortage of medical providers and the need for medical decisions to be responsive to community needs, including lay health providers in health teams has been recommended as essential for the successful management of global health care systems. Brazil's Unified Health System (UHS) is a model for delivering community-based care through Family Health Strategy (FHS) interdisciplinary teams comprised of medical and lay health providers-Community Health Agents (CHAs), nurses, and physicians. This study aims to understand how medical and lay health providers' perceptions and attitudes could impact the delivery of community-based care...
May 27, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28551536/decision-making-in-irrigation-networks-selecting-appropriate-canal-structures-using-multi-attribute-decision-analysis
#2
Zeinab Hosseinzade, Sheree A Pagsuyoin, Kumaraswamy Ponnambalam, Mohammad J Monem
The stiff competition for water between agriculture and non-agricultural production sectors makes it necessary to have effective management of irrigation networks in farms. However, the process of selecting flow control structures in irrigation networks is highly complex and involves different levels of decision makers. In this paper, we apply multi-attribute decision making (MADM) methodology to develop a decision analysis (DA) framework for evaluating, ranking and selecting check and intake structures for irrigation canals...
May 25, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28551325/predictors-of-overall-and-recurrence-free-survival-after-neoadjuvant-chemotherapy-for-gastroesophageal-adenocarcinoma-pooled-analysis-of-individual-patient-data-ipd-from-randomized-controlled-trials-rcts
#3
U Ronellenfitsch, M Schwarzbach, R Hofheinz, P Kienle, K Nowak, M Kieser, T E Slanger, B Burmeister, D Kelsen, D Niedzwiecki, C Schuhmacher, S Urba, C van de Velde, T N Walsh, M Ychou, K Jensen
BACKGROUND: Neoadjuvant chemotherapy improves prognosis of patients with locally advanced gastroesophageal adenocarcinoma. The aim of this study was to identify predictors for postoperative survival following neoadjuvant therapy. These could be useful in deciding about postoperative continuation of chemotherapy. METHODS: This meta-analysis used IPD from RCTs comparing neoadjuvant chemotherapy with surgery alone for gastroesophageal adenocarcinoma. Trials providing IPD on age, sex, performance status, pT/N stage, resection status, overall and recurrence-free survival were included...
May 18, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28551278/reducing-construction-waste-a-study-of-urban-infrastructure-projects
#4
REVIEW
Ruane Fernandes de Magalhães, Ângela de Moura Ferreira Danilevicz, Tarcisio Abreu Saurin
The construction industry is well-known for producing waste detrimental to the environment, and its impacts have increased with the development process of cities. Although there are several studies focused on the environmental impact of residential and commercial buildings, less knowledge is available regarding decreasing construction waste (CW) generation in urban infrastructure projects. This study presents best practices to reduce waste in the said projects, stressing the role of decision-making in the design stage and the effective management of construction processes in public sector...
May 24, 2017: Waste Management
https://www.readbyqxmd.com/read/28551110/the-pattern-of-cervical-lymph-node-metastasis-in-thoracic-esophageal-squamous-cell-carcinoma-may-affect-the-target-decision-for-definitive-radiotherapy
#5
Junqiang Chen, WenJie Cai, Xiongwei Zheng, Yuanmei Chen, Yu Lin, Xiaohui Chen, Kunshou Zhu, Chuanben Chen
BACKGROUND: Metastasis to lymph nodes is a key determinant of thoracic esophageal squamous cell carcinoma (TE-SCC) prognosis. We sought to identify factors linked with cervical lymph node metastasis, which could be used to inform the decision of surgical and definitive radiotherapy. METHODS: We retrospectively reviewed records from 1715 patients who had had radical esophagectomy with three-field lymphadenectomy between January 1993 and March 2007 in our hospital...
May 24, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28551035/examining-the-role-of-patient-values-in-decisions-about-long-term-enteral-feeding-a-qualitative-study
#6
Sean White, Louise Brereton
BACKGROUND & AIMS: Although studies demonstrate the range of impacts of home enteral feeding (HEF) on patients' lives, a dearth of evidence focussing on the decision to have a gastrostomy placed exists. The importance of taking account of patient values (i.e. their unique preferences, concerns and expectations) when considering the consequences of clinical decisions is increasingly recognised. This study explores patient's views on the role of their values in their decision to have a gastrostomy...
May 6, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28551002/development-of-a-computer-interpretable-clinical-guideline-model-for-decision-support-in-the-differential-diagnosis-of-hyponatremia
#7
Arturo González-Ferrer, M Ángel Valcárcel, Martín Cuesta, Joan Cháfer, Isabelle Runkle
INTRODUCTION: Hyponatremia is the most common type of electrolyte imbalance, occurring when serum sodium is below threshold levels, typically 135mmol/L. Electrolyte balance has been identified as one of the most challenging subjects for medical students, but also as one of the most relevant areas to learn about according to physicians and researchers. We present a computer-interpretable guideline (CIG) model that will be used for medical training to learn how to improve the diagnosis of hyponatremia applying an expert consensus document (ECDs)...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550986/acute-deep-infections-of-the-upper-extremity-the-utility-of-obtaining-atypical-cultures-in-the-presence-of%C3%A2-purulence
#8
Nikolas H Kazmers, George W Fryhofer, Daniel Gittings, David J Bozentka, David R Steinberg, Benjamin L Gray
PURPOSE: In the setting of acute deep upper extremity infections, evidence is lacking to guide the decision whether to send atypical cultures (fungal and acid-fast-bacillus [AFB]) during surgical debridement, especially in the presence of purulent fluid that is commonly observed with typical bacterial infections. Our purpose was to determine the frequency of positive atypical cultures and the frequency with which they alter treatment, and identify factors associated with positive atypical cultures...
May 25, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28550920/neural-network-prediction-of-severe-lower-intestinal-bleeding-and-the-need-for-surgical-intervention
#9
Tyler J Loftus, Scott C Brakenridge, Chasen A Croft, Robert Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Janeen R Jordan
BACKGROUND: The prognosis for patients with severe acute lower intestinal bleeding (ALIB) may be assessed by complex artificial neural networks (ANNs) or user-friendly regression-based models. Comparisons between these modalities are limited, and predicting the need for surgical intervention remains elusive. We hypothesized that ANNs would outperform the Strate rule to predict severe bleeding and would also predict the need for surgical intervention. METHODS: We performed a 4-y retrospective analysis of 147 adult patients who underwent endoscopy, angiography, or surgery for ALIB...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550909/readability-complexity-and-suitability-of-online-resources-for-mastectomy-and-lumpectomy
#10
Bao Ngoc N Tran, Mansher Singh, Dhruv Singhal, Rima Rudd, Bernard T Lee
BACKGROUND: Nearly half of American adults have low or marginal health literacy. This negatively affects patients' participation, decision-making, satisfaction, and overall outcomes especially when there is a mismatch between information provided and the skills of the intended audience. Recommendations that patient information be written below the sixth grade level have been made for over three decades. This study compares online resources for mastectomy versus lumpectomy using expanded metrics including readability level, complexity, and density of data and overall suitability for public consumption...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550798/sediment-quality-in-a-metal-contaminated-tropical-bay-assessed-with-a-multiple-lines-of-evidence-approach
#11
Sarah K Rodrigues, Denis M S Abessa, Ana Paula de C Rodrigues, Abílio Soares-Gomes, Carolina B Freitas, Ricardo E Santelli, Aline S Freire, Wilson Machado
A sediment quality assessment was performed near to the main industrial source of metal contamination in Sepetiba Bay, Brazil, which represents one of the worst cases of trace metal contamination reported for coastal areas. Acute and chronic toxicity tests, benthic fauna community analysis and metal bioavailability evaluations were applied to identify risks to the benthic community. Significant amphipod mortality was observed close to the major pollution source and lower copepod fertility was observed for all stations...
May 24, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28550592/certolizumab-pegol-for-treating-rheumatoid-arthritis-following-inadequate-response-to-a-tnf-%C3%AE-inhibitor-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#12
REVIEW
Iñigo Bermejo, Matt Stevenson, Rachel Archer, John W Stevens, Edward Goka, Mark Clowes, David L Scott, Adam Young
As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (UCB Pharma) of certolizumab pegol (CZP; Cimzia(®)) to submit evidence of its clinical and cost effectiveness for the treatment of rheumatoid arthritis (RA) following inadequate response to a tumour necrosis factor-α inhibitor (TNFi). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
May 26, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28550406/statistical-shape-modelling-to-aid-surgical-planning-associations-between-surgical-parameters-and-head-shapes-following-spring-assisted-cranioplasty
#13
Naiara Rodriguez-Florez, Jan L Bruse, Alessandro Borghi, Herman Vercruysse, Juling Ong, Greg James, Xavier Pennec, David J Dunaway, N U Owase Jeelani, Silvia Schievano
PURPOSE: Spring-assisted cranioplasty is performed to correct the long and narrow head shape of children with sagittal synostosis. Such corrective surgery involves osteotomies and the placement of spring-like distractors, which gradually expand to widen the skull until removal about 4 months later. Due to its dynamic nature, associations between surgical parameters and post-operative 3D head shape features are difficult to comprehend. The current study aimed at applying population-based statistical shape modelling to gain insight into how the choice of surgical parameters such as craniotomy size and spring positioning affects post-surgical head shape...
May 26, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28550393/interval-magnetic-resonance-imaging-an-alternative-to-guidelines-for-indeterminate-nodules-discovered-in-the-cirrhotic-liver
#14
Eliza W Beal, Joseph F Kearney, Jeffery M Chakedis, A James Hanje, Lanla F Conteh, Sylvester M Black, Kenneth Washburn, Kristin M Dittmar, Timothy M Pawlik, Mary R Dillhoff, Carl R Schmidt
BACKGROUND: Current guidelines for the management of indeterminate nodules discovered on surveillance imaging recommend alternate imaging modality or biopsy. This study evaluates the use of short interval MRI rather than immediate CT or biopsy. METHOD: This retrospective cohort study examines outcomes of 111 patients with indeterminate nodules reviewed by a single institution's Liver Tumor Board 2011-2016. Analysis was focused on outcomes stratified by management decision...
May 26, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28550383/-you-can-carry-the-torch-now-a-qualitative-analysis-of-parents-experiences-caring-for-a-child-with-trisomy-13-or-18
#15
Joshua D Arthur, Divya Gupta
Trisomy 13 and 18 (T 13/18) are rare chromosomal abnormalities associated with high morbidity and mortality. Improved survival rates and increased prevalence of aggressive medical intervention have resulted in families and physicians holding different perspectives regarding the appropriate management of children with T 13/18. Families were invited for open-ended interviews regarding their experiences with the medical care of a child with T 13/18 over the past 5 years. Seven of 33 invited families were surveyed; those who had spent more than 40 days in the hospital were most likely to accept the invitation (OR 8...
May 26, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28550055/potential-drug-interactions-mediated-by-renal-organic-anion-transporter-oatp4c1
#16
Toshihiro Sato, Eikan Mishima, Nariyasu Mano, Takaaki Abe, Hiroaki Yamaguchi
OATP4C1 is an organic anion transporter expressed in the basolateral membrane of the renal proximal tubules. It plays a major role in the urinary excretion of both exogenous drugs and endogenous compounds. Our previous studies have indicated the importance of OATP4C1 in pathological and physiological conditions; however, the majority of its pharmacological characteristics remained unclear. Therefore, to provide essential information for clinical drug therapy decisions and drug development, we, in this study, attempted to clarify drug interactions mediated by OATP4C1...
May 26, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28550028/the-impact-of-a-hepatobiliary-multidisciplinary-team-assessment-in-patients-with-colorectal-cancer-liver-metastases-a-population-based-study
#17
Jennie Engstrand, Nikolaos Kartalis, Cecilia Strömberg, Mats Broberg, Anna Stillström, Tobias Lekberg, Eduard Jonas, Jacob Freedman, Henrik Nilsson
BACKGROUND: Assessing patients with colorectal cancer liver metastases (CRCLM) by a liver multidisciplinary team (MDT) results in higher resection rates and improved survival. The aim of this study was to evaluate the potentially improved resection rate in a defined cohort if all patients with CRCLM were evaluated by a liver MDT. PATIENTS AND METHODS: A retrospective analysis of patients diagnosed with colorectal cancer during 2008 in the greater Stockholm region was conducted...
May 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28550002/public-response-to-obamacare-on-twitter
#18
Matthew A Davis, Kai Zheng, Yang Liu, Helen Levy
BACKGROUND: The Affordable Care Act (ACA), often called "Obamacare," is a controversial law that has been implemented gradually since its enactment in 2010. Polls have consistently shown that public opinion of the ACA is quite negative. OBJECTIVE: The aim of our study was to examine the extent to which Twitter data can be used to measure public opinion of the ACA over time. METHODS: We prospectively collected a 10% random sample of daily tweets (approximately 52 million since July 2011) using Twitter's streaming application programming interface (API) from July 10, 2011 to July 31, 2015...
May 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28549742/a-qualitative-exploratory-study-of-nurses-decision-making-when-interrupted-during-medication-administration-within-the-paediatric-intensive-care-unit
#19
Rachel A Bower, Jane E Coad, Joseph C Manning, Theresa A Pengelly
OBJECTIVE: In the paediatric intensive care unit (PICU), medication administration is challenging. Empirical studies demonstrate that interruptions occur frequently and that nurses are fundamental in the delivery of medication. However, little is known about nurse's decision making when interrupted during medication administration. Therefore, the objective is to understand decision making when interrupted during medication administration within the PICU. RESEARCH DESIGN: A qualitative study incorporating non-participant observation and audio recorded semi-structured interviews...
May 23, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28549467/the-prediction-diagnosis-and-management-of-complications-in-monochorionic-twin-pregnancies-the-ommit-optimal-management-of-monochorionic-twins-study
#20
Fiona L Mackie, R Katie Morris, Mark D Kilby
BACKGROUND: Monochorionic twin pregnancies are at increased risk of complications due to sharing a single placenta and potentially developing unbalanced vascular anastomoses. Complications include twin-twin transfusion syndrome (TTTS) which affects 10-15% monochorionic twins, and if untreated has a 70-90% perinatal loss rate. We are currently unable to predict which twins will develop complications or to what severity. We have previously shown differences in angiogenic and placental growth factors in maternal blood in pregnancies complicated by TTTS compared to twin pregnancies not complicated by TTTS but matched for gestation...
May 26, 2017: BMC Pregnancy and Childbirth
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