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https://www.readbyqxmd.com/read/28431138/cardiovascular-outcome-trials-in-patients-with-chronic-kidney-disease-challenges-associated-with-selection-of-patients-and-endpoints
#1
Patrick Rossignol, Rajiv Agarwal, Bernard Canaud, Alan Charney, Gilles Chatellier, Jonathan C Craig, William C Cushman, Ronald T Gansevoort, Bengt Fellström, Dahlia Garza, Nicolas Guzman, Frank A Holtkamp, Gerard M London, Ziad A Massy, Alexandre Mebazaa, Peter G M Mol, Marc A Pfeffer, Yves Rosenberg, Luis M Ruilope, Jonathan Seltzer, Amil M Shah, Salim Shah, Bhupinder Singh, Bergur V Stefánsson, Norman Stockbridge, Wendy Gattis Stough, Kristian Thygesen, Michael Walsh, Christoph Wanner, David G Warnock, Christopher S Wilcox, Janet Wittes, Bertram Pitt, Aliza Thompson, Faiez Zannad
Although cardiovascular disease is a major health burden for patients with chronic kidney disease, most cardiovascular outcome trials have excluded patients with advanced chronic kidney disease. Moreover, the major cardiovascular outcome trials that have been conducted in patients with end-stage renal disease have not demonstrated a treatment benefit. Thus, clinicians have limited evidence to guide the management of cardiovascular disease in patients with chronic kidney disease, particularly those on dialysis...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#2
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28423814/ubiquitous-adoption-of-innovative-and-supportive-information-and-communications-technology-across-health-and-social-care-needs-education-for-clinicians
#3
Paula M Procter
The paper presents the development, use and evaluation of an on-line undergraduate module delivering an academic-led programme of eHealth learning within nursing, midwifery, allied health professional and social work courses. The health information technology competency frameworks are explored along with an overview of the resulting module. The need for an academically led module will be made along with a description of the management required to maintain validity of content materials. A review of student evaluations will be presented...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423285/the-epidemiology-of-high-ankle-sprains-in-national-collegiate-athletic-association-sports
#4
Timothy C Mauntel, Erik A Wikstrom, Karen G Roos, Aristarque Djoko, Thomas P Dompier, Zachary Y Kerr
BACKGROUND: Ankle sprains are among the most common injuries experienced by collegiate athletes. The type of ankle sprain is rarely differentiated in epidemiological studies. This differentiation is necessary, as each ankle sprain type has a unique injury mechanism and recovery period. High ankle sprains commonly result in long recovery periods. Thus, a further examination of the epidemiology of high ankle sprains is warranted. PURPOSE: To describe the epidemiology of high ankle sprains in National Collegiate Athletic Association (NCAA) sports during the 2009/2010-2014/2015 academic years...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28422932/clarifying-the-conundrum-evidence-based-practice-quality-improvement-or-research-the-clinical-scholarship-continuum
#5
Eileen J Carter, Kari Mastro, Courtney Vose, Reynaldo Rivera, Elaine L Larson
Nurses' active involvement in clinical scholarship is necessary to advance the nursing profession and improve patient outcomes. Yet, definitional confusion and numerous barriers exist to clinical scholarship in and across academic and patient care settings. We discuss factors that pose barriers to the continuum of clinical scholarship and suggest opportunities for clinician-researcher collaborations that promote nurses' engagement in evidence-based practice, quality improvement, and research.
May 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28418940/assessment-of-the-albumin-bilirubin-albi-grade-as-a-prognostic-indicator-for-hepatocellular-carcinoma-patients-treated-with-radioembolization
#6
Bin Gui, Ashley A Weiner, John Nosher, Shou-En Lu, Gretchen M Foltz, Omar Hasan, Seung K Kim, Vyacheslav Gendel, Naganathan B Mani, Darren R Carpizo, Nael E Saad, Timothy J Kennedy, Darryl A Zuckerman, Jeffrey R Olsen, Parag J Parikh, Salma K Jabbour
OBJECTIVE: As the utility of Child-Pugh (C-P) class is limited by the subjectivity of ascites and encephalopathy, we evaluated a previously established objective method, the albumin-bilirubin (ALBI) grade, as a prognosticator for yttrium-90 radioembolization (RE) treatment for patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 117 patients who received RE for HCC from 2 academic centers were reviewed and stratified by ALBI grade, C-P class, and Barcelona Clinic Liver Cancer stage...
April 17, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28418066/a-national-survey-on-the-effect-of-the-geriatric-academic-career-award-in-advancing-academic-geriatric-medicine
#7
Kevin T Foley, Clare C Luz, Katherine V Hanson, Yuning Hao, Elisia M Ray
A workforce that understands principles of geriatric medicine is critical to addressing the care needs of the growing elderly population. This will be impossible without a substantial increase in academicians engaged in education and aging research. Limited support of early-career clinician-educators is a major barrier to attaining this goal. The Geriatric Academic Career Award (GACA) was a vital resource that benefitted 222 junior faculty members. GACA availability was interrupted in 2006, followed by permanent discontinuation after the Geriatrics Workforce Education Program (GWEP) subsumed it in 2015, leaving aspiring clinician-educators with no similar alternatives...
April 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#8
Santiago Romero-Brufau, Bruce W Morlan, Matthew Johnson, Joel Hickman, Lisa L Kirkland, James M Naessens, Jeanne Huddleston
BACKGROUND: The use of rapid response systems (RRS), which were designed to bring clinicians with critical care expertise to the bedside to prevent unnecessary deaths, has increased. RRS rely on accurate detection of acute deterioration events. Early warning scores (EWS) have been used for this purpose but were developed using heterogeneous populations. Predictive performance may differ in medical vs surgical patients. OBJECTIVE: To evaluate the performance of published EWS in medical vs surgical patient populations...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28410187/comparing-web-based-provider-initiated-and-patient-initiated-survivorship-care-planning-for-cancer-patients-a-randomized-controlled-trial
#9
Katherine Clegg Smith, Elliott Tolbert, Susan M Hannum, Archana Radhakrishnan, Kelsey Zorn, Amanda Blackford, Stephen Greco, Karen Smith, Claire F Snyder
BACKGROUND: Survivorship care plans (SCPs) are intended to facilitate communication and coordination between patients, oncologists, and primary care providers. Most SCP initiatives have focused on oncology providers initiating the SCP process, but time and resource barriers have limited uptake. OBJECTIVE: This trial compares the feasibility and value of 2 Web-based SCP tools: provider-initiated versus patient-initiated. METHODS: This mixed-methods study recruited clinicians from 2 academically-affiliated community oncology practices...
August 30, 2016: JMIR Cancer
https://www.readbyqxmd.com/read/28409243/validation-of-the-sinhala-translation-of-the-international-consultation-on-incontinence-modular-questionnaire-for-female-lower-urinary-tract-symptoms-among-women-in-sri-lanka
#10
Gayan de Silva, Rameez Furukan, Malik Goonewardene
INTRODUCTION AND HYPOTHESIS: The objective of this study was to translate the International Consultation on Incontinence Modular Questionnaire for female lower urinary tract symptoms (ICIQ-FLUTS) into Sinhala and validate the Sinhala translation for use in clinical practice. METHODS: The ICIQ-FLUTS was translated into Sinhala in accordance with the ICIQ validation protocol. The Sinhala translation was validated by administering it to 133 women with FLUTS, mainly urinary incontinence and or urgency, and to 118 women with symptoms other than FLUTS during the period 25 October 2013 to 23 December 2016, in the Academic Obstetrics and Gynaecology Unit, Teaching Hospital Mahamodara, Galle, Sri Lanka...
April 13, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28408338/the-value-of-urodynamics-in-an-academic-specialty-referral-practice
#11
Anne M Suskind, Lindsey Cox, J Quentin Clemens, Ann Oldendorf, John T Stoffel, Bahaa Malaeb, Yongmei Qin, Anne P Cameron
OBJECTIVES: To describe and evaluate the use of urodynamic (UDS) studies for all indications in an academic specialty referral urology practice. METHODS: This is a prospective questionnaire-based study wherein clinicians completed a pre- and post-UDS questionnaire on each UDS that they ordered for all clinical indications between May 2013 and August 2014. Questions pertained to patient demographics and history, the clinical indication for the UDS, the clinician's pre- and post-UDS clinical impressions, and changes in post-UDS management plans...
April 10, 2017: Urology
https://www.readbyqxmd.com/read/28407386/the-predictive-value-of-epaq-in-the-urodynamic-diagnoses-a-prospective-cohort-study
#12
Shanteela McCooty, Peter Nightingale, Pallavi Latthe
AIMS: To assess whether the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) had accuracy in predicting the urodynamic diagnoses of Detrusor Overactivity (DO) and/or Urodynamic Stress Incontinence (USI). METHODS: Tertiary urogynaecology unit linked to an academic university teaching hospital. Consecutive women who presented with lower urinary tract symptoms (LUTS) and were booked to have urodynamic studies. Women completed an ePAQ-PF prior to having urodynamics (UDS) by clinicians who were blinded to the ePAQ-PF results while conducting this procedure...
April 13, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28401723/the-clinical-academic-workforce-in-australia-and-new-zealand-report-on-the-second-binational-summit-to-implement-a-sustainable-training-pathway
#13
John Windsor, Tamsin Garrod, Nicholas J Talley, Carmel Tebbutt, James Churchill, Elizabeth Farmer, Louise Baur, Julian A Smith
There has been a decline in the proportion of clinical academics compared with full-time clinicians, since 2004. A Working Party was established to help develop and implement a model for the training of clinical academics. After a highly successful first summit in 2014 that summarised the challenges faced by clinical academics in Australia and New Zealand, a second summit was convened late in 2015 to report on progress and to identify key areas for further action. The second summit provided survey results that identified the varied training pathways currently offered to clinical academics and the institutions willing to be involved in developing improved pathways...
April 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28401131/perceptions-and-experiences-of-a-gender-gap-at-a-canadian-research-institute-and-potential-strategies-to-mitigate-this-gap-a-sequential-mixed-methods-study
#14
Alekhya Mascarenhas, Julia E Moore, Andrea C Tricco, Jemila Hamid, Caitlin Daly, Julie Bain, Sabrina Jassemi, Tara Kiran, Nancy Baxter, Sharon E Straus
BACKGROUND: The gender gap in academia is long-standing. Failure to ensure that our academic faculty reflect our student pool and national population deprives Canada of talent. We explored the gender distribution and perceptions of the gender gap at a Canadian university-affiliated, hospital-based research institute. METHODS: We completed a sequential mixed-methods study. In phase 1, we used the research institute's registry of scientists (1999-2014) and estimated overall prevalence of a gender gap and the gap with respect to job description (e...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28395034/student-travel-health-and-the-role-of-universities-and-health-clinics-in-new-zealand-to-prevent-imported-infections-a-cross-sectional-study
#15
Penny E Neave, Balakrishnan Nair, Anita E Heywood
Background: Tertiary students are at risk of acquiring infectious diseases during overseas travel as they visit low-income countries, have low perceptions of risk and are unlikely to access travel health advice. Some will visit friends and relatives abroad, a group identified as disproportionately affected by imported infections. There is no national student travel health policy in NZ. This study aimed to explore travel health training of university-based health providers; academics' practices and perceptions of travel health; reasons for travel and countries visited by NZ university students, their travel health uptake and factors affecting decision making about this...
May 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28395002/monitored-anesthesia-care-vs-intubation-for-vertebrobasilar-stroke-endovascular-therapy
#16
Ashutosh P Jadhav, Mehdi Bouslama, Amin Aghaebrahim, Leticia C Rebello, Matthew T Starr, Diogo C Haussen, Manasa Ranginani, Matthew K Whalin, Tudor G Jovin, Raul G Nogueira
Importance: No consensus regarding the ideal sedation treatment for stroke endovascular therapy has been reached, and practices remain largely based on local protocols and clinician preferences. Most studies have focused on anterior circulation strokes; therefore, little is known regarding the optimal anesthesia type for vertebrobasilar occlusion strokes. Objective: To compare clinical and angiographic outcomes between monitored anesthesia care (MAC) and general anesthesia (GA) in patients presenting with vertebrobasilar occlusion strokes...
April 10, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28388954/strategies-to-facilitate-integrated-care-for-people-with-alcohol-and-other-drug-problems-a-systematic-review
#17
REVIEW
Michael Savic, David Best, Victoria Manning, Dan I Lubman
BACKGROUND: There is a growing body of research highlighting the potential benefits of integrated care as a way of addressing the needs of people with alcohol and other drug (AOD) problems, given the broad range of other issues clients often experience. However, there has been little academic attention on the strategies that treatment systems, agencies and clinicians could implement to facilitate integrated care. METHODS: We synthesised the existing evidence on strategies to improve integrated care in an AOD treatment context by conducting a systematic review of the literature...
April 7, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28387268/evidence-summary-the-relationship-between-oral-health-and-pulmonary-disease
#18
D Manger, M Walshaw, R Fitzgerald, J Doughty, K L Wanyonyi, S White, J E Gallagher
Introduction This paper is the second of four reviews exploring the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policymakers.Aim This review aimed to explore the most contemporary evidence on whether poor oral health and pulmonary disease occurs in the same individuals or populations, to outline the nature of the relationship between these two health outcomes, and discuss the implication of any findings for health services and future research...
April 7, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28387129/integrating-palliative-care-to-promote-earlier-conversations-and-to-increase-the-skill-and-comfort-of-nonpalliative-care-clinicians-lessons-learned-from-an-interventional-field-trial
#19
Marilyn K Szekendi, Jocelyn Vaughn, Beth McLaughlin, Carol Mulvenon, Karin Porter-Williamson, Chris Sydenstricker, Mary Williamson
While the uptake of palliative care in the United States is steadily improving, there continues to be a gap in which many patients are not offered care that explicitly elicits and respects their personal wishes. This is due in part to a mismatch of supply and demand; the number of seriously ill individuals far exceeds the workload capacities of palliative care specialty providers. We conducted a field trial of an intervention designed to promote the identification of seriously ill patients appropriate for a discussion of their goals of care and to advance the role of nonpalliative care clinicians by enhancing their knowledge of and comfort with primary palliative care skills...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28385479/opportunity-to-reduce-transfer-of-patients-with-mild-traumatic-brain-injury-and-intracranial-hemorrhage-to-a-level-1-trauma-center
#20
Brian J Yun, Benjamin A White, H Benjamin Harvey, Anand M Prabhakar, Jonathan D Sonis, McKinley Glover, Emily Vallillo, Sun Choi, Pierre Borczuk, Ali S Raja
OBJECTIVE: Current guidelines do not address the disposition of patients with mild traumatic brain injury (TBI) and resultant intracranial hemorrhage (ICH). Emergency medicine clinicians working in hospitals without neurosurgery coverage typically transfer patients with both to a trauma center with neurosurgery capability. Evidence is accruing which demonstrates that the risk of neurologic decompensation depends on the type of ICH and as a result, not every patient may need to be transferred...
March 30, 2017: American Journal of Emergency Medicine
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