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https://www.readbyqxmd.com/read/28098627/global-collaboration-in-acute-care-clinical-research-opportunities-challenges-and-needs
#1
John C Marshall
The most impactful research in critical care comes from trials groups led by clinician-investigators who study questions arising through the day-to-day care of critically ill patients. The success of this model reflects both "necessity"-the paucity of new therapies introduced through industry-led research-and "clinical reality"-nuanced modulation of standard practice can have substantial impact on clinically important outcomes. Success in a few countries has fueled efforts to build similar models around the world and to collaborate on an unprecedented scale in large international trials...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096740/unanswered-clinical-questions-a-survey-of-specialists-and-primary-care-providers
#2
Ellen Brassil, Bridget Gunn, Anant M Shenoy, Rebecca Blanchard
OBJECTIVE: With the myriad of cases presented to clinicians every day at our integrated academic health system, clinical questions are bound to arise. Clinicians need to recognize these knowledge gaps and act on them. However, for many reasons, clinicians might not seek answers to these questions. Our goal was to investigate the rationale and process behind these unanswered clinical questions. Subsequently, we explored the use of biomedical information resources among specialists and primary care providers and identified ways to promote more informed clinical decision making...
January 2017: Journal of the Medical Library Association: JMLA
https://www.readbyqxmd.com/read/28095977/multidisciplinary-alternatives-to-cpap-program-for-cpap-intolerant-patients
#3
Anita Valanju Shelgikar, Sharon Aronovich, Jeffrey J Stanley
Continuous positive airway pressure (CPAP) intolerance remains a persistent problem for many obstructive sleep apnea patients. Clinicians and researchers continue to search for other effective treatment modalities given the well-documented sequelae associated with untreated obstructive sleep apnea. A multidisciplinary "Alternatives to CPAP program" (ALT) can facilitate systematic evaluation of non-CPAP therapies appropriate for an individual patient. We review successful strategies and barriers encountered during implementation of an ALT at our institution...
January 11, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28095818/when-parents-won-t-vaccinate-their-children-a-qualitative-investigation-of-australian-primary-care-providers-experiences
#4
Nina J Berry, Alexandra Henry, Margie Danchin, Lyndal J Trevena, Harold W Willaby, Julie Leask
BACKGROUND: Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of investigation. However, the experiences of clinicians who encounter these parents in the course of their work has received little academic attention to date. This study aimed to understand the challenges faced and strategies used when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children. METHODS: Primary care providers were recruited from regions identified through the Australian Childhood Immunisation Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28073345/reasons-for-faculty-departures-from-an-academic-medical-center-a-survey-and-comparison-across-faculty-lines
#5
Sabine C Girod, Magali Fassiotto, Roseanne Menorca, Henry Etzkowitz, Sherry M Wren
BACKGROUND: Faculty departure can present significant intellectual costs to an institution. The authors sought to identify the reasons for clinical and non-clinical faculty departures at one academic medical center (AMC). METHOD: In May and June 2010, the authors surveyed 137 faculty members who left a west coast School of Medicine (SOM) between 1999 and 2009. In May and June 2015, the same survey was sent to 40 faculty members who left the SOM between 2010-2014, for a total sample size of 177 former faculty members...
January 10, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28059948/sports-related-concussion-in-children-and-adolescents
#6
Christian A Refakis, Christian D Turner, Patrick J Cahill
Concussions are becoming increasingly important to manage properly as sports participation continues to rise. Repeated injuries occurring before the brain has had a chance to recover from an initial insult are particularly dangerous and must be prevented. Although much national media attention has been devoted to concussions in professional sports, it is important to appreciate that athletes in any age group, children and adolescents in particular, are at risk of sports-related concussion. It is crucial to remove an athlete from play any time concussion is suspected...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28040449/women-s-beliefs-about-the-purpose-and-value-of-routine-pelvic-examinations
#7
Laura L Norrell, Miriam Kuppermann, Michelle N Moghadassi, George F Sawaya
BACKGROUND: The American Congress of Obstetricians and Gynecologists recommends that a pelvic examination be offered to asymptomatic women after an informed discussion with their provider. While the adverse health outcomes the examination averts were not delineated, the organization stated that it helps establish open communication between patients and physicians. Recent surveys have focused on obstetrician-gynecologists' attitudes and beliefs about the examination, but the perspectives of women have not been well characterized...
December 28, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28039014/what-can-five-high-cost-patients-teach-us-about-healthcare-spending
#8
Ishani Ganguli, Ryan W Thompson, Timothy G Ferris
The highest cost patients account for a disproportionately large share of American healthcare costs and are increasingly the focus of research and policy efforts to stem the rapid growth of these costs. These patients tend to be medically complex and frail, but we know little about how such characteristics influence healthcare spending from the perspectives of the patients and their caregivers. Therefore, we examined five of the highest cost patients at an academic medical center in a case series. We interviewed the patients, their family members, and their clinicians and analyzed their claims data and medical charts to explore how patient and health system characteristics influenced their health costs...
December 27, 2016: Healthcare
https://www.readbyqxmd.com/read/28035775/reducing-liberal-red-blood-cell-transfusions-at-an-academic-medical-center
#9
Harry S Saag, Claudette M Lajam, Simon Jones, Nikita Lakomkin, Joseph A Bosco, Rebecca Wallack, Spiros G Frangos, Prashant Sinha, Nicole Adler, Patti Ursomanno, Leora I Horwitz, Frank M Volpicelli
BACKGROUND: Educational and computerized interventions have been shown to reduce red blood cell (RBC) transfusion rates, yet controversy remains surrounding the optimal strategy needed to achieve sustained reductions in liberal transfusions. STUDY DESIGN AND METHODS: The purpose of this study was to assess the impact of clinician decision support (CDS) along with targeted education on liberal RBC utilization to four high-utilizing service lines compared with no education to control service lines across an academic medical center...
December 30, 2016: Transfusion
https://www.readbyqxmd.com/read/28033064/recent-trends-in-oral-cavity-cancer-research-support-in-the-united-states
#10
A M Fribley, P F Svider, B M Warner, D M Garshott, S N Raza, K L Kirkwood
The objectives were to characterize oral cavity cancer (OCC) funding from the National Institutes of Health (NIH) with a secondary aim of comparing NIH support provided to OCC and other malignancies. NIH awards supporting OCC inquiry from 2000 to 2014 were accessed from the NIH RePORTER database. These data were used to evaluate temporal trends and the role of human papilloma virus and to determine the academic training and professional profiles of the principal investigators. Comparison of 2014 funding levels with other malignancies was also performed, controlling for incidence...
January 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28030421/the-political-future-of-social-medicine-reflections-on-physicians-as-activists
#11
H Jack Geiger
The academic discipline of social medicine has always had a political and policy advocacy component, in addition to its core functions of research and teaching. Its origins lie in the 18th and 19th centuries, in the work of Johann Peter Frank and Rudolph Virchow, among others. Virchow's dictum that "politics is nothing else but medicine on a large scale" highlights that most social determinants of health are politically determined and shape population health. Yet despite intense epidemiological and sociological research on the social determinants of health, less attention has been paid to this political and policy dimension...
December 27, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28028673/outcomes-of-elderly-critically-ill-medical-and-surgical-patients-a-multicentre-cohort-study
#12
Ian M Ball, Sean M Bagshaw, Karen E A Burns, Deborah J Cook, Andrew G Day, Peter M Dodek, Demetrios J Kutsogiannis, Sangeeta Mehta, John G Muscedere, Alexis F Turgeon, Henry T Stelfox, George A Wells, Ian G Stiell
PURPOSE: Very elderly (over 80 yr of age) critically ill patients admitted to medical-surgical intensive care units (ICUs) have a high incidence of mortality, prolonged hospital length of stay, and dependent living conditions should they survive. The primary purpose of this study is to describe the outcomes and differences in outcomes between very elderly medical patients and their surgical counterparts admitted to Canadian ICUs, thereby informing decision-making for clinicians and substitute decision-makers...
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28026700/how-are-canadian-universities-training-and-supporting-undergraduate-medical-physiotherapy-and-occupational-therapy-students-for-global-health-experiences-in-international-low-resource-settings
#13
Jennifer Bessette, Chantal Camden
OBJECTIVES: Canadian medical (MD), physiotherapy (PT) and occupational therapy (OT) students increasingly show an interest in global health experiences (GHEs). As certain moral hazards can occur as a result of student GHEs, a growing consensus exists that universities must have an established selection process, in-depth pre-departure training (PDT), adequate onsite supervision and formal debriefing for their students. This study aimed to identify current practices in Canadian MD, PT and OT programs and discuss areas for improvement by comparing them with recommendations found in the literature...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28024994/teaching-the-art-of-difficult-family-conversations
#14
Rita Dadiz, Michael L Spear, Erin Denney-Koelsch
CONTEXT: Difficult family conversations are a challenge for even the most seasoned clinicians. Teaching the skills of successful communication between providers, family members, and patients are a vital component of medical education. However, traditional teaching methods using didactics and expert role modeling are often inadequate. OBJECTIVES: The train-the-educator workshop aimed to teach educators how to create and conduct workshops on facilitating difficult family conversations that target their own learners' needs...
December 23, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28017821/identification-of-a-p-arg708gln-variant-in-col1a2-in-atypical-femoral-fractures
#15
Funck-Brentano Thomas, Ostertag Agnes, Debiais Francoise, Fardellone Patrice, Corinne Collet, Mornet Etienne, Cohen-Solal Martine
OBJECTIVES: Long-term bisphosphonates exposure is a proven risk factor for atypical femoral fractures (AFF) but several cases occur in untreated patients. The identification of other risk factors for AFF is critical for the management of osteoporosis. We here assessed the genetic factors associated with AFF regardless of the treatment. METHODS: Cases were identified through ICD-10 codes in 3 academic centers. Medical records were analyzed by 2 investigators that adjudicated X-rays for typical or atypical fractures...
December 22, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28017603/guideline-for-reporting-interventions-on-spinal-manipulative-therapy-consensus-on-interventions-reporting-criteria-list-for-spinal-manipulative-therapy-circle-smt
#16
Ruud Groeneweg, Sidney M Rubinstein, Rob A B Oostendorp, Raymond W J G Ostelo, Maurits W van Tulder
OBJECTIVE: The aim of the Consensus on Interventions Reporting Criteria List for Spinal Manipulative Therapy (CIRCLe SMT) study was to develop a criteria list for reporting spinal manipulative therapy (SMT). METHODS: A Delphi procedure was conducted from September 2011 to April 2013 and consisted of international experts in the field of SMT. The authors formed a steering committee and invited participants, selected initial items, structured the comments of the participants after each Delphi round, and formulated the feedback...
December 22, 2016: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28001466/the-intensive-palliative-care-unit-changing-outcomes-for-hospitalized-cancer-patients-in-an-academic-medical-center
#17
Haipeng Zhang, Constance Barysauskas, Elizabeth Rickerson, Paul Catalano, Joseph Jacobson, Carol Dalby, Charlotta Lindvall, Kathy Selvaggi
BACKGROUND: Patients with advanced cancer often require complex symptom management. At Dana-Farber/Brigham and Women's Cancer Center, the intensive palliative care unit (IPCU) admits symptomatic oncology patients with uncontrolled symptoms throughout the trajectory of illness. Patients are uniquely managed by an interdisciplinary team of clinicians who focus on symptom management and advance care planning. OBJECTIVE: The purpose of our analysis was to investigate goals-of-care outcomes and healthcare utilization after admission to the IPCU...
December 21, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27993918/conflicts-of-interest-and-expertise-of-independent-commenters-in-news-stories-about-medical-research
#18
Michael T M Wang, Andrew Grey, Mark J Bolland
BACKGROUND: Media coverage of medical research influences the views and behaviours of clinicians, scientists and members of the public. We examined how frequently commenters in news stories about medical research have relevant expertise and have academic and financial conflicts, how often such conflicts are reported and whether there are associations between the conflicts and the disposition of the comments toward the findings of the source research. METHODS: We analyzed 104 independent comments in news stories on original clinical research published in high-impact medical journals from Jan...
December 19, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27988241/current-understandings-of-the-research-practice-gap-from-the-viewpoint-of-complementary-medicine-academics-a-mixed-method-investigation
#19
Matthew J Leach, Basil Tucker
CONTEXT: Research plays an important role in advancing health and healthcare. However, much research evidence is not reflected in contemporary complementary and alternative medicine (CAM) practice. Understanding and addressing the reasons for this research-practice gap may have positive implications for quality of care. OBJECTIVE: To shed light on the gap between research and CAM practice. DESIGN: Descriptive cross-sectional, mixed-method study...
October 21, 2016: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/27987571/-active-participation-in-research-and-teaching-during-post-graduate-gp-training-perspectives-of-future-general-practitioners
#20
Hannah Haumann, Elisabeth Flum, Stefanie Joos
BACKGROUND: Academic institutions of general practice at German medical faculties have grown during the past years. This leads to an increase in the need of qualified young researchers and teachers in general practice (GP). Little is known about the interest in research and teaching skills and their training among general practice trainees and young GPs. RESEARCH QUESTION: This cross-sectional survey among GP trainees and young GPs examined 1. if there is an interest in the training in research and teaching skills during post-graduate GP training, 2...
December 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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