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https://www.readbyqxmd.com/read/28430565/do-physicians-have-an-ethical-duty-to-repair-relationships-with-so-called-difficult-patients
#1
Micah Johnson
This essay argues that physicians hold primary ethical responsibility for repairing damaged patient-physician relationships. The first section establishes that the patient-physician relationship has an important influence on patient health and argues that physicians' duty to treat should be understood as including a responsibility to repair broken relationships, regardless of which party was "responsible" for the initial tension. The second section argues that the person with more power to repair the relationship also has more responsibility to do so and considers the moral psychology of pain as foundational to conceiving the patient in this case as especially vulnerable and disempowered...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28429723/pressure-self-focusing-effect-and-novel-methods-for-increasing-the-maximum-pressure-in-traditional-and-rotational-diamond-anvil-cells
#2
Biao Feng, Valery I Levitas
The main principles of producing a region near the center of a sample, compressed in a diamond anvil cell (DAC), with a very high pressure gradient and, consequently, with high pressure are predicted theoretically. The revealed phenomenon of generating extremely high pressure gradient is called the pressure self-focusing effect. Initial analytical predictions utilized generalization of a simplified equilibrium equation. Then, the results are refined using our recent advanced model for elastoplastic material under high pressures in finite element method (FEM) simulations...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28429392/metal-free-formal-oxidative-c-c-coupling-by-in%C3%A2-situ-generation-of-an-enolonium-species
#3
Daniel Kaiser, Aurélien de la Torre, Saad Shaaban, Nuno Maulide
Much contemporary organic synthesis relies on transformations that are driven by the intrinsic, so-called "natural", polarity of chemical bonds and reactive centers. The design of unconventionally polarized synthons is a highly desirable strategy, as it generally enables unprecedented retrosynthetic disconnections for the synthesis of complex substances. Whereas the umpolung of carbonyl centers is a well-known strategy, polarity reversal at the α-position of a carbonyl group is much rarer. Herein, we report the design of a novel electrophilic enolonium species and its application in efficient and chemoselective, metal-free oxidative C-C coupling...
April 21, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28429047/therapeutic-outcome-of-ct-guided-radiofrequency-ablation-in-patients-with-osteoid-osteoma
#4
Louis Lassalle, R Campagna, G Corcos, A Babinet, F Larousserie, J Stephanazzi, A Feydy
OBJECTIVE: To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO). MATERIALS AND METHODS: Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications...
April 20, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28428646/-hpv-vaccination-active-offer-in-an-italian-region
#5
Elisa Terracciano, Gian Loreto D'Alò, Silvia Aquilani, Anna Maria Aversa, Giuseppina Bartolomei, Maria Gabriella Calenda, Raffaele Catapano, Silvio Compagno, Piera Della Rovere, Angelo Fraioli, Roberto Ieraci, Daniela Reggiani, Stefano Sgricia, Antonietta Spadea, Laura Zaratti, Elisabetta Franco
Human Papillomavirus is responsible for 4.8% of cancers, and is the main cause of cervical cancer. Cervical cancer can be reduced by mean of secondary prevention (PAP-test, HPV-DNA test), while through primary prevention (anti-HPV vaccine) the incidence of other HPV-attributable cancers can also be reduced. In Italy, anti-HPV vaccination is part of the immunization schedule in girls since 2008, and in 2017 it was extended to boys. However, vaccine coverage is decreasing nationwide. This study aims to examine anti-HPV vaccination practices in Health care services of Lazio Region, Italy...
January 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28428356/biological-variation-estimates-obtained-from-91-healthy-study-participants-for-9-enzymes-in-serum
#6
Anna Carobene, Thomas Røraas, Una Ørvim Sølvik, Marit Sverresdotter Sylte, Sverre Sandberg, Elena Guerra, Irene Marino, Niels Jonker, Gerhard Barla, William A Bartlett, Pilar Fernandez-Calle, Jorge Díaz-Garzón, Francesca Tosato, Mario Plebani, Abdurrahman Coŝkun, Mustafa Serteser, Ibrahim Unsal, Ferruccio Ceriotti
BACKGROUND: We sought to develop estimates of biological variation (BV) for 9 enzymes in blood serum as part of the European Biological Variation Study. METHODS: Ninety-one healthy study participants (38 male and 53 female, 21-69 years old) were phlebotomized in each of 10 consecutive weeks at 6 European laboratories. The same preanalytical sample-handling protocol was followed at each center before transport to San Raffaele Hospital, Milan, Italy, for analysis...
April 20, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28427137/-bibliometric-analysis-of-scientific-articles-on-epidemiological-study-of-burns-in-china
#7
W F Cheng, Z A Shen, D X Zhao, D W Li, Y R Shang
Objective: To analyze the current status of epidemiological study of burns in China, and to explore the related strategies. Methods: Retrospective or cross-sectional scientific articles in Chinese or English on epidemiological study of burns in China published from January 2005 to December 2015 were systemically retrieved from 4 databases. The databases include PubMed, Embase, China Biology Medicine disc, and Chinese Journals Full-text Database. From the results retrieved, data with regard to publication year, journal distribution, number of institutions participated in the study, affiliation of the first author and its location, and admission time span and age of patients in all the scientific articles were collected...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28426536/exploring-the-interaction-between-nursing-decision-making-and-patient-outcomes-in-2-european-cancer-centers-a-qualitative-study
#8
Dario Valcarenghi, Annamaria Bagnasco, Giuseppe Aleo, Gianluca Catania, Milko Zanini, Bruno Cavaliere, Franco Carnevale, Loredana Sasso
BACKGROUND: In some clinical settings, nurses have difficulty describing the outcomes of their caring activities. Understanding the reasons for this could help nurse leaders to improve the effectiveness and visibility of nursing practice and safeguard nurses' working conditions. OBJECTIVE: The aims of this study were to understand how nurses working in 2 different adult cancer centers make healthcare decisions and assess the respective outcomes on their patients...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28423963/patient-perceptions-of-environmental-control-units-experiences-of-veterans-with-spinal-cord-injuries-and-disorders-receiving-inpatient-va-healthcare
#9
Bella Etingen, Rachael N Martinez, Marissa A Vallette, Ryan Dendinger, Balmatee Bidassie, Scott Miskevics, Hira T Khan, Huberta T Cozart, Sara M Locatelli, Frances M Weaver
PURPOSE: To assess patients' perceptions of environmental control units (ECUs) at Veterans Affairs Spinal Cord Injury Centers. MATERIALS AND METHODS: A brief questionnaire was conducted with patients in real-time while they were hospitalised ("on-the-spot questionnaire"); a survey was mailed to patients who had recently been discharged from a hospital stay ("discharge survey"). Data were analysed using descriptive statistics. RESULTS: Seventy on-the-spot questionnaires and 80 discharge surveys were collected...
April 19, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28423853/square
#10
Carsten Oliver Schmidt, Christine Krabbe, Janka Schössow, Martin Albers, Dörte Radke, Jörg Henke
Valid scientific inferences from epidemiological and clinical studies require high data quality. Data generating departments therefore aim to detect data irregularities as early as possible in order to guide quality management processes. In addition, after the completion of data collections the obtained data quality must be evaluated. This can be challenging in complex studies due to a wide scope of examinations, numerous study variables, multiple examiners, devices, and examination centers. This paper describes a Java EE web application used to monitor and evaluate data quality in institutions with complex and multiple studies, named Square<sup>2</sup>...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423808/security-policy-and-infrastructure-in-the-context-of-a-multi-centeric-information-system-dedicated-to-autism-spectrum-disorder
#11
Mohamed Ben Said, Laurence Robel, Bernard Golse, Jean Philippe Jais
Autism spectrum disorders (ASD) are complex neuro-developmental disorders affecting children in their early age. The diagnosis of ASD relies on multidisciplinary investigations, in psychiatry, neurology, genetics, electrophysiology, neuro-imagery, audiology and ophthalmology. In order to support clinicians, researchers and public health decision makers, we designed an information system dedicated to ASD, called TEDIS. TEDIS was designed to manage systematic, exhaustive and continuous multi-centric patient data collection via secured Internet connections...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423145/brief-behavioral-therapy-for-pediatric-anxiety-and-depression-in-primary-care-a-randomized-clinical-trial
#12
V Robin Weersing, David A Brent, Michelle S Rozenman, Araceli Gonzalez, Megan Jeffreys, John F Dickerson, Frances L Lynch, Giovanna Porta, Satish Iyengar
Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations. Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care. Design, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8...
April 19, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28421672/a-transplant-specific-quality-initiative-introducing-transqip-a-joint-effort-of-the-asts-and-acs
#13
Justin Parekh, Clifford Ko, Jacqueline Lappin, Stuart Greenstein, Ryutaro Hirose
In an attempt to improve surgical quality in the field of transplantation, the American College of Surgeons (ACS) and American Society and Transplant Surgeons have initiated a national quality improvement program in transplantation. This transplant specific quality improvement program, called TransQIP, has been built from the ground up by transplant surgeons and captures detailed information on donor and recipient factors as well as transplant specific outcomes. It is built upon the existing ACS/NSQIP infrastructure and is designed to capture 100% of liver and kidney transplants performed at participating sites...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28421225/using-telephony-data-to-facilitate-discovery-of-clinical-workflows
#14
Donald W Rucker
BACKGROUND:  Discovery of clinical workflows to target for redesign using methods such as Lean and Six Sigma is difficult. VoIP telephone call pattern analysis may complement direct observation and EMR-based tools in understanding clinical workflows at the enterprise level by allowing visualization of institutional telecommunications activity. OBJECTIVE:  To build an analytic framework mapping repetitive and high-volume telephone call patterns in a large medical center to their associated clinical units using an enterprise unified communications server log file and to support visualization of specific call patterns using graphical networks...
April 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28420324/evaluation-of-a-technology-enhanced-integrated-care-model-for-frail-older-persons-protocol-of-the-spec-study-a-stepped-wedge-cluster-randomized-trial-in-nursing-homes
#15
Hongsoo Kim, Yeon-Hwan Park, Young-Il Jung, Hyoungshim Choi, Seyune Lee, Gi-Soo Kim, Dong-Wook Yang, Myunghee Cho Paik, Tae-Jin Lee
BACKGROUND: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. METHODS/DESIGN: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate...
April 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#16
Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock, Jean Kutner
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual's acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable...
April 18, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28416023/the-new-childhood-arthritis-and-rheumatology-research-alliance-carra-registry-design-rationale-and-characteristics-of-patients-enrolled-in-the-first-12%C3%A2-months
#17
Timothy Beukelman, Yukiko Kimura, Norman T Ilowite, Kelly Mieszkalski, Marc D Natter, Grendel Burrell, Brian Best, Jason Jones, Laura E Schanberg
BACKGROUND: Herein we describe the history, design, and rationale of the new Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and present the characteristics of patients with juvenile idiopathic arthritis (JIA) enrolled in the first 12 months of operation. METHODS: The CARRA Registry began prospectively collecting data in the United States and Canada in July 2015 to evaluate the safety of therapeutic agents in persons with childhood-onset rheumatic disease, initially restricted to JIA...
April 17, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28413896/congenital-malformations-palliative-care-and-postnatal-redirection-to-more-intensive-treatment-a-review-at-a-swiss-tertiary-center
#18
Ulrich Pfeifer, Deborah Gubler, Eva Bergstraesser, Dirk Bassler
PURPOSE: The so-called lethal malformations pose ethical challenges. Most affected fetuses die before or at birth. Live-born neonates commonly receive palliative care. If the postnatal course is better than expected, redirection towards more treatment may occur. We aimed to analyze this in a Swiss patient cohort. MATERIALS AND METHODS: Over 6 years, fetal malformation was suspected in 1113 cases. We identified patients prenatally assigned to palliative care, assessed pre- and postnatal diagnoses, and outcomes...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#19
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/28410705/patients-perception-towards-directly-observed-treatment-a-qualitative-study-from-kollam-district-kerala-southern-india
#20
P S Rakesh, Shibu Balakrishnan, V Krishnaveni, Vishnu Narayanan, Swapna Pillai, Sumi Merin Thomas
BACKGROUND: The Direct Observation of Treatment (DOT) is an important component of the country's TB Control strategy. Standards of TB care in India and the End TB strategy emphasised the importance of a patient-centered approach to foster adherence. A qualitative study was conducted to explore the perception of people with Tuberculosis in Kerala regarding DOT, mechanisms to make the treatment of TB more patients centered and to identify the preferable mechanisms to ensure adherence. METHODS: Six focus group discussions were conducted - two among people with TB from rural area, two among people with TB in urban area, one among multipurpose health workers of rural area and one among key field staff of TB control in urban area...
April 2017: Indian Journal of Tuberculosis
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