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https://www.readbyqxmd.com/read/27905893/computational-prediction-of-multidisciplinary-team-decision-making-for-adjuvant-breast-cancer-drug-therapies-a-machine-learning-approach
#1
Frank P Y Lin, Adrian Pokorny, Christina Teng, Rachel Dear, Richard J Epstein
BACKGROUND: Multidisciplinary team (MDT) meetings are used to optimise expert decision-making about treatment options, but such expertise is not digitally transferable between centres. To help standardise medical decision-making, we developed a machine learning model designed to predict MDT decisions about adjuvant breast cancer treatments. METHODS: We analysed MDT decisions regarding adjuvant systemic therapy for 1065 breast cancer cases over eight years. Machine learning classifiers with and without bootstrap aggregation were correlated with MDT decisions (recommended, not recommended, or discussable) regarding adjuvant cytotoxic, endocrine and biologic/targeted therapies, then tested for predictability using stratified ten-fold cross-validations...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27905860/a-scoping-review-on-models-of-integrative-medicine-what-is-known-from-the-existing-literature
#2
Eun Jin Lim, Janette L Vardy, Byeong Sang Oh, Haryana M Dhillon
OBJECTIVES: Integrative medicine (IM) has been recognized and introduced into Western healthcare systems over the past two decades. Limited information on IM models is available to guide development of an optimal healthcare service. A scoping review was carried out to evaluate IM models in the extant literature, including the distinctive features of each model, to gain an understanding of the core requirements needed to develop models of IM that best meet the needs of patients. DESIGN: Directed content analysis was used to classify the IM models into systems based on coding schema developed from theoretical models and to identify the key concepts of each system...
December 1, 2016: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/27904909/from-left-ventricular-assist-device-to-transplant-to-home-an-interdisciplinary-team-approach-to-treating-medically-complex-cardiac-patients-during-the-bridge-to-transplantation-a-case-report
#3
Keith J Foster, Angelica Cota, Stephanie Cleves
CASE REPORT: A 56-year-old man presented with advanced heart failure requiring implantation of a left ventricular assist device and was discharged home. after implantation He returned to the hospital with right posterior putamen stroke and after a comprehensive rehabilitation programme was discharged home with the ability to be independent. The patient later underwent heart transplantation and subsequently required readmission to inpatient rehabilitation. He again completed a comprehensive rehabilitation programme and returned home with the ability to be independent with use of a single-point cane for ambulation...
November 30, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27904854/legal-issues-related-to-postoperative-pulmonary-thromboembolism-in-korea
#4
Bo Young Park, Min Ji Kim, So Ra Kang, Seung Eun Hong
PURPOSE: Currently, development of pulmonary thromboembolism (PTE) after surgery is frequently being followed by legal action in Korea, as consequences may be fatal. In the current study, we assessed possible countermeasures that medical teams can take when faced with conflicting opinions on responsibility for PTE. METHODS: A retrospective analysis of claims handled by the Supreme Court and subordinate courts, from 1999 to 2015, was performed. We analyzed the type of procedure, associated complications, and critical legal points from the recorded judgments along with any liability limitations on surgeons...
December 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27904743/frontline-worker-perceptions-of-medication-safety-in-india
#5
Sangeeta Sharma, Fauzia Tabassum, Sarbjeet Khurana, Kaveri Kapoor
BACKGROUND: To explore interprofessionals' perceptions about patient safety, particularly medication safety and associated factors and barriers. METHODS: A total of 389 respondents were recruited using convenience sample in the cross sectional survey. RESULTS: Medication safety was perceived as somewhat safe (60%). One-third of respondents witnessed 3-4 or more medication errors (MEs) within the past 1 year. Out of that, one quarter were reportedly, sentinel events...
December 2016: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/27903999/burnout-syndrome-among-hemodialysis-and-peritoneal-dialysis-nurses
#6
Ayten Karakoc, Murvet Yilmaz, Nilufer Alcalar, Bennur Esen, Hasan Kayabasi, Dede Sit
INTRODUCTION: Burnout, a syndrome with 3 dimensions of emotional exhaustion, depersonalization, and reduction of personal accomplishment, is very common among hemodialysis nurses, while data are scarce regarding the prevalence of burnout syndrome (BS) among peritoneal dialysis (PD) nurses. This study aimed to assess and compare demographic and professional characteristics and burnout levels in hemodialysis and PD nurses, and to investigate factors that increase the level of burnout in dialysis nurses...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27903757/beyond-hand-hygiene-a-qualitative-study-of-the-everyday-work-of-preventing-cross-contamination-on-hospital-wards
#7
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27903664/practical-considerations-for-therapies-targeting-the-prostacyclin-pathway
#8
REVIEW
Harrison W Farber, Wendy Gin-Sing
Therapies that target the prostacyclin pathway play a key role in the treatment of both early- and late-stage pulmonary arterial hypertension, and provide significant clinical benefits for patients. A number of agents have been approved, which are administered via intravenous, subcutaneous, inhaled or oral routes. The use of these therapies is associated with practical challenges, relating to the need for up-titration and their routes of administration. We discuss here a number of measures that can be taken to support patients and healthcare professionals in order to address the complexities of using these therapies and to encourage compliance...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27903210/resource-use-governance-and-case-load-of-rapid-response-teams-in-australia-and-new-zealand-in-2014
#9
(no author information available yet)
BACKGROUND: Rapid response teams (RRTs) are a mandatory element of Australian national health care policy. However, the uptake, resourcing, case load and funding of RRTs in Australian and New Zealand hospitals remain unknown. AIM: To assess the clinical activity, funding, staffing and governance of RRTs in Australian and New Zealand hospitals. METHODS: Survey of Australian and New Zealand hospitals as part of a biannual audit of intensive care resources and capacity...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#10
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27903138/partnerships-between-health-care-and-legal-providers-in-the-veterans-health-administration
#11
Jack Tsai, Margaret Middleton, Randye Retkin, Cindy Johnson, Kevin Kenneally, Scott Sherman, Robert A Rosenheck
Medical-legal partnerships (MLPs) represent an innovative service model in which lawyers are integrated into health care teams to address diverse legal problems that affect vulnerable populations. The Veterans Health Administration (VHA) operates the largest safety-net health care system in the country and serves many low-income and disabled veterans who could benefit from MLP services. In this column, the authors describe the development and operations of MLPs at four VHA medical centers that serve veterans who are homeless or who have serious mental illness...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27903039/management-of-bipolar-disorder-over-the-perinatal-period
#12
Philip Boyce, Anne Buist
BACKGROUND: Women with bipolar disorder have a high risk of relapse following childbirth. The risk of relapse can be reduced by mood stabilisers, but they are potentially harmful to the developing fetus. OBJECTIVE: The objective of this article is to provide an up-to-date review of the strategies for managing women with bipolar disorder over the perinatal period. DISCUSSION: Discussing the risks of taking mood stabilisers or having a medication-free pregnancy is essential for women with bipolar disorder...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#13
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27902840/team-based-interprofessional-competency-training-for-dementia-screening-and-management
#14
Zaldy S Tan, JoAnn Damron-Rodriguez, Mary Cadogan, Daphna Gans, Rachel M Price, Sharon S Merkin, Lee Jennings, Heather Schickedanz, Sam Shimomura, Dan Osterweil, Joshua Chodosh
As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress...
November 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#15
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27901516/psychotropic-drug-changes-contributing-to-readmissions-in-medically-hospitalized-psychiatric-patients-a-retrospective-study
#16
Subramoniam Madhusoodanan, Biling Xu, Srikanth Prayaga, Piotr Slowik, Ronald Brenner, Wallace Thomas, Natalie Schwartz
BACKGROUND: Psychotropic drug changes during medical hospitalizations may lead to psychiatric and medical readmissions. METHODS: One-year hospitalization records of nursing home patients with chronic mental illness and a psychotropic drug change during medical admission were reviewed. We calculated the readmission rates for 30, 60, and 90 days; the classes of the psychotropic drugs changed; the reason for change; and the specialties of the responsible physicians...
November 2016: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/27901408/four-steps-to-eliminate-or-reduce-pain-in-children-caused-by-needles-part-1
#17
Stefan J Friedrichsdorf
Dr Stefan Friedrichsdorf* speaks to Jade Parker, Commissioning Editor: Stefan J Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota, Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The interdisciplinary pain team is devoted to prevent and treat acute, procedural, neuropathic, psycho-social-spiritual, visceral, and chronic/complex pain for all inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota...
November 30, 2016: Pain Management
https://www.readbyqxmd.com/read/27900227/urachal-cyst-causing-small-bowel-obstruction-in-an-adult-with-a-virgin-abdomen
#18
Michael P O'Leary, Zane W Ashman, David S Plurad, Dennis Y Kim
Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27899834/evaluation-of-interprofessional-team-disclosure-of-a-medical-error-to-a-simulated-patient
#19
Kelly R Ragucci, Donna H Kern, Sarah P Shrader
Objective. To evaluate the impact of an Interprofessional Communication Skills Workshop on pharmacy student confidence and proficiency in disclosing medical errors to patients. Pharmacy student behavior was also compared to that of other health professions' students on the team. Design. Students from up to four different health professions participated in a simulation as part of an interprofessional team. Teams were evaluated with a validated rubric postsimulation on how well they handled the disclosure of an error to the patient...
October 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/27899191/genetic-predisposition-to-endocrine-tumors-diagnosis-surveillance-and-challenges-in-care
#20
REVIEW
Elisabeth Joye Petr, Tobias Else
Endocrine tumor syndromes, eg, multiple endocrine neoplasia types 1 and 2, were among the first recognized hereditary predisposition syndromes to tumor development. Over time, the number of endocrine tumor syndromes has significantly expanded, eg, with the recent inclusion of hereditary paraganglioma syndromes. Associations of non-endocrine tumors with hereditary endocrine tumor syndromes and endocrine tumors with non-classical endocrine tumor syndromes have emerged. These findings have certainly expanded the scope of care, necessitating a multidisciplinary approach by a team of medical professionals and researchers, integrating shared patient decision-making at every step of surveillance, diagnosis, and treatment...
October 2016: Seminars in Oncology
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