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https://www.readbyqxmd.com/read/28544750/unexpected-ethical-dilemmas-in-sex-assignment-in-46-xy-dsd-due-to-5-alpha-reductase-type-2-deficiency
#1
Heather M Byers, Lauren H Mohnach, Patricia Y Fechner, Ming Chen, Inas H Thomas, Linda A Ramsdell, Margarett Shnorhavorian, Elizabeth A McCauley, Anne-Marie E Amies Oelschlager, John M Park, David E Sandberg, Margaret P Adam, Catherine E Keegan
Sex assignment at birth remains one of the most clinically challenging and controversial topics in 46,XY disorders of sexual development (DSD). This is particularly challenging in deficiency of 5-alpha reductase type 2 given that external genitalia are typically undervirilized at birth but typically virilize at puberty to a variable degree. Historically, most individuals with 5-alpha reductase deficiency were raised females. However, reports that over half of patients who underwent a virilizing puberty adopted an adult male gender identity have challenged this practice...
May 25, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28544310/implementing-the-psychosocial-standards-in-pediatric-cancer-current-staffing-and-services-available
#2
Michele A Scialla, Kimberly S Canter, Fang Fang Chen, E Anders Kolb, Eric Sandler, Lori Wiener, Anne E Kazak
BACKGROUND: Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards...
May 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28544066/type-2-diabetes-and-glucose-intolerance-in-a-population-with-intellectual-disabilities-the-stop-diabetes-cross-sectional-screening-study
#3
A J Dunkley, F Tyrer, L J Gray, S Bhaumik, R Spong, Y Chudasama, S-A Cooper, S Ganghadaran, M Davies, K Khunti
BACKGROUND: Adults with intellectual disabilities (ID) may be at increased risk of developing type 2 diabetes and cardiovascular disease, due to lifestyle factors, medications and other diagnosed conditions. Currently, there is lack of evidence on prevalence and prevention in this population. The aim of this study was to conduct a diabetes screening programme to determine prevalence of previously undiagnosed type 2 diabetes and impaired glucose regulation in people with ID. METHODS: Screening was conducted in a variety of community settings in Leicestershire, UK...
May 21, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28542981/dental-providers-and-pharmacists-a-call-for-enhanced-interprofessional-collaboration
#4
Henning Lygre, Reidun Lisbet Skeide Kjome, Hailey Choi, Autumn L Stewart
Reports concerning medication discrepancies in dental records indicate that the concept of interprofessional collaboration between the dental team and pharmacists should be considered at all educational levels in dentistry and pharmacy. Inclusion of oral health as a therapeutic area in didactic pharmacy curricula is needed. Early exposure of dental students and student pharmacists to collaborative practices through interprofessional educational experiences may create a higher degree of awareness of the role of each profession and the potential to improve patient outcomes...
May 21, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28541453/critical-health-literacy-in-american-deaf-college-students
#5
Poorna Kushalnagar, Claire Ryan, Scott Smith, Raja Kushalnagar
This study investigates the relationship between critical health literacy (CHL) and discussion of health information among college deaf students who use American Sign Language. CHL is crucial in making appropriate health-related decisions for oneself and aiding others in making good health-choices. Research on general youth population shows that frequent health-related discussions with both friends and family is associated with higher health literacy. However, for our sample of deaf college-aged students who might have had less access to communication at home, we hypothesize that health-related discussions with same-age peers may be more important for critical health literacy...
May 24, 2017: Health Promotion International
https://www.readbyqxmd.com/read/28541234/psychiatric-specialty-training-in-greece
#6
EDITORIAL
M Margariti, V Kontaxakis, D Ploumpidis
The reform and development of psychiatric services require, in addition to financial resources, reserves in specialized human resources. The role of psychiatrists in this process, and at reducing the consequences of mental morbidity is evident. Psychiatrists are required to play a multifaceted role as clinicians, as experts in multidisciplinary team environments and as advisors in the recognition of public needs in mental health issues, as teachers and mentors for students and other health professionals, as researchers in order to enrich our knowledge in the scientific field of psychiatry, and as public health specialists in the development of the mental health services system...
January 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#7
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28540287/it-s-a-process-reactions-to-hiv-diagnosis-and-engagement-in-hiv-care-among-high-risk-heterosexuals
#8
Alexandra H Kutnick, Marya Viorst Gwadz, Charles M Cleland, Noelle R Leonard, Robert Freeman, Amanda S Ritchie, Talaya McCright-Gill, Kathy Ha, Belkis Y Martinez
After HIV diagnosis, heterosexuals in high-poverty urban areas evidence delays in linkage to care and antiretroviral therapy initiation compared to other groups. Yet barriers to/facilitators of HIV care among these high-risk heterosexuals are understudied. Under the theory of triadic influence, putative barriers to HIV care engagement include individual/attitudinal-level (e.g., fear, medical distrust), social-level (e.g., stigma), and structural-level influences (e.g., poor access). Participants were African-American/Black and Hispanic adults found newly diagnosed with HIV (N = 25) as part of a community-based HIV testing study with heterosexuals in a high-poverty, high-HIV-incidence urban area...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28539087/artificial-intelligence-methodologies-and-their-application-to-diabetes
#9
Mercedes Rigla, Gema García-Sáez, Belén Pons, Maria Elena Hernando
In the past decade diabetes management has been transformed by the addition of continuous glucose monitoring and insulin pump data. More recently, a wide variety of functions and physiologic variables, such as heart rate, hours of sleep, number of steps walked and movement, have been available through wristbands or watches. New data, hydration, geolocation, and barometric pressure, among others, will be incorporated in the future. All these parameters, when analyzed, can be helpful for patients and doctors' decision support...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#10
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538636/the-role-of-nigms-p50-sponsored-team-science-in-our-understanding-of-multiple-organ-failure
#11
Frederick A Moore, Ernest E Moore, Timothy R Billiar, Yoram Vodovotz, Anirban Banerjee, Lyle L Moldawer
The history of the National Institute of General Medical Sciences (NIGMS) Research Centers in Peri-operative Sciences (RCIPS) is the history of clinical, translational and basic science research into the etiology and treatment of posttraumatic multiple organ failure (MOF). Born out of the activism of trauma and burn surgeons after the Viet Nam war, the P50 trauma research centers have been a nidus of research advances in the field, and the training of future academic physician-scientists in the fields of trauma, burns, sepsis and critical illness...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538496/committee-opinion-no-702-female-athlete-triad
#12
(no author information available yet)
The female athlete triad is a medical condition observed in physically active females involving three components: 1) low energy availability with or without disordered eating, 2) menstrual dysfunction, and 3) low bone density. An individual does not need to show clinical manifestations of all three components of the female athlete triad simultaneously to be affected by the condition. Consequences of these clinical conditions may not be completely reversible, so prevention, early diagnosis, and intervention are critical...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28538492/committee-opinion-no-702-summary-female-athlete-triad
#13
(no author information available yet)
The female athlete triad is a medical condition observed in physically active females involving three components: 1) low energy availability with or without disordered eating, 2) menstrual dysfunction, and 3) low bone density. An individual does not need to show clinical manifestations of all three components of the female athlete triad simultaneously to be affected by the condition. Consequences of these clinical conditions may not be completely reversible, so prevention, early diagnosis, and intervention are critical...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28538442/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-treated-with-continuous-infusion-hypertonic-saline-a-pilot-study
#14
Heidi M Riha, Michael J Erdman, Joseph E Vandigo, Lauren A Kimmons, Nitin Goyal, K Erin Davidson, Abhi Pandhi, G Morgan Jones
OBJECTIVES: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28538140/comparison-of-policies-for-recognising-and-responding-to-clinical-deterioration-across-five-victorian-health-services
#15
Julie Considine, Anastasia F Hutchison, Helen Rawson, Alison M Hutchinson, Tracey Bucknall, Trisha Dunning, Mari Botti, Maxine M Duke, Maryann Street
Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia.Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes.Results In all, 22 guidance documents and five graphic observation and response charts were reviewed...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28538138/factors-leading-to-overutilisation-of-hospital-pathology-testing-the-junior-doctor
#16
William Ericksson, Janine Bothe, Heidi Cheung, Kate Zhang, Simone Kelly
Objective Pathology overutilisation is a significant issue affecting the quality and cost of health care. Because junior medical officers (JMOs) order most pathology tests in the hospital setting, the aim of the present study was to identify the main reasons for hospital pathology overutilisation from the perspective of the JMO.Methods A qualitative method, using focus group methodology, was undertaken. Sixteen JMOs from two hospitals participated in three focus groups. Data were analysed using thematic analysis...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28537945/making-sense-of-effective-partnerships-among-senior-leaders-in-the-national-health-service
#17
Mahima Mitra, Timothy Hoff, Paul Brankin, Sue Dopson
BACKGROUND: Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. PURPOSE: The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K. National Health Service. We explored (a) how they make sense of and act with respect to specific collaborative tensions in their interactions and (b) which aspects of their everyday leadership contexts heighten the probability for producing and resolving such tensions...
May 22, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28537818/adolescent-and-young-adult-patients-with-cancer-perceptions-of-care
#18
Kayla N LaRosa, Marilyn Stern, Jennifer Bleck, Courtney Lynn, Janella Hudson, Damon R Reed, Gwendolyn P Quinn, Kristine A Donovan
BACKGROUND: Adolescent and young adults with cancer (AYACs) face unique medical, psychosocial, and supportive care needs. The purpose of this study was to identify AYACs perceptions and expectations of cancer care services on and off treatment. METHODS: Semistructured interviews were conducted with 23 AYACs aged 19-38 years (13 on and 10 off treatment), who were receiving care at a comprehensive cancer center. Verbatim transcripts were created from audiotaped interviews and hand coded using inductive content analysis methodology...
May 24, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28537777/palliative-care-office-hours-for-patients-with-hematologic-malignancies-an-innovative-model-for-symptom-management-and-education
#19
Anessa M Foxwell, Mary E Moyer, David J Casarett, Nina R O'Connor
BACKGROUND: Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. OBJECTIVES: To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. METHODS: A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress...
May 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28537208/coding-of-significant-comorbidities-and-complications-for-stroke-in-rehabilitation
#20
Joanne Murray, Rhonda Pfeiffer, Ingrid Scholten
Background Comorbidities and complications of stroke have implications for level of care and hospital resources. It is critical, therefore, that hospital morbidity data accurately reflect the prevalence of these additional diagnoses. Objective This study aimed to measure and describe the concordance between stroke clinicians/researchers and medical record coders when recording stroke and related diagnoses. Method Diagnoses recorded prospectively, according to defined criteria by a clinical research team, were compared with the coding of stroke comorbidities and complications as per the Australian Coding Standards (ACS) from the separations of 100 inpatients from three rehabilitation facilities in South Australia...
January 1, 2017: HIM Journal
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