178,348 results match your criteria Best practice & research. Clinical rheumatology[Journal]


A Step Towards Standardization: Results of Two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations.

Clin Transplant 2020 Jul 11:e14035. Epub 2020 Jul 11.

Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, United States.

Donation after circulatory death (DCD) liver allografts remain underutilized. Inconsistent processes for DCD procurement may contribute to allograft discard. Optimal surgical and organ procurement organization (OPO) practices for DCD liver recovery should be developed and adopted. Read More

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http://dx.doi.org/10.1111/ctr.14035DOI Listing

Is wearing a face mask safe for people with epilepsy?

Acta Neurol Scand 2020 Jul 12. Epub 2020 Jul 12.

Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.

Since December 2019, the world has been experiencing a catastrophic pandemic of coronavirus disease (COVID-19) caused by SARS-CoV2. This virus primarily targets the human respiratory system. Available information suggests that people with epilepsy (PWE) are not at higher risk of being infected by the virus, nor of more severe COVID-19 manifestations, as a result of the epilepsy alone. Read More

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http://dx.doi.org/10.1111/ane.13316DOI Listing

Assessment of Fetal Lung Maturity Using Quantitative Ultrasound Analysis in Patients with Prelabor Rupture of Membranes.

Fetal Diagn Ther 2020 Jul 10:1-6. Epub 2020 Jul 10.

Medical Sciences Post Graduation, Universidade Federal Fluminense, Niterói, Brazil,

Introduction: Prelabor rupture of membranes (PROM) is a frequent clinical situation, and the decision about the best time for delivery remains controversial, mainly due to the risk of neonatal respiratory morbidity (NRM). Assessment of fetal lung maturity using ultrasound, a safe method and widely used in current obstetrical practice, could change this scenario. This study was designed to evaluate the ability of quantitative ultrasound method QuantusFLM® to predict NRM in patients with PROM and whether maternal BMI, gestational age, occurrence of the disease, and presence of oligohydramnios influenced the performance. Read More

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http://dx.doi.org/10.1159/000507550DOI Listing

Characterisation of aluminium black dross before and after stepwise salt-phase dissolution in non-aqueous solvents.

J Hazard Mater 2020 Jun 30;401:123351. Epub 2020 Jun 30.

Department of Chemical & Biological Engineering, University of Sheffield, Sheffield, South Yorkshire, S1 3JD, United Kingdom.

Aqueous leaching to recover salts from black dross is accompanied by hazardous gas generation. The gas-generating phases vary significantly across differently sourced black dross. The challenge for the industry is how to accurately qualify and quantify the problematic components of black dross, especially minor reactive phases. Read More

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http://dx.doi.org/10.1016/j.jhazmat.2020.123351DOI Listing

Scholarly Evaluation of Curricula and Educational Programs: Using a Systematic Approach to Produce Publishable Scholarship.

Acad Pediatr 2020 Jul 9. Epub 2020 Jul 9.

Departments of Medical Education and Pediatrics, University of Virginia School of Medicine, Charlottesville, VA.

The goal of designing innovative curricula and programs in medical education is to create interventions that will change the attitudes, knowledge, skills, and behaviors of learners in order to prepare them to contribute to the health of patients and communities they serve. Systematic evaluation allows curriculum/program developers to optimize their curriculum/program and ensure that the goals of the curriculum/program are met. While curriculum/program evaluation is distinct from educational research, when approached in a rigorous manner, curriculum/program evaluation can be published as educational scholarship. Read More

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http://dx.doi.org/10.1016/j.acap.2020.07.005DOI Listing

The patient and clinician experience of informed consent for surgery: a systematic review of the qualitative evidence.

BMC Med Ethics 2020 Jul 11;21(1):58. Epub 2020 Jul 11.

Centre for Public Health, Queen's University Belfast, Belfast, UK.

Background: Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set (COS) to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Read More

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http://dx.doi.org/10.1186/s12910-020-00501-6DOI Listing

Evidence-based medicine and COVID-19: what to believe and when to change.

Emerg Med J 2020 Jul 10. Epub 2020 Jul 10.

Emergency Medicine, Manchester Metropolitan University - All Saints Campus, Manchester, UK.

The COVID-19 pandemic has led to a surge of information being presented to clinicians regarding this novel and deadly disease. There is a clear urgency to collate, review, appraise and act on this information if we are to do the best for clinicians and patients. However, the speed of the pandemic is a threat to traditional models of knowledge translation and practice change. Read More

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http://dx.doi.org/10.1136/emermed-2020-210098DOI Listing

Outcomes Measurement in Global Hand Surgery.

J Hand Surg Am 2020 Jul 7. Epub 2020 Jul 7.

Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:

The global burden of musculoskeletal trauma is high. There is a need to improve access to safe, high-quality surgery in many low- and middle-income countries (LMICs). Numerous initiatives have taken aim at solving this underlying shortage in surgical care, including mission trips, academic programs, and international collaborations. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.04.026DOI Listing

Achieving a Quintuple Aim for Telehealth in Pediatrics.

Pediatr Clin North Am 2020 Aug 11;67(4):683-705. Epub 2020 Jun 11.

Department of Medicine, Stanford School of Medicine, Stanford, CA 94305, USA.

Pediatric practice increasingly involves providing care for children with medical complexity. Telehealth offers a strategy for providers and health care systems to improve care for these patients and their families. However, lack of awareness related to the unintended negative consequences of telehealth on vulnerable populations--coupled with failure to intentional design best practices for telehealth initiatives--implies that these novel technologies may worsen health disparities in the long run. Read More

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http://dx.doi.org/10.1016/j.pcl.2020.04.015DOI Listing

Blood pressure control in patients with a previous stroke/transient ischaemic attack in primary care in Ireland: a cross sectional study.

BMC Fam Pract 2020 Jul 10;21(1):139. Epub 2020 Jul 10.

Graduate Entry Medical School, University of Limerick, Limerick, Ireland.

Background: Uncontrolled blood pressure (BP) is an important modifiable risk factor for recurrent stroke. Secondary prevention measures when implemented can reduce stroke re-occurrence by 80%. However, hypertension control rates remain sub-optimal, and little data is available from primary care where most management occurs. Read More

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http://dx.doi.org/10.1186/s12875-020-01211-zDOI Listing

Best Practices in Modified Barium Swallow Studies.

Am J Speech Lang Pathol 2020 Jul 10;29(2S):1078-1093. Epub 2020 Jul 10.

Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.

Purpose The modified barium swallow study (MBSS) is a widely used videofluoroscopic evaluation of the functional anatomy and physiology of swallowing that permits visualization of bolus flow throughout the upper aerodigestive tract in real time. The information gained from the examination is critical for identifying and distinguishing the type and severity of swallowing impairment, determining the safety of oral intake, testing the effect of evidence-based frontline interventions, and formulating oral intake recommendations and treatment planning. The goal of this review article is to provide the state of the science and best practices related to MBSS. Read More

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http://dx.doi.org/10.1044/2020_AJSLP-19-00189DOI Listing

Introduction to the Special Issue: Select Papers From the 2018 Charleston Swallowing Conference at Northwestern University.

Am J Speech Lang Pathol 2020 Jul 10;29(2S):917-918. Epub 2020 Jul 10.

University of Kentucky, Communication Sciences and Disorders, Lexington.

The Charleston Swallowing Conference at Northwestern University is a clinical multidisciplinary conference designed for dysphagia clinicians who practice across all care settings and treat individuals of all ages. This special issue of the contains selected articles from the July 2018 conference dedicated to innovation and implementation of dysphagia practice. The collection of articles includes clinical best practices, new patient-centered assessment and treatment discoveries, re-examination and application of current practices across the age spectrum, and the role of novel technology and data science initiatives. Read More

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http://dx.doi.org/10.1044/2020_AJSLP-20-00106DOI Listing

Integrated 3D Information for Custom-Made Bone Grafts: Focus on Biphasic Calcium Phosphate Bone Substitute Biomaterials.

Int J Environ Res Public Health 2020 Jul 8;17(14). Epub 2020 Jul 8.

Private Practice, 22015 Gravedona, CO, Italy.

Purpose: Several studies showed that the sintering temperature of 1250 °C could affect the formation of α-Ca(PO), which is responsible for the reduction of the hardness value of biphasic calcium phosphate biocomposites, but they did not evaluate the inference of the sintering time at peak temperature on transition of β-Ca(PO) to α-Ca(PO). This analysis explored, in an innovative way, inferences and correlations between volumetric microstructure, mechanical properties, sintering temperature, and time at peak temperature in order to find the best sintering conditions for biphasic calcium phosphate composites grafted in severe alveolar bone defects.

Methods: Sintered biphasic calcium phosphates (30%-hydroxyapatite/70%-tricalcium phosphate) were tested by microCT imaging for the 3D morphometric analysis, by compressive loading to find their mechanical parameters, and by X-ray diffraction to quantify the phases via Rietveld refinement for different sintering temperatures and times at the peak temperature. Read More

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http://dx.doi.org/10.3390/ijerph17144931DOI Listing

Ulcerated breast cancer with single brain metastasis: A combined surgical approach. Clinical presentation at one year follow up - A case report.

Int J Surg Case Rep 2020 Jun 20;73:75-78. Epub 2020 Jun 20.

Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Viale Oxford, 81, 00133, Rome, Italy. Electronic address:

Introduction: Breast cancer is the most common malignancy in woman. Approximately 5-10% of breast cancer occurs as de novo stage IV and some studies have shown that from 10% to 30% of those patients presents Brain Metastasis.

Presentation Of Case: In this study, we report a case of solitary brain metastasis of breast cancer in a 63-year-old Italian Caucasian woman with neurological symptoms as first clinical presentation. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.06.074DOI Listing

Quality of Evidence Supporting Surviving Sepsis Campaign Recommendations.

Anaesth Crit Care Pain Med 2020 Jul 7. Epub 2020 Jul 7.

Scientifical Research, CHU Nîmes, University Montpellier-Nîmes, Nîmes, France; UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia.

Introduction: The Surviving Sepsis Campaign (SSC) guidelines, released in 2017, are a combination of expert opinion and evidence-based medicine, adopted by many institutions as a standard of practice. The aim was to analyse the quality of evidence supporting recommendations on the management of sepsis.

Methods: The strength and quality of evidence (high, moderate, low-very low and best practice statements) of each recommendation were extracted. Read More

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http://dx.doi.org/10.1016/j.accpm.2020.06.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340061PMC

Managing hypertension in frail oldest-old-The role of guideline use by general practitioners from 29 countries.

PLoS One 2020 10;15(7):e0236064. Epub 2020 Jul 10.

Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.

Background: The best management of hypertension in frail oldest-old (≥80 years of age) remains unclear and we still lack guidelines that provide specific recommendations. Our study aims to investigate guideline use in general practitioners (GPs) and to examine if guideline use relates to different decisions when managing hypertension in frail oldest-old.

Design/setting: Cross-sectional study among currently active GPs from 29 countries using a case-vignettes survey. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236064PLOS

Cardiovascular morbidity and mortality among persons diagnosed with tuberculosis: A systematic review and meta-analysis.

PLoS One 2020 10;15(7):e0235821. Epub 2020 Jul 10.

Provincial TB Services, British Columbia Centre for Disease Control, Vancouver, Canada.

Introduction: The emerging epidemiological evidence of increased cardiovascular disease (CVD) risk among persons diagnosed with tuberculosis (TB) has not been systematically reviewed to date. Our aim was to review the existing epidemiological evidence for elevated risk of CVD morbidity and mortality among persons diagnosed with TB compared to controls.

Materials And Methods: EMBASE, MEDLINE, and Cochrane databases were searched (inception to January 2020) for terms related to "tuberculosis" and "cardiovascular diseases". Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235821PLOS

Systematic review of the methods of health economic models assessing antipsychotic medication for schizophrenia.

PLoS One 2020 10;15(7):e0234996. Epub 2020 Jul 10.

King's Health Economics (KHE), Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, United Kingdom.

Background: Numerous economic models have assessed the cost-effectiveness of antipsychotic medications in schizophrenia. It is important to understand what key impacts of antipsychotic medications were considered in the existing models and limitations of existing models in order to inform the development of future models.

Objectives: This systematic review aims to identify which clinical benefits, clinical harms, costs and cost savings of antipsychotic medication have been considered by existing models, to assess quality of existing models and to suggest good practice recommendations for future economic models of antipsychotic medications. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234996PLOS

Sustaining improvements in relational coordination following team training and practice change: A longitudinal analysis.

Health Care Manage Rev 2020 Jul 1. Epub 2020 Jul 1.

Erin Abu-Rish Blakeney, PhD, RN, is Research Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle. E-mail: Hebatallah Naim Ali, MD, MS/IHPM, is PhD Candidate, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Nicole Summerside, MHA, is with the Center for Health Sciences Interprofessional Education, Research and Practice, University of Washington, Seattle. Danielle C. Lavallee, PharmD, PhD, is Research Associate Professor, Department of Surgery, University of Washington, Seattle. Benjamin Kragen, MBA Student and PhD Student, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Mayumi A. Willgerodt, PhD, RN, is Associate Professor, Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle. Bryan J. Weiner, PhD, is Professor, Departments of Global Health and Health Services, School of Public Health, University of Washington, Seattle. Leah Spacciante, MN, RN, is Nurse Manager, University of Washington Medical Center, Seattle. Brenda K. Zierler, PhD, RN, is Professor, Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle.

Background: Poor communication is a leading cause of errors in health care. Structured interprofessional bedside rounds are a promising model to improve communication.

Purpose: The aim of the study was to test if an intervention to improve communication and coordination in an inpatient heart failure care unit would result in lasting change. Read More

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http://dx.doi.org/10.1097/HMR.0000000000000288DOI Listing

Compliance to immediate newborn care practice among midwives working in maternity wards: a best practice implementation project.

Int J Evid Based Healthc 2020 Jul 9. Epub 2020 Jul 9.

Department of Health, Behavior and Society, Ethiopian Evidence Based Healthcare Centre, Institute of Health, Jimma University, Jimma, Ethiopia.

Background: The WHO has a series of comprehensive care instructions to improve the health of newborns from prior to conception, throughout pregnancy, soon after birth and in the postnatal period.

Objective: The objective of this best practice implementation project was to promote evidence-based best practice of immediate newborn care practice among midwives working in the maternity ward.

Methods: Baseline and postimplementation audits were conducted using the Joanna Briggs Institute Practical Application of Evidence System using nine audit criteria for immediate newborn care. Read More

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http://dx.doi.org/10.1097/XEB.0000000000000237DOI Listing

Evidence-based inpatient postnatal care among women in a national hospital in Kazakhstan: a best practice implementation project.

Int J Evid Based Healthc 2020 Jul 9. Epub 2020 Jul 9.

School of Medicine, Nazarbayev University.

Objective: The current project generally aims to assess compliance with evidence-based criteria regarding postnatal care among women in a national hospital in Kazakhstan.

Introduction: Improvements in reducing maternal and infant mortality in Kazakhstan have been noted over the past 2 decades. However, recent studies have indicated that care given to women during the perinatal period, which includes the postnatal period, is unsatisfactory. Read More

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http://dx.doi.org/10.1097/XEB.0000000000000234DOI Listing

Implementation of the chronic obstructive pulmonary disease Assessment Test in clinical practice.

Authors:
Meghan E Abrams

J Am Assoc Nurse Pract 2020 Jul 7. Epub 2020 Jul 7.

University of Colorado College of Nursing, Aurora, Colorado.

Background: The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a questionnaire used for COPD symptom assessment that is validated, reliable, and evidence based; yet, few specialty or primary care practices have formally implemented it in practice.

Local Problem: The University of Colorado's pulmonary division has consistently been rated the best in the country by US News and World Reports; however, the dedicated multidisciplinary COPD clinic at the University had yet to formally implement any COPD Assessment tools for COPD symptom management. This quality improvement project focused on the successful implementation of the CAT for management of COPD and whether its use impacts symptom management. Read More

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http://dx.doi.org/10.1097/JXX.0000000000000449DOI Listing

Asthma guidelines: the best of three.

Authors:
Andrew Booth

Br J Nurs 2020 Jul;29(13):730-736

Independent Prescriber, and Respiratory Clinical Tutor, Primary Care Training Centre, Bradford, and Practice Nurse, Oakwood Lane Medical Practice, Leeds.

National and international guidelines provide evidence-based advice on the diagnosis and management of asthma. There are now three potential asthma guidelines to follow, each taking its own its own unique, and sometimes conflicting direction, creating a total of over 700 pages of high-quality evidence. A puzzle is thus presented to the busy health professional: which guideline do I follow? This article compares and contrasts two national and one international asthma guideline, focusing particularly on diagnosis and pharmacological management. Read More

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http://dx.doi.org/10.12968/bjon.2020.29.13.730DOI Listing

Management of COPD exacerbations: pharmacotherapeutics of medications.

Authors:
David Moore

Br J Nurs 2020 Jul;29(13):738-743

Respiratory Nurse Specialist and Independent Nurse Prescriber, Mater Hospital, Belfast.

Chronic obstructive pulmonary disease (COPD) is widely established as a health challenge, with predictions that it will be the third leading cause of global mortality and reduced health status within the next 10 years. Exacerbations of COPD are now the second largest cause of emergency hospitalisation in the UK. The respiratory clinical nurse specialist has an active role in the acute management of COPD exacerbations in the hospital setting, and it is essential that prescribing decisions are made based on the best available evidence. Read More

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http://dx.doi.org/10.12968/bjon.2020.29.13.738DOI Listing

Assessing reliability and validity of a functional outcome measure for adolescents with hypermobility spectrum disorder.

Disabil Rehabil 2020 Jul 10:1-6. Epub 2020 Jul 10.

College of Health Science and School of Nursing, University of Indianapolis, Indianapolis, IN, USA.

Purpose: To determine the reliability and validity of the upper extremity function and pain scales of the Pediatric Outcomes Data Collecton Instrument (PODCI UEF and PODCI P) as an outcome measure in adolescents with Hypermobility Spectrum Disorder (HSDs).

Materials And Methods: An observational study using a cross-section design was conducted. A convenience sample of 83 adolescents (age 11-18 years) with HSDs were recruited. Read More

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http://dx.doi.org/10.1080/09638288.2020.1788177DOI Listing

Dual-Trajectories of Opioid and Gabapentinoid Use and Risk of Subsequent Drug Overdose among Medicare Beneficiaries in the United States: A Retrospective Cohort Study.

Addiction 2020 Jul 10. Epub 2020 Jul 10.

Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.

Background And Aims: Little is known about opioid and gabapentinoid (OPI-GABA) use duration and dose patterns' associations with adverse outcomes risks. We examined associations between OPI-GABA dose and duration trajectories and subsequent drug overdose.

Design: Retrospective cohort study. Read More

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http://dx.doi.org/10.1111/add.15189DOI Listing

Managing Access by Generating Improvements in Cannulation: A national quality improvement project.

J Vasc Access 2020 Jul 10:1129729820939334. Epub 2020 Jul 10.

NHS Greater Glasgow and Clyde, Glasgow, UK.

Cannulation is essential for haemodialysis with arteriovenous access, but also damages the arteriovenous access making it prone to failure, is associated with complications and affects patients' experiences of haemodialysis. Managing Access by Generating Improvements in Cannulation is a national UK quality improvement project, designed to improve cannulation practice in the United Kingdom, ensuring it reflects current needling recommendations. It uses a simple quality improvement method, the Model for Improvement, to structure improvement to cannulation practice. Read More

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http://dx.doi.org/10.1177/1129729820939334DOI Listing

Evaluation of a pilot interprofessional Arclight™ workshop for healthcare students in Rwanda: promoting collaborative practice in eye health.

J Interprof Care 2020 Jul 10:1-4. Epub 2020 Jul 10.

School of Medicine, University of St Andrews , St Andrews, Scotland.

Preventable and treatable visual impairment affects more than 1 billion people worldwide. Rwanda has an estimated visual impairment prevalence of 3.7% amongst the 12 million inhabitants. Read More

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http://dx.doi.org/10.1080/13561820.2020.1782356DOI Listing

Clinical Practice Guideline Recommendation on the Use of Low Intensity Extracorporeal Shock Wave Therapy and Low Intensity Pulsed Ultrasound Shock Wave Therapy to Treat Erectile Dysfunction: The Asia-Pacific Society for Sexual Medicine Position Statement.

World J Mens Health 2020 Jun 2. Epub 2020 Jun 2.

Department of Urology and Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Published literature shows low intensity extracorporeal shock wave therapy (LIESWT) and low intensity pulsed ultrasound (LIPUS) therapy to improve erectile function and penile hemodynamic by inducing neovascularisation and promoting tissue regeneration. Key opinion leaders across the Asia Pacific region attended the recent biennial meeting of the Asia Pacific Society for Sexual Medicine in Australia, and presented the current evidence on LIESWT and LIPUS for erectile dysfunction (ED). The clinical findings were internally discussed, and the quality of evidence was graded based on the Oxford Centre for Evidence-Based Medicine recommendations. Read More

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http://dx.doi.org/10.5534/wjmh.200077DOI Listing

The quality of information about elective oocyte cryopreservation (EOC) on Australian fertility clinic websites.

Aust N Z J Obstet Gynaecol 2020 Jul 9. Epub 2020 Jul 9.

Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Background: The number of women who undergo elective oocyte cryopreservation (EOC) in the hope of preserving their fertility is increasing. Fertility clinic websites often serve as the first point of contact for women contemplating EOC. There are no guidelines for Australian fertility clinics regarding how information about procedures should be presented. Read More

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http://dx.doi.org/10.1111/ajo.13174DOI Listing

Final Results of a Phase I/II Trial of the Combination Bendamustine and Rituximab With Temsirolimus (BeRT) in Relapsed Mantle Cell Lymphoma and Follicular Lymphoma.

Hemasphere 2020 Jun 8;4(3):e398. Epub 2020 Jun 8.

Department of Medicine III, Ludwig - Maximilians-University Munich, Germany.

In this phase I/II study, we explored the combination of Temsirolimus with Bendamustine and Rituximab (BeRT) in patients with relapsed or refractory (r/r) follicular lymphoma (FL) or mantle cell lymphoma (MCL). Patients with 1 to 3 previous therapies received Bendamustine (90 mg/m, day 1 + 2) and Rituximab (375 mg/m, day 1) with Temsirolimus in doses from 25 to 75 mg in phase I and 50 mg Temsirolimus in phase II, added on day 1, 8, 15 of a 28 days cycle. The primary endpoint of the phase II was ORR at the end of treatment. Read More

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http://dx.doi.org/10.1097/HS9.0000000000000398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306311PMC

Integrating simulation into advanced pharmacy practice experience curriculum: An innovative approach to training.

Saudi Pharm J 2020 Jul 18;28(7):837-843. Epub 2020 Jun 18.

Pharmacy Practice Department, College of Pharmacy, Princess Nourah bint Abdulrahman University, Saudi Arabia.

Background: The use of simulation-based education (SBE) in pharmacy education can help students acquire the essential clinical knowledge and skills for practice and can enhance patients' safety. Simulation-based training has been implemented in inter-professional education training, introductory pharmacy practice experiences, pharmacy residency training. Still, there is limited information in the literature that assesses the use of simulation in advanced pharmacy practice experience (APPE). Read More

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http://dx.doi.org/10.1016/j.jsps.2020.06.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335712PMC

Mental capacity assessment: a descriptive, cross-sectional study of what doctors think, know and do.

J Med Ethics 2020 Jul 9. Epub 2020 Jul 9.

Department of Reproductive Health, UCL Elizabeth Garrett Anderson Institute for Women's Health, UCL, London, UK

Background: The Mental Capacity Act (MCA) (2005) was enacted in 2007 in England and Wales, but the assessment of mental capacity still remains an area of professional concern. Doctors' compliance with legal and professional standards is inconsistent, but the reasons for poor compliance are not well understood. This preliminary study investigates doctors' experiences of and attitudes toward mental capacity assessment (MCAx). Read More

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http://dx.doi.org/10.1136/medethics-2019-105819DOI Listing

Increased opioid use following rotator cuff repair associated with prior opioid use and surgeon prescription patterns.

J Shoulder Elbow Surg 2020 Jul 9;29(7S):S115-S125. Epub 2020 Jun 9.

Steadman Hawkins Clinic of the Carolinas, Prisma Health - Upstate, Greenville, SC, USA. Electronic address:

Background: Prescription opioids are standard of care for postoperative pain management after musculoskeletal surgery, but there is no guideline or consensus on best practices. Variability in the intensity of opioids prescribed for postoperative recovery has been documented, but it is unclear whether this variability is clinically motivated or associated with provider practice patterns, or how this variation is associated with patient outcomes. This study described variation in the intensity of opioids prescribed for patients undergoing rotator cuff repair (RCR) and examined associations with provider prescribing patterns and patients' long-term opioid use outcomes. Read More

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http://dx.doi.org/10.1016/j.jse.2020.04.037DOI Listing

Real-world evidence use in assessments of cancer drugs by NICE.

Int J Technol Assess Health Care 2020 Jul 10:1-7. Epub 2020 Jul 10.

Manchester Centre for Health Economics, The University of Manchester, Manchester, UK.

Objective: To establish how real-world evidence (RWE) has been used to inform single technology appraisals (STAs) of cancer drugs conducted by the National Institute for Health and Care Excellence (NICE).

Methods: STAs published by NICE from April 2011 to October 2018 that evaluated cancer treatments were reviewed. Information regarding the use of RWE to directly inform the company-submitted cost-effectiveness analysis was extracted and categorized by topic. Read More

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http://dx.doi.org/10.1017/S0266462320000434DOI Listing

Using predictive process monitoring to assist thrombolytic therapy decision-making for ischemic stroke patients.

BMC Med Inform Decis Mak 2020 Jul 9;20(Suppl 3):120. Epub 2020 Jul 9.

Information Center, Academy of Military Medical Sciences, Beijing, People's Republic of China.

Background: Although clinical guidelines provide the best practice for medical activities, there are some limitations in using clinical guidelines to assistant decision-making in practical application, such as long update cycle and low compliance of doctors with the guidelines. Driven by data of actual cases, process mining technology provides the possibility to remedy these shortcomings of clinical guidelines.

Methods: We propose a clinical decision support method using predictive process monitoring, which could be complementary with clinical guidelines, to assist medical staff with thrombolytic therapy decision-making for stroke patients. Read More

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http://dx.doi.org/10.1186/s12911-020-1111-6DOI Listing

Atypical Multiple Sclerosis Lesions or Progressive Multifocal Leukoencephalopathy Lesions: That Is the Question.

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620939802

University of Torino, Orbassano, Italy.

Progressive multifocal leukoencephalopathy (PML) is a serious infective disease of the central nervous system that may occur in case of severe immunosuppression or after some treatment for multiple sclerosis (MS) with natalizumab, dimethyl fumarate, and fingolimod. In these case reports, we highlight the importance of differential diagnosis between PML and MS lesions in order to provide rapidly the best treatment option, by discussing the finding of brain (magnetic resonance imaging) MRI suggestive for PML in 2 MS patients, one treated with dimethyl fumarate and the other during natalizumab withdrawal. In both cases, although brain MRI was highly suggestive for PML, the detection of John Cunningham virus-DNA copies in cerebrospinal fluid resulted in negative result. Read More

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http://dx.doi.org/10.1177/2324709620939802DOI Listing

Liver graft from donation after circulatory death donor: Real practice to improve graft viability.

Authors:
Koji Hashimoto

Clin Mol Hepatol 2020 Jul 10. Epub 2020 Jul 10.

Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.

Donation after circulatory death (DCD) is an increasing source of liver grafts for transplantation, yet outcomes have been inferior compared to donation after brain death liver transplantation. These worse outcomes are mainly due to the severe graft injury resulting from mandatory warm ischemia during DCD organ recovery. New evidence, however, indicates that improved donor selection and surgical techniques can decrease the risk of graft failure and ischemic cholangiopathy (IC). Read More

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http://dx.doi.org/10.3350/cmh.2020.0072DOI Listing

Barriers to evidence-based treatment of serious burns: The impact of implicit bias on clinician perceptions of patient adherence.

J Burn Care Res 2020 Jul 10. Epub 2020 Jul 10.

Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham.

The underlying assumption of modern evidence-based practice is that treatment decisions made by health care providers are based solely on the best available scientific data. However, the connection between evidence informed care guidelines, and the provision of care remains ambiguous. In reality a number of contextual and non-clinical factors can also play a role, amongst which is the implicit bias that affects the way in which we approach or treat others based on irrelevant, individual characteristics despite conscious efforts to treat everyone equally. Read More

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http://dx.doi.org/10.1093/jbcr/iraa114DOI Listing

Ovarian reserve as a predictor of cumulative live birth.

Eur J Obstet Gynecol Reprod Biol 2020 Jul 2;252:273-277. Epub 2020 Jul 2.

Reproductive Medicine Unit, University College London Hospital, 250 Euston Road, London, NW1 2BU, United Kingdom.

Objectives: Develop an up to date prediction model using recent cycle data and key pre-treatment predictor variables to estimate a couple's individualised probability of a cumulative live birth after one cycle of ovarian stimulation and transfer of all frozen embryos, before the first embryo transfer.

Study Design: This was a retrospective cohort study. To estimate the cumulative live birth rate we only included couples who had used all embryos from their initial stimulation or achieved a live birth. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2020.06.063DOI Listing

Implementing the Behavioral and Mental Health Entrustable Professional Activity: Insights for a Path Forward.

Acad Pediatr 2020 Jul 6. Epub 2020 Jul 6.

Department of Pediatrics, Cincinnati Children's Hospital Medical Center (CCHMC), 3333 Burnet Ave, ML 2008, Cincinnati, OH 45229; Division of Emergency Medicine, CCHMC, 3333 Burnet Ave, ML 2008, Cincinnati, OH 45229. Electronic address:

Introduction: Mental health problems in children and youth are growing exponentially. General pediatricians, while in a unique position to address these issues as they arise, report they lack adequate training in assessing and managing behavioral/mental health (B/MH) problems. Underscoring the importance of this area, the American Board of Pediatrics has defined B/MH as one of only 17 foundational entrustable professional activities (EPAs) for general pediatric practice. Read More

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http://dx.doi.org/10.1016/j.acap.2020.07.002DOI Listing

Spiritual care provision to end of life patients: A systematic literature review.

J Clin Nurs 2020 Jul 9. Epub 2020 Jul 9.

School of Nursing, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.

Aim: To develop an understanding of how nurses provide spiritual care to terminally ill patients in order to develop best practice.

Background: Patients approaching the end of life (EoL) can experience suffering physically, emotionally, socially and spiritually. Nurses are responsible for assessing these needs and providing holistic care, yet are given little implementable, evidence-based guidance regarding spiritual care. Read More

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http://dx.doi.org/10.1111/jocn.15411DOI Listing

Ferritin and C-reactive protein are predictive biomarkers of mortality and macrophage activation syndrome in adult onset Still's disease. Analysis of the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort.

PLoS One 2020 9;15(7):e0235326. Epub 2020 Jul 9.

Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Objective: To assess the predictive role of ferritin and C-reactive protein (CRP) on occurrence of macrophage activation syndrome (MAS) and mortality in patients with adult onset Still's disease (AOSD), a rare and severe disease, included in the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort.

Methods: The predictive role, at the time of diagnosis, of serum levels of ferritin and CRP on occurrence of MAS and mortality, was evaluated by logistic regression analyses and receiver-operating characteristic (ROC) curves were built to identify patients at high risk of MAS and mortality, respectively.

Results: In assessed 147 patients with AOSD, levels of ferritin were predictive of MAS (OR: 1. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235326PLOS

A CFD strategy to retrofit an anaerobic digester to improve mixing performance in wastewater treatment.

Water Sci Technol 2020 Apr;81(8):1646-1657

University of Bradford, Bradford BD7 1DP, United Kingdom E-mail:

To date, mixing design practice in anaerobic digestion has focussed on biogas production, but no adequate consideration has been given to energy efficiency. A coherent, comprehensive and generalized strategy based on computational fluid dynamics (CFD) modelling is proposed to improve mixing efficiency of a full-scale, unconfined gas-mixed digester for wastewater treatment. The model consists of an Euler-Lagrange (EL) model where biogas bubbles are modelled as the Eulerian dispersed phase, and non-Newtonian sludge as the Lagrangian continuous phase. Read More

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http://dx.doi.org/10.2166/wst.2020.086DOI Listing

The lecture-free curriculum: Setting the stage for life-long learning: AMEE Guide No. 135.

Med Teach 2020 Jul 9:1-8. Epub 2020 Jul 9.

Faculty Development Unit, Education Development Center, Tehran University of Medical Sciences, Tehran, Iran.

In this AMEE Guide we propose that instruction in health sciences education transform to 'lecture-free.' We present rationale for this proposal, guidance on approaches and strategies to achieve the goal, likely challenges, and what we consider the value-added outcomes. We are supported by a confluence of factors: advances in the science of learning the learning of science and clinical reasoning, incontrovertible evidence that active and engaged learning strategies have better outcomes, current and emerging technology infrastructure in and out of the classroom, and best-practice instructional design. Read More

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http://dx.doi.org/10.1080/0142159X.2020.1789083DOI Listing

School Psychology: Training Individuals for One of the Best Kept Secrets in Professional Psychology.

J Psychol 2020 Jul 9:1-17. Epub 2020 Jul 9.

Independent Practice, Garden City, New York.

School psychology training at the doctoral level is discussed. Given the increasing diversity in the schools as well as the varied education and mental health needs of the population, school psychology training is necessarily broad, involving traditional skills such as assessment, intervention, consultation, and counseling, all of which are taught within a context of a changing school population with changing needs. Because there is compulsory education, school psychologists' interface with a broad cross-section of individual children, their parents, and their teachers. Read More

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http://dx.doi.org/10.1080/00223980.2020.1774485DOI Listing

Extended lumbar drainage in idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis of diagnostic test accuracy.

Br J Neurosurg 2020 Jul 9:1-7. Epub 2020 Jul 9.

Department of Neurosurgery, Southmead Hospital, Bristol, UK.

Background: When appropriately selected, a high proportion of patients with suspected idiopathic normal pressure hydrocephalus (iNPH) will respond to cerebrospinal fluid diversion with a shunt. Extended lumbar drainage (ELD) is regarded as the most accurate test for this condition, however, varying estimates of its accuracy are found in the current literature. Here, we review the literature in order to provide summary estimates of sensitivity, specificity, positive- and negative predictive value for this test through meta-analysis of suitably rigorous studies. Read More

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http://dx.doi.org/10.1080/02688697.2020.1787948DOI Listing

Functional assessment and function-based treatment delivered via telehealth: A brief summary.

J Appl Behav Anal 2020 Jul 9. Epub 2020 Jul 9.

The University of Iowa, USA.

As the world navigates the COVID-19 health crisis, behavior analysts are considering how best to support families while maintaining services and ensuring the health and safety of everyone involved. Telehealth is one service delivery option that provides families with access to care in their own communities and homes. In this article, we provide a brief summary of the telehealth literature in applied behavior analysis that provided coaching and training to families for individuals who displayed challenging behavior. Read More

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http://dx.doi.org/10.1002/jaba.742DOI Listing

Optimizing preclinical learning with retrieval practice: A call to action.

Med Teach 2020 Jul 9:1-3. Epub 2020 Jul 9.

Department of Neurology, Yale School of Medicine, New Haven, CT, USA.

This Personal View is about our experience with preclinical education as medical students. We discuss the problem with current medical education in light of an ever-growing body of medical knowledge and increasing student disengagement with preclinical lectures. We briefly review the concept of retrieval practice as an effective, evidence-based learning strategy that helped us retain knowledge for longer periods and propose that medical educators should adopt this strategy to best prepare medical students to navigate the vastly expanding scope of modern medicine. Read More

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http://dx.doi.org/10.1080/0142159X.2020.1788212DOI Listing