1,229,048 results match your criteria Healthcare informatics : the business magazine for information and communication systems[Journal]


Preterm Prelabor Rupture of Membranes: Outcomes with Expectant Management until 34 versus 35 Weeks.

Am J Perinatol 2018 Dec 15. Epub 2018 Dec 15.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York.

Objective:  To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks.

Study Design:  This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks. Read More

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December 2018
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The state of bereavement support in adult intensive care: A systematic review and narrative synthesis.

J Crit Care 2018 Dec 1;50:177-187. Epub 2018 Dec 1.

University of Ottawa, Faculty of Health Sciences, School of Nursing, 3245B Roger Guindon Hall, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada. Electronic address:

Purpose: Despite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions.

Methods: A systematic review and narrative synthesis. Read More

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December 2018
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Intentional early delivery versus expectant management for preterm premature rupture of membranes at 28-32 weeks' gestation: A multicentre randomized controlled trial (MICADO STUDY).

Eur J Obstet Gynecol Reprod Biol 2018 Dec 5;233:30-37. Epub 2018 Dec 5.

Department of Obstetrics and Gynecology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France.

Objectives: Preterm premature rupture of fetal membranes (PPROM) exposes the fetus to preterm birth, and optimal timing for delivery is controversial. The aim of this study was to compare intentional early delivery ("active management") with expectant management in very preterm birth (28-32 weeks).

Study Design: We conducted a prospective randomized controlled trial with intent-to-treat analysis, at 19 tertiary-care hospitals in France and 1 in Geneva, Switzerland. Read More

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December 2018

Design of a randomized controlled trial on the efficacy of a reproductive health survivorship care plan in young breast cancer survivors.

Contemp Clin Trials 2018 Dec 12. Epub 2018 Dec 12.

Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Dr. La Jolla, CA 92093-090, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, 9300 Campus Pointe Drive, MC 7433, La Jolla, CA 92037, USA. Electronic address:

Background: Young breast cancer survivors (YBCS) have unmet needs for managing hot flashes, fertility-related concerns, sexual health and contraception.

Purpose: Describe the design and participant characteristics of a randomized controlled trial testing the efficacy of the survivorship care plan on reproductive health (SCP-R) intervention on improving hot flashes, fertility-related concerns, sexual health, and contraception in YBCS.

Methods: SCP-R is a web-based intervention with text message support encompassing evidence- based practices on four reproductive health issues. Read More

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December 2018

Telephone-delivered cognitive behavioral therapy for veterans with chronic pain following traumatic brain injury: Rationale and study protocol for a randomized controlled trial study.

Contemp Clin Trials 2018 Dec 12. Epub 2018 Dec 12.

Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, Washington 98195-6490, USA; VA Puget Sound Healthcare System, 1660 S. Columbian Way, RCS-117, Seattle, WA 98108, USA. Electronic address:

Background And Objectives: Chronic pain is a highly prevalent and potentially disabling condition in Veterans who have had a traumatic brain injury (TBI) and access to non-pharmacological pain treatments such as cognitive behavioral therapy is limited and variable. The purpose of this randomized controlled trial (RCT) is to evaluate the efficacy of a telephone-delivered cognitive behavioral therapy (T-CBT) for pain in Veterans with a history of TBI.

Methods: Veterans with a history of TBI and chronic pain of at least six months duration (N = 160) will be randomized to either T-CBT or a telephone-delivered pain psychoeducational active control condition (T-Ed). Read More

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December 2018
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Bundle payment model in spine surgery: Current challenges and opportunities, a systematic review.

World Neurosurg 2018 Dec 12. Epub 2018 Dec 12.

Department of Neurosurgery, University of Louisville, 200 Abraham Flexner Hwy, Louisville, KY, U.S.A- 40202. Electronic address:

Introduction: Bundled payments offer a lump sum for management of particular conditions over a specified time period that has the potential to reduce healthcare payments. Additionally, bundled payments represent a shift toward patient-centered reimbursement that has the upside of improved care coordination among providers and may lead to improved outcomes.

Aim: To review the challenges and sources of payment variation and opportunities for restructuring bundled payments plans in context of spine surgery. Read More

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December 2018
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Effective communication in the era of precision medicine: A pilot intervention with low health literacy patients to improve genetic counseling communication.

Eur J Med Genet 2018 Dec 12. Epub 2018 Dec 12.

Department of Social & Behavioral Sciences, University of California, San Francisco, United States.

Effective communication, where all parties share a common understanding, is necessary to realize the promise of Genomic Medicine. It is especially salient given the imperative to increase the participation of diverse populations in genomics research and to expand the reach of clinical genomics. We have previously shown that cancer genetic counseling is suboptimal for patients with limited health literacy. Read More

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December 2018
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Comparison of fatigue, pain and depression in patients with advanced kidney disease and cancer - symptom burden and clusters.

J Pain Symptom Manage 2018 Dec 12. Epub 2018 Dec 12.

Department of Surgery, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA.

Context: While symptom clusters have been studied in the context of cancer, few data exist in chronic and end stage kidney disease (CKD/ESKD) patients.

Objectives: To (1) characterize and compare symptom cluster phenotypes in patients with advanced CKD, ESKD and cancer, and (2) explore predictors of symptom clusters.

Methods: We conducted secondary data analysis of three prospective studies in which pain, depression, and fatigue were assessed in patients with stage 4-5 CKD, ESKD and gastrointestinal (GI) cancer. Read More

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December 2018

Comparison of recurrence and postoperative complications between 3 different techniques for surgical repair of idiopathic hydrocele.

Urology 2018 Dec 12. Epub 2018 Dec 12.

Central Texas Veterans Healthcare System, 1901 Veterans Memorial Dr, Temple, TX.

Objectives: To determine if recurrence rates and complication rates differ between three different techniques for treatment of idiopathic hydrocele: Jaboulay bottleneck, Hydrocelectomy, or Lord's technique.

Methods: All surgeries for idiopathic hydrocele in the health system were reviewed from 2000 - 2011. Recurrence rate, complication rate, and other surgical data were collected and analyzed. Read More

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December 2018

The neural correlates of discrete gait characteristics in ageing: A Structured Review.

Neurosci Biobehav Rev 2018 Dec 12. Epub 2018 Dec 12.

Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle Upon Tyne, UK; Newcastle Upon Tyne Hospital NHS Foundation Trust, UK. Electronic address:

Gait is complex, described by diverse characteristics underpinned by widespread central nervous system networks including motor and cognitive functions. Despite this, neural substrates of discrete gait characteristics are poorly understood, limiting understanding of gait impairment in ageing and disease. This structured review aims to map gait characteristics, defined from a pre-specified model reflecting independent gait domains, to brain imaging parameters in older adults. Read More

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December 2018
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Transitional care for patients with surgical pediatric hepatobiliary disease: choledochal cysts and biliary atresia.

J Gastroenterol Hepatol 2018 Dec 15. Epub 2018 Dec 15.

University of Rochester School of Medicine, Rochester, NY, USA.

Choledochal cysts (CDCs) and biliary atresia (BA) are rare pediatric hepatobiliary anomalies that require surgical intervention due to increased risk of malignancy and liver failure, respectively. The underlying disease and operative procedures place patients at risk for long-term complications, which may continue to affect them into adulthood. Lack of a transitional care model in the health care system potentiates the challenges they will face following aging out of their pediatric providers' care. Read More

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December 2018

Diagnostic diversity - an indicator of institutional and regional healthcare quality.

Swiss Med Wkly 2018 Dec 15;148:w14691. Epub 2018 Dec 15.

Lung Centre, Cantonal Hospital St Gallen, Switzerland.

Aim: Our aim was to estimate the diagnostic performance of institutions and healthcare regions from a nationwide hospitalisation database.

Methods: The Shannon diversity index was used as an indicator of diagnostic performance based on the International Classification of Disease, 10th revision, German Modification (ICD-10-GM codes). The dataset included a total of 9,325,326 hospitalisation cases from 2009 to 2015 and was provided by the Swiss Federal Office for Statistics. Read More

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December 2018

Receptor tyrosine kinase MET as potential target of multi-kinase inhibitor and radiosensitizer sorafenib in HNSCC.

Head Neck 2018 Dec 15. Epub 2018 Dec 15.

Laboratory of Radiobiology and Experimental Radiation Oncology, Hubertus Wald Tumorzentrum-University Cancer Center Hamburg, Hamburg-Eppendorf, Germany.

Background: The multi-kinase inhibitor sorafenib displays antitumoral effects in head and neck squamous cell carcinoma (HNSCC); however, the targeted kinases are unknown. Here we aimed to identify those kinases to determine the mechanism of sorafenib-mediated effects and establish candidate biomarkers for patient stratification.

Methods: The effects of sorafenib and MET inhibitors crizotinib and SU11274 were analyzed using a slide-based antibody array, Western blotting, proliferation, and survival assays. Read More

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December 2018

The experience of Person-centred Practice in a 100% single-room environment in acute care settings - a narrative literature review.

J Clin Nurs 2018 Dec 15. Epub 2018 Dec 15.

Nursing Research and Practice Development, Ulster University, and South Eastern Health and Social Care Trust, Northern Ireland.

Aims And Objectives: To review published research into the staff and adult patient experience of person-centred practice in a 100% single-room environment in acute care.

Background: There has been a significant move towards the 100% single-room environment within healthcare systems. Furthermore, there has been a global move for developing person-centred practice in a range of healthcare settings. Read More

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December 2018
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A comparative effectiveness study of degludec and insulin glargine 300U/mL in insulin-naïve patients with type 2 diabetes.

Diabetes Obes Metab 2018 Dec 15. Epub 2018 Dec 15.

Clinical Research, Endocrine and Metabolic Consultants, Rockville, MD, USA.

Aims: To compare the real-world effectiveness of insulin degludec (degludec) and glargine 300 units/mL (glargine U300) in insulin-naïve adult patients with type 2 diabetes in routine US clinical practice.

Materials And Methods: CONFIRM is a non-interventional comparative effectiveness study following US patients across the continuum of care, through electronic medical records from multiple health systems and integrated delivery networks. Propensity-score matching controlled for confounding. Read More

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December 2018
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To explore of the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: a review.

J Clin Nurs 2018 Dec 15. Epub 2018 Dec 15.

DMedEth RN SFHEA Senior Lecturer University of Birmingham.

Aims And Objectives: To explore of the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: a review.

Background: End-stage heart failure is associated with significant symptom burden at rest. Left ventricular assist devices are not curative nevertheless they alleviate symptoms and prolong survival. Read More

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December 2018

Cancer survivorship: an integral part of Europe's research agenda.

Mol Oncol 2018 Dec 15. Epub 2018 Dec 15.

Huntsman Cancer Institute, Salt Lake City, Utah, USA.

Cancer survivorship has traditionally received little prioritisation and attention. For a long time, the treatment of cancer has been the main focus of healthcare providers' efforts. It is time to increase the amount of attention given to patients' long-term well-being and their ability to return to a productive and good life. Read More

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December 2018

Healthcare staff's evaluation of a walk-in centre at a healthcare centre in an immigrant-dense area.

J Clin Nurs 2018 Dec 15. Epub 2018 Dec 15.

Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Aims And Objectives: To evaluate a walk-in centre at a healthcare centre in an immigrant-dense area where a high proportion of the patients have limited language ability in Swedish, from the perspective of healthcare personnel.

Background: Increased global migration results in higher vulnerability in migrants, with the risk of increased morbidity and mortality. Migrants' health often deteriorates, which can be attributed to an increased level of stress and adaptation to a new lifestyle. Read More

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December 2018

Unit Leadership and Climates for Evidence-Based Practice Implementation in Acute Care: A Cross-Sectional Descriptive Study.

J Nurs Scholarsh 2018 Dec 15. Epub 2018 Dec 15.

Rho, Professor, University of Michigan School of Nursing, Ann Arbor, MI, USA.

Purpose: The purposes of this study were to (a) describe nurse manager (NM) leadership behaviors for evidence-based practice, NM evidence-based practice competencies, and unit climates for evidence-based practice implementation in acute care, and (b) test for differences in NMs' and staff nurses' (RNs') perceptions.

Design: A multisite cross-sectional design was used to collect data from a sample of 24 NMs and 553 RNs from 24 adult medical-surgical units in seven U.S. Read More

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December 2018

Diagnostic value of computed tomography combined with ultrasonography in detecting cervical recurrence in patients with thyroid cancer.

Head Neck 2018 Dec 14. Epub 2018 Dec 14.

Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.

Background: To determine the diagnostic role of CT added to ultrasound for the diagnosis of recurrent differentiated thyroid cancer (DTC) and to evaluate potential benefits for patients.

Methods: A total of 193 patients with recurrent DTC were retrospectively included. The diagnostic performances of ultrasound and combination of ultrasound and CT (ultrasound/CT) in detecting recurrence were compared. Read More

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December 2018

Physician referral to a psychologist: Testing alternative behavioral healthcare seeking models.

J Clin Psychol 2018 Dec 15. Epub 2018 Dec 15.

Psychology Department, Virginia Commonwealth University, Richmond, Virginia.

Objective: Primary care physicians (PCPs) often refer patients to psychological services, but help-seeking factors in the context of behavioral healthcare referral are understudied. This study examined perceptions of seeking psychological help for depression by comparing alternative structural equation models derived from the Theory of Reasoned Action (TRA).

Method: Internet survey participants (N = 685 US adults, 77% female, M  = 45) imagined themselves in a vignette scenario in which they are experiencing depression symptoms and encouraged by a PCP to see a psychologist. Read More

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December 2018

Identification of microRNAs related to myocardial ischemic reperfusion injury.

J Cell Physiol 2018 Dec 14. Epub 2018 Dec 14.

Department of Anesthesiology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.

Previous studies have suggested that microRNAs (miRNAs) are associated with the progression of myocardial ischemic reperfusion (I/R) injury. However, inconsistent results have been obtained due to the differences in sequencing platform, control selection, and filtering conditions. To explore the key miRNAs in the pathogenesis of myocardial I/R injury and develop miRNA diagnostic biomarkers for myocardial I/R injury prevention, we performed a systematic analysis of publicly available myocardial I/R injury miRNA expression data and investigated the function of the signature miRNA. Read More

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December 2018

A three dimensional microfluidized liver system to assess hepatic drug metabolism and hepatotoxicity.

Biotechnol Bioeng 2018 Dec 14. Epub 2018 Dec 14.

Center for Advanced Biomaterials for HealthCare@CRIB, Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, Naples, Italy.

In this work we propose the design and fabrication of a liver system on chip. We first chose the most suitable 3D liver-like model between cell spheroids and microtissue-precursors, both based on the use of hepatocellular carcinoma cells (HepG2) to provide proof-of-concept data. Spheroids displayed high cell density but low expression of the typical hepatic biomarkers, while microtissue-precursors showed stable viability and function over the entire culture time. Read More

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December 2018

The Drug Shortage Crisis in the United States: Impact on Cancer Pharmaceutical Safety.

Cancer Treat Res 2019 ;171:75-92

University of Colorado Denver, Denver, CO, USA.

Drug shortages pose a significant public health concern in the United States, and cancer drugs are among those most affected. Shortages present serious safety risks for patients and substantial burden on providers and the healthcare system. Multifaceted drivers of this complex problem include manufacturing disruptions, raw material shortages, regulatory issues, market dynamics, and limited financial incentives that reward quality and production of off-patent drugs. Read More

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January 2019

Effect of Levothyroxine Treatment on Incident Dementia in Adults with Atrial Fibrillation and Hypothyroidism.

Clin Drug Investig 2018 Dec 14. Epub 2018 Dec 14.

Center for Primary Health Care Research, Lund University, Malmö, Sweden.

Background And Objective: The possible adverse or positive effects of levothyroxine treatment among patients with atrial fibrillation have been debated. Atrial fibrillation, levothyroxine treatment, and dementia are common among older adults, yet little is known about the effects of levothyroxine on the development of dementia.

Methods: The study population included all adults (n = 12,057) aged ≥ 45 years with a diagnosis of atrial fibrillation at 75 primary care centers in Sweden during 2001-2007 without an earlier recorded dementia diagnosis. Read More

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December 2018

Diagnostic pathways and management in women with pregnancy-associated breast cancer (PABC): no evidence of treatment delays following a first healthcare contact.

Breast Cancer Res Treat 2018 Dec 14. Epub 2018 Dec 14.

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Background: Women with pregnancy-associated breast cancer (PABC), i.e. diagnosed during or within 2 years of pregnancy, have a poor prognosis. Read More

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December 2018

Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women.

Support Care Cancer 2018 Dec 14. Epub 2018 Dec 14.

College of Nursing, Michigan State University, East Lansing, MI, 48824, USA.

Purpose: This project's purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study.

Methods: A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two training sessions by a professional reflexologist) or attention control. The Conventional Health Service and Productivity Costs Form was used to collect information on health service utilization and out-of-pocket expenditure of symptom management. Read More

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December 2018

Radiologic types of Mycobacterium xenopi pulmonary disease: different patients with similar short-term outcomes.

Eur J Clin Microbiol Infect Dis 2018 Dec 14. Epub 2018 Dec 14.

Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada.

Mycobacterium xenopi pulmonary disease (Mxe-PD) is common among nontuberculous mycobacterial infections in Europe and Canada. Associations between radiological pattern and clinical features and outcomes are inadequately studied in Mxe-PD. We sought to investigate clinical characteristics and outcomes according to the dominant radiological pattern among patients with Mxe-PD. Read More

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December 2018

Cardioimmunology of arrhythmias: the role of autoimmune and inflammatory cardiac channelopathies.

Nat Rev Immunol 2018 Dec 14. Epub 2018 Dec 14.

Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.

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December 2018

Transcriptome 3'end organization by PCF11 links alternative polyadenylation to formation and neuronal differentiation of neuroblastoma.

Nat Commun 2018 Dec 14;9(1):5331. Epub 2018 Dec 14.

Posttranscriptional Gene Regulation, Cancer Research and Experimental Haemostasis, University Medical Centre Mainz, Mainz, 55131, Germany.

Diversification at the transcriptome 3'end is an important and evolutionarily conserved layer of gene regulation associated with differentiation and dedifferentiation processes. Here, we identify extensive transcriptome 3'end-alterations in neuroblastoma, a tumour entity with a paucity of recurrent somatic mutations and an unusually high frequency of spontaneous regression. Utilising extensive RNAi-screening we reveal the landscape and drivers of transcriptome 3'end-diversification, discovering PCF11 as critical regulator, directing alternative polyadenylation (APA) of hundreds of transcripts including a differentiation RNA-operon. Read More

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December 2018

Comprehensive Evaluation of User Interface for Ventilators Based on Respiratory Therapists' Performance, Workload, and User Experience.

Med Sci Monit 2018 Dec 15;24:9090-9101. Epub 2018 Dec 15.

Department of Medical Engineering, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).

BACKGROUND Poor ergonomic design of ventilators can result in human errors. In this study, we evaluated the ergonomics of ventilators through respiratory therapists' performance, workload, and user experience. MATERIAL AND METHODS Sixteen respiratory therapists were recruited to this usability study of 3 ventilators. Read More

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December 2018

Dexamethasone versus prednisone for children receiving asthma treatment in the paediatric inpatient population: protocol for a feasibility randomised controlled trial.

BMJ Open 2018 Dec 14;8(12):e025630. Epub 2018 Dec 14.

Departments of Pediatrics and Emergency Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.

Introduction: Asthma exacerbations are a leading cause of paediatric hospitalisations. Corticosteroids are key in the treatment of asthma exacerbations. Most current corticosteroids treatment regimens for children admitted with asthma exacerbation consist of a 5-day course of prednisone or prednisolone. Read More

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December 2018

Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews.

BMJ Open 2018 Dec 14;8(12):e024262. Epub 2018 Dec 14.

Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.

Objectives: Self-management support aims to give people with chronic disease confidence to actively manage their disease, in partnership with their healthcare provider. A meta-review can inform policy-makers and healthcare managers about the effectiveness of self-management support strategies for people with type 2 diabetes, and which interventions work best and for whom.

Design: A meta-review of systematic reviews of randomised controlled trials (RCTs) was performed adapting Cochrane methodology. Read More

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December 2018

Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers.

BMJ Open 2018 Dec 14;8(12):e024068. Epub 2018 Dec 14.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Objective: Home healthcare is the fastest growing arena in the healthcare system but patient safety research in this context is limited. The aim was to explore how patient safety in Swedish specialised home healthcare is described and adressed from multidisciplinary teams' and clinical managers' perspectives.

Design: An explorative qualitative study. Read More

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December 2018

Survival and new-onset morbidity after critical care admission for acute pancreatitis in Scotland: a national electronic healthcare record linkage cohort study.

BMJ Open 2018 Dec 14;8(12):e023853. Epub 2018 Dec 14.

Surgery, School of Medicine, University of Edinburgh, Edinburgh, UK.

Introduction: Severe acute pancreatitis (AP) requiring critical care admission (ccAP) impacts negatively on long-term survival.

Objective: To document organ-specific new morbidity and identify risk factors associated with premature mortality after an episode of ccAP.

Design: Cohort study. Read More

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December 2018

Disability and morbidity among older patients in the emergency department: a Danish population-based cohort study.

BMJ Open 2018 Dec 14;8(12):e023803. Epub 2018 Dec 14.

Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.

Objectives: The objective was to describe the prevalence of geriatric conditions among older medical patients in the emergency department (ED) and the association with admission, mortality, reattendance and loss of independency.

Design: Population-based prospective cohort study.

Setting: ED of a large university hospital. Read More

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December 2018

How is the audit of therapy intensity influencing rehabilitation in inpatient stroke units in the UK? An ethnographic study.

BMJ Open 2018 Dec 14;8(12):e023676. Epub 2018 Dec 14.

School of Population Health and Environmental Sciences, King's College London, London, UK.

Objectives: Occupational therapy, physiotherapy and speech and language therapy are central to rehabilitation after a stroke. The UK has introduced an audited performance target: that 45 min of each therapy should be provided to patients deemed appropriate. We sought to understand how this has influenced delivery of stroke unit therapy. Read More

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December 2018

Qualitative exploration of sociocultural determinants of health inequities of Dalit population in Dhaka City, Bangladesh.

BMJ Open 2018 Dec 14;8(12):e022906. Epub 2018 Dec 14.

Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.

Objectives: In recent years, Bangladesh has made remarkable advances in health outcomes; however, the benefits of these gains are unequally shared among citizens and population groups. Dalits ( sweepers), a marginalised traditional working community, have relatively poor access to healthcare services. This study sought to explore the sociopolitical and cultural factors associated with health inequalities among Dalits in an urban setting. Read More

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December 2018

Cost of oropharyngeal dysphagia after stroke: protocol for a systematic review.

BMJ Open 2018 Dec 14;8(12):e022775. Epub 2018 Dec 14.

Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.

Introduction: Oropharyngeal dysphagia (OD) is a major disorder following stroke. OD can produce alterations in both the efficacy and safety of deglutition and may result in malnutrition, dehydration, frailty, respiratory infections and pneumonia. These complications can be avoided by early detection and treatment of OD in poststroke patients, and hospital stays, medication and mortality rates can be reduced. Read More

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December 2018

Costs and outcomes in evaluating management of unhealed surgical wounds in the community in clinical practice in the UK: a cohort study.

BMJ Open 2018 Dec 14;8(12):e022591. Epub 2018 Dec 14.

Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.

Objective: To evaluate the patient pathways and associated health outcomes, resource use and corresponding costs attributable to managing unhealed surgical wounds in clinical practice, from initial presentation in the community in the UK.

Methods: This was a retrospective cohort analysis of the records of 707 patients in The Health Improvement Network (THIN) database whose wound failed to heal within 4 weeks of their surgery. Patients' characteristics, wound-related health outcomes and healthcare resource use were quantified, and the total National Health Service (NHS) cost of patient management was estimated at 2015/2016 prices. Read More

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December 2018

Ten-year trends in traumatic brain injury: a retrospective cohort study of California emergency department and hospital revisits and readmissions.

BMJ Open 2018 Dec 14;8(12):e022297. Epub 2018 Dec 14.

Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.

Objective: To describe visits and visit rates of adults presenting to emergency departments (EDs) with a diagnosis of traumatic brain injury (TBI). TBI is a major cause of death and disability in the USA; yet, current literature is limited because few studies examine longer-term ED revisits and hospital readmission patterns of TBI patients across a broad spectrum of injury severity, which can help inform potential unmet healthcare needs.

Design: We performed a retrospective cohort study. Read More

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December 2018

study: protocol for a stepped-wedge cluster randomised trial to compare access to care for a mobile app versus a workstation-based store-and-forward teledermatology process.

BMJ Open 2018 Dec 14;8(12):e022218. Epub 2018 Dec 14.

US Department of Veterans Affairs, Center for Access Policy, Evaluation and Research, Boston, Massachusetts, USA.

Introduction: Teledermatology has emerged as an important strategy to enhance access to high-quality skin care. is a provider-facing, web-based mobile app designed to integrate into the existing teledermatology workflow in the US Veterans Health Administration (VHA). In this study, we will conduct a systematic evaluation of on access outcomes in VHA facilities using a pragmatic trial guided by clinical and operational leaders. Read More

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December 2018
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Indigenous health worker support for patients with poorly controlled type 2 diabetes: study protocol for a cluster randomised controlled trial of the Mana Tū programme.

BMJ Open 2018 Dec 14;8(12):e019572. Epub 2018 Dec 14.

Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand.

Introduction: Type 2 diabetes mellitus (T2DM) and its complications are more common among Māori and Pacific people compared with other ethnic groups in New Zealand. Comprehensive and sustained approaches that address social determinants of health are required to address this condition, including culturally specific interventions. Currently, New Zealand has no comprehensive T2DM management programme for Māori or Pacific people. Read More

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December 2018

Emergency Room Safer Transfer of Patients (ER-STOP): a quality improvement initiative at a community-based hospital to improve the safety of emergency room patient handovers.

BMJ Open 2018 Dec 14;8(12):e019553. Epub 2018 Dec 14.

Department of Medicine, Division of Respirology, University of Toronto and Michael Garron Hospital, Michael Garron Hospital, Toronto, Ontario, Canada.

Objectives: Ensure early identification and timely management of patient deterioration as essential components of safe effective healthcare. Prompted by analyses of incident reports and deterioration events, a multicomponent organisational rescue from danger system was redesigned to decrease unexpected inpatient deterioration.

Design: Quality improvement before-after unblinded trial. Read More

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December 2018

Pancreas Volume Declines During the First Year After Diagnosis of Type 1 Diabetes and Exhibits Altered Diffusion at Disease Onset.

Diabetes Care 2018 Dec 14. Epub 2018 Dec 14.

Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN

Objective: This study investigated the temporal dynamics of pancreas volume and microstructure in children and adolescents with recent-onset type 1 diabetes (T1D) and individuals without diabetes, including a subset expressing autoantibodies associated with the early stages of T1D.

Research Design And Methods: MRI was performed in individuals with recent-onset stage 3 T1D ( = 51; median age 13 years) within 100 days after diagnosis (mean 67 days), 6 months, and 1 year postdiagnosis. Longitudinal MRI measurements were also made in similarly aged control participants ( = 57) and in autoantibody-positive individuals without diabetes ( = 20). Read More

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December 2018
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An overview of the 6th World Symposium on Pulmonary Hypertension.

Eur Respir J 2018 Dec 14. Epub 2018 Dec 14.

Univ. Paris-Sud, AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Service de Pneumologie, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Hôpital de Bicêtre, Le Kremlin Bicêtre, France.

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December 2018

Patient and provider characteristics associated with communication about opioids: An observational study.

Patient Educ Couns 2018 Dec 3. Epub 2018 Dec 3.

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Regenstrief Institute, Inc., Indianapolis, IN, USA; Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; Center for Health Information and Communication, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA.

Objective: Our objective is to examine the relationship of patient and provider characteristics and communication with chronic non-cancer pain and opioid management in primary care.

Method: We conducted an observational study using audio-recorded primary care appointments (up to 3/patient) and self-reported assessments of primary care providers (PCPs) and patients. We coded visit transcripts for 1) opioid and pain management talk and 2) mental health and opioid safety talk. Read More

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December 2018

Off-hours use of a smartphone intervention to extend support for individuals with schizophrenia spectrum disorders recently discharged from a psychiatric hospital.

Schizophr Res 2018 Dec 11. Epub 2018 Dec 11.

The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA.. Electronic address:

Introduction: Technology-delivered healthcare interventions may enhance dissemination of evidence-based treatments in low-resource areas. These interventions may be accessed 'on-demand,' including after hours. Patients with schizophrenia do engage with technological aids but when/how they would utilize these tools is not known. Read More

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December 2018

How Can We Ensure Vascular Surgical Trainees Become Competent in Open Aortic Surgery in the Future Training Environment?

Eur J Vasc Endovasc Surg 2018 Dec 11. Epub 2018 Dec 11.

Department of Vascular Surgery, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address:

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December 2018

Survival benefits associated with surgery for advanced non-small cell lung cancer.

J Thorac Cardiovasc Surg 2018 Nov 14. Epub 2018 Nov 14.

UC Davis Comprehensive Cancer Center, UC Davis Health, Sacramento, Calif.

Objective: Overall survival (OS) for advanced stage (IIIA-IV) non-small cell lung cancer (NSCLC) is highly variable, and retrospective data show a survival advantage for patients receiving therapeutic intent pulmonary resection. We hypothesized that this variability in OS can be modeled separately by stage to allow a personalized estimate of OS.

Methods: In a cohort of patients with advanced-stage NSCLC from the National Cancer Database, we assessed the accuracy of Surgical Selection Score (SSS) to predict OS using Cox proportional hazards models and determined by stage the effect of surgery on survival among people with similarly high levels of SSS. Read More

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November 2018
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