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241. How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study. Full Text available with Trip Pro

How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study. Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs.A mixed-methods approach integrated data from descriptive qualitative interviews (...) lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2017 BMJ open

242. Home palliative care works: but how? A meta-ethnography of the experiences of patients and family caregivers. Full Text available with Trip Pro

Home palliative care works: but how? A meta-ethnography of the experiences of patients and family caregivers. To understand patients and family caregivers' experiences with home palliative care services, in order to identify, explore and integrate the key components of care that shape the experiences of service users.We performed a meta-ethnography of qualitative evidence following PRISMA recommendations for reporting systematic reviews. The studies were retrieved in 5 electronic databases (...) of living life and preparing death at home.Home palliative care teams improve patients and caregivers experience of security when facing life-limiting illnesses at home, by providing competent care and being present. These teams should therefore be widely available and empowered with the resources to be present and provide competent care.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products

2017 BMJ Supportive & Palliative Care

243. How are adjacent spinal levels affected by vertebral fracture, and by vertebroplasty? a biomechanical study on cadaveric spines. Full Text available with Trip Pro

How are adjacent spinal levels affected by vertebral fracture, and by vertebroplasty? a biomechanical study on cadaveric spines. Spinal injuries and surgery may have important effects on neighboring spinal levels, but previous investigations of adjacent-level biomechanics have produced conflicting results. We use "stress profilometry" and noncontact strain measurements to investigate thoroughly this long-standing problem.This study aimed to determine how vertebral fracture and vertebroplasty (...) vertebrae, and again after the injury had been treated by vertebroplasty. The study was funded by a grant from Action Medical Research, UK ($143,230). Authors of this study have no conflicts of interest to disclose.Injury usually involved endplate fracture, often combined with deformation of the anterior cortex, so that the affected vertebral body developed slight anterior wedging. Injury reduced IDP at the affected level, to an average 47% of pre-fracture values (p<.001), and transferred compressive

2017 The Spine Journal

244. How well do we currently care for our dying patients in acute hospitals: the views of the bereaved relatives? Full Text available with Trip Pro

How well do we currently care for our dying patients in acute hospitals: the views of the bereaved relatives? The National Care of the Dying Audit-Hospitals (NCDAH) is used as a method to evaluate care for dying patients in England. An additional component to the 2013/2014 audit was the Local Survey of Bereaved Relatives Views using the 'Care Of the Dying Evaluation' (CODE) questionnaire.Within the context of the NCDAH audit, to evaluate quality of care provided to dying patients (...) addition. On the whole, the majority of participants reported good or excellent care. A small but significant minority, however, perceived poor quality of patient care with clear and timely communication urgently needed.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2017 BMJ Supportive & Palliative Care

245. NIHR Clinical Research Networks: what they do and how they help paediatric research. (Abstract)

NIHR Clinical Research Networks: what they do and how they help paediatric research. This review provides paediatricians with an update on the new structure of the National Institute for Health Research's (NIHR) Clinical Research Network (CRN): Children and its role within the wider NIHR infrastructure. The network supports delivery of high-quality research within the NHS in England and supports researchers, through provision of staff and resources, with feasibility, site set-up, patient (...) of paediatric research.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2017 Archives of Disease in Childhood

246. How prepared are UK medical graduates for practice? A rapid review of the literature 2009-2014. Full Text available with Trip Pro

How prepared are UK medical graduates for practice? A rapid review of the literature 2009-2014. To understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions.A rapid review of the literature (registration #CRD42013005305).Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information (...) Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2017 BMJ open

247. Improving patient safety through better teamwork: how effective are different methods of simulation debriefing? Protocol for a pragmatic, prospective and randomised study. Full Text available with Trip Pro

Improving patient safety through better teamwork: how effective are different methods of simulation debriefing? Protocol for a pragmatic, prospective and randomised study. Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation (...) settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects. Furthermore, teamwork-training sessions and studies examining education effects on undergraduates are rare. The study aims to evaluate the effects of two teamwork-focused debriefings on team performance after an extensive medical student teamwork training.A prospective experimental study has been designed to compare a well

2017 BMJ open

248. How can we ensure that the coroner's autopsy is not an invasion of human rights? (Abstract)

How can we ensure that the coroner's autopsy is not an invasion of human rights? Despite public inquiries, and some changes to legislation following high-profile multiple homicides that were not detected by autopsy, coroners continue to rely largely on the autopsy. Regardless of the extent of quality failings and excess deaths at some hospitals, not detected through the coroner system, the autopsy is scarcely used by hospitals to monitor standards and educate.To explore when a compulsory (...) in healthcare can undoubtedly result from detailed coroners' inquiries, those deaths where the matters investigated relate only to the accuracy of a natural cause of death or sit with a healthcare provider's internal quality assurance, should be investigated by the healthcare system in collaboration with the bereaved.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

2017 Journal of Clinical Pathology

249. How are non-numerical prognostic statements interpreted and are they subject to positive bias? Full Text available with Trip Pro

How are non-numerical prognostic statements interpreted and are they subject to positive bias? Frank, clear communication with family members of terminally ill or incapacitated patients has important implications for well-being, satisfaction with care and sound decision-making. However, numerical prognostic statements, particularly more negative ones, have been found to be interpreted in a positively biased manner. Less precise non-numerical statements, preferred by physicians, and particularly (...) but this was not, however, affected by the wording of the prognoses in terms of dying versus surviving.The findings illuminate the ways in which commonly used non-numeric language may be understood in numeric terms during prognostic discussions and provide further evidence of recipients' propensity for positive bias.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

2017 BMJ Supportive & Palliative Care

250. How do smoking cessation medicines compare with respect to their neuropsychiatric safety? A protocol for a systematic review, network meta-analysis and cost-effectiveness analysis. Full Text available with Trip Pro

How do smoking cessation medicines compare with respect to their neuropsychiatric safety? A protocol for a systematic review, network meta-analysis and cost-effectiveness analysis. Cigarette smoking is one of the leading causes of early death in the UK and worldwide. Public health guidance recommends the use of varenicline, bupropion and nicotine replacement therapy (NRT) as smoking cessation aids in the UK. Additionally, the first electronic cigarette has been licensed for use as a smoking (...) cessation medicine. However, there are ongoing concerns about the safety of these medicines. We present a protocol for a systematic review and network meta-analysis (NMA) to determine how these smoking cessation medicines compare to each other with respect to their neuropsychiatric safety in adult smokers. Secondary aims include updating the evidence regarding the effectiveness and cardiovascular safety of these medicines for use in a cost-effectiveness analysis.We will include randomised controlled

2017 BMJ open

251. How sustainable household environment and knowledge of healthy practices relate to childhood morbidity in South Asia: analysis of survey data from Bangladesh, Nepal and Pakistan. Full Text available with Trip Pro

How sustainable household environment and knowledge of healthy practices relate to childhood morbidity in South Asia: analysis of survey data from Bangladesh, Nepal and Pakistan. Prevalence of diarrhoea and acute respiratory infection (ARI) is considerably high among South Asian children. The objective of this study is to compare the associations of sustainable household environment and knowledge of healthy practices with episodes of these diseases among the children in the region.The study (...) in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

2017 BMJ open

252. Understanding how and why audits work: protocol for a realist review of audit programmes to improve hospital care. Full Text available with Trip Pro

Understanding how and why audits work: protocol for a realist review of audit programmes to improve hospital care. Many types of audits are commonly used in hospital care to promote quality improvements. However, the evidence on the effectiveness of audits is mixed. The objectives of this proposed realist review are (1) to understand how and why audits might, or might not, work in terms of delivering the intended outcome of improved quality of hospital care and (2) to examine under what (...) circumstances audits could potentially be effective. This protocol will provide the rationale for using a realist review approach and outline the method.This review will be conducted using an iterative four-stage approach. The first and second steps have already been executed. The first step was to develop an initial programme theory based on the literature that explains how audits are supposed to work. Second, a systematic literature search was conducted using relevant databases. Third, data

2017 BMJ open

253. How common is clinically inactive disease in a prospective cohort of patients with juvenile idiopathic arthritis? The importance of definition. Full Text available with Trip Pro

How common is clinically inactive disease in a prospective cohort of patients with juvenile idiopathic arthritis? The importance of definition. Many criteria for clinically inactive disease (CID) and minimal disease activity (MDA) have been proposed for juvenile idiopathic arthritis (JIA). It is not known to what degree each of these criteria overlap within a single patient cohort. This study aimed to compare the frequency of MDA and CID across different criteria in a cohort of children (...) -off were in CID according to both criteria.In a large JIA prospective inception cohort, a majority of patients have evidence of persistent disease activity after 1 year. Published criteria to capture MDA and CID do not always identify the same groups of patients. This has significant implications when defining and applying treat-to-target strategies.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com

2017 Annals of the Rheumatic Diseases

254. How is rehabilitation with and without an integrated self-management approach perceived by UK community-dwelling stroke survivors? A qualitative process evaluation to explore implementation and contextual variations. Full Text available with Trip Pro

How is rehabilitation with and without an integrated self-management approach perceived by UK community-dwelling stroke survivors? A qualitative process evaluation to explore implementation and contextual variations. Self-management programmes could support long-term needs after stroke and using methods integrated into rehabilitation is one option. To explore theoretical assumptions and possible mechanisms of implementation a process evaluation was delivered alongside a cluster trial which has (...) evaluation analysed thematically.Study was based in South London; all interviews were carried out in participants' home setting.22 stroke participants recruited; 12 from integrated self-management sites and 10 from usual care sites.All participants revealed shared appreciation of knowledge and support from therapists but subtle differences emerged between sites in respect to perceptions about responsibility, control and how previous experiences were used. Accounts depicted a variance regarding who had

2017 BMJ open

255. Antenatal consultations for preterm labour: how are future mothers reassured? (Abstract)

Antenatal consultations for preterm labour: how are future mothers reassured? To evaluate whether the antenatal consultation for preterm labour worries or reassures women, and to identify factors contributing to these feelings.This is a prospective survey study from April 2012 to September 2013. This mixed-methodology tool was co-constructed with patients and first tested in a single-centre pilot study.Three university-affiliated, tertiary care, high-risk obstetrics inpatient units in Quebec (...) otherwise expressly granted.

2017 Archives of Disease in Childhood. Fetal and Neonatal Edition

256. Staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden. Full Text available with Trip Pro

Staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden. To explore healthcare staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts.Two focus group discussions were performed.Two settings were included: a rheumatology department and an orthopaedic section (...) both situated in Sweden.Healthcare staff and managers (n=13) from the two settings.Two workshops were performed, one at each setting. Workshops were initiated by a short introduction to simulation modelling. Results from the respective simulation model were then presented and discussed in the following focus group discussion.Categories from the content analysis are presented according to the following research questions: how and when simulation modelling can assist healthcare improvement? Regarding

2017 BMJ open

257. A realist review to explore how low-income pregnant women use food vouchers from the UK's Healthy Start programme. Full Text available with Trip Pro

A realist review to explore how low-income pregnant women use food vouchers from the UK's Healthy Start programme. To explore how low-income pregnant women use Healthy Start food vouchers, the potential impacts of the programme, and which women might experience these impacts and why.A realist review.Primary or empirical studies (of any design) were included if they contributed relevant evidence or insights about how low-income women use food vouchers from the Healthy Start (UK) or the Special (...) Start and 34 studies on WIC. Two main outcome strands were identified: dietary improvements (intended) and financial assistance (unintended). Three evidence-informed programme theories were proposed to explain how aspects of context (and mechanisms) may generate these outcomes: the 'relative value' of healthy eating (prioritisation of resources); retailer discretion (pressure to 'bend the rules'); the influence of other family members (disempowerment).This realist review suggests that some low

2017 BMJ open

258. An anonymous Canadian foundation grants $3 million to study naturopathic oncology

An anonymous Canadian foundation grants $3 million to study naturopathic oncology An anonymous Canadian foundation grants $3 million to study naturopathic oncology | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation An anonymous Canadian foundation grants $3 million to study naturopathic oncology By on April 1, 2015. It's no secret that I don't have a high opinion of naturopathy. Just enter the word "naturopathy" into the search box of this blog, and you'll quickly see (...) , or, as I like to call it, doing a clinical trial of magic. At first I thought the melatonin study might be part of the Thoracic POISE study, but I saw rapidly that it had been entered in the database back in 2008, long before the grant received by the OICC. The homeopathy trial doesn't specify thoracic malignancies and is open to patients with any cancer who are undergoing chemotherapy. So, no, this doesn't look like it's part of Thoracic POISE either. Next, I looked up , using Seely's name and various

2015 Respectful Insolence

259. Three simple tips to survive grant writing

submission. That’s at least one full month of work for the PI alone! Add to that the fact that grant funding can make or break a career and it’s no wonder that grant writing is stressful. To avoid burn out from writing a grant (or dissertation), try the following tips. 1. Give yourself a break Keep your mind energized by taking breaks from work. Image courtesy: Marcel Oosterwijk from Amsterdam, The Netherlands [CC BY-SA 2.0], via Wikimedia Commons Grant writing can be an all encompassing process (...) Three simple tips to survive grant writing Three simple tips to survive grant writing | PLOS ECR Community PLOS Blogs Staff Blogs Blogs by Topic Biology & Life Sciences Earth & Environmental Sciences Multi-disciplinary Sciences Medicine & Health Research Analysis & Scientific Policy Diverse perspectives on science and medicine Staff Blogs Blogs by Topic Biology & Life Sciences Earth & Environmental Sciences Multi-disciplinary Sciences Medicine & Health Research Analysis & Scientific Policy Post

2015 PLOS Blogs Network

260. Metabolic Health: How Our Diet Affects Joint Pain

Metabolic Health: How Our Diet Affects Joint Pain Metabolic Health: How Our Diet Affects Joint Pain – Howard J. Luks, MD | Search for: Metabolic Health: How Our Diet Affects Joint Pain Last Updated April 22, 2019 by Howard J. Luks, MD . Other papers found Those authors recommended lipid studies for patients with rotator cuff tears. I hope you are starting to see the connection between our metabolic health and our Orthopedic or Sports Medicine wellness. Granted, correcting your lipid profile (...) isn’t going to reverse your arthritis, but it just might delay the onset of your next joint problem. Inflammation is a trouble maker. It is one of the pillars of heart disease, and systemic inflammation can affect how you perceive pain. People with diabetes have more pain with Orthopedic issues than non-diabetics. People with elevated serum (blood) markers for inflammation have a higher chance of having pain due to osteoarthritis. So elevated cholesterol and LDL increases your risk for shoulder pain

2019 Howard J. Luks, MD blog

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