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2. Targeted therapies in genetic dilated and hypertrophic cardiomyopathies: from molecular mechanisms to therapeutic targets. A position paper from the Heart Failure Association (HFA) and the Working Group on Myocardial Function of the European Society of Cardiology (ESC)
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de Boer, Rudolf A., Heymans, Stephane, Backs, Johannes, Carrier, Lucie, Coats, Andrew J. S., Dimmeler, Stefanie, Eschenhagen, Thomas, Filippatos, Gerasimos, Gepstein, Lior, Hulot, Jean-Sebastien, Knöll, Ralph, Kupatt, Christian, Linke, Wolfgang A., Seidman, Christine E., Tocchetti, C. Gabriele, van der Velden, Jolanda, Walsh, Roddy, Seferovic, Petar M., and Thum, Thomas
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HOMEOSTASIS , *X-linked genetic disorders , *CARDIAC hypertrophy , *TREATMENT effectiveness , *GENETIC engineering , *GENE therapy , *ARRHYTHMIA , *HEART failure , *MEDICAL societies , *PHENOTYPES - Abstract
Genetic cardiomyopathies are disorders of the cardiac muscle, most often explained by pathogenic mutations in genes encoding sarcomere, cytoskeleton, or ion channel proteins. Clinical phenotypes such as heart failure and arrhythmia are classically treated with generic drugs, but aetiology-specific and targeted treatments are lacking. As a result, cardiomyopathies still present a major burden to society, and affect many young and older patients. The Translational Committee of the Heart Failure Association (HFA) and the Working Group of Myocardial Function of the European Society of Cardiology (ESC) organized a workshop to discuss recent advances in molecular and physiological studies of various forms of cardiomyopathies. The study of cardiomyopathies has intensified after several new study setups became available, such as induced pluripotent stem cells, three-dimensional printing of cells, use of scaffolds and engineered heart tissue, with convincing human validation studies. Furthermore, our knowledge on the consequences of mutated proteins has deepened, with relevance for cellular homeostasis, protein quality control and toxicity, often specific to particular cardiomyopathies, with precise effects explaining the aberrations. This has opened up new avenues to treat cardiomyopathies, using contemporary techniques from the molecular toolbox, such as gene editing and repair using CRISPR-Cas9 techniques, antisense therapies, novel designer drugs, and RNA therapies. In this article, we discuss the connection between biology and diverse clinical presentation, as well as promising new medications and therapeutic avenues, which may be instrumental to come to precision medicine of genetic cardiomyopathies. [ABSTRACT FROM AUTHOR]
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- 2022
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3. Design paper: Japan Endoscopy Database ( JED): A prospective, large database project related to gastroenterological endoscopy in Japan.
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Matsuda, Koji, Tanaka, Kiyohito, Fujishiro, Mitsuhiro, Saito, Yutaka, Ohtsuka, Kazuo, Oda, Ichiro, Katada, Chikatoshi, Kato, Masayuki, Kida, Mitsuhiro, Kobayashi, Kiyonori, Hoteya, Shu, Horimatsu, Takahiro, Kodashima, Shinya, Matsuda, Takahisa, Muto, Manabu, Yamamoto, Hironori, Ryozawa, Shomei, Iwakiri, Ryuichi, Kutsumi, Hiromu, and Miyata, Hiroaki
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ENDOSCOPY , *GASTROENTEROLOGY , *MEDICAL care , *MEDICAL societies , *CORE competencies - Abstract
The advent of electronic medical records brought image filing systems to many hospitals, as well as electronic endoscopic medical records. However, data integration among multiple different vendors has not yet been accomplished. We start the Japan Endoscopic Database ( JED) Project endorsed by Japan Gastroenterological Endoscopy Society ( JGES) from January 2015. The purposes of this project are as follows: (i) developing the world's largest endoscopic database generated from daily use of the reporting system; (ii) capturing the actual performance of endoscopic practice in Japan; and (iii) standardizing the terminology and fundamental items for registry of clinical studies. Moreover, the JED project has the potential to automatically collect data about adverse events, competency and evaluation of residents, and actual numbers of procedures on a nationwide scale, certification for the specialty board system, and so on. We believe that this design paper will be helpful not only for future nationwide research but also for international research ( UMIN000016093). [ABSTRACT FROM AUTHOR]
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- 2018
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4. How to write research papers and grants: 2011 Asian Pacific Society for Respirology Annual Scientific Meeting Postgraduate Session.
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EASTWOOD, PETER R., NAUGHTON, MATTHEW T., CALVERLEY, PETER, ZENG, GUANGQIAO, BEASLEY, RICHARD, ROBINSON, BRUCE, and LEE, Y.C. GARY
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REPORT writing , *RESEARCH grants , *RESPIRATION , *MEDICAL societies , *MEDICAL research , *ADULT education workshops - Abstract
ABSTRACT This review article summarizes the content of a series of interrelated workshop presentations from the Annual Scientific Meeting of the Asian Pacific Society of Respirology held in Shanghai in November, 2011. The article describes tips and strategies for writing research papers and research grant applications and includes discussion of: the role of pulmonologists in research; the debates around the use of the journal impact factor; tips for writing manuscripts and publishing research in high-impact journals; how journals assess manuscripts and the most common reasons editors reject manuscripts; how to write grant applications and what grant panels look for in successful proposals; and how to undertake research in resource-limited countries. [ABSTRACT FROM AUTHOR]
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- 2012
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5. Abstracts of papers presented at the 37th Annual Meeting of the American Society of Dermatopathology.
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SKIN diseases , *MEDICAL societies - Abstract
Discusses the abstracts of papers about dermatopathology, presented at the 37th annual meeting of the American Society of Dermatopathology, held October 19-22, 2000 at the Omni Inner Harbor Hotel in Baltimore, Maryland.
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- 2000
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6. Abstracts of "Duel in Dermatopathology" Papers presented at the 37th Annual Meeting of the American Society of Dermatopathology.
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SKIN diseases , *MEDICAL societies - Abstract
Discusses the abstracts of papers about dermatopathology presented at the 37th annual meeting of the American Society of Dermatopathology, held October 19-22, 2000 at the Omni Inner Harbor Hotel in Baltimore, Maryland. 'Lupus Erythematosus Panniculitis: A Unique Subset of Lupus Erythematosus,' by Iftikhar Ahmed and Debra Ahmed; 'The Histological Spectrum of Acral Melanomas,' by Iftikhar Ahmed.
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- 2000
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7. European Society of Cardiology/Heart Failure Association position paper on the role and safety of new glucose-lowering drugs in patients with heart failure.
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Seferović, Petar M., Coats, Andrew J.S., Ponikowski, Piotr, Filippatos, Gerasimos, Huelsmann, Martin, Jhund, Pardeep S., Polovina, Marija M., Komajda, Michel, Seferović, Jelena, Sari, Ibrahim, Cosentino, Francesco, Ambrosio, Giuseppe, Metra, Marco, Piepoli, Massimo, Chioncel, Ovidiu, Lund, Lars H., Thum, Thomas, De Boer, Rudolf A., Mullens, Wilfried, and Lopatin, Yuri
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HEART failure ,HEART failure patients ,GLUCAGON-like peptide-1 receptor ,GLUCAGON-like peptide-1 agonists ,TYPE 2 diabetes ,CARDIOVASCULAR diseases risk factors ,THERAPEUTIC use of protease inhibitors ,CARDIOLOGY ,BENZENE ,CLINICAL trials ,HYPOGLYCEMIC agents ,GLYCOSIDES ,GLUCOSE ,MEDICAL societies ,DISEASE complications - Abstract
Type 2 diabetes mellitus (T2DM) is common in patients with heart failure (HF) and associated with considerable morbidity and mortality. Significant advances have recently occurred in the treatment of T2DM, with evidence of several new glucose-lowering medications showing either neutral or beneficial cardiovascular effects. However, some of these agents have safety characteristics with strong practical implications in HF [i.e. dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RA), and sodium-glucose co-transporter type 2 (SGLT-2) inhibitors]. Regarding safety of DPP-4 inhibitors, saxagliptin is not recommended in HF because of a greater risk of HF hospitalisation. There is no compelling evidence of excess HF risk with the other DPP-4 inhibitors. GLP-1 RAs have an overall neutral effect on HF outcomes. However, a signal of harm suggested in two small trials of liraglutide in patients with reduced ejection fraction indicates that their role remains to be defined in established HF. SGLT-2 inhibitors (empagliflozin, canagliflozin and dapagliflozin) have shown a consistent reduction in the risk of HF hospitalisation regardless of baseline cardiovascular risk or history of HF. Accordingly, SGLT-2 inhibitors could be recommended to prevent HF hospitalisation in patients with T2DM and established cardiovascular disease or with multiple risk factors. The recently completed trial with dapagliflozin has shown a significant reduction in cardiovascular mortality and HF events in patients with HF and reduced ejection fraction, with or without T2DM. Several ongoing trials will assess whether the results observed with dapagliflozin could be extended to other SGLT-2 inhibitors in the treatment of HF, with either preserved or reduced ejection fraction, regardless of the presence of T2DM. This position paper aims to summarise relevant clinical trial evidence concerning the role and safety of new glucose-lowering therapies in patients with HF. [ABSTRACT FROM AUTHOR]
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- 2020
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8. Anniversary Paper: Activities of the American Association of Physicists in Medicine 1999–2008.
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Rothenberg, Lawrence N. and Hendee, William R.
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MEDICAL societies , *PHYSICISTS , *MEDICAL physics , *SCHOLARSHIPS , *TRAINING , *EDUCATION - Abstract
The article chronicles the activities of the American Association of Physicists in Medicine (AAPM) from 1999 to 2008. In 1999, AAPM's TG-51 calibration protocol was published. The AAPM Summer Research Fellow Program started in 2001. In 2004, a major undertaking of AAPM was the reorganization of committees and councils. In 2007, issues related to education and training were prominent in AAPM's agenda.
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- 2008
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9. Anniversary Paper: The AAPM Professional Council—50th Anniversary, 2008.
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Herman, Michael G.
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MEDICAL societies , *MEDICAL physics , *PHYSICISTS , *MEDICINE , *PHYSICS - Abstract
The following article represents a view of the professional aspects and endeavors of the American Association of Physicists in Medicine (AAPM) through the eyes and experiences of the current Professional Council Chair, information gathered from previous Council chairs and AAPM documents. Over its 50 year history the AAPM has made numerous contributions to the profession and practice of medical physics, through leadership and collaboration. Throughout this period the association went through growing pains and struggled to define and establish the proper level of professional responsibilities and commitment. It is likely that as medicine changes and the profession continues to evolve, that the AAPM will continue to grow, struggle, and adapt to address the future direction of medical physics. [ABSTRACT FROM AUTHOR]
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- 2008
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10. Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy.
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Sliwa, Karen, Petrie, Mark C., Hilfiker‐Kleiner, Denise, Mebazaa, Alexandre, Jackson, Alice, Johnson, Mark R., van der Meer, Peter, Mbakwem, Amam, Bauersachs, Johann, and Hilfiker-Kleiner, Denise
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PERIPARTUM cardiomyopathy ,HEART failure ,PREGNANCY ,PREGNANCY complications ,CONTRACEPTION ,TREATMENT of cardiomyopathies ,CARDIOLOGY ,CHILDBIRTH ,DISEASES ,FORECASTING ,MEDICAL protocols ,MEDICAL societies ,CARDIOMYOPATHIES ,DISEASE management ,DISEASE complications ,PREVENTION - Abstract
Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. Outcome varies from full recovery to residual left ventricular systolic dysfunction and even death. Many women return to their physician to acquire information on their long-term prognosis, to seek medical advice regarding contraception, or when planning a subsequent pregnancy. This position paper summarizes current evidence for long-term outcome, risk stratification of further pregnancies and overall management. Based on the best available evidence, as well as the clinical experience of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy members, a consensus on pre- and postpartum management algorithms for women undergoing a subsequent pregnancy is presented. [ABSTRACT FROM AUTHOR]
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- 2018
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11. Exercise training in patients with ventricular assist devices: a review of the evidence and practical advice. A position paper from the Committee on Exercise Physiology and Training and the Committee of Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology.
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Adamopoulos, Stamatis, Corrà, Ugo, Laoutaris, Ioannis D., Pistono, Massimo, Agostoni, Pier Giuseppe, Coats, Andrew J.S., Crespo Leiro, Maria G., Cornelis, Justien, Davos, Constantinos H., Filippatos, Gerasimos, Lund, Lars H., Jaarsma, Tiny, Ruschitzka, Frank, Seferovic, Petar M., Schmid, Jean‐Paul, Volterrani, Maurizio, Piepoli, Massimo F., and Schmid, Jean-Paul
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HEART assist devices ,HEART failure ,HEART ,EXERCISE ,CARDIOVASCULAR diseases ,CARDIOLOGY ,EXERCISE therapy ,MEDICAL protocols ,MEDICAL societies - Abstract
Exercise training (ET) and secondary prevention measures in cardiovascular disease aim to stimulate early physical activity and to facilitate recovery and improve health behaviours. ET has also been proposed for heart failure patients with a ventricular assist device (VAD), to help recovery in the patient's functional capacity. However, the existing evidence in support of ET in these patients remains limited. After a review of current knowledge on the causes of the persistence of limitation in exercise capacity in VAD recipients, and concerning the benefit of ET in VAD patients, the Heart Failure Association of the European Society of Cardiology has developed the present document to provide practical advice on implementing ET. This includes appropriate screening to avoid complications and then starting with early mobilisation, ET prescription is individualised to meet the patient's needs. Finally, gaps in our knowledge are discussed. [ABSTRACT FROM AUTHOR]
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- 2019
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12. If At First You Don't Succeed: The Fate of Manuscripts Rejected by Academic Emergency Medicine.
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Grant, William D., Cone, David C., and Gaddis, Gary
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AUTHORSHIP ,EDITORS ,EMERGENCY medicine ,FISHER exact test ,MANUSCRIPTS ,MEDICAL protocols ,MEDICAL societies ,PUBLISHING ,DATA analysis ,RETROSPECTIVE studies - Abstract
Objectives The purpose of this study was to characterize the publication fate of a recent 2-year sample of manuscripts declined by Academic Emergency Medicine ( AEM), the journal of the Society for Academic Emergency Medicine. Methods This was a retrospective analysis of manuscripts submitted to AEM in 2010 and 2011 that were declined by the AEM editorial review process. An online search was conducted for each declined paper, to determine whether or not it was published in another clinical/scientific journal after being declined by AEM. The investigators used Scopus and Google Scholar, using the submitting author's name, the verbatim title, and key words and phrases from the title, to search for subsequent publication of each paper. Results Of 1,542 manuscript submissions to the journal in 2010 and 2011, 1,052 papers were declined. Of these, 693 (65.9%) were subsequently published elsewhere, in a total of 229 journals: 362 papers in 22 different EM journals, 81 in 14 EM subspecialty journals, 237 in 185 non- EM journals, and 13 in eight nursing journals. Papers were published a median of 16.7 months (interquartile range [ IQR] = 11.8 to 22.0 months) after being declined at AEM. Of the 229 journals, 19 do not have h-indices. The median h-index of the remaining 210 journals is 36 ( IQR = 17 to 64; maximum = 229; AEM's h-index is 78). Thirty of these 210 journals, publishing 43 papers, have higher h-indices than AEM; the other 650 papers were published in journals either with lower h-indices than AEM's ( n = 180 journals) or in journals without h-indices ( n = 19 journals). U.S. and non-U.S. authors had similar rates of subsequent publication (65.3% vs 66.6%, p = 0.69) for papers initially declined by AEM. Papers in the educational advances category were less likely to be subsequently published than those in the original contributions (p < 0.0001) and brief reports (p = 0.0137) categories. Conclusions Nearly two-thirds of manuscripts declined by SAEM's journal are eventually published elsewhere, in a large number and wide variety of both EM and non- EM journals, in a median of 16.7 months. Authors of manuscripts declined by AEM should consider submission elsewhere, as subsequent publication of these manuscripts in another journal is probable. [ABSTRACT FROM AUTHOR]
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- 2015
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13. Ethical Issues in the Response to Ebola Virus Disease in United States Emergency Departments: A Position Paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.
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Venkat, Arvind, Asher, Shellie L., Wolf, Lisa, Geiderman, Joel M., Marco, Catherine A., McGreevy, Jolion, Derse, Arthur R., Otten, Edward J., Jesus, John E., Kreitzer, Natalie P., Escalante, Monica, Levine, Adam C., and Cone, David C.
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EVALUATION of medical care ,MEDICAL practice ,PATIENTS ,EBOLA virus disease ,EMERGENCY medicine ,EMERGENCY physicians ,EPIDEMICS ,ETHICS ,HOSPITAL emergency services ,MEDICAL personnel ,MEDICAL students ,MEDICAL societies ,PUBLIC health ,SAFETY ,STUDENTS ,VOLUNTEERS ,NURSES' associations ,DISEASE complications ,DIAGNOSIS - Abstract
The 2014 outbreak of Ebola virus disease ( EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments ( EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians ( EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. [ABSTRACT FROM AUTHOR]
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- 2015
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14. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC).
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Zamorano, Jose Luis, Lancellotti, Patrizio, Rodriguez Muñoz, Daniel, Aboyans, Victor, Asteggiano, Riccardo, Galderisi, Maurizio, Habib, Gilbert, Lenihan, Daniel J., Lip, Gregory Y. H., Lyon, Alexander R., Lopez Fernandez, Teresa, Mohty, Dania, Piepoli, Massimo F., Tamargo, Juan, Torbicki, Adam, Suter, Thomas M., Achenbach, Stephan, Agewall, Stefan, Badimon, Lina, and Barón-Esquivias, Gonzalo
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CARDIOTOXICITY ,PUBLIC health ,ONCOLOGY ,MEDICAL personnel ,ANTINEOPLASTIC agents ,CARDIOLOGY ,CONFERENCES & conventions ,HEART diseases ,MEDICAL protocols ,MEDICAL societies ,TUMORS - Published
- 2017
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15. American College of Rheumatology White Paper on Performance Outcome Measures in Rheumatology.
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Suter, Lisa G., Barber, Claire E., Herrin, Jeph, Leong, Amye, Losina, Elena, Miller, Amy, Newman, Eric, Robbins, Mark, Tory, Heather, and Yazdany, Jinoos
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RHEUMATISM treatment ,MEDICAL quality control ,MEDICAL societies ,HEALTH outcome assessment ,RESEARCH funding ,RHEUMATOLOGY ,STANDARDS - Abstract
Objective: To highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes.Methods: We constructed a hypothetical performance outcome measure to demonstrate the benefits and challenges of designing quality measures that assess patient outcomes. We defined the data source, measure cohort, reporting period, period at risk, measure outcome, outcome attribution, risk adjustment, reliability and validity, and reporting approach. We discussed outcome measure challenges specific to rheumatology and to fields where patients have predominantly chronic, complex, ambulatory care-sensitive conditions.Results: Our hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. We summarized the components, benefits, challenges, and tradeoffs between feasibility and usability. We highlighted how different measure applications, such as for rapid cycle quality improvement efforts versus pay for performance programs, require different approaches to measure development and testing. We provided a summary table of key take-home points for clinicians and policymakers.Conclusion: Performance outcome measures are coming to rheumatology, and the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers. This study provides an overview of key issues and is intended to stimulate a productive dialogue between patients, practitioners, insurers, and government agencies regarding optimal performance outcome measure development. [ABSTRACT FROM AUTHOR]- Published
- 2016
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16. John J. Sciarra Prize Paper Award for 2017.
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GYNECOLOGY , *MEDICAL societies - Published
- 2017
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17. Position paper on the initiation of clinicaltrials of xenotransplantationThe American Society of Transplantation and The American Society ofTransplant Surgeons.
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XENOGRAFTS , *TRANSPLANTATION of organs, tissues, etc. , *MEDICAL societies , *ETHICS - Abstract
Presents the position of the American Society of Transplantation and the American Society of Transplant Surgeons on the issue of xenotransplantation. Moral and ethical aspects; Potential risks involved in xenotransplantation; Complex issues associated with xenotransplantation.
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- 2000
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18. Obesity as a Disease: A White Paper on Evidence and Arguments Commissioned by the Council of The Obesity Society.
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Allison, David B., Downey, Morgan, Atkinson, Richard L., Billington, Charles J., Bray, George A., Eckel, Robert H., Finkelstein, Eric A., Jensen, Michael D., and Tremblay, Angelo
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OBESITY ,MEDICAL societies ,METABOLIC disorders ,SOCIAL stigma ,DISCRIMINATION (Sociology) ,OVERWEIGHT persons - Abstract
The article examines the decision of a panel of experts who were commissioned by the Council of the Obesity Society to declare obesity as a disease. The panel concluded that considering obesity as a disease benefit most people by seeking more resources on prevention and treatment and lessening the stigma and discrimination against obese persons. The authors explain the major approaches they applied to address the question of whether obesity should be labeled a disease. They discuss the effects of labeling obesity as a disease on the public.
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- 2008
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19. Treatment and management of chronic thromboembolic pulmonary hypertension (CTEPH): A global cross‐sectional scientific survey (CLARITY).
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Skoro‐Sajer, Nika, Sheares, Karen, Forfia, Paul, Heresi, Gustavo A., Jevnikar, Mitja, Kopeć, Grzegorz, Moiseeva, Olga, Terra‐Filho, Mario, Whitford, Helen, Zhai, Zhenguo, Beaudet, Amélie, Gressin, Virginie, Meijer, Catherina, Tan, Yan Zhi, and Abe, Kohtaro
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THROMBOEMBOLISM ,MEDICAL specialties & specialists ,ANTICOAGULANTS ,TRANSLUMINAL angioplasty ,MEDICAL societies - Abstract
Advances in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) over the past decade changed the disease landscape, yet global insight on clinical practices remains limited. The CTEPH global cross‐sectional scientific survey (CLARITY) aimed to gather information on the current diagnosis, treatment, and management of CTEPH and to identify unmet medical needs. This paper focuses on the treatment and management of CTEPH patients. The survey was circulated to hospital‐based medical specialists through Scientific Societies and other medical organizations from September 2021 to May 2022. The majority of the 212 respondents involved in the treatment of CTEPH were from centers performing up to 50 pulmonary endarterectomy (PEA) and/or balloon pulmonary angioplasty (BPA) procedures per year. Variation was observed in the reported proportion of patients deemed eligible for PEA/BPA, as well as those that underwent the procedures, including multimodal treatment and subsequent follow‐up practices. Prescription of pulmonary arterial hypertension‐specific therapy was reported for a variable proportion of patients in the preoperative setting and in most nonoperable patients. Reported use of vitamin K antagonists and direct oral anticoagulants was similar (86% vs. 82%) but driven by different factors. This study presents heterogeneity in treatment approaches for CTEPH, which may be attributed to center‐specific experience and region‐specific barriers to care, highlighting the need for new clinical and cohort studies, comprehensive clinical guidelines, and continued education. [ABSTRACT FROM AUTHOR]
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- 2024
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20. A scoping review exploring the impact and negotiation of hierarchy in healthcare organisations.
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Essex, Ryan, Kennedy, Jack, Miller, Denise, and Jameson, Jill
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AUTHORITY ,PSYCHOLOGY information storage & retrieval systems ,CINAHL database ,NEGOTIATION ,LEADERSHIP ,SYSTEMATIC reviews ,ORGANIZATIONAL structure ,RESEARCH methodology ,ATTITUDES of medical personnel ,MEDICAL care ,COMMUNICATION ,HEALTH ,LITERATURE reviews ,MEDLINE ,EMOTIONS ,MEDICAL societies ,PATIENT safety ,CORPORATE culture - Abstract
Healthcare organisations are hierarchical; almost all are organised around the ranking of individuals by authority or status, whether this be based on profession, expertise, gender or ethnicity. Hierarchy is important for several reasons; it shapes the delivery of care, what is prioritised and who receives care. It also has an impact on healthcare workers and how they work and communicate together in organisations. The purpose of this scoping review is to explore the qualitative evidence related to hierarchy in healthcare organisations defined broadly, to address gaps in macro‐level healthcare organisational research, specifically focusing on the (1) impact of hierarchy for healthcare workers and (2) how hierarchy is negotiated, sustained and challenged in healthcare organisations. After a search and screening, 32 papers were included in this review. The findings of this review detail the wide‐reaching impacts that hierarchy has on healthcare delivery and health workers. The majority of studies spoke to hierarchy's impact on speaking up, that is, how it shaped communication between staff with differential status: not only what was said, but how it had an impact on what was acceptable to say, by whom and at what time. Hierarchy was also noted to have substantial personal costs, impacting on the well‐being of those in less powerful positions. These findings also provide insight into the complex ways in which hierarchy was negotiated, challenged and reproduced. Studies not only detailed the way in which hierarchy was navigated day to day but also spoke to the reasons as to why hierarchy is often entrenched and difficult to shift. A number of studies spoke to the impact that hierarchy had in sustaining gender and ethnic inequalities, maintaining historically discriminatory practices. Importantly, hierarchy should not be reduced to differences between or within the professions in localised contexts but should be considered at a broad organisational level. [ABSTRACT FROM AUTHOR]
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- 2023
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21. Peer-reviewed publication following presentation at a regional surgical meeting.
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Bowrey, David J, Morris‐Stiff, Gareth J, Clark, Geoffrey W B, Carey, P Declan, and Mansel, Robert E
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CONTINUING medical education ,MEDICAL publishing - Abstract
Objectives The aim of the study was to investigate the proportion of publications arising from work presented at a regional surgical meeting. Design A list of all presentations to the Welsh Surgical Society 1983–95 was compiled and a detailed search made of the Medline Database. The surgical topic of each presentation, the date of presentation, the date of publication and the journal of publication were recorded. Setting University Hospital of Wales. Results Four hundred and ninety-six papers were presented to the society, of which 402 (81%) were by trainees. The most frequent topics of presentation were colorectal (15%), vascular (15%) and hepato–pancreatico–biliary (11%). Two hundred and thirty-three papers (47%) have been published in peer-reviewed journals. The most popular journals for publication were Annals of the Royal College of Surgeons of England (19%), British Journal of Surgery (16%) and Journal of the Royal College of Surgeons of Edinburgh (8%). The median time from presentation to publication was 17·0 months (interquartile range 10·0–27·5 months). Conclusions Regional surgical meetings have an important role in the annual surgical calendar and they are the ideal initial setting for presentation by trainees. [ABSTRACT FROM AUTHOR]
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- 1999
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22. European Society of Endodontology position statement: Use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by.
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Patel, S., Brown, J., Semper, M., Abella, F., and Mannocci, F.
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CONE beam computed tomography ,ENDODONTICS ,MEDICAL societies ,MISSION statements ,HEALTH planning ,DECISION making in clinical medicine - Abstract
This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT) in Endodontics. This paper is an update of the ESE CBCT position statement which was published in 2014 (European Society of Endodontology 2014, https://doi.org/10.1111/iej.12267). Recent review articles provide more detailed background information and the basis for this position statement. It is intended that this position statement will be updated at least every 4‐5 years to keep abreast of relevant research. The aim of this paper is to provide clinicians with evidence‐based guidance on the application of CBCT in Endodontics. Since 2014, there has been an increase in the number of clinical studies confirming the positive impact of CBCT on treatment planning, decision‐making when reviewing cases and reduced practitioner stress levels. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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23. The applicability of grading systems for guidelines.
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Baker, Adrian, Potter, Jonathan, Young, Katharine, and Madan, Ira
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MEDICAL protocols ,MEDICAL societies ,EVIDENCE-based medicine ,QUALITATIVE research - Abstract
Rationale This study focused on factors that most concern specialist societies when choosing an evidence grading system, such as methodological strengths and weaknesses, applicability and ease of use. The grading systems chosen were the Scottish Intercollegiate Guidelines Network (SIGN), the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and the National Service Framework for long-term neurological conditions critical appraisal tool (NSF-LTC). Methodology Twelve assessors, representing typical members of society-based guideline development groups, graded papers and a recommendation using a key question as a guide. Key questions and recommendations were extracted from existing clinical guidelines representing a variety of research fields. Assessors were given 3 months to grade the papers using the grading systems and to complete a semi-structured qualitative questionnaire. The results were independently assessed for emerging themes. Results Assessors felt all three systems had strengths and weaknesses depending on the type of evidence being graded. GRADE was seen as the most complex but rigorous system, while SIGN and NSF were seen as easier and more flexible to use, but less methodologically rigorous. In grading the evidence, 10% of assessors used GRADE incorrectly, 33% used SIGN incorrectly and 75% used NSF-LTC incorrectly. In grading the recommendations, 60% used GRADE incorrectly, 50% used SIGN incorrectly and 50% used NSF-LTC incorrectly. Implications It is recommended that specialist societies consider the type of evidence they will be evaluating and the research experience of the appraisers before selecting a grading system. Additionally, appraisers should have training in appraising and grading evidence using the system to be employed. [ABSTRACT FROM AUTHOR]
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- 2011
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24. Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology.
- Author
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Čelutkienė, Jelena, Lainscak, Mitja, Anderson, Lisa, Gayat, Etienne, Grapsa, Julia, Harjola, Veli‐Pekka, Manka, Robert, Nihoyannopoulos, Petros, Filardi, Pasquale Perrone, Vrettou, Rosa, Anker, Stefan D., Filippatos, Gerasimos, Mebazaa, Alexandre, Metra, Marco, Piepoli, Massimo, Ruschitzka, Frank, Zamorano, Jose Luis, Rosano, Giuseppe, Seferovic, Petar, and Harjola, Veli-Pekka
- Subjects
HEART failure ,RAPID tooling ,MAGNETIC resonance ,CORONARY angiography ,CARDIOLOGY ,HEART failure treatment ,PATIENT aftercare ,MAGNETIC resonance imaging ,COMPUTED tomography ,MEDICAL societies ,DISCHARGE planning - Abstract
Acute heart failure is one of the main diagnostic and therapeutic challenges in clinical practice due to a non-specific clinical manifestation and the urgent need for timely and tailored management at the same time. In this position statement, the Heart Failure Association aims to systematize the use of various imaging methods in accordance with the timeline of acute heart failure care proposed in the recent guidelines of the European Society of Cardiology. During the first hours of admission the point-of-care focused cardiac and lung ultrasound examination is an invaluable tool for rapid differential diagnosis of acute dyspnoea, which is highly feasible and relatively easy to learn. Several portable and stationary imaging modalities are being increasingly used for the evaluation of cardiac structure and function, haemodynamic and volume status, precipitating myocardial ischaemia or valvular abnormalities, and systemic and pulmonary congestion. This paper emphasizes the central role of the full echocardiographic examination in the identification of heart failure aetiology, severity of cardiac dysfunction, indications for specific heart failure therapy, and risk stratification. Correct evaluation of cardiac filling pressures and accurate prognostication may help to prevent unscheduled short-term readmission. Alternative advanced imaging modalities should be considered to assist patient management in the pre- and post-discharge phase, including cardiac magnetic resonance, computed tomography, nuclear studies, and coronary angiography. The Heart Failure Association addresses this paper to the wide spectrum of acute care and heart failure specialists, highlighting the value of all available imaging techniques at specific stages and in common clinical scenarios of acute heart failure. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
25. AHS Members' Choice Award for the Best Article in Headache.
- Author
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Ward, Thomas N.
- Subjects
AWARDS ,DECISION making ,HEADACHE ,INTRACRANIAL hypertension ,MEDICAL societies ,SERIAL publications ,MEMBERSHIP - Abstract
The article announces invitation to American Headache Society (AHS) members to vote on their favorite paper published in Headache over the previous 12 months for the AHS Members' Choice Award. It states that the winning paper will be announced both in the July and August 2019 issue of Headache as well as at the 2019 AHS Annual Scientific Meeting.
- Published
- 2019
- Full Text
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26. Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2010.
- Author
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Shayne, Philip, Coates, Wendy C., Farrell, Susan E., Kuhn DO, Gloria J., Lin, Michelle, Maggio, Lauren A., and Fisher, Jonathan
- Subjects
MEDICAL research evaluation ,DATABASES ,EMERGENCY medicine ,MEDICAL societies ,MEDLINE ,ONLINE information services ,SERIAL publications ,DATA analysis ,ACQUISITION of data - Abstract
ACADEMIC EMERGENCY MEDICINE 2011; 18:1081-1089 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: The objective was to critically appraise and highlight medical education research studies published in 2010 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). Methods: A search of the English language literature in 2010 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified 41 EM studies that used hypothesis-testing or observational investigations of educational interventions. Five reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008 and 2009. Results: Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Comparing the literature of 2010 to 2008 and 2009, the number of published educational research papers increased from 30 to 36 and then to 41. The number of funded studies remained fairly stable over the past 3 years at 13 (2008), 16 (2009), and 9 (2010). As in past years, research involving the use of technology accounted for a significant number of publications (34%), including three of the five highlighted studies. Conclusions: Forty-one EM educational studies published in 2010 were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2010 papers are noted. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
27. Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology.
- Author
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Čelutkienė, Jelena, Plymen, Carla M., Flachskampf, Frank A., de Boer, Rudolf A., Grapsa, Julia, Manka, Robert, Anderson, Lisa, Garbi, Madalina, Barberis, Vassilis, Filardi, Pasquale Perrone, Gargiulo, Paola, Zamorano, Jose Luis, Lainscak, Mitja, Seferovic, Petar, Ruschitzka, Frank, Rosano, Giuseppe M.C., and Nihoyannopoulos, Petros
- Subjects
HEART failure ,CARDIOLOGY ,CONSENSUS (Social sciences) ,DIAGNOSTIC imaging ,EXERCISE tests ,MEDICAL societies ,DIAGNOSIS - Abstract
Myriad advances in all fields of cardiac imaging have stimulated and reflected new understanding of cardiac performance, myocardial damage and the mechanisms of heart failure. In this paper, the Heart Failure Association assesses the potential usefulness of innovative imaging modalities in enabling more precise diagnostic and prognostic evaluation, as well as in guiding treatment strategies. Many new methods have gradually penetrated clinical practice and are on their way to becoming a part of routine evaluation. This paper focuses on myocardial deformation and three-dimensional ultrasound imaging; stress tests for the evaluation of contractile and filling function; the progress of magnetic resonance techniques; molecular imaging and other sound innovations. The Heart Failure Association aims to highlight the ways in which paradigms have shifted in several areas of cardiac assessment. These include reassessing of the simplified concept of ejection fraction and implementation of the new parameters of cardiac performance applicable to all heart failure phenotypes; switching from two-dimensional to more accurate and reproducible three-dimensional ultrasound volumetric evaluation; greater tissue characterization via recently developed magnetic resonance modalities; moving from assessing cardiac function and congestion at rest to assessing it during stress; from invasive to novel non-invasive hybrid techniques depicting coronary anatomy and myocardial perfusion; as well as from morphometry to the imaging of pathophysiologic processes such as inflammation and apoptosis. This position paper examines the specific benefits of imaging innovations for practitioners dealing with heart failure aetiology, risk stratification and monitoring, and, in addition, for scientists involved in the development of future research. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
28. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition.
- Author
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Compher, Charlene, Bingham, Angela L., McCall, Michele, Patel, Jayshil, Rice, Todd W., Braunschweig, Carol, and McKeever, Liam
- Subjects
ENTERAL feeding ,PARENTERAL feeding ,DIET therapy ,CRITICAL care medicine ,CRITICALLY ill ,CRITICALLY ill children ,CRITICALLY ill patient care ,INTENSIVE care units ,ONLINE information services ,NUTRITIONAL assessment ,CONFIDENCE intervals ,PATIENTS ,NUTRITIONAL requirements ,MEDICAL protocols ,CATASTROPHIC illness ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,MEDLINE ,MEDICAL societies ,NUTRITIONAL status ,ADULTS - Abstract
Background: This guideline updates recommendations from the 2016 American Society for Parenteral and Enteral Nutrition (ASPEN)/Society of Critical Care Medicine (SCCM) critical care nutrition guideline for five foundational questions central to critical care nutrition support. Methods: The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) process was used to develop and summarize evidence for clinical practice recommendations. Clinical outcomes were assessed for (1) higher vs lower energy dose, (2) higher vs lower protein dose, (3) exclusive isocaloric parenteral nutrition (PN) vs enteral nutrition (EN), (4) supplemental PN (SPN) plus EN vs EN alone, (5A) mixed‐oil lipid injectable emulsions (ILEs) vs soybean oil, and (5B) fish oil (FO)–containing ILE vs non‐FO ILE. To assess safety, weight‐based energy intake and protein were plotted against hospital mortality. Results: Between January 1, 2001, and July 15, 2020, 2320 citations were identified and data were abstracted from 36 trials including 20,578 participants. Patients receiving FO had decreased pneumonia rates of uncertain clinical significance. Otherwise, there were no differences for any outcome in any question. Owing to a lack of certainty regarding harm, the energy prescription recommendation was decreased to 12–25 kcal/kg/day. Conclusion: No differences in clinical outcomes were identified among numerous nutrition interventions, including higher energy or protein intake, isocaloric PN or EN, SPN, or different ILEs. As more consistent critical care nutrition support data become available, more precise recommendations will be possible. In the meantime, clinical judgment and close monitoring are needed. This paper was approved by the ASPEN Board of Directors. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
29. Celebrating research contributions from Australia: Marking the XXIVth annual meeting of the Eating Disorder Research Society.
- Author
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Wade, Tracey
- Subjects
CONFERENCES & conventions ,EATING disorders ,MEDICAL research ,MEDICAL societies ,SERIAL publications ,RESEARCH personnel - Abstract
This Virtual Issue of the International Journal of Eating Disorders (IJED) is released to mark the XXIVth Eating Disorder Research Society (EDRS) meeting in Sydney, Australia. This is the second EDRS meeting in Australia, reflecting the strong contribution of Australian researchers to eating disorder research internationally. Attendees at the Sydney EDRS meeting will be able to access the top 10 cited papers from IJED by Australian authors in 2016–2017, cited an average of 10.2 times each. It is pleasing to note the strong representation of early career researchers and the range of topics addressed. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
30. Scientism, conflicts of interest, and the marginalization of ethics in medical education.
- Author
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Mayes, Christopher, Williams, Jane, Kerridge, Ian, and Lipworth, Wendy
- Subjects
MEDICAL education ,CONFLICT of interests ,DEBATE ,MEDICAL care ,MEDICAL schools ,MEDICAL ethics ,HEALTH policy ,PSYCHOLOGY of medical students ,MEDICAL practice ,MEDICAL research ,MEDICAL societies ,SCIENTISTS ,SOCIOLOGY ,TEACHER-student relationships ,EMAIL ,EVIDENCE-based medicine - Abstract
Abstract: Aim: This paper reports on the findings from 6 focus groups conducted with Australian medical students. The focus groups sought students' perspectives on how the influence of commercial interests on medical practice and education could be managed. Method: We conducted 6 focus groups with medical students in New South Wales, Australia. Participants were recruited via student‐run medical society and faculty e‐mail lists. Forty‐nine students from 6 medical schools in New South Wales participated. The research team reflected on the extent to which students uncritically appealed to science in the abstract as a management solution for conflicts of interest. Data analysis was largely inductive, looking for uses of scientific terminology, EBM, and appeals to “science” in the management of COI and applied theoretical analyses of scientism. Results: The students in our study suggested that science and evidence‐based medicine, rather than ethics or professionalism, were the best tools to deal with undue influence and bias. This paper uses philosophy of science literature to critically examine these scientistic appeals to science and EBM as a means of managing the influence of pharmaceutical reps and commercial interests. We argue that a scientistic style of reasoning is reinforced through medical curricula and that students need to be made aware of the epistemological assumptions that underpin science, medicine, and EBM to address the ethical challenges associated with commercialised health care. Conclusion: More work is needed to structure medical curricula to reflect the complexities of practice and realities of science. However, curricula change alone will not sufficiently address issues associated with commercial interests in medicine. For real change to occur, there needs to be a broader social and professional debate about the ways in which medicine and industry interact, and structural changes that restrict or mitigate commercial influences in educational, research, and policy settings. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
31. The 2017 <italic>Academic Emergency Medicine</italic> Consensus Conference: Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes.
- Author
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Bond, William F., Hui, Joshua, and Fernandez, Rosemarie
- Subjects
EVALUATION of medical care ,RESEARCH evaluation ,CONFERENCES & conventions ,INTERDISCIPLINARY education ,INTERPROFESSIONAL relations ,MEDICAL societies ,SYSTEM analysis ,NATIONAL competency-based educational tests ,ORGANIZATIONAL goals - Abstract
Abstract: Over the past decade, emergency medicine (EM) took a lead role in healthcare simulation in part due to its demands for successful interprofessional and multidisciplinary collaboration, along with educational needs in a diverse array of cognitive and procedural skills. Simulation‐based methodologies have the capacity to support training and research platforms that model micro‐, meso‐, and macrosystems of healthcare. To fully capitalize on the potential of simulation‐based research to improve emergency healthcare delivery will require the application of rigorous methods from engineering, social science, and basic science disciplines. The
Academic Emergency Medicine (AEM) Consensus Conference “Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcome” was conceived to foster discussion among experts in EM, engineering, and social sciences, focusing on key barriers and opportunities in simulation‐based research. This executive summary describes the overall rationale for the conference, conference planning, and consensus‐building approaches and outlines the focus of the eight breakout sessions. The consensus outcomes from each breakout session are summarized in proceedings papers published in this issue ofAcademic Emergency Medicine . Each paper provides an overview of methodologic and knowledge gaps in simulation research and identifies future research targets aimed at improving the safety and quality of healthcare. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
32. Including health promotion and illness prevention in medical education: a progress report.
- Author
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Hays, Richard
- Subjects
HEALTH promotion ,PREVENTIVE medicine ,MEDICAL education standards ,MEDICAL school curriculum ,EVALUATION of medical education ,PROFESSIONAL education ,HIGHER education ,GOVERNMENT policy ,EDUCATION of physicians ,DATABASES ,INSTRUCTIONAL materials centers ,LEGISLATION ,MEDICAL students ,MEDICAL societies ,MEDLINE ,ONLINE information services ,PATIENT safety ,REPORT writing ,WORLD health ,UNDERGRADUATES - Abstract
Context In 1988, the World Federation of Medical Education called for reform in medical education, publishing 12 recommendations. The sixth recommendation of this Edinburgh Declaration was to 'complement instruction about the management of patients with increased emphasis on promotion of health and prevention of disease'. Thirty years on, this paper reports an exploration of what has changed since then. Methods Several search strategies were used, including websites of medical standards organisations, and formal searches of Pub Med and Google Scholar using key words such as 'medical education standards', 'health promotion', 'illness prevention', 'effectiveness' and 'assessment'. As these searches produced more descriptive than evidence-based papers, the exploration widened to follow evolving discussions about changing emphases in medical education relevant to public health. Results Health promotion and illness prevention are in the undergraduate medical education standards of the more influential regulators. There is little evidence of the impact of this inclusion on graduate outcomes and later medical practice, although 'differently educated' doctors may have contributed to the success of broader public health strategies achieved through reorganisation of health care, media campaigns and legislation changes. There is greater success in postgraduate specialty training of general practitioners and public health doctors. The discussion about public health interventions and the roles of doctors has moved on to topics such as patient safety, the health of doctors, global health and planetary health. Conclusions The inclusion of health promotion and illness prevention strategies in undergraduate curricula varied considerably, but was strongest in programmes claiming social accountability and responding to medical education standards of the more influential regulators. However, the contribution of medical education to improvements in health care and the health of populations is difficult to measure. It may be timely to revisit the purpose and practicality of broadening the scope of undergraduate medical curricula in public health medicine. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
33. A journal club as a teaching and learning strategy in nurse teacher education.
- Author
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Sheehan J
- Subjects
MEDICAL societies ,NURSES - Abstract
An account of the operation of a journal club in a Postgraduate Certificate in Education course for teachers of nursing is reported here. The paper is based on three issues: the background to journal clubs, the process involved in the operation of the club concerned, and the expected outcomes. The origins of journal clubs and the reading habits of nurses are considered in the background section through a review of some of the relevant literature. The negotiation involved, the frequency of meetings and the ethos in which they were conducted are discussed in the section on the processes involved. In the final section, both the tangible and personal outcomes are discussed and the conclusion reached is that a journal club is a worthwhile educational activity. [ABSTRACT FROM AUTHOR]
- Published
- 1994
- Full Text
- View/download PDF
34. How to implement medical and patient associations in low‐income countries: A proposition from the African French Alliance for the Treatment of Haemophilia (AFATH).
- Author
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Sannié, Thomas, de Moerloose, Philippe, Albert, Brigitte, Anani, Ludovic, Arcé, Claire, Baglo, Tatiana Priscilla, Bahayde, Cheikh, Bollahi, Mohamed Abdallahi, Bouchez, Jean‐Michel, Castet, Sabine, Chami, Irene, Daviet, Bernard, Diallo, Abdou Ramane, Diallo, Maimouna, Dien, Maryse, Diop, Saliou, Dokekias, Alexis Elira, Duport, Gaetan, Duport, Jean‐François, and Ehungu, Gini
- Subjects
LOW-income countries ,MEDICAL societies ,HEMOPHILIA ,MEDICAL personnel ,PATIENT advocacy - Abstract
Introduction: There is a lack of joint recommendations by healthcare professionals (HCP) and patient organizations when a partnership between high and low‐income countries in the field of haemophilia is planned. Aim: To draft recommendations to clarify the methodology when a partnership between low‐ and high‐income countries is planned with the objective of a long‐term implication. This methodology is to be implemented for fulfilling both medical and associative aims. Methods: Based on the available literature, a first document was written, then diffused to AFATH (Alliance Franco‐Africaine pour le Traitement de l'Hémophilie) members, and after a one‐day meeting and further amendments, a second draft was approved by all members before submission for publication. Results: Based on 6 years experience, several recommendations regarding the joint and separate roles of patient association and HCP for a first mission in French‐speaking sub‐Saharan African countries have been established. The proposed methodology for establishing preliminary contacts, the first visit and the key points for diagnostic action, medical follow‐up, patient education and advocacy strategy outlines a model of partnership between patients and HCP. Conclusion: This paper written jointly by patients and physicians underlines the importance of reciprocal expert guidance and a partnership based on complementary inputs. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
35. The Distribution of the H-index Among Academic Emergency Physicians in the United States La Distribución del Índice-h entre los Urgenciólogos Universitarios de Estados Unidos.
- Author
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DeLuca, Lawrence A., St. John, Alex, Stolz, Uwe, Matheson, Lincoln, Simpson, Allan, Denninghoff, Kurt R., and Cone, David C.
- Subjects
SERIAL publications ,ACADEMIC achievement ,DATABASES ,EMERGENCY medicine ,EMERGENCY physicians ,INTERNSHIP programs ,MEDICAL societies ,DATA analysis ,CROSS-sectional method - Abstract
Copyright of Academic Emergency Medicine is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
- Full Text
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36. The European Society of Cardiology Heart Failure Association Study Group on Peripartum Cardiomyopathy - what has been achieved in 10 years.
- Author
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Sliwa, Karen, Bauersachs, Johann, and Coats, Andrew J.S.
- Subjects
HEART failure ,MEDICAL personnel ,PERIPARTUM cardiomyopathy ,CARDIOLOGY ,DISEASE risk factors ,CHILDBIRTH ,CARDIOVASCULAR diseases in pregnancy ,CARDIOMYOPATHIES ,PUERPERAL disorders ,MEDICAL societies - Published
- 2020
- Full Text
- View/download PDF
37. Ethics in medical information and advertising
- Author
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Serour, G.I. and Dickens, B.M.
- Subjects
MEDICAL ethics ,ADVERTISING ,CONFERENCES & conventions ,ADVERTISING ethics ,GOVERNMENT agencies ,HEALTH facilities ,MASS media ,MEDICAL societies ,NEWSLETTERS ,PHYSICIANS ,PUBLISHING ,COMMUNICATION ethics ,HEALTH care industry ,OCCUPATIONAL roles - Abstract
This article presents findings and recommendations of an international conference held in Cairo, Egypt in 2003 concerning issues of ethical practice in how information is provided to and by medical practitioners. Professional advertising to practitioners and the public is necessary, but should exclude misrepresentation of qualifications, resources, and authorship of research papers. Medical institutions are responsible for how staff members present themselves, and their institutions. Medical associations, both governmental licensing authorities and voluntary societies, have powers and responsibilities to monitor professional advertisement to defend the public interest against deception. Medical journals bear duties to ensure authenticity of authorship and integrity in published papers, and the scientific basis of commercial advertisers’ claims. A mounting concern is authors’ conflict of interest. Mass newsmedia must ensure accuracy and proportionality in reporting scientific developments, and product manufacturers must observe truth in advertising, particularly in Direct-to-Consumer advertising. Consumer protection by government agencies is a continuing responsibility. [Copyright &y& Elsevier]
- Published
- 2004
- Full Text
- View/download PDF
38. Trends in national licensing examinations in medicine.
- Author
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Swanson, David B and Roberts, Trudie E
- Subjects
PROFESSIONAL education ,ADULTS ,PROFESSIONAL licensure examinations ,MEDICAL schools ,STUDY & teaching of medicine ,COGNITION ,CURRICULUM planning ,LABOR supply ,MEDICAL societies ,U.S. states ,HEALTH literacy ,EVALUATION - Abstract
Context As a contribution to this special issue commemorating the journal's 50th volume, this paper seeks to explore directions for national licensing examinations ( NLEs) in medicine. Increases in the numbers of new medical schools and the mobility of doctors across national borders mean that NLEs are becoming even more important to ensuring physician competence. Objectives The purpose of this paper is to explore the use of NLEs in the future in the context of global changes in medical education and health care delivery. Methods Because the literature related to NLEs is so large, we have not attempted a comprehensive review, but have focused instead on a small number of topics on which we think we have something useful to say. The paper is organised around five predicted trends for NLEs. Discussion The first section discusses reasons why we think the use of NLEs will increase in the coming years. The second section discusses the ongoing problem of content specificity and its implications for the design of NLEs. The third section examines the evolution of large-scale, standardised cognitive assessments in NLEs and suggests some future directions. Reflecting the fact that NLEs are, increasingly, attempting to assess more than just knowledge, the fourth section addresses the future of large-scale clinical skills assessments in NLEs, predicting both increases in their use and some shifts in the nature of the stations used. The fifth section discusses workplace-based assessments, predicting increases in their use for formative assessment and identifying some limitations in their direct application in NLEs. The concluding section discusses the cost of NLEs and indulges in some further speculations about their evolution. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
39. Development of a research agenda for medical grade footwear in the Netherlands: A multidisciplinary multiphase project to determine the key research questions to advance scientific knowledge in the field.
- Author
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van Netten, Jaap J., Dahmen, Rutger, Holtkamp, Fred, Aussems, Johanna P., Jansen, Gaston, Mik, Esther, and Bus, Sicco A.
- Subjects
RESEARCH questions ,ORTHOPEDIC apparatus ,FOOT diseases ,ASSISTIVE technology ,MEDICAL societies - Abstract
Background: The field of medical grade footwear is dynamic. Originally, a field where individual knowledge, expertise and skills determined the footwear and its outcomes, now becoming a more evidence‐based and data‐driven field with protocols and systems in place to create appropriate footwear. However, scientific evidence concerning medical grade footwear is still limited. Evidently, all stakeholders, from patients to pedorthists to rehabilitation physicians, will profit from a larger evidence‐base in this field. A widely supported research agenda is an essential first step to advance and facilitate new knowledge. Methods: We formed a multidisciplinary team and followed the methodology from Dutch medical societies for the development of a research agenda on medical grade footwear. This consisted of seven steps: (1) inventory of relevant questions with users and professionals; (2) analyses of responses; (3) analyses of existing knowledge and evidence; (4) formulating research questions; (5) prioritising research questions by users and professionals; (6) finalising the research agenda and (7) implementing the research agenda. Results: In phase 1, 109 participants completed a survey, including 50% pedorthists, 6% rehabilitation physicians and 3% users. Participants provided 228 potential research questions. In phases 2–4, these were condensed to 65 research questions. In phase 5, 152 participants prioritised these 65 research questions, including 50% pedorthists, 13% rehabilitation physicians and 9% users. In phase 6, the final research agenda was created, with 26 research questions, categorised based on the International Classification of Functioning Disability and Health 'process description assistive devices'. In phase 7, an implementation meeting was held with over 50 stakeholders (including users and professionals), resulting in seven applications for research projects based on one or more research questions from the research agenda. Conclusions: This research agenda structures and guides knowledge development within the field of medical grade footwear in the Netherlands and elsewhere. We expect that this will help to stimulate the field to tackle the research questions prioritised and with that to advance scientific knowledge in this field. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
40. "I'm not what I used to be": A qualitative study exploring how young people experience being diagnosed with a chronic illness.
- Author
-
Kirk, Susan and Hinton, Denise
- Subjects
CHRONIC disease diagnosis ,BIOGRAPHY (Literary form) ,COGNITION ,COUNSELING ,CURRICULUM ,EMOTIONS ,GROUNDED theory ,INTERVIEWING ,MEDICAL care ,MEDICAL societies ,MENTAL health services ,SOCIAL skills ,TEENAGERS' conduct of life ,QUALITATIVE research ,SOCIAL support ,HEALTH literacy ,ADOLESCENCE - Abstract
Background: Childhood long‐term conditions are usually diagnosed in infancy or early childhood. Little is known about the particular experiences and needs of young people who receive a chronic illness diagnosis during adolescence or late childhood. This paper will examine this experience in relation to multiple sclerosis (MS), which is increasingly being diagnosed before adulthood. Aims: To explore how young people experience an MS diagnosis. Methods: Qualitative study using a grounded theory approach. In‐depth interviews were conducted with 21 young people diagnosed with MS. Participants were recruited through health service and voluntary sector organizations in the United Kingdom. Results: Young people's pre‐illness normality was disrupted by the diagnosis of a chronic illness (MS). Participants experienced their body as changed physically, cognitively, and emotionally and as changeable due to symptom unpredictability. This influenced how participants perceived and presented their identity, disrupted their relationships, and altered their future biography. Young people developed strategies to manage their condition and identities in order to incorporate MS into their current and future lives, which required continual illness and identity work in response to changing symptoms, social contexts, and relationships. Conclusions: Although young peoples' experience of living with chronic illness has been widely explored, the aftermath of diagnosis has been underresearched from their perspective. This study contributes to this knowledge gap by illuminating how young people experience a chronic illness diagnosis and negotiate the resulting changes to their identity, relationships, and future. The findings suggest that young people need preparation and support in disclosing their diagnosis to others. Professionals supporting young people with long‐term conditions need to work closely with specialist mental health services to ensure that they receive appropriate emotional support. Schools have an important role in ensuring young people with long‐term conditions achieve their academic potential and receive appropriate careers advice. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
41. The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology.
- Author
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Mullens, Wilfried, Damman, Kevin, Harjola, Veli‐Pekka, Mebazaa, Alexandre, Brunner‐La Rocca, Hans‐Peter, Martens, Pieter, Testani, Jeffrey M., Tang, W.H. Wilson, Orso, Francesco, Rossignol, Patrick, Metra, Marco, Filippatos, Gerasimos, Seferovic, Petar M., Ruschitzka, Frank, Coats, Andrew J., Harjola, Veli-Pekka, and Brunner-La Rocca, Hans-Peter
- Subjects
HEART failure ,DIURETICS ,HEART ,CARDIOLOGY ,CONSENSUS (Social sciences) ,MEDICAL societies ,RESEARCH funding ,STROKE volume (Cardiac output) - Abstract
The vast majority of acute heart failure episodes are characterized by increasing symptoms and signs of congestion with volume overload. The goal of therapy in those patients is the relief of congestion through achieving a state of euvolaemia, mainly through the use of diuretic therapy. The appropriate use of diuretics however remains challenging, especially when worsening renal function, diuretic resistance and electrolyte disturbances occur. This position paper focuses on the use of diuretics in heart failure with congestion. The manuscript addresses frequently encountered challenges, such as (i) evaluation of congestion and clinical euvolaemia, (ii) assessment of diuretic response/resistance in the treatment of acute heart failure, (iii) an approach towards stepped pharmacologic diuretic strategies, based upon diuretic response, and (iv) management of common electrolyte disturbances. Recommendations are made in line with available guidelines, evidence and expert opinion. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
42. The role of medical mycology societies in combating invasive fungal infections in low‐ and middle‐income countries: A Nigerian model.
- Author
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Oladele, Rita O., Osaigbovo, Iriagbonse I., Ayanlowo, Olusola O., Otu, Akaninyene A., Hoenigl, Martin, Cornely, Oliver A., Chakrabarti, Arunaloke, and Denning, David W.
- Subjects
MEDICAL mycology ,MYCOSES ,MEDICAL microbiology ,FUNGAL lung diseases ,MIDDLE-income countries - Abstract
Summary: The discipline of medical mycology has become increasingly relevant in the face of the rising incidence of invasive fungal infections (IFI), which pose diagnostic and therapeutic challenges for contemporary medical practice. While firmly established in developed countries, medical mycology remains obscure in many low‐ and middle‐income countries (LMICs). With a teeming vulnerable populace and an incidence rate of 11.8%, Nigeria has one of the highest estimated burdens of invasive fungal infections (IFIs) in the world. Regardless, the scourge of IFIs has remained silent due to a combination of factors principal amongst which are a lack of awareness and dearth in personnel skilled in diagnosis. The present narrative examines the status of medical mycology practice in Nigeria and chronicles the journey to change the status quo spurred by the Leading International Fungal Education (LIFE)‐facilitated burden estimate paper and culminating in the birth of the Medical Mycology Society of Nigeria (MMSN), the pioneer national medical mycology society in Africa. The prospects of tackling the IFI challenge are highlighted from the perspective of the nascent society. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
43. Gemellus.
- Subjects
RESTORATIVE proctocolectomy ,HEMORRHOIDS ,TREATMENT delay (Medicine) ,SURGICAL excision ,MEDICAL societies ,INFLAMMATORY bowel diseases - Abstract
Although it has always been assumed that treatment delay may have detrimental effects on cancer outcomes, Gemellus has never thought that a few weeks would ever make much difference in a disease that is slow and progressive. I Although the costs and quality of life following individual banding treatments have been investigated, little is known about the cumulative cost and the quality of life from sequential banding therapy or how these cumulative costs compare to surgical therapy. Notes that the authors conclude that, although treatment of refractory IBD in children remains challenging, STC followed by IPAA is an approach that provides symptom relief and preserves continence. [Extracted from the article]
- Published
- 2020
- Full Text
- View/download PDF
44. Society news.
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MEDICAL societies ,WOUND care ,ASSOCIATIONS, institutions, etc. ,WOUND healing ,LEG injuries ,ULCERS - Abstract
Presents an update on wound care societies and associations as of March 2005. Views of the European Wound Management Association (EWMA) on the need to provide an international classification of compression therapy for venous leg ulcers; Overview of a positioning paper on wound bed preparation issued by EWMA; International consensus document published by the World Union of Wound Healing Societies.
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- 2005
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45. Comprehensive in-hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).
- Author
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Harjola, Veli‐Pekka, Parissis, John, Brunner‐La Rocca, Hans‐Peter, Čelutkienė, Jelena, Chioncel, Ovidiu, Collins, Sean P., De Backer, Daniel, Filippatos, Gerasimos S., Gayat, Etienne, Hill, Loreena, Lainscak, Mitja, Lassus, Johan, Masip, Josep, Mebazaa, Alexandre, Miró, Òscar, Mortara, Andrea, Mueller, Christian, Mullens, Wilfried, Nieminen, Markku S., and Rudiger, Alain
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HEART failure patients ,INPATIENT care ,BIOLOGICAL tags ,HOSPITAL care ,MEDICAL protocols ,HEART failure treatment ,CARDIOLOGY ,HOSPITAL patients ,MEDICAL research ,MEDICAL societies ,PATIENT monitoring ,ACUTE diseases - Abstract
This paper provides a practical clinical application of guideline recommendations relating to the inpatient monitoring of patients with acute heart failure, through the evaluation of various clinical, biomarker, imaging, invasive and non-invasive approaches. Comprehensive inpatient monitoring is crucial to the optimal management of acute heart failure patients. The European Society of Cardiology heart failure guidelines provide recommendations for the inpatient monitoring of acute heart failure, but the level of evidence underpinning most recommendations is limited. Many tools are available for the in-hospital monitoring of patients with acute heart failure, and each plays a role at various points throughout the patient's treatment course, including the emergency department, intensive care or coronary care unit, and the general ward. Clinical judgment is the preeminent factor guiding application of inpatient monitoring tools, as the various techniques have different patient population targets. When applied appropriately, these techniques enable decision making. However, there is limited evidence demonstrating that implementation of these tools improves patient outcome. Research priorities are identified to address these gaps in evidence. Future research initiatives should aim to identify the optimal in-hospital monitoring strategies that decrease morbidity and prolong survival in patients with acute heart failure. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
46. Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation.
- Author
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Krcevski‐Skvarc, N., Wells, C., Häuser, W., Krcevski-Skvarc, N, and Häuser, W
- Subjects
PAIN management ,ANTIEMETICS ,ANTINEOPLASTIC agents ,CANNABIS (Genus) ,COMBINATION drug therapy ,CHRONIC pain ,DRUGS ,HYDROCARBONS ,MEDICAL societies ,MULTIPLE sclerosis ,NAUSEA ,NEUROTRANSMITTERS ,PALLIATIVE treatment ,SPASTICITY ,VOMITING ,MEDICAL marijuana ,DRUG approval ,DISEASE complications ,THERAPEUTICS - Abstract
Background: There is considerable public and political interest in the use of cannabis products for medical purposes.Methods: The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care.Results: Thirty-one out of 37 contacted councillors responded. Plant-derived tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray is approved for spasticity in multiple sclerosis refractory to conventional treatment in 21 EFIC chapters. Plant-derived THC (dronabinol) is approved for some palliative care conditions in four EFIC chapters. Synthetic THC analogue (nabilone) is approved for chemotherapy-associated nausea and vomiting refractory to conventional treatment in four EFIC chapters'. Eight EFIC chapters' countries have an exceptional and six chapters an expanded access programme for medical cannabis. German and Israeli pain societies recommend the use of cannabis-based medicines as third-line drug therapies for chronic pain within a multicomponent approach. Conversely, the German medical association and a team of finish experts and officials do not recommend the prescription of medical cannabis due to the lack of high-quality evidence of efficacy and the potential harms.Conclusions: There are marked differences between the countries represented in EFIC in the approval and availability of cannabis-based products for medical use. EFIC countries are encouraged to collaborate with the European Medicines Agency to publish a common document on cannabis-based medicines.Significance: There are striking differences between European countries in the availability of plant-derived and synthetic cannabinoids and of medical cannabis for pain management and for symptom control in palliative care and in the covering of costs by health insurance companies or state social security systems. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
47. Communicating Value in Simulation: Cost–Benefit Analysis and Return on Investment.
- Author
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Asche, Carl V., Kim, Minchul, Brown, Alisha, Golden, Antoinette, Laack, Torrey A., Rosario, Javier, Strother, Christopher, Totten, Vicken Y., and Okuda, Yasuharu
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CLINICAL competence ,COMMUNICATION ,CONFERENCES & conventions ,COST effectiveness ,ECONOMICS ,HEALTH facility administration ,HEALTH services administrators ,HOSPITALS ,INVESTMENTS ,LEADERSHIP ,EVALUATION of medical care ,MEDICAL societies ,RESOURCE allocation ,ORGANIZATIONAL goals - Abstract
Abstract: Value‐based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and the economic effects of potentially expensive simulation programs to rationalize the costs. Given the often‐disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost‐effectiveness to effectively communicate with administrators. At the 2017
Academic Emergency Medicine Consensus Conference “Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes,” our breakout session critically evaluated the cost‐benefit and return on investment of simulation. In this paper we provide an overview of some of the economic tools that a clinician may use to present the value of simulation training to financial officers and other administrators in the economic terms they understand. We also define three themes as a call to action for research related to cost–benefit analysis in simulation as well as four specific research questions that will help guide educators and hospital leadership to make decisions on the value of simulation for their system or program. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
48. Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology.
- Author
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Gorter, Thomas M., van Veldhuisen, Dirk J., Bauersachs, Johann, Borlaug, Barry A., Celutkiene, Jelena, Coats, Andrew J. S., Crespo‐Leiro, Marisa G., Guazzi, Marco, Harjola, Veli‐Pekka, Heymans, Stephane, Hill, Loreena, Lainscak, Mitja, Lam, Carolyn S. P., Lund, Lars H., Lyon, Alexander R., Mebazaa, Alexandre, Mueller, Christian, Paulus, Walter J., Pieske, Burkert, and Piepoli, Massimo F.
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HEART failure treatment ,VENTRICULAR ejection fraction ,BIOMARKERS ,PATHOLOGICAL physiology ,CARDIOLOGY ,HEART ventricle diseases ,RIGHT heart ventricle ,HEART failure ,MEDICAL protocols ,MEDICAL societies ,STROKE volume (Cardiac output) ,DISEASE complications ,DIAGNOSIS - Abstract
There is an unmet need for effective treatment strategies to reduce morbidity and mortality in patients with heart failure with preserved ejection fraction (HFpEF). Until recently, attention in patients with HFpEF was almost exclusively focused on the left side. However, it is now increasingly recognized that right heart dysfunction is common and contributes importantly to poor prognosis in HFpEF. More insights into the development of right heart dysfunction in HFpEF may aid to our knowledge about this complex disease and may eventually lead to better treatments to improve outcomes in these patients. In this position paper from the Heart Failure Association of the European Society of Cardiology, the Committee on Heart Failure with Preserved Ejection Fraction reviews the prevalence, diagnosis, and pathophysiology of right heart dysfunction and failure in patients with HFpEF. Finally, potential treatment strategies, important knowledge gaps and future directions regarding the right side in HFpEF are discussed. [ABSTRACT FROM AUTHOR]
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- 2018
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49. Conflicts of Interest in Emergency Medicine.
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Geiderman, Joel Martin, Iserson, Kenneth V., Marco, Catherine A., Jesus, John, Venkat, Arvind, and Zink, Brian J.
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CONFLICT of interests ,EMERGENCY medicine ,ETHICS ,INDUSTRIES ,MEDICAL care ,MEDICAL consultants ,MEDICAL education ,MEDICAL practice ,MEDICAL societies ,PATIENTS ,PATIENT safety ,RESEARCH ,WITNESSES ,HEALTH insurance reimbursement ,PROFESSIONALISM - Abstract
Conflicts of interest ( COIs) are common in the practice of emergency medicine and may be present in the areas of clinical practice, relations with industry, expert witness testimony, medical education, research, and organizations. A COI occurs when there is dissonance between a primary interest and another interest. The concept of professionalism in medicine places the patient as the primary interest in any interaction with a physician. We contend that patient welfare is the ultimate interest in the entire enterprise of medicine. Recognition and management of potential, real, and perceived COIs is essential to the ethical practice of emergency medicine. This paper discusses how to recognize, address, and manage them. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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50. WEO Newsletter and Contents.
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ENDOSCOPY ,MEDICAL societies ,TEACHING demonstrations ,SURGICAL excision ,COLON surgery - Abstract
The article presents several papers related to endoscopy and the World Endoscopy Organization (WEO) as of May 2013. It discusses papers on the Master Course in Gastroenterology event held in Sudan and the ethical implications of using live demonstrations in endoscopy. It also highlights an article regarding the techniques of endoscopic mucosal resection (EMR) in the colon.
- Published
- 2013
- Full Text
- View/download PDF
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