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| http://dx.doi.org/10.3399/bjgp17X693185 | DOI Listing |
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How does organisational culture facilitate uptake of home dialysis? An ethnographic study of kidney centres in England.
BMJ Open
December 2024
School of Medicine, Keele University, Keele, UK.
Objective: The proportion of people having home dialysis for kidney disease varies considerably by treating centre, socioeconomic deprivation levels in the area and to some extent ethnicity. This study aimed to gain in-depth insights into cultural and organisational factors contributing to this variation in uptake.
Design: This is the first ethnographic study of kidney centre culture to focus on home dialysis uptake.
Implantable cardioverter defibrillator deactivation and end-of-life: British Heart Rhythm Society practical consensus guideline.
BMJ Support Palliat Care
December 2024
Wolfson Palliative Care Research Centre, University of Hull, Hull, UK.
Implantable cardioverter defibrillators (ICDs) are implanted in increasing numbers of patients with the aim of treating ventricular arrhythmias in high-risk patients and reducing their risk of dying. Individuals are also living longer with these devices. As a result, a greater number of patients with an ICD will deteriorate either with worsening cardiac failure, another non-cardiac condition or general frailty and will have a limited prognosis.
View Article and Find Full Text PDFMetabolic factors modulate effort-based decision-making in major depressive disorder.
J Affect Disord
December 2024
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Electronic address:
Background: Abnormalities in effort-based decision-making have been consistently reported in major depressive disorder (MDD). Evidence indicates that metabolic factors, such as insulin resistance and dyslipidemia, which are highly prevalent in MDD, are independently associated with reward disturbances. Herein, we investigate the moderating effect of metabolic factors on effort-based decision-making in individuals with MDD.
View Article and Find Full Text PDFPredicting lack of clinical improvement following varicose vein ablation using machine learning.
J Vasc Surg Venous Lymphat Disord
December 2024
Department of Surgery, University of Toronto, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Temerty Centre for Artificial Intelligence Research and Education in Medicine (T-CAIREM), University of Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Canada; Department of Surgery, King Faisal Specialist Hospital and Research Center, Saudi Arabia. Electronic address:
Objective: Varicose vein ablation is generally indicated in patients with active/healed venous ulcers. However, patient selection for intervention in individuals without venous ulcers is less clear. Tools that predict lack of clinical improvement (LCI) following vein ablation may help guide clinical decision-making but remain limited.
View Article and Find Full Text PDFAccuracy of Electronic Health Record Phenotypes to Detect Recognition of Hypertension in Pediatric Primary Care.
Acad Pediatr
December 2024
Department of Pediatrics, Yale School of Medicine; Department of Biostatistics, Yale School of Public Health.
Objective: To evaluate the accuracy of extractable electronic health record (EHR) data to define clinician recognition of hypertension in pediatric primary care.
Methods: We used EHR data to perform a cross-sectional study of children aged 3-18 years at well-visits in Connecticut from 2018-2023 (n=50,290) that had either: (1) incident hypertension (hypertensive BP at the well-visit and ≥2 prior hypertensive BPs without prior diagnosis of hypertension); or (2) isolated hypertensive BP at the well-visit without necessarily having prior hypertensive BPs. We tested the accuracy of EHR phenotypes to detect recognition of incident hypertension or hypertensive BP using structured elements, including diagnosis codes, problem list entries, number of BP measurements, orders, and follow-up information.
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