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https://www.readbyqxmd.com/read/29793140/effectiveness-of-a-voluntary-family-befriending-service-a-mixed-methods-evaluation-using-the-donabedian-model
#1
S V Gentry, E F J Powers, N Azim, M Maidrag
OBJECTIVES: Voluntary befriending schemes operate in many countries, promoting public health by supporting vulnerable individuals and families. Use of third sector and voluntary services to complement health and social care provision is increasingly important globally in the context of economic and demographic challenges, but the evidence base around such collaborations is limited. This article reports the results of operational evaluation research seeking to use robust routine work to generate transferable findings for use by those commissioning and providing services...
May 21, 2018: Public Health
https://www.readbyqxmd.com/read/29792459/teamwork-in-healthcare-key-discoveries-enabling-safer-high-quality-care
#2
Michael A Rosen, Deborah DiazGranados, Aaron S Dietz, Lauren E Benishek, David Thompson, Peter J Pronovost, Sallie J Weaver
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29791775/vaginal-microbiome-in-early-pregnancy-and-subsequent-risk-of-spontaneous-preterm-birth-a-case-control-study
#3
Negar Tabatabaei, A Murat Eren, Luis B Barreiro, Vania Yotova, Anne Dumaine, Catherine Allard, William D Fraser
OBJECTIVES: To explore differences in vaginal microbiome between preterm and term deliveries. DESIGN: Nested case-control study in 3D cohort. SETTING: Quebec, Canada. SAMPLE: Ninety-four cases with spontaneous preterm birth (17 early (<34 wk) and 77 late (34-36 wk) preterm birth) and 356 controls with term delivery (≥37 wk). METHODS: To assess vaginal microbiome by sequencing the V4 region of 16S ribosomal-RNA (rRNA) gene in swabs self-collected early pregnancy...
May 23, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29789458/flying-real-time-network-to-coordinate-disaster-relief-activities-in-urban-areas-%C3%A2
#4
Matias Micheletto, Vinicius Petrucci, Rodrigo Santos, Javier Orozco, Daniel Mosse, Sergio F Ochoa, Roc Meseguer
While there have been important advances within wireless communication technology, the provision of communication support during disaster relief activities remains an open issue. The literature in disaster research reports several major restrictions to conducting first response activities in urban areas, given the limitations of telephone networks and radio systems to provide digital communication in the field. In search-and-rescue operations, the communication requirements are increased, since the first responders need to rely on real-time and reliable communication to perform their activities and coordinate their efforts with other teams...
May 22, 2018: Sensors
https://www.readbyqxmd.com/read/29788959/internal-contracting-of-health-services-in-cambodia-drivers-for-change-and-lessons-learned-after-a-decade-of-external-contracting
#5
Sreytouch Vong, Joanna Raven, David Newlands
BACKGROUND: Since the late 1990s, contracting has been employed in Cambodia in an attempt to accelerate rural health system recovery and improve health service delivery. Special Operating Agencies (SOA), a form of 'internal contracting', was introduced into selected districts by the Cambodia Ministry of Health in 2009. This study investigates how the SOA model was implemented and identifies effects on service delivery, challenges in operation and lessons learned. METHODS: The study was carried out in four districts, using mixed methods...
May 22, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#6
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29782373/compliance-and-high-reliability-in-a-complex-healthcare-organization
#7
Maxine dellaBadia Simon
When considering the impact of regulation on healthcare, visualize a spider's web. The spider weaves sections together to create the whole, with each fiber adding to the structure to support its success or lead to its failure. Each section is dependent on the others, and all must be aligned to maintain the structure. Outside forces can cause a shift in the web's fragile equilibrium.The interdependence of the sections of the spider's web is similar to the way hospital departments and services work together. An organization's structure must be shaped to support its mission and vision...
2018: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29782022/practical-use-of-rna-interference-oral-delivery-of-double-stranded-rna-in-liposome-carriers-for-cockroaches
#8
Jia-Hsin Huang, Yun Liu, Yu-Hsien Lin, Xavier Belles, How-Jing Lee
RNA interference (RNAi) has been widely applied for uncovering the biological functions of numerous genes, and has been envisaged as a pest control tool operating by disruption of essential gene expression. Although different methods, such as injection, feeding, and soaking, have been reported for successful delivery of double-stranded RNA (dsRNA), the efficiency of RNAi through oral delivery of dsRNA is highly variable among different insect groups. The German cockroach, Blattella germanica, is highly sensitive to the injection of dsRNA, as shown by many studies published previously...
May 1, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29782016/in-vivo-gene-transfer-to-the-rabbit-common-carotid-artery-endothelium
#9
Bradley K Wacker, Lianxiang Bi, David A Dichek
The goal of this method is to introduce a transgene into the endothelium of isolated segments of both rabbit common carotid arteries. The method achieves focal endothelial-selective transgenesis, thereby allowing an investigator to determine the biological roles of endothelial-expressed transgenes and to quantify the in vivo transcriptional activity of DNA sequences in large artery endothelial cells. The method uses surgical isolation of rabbit common carotid arteries and an arteriotomy to deliver a transgene-expressing viral vector into the arterial lumen...
May 6, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29781847/identification-of-the-critical-nontechnical-skills-for-surgeons-needed-for-high-performance-in-a-variable-resource-context-notss-vrc
#10
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta Mutabazi, William A Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVE: To identify the critical nontechnical skills (NTS) required for high performance in variable-resource contexts (VRC). BACKGROUND: As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in these settings are required. NTS are critical for high performance in surgery around the world. However, the essential NTS used by surgeons operating in LMICs to overcome the challenges specific to their contexts have never been described...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29781540/clinical-significance-of-platelet-to-lymphocyte-ratio-in-women-with-preeclampsia
#11
Min-A Kim, Gwan Hee Han, Ja-Young Kwon, Young-Han Kim
PROBLEM: Preeclampsia (PE) is a serious pregnancy complication leading to high maternal, perinatal morbidity, and mortality. We aimed to investigate the clinical effectiveness of the platelet-to-lymphocyte ratio (PLR) in women with PE and compare this measurement to platelet indices as a diagnostic and prognostic marker of PE. METHOD OF STUDY: A total of 471 healthy pregnant women, 126 women diagnosed with mild PE, and 227 with severe PE were included in this retrospective study...
May 21, 2018: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29781009/electrically-controlled-drug-release-using-ph-sensitive-polymer-films
#12
S Ephraim Neumann, Christian F Chamberlayne, Richard N Zare
Drug delivery systems (DDS) that allow spatially and temporally controlled release of drugs are of particular interest in the field of drug delivery. These systems create opportunities for individually tailored doses of drugs to be administered as well as reduce side effects by localizing the initial drug dose to the organ of interest. We present an electroresponsive DDS in the form of a bioresorbable nanocomposite film which operates at low voltages (<-2 V). The method is based on electrochemically generating local pH changes at an electrode surface to induce dissolution of a pH-sensitive polymer, which is used as the carrier material...
May 21, 2018: Nanoscale
https://www.readbyqxmd.com/read/29778331/goal-directed-perfusion-to-reduce-acute-kidney-injury-a-randomized-trial
#13
Marco Ranucci, Ian Johnson, Timothy Willcox, Robert A Baker, Christa Boer, Andreas Baumann, George A Justison, Filip de Somer, Paul Exton, Seema Agarwal, Rachael Parke, Richard F Newland, Renard G Haumann, Dirk Buchwald, Nathaen Weitzel, Rajamiyer Venkateswaran, Valeria Pistuddi
OBJECTIVE: To determine whether a goal-directed perfusion (GDP) strategy aimed at maintaining oxygen delivery (DO2 ) at ≥280 mL·min-1 ·m-2 reduces the incidence of acute kidney injury (AKI). METHODS: This multicenter randomized trial enrolled a total of 350 patients undergoing cardiac surgery in 9 institutions. Patients were randomized to receive either GDP or conventional perfusion. A total of 326 patients completed the study and were analyzed. Patients in the treatment arm were treated with a GDP strategy during cardiopulmonary bypass (CPB) aimed to maintain DO2 at ≥280 mL·min-1 ·m-2 ...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778067/succession-of-bacterial-and-fungal-communities-within-biofilms-of-a-chlorinated-drinking-water-distribution-system
#14
I Douterelo, K E Fish, J B Boxall
Understanding the temporal dynamics of multi-species biofilms in Drinking Water Distribution Systems (DWDS) is essential to ensure safe, high quality water reaches consumers after it passes through these high surface area reactors. This research studied the succession characteristics of fungal and bacterial communities under controlled environmental conditions fully representative of operational DWDS. Microbial communities were observed to increase in complexity after one month of biofilm development but they did not reach stability after three months...
May 3, 2018: Water Research
https://www.readbyqxmd.com/read/29777846/an-academic-tertiary-referral-center-s-experience-with-a-vascular-surgery-based-uterine-artery-embolization-program
#15
Naiem Nassiri, Adrian Balica, Nolan C Cirillo-Penn, Dustin Tyler Crystal, Gloria A Bachmann
OBJECTIVE: Despite growing endovascular experience within the vascular surgery community, some catheter-based interventions - such as uterine artery embolization (UAE) - remain outside the clinical scope of most vascular surgeons, owing in part to established referral patterns and limited awareness among referring colleagues. We present our experience with a vascular surgery-based, multidisciplinary UAE program at an academic tertiary referral center. METHODS: In a collaborative effort between vascular surgery and gynecology, a Pelvic Vascular Disease Program has been established to provide palliative, prophylactic, and therapeutic embolizations including, but not limited to, UAE...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29776928/enrichment-of-clinically-relevant-organisms-in-spontaneous-preterm-delivered-placenta-and-reagent-contamination-across-all-clinical-groups-in-a-large-uk-pregnancy-cohort
#16
Lydia J Leon, Ronan Doyle, Ernest Diez-Benavente, Taane G Clark, Nigel Klein, Philip Stanier, Gudrun E Moore
In this study differences in the placental microbiota of term and preterm deliveries from a large UK pregnancy cohort were studied using 16S targeted amplicon sequencing. The impact of contamination from DNA extraction, PCR reagents, as well as those from delivery itself were also examined. A total of 400 placental samples from 256 singleton pregnancies were analysed and differences investigated between spontaneous preterm, non-spontaneous preterm, and term delivered placenta. DNA from recently delivered placenta was extracted, and screening for bacterial DNA was carried out using targeted sequencing of the 16S rRNA gene on the Illumina MiSeq platform...
May 18, 2018: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/29774088/endoscopic-ultrasound-guided-drainage-of-pancreatic-walled-off-necrosis-using-self-expanding-metal-stents-without-fluoroscopy
#17
Barbara Braden, Andreas Koutsoumpas, Michael A Silva, Zahir Soonawalla, Christoph F Dietrich
AIM: To investigate whether endoscopic ultrasound (EUS)-guided insertion of fully covered self-expandable metal stents in walled-off pancreatic necrosis (WOPN) is feasible without fluoroscopy. METHODS: Patients with symptomatic pancreatic WOPN undergoing EUS-guided transmural drainage using self-expandable and fully covered self expanding metal stents (FCSEMS) were included. The EUS visibility of each step involved in the transmural stent insertion was assessed by the operators as "visible" or "not visible": (1) Access to the cyst by needle or cystotome; (2) insertion of a guide wire; (3) introducing of the diathermy and delivery system; (4) opening of the distal flange; and (5) slow withdrawal of the delivery system until contact of distal flange to cavity wall...
May 16, 2018: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29772053/delivery-outcome-after-trial-of-labor-in-nulliparous-women-over-40-years-of-age-a-population-based-study
#18
Victoria Ankarcrona, Daniel Altman, Anna-Karin Wikström, Bo Jacobsson, Sophia Brismar Wendel
INTRODUCTION: An increasing proportion of nulliparous women are over 40 years and labor is more often induced. The aim of this study was to assess delivery outcome in women over 40 years, accounting for the interaction between age and induction. MATERIAL AND METHODS: Population-based study of 1 644 598 nulliparous women with live singleton cephalic term deliveries 1992 to 2011. Risks of intrapartum cesarean section, operative vaginal delivery, obstetric anal sphincter injury (OASIS), and 5-minutes Apgar score <7 were calculated in women ≥40 years with induced or spontaneous labor, and women <40 years with induced labor by unconditional logistic regression, and presented with crude and adjusted odds ratios (aOR) with 95% confidence intervals (95%CI)...
May 17, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29771228/clinical-leadership-training-an-evaluation-of-the-welsh-fellowship-programme
#19
Suzanne Phillips, Alison Bullock
Purpose UK fellowship schemes have been set up to address low-level engagement of doctors with leadership roles. Established in 2013, the Welsh Clinical Leadership Fellowship (WCLF) programme aims to recruit aspiring future clinical leaders and equip them with knowledge and skills to lead improvements in healthcare delivery. This paper aims to evaluate the 12-month WCLF programme in its first two years of operation. Design/methodology/approach Focused on the participants ( n = 8), the authors explored expectations of the programme, reactions to academic components (provided by Academi Wales) and learning from workplace projects and other opportunities...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29771222/structure-of-health-care-dyad-leadership-an-organization-s-experience
#20
Anurag Saxena, Maura Davies, Don Philippon
Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys...
May 8, 2018: Leadership in Health Services
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