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https://www.readbyqxmd.com/read/27910294/medication-management-in-the-older-adult-a-narrative-exploration
#1
Johnanna Hernandez
BACKGROUND AND PURPOSE: The purpose of this study was to characterize the meaning nurse practitioners (NPs) ascribed to personal experiences providing care to older adults who take multiple medications to manage complex conditions. The study illuminated the NP experience in caring for the older adult while addressing the complexities of medication management through narrative stories in practice. METHODS: NPs self-identifying as caring for older adults were interviewed (N=15)...
December 2, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27864204/integrating-pharmacogenomics-into-electronic-health-records-with-clinical-decision-support
#2
J Kevin Hicks, Henry M Dunnenberger, Karl F Gumpper, Cyrine E Haidar, James M Hoffman
PURPOSE: Existing pharmacogenomic informatics models, key implementation steps, and emerging resources to facilitate the development of pharmacogenomic clinical decision support (CDS) are described. SUMMARY: Pharmacogenomics is an important component of precision medicine. Informatics, especially CDS in the electronic health record (EHR), is a critical tool for the integration of pharmacogenomics into routine patient care. Effective integration of pharmacogenomic CDS into the EHR can address implementation challenges, including the increasing volume of pharmacogenomic clinical knowledge, the enduring nature of pharmacogenomic test results, and the complexity of interpreting results...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27793961/acute-kidney-injury-in-the-era-of-the-aki-e-alert
#3
Jennifer Holmes, Timothy Rainer, John Geen, Gethin Roberts, Kate May, Nick Wilson, John D Williams, Aled O Phillips
BACKGROUND AND OBJECTIVES: Our aim was to use a national electronic AKI alert to define the incidence and outcome of all episodes of community- and hospital-acquired adult AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective national cohort study was undertaken in a population of 3.06 million. Data were collected between March of 2015 and August of 2015. All patients with adult (≥18 years of age) AKI were identified to define the incidence and outcome of all episodes of community- and hospital-acquired AKI in adults...
October 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27714688/purine-signaling-and-microglial-wrapping
#4
Bernardo Castellano, Mar Bosch-Queralt, Beatriz Almolda, Nàdia Villacampa, Berta González
Microglial cells are highly dynamic cells with processes continuously moving to survey the surrounding territory. Microglia possess a broad variety of surface receptors and subtle changes in their microenvironment cause microglial cell processes to extend, retract, and interact with neuronal synaptic contacts. When the nervous system is disturbed, microglia activate, proliferate, and migrate to sites of injury in response to alert signals. Released nucleotides like ATP and UTP are among the wide range of molecules promoting microglial activation and guiding their migration and phagocytic function...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27695959/transanal-total-mesorectal-excision-dissection-tips-using-o-s-and-triangles
#5
M-P Bernardi, A L A Bloemendaal, M Albert, M Whiteford, A R L Stevenson, R Hompes
PURPOSE: Transanal total mesorectal excision (taTME) requires specific technical expertise, as it is often difficult to ascertain the correct dissection plane. Consequently, one can easily enter an incorrect plane, potentially resulting in bleeding (sidewall or presacral vessels), autonomic nerve injury and urethral injury. We aim to demonstrate specific visual features, which may be encountered during surgery and can guide the surgeon to perform the dissection in the correct plane. METHOD: Specific features of dissection in the correct and incorrect planes are demonstrated in the accompanying video...
October 1, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27686871/role-of-the-internet-in-care-initiation-by-people-living-with-hiv
#6
Joseph Perazzo, Stephen Haas, Allison Webel, Joachim Voss
People frequently use the internet to obtain information, including information about health, but we lack understanding of how people living with HIV (PLHIV) use the internet in their care and treatment decisions. In this secondary analysis, interviews with 23 individuals who initiated HIV care at an urban, Midwestern medical center and mentioned internet use were analyzed using qualitative content analysis to explore how they used the internet during the process of initiating HIV care. HIV care had been initiated by this sample from less than one month to three years post-diagnosis...
September 30, 2016: Research in Nursing & Health
https://www.readbyqxmd.com/read/27650888/managing-serious-clinical-deterioration-in-a-tertiary-hospital-in-hong-kong-from-indicators-development-to-multiple-measures-in-reducing-the-rates
#7
Jasperine Ka Yee Ho, Quinnie Lee, Jaden Chun Ho Lam, Kam Shing Tang
RATIONALE, AIMS AND OBJECTIVES: Timely detection and management of acutely deteriorating patients can save lives. Tuen Mun Hospital (TMH), a 1800-bed acute tertiary hospital serving more than 1.06 million populations in Hong Kong, is exploring to quantitatively monitor serious clinical deterioration (SCD) and uses it to guide patient care improvement initiatives. METHODS: Literature review on definition and measurement of SCD was conducted. Monthly SCD rates of TMH were first calculated according to the published methodology and benchmarked against those of international centres...
September 21, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27634801/2b-alert-web-an-open-access-tool-for-predicting-the-effects-of-sleep-wake-schedules-and-caffeine-consumption-on-neurobehavioral-performance
#8
Jaques Reifman, Kamal Kumar, Nancy J Wesensten, Nikolaos A Tountas, Thomas J Balkin, Sridhar Ramakrishnan
STUDY OBJECTIVES: Computational tools that predict the effects of daily sleep/wake amounts on neurobehavioral performance are critical components of fatigue management systems, allowing for the identification of periods during which individuals are at increased risk for performance errors. However, none of the existing computational tools is publicly available, and the commercially available tools do not account for the beneficial effects of caffeine on performance, limiting their practical utility...
September 9, 2016: Sleep
https://www.readbyqxmd.com/read/27618591/image-guided-resuscitation-with-limited-transthoracic-echocardiogram-in-pediatric-trauma-patients
#9
Valerie Plant, Poornima Vanguri, Rahul Anand, Jeffrey Haynes, Michel Aboutanos, Paula Ferrada
INTRODUCTION: Limited transthoracic echocardiogram (LTTE) has been shown to be a useful tool in guiding resuscitation in adult trauma patients. Our hypothesis is that image-guided resuscitation in pediatric trauma patients with LTTE is feasible. METHODS: A retrospective chart review was performed on highest level pediatric trauma alerts (age 18 years or younger) at our level I trauma center during a 6-month period. Patients were divided into 2 groups as follows: those who had LTTE performed (LTTE group) and those who did not have LTTE performed (non-LTTE group)...
September 9, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27606649/-algorithm-for-the-management-of-nasal-obstruction-in-neonates-and-infants
#10
Hugo Rodríguez, Giselle Cuestas, Máximo Rodríguez D Aquila, Juan A Rodríguez D Aquila
The main cause of nasal obstruction in neonates and infants is inflammatory or infectious rhinitis. Congenital, neoplastic, traumatic or iatrogenic causes are less frequent. The pediatrician will alert to signs and symptoms of diseases less commonbut serious which should be diagnosed early. We present a proposal of simple algorithm for the management of unilateral and bilateral nasal obstruction in neonates and infants. We describe the pathologies that cause nasal respiratory failure, either those that occur very often or those which are important for their severity, their guiding symptoms to the presumptive diagnosis, additional studies and treatment...
October 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27605692/reversible-intraoperative-neurophysiologic-monitoring-alerts-in-patients-undergoing-arthrodesis-for-adolescent-idiopathic-scoliosis-what-are-the-outcomes-of-surgery
#11
Amer F Samdani, James T Bennett, Robert J Ames, Jahangir K Asghar, Giuseppe Orlando, Joshua M Pahys, Burt Yaszay, Firoz Miyanji, Baron S Lonner, Ronald A Lehman, Peter O Newton, Patrick J Cahill, Randal R Betz
BACKGROUND: Confidence in intraoperative neurophysiologic monitoring (IONM) data can allow scoliosis surgeons to proceed with surgery even after a monitoring alert, assuming the recovery of signals. We sought to determine the outcomes of surgical treatment of adolescent idiopathic scoliosis (AIS) after a notable IONM alert. METHODS: We identified 676 patients who underwent arthrodesis with use of IONM for the treatment of AIS. The patients were divided into 2 cohorts: those who experienced a lower-extremity IONM alert and those who did not...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27552535/the-impact-of-pharmacists-input-to-reduce-serotonin-syndrome-drug-interactions-in-an-australian-hospital
#12
Viviane Khalil, Karen Chin, Melissa Tran, Danica Furtula
BACKGROUND: Drug interactions contribute significantly to adverse-related events and hospital admissions. Example of common drug interactions includes combinations of medications that induces serotonin syndrome. Pharmacists are well placed in the multidisciplinary team to alert prescribers of these drug interactions and offer an alternative management. OBJECTIVE: The objective is to evaluate the effectiveness of pharmacists' input in preventing patients being discharged on clinically relevant drug interactions that have the potential to cause serotonin syndrome in an Australian hospital...
September 2016: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/27543592/acute-kidney-outreach-to-reduce-deterioration-and-death-akordd-trial-the-protocol-for-a-large-pilot-study
#13
Tarek Samy Abdelaziz, Antje Lindenmeyer, Jyoti Baharani, Hema Mistry, Alice Sitch, R Mark Temple, Gavin Perkins, Mark Thomas
INTRODUCTION: Acute kidney injury (AKI) contributes to morbidity and mortality, and its care is often suboptimal and/or delayed. The Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD) study is a large pilot testing provision of early specialist advice, to improve outcomes for patients with AKI. METHODS AND ANALYSIS: This before and after study will test an Outreach service for adult patients with AKI, identified using the national algorithm. During the 2-month before phase, AKI outcomes (30-day mortality, need for dialysis or AKI stage deterioration) will be observed in the intervention and control hospitals and their respective community areas; no interventions will be delivered...
2016: BMJ Open
https://www.readbyqxmd.com/read/27528494/interventions-to-reduce-corruption-in-the-health-sector
#14
REVIEW
Rakhal Gaitonde, Andrew D Oxman, Peter O Okebukola, Gabriel Rada
BACKGROUND: Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. OBJECTIVES: Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27507927/nurse-students-experiences-with-clinical-placement-in-outpatient-unit-a-qualitative-study
#15
Ann Karin Helgesen, Anne Grethe Gregersen, Anne Karine Østbye Roos
BACKGROUND: The recent reforms in the health care sector have changed the requirements for professional nursing competence in the clinical field. The reforms have also required nursing education to consider different areas for clinical placements for their students, and outpatient units in hospitals have been increasingly formalized as clinical learning environments. The complex technologies in some of these units represent a challenge for students who have limited existing knowledge or experience...
2016: BMC Nursing
https://www.readbyqxmd.com/read/27502802/welcoming-max-increasing-pediatric-provider-knowledge-of-service-dogs
#16
REVIEW
Laura Britton Stace
Service dogs have been used in the adult population for decades. Recently, there has been a diversification in types of service dogs, specifically for the pediatric population. Although guide dogs and mobility dogs are accepted in society, autism assistance dogs, seizure alert and response dogs and diabetic alert dogs are relatively new. As pediatric service dogs attract more attention, pediatric providers need to be prepared to answer parental inquires regarding service dog use. The pediatric provider is well equipped to identify children who could benefit from a service dog intervention and should be able to make a referral to a reputable service dog provider...
August 2016: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/27479493/pain-buddy-a-novel-use-of-m-health-in-the-management-of-children-s-cancer-pain
#17
Michelle A Fortier, Winnie W Chung, Ariana Martinez, Sergio Gago-Masague, Leonard Sender
BACKGROUND: Over 12,000 children are diagnosed with cancer every year in the United States. In addition to symptoms associated with their disease, children undergoing chemotherapy frequently experience significant pain, which is unfortunately often undertreated. The field of m-Health offers an innovative avenue for pain assessment and intervention in the home setting. The current study describes the development and initial evaluation of a tablet-based program, Pain Buddy, aimed to enhance pain management and foster improved quality of life in children ages 8-18 years undergoing cancer treatment...
September 1, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27451417/novel-public-health-risk-assessment-process-developed-to-support-syndromic-surveillance-for-the-2012-olympic-and-paralympic-games
#18
Gillian E Smith, Alex J Elliot, Sue Ibbotson, Roger Morbey, Obaghe Edeghere, Jeremy Hawker, Mike Catchpole, Tina Endericks, Paul Fisher, Brian McCloskey
BACKGROUND: Syndromic surveillance aims to provide early warning and real time estimates of the extent of incidents; and reassurance about lack of impact of mass gatherings. We describe a novel public health risk assessment process to ensure those leading the response to the 2012 Olympic Games were alerted to unusual activity that was of potential public health importance, and not inundated with multiple statistical 'alarms'. METHODS: Statistical alarms were assessed to identify those which needed to result in 'alerts' as reliably as possible...
July 22, 2016: Journal of Public Health
https://www.readbyqxmd.com/read/27447871/tensor-and-non-tensor-tractography-for-the-assessment-of-the-corticospinal-tract-of-children-with-motor-disorders-a-comparative-study
#19
Maria-Ioanna Stefanou, Daniel E Lumsden, Jonathan Ashmore, Keyoumars Ashkan, Jean-Pierre Lin, Geoffrey Charles-Edwards
INTRODUCTION: Non-invasive measures of corticospinal tract (CST) integrity may help to guide clinical interventions, particularly in children and young people (CAYP) with motor disorders. We compared diffusion tensor imaging (DTI) metrics extracted from the CST generated by tensor and non-tensor based tractography algorithms. METHODS: For a group of 25 CAYP undergoing clinical evaluation, the CST was reconstructed using (1) deterministic tensor-based tractography algorithm, (2) probabilistic tensor-based, and (3) constrained spherical deconvolution (CSD)-derived tractography algorithms...
July 22, 2016: Neuroradiology
https://www.readbyqxmd.com/read/27436837/fluid-volume-overload-and-congestion-in-heart-failure-time-to-reconsider-pathophysiology-and-how-volume-is-assessed
#20
Wayne L Miller
Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid congestion remain primary issues for patients with chronic heart failure. The pathophysiology is complex, and the simple concept of intravascular fluid accumulation is not adequate...
August 2016: Circulation. Heart Failure
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