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https://www.readbyqxmd.com/read/28724193/saline-irrigation-for-the-management-of-skin-extravasation-injury-in-neonates
#1
REVIEW
P N Gopalakrishnan, Nitin Goel, Sujoy Banerjee
BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28723811/the-afya-bora-fellowship-an-innovative-program-focused-on-creating-an-interprofessional-network-of-leaders-in-global-health
#2
Wendy M Green, Carey Farquhar, Yohana Mashalla
PROBLEM: Most current health professions education programs are focused on the development of clinical skills. As a result, they may not address the complex and interconnected nature of global health. Trainees require relevant clinical, programmatic, and leadership skills to meet the challenges of practicing in an increasingly globalized environment. APPROACH: To develop health care leaders within sub-Saharan Africa, the Afya Bora Consortium developed a one-year fellowship for medical doctors and nurses...
July 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28723479/infectious-complications-of-circumcision-and-their-prevention
#3
REVIEW
Itzhak Brook
CONTEXT: A growing body of evidence supports the health benefits of circumcision, but the occurrence of infectious complications is of concern. OBJECTIVE: To review literature presenting past data and studies of infectious complications of circumcision and their prevention. EVIDENCE ACQUISITION: A literature search was conducted of the Cochrane Library, Embase, Turning Research into Practice, PubMed, and Medline databases from their inception through June 25, 2015...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723244/evaluation-of-the-national-health-service-nhs-direct-pilot-telehealth-program-cost-effectiveness-analysis
#4
Malcolm Clarke, Joanna Fursse, Nancy Connolly, Urvashi Sharma, Russell Jones
OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program...
July 18, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28721771/picture-this-photos-improve-wound-management
#5
Elaine Cole
Harefield Hospital's clinical nurse specialist in surveillance Melissa Rochon introduced Photo at Discharge (PaD) to reduce the impact of surgical site infections (SSIs).
July 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28721077/food-protein-induced-enterocolitis-syndrome-a-review-of-the-literature-with-focus-on-clinical-management
#6
REVIEW
Marine Michelet, Dominique Schluckebier, Laetitia-Marie Petit, Jean-Christoph Caubet
Food protein-induced enterocolitis syndrome (FPIES) is a potentially severe presentation of non-IgE-mediated gastrointestinal food allergy (non-IgE-GI-FA) with heterogeneous clinical manifestations. Acute FPIES is typically characterized by profuse vomiting and lethargy, occurring classically 1-4 hours after ingestion of the offending food. When continuously exposed to the incriminated food, a chronic form has been described with persistent vomiting, diarrhea, and/or failure to thrive. Although affecting mainly infants, FPIES has also been described in adults...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28721049/the-potential-role-of-vagus-nerve-stimulation-in-the-treatment-of-hiv-associated-depression-a-review-of-literature
#7
REVIEW
William C Nicholson, Mirjam-Colette Kempf, Linda Moneyham, David E Vance
Depression is the most common comorbidity and neuropsychiatric complication in HIV. Estimates suggest that the prevalence rate for depression among HIV-infected individuals is three times that of the general population. The association between HIV and clinical depression is complex; however, chronic activation of inflammatory mechanisms, which disrupt central nervous system (CNS) function, may contribute to this association. Disruptions in CNS function can result in cognitive disorders, social withdrawal, fatigue, apathy, psychomotor impairment, and sleep disturbances, which are common manifestations in depression and HIV alike...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28720751/exploring-the-perspectives-of-clinical-professionals-and-support-staff-on-implementing-supported-self-management-for-asthma-in-uk-general-practice-an-imp-2-art-qualitative-study
#8
Susan Morrow, Luke Daines, Sharon Wiener-Ogilvie, Liz Steed, Lorna McKee, Ann-Louise Caress, Stephanie J C Taylor, Hilary Pinnock
Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices...
July 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28720631/accrued-cost-savings-of-a-free-clinic-using-quality-adjusted-life-years-saved-and-return-on-investment
#9
Jim Sanders, Marcus Lacey, Clare E Guse
INTRODUCTION: Savings garnered through the provision of preventive services is a form of profit for health systems. Free clinics have been using this logic to demonstrate their cost-savings. The Community-Based Chronic Disease Management (CCDM) clinic treats hypertension using nurse-led teams, clinical protocols, and community-based settings. METHODS: We calculated CCDM's cost-effectiveness from 2007 to 2013 using 2 metrics: Quality-adjusted life years (QALYs) saved and return on investment (ROI)...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28718321/breathlessness-services-as-a-new-model-of-support-for-patients-with-respiratory-disease
#10
Claudia Bausewein, Michaela Schunk, Philipp Schumacher, Julika Dittmer, Anna Bolzani, Sara Booth
The complexity of breathlessness in advanced disease requires a diversity of measures ideally tailored to the individual patient needs. 'Breathlessness services' have been systematically developed and tested to provide specific interventions and support for patients and their carers. The aim of this article is (1) to identify and describe components of breathlessness services and (2) to describe the clinical model of one specific service in more detail. This article is based on a systematic review evaluating randomized controlled trials (RCTs) and quasi-RCTs which examine the effectiveness of services aiming to improve breathlessness of patients with advanced disease...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28716999/improving-recognition-of-anxiety-and-depression-in-rheumatoid-arthritis-a-qualitative-study-in-a-community-clinic
#11
Annabelle Machin, Samantha Hider, Nicky Dale, Carolyn Chew-Graham
BACKGROUND: Comorbid anxiety and depression are common in patients with rheumatoid arthritis (RA) but are often under-recognised and treated, contributing to worse outcomes. National Institute for Health and Care Excellence (NICE) recommends that patients with RA should be offered a holistic annual review, including an assessment of mood. AIM: To explore patients' perspectives of anxiety and depression in RA and preferences for disclosure and management of mood problems...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28716313/telemedicine-for-management-of-inflammatory-bowel-disease-myibdcoach-a-pragmatic-multicentre-randomised-controlled-trial
#12
Marin J de Jong, Andrea E van der Meulen-de Jong, Mariëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens, Astrid van Tubergen, Daisy M Jonkers, Marie J Pierik
BACKGROUND: Tight and personalised control of inflammatory bowel disease in a traditional setting is challenging because of the disease complexity, high pressure on outpatient clinics, and rising incidence. We compared the effects of self-management with a telemedicine system, which was developed for all subtypes of inflammatory bowel disease, on health-care utilisation and patient-reported quality of care versus standard care. METHODS: We did this pragmatic, randomised trial in two academic and two non-academic hospitals in the Netherlands...
July 14, 2017: Lancet
https://www.readbyqxmd.com/read/28716081/impact-of-a-nurse-led-telephone-intervention-on-satisfaction-and-health-outcomes-of-children-with-inflammatory-rheumatic-diseases-and-their-families-a-crossover-randomized-clinical-trial
#13
Anne-Sylvie Ramelet, Béatrice Fonjallaz, Laura Rio, Sandra Zoni, Pierluigi Ballabeni, Joachim Rapin, Christophe Gueniat, Michaël Hofer
BACKGROUND: Children suffering from rheumatic disease are faced with multidimensional challenges that affect their quality of life and family dynamics. Symptom management and monitoring of the course of the disease over time are important to minimize disability and pain. Poor disease control and anticipation of the need for treatment changes may be prompted by specialist medical follow-up and regular nurse-led consultations with the patient and families, in which information and support is provided...
July 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#14
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28715903/parkinson-s-disease-and-parkinson-s-disease-psychosis-a-perspective-on-the-challenges-treatments-and-economic-burden
#15
Doral Fredericks, James C Norton, Carolyn Atchison, Robert Schoenhaus, Michael W Pill
Parkinson's disease (PD) is a progressive neurodegenerative disease associated with a decrease in the neurotransmitter dopamine and characterized by the cardinal motor hallmarks of resting tremor, rigidity, bradykinesia/akinesia, and postural instability. Lesser-known features of PD revolve around nonmotor concerns including psychosis, dementia, sleep disturbances, autonomic dysfunction, and sensory abnormalities. Parkinson's disease psychosis (PDP) contributes significantly to morbidity, mortality, nursing home placement, and quality of life (QOL)...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28715603/an-exploratory-study-on-exemplary-practice-of-nurse-consultants
#16
Frances Kam Yuet Wong, Ada Tak Yin Lau, Rebecca Ng, Elaine Wing Yee Wong, So Man Wong, Eva Ching Yee Kan, Eva Liu, Denise Bryant-Lukosius
PURPOSE: To examine the exemplary practice of nurse consultants (NCs) and derive a model to illustrate the highest level of advanced nursing practice. DESIGN: A descriptive study was conducted to examine the practice and outcomes of seven NC roles in varied clinical specialties in Hong Kong. Exemplary practice was examined in relation to competencies for advanced practice nursing in Hong Kong and the United Kingdom. METHODS: Data about NC characteristics and their practices were collected using a structured questionnaire and analyzed using descriptive statistics...
July 17, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#17
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#18
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28709688/multidisciplinary-consensus-on-the-nonadherence-to-clinical-management-of-inhaled-therapy-in-spanish-asthma-patients
#19
Antolín López-Viña, Jordi Giner, Jesús Molina, Javier Palicio, Javier Plaza, José Antonio Quintano, Santiago Quirce, Cristina Soria, Ana María Uréndez, Vicente Plaza
PURPOSE: Rates of nonadherence to asthma treatment in Spain are between 24% and 76%, which results in poor disease control and increased health care costs. The main objective of this multidisciplinary consensus was to investigate the opinions of health professionals and patients regarding adherence to inhaled therapy in Spain. The results will help to identify the causes of nonadherence and to establish strategies to detect and correct the problem. METHODS: This research was conducted by using a modified Delphi method organized into 2 rounds and involving a panel of 64 physicians, 16 nurses, and 10 community pharmacists...
July 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#20
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
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