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https://www.readbyqxmd.com/read/29142744/-who-has-to-do-it-at-the-end-of-the-day-programme-officials-or-hospital-authorities-airborne-infection-control-at-drug-resistant-tuberculosis-dr-tb-centres-of-karnataka-india-a-mixed-methods-study
#1
Kibballi Madhukeshwar Akshaya, Hemant Deepak Shewade, Ottapura Prabhakaran Aslesh, Sharath Burugina Nagaraja, Abhay Subashrao Nirgude, Anil Singarajipura, Anil G Jacob
Background: Drug resistant tuberculosis (DR-TB) centers admit patients with DR-TB for initiation of treatment and thereby concentrate the patients under one setting. It becomes imperative to assess the compliance of DR-TB centres to national airborne infection control (AIC) guidelines and explore the provider perspectives into reasons for unsatisfactory compliance. Methods: This mixed methods study (triangulation design) was carried out across all the six DR-TB centers of Karnataka state, India, between November 2016 and April 2017...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29129270/patient-centeredness-of-integrated-care-programs-for-people-with-multimorbidity-results-from-the-european-icare4eu-project
#2
Iris van der Heide, Sanne Snoeijs, Sabrina Quattrini, Verena Struckmann, Anneli Hujala, François Schellevis, Mieke Rijken
INTRODUCTION: This paper aims to support the implementation of patient-centered care for people with multimorbidity in Europe, by providing insight into ways in which patient-centeredness is currently shaped in integrated care programs for people with multimorbidity in European countries. METHODS: In 2014, expert organizations in 31 European countries identified 200 integrated care practices ('programs') in 25 countries of which 123 were included in our study. Managers of 112 programs from 24 countries completed a questionnaire about characteristics and results of the program, including questions on elements of patient-centeredness...
November 6, 2017: Health Policy
https://www.readbyqxmd.com/read/29128649/design-of-a-randomized-controlled-trial-examining-the-efficacy-and-biological-mechanisms-of-web-prolonged-exposure-and-present-centered-therapy-for-ptsd-among-active-duty-military-personnel-and-veterans
#3
Carmen P McLean, Sheila A M Rauch, Edna B Foa, Rebecca K Sripada, Hallie S Tannahill, Jim Mintz, Jeffrey Yarvis, Stacey Young-McCaughan, Katherine A Dondanville, Brittany N Hall-Clark, Brooke A Fina, Terence M Keane, Alan L Peterson
Improved accessibility of effective and efficient evidence-based treatments (EBTs) for military personnel suffering with posttraumatic stress disorder (PTSD) is an urgent need to meet the growing demand for timely care. In addition, a better understanding of the mechanism of action of behavioral therapy can inform the delivery of care to meet accessibility demands. Effective EBTs for PTSD are available, but logistical and stigma-related barriers to accessing behavioral healthcare can deter military personnel from receiving these treatments...
November 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29119464/pediatric-cataract-importance-of-early-detection-and-management
#4
REVIEW
Sudarshan Khokhar, Ganesh Pillay, Esha Agarwal
Pediatric cataract is often diagnosed and managed late. This delay may be due to the ignorance on the part of the community, financial constraints, delay in the diagnosis and lack of tertiary care facilities. There is an urgent need to include rubella vaccination in the universal immunization program. A Simple Red Reflex test to detect a cataract and guiding the parent for early intervention will go a long way in achieving the target of eliminating cataract as a cause of childhood blindness. The importance of early detection and quick referral to a multispecialty center can save the child of lot many blind-years...
November 9, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29100662/management-of-partial-fingertip-amputation-in-adults-operative-and-non-operative-treatment
#5
REVIEW
Kunal Sindhu, Steven F DeFroda, Andrew P Harris, Joseph A Gil
BACKGROUND: Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29094806/performance-of-an-algorithm-based-approach-to-the-diagnosis-and-management-of-functional-gastrointestinal-disorders-a-pilot-trial
#6
E C Linedale, A Mikocka-Walus, A D Vincent, P R Gibson, J M Andrews
BACKGROUND: Recent advances in the development of diagnostic criteria and effective management options for functional gastrointestinal disorders (FGIDs) have not yet been integrated into clinical practice. There is a clear need for the development and validation of a simple clinical pathway for the diagnosis and management of FGIDs which can be used in primary care. METHODS: In this controlled pilot study, we designed and evaluated a non-specialist-dependent, algorithm-based approach for the diagnosis and management of FGIDs (ADAM-FGID)...
November 2, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29089038/the-impact-of-n-acetylcysteine-and-ascorbic-acid-in-contrast-induced-nephropathy-in-critical-care-patients-an-open-label-randomized-controlled-study
#7
Eleni Palli, Demosthenes Makris, John Papanikolaou, Grigorios Garoufalis, Irini Tsilioni, Paris Zygoulis, Epaminondas Zakynthinos
BACKGROUND: The aim was to investigate whether the use of N-acetylcysteine and ascorbic acid reduce contrast-induced nephropathy incidence in critical care patients. METHODS: This was a one-center, two-arm, prospective, randomized, open-label, controlled trial in the Intensive Care Unit of the University Hospital of Larissa, Greece. Patients with stable renal function, who underwent non urgent contrast-enhanced computed tomography for diagnostic purposes, were included in the study...
October 31, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29073234/the-effects-of-patient-cost-sharing-on-inpatient-utilization-cost-and-outcome
#8
Yuan Xu, Ning Li, Mingshan Lu, Elijah Dixon, Robert P Myers, Rachel J Jelley, Hude Quan
BACKGROUND: Health insurance and provider payment reforms all over the world beg a key empirical question: what are the potential impacts of patient cost-sharing on health care utilization, cost and outcomes? The unique health insurance system and rich electronic medical record (EMR) data in China provides us a unique opportunity to study this topic. METHODS: Four years (2010 to 2014) of EMR data from one medical center in China were utilized, including 10,858 adult patients with liver diseases...
2017: PloS One
https://www.readbyqxmd.com/read/29072604/do-preschools-offer-healthy-beverages-to-children-a-nationwide-study-in-poland
#9
Joanna Myszkowska-Ryciak, Anna Harton
BACKGROUND: Children's beverage consumption patterns have received increased attention in light of the obesity epidemic in this group. In day care centers (DCCs), children spend up to 10 h a day, and typically consume half to three quarters of their daily food intake. The purpose of the study was to investigate what beverages are typically served to children in preschools in Poland, and to evaluate the practices associated with adding sugar and other sweetening agents to beverages. METHODS: Direct interviews with preschools staff were conducted with a questionnaire regarding offered beverages and adding sugar and other sweetening agents...
October 26, 2017: Nutrients
https://www.readbyqxmd.com/read/29072183/assessing-depression-in-greek-dementia-patients-which-scale-to-use
#10
A A Mougias, A Politis, M A Mougias, I N Beratis, P Skapinakis, Chr Armata, V G Mavreas
Depression in dementia is known to deteriorate patients' cognitive function and Quality of Life and to increase the burden of care. Although detecting depression in dementia is crucial, there is no gold standard for its screening and diagnosis. We examined the psychometric properties of 3 different scales in detecting depression in dementia. Results will be useful as community services for dementia in the country are developing and the need for reliable detection of depression in dementia patients is urgent...
July 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29071666/correction-to-expanding-antimicrobial-stewardship-to-urgent-care-centers-through-a-pharmacist-led-culture-follow-up-program
#11
Lisa E Dumkow, Thomas S Beuschel, Kasey L Brandt
In the original publication, the data labels have been inverted in Figure 1. The corrected figure is given here.
October 25, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#12
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid)...
October 20, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29050889/nine-point-plan-to-improve-care-of-the-injured-patient-a-case-study-from-kenya
#13
Abdulgafoor M Bachani, Isaac Botchey, Fatima Paruk, Daniel Wako, Hassan Saidi, Bethuel Aliwa, Simon Kibias, Adnan A Hyder
BACKGROUND: Injury rates in low- and middle-income countries are among the greatest in the world, with >90% of unintentional injury occurring in low- or middle-income countries. The risk of death from injuries is 6 times more in low- and middle-income countries than in high-income countries. This increased rate of injury is partly due to the lack of availability and access to timely and appropriate medical care for injured individuals. Kenya, like most low- and middle-income countries, has seen a 5-fold increase in injury fatalities throughout the past 4 decades, in large part related to the absence of a coordinated, integrated system of trauma care...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29049268/patient-and-parent-satisfaction-with-sling-use-after-pediatric-upper-extremity-fractures-a-randomized-controlled-trial-of-a-customized-cast-sling-versus-standard-cast-and-sling
#14
Aristides I Cruz, Steven F DeFroda, Joseph A Gil, Heather Hansen, Alexandre Bolous, Michaela Procaccini, Mark R Zonfrillo
BACKGROUND: Long arm cast immobilization after operative and nonoperative treatment of pediatric upper extremity fractures is common. The use of a sling to aid in carrying the casted extremity as well as provide further immobilization is also common practice. Off-the-shelf slings vary in quality and fit, can be confusing for parents/patients to apply, and lead to frustration and dissatisfaction with its use. The purpose of this investigation was to compare patient/parent centered outcomes after the use of a customized sling compared with a standard sling by utilizing a prospective, randomized-controlled trial...
October 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#15
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29035618/impact-of-intensity-modulated-radiotherapy-on-health-care-costs-of-patients-with-anal-squamous-cell-carcinoma
#16
Alexander L Chin, Erqi L Pollom, Yushen Qian, Albert C Koong, Daniel T Chang
PURPOSE: Drivers of variation in the cost of care after chemoradiotherapy for the management of anal squamous cell carcinoma (SCC) have not been fully elucidated. We sought to characterize the direct and indirect impact of radiotherapy modality on health care costs among patients with anal SCC. PATIENTS AND METHODS: A retrospective cohort study was performed using the 2014 linkage of the SEER-Medicare database. We identified 1,025 patients with anal SCC diagnosed between 2001 and 2011 and treated with chemoradiotherapy...
October 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29033516/primary-endovascular-intervention-for-acute-mesenteric-ischemia-performed-by-interventional-cardiologists-a-single-center-experience
#17
Tsung-Yan Chen, Chih-Horng Wu, Wen-Feng Hsu, Lin Lin, Ren-Huei Wang, Chao-Lun Lai, Kuei-Chin Tsai, Li-Ta Keng, Chih-Cheng Wu, Mu-Yang Hsieh
The current standard care for acute mesenteric ischemia (AMEI) involves urgent revascularization and resection of the necrotic bowel. Since 2012, we have used an AMEI protocol of our own design, which focused on early treatment and allowed interventional cardiologists to become involved when interventional radiologist was not available. A total of 8 patients were treated, and two interventional cardiologists performed all the stenting procedures. The procedure success rate was 100% in patients with non-calcified lesions (6/8)...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29033272/graduating-surgical-residents-lack-competence-in-critical-care-ultrasound
#18
Renuka Tripu, Margaret H Lauerman, Daniel Haase, Syeda Fatima, Jacob Glaser, Cassandra Cardarelli, Thomas M Scalea, Sarah Murthi
OBJECTIVE: Ultrasound provides accessible imaging for bedside diagnostics and procedural guidance, but may lead to misdiagnosis in untrained users. The main objective of this study was to determine observed and self-perceived competence with critical care ultrasound in graduated general surgery residents. DESIGN: The design of this study was a retrospective review. Ultrasound training program records were reviewed for number of prior ultrasound examinations performed, self-perceived competence, observed competence on faculty examinations, and intended future use of individual critical care ultrasound examinations...
October 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29025259/using-the-capture-recapture-method-to-estimate-the-human-immunodeficiency-virus-positive-population
#19
Jalal Poorolajal, Younes Mohammadi, Farzad Farzinara
OBJECTIVES: The capture-recapture method was applied to estimate the number of human immunodeficiency virus (HIV)-positive individuals not registered with any data sources. METHODS: This cross-sectional study was conducted in Lorestan Province, in the west of Iran, in 2016. Three incomplete sources of HIV-positive individuals, with partially overlapping data, were used, including: (a) transfusion center, (b) volunteer counseling and testing centers (VCTCs), and (c) prison...
2017: Epidemiology and Health
https://www.readbyqxmd.com/read/29022369/psychosocially-supportive-design-the-case-for-greater-attention-to-social-space-within-the-pediatric-hospital
#20
Rebecca McLaughlan
OBJECTIVE: Models of patient and family-centered care advocate catering to psychosocial needs when designing healthcare facilities yet there is little evidence available to determine how the built environment can cater to psychosocial needs. This article highlights the obstacles to overcoming this knowledge deficit in the pursuit of evidence-based guidelines to inform social provisions within the pediatric hospital setting. It will propose a working definition for psychosocial space and identify new research directions to enhance understandings of the relationship between social space and well-being...
January 1, 2017: HERD
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