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https://www.readbyqxmd.com/read/28431551/guided-internet-based-versus-face-to-face-clinical-care-in-the-management-of-tinnitus-study-protocol-for-a-multi-centre-randomised-controlled-trial
#1
Eldré W Beukes, David M Baguley, Peter M Allen, Vinaya Manchaiah, Gerhard Andersson
BACKGROUND: Innovative strategies are required to improve access to evidence-based tinnitus interventions. A guided Internet-based cognitive behavioural therapy (iCBT) intervention for tinnitus was therefore developed for a U.K. POPULATION: Initial clinical trials indicated efficacy of iCBT at reducing tinnitus severity and associated comorbidities such as insomnia and depression. The aim of this phase III randomised controlled trial is to compare this new iCBT intervention with an established intervention, namely face-to-face clinical care for tinnitus...
April 21, 2017: Trials
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#2
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#3
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429148/an-observational-time-and-motion-study-of-denosumab-subcutaneous-injection-and-zoledronic-acid-intravenous-infusion-in-patients-with-metastatic-bone-disease-results-from-three-european-countries
#4
Jean-Jacques Body, Francesca Gatta, Erwin De Cock, Sunning Tao, Persefoni Kritikou, Pauline Wimberger, Jeroen Mebis, Marc Peeters, Paolo Pedrazzoli, Augusto Caraceni, Vincenzo Adamo, Guy Hechmati
PURPOSE: Denosumab (administered via subcutaneous injection) demonstrated superior efficacy versus the intravenously administered zoledronic acid in the prevention of skeletal-related events in an integrated analysis of three head-to-head phase III trials in patients with bone metastases secondary to solid tumors. To date, no studies have evaluated treatment administration duration endpoints of these two agents. METHODS: A multinational, multi-site, observational time and motion study conducted in 10 day oncology units (DOUs) across Belgium, Germany, and Italy...
April 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#5
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28428643/-misscare-survey-italian-version-findings-from-an-italian-validation-study
#6
Luisa Sist, Carla Contini, Anna Bandini, Stefania Bandini, Licia Massa, Roberta Zanin, Rita Maricchio, Gloria Gianesini, Erika Bassi, Daniela Tartaglini, Alvisa Palese, Annamaria Ferraresi
BACKGROUND: The Missed Nursing Care (MNC) refers to nursing interventions that are not completed, partially completed, or postponed. Despite the relevance of MNC, no assessment tools are available in the Italian context, and no data regarding the occurrence of this phenomenon has been documented on a large scale to date. OBJECTIVES: The study aims were: (1) to validate the Italian version of the MISSCARE Survey tool; (2) to measure the prevalence of missed interventions and reasons for missed care as perceived by clinical nurses working in Italian health care settings...
January 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#7
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28427373/a-protocol-for-a-cluster-randomized-controlled-trial-of-a-self-help-psycho-education-programme-to-reduce-diagnosis-delay-in-women-with-breast-cancer-symptoms-in-indonesia
#8
Hari Setyowibowo, Marit Sijbrandij, Aulia Iskandarsyah, Joke A M Hunfeld, Sawitri S Sadarjoen, Dharmayanti F Badudu, Drajat R Suardi, Jan Passchier
BACKGROUND: Breast cancer (BC) is the most frequent cancer occurring in women across the world. Its mortality rate in low-middle income countries (LMICs) is higher than in high-income countries (HICs), and in Indonesia BC is the leading cause of cancer deaths among women. Delay in breast cancer diagnosis negatively impacts cancer prognosis. Only about 30% of patients who come to the hospital to check on their breast abnormalities, continue thorough examination to biopsy to get a diagnosis based on the results of anatomical pathology...
April 20, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28425571/clinical-factors-affecting-costs-in-patients-receiving-systemic-antifungal-therapy-in-intensive-care-units-in-greece-results-from-the-estimator-study
#9
A Armaganidis, S Nanas, E Antoniadou, K Mandragos, K Liakou, A Koutsoukou, G Baltopoulos, G Nakos, A Kounougeri, K Ganas, A Prekates, M Kompoti, D Georgopoulos, I Pneumatikos, E Zakynthinos
Invasive fungal infections are common in intensive care units (ICUs) but there is a great variability in factors affecting costs of different antifungal treatment strategies in clinical practice. To determine factors affecting treatment cost in adult ICU patients with or without documented invasive fungal infection receiving systemic antifungal therapy (SAT) we have performed a prospective, multicentre, observational study enrolling patients receiving SAT in participating ICUs in Greece. During the study period, 155 patients received SAT at 14 participating ICUs: 37 (23...
April 20, 2017: Mycoses
https://www.readbyqxmd.com/read/28424137/improvement-of-treatment-outcomes-after-implementation-of-a-massive-transfusion-protocol-a-level-i-trauma-center-experience
#10
Andrew Nunn, Peter Fischer, Ronald Sing, Megan Templin, Michael Avery, A Britton Christmas
We assessed the effectiveness of the implementation of an institutional massive transfusion protocol (MTP) for resuscitation with a 1:1:1 transfusion ratio of packed red blood cell (PRBC), fresh frozen plasma, and platelet units. In a Level I trauma center database, all trauma admissions (2004-2012) that received massive transfusions (≥10 units PRBCs in the first 24 hours) were reviewed retrospectively. Demographic data, transfusion ratios, and outcomes were compared before (PRE) and after (POST) MTP implementation in May 2008...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422919/the-lung-rescue-unit-lru-does-a-dedicated-intensive-care-unit-for-veno-venous-extra-corporeal-membrane-oxygenation-vv-ecmo-improve-survival-to-discharge
#11
Jay Menaker, Katelyn Dolly, Raymond Rector, Joseph Kufera, Eugenia E Lee, Ali Tabatabai, Ronald P Rabinowitz, Zachary Kon, Pablo Sanchez, Si Pham, Daniel L Herr, James V O'Connor, Deborah M Stein, Thomas M Scalea
BACKGROUND: The use of veno-venous extra corporeal membrane oxygenation (VV ECMO) for acute respiratory failure/distress syndrome (ARF/ARDS) has increased since 2009. Specialized units for patients requiring VV ECMO are not standard and patients are often cohorted with other critically ill patients. The purpose of this study was to report the outcome of adult patients admitted in 2015 to the LRU, which, to our knowledge, is the first intensive care unit in the United States that has been specifically created to provide care for patients requiring VV ECMO...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#12
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#13
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28422440/blood-parameters-of-preterm-neonates-postnatal-evolution-according-to-gestational-age
#14
P Roudil, C Vasselon, B Trombert-Paviot, C Berger, H Patural
INTRODUCTION: The blood count provides qualitative and quantitative essential information on bloodlines. Reference hematologic parameters have been established in children and neonates, but few data are available regarding the premature population during the first month of life. The main objective of this study was to establish normative values for blood parameters for premature infants born between 26 and <37 weeks of gestation, during the first month of life, taking into account gestational and postnatal age and treatments that can impact the threshold values...
April 19, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#15
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#16
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419594/catheter-ablation-for-the-treatment-of-atrial-fibrillation-is-associated-with-a-reduction-in-health-care-resource-utilization
#17
Michelle Samuel, Meytal Avgil Tsadok, Jacqueline Joza, Hassan Behlouli, Atul Verma, Vidal Essebag, Louise Pilote
BACKGROUND: Catheter ablation (CA) is superior to antiarrhythmic therapy at reducing recurrence of atrial fibrillation (AF); however, there is limited data regarding whether this decrease translates into a reduction in health care resource utilization. OBJECTIVE: To evaluate the impact of AF ablation on long-term health care resource utilization. METHODS: A population-based cohort was constructed to include patients who underwent CA for AF in Quebec, Canada between April 2005 and March 2011...
April 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28419552/feasibility-and-utility-of-portable-ultrasound-during-retrieval-of-sick-preterm-infants
#18
Kathryn Browning Carmo, Tracey Lutz, Mark Greenhalgh, Andrew Berry, Martin Kluckow, Nick Evans
AIM: Document the incidence of haemodynamic pathology in critically ill preterm newborns requiring transport. METHOD: A transport neonatologist performed cardiac and cerebral ultrasound before and after transportation of infants born ≤ 30 weeks gestation. RESULTS: 44 newborns were studied 2008 - 2015, 21 transported by road, 19 by helicopter and 4 by fixed wing. Median birth weight 1130g (680-1960g), median gestation 27 weeks (23-30) and 30/44 were male...
April 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#19
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28419264/evaluating-the-impact-of-contracting-out-basic-health-care-services-in-the-state-of-s%C3%A3-o-paulo-brazil
#20
Jane Greve, Vera Schattan Ruas Pereira Coelho
As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use...
April 16, 2017: Health Policy and Planning
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