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https://www.readbyqxmd.com/read/28077751/performance-of-health-workers-using-an-electronic-algorithm-for-the-management-of-childhood-illness-in-tanzania-a-pilot-implementation-study
#1
Clotilde Rambaud-Althaus, Amani Shao, Josephine Samaka, Ndeniria Swai, Seneca Perri, Judith Kahama-Maro, Marc Mitchell, Valérie D'Acremont, Blaise Genton
In low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28048903/su-f-e-17-a-dedicated-teaching-and-research-linac-as-a-stepping-stone-to-introduce-medical-physics-to-students
#2
L Beaulieu, L Gingras, M Bergeron, L Archambault
PURPOSE: This work describes how a non-clinical, research and teaching Linac is used as an extremely motivating and exciting way to introduce students to medical physics. METHODS: The dedicated facility was inaugurated in 2014. The facility is composed of a fully equipped and functional state-of-the-art Varian TrueBeam Linac and a complete set of physics instruments and QA phantoms for the Linac and onboard imaging. The Linac bunker and treatment console are oversized such that a class of 12-15 can comfortably fit, seated if needed for longer sessions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048683/tu-fg-brb-08-challenges-limitations-and-future-outlook-towards-clinical-translation-of-proton-acoustic-range-verification
#3
S Yousefi, M Ahmad, L Xiang, S Tang, Y Chen, M Zhang, J Zou, K Umegaki, H Shirato, L Xing
PURPOSE: To report our investigations of proton acoustic imaging, including computer simulations and preliminary experimental studies at clinical facilities. The ultimate achievable accuracy, sensitivity and clinical translation challenges are discussed. METHODS: The acoustic pulse due to pressure rise was estimated using finite element model. Since the ionoacoustic pulse is highly dependent on the proton pulse width and energy, multiple pulse widths were studied...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048018/su-f-j-52-a-novel-approach-to-x-ray-tube-quality-assurance-for-cbct-systems-in-order-to-better-assess-the-patient-imaging-dose-in-a-large-multi-unit-treatment-facility
#4
L Buckley, R Webb, C Lambert, B Nyiri, L Gerig
PURPOSE: To standardize the tube calibration for Elekta XVI cone beam CT (CBCT) systems in order to provide a meaningful estimate of the daily imaging dose and reduce the variation between units in a large centre with multiple treatment units. METHODS: Initial measurements of the output from the CBCT systems were made using a Farmer chamber and standard CTDI phantom. The correlation between the measured CTDI and the tube current was confirmed using an Unfors Xi detector which was then used to perform a tube current calibration on each unit...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047658/we-fg-bra-05-potential-clinical-benefit-of-linac-flattening-filter-free-fff-mode-improvement-of-treatment-therapeutic-ratio
#5
S Chang, J Rivera, H Tian, A Price, C Santos, Y Zhang
PURPOSE: Ultrahigh dose-rate radiation at >40Gy/s has demonstrated astonishing normal-tissue sparing and tumor control in recent preclinical naive and tumor-bearing rodent studies when compared to the same radiation dose at a conventional dose-rate. The working mechanism of this fascinating dose-rate effect is currently under investigation. The aims of this work include investigating 1) whether LINAC FFF mode radiation at approximately 1Gy/s also has an improved therapeutic ratio compared to the same radiation dose at the conventional dose-rate of 0...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#6
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28003248/development-of-a-smartphone-enabled-hypertension-and-diabetes-mellitus-management-package-to-facilitate-evidence-based-care-delivery-in-primary-healthcare-facilities-in-india-the-mpower-heart-project
#7
Vamadevan S Ajay, Devraj Jindal, Ambuj Roy, Vidya Venugopal, Rakshit Sharma, Abha Pawar, Sanjay Kinra, Nikhil Tandon, Dorairaj Prabhakaran
BACKGROUND: The high burden of undetected and undertreated hypertension and diabetes mellitus is a major health challenge worldwide. The mPower Heart Project aimed to develop and test a feasible and scalable intervention for hypertension and diabetes mellitus by task-sharing with the use of a mobile phone-based clinical decision support system at Community Health Centers in Himachal Pradesh, India. METHODS AND RESULTS: The development of the intervention and mobile phone-based clinical decision support system was carried out using mixed methods in five Community Health Centers...
December 21, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#8
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27990259/anterior-single-odontoid-screw-placement-for-type-ii-odontoid-fractures-our-modified-surgical-technique-and-initial-results-in-a-cohort-study-of-15-patients
#9
Binod Bhattarai, Sunil Munakomi, Karuna Tamrakar, Pramod Kumar Chaudhary
Objective: Anterior odontoid screw fixation for type II odontoid fracture is the ideal management option. However in the context of unavailability of an O-arm or neuro-navigation and poor images from the available C-arm may be an obstacle to ideal trajectory and placement of the odontoid screw. We herein detail  our surgical technique so as to ensure a correct trajectory and subsequent good fusion in Type II odontoid fractures. This may be advantageous  in clinical set ups lacking state of the art facilities...
2016: F1000Research
https://www.readbyqxmd.com/read/27984031/polestriding-intervention-improves-gait-and-axial-symptoms-in-mild-to-moderate-parkinson-s-disease
#10
Narayanan Krishnamurthi, Holly Shill, Darolyn O'Donnell, Padma Mahant, Johan Samanta, Abraham Lieberman, James Abbas
OBJECTIVE: To evaluate the effects of 12-week polestriding intervention on gait and disease severity in people with mild to moderate Parkinson's disease DESIGN: A-B-A withdrawal study design SETTING: Outpatient movement disorder center and community facility. PARTICIPANTS: Individuals (9 females and 8 males; mean age: 63.7 ± 4.9 years; range 53 - 72 years) with mild to moderate PD according to UK brain bank criteria with Hoehn and Yahr (H&Y) score from 2.5 to 3...
October 27, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27974996/performance-reliability-usability-and-safety-of-the-id-cap-system-for-ingestion-event-monitoring-in-healthy-volunteers-a-pilot-study
#11
Glen P Flores, Brian Peace, Tony C Carnes, Susan L Baumgartner, D Eric Buffkin, Neil R Euliano, Larry N Smith
Background: Nonadherence to prescribed medications is an important consideration in the clinical management of patients and in clinical research and drug development. The ID-Cap System is a novel technology that provides an objective measure of medication ingestion and enables real-time reporting of verified medication adherence data at the dose level. The ID-Cap System consists of an ingestible microsensor that is embedded in an oral dosage form and, once activated by stomach fluid, communicates digital messages to an external wearable reader to confirm ingestion...
September 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/27965033/medication-management-policy-practice-and-research-in-australian-residential-aged-care-current-and-future-directions
#12
Janet K Sluggett, Jenni Ilomäki, Karla L Seaman, Megan Corlis, J Simon Bell
Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities...
December 10, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27941328/upper-extremity-function-predicts-adverse-health-outcomes-among-older-adults-hospitalized-for-ground-level-falls
#13
Bellal Joseph, Nima Toosizadeh, Tahereh Orouji Jokar, Michelle R Heusser, Jane Mohler, Bijan Najafi
BACKGROUND: Despite National Surgical Quality Improvement guidelines to integrate frailty into surgical elder assessments, a quick, accurate, and simple frailty assessment tool suitable for busy clinical settings is still not available. Recently, we have demonstrated that a simple upper-extremity function (UEF) test based on wearable sensors could identify frailty with high agreement with conventional assessments by testing 20-s repetitive elbow flexion and extension. OBJECTIVE: We examined whether UEF parameters are sensitive for predicting adverse health outcomes in bedbound older adults admitted to hospital due to ground-level fall injuries...
December 10, 2016: Gerontology
https://www.readbyqxmd.com/read/27912126/evaluation-of-the-inactivation-effect-of-triton-x-100-on-ebola-virus-infectivity
#14
Francesca Colavita, Serena Quartu, Eleonora Lalle, Licia Bordi, Daniele Lapa, Silvia Meschi, Antonella Vulcano, Antonietta Toffoletti, Eugenio Bordi, Maria Grazia Paglia, Antonino Di Caro, Giuseppe Ippolito, Maria Rosaria Capobianchi, Concetta Castilletti
BACKGROUND: The recent Ebola virus disease outbreak occurred in West Africa since December 2013 highlighted the need of appropriate virus inactivation procedures to be set up to allow the necessary processing of specimens outside BSL-4 facilities and to perform laboratory tests without affecting clinical decisions. For this purpose, international guidelines suggest the pre-treatment of the samples with Triton X-100. OBJECTIVES: Due to the limited scientific evidence about the efficacy of Triton X-100 on enveloped-viruses, the aim of this work was to evaluate the effect of Triton X-100 on the virus infectivity and to establish the optimal conditions for its use...
January 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27906029/trends-in-clinical-characteristics-and-outcomes-of-pre-art-care-at-a-large-hiv-clinic-in-nairobi-kenya-a-retrospective-cohort-study
#15
Jared O Mecha, Elizabeth N Kubo, Lucy W Nganga, Peter N Muiruri, Lilian N Njagi, Immaculate N Mutisya, Justine J Odionyi, Syokau C Ilovi, Mary Wambui, Christopher Githu, Richard Ngethe, Elizabeth M Obimbo, Zipporah W Ngumi
BACKGROUND: The success of antiretroviral therapy in resource-scarce settings is an illustration that complex healthcare interventions can be successfully delivered even in fragile health systems. Documenting the success factors in the scale-up of HIV care and treatment in resource constrained settings will enable health systems to prepare for changing population health needs. This study describes changing demographic and clinical characteristics of adult pre-ART cohorts, and identifies predictors of pre-ART attrition at a large urban HIV clinic in Nairobi, Kenya...
November 14, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27895697/trends-in-clinical-characteristics-and-outcomes-of-pre-art-care-at-a-large-hiv-clinic-in-nairobi-kenya-a-retrospective-cohort-study
#16
Jared O Mecha, Elizabeth N Kubo, Lucy W Nganga, Peter N Muiruri, Lilian N Njagi, Immaculate N Mutisya, Justine J Odionyi, Syokau C Ilovi, Mary Wambui, Christopher Githu, Richard Ngethe, Elizabeth M Obimbo, Zipporah W Ngumi
BACKGROUND: The success of antiretroviral therapy in resource-scarce settings is an illustration that complex healthcare interventions can be successfully delivered even in fragile health systems. Documenting the success factors in the scale-up of HIV care and treatment in resource constrained settings will enable health systems to prepare for changing population health needs. This study describes changing demographic and clinical characteristics of adult pre-ART cohorts, and identifies predictors of pre-ART attrition at a large urban HIV clinic in Nairobi, Kenya...
2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27875999/helping-babies-breathe-hbb-training-what-happens-to-knowledge-and-skills-over-time
#17
Akash Bang, Archana Patel, Roopa Bellad, Peter Gisore, Shivaprasad S Goudar, Fabian Esamai, Edward A Liechty, Sreelatha Meleth, Norman Goco, Susan Niermeyer, William Keenan, Beena D Kamath-Rayne, George A Little, Susan B Clarke, Victoria A Flanagan, Sherri Bucher, Manish Jain, Nilofer Mujawar, Vinita Jain, Janet Rukunga, Niranjana Mahantshetti, Sangappa Dhaded, Manisha Bhandankar, Elizabeth M McClure, Waldemar A Carlo, Linda L Wright, Patricia L Hibberd
BACKGROUND: The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities. METHODS: We conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT)...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27786359/music-therapy-for-children-and-adolescents-with-behavioural-and-emotional-problems-a-randomised-controlled-trial
#18
Sam Porter, Tracey McConnell, Katrina McLaughlin, Fiona Lynn, Christopher Cardwell, Hannah-Jane Braiden, Jackie Boylan, Valerie Holmes
BACKGROUND: Although music therapy (MT) is considered an effective intervention for young people with mental health needs, its efficacy in clinical settings is unclear. We therefore examined the efficacy of MT in clinical practice. METHODS: Two hundred and fifty-one child (8-16 years, with social, emotional, behavioural and developmental difficulties) and parent dyads from six Child and Adolescent Mental Health Service community care facilities in Northern Ireland were randomised to 12 weekly sessions of MT plus usual care [n = 123; 76 in final analyses] or usual care alone [n = 128; 105 in final analyses]...
October 27, 2016: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/27784509/retention-and-mortality-outcomes-from-a-community-supported-public-private-hiv-treatment-programme-in-myanmar
#19
Gitau Mburu, Aung Zayar Paing, Nwe Ni Myint, Win Di, Kaung Htet Thu, Mala Ram, Christopher J Hoffmann, Bangyuan Wang, Soe Naing
INTRODUCTION: There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low- and middle-income settings. This article describes a public-private partnership that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community-based non-governmental organization (International HIV/AIDS Alliance). METHODS: Retrospective analysis of 2119 patient records dating from March 2009 to April 2015 was conducted...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/27784302/addressing-the-intersection-between-alcohol-consumption-and-antiretroviral-treatment-needs-assessment-and-design-of-interventions-for-primary-healthcare-workers-the-western-cape-south-africa
#20
M Schneider, M Chersich, M Temmerman, C D Parry
BACKGROUND: At the points where an infectious disease and risk factors for poor health intersect, while health problems may be compounded, there is also an opportunity to provide health services. Where human immunodeficiency virus (HIV) infection and alcohol consumption intersect include infection with HIV, onward transmission of HIV, impact on HIV and acquired immunodeficiency syndrome (AIDS) disease progression, and premature death. The levels of knowledge and attitudes relating to the health and treatment outcomes of HIV and AIDS and the concurrent consumption of alcohol need to be determined...
October 26, 2016: Globalization and Health
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