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https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#1
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28720400/viewing-an-ultra-brief-chest-compression-only-video-improves-some-measures-of-bystander-cpr-performance-and-responsiveness-at-a-mass-gathering-event
#2
Daniel L Beskind, Uwe Stolz, Rebecca Thiede, Riley Hoyer, Whitney Robertson, Jeffrey Brown, Melissa Ludgate, Timothy Tiutan, Romy Shane, Deven McMorrow, Michael Pleasants, Karl B Kern, Ashish R Panchal
BACKGROUND: CPR training at mass gathering events is an important part of health initiatives to improve cardiac arrest survival. However, it is unclear whether training lay bystanders using an ultra-brief video at a mass gathering event improves CPR quality and responsiveness. OBJECTIVE: To determine if showing a chest-compression only (CCO) Ultra-Brief Video (UBV) at a mass gathering event is effective in teaching lay bystanders CCO-CPR. METHODS: Prospective control trial in adults (age >18) who attended either a women's University of Arizona or a men's Phoenix Suns basketball game...
July 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28694679/a-clinical-perspective-on-a-pain-neuroscience-education-approach-to-manual-therapy
#3
Adriaan Louw, Jo Nijs, Emilio J Puentedura
In recent years, there has been an increased interest in pain neuroscience education (PNE) in physical therapy. There is growing evidence for the efficacy of PNE to decrease pain, disability, fear-avoidance, pain catastrophization, limited movement, and health care utilization in people struggling with pain. PNE teaches people in pain more about the biology and physiology of their pain experience including processes such as central sensitization, peripheral sensitization, allodynia, inhibition, facilitation, neuroplasticity and more...
July 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/28691973/a-swift-method-for-handing-off-obstetrical-patients-on-the-labor-floor
#4
Jean-Ju Sheen, Laura Reimers, Shravya Govindappagari, Ivan M Ngai, Diana Garretto, Roopali Donepudi, Pamela Tropper, Dena Goffman, Ashlesha K Dayal, Peter S Bernstein
OBJECTIVE: The aim of this study was to improve patient handoffs on the labor floor. METHODS: A prospective cohort study of obstetrics residents at Montefiore Medical Center was performed between 2012 and 2014. Labor-floor handoffs were recorded before and after didactic sessions as well as after installation of whiteboards formatted with the mnemonic SWIFT (Subject, Why?, Issues, Fetus, Tasks). Handoff transcripts were evaluated by obstetricians blinded to timing and speaker identity...
July 6, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28689707/any-questions-yes-do-pharmacists-monitor-medications-at-refill
#5
Matthew J Witry, Lisa M Guirguis
OBJECTIVES: To describe pharmacists' self-reported refill monitoring activities and test for demographic and work setting differences that contribute to variation. METHODS: This study used a cross-sectional survey design. A 4-contact survey was mailed to 599 community pharmacists randomly selected from a list provided by the state board of pharmacy. Surveys were mailed in June and July 2013. Descriptive statistics and analysis of variance were used to characterize these data...
July 6, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28647945/the-emerging-adult-with-diabetes-transitioning-from-pediatric-to-adult-care
#6
Jodi Krall, Ingrid Libman, Linda Siminerio
Transfer from pediatric to adult health care is a significant life event for youth with chronic medical conditions. Unfortunately, youth may not be well prepared to navigate the shift in health care services, increasing their risk for loss to follow up and poor health outcomes. This review explores transition in care through the lens of type 1 diabetes, highlighting current practices and guidelines and offering recommendations for future consideration. Limited evidence suggests that transition programs that focus on strategies to prepare youth developmentally and equip the health care system appropriately have positive impact on the hand off of care, and health outcomes...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28614671/gestalt-breastfeeding-helping-mothers-and-infants-optimize-positional-stability-and-intraoral-breast-tissue-volume-for-effective-pain-free-milk-transfer
#7
Pamela Douglas, Renee Keogh
In the past decade, biological nurturing and activation of maternal and infant instincts after birth have constituted a major advance in clinical breastfeeding support. Yet, physiologic breastfeeding initiation is not enough to ensure ongoing pain-free and effective breastfeeding for many pairs. Current interventions, including "hands-off" mammalian approaches, do not improve breastfeeding outcomes, including in randomized controlled trials. Back-arching, difficulty latching or staying on the breast, and fussing at the breast are common signs of infant positional instability during breastfeeding...
August 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28608597/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma
#8
REVIEW
Vigdis Aasheim, Anne Britt Vika Nilsen, Liv Merete Reinar, Mirjam Lukasse
BACKGROUND: Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011. OBJECTIVES: To assess the effect of perineal techniques during the second stage of labour on the incidence and morbidity associated with perineal trauma...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#9
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28575448/bacillus-subtilis-dna-polymerases-polc-and-dnae-are-required-for-both-leading-and-lagging-strand-synthesis-in-spp1-origin-dependent-dna-replication
#10
Elena M Seco, Silvia Ayora
Firmicutes have two distinct replicative DNA polymerases, the PolC leading strand polymerase, and PolC and DnaE synthesizing the lagging strand. We have reconstituted in vitro Bacillus subtilis bacteriophage SPP1 θ-type DNA replication, which initiates unidirectionally at oriL. With this system we show that DnaE is not only restricted to lagging strand synthesis as previously suggested. DnaG primase and DnaE polymerase are required for initiation of DNA replication on both strands. DnaE and DnaG synthesize in concert a hybrid RNA/DNA 'initiation primer' on both leading and lagging strands at the SPP1 oriL region, as it does the eukaryotic Pol α complex...
May 30, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/28567408/evidence-based-adaptation-and-scale-up-of-a-mobile-phone-health-information-service
#11
Kelly L'Engle, Kate F Plourde, Trinity Zan
BACKGROUND: The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs...
2017: MHealth
https://www.readbyqxmd.com/read/28528021/multicystic-peritoneal-mesothelioma-a-short-review
#12
Chi-Hao Zhang, Ji-Wei Yu, Meng Luo
Multicystic peritoneal mesothelioma (MCPM) is a rare neoplasm, predominantly affecting female patients during their reproductive years. The lesion is usually distributed diffusely in the abdomen and pelvis, but the peritoneum of the pelvic organs is the most common site. MCPM is composed of fluid-filled translucent cysts, connected by varying amounts of fibrous tissue, and lined by a layer of mesothelial cells. Because of the rarity of this disease, the pathogenesis and natural history of MCPM remain poorly understood and continuously debated...
March 31, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28488507/how-to-assist-patients-with-sit-stand-transfers
#13
Janice Taylor
Rationale and key points This article discusses optimal methods for assisting patients with sit-stand transfers where moving-and-handling equipment is not required. The article explains the importance of effective mobility care in optimising patients' rehabilitation and enhancing their independence. » The term 'assistance' is used in this article to refer to the support nurses can provide to patients during sit-stand transfers, but excludes manual assistance. Nurses should attempt various 'hands-off' mobility-enhancing strategies to assist the patient, such as the use of verbal, visual or light manual cues...
May 10, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28483276/effectiveness-of-finger-marker-for-maintaining-the-correct-compression-point-during-paediatric-resuscitation-a-simulation-study
#14
Jae Yun Jung, Young Ho Kwak, Hyuksool Kwon, Yoo Jin Choi, Do Kyun Kim, Hee Chan Kim, Jung Chan Lee, Ji Heum Park, Hyungsoo Lim
OBJECTIVE: High-quality cardiopulmonary resuscitation is a significant factor for increasing the survival rate of paediatric patients. This study is to investigate the effectiveness of finger-marker stickers for maintaining the correct compression point during simulated infant cardiopulmonary resuscitation (CPR). METHODS: This crossover simulation study was conducted with 40 emergency physicians and paramedics at emergency departments of 2 tertiary hospitals. We used a remodeled infant CPR manikin developed to measure CPR quality indicators...
April 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28469889/a-quality-improvement-approach-to-standardization-and-sustainability-of-the-hand-off-process
#15
Craig Fryman, Carine Hamo, Siddharth Raghavan, Nirvani Goolsarran
There is mounting evidence that communication and hand-off failures are a root cause of two-thirds of sentinel events in hospitals. Several studies have shown that non-standardized hand-offs have yielded poor patient outcomes and adverse events. At Stony Brook University Hospital, there were numerous reported adverse events related to poor hand-off during the transfer of patient responsibility from one resident caregiver to the next. A resident-conducted root cause analysis identified lack of a standardized hand-off process and formal training on safe and efficient hand-off among caregivers as key contributing factors...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28457385/blood-lactate-concentrations-before-and-after-withdrawal-of-life-sustaining-treatments-in-controlled-donation-after-circulatory-death-a-case-report-from-italy
#16
F Baroncelli, M C Alberione, V Cacciotti, D Artusio, M Vergano, S Livigni
A 20-minute hands-off period with isoelectric electrocardiography (ECG) monitoring is currently required for the declaration of cardiac death in Italy, thus prolonging the warm ischemia time (WIT) during donation after circulatory death (DCD). Normothermic regional perfusion (NRP) can be a valid tool to optimize organ perfusion as a bridge to donation. A 62-year-old woman with catastrophic brain injury due to massive intracranial hemorrage, not fulfilling brain death criteria, underwent controlled DCD after withdrawal of life-sustaining therapies (WLST)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28455081/optimizing-postpartum-care-for-the-patient-with-gestational-diabetes-mellitus
#17
Noelle G Martinez, Charlotte M Niznik, Lynn M Yee
Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be <50%, with particularly low rates in Latina patients, as well as patients with public insurance, low education levels, and low health literacy...
April 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28452917/quality-of-handoffs-in-community-pharmacies
#18
Ephrem Abebe, Jamie A Stone, Corey A Lester, Michelle A Chui
OBJECTIVES: The aims of the study were to characterize handoffs in community pharmacies and to examine factors that contribute to perceived handoff quality. METHODS: A cross-sectional study of community pharmacists in a Midwest State of the United States. Self-administered questionnaires were used to collect information on participant and practice setting characteristics. Data were analyzed using descriptive statistics and multivariate logistic regression. RESULTS: A total of 445 completed surveys were returned (response rate, 82%)...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28449852/radiation-exposure-during-intramedullary-nailing
#19
David J Hak
Surgeons should aim to keep radiation exposure "As Low As Reasonably Achievable (ALARA)" during intramedullary nailing and other minimally invasive surgical procedures. This requires understanding the principles of ionizing radiation and methods for minimizing exposure risk. The main source of radiation exposure to surgical personnel during fluoroscopy is from scattered radiation. Since radiation scatter is mainly directed towards the fluoroscopy source, the best configuration during surgery to reduce radiation dose to the surgeon is to position the fluoroscopic source below the operating room table and the image collector above the table...
April 24, 2017: Injury
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#20
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
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