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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
#1
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...
June 1, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28381086/automated-quantitative-enzyme-biosensing-in-24-well-microplates
#15
Somjai Teanphonkrang, Albert Schulte
We report a novel system for glucose estimation in model and real samples, utilizing enzyme-modified pencil leads (PL) as effective electrochemical biosensors for robotic substrate quantification in 24-well microplates. Electrochemically formed carboxyl groups on the surface of the graphite were cross-linked to amino groups in the enzyme so as to attach glucose oxidase to the PL surface. Automated amperometric sensing of glucose solutions in microtiter-plate wells used computer-controlled stepper motors to move the biosensor/counter/reference electrode assemblies sequentially between the samples...
April 24, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28376986/transition-hand-off-from-inpatient-to-outpatient-treatment-of-acute-pyelonephritis-in-an-elderly-male
#16
Patricia L Orlando, Laura Shane-McWhorter
Pyelonephritis is the progression of a urinary tract infection (UTI) to the kidney. In younger patients the infection may not be as severe and may even be treated with oral antibiotics. However, in elderly males pyelonephritis can be more complex and may require hospitalization and treatment with intravenous antibiotics. In the United States UTIs are responsible for frequent visits to emergency departments by elderly individuals. Current literature suggests that pyelonephritis in elderly males is a serious infection that may result in significant morbidity and mortality...
April 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28376849/effect-of-an-interactive-cardiopulmonary-resuscitation-assist-device-with-an-automated-external-defibrillator-synchronised-with-a-ventilator-on-the-cpr-performance-of-emergency-medical-service-staff-a-randomised-simulation-study
#17
Rainer Nitzschke, Christoph Doehn, Jan F Kersten, Julian Blanz, Tobias J Kalwa, Norman A Scotti, Jens C Kubitz
BACKGROUND: The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linked to a ventilator and provides synchronised visual and acoustic instructions for guidance through the ALS algorithm and assistance for face-mask ventilations. METHODS: We compared the cardiopulmonary resuscitation (CPR) quality of emergency medical system (EMS) staff members using the study device or standard equipment in a mannequin simulation study with a prospective, controlled, randomised cross-over study design...
April 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28340542/expectations-and-attitudes-of-individuals-with-type-1-diabetes-after-using-a-hybrid-closed-loop-system
#18
Esti Iturralde, Molly L Tanenbaum, Sarah J Hanes, Sakinah C Suttiratana, Jodie M Ambrosino, Trang T Ly, David M Maahs, Diana Naranjo, Natalie Walders-Abramson, Stuart A Weinzimer, Bruce A Buckingham, Korey K Hood
Purpose The first hybrid closed loop (HCL) system, which automates insulin delivery but requires user inputs, was approved for treatment of type 1 diabetes (T1D) by the US Food and Drug Administration in September 2016. The purpose of this study was to explore the benefits, expectations, and attitudes of individuals with T1D following a clinical trial of an HCL system. Methods Thirty-two individuals with T1D (17 adults, 15 adolescents) participated in focus groups after 4 to 5 days of system use. Content analysis generated themes regarding perceived benefits, hassles, and limitations...
April 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#19
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328729/the-superiority-of-the-two-thumb-over-the-two-finger-technique-for-single-rescuer-infant-cardiopulmonary-resuscitation
#20
Sang Yoon Lee, Jun Young Hong, Je Hyeok Oh, Sun-Han Son
OBJECTIVES: The two-finger technique (TFT) using the index-middle fingers of the right hand (TFT-R23) was recently confirmed to produce deeper chest compression depth (CCD) compared with the TFT using any other fingers. This study was carried out to confirm whether the TFT-R23 would be as effective as the two-thumb technique (TTT). In addition, individual finger strengths were measured to identify the reasons why the TTT and TFT-R23 produced deeper CCD than any other methods. METHODS: This prospective randomized cross-over trial compared TTT with TFT-R23...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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