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https://www.readbyqxmd.com/read/28636060/developing-mobile-clinical-decision-support-for-nursing-home-staff-assessment-of-urinary-tract-infection-using-goal-directed-design
#1
Wallace Jones, Cynthia Drake, David Mack, Blaine Reeder, Barbara Trautner, Heidi Wald
BACKGROUND: Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. OBJECTIVES: We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff...
June 20, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#2
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28634678/the-iliac-crest-in-forensic-age-estimation-evaluation-of-three-methods-in-pelvis-x-rays
#3
Viola Bartolini, Vilma Pinchi, Barbara Gualco, Stefano Vanin, Giusto Chiaracane, Giovanni D'Elia, Gian-Aristide Norelli, Martina Focardi
Age assessment in children and young adults is a relevant forensic issue. It is requested not only in evaluating criminal responsibility in youths without proper identification documents, often in relation to age thresholds, but also for release of a residency permit, and asylum seekers of minors. The analysis of the Risser sign and the iliac crest ossification process has been proposed as a useful tool for forensic age estimation. We evaluated the applicability of three different age estimation methods on a sample of 497 pelvic radiographs of Italian individuals between 10 and 25 years of age...
June 20, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28634641/a-novel-technique-for-ultrasound-guided-central-venous-catheterization-under-short-axis-out-of-plane-approach-stepwise-flashing-with-triangulation
#4
Toshinori Horiuchi, Chie Okuda, Naoko Kurita, Ayako Yamaguchi, Kazuhiko Kitagawa, Masafumi Takeda, Keiichi Sha, Toshihiro Nagahata
In ultrasound-guided central venous catheterization, there is no standard technique either for the needle tip visualization or for the adequate needle angle and entry to the skin with short-axis view under out-of-plane technique. In the present study, we propose a novel technique named "stepwise flashing with triangulation", and the efficacy of this technique is assessed. Before and after a didactic session in which the technique was explained, 12 novice residents were asked to position the needle tip on or into the imitation vessels and to avoid deeper penetration by using an agar tissue phantom with ultrasound guidance...
June 20, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28634576/disability-in-patients-with-inflammatory-bowel-disease-correlations-with-quality-of-life-and-patient-s-characteristics
#5
Konstantinos Argyriou, Andreas Kapsoritakis, Konstantinos Oikonomou, Anastassios Manolakis, Eirini Tsakiridou, Spyridon Potamianos
BACKGROUND: Inflammatory bowel diseases may cause significant disability. However, little is known regarding the life domains where patients encounter most limitations. OBJECTIVES: To assess patients' overall disability and determine the life domains where most restrictions were applied. Secondarily, we sought for possible relationships among disability, quality of life (HRQoL), and population characteristics. METHOD: The study lasted for two years (2013-2015) and included 200 patients [52%  ulcerative  colitis  (UC)] from a referral centre...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28634520/effect-of-heartfulness-meditation-on-burnout-emotional-wellness-and-telomere-length-in-health-care-professionals
#6
Jayaram Thimmapuram, Robert Pargament, Kedesha Sibliss, Rodney Grim, Rosana Risques, Erik Toorens
Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals. Objective: We assessed the effects of a 12-week 'Heartfulness Meditation' program on burnout, emotional wellness, and telomere length in residents, faculty members, and nurses at a large community teaching hospital during the 2015-16 academic year...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28633633/utilization-and-farmers-knowledge-on-pigeonpea-diversity-in-benin-west-africa
#7
Mathieu Anatole Tele Ayenan, Agyemang Danquah, Léonard Essehou Ahoton, Kwadwo Ofori
BACKGROUND: Understanding factors driving farmers' uses of crop genetic resources is a key component not only to design appropriate conservation strategies but also to promote sustainable production. However, in Benin, limited information is available on farmers' knowledge related to pigeonpea uses and conservation. This study aimed at i) identifying and investigating the different uses of pigeonpea in relation with socio-cultural factors, namely age, gender, ethnic group and respondents' residence, ii) assessing pigeonpea varieties richness at household level and iii) evaluating the extent and distribution of pigeonpea varieties...
June 20, 2017: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/28633175/the-marshall-family-medicine-residency-twintern-schedule-the-impact-of-an-innovative-hospital-coverage-scheme-on-resident-fatigue
#8
Adam Franks, Stephen M Petrany, Sydnee McElroy, Adam Alley
BACKGROUND AND OBJECTIVES: Work hour restriction has strained the balance between resident service and education. Night Float (NF) rotations are a popular answer to managing this balance but weakens continuity, an essential tenant of family medicine. An innovative short call system for Marshall University's Family Medicine Hospital Service (FMHS), the twINTERN call model, was created in response. We studied the impact of this approach on resident fatigue. METHODS: Anonymous surveys assessed fatigue of the Marshall University's 2013-2014 Family Medicine intern resident class while on NF rotations (ICU, Pediatrics and Surgery) and the twINTERN call...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633173/exploring-residents-skills-in-diagnosing-dementia-the-unexpected-dissonance-between-ability-and-confidence
#9
Brian S Lerner, Virginia Kalish, Christy J W Ledford
BACKGROUND AND OBJECTIVES: The diagnosis of dementia is a challenge for physicians due to numerous interrelated barriers. Research shows that this difficulty may be rooted in an incomplete knowledge about dementia. To address this gap, we developed an assessment scale of resident confidence in the diagnosis of dementia and used it to compare resident confidence to their practical ability to diagnose dementia. METHODS: The study used a piloted confidence assessment tool for diagnosing dementia correlated with family medicine residents (n=45) performance during an objective structured clinical examination (OSCE)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633171/examining-accuracy-of-self-assessment-of-in-training-examination-performance-in-a-context-of-guided-self-assessment
#10
Oksana Babenko, Denise Campbell-Scherer, Shirley Schipper, John Chmelicek, Tanya Barber, Kimberley Duerksen, Shelley Ross
BACKGROUND AND OBJECTIVES: In our family medicine residency program, we have established a culture of guided self-assessment through a systematic approach of direct observation of residents and documentation of formative feedback. We have observed that our residents have become more accurate in self-assessing their clinical performance. The objective of this study was to examine whether this improved accuracy extended to residents' self-assessment of their medical knowledge and clinical reasoning on the In-Training Examination (ITE)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633170/teaching-primary-care-genetics-a-randomized-controlled-trial-comparison
#11
Deanna Telner, June C Carroll, Glenn Regehr, Diana Tabak, Kara Semotiuk, Risa Freeman
BACKGROUND AND OBJECTIVE: Given the increasing discussions of the impact of genetic medicine within family medicine, it is important to determine the most effective way of teaching this material to family medicine residents (FMRs). The objective of this study was to evaluate and compare the impact of three methods of delivering primary care genetic content to FMRs. METHODS: Curriculum materials and assessment tools were created to teach and evaluate knowledge, skills, and attitudes around four core competencies in primary care genetics, with a focus on hereditary colorectal cancer (CRC)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28632531/a-descriptive-survey-of-anesthesiology-residency-simulation-programs-how-are-programs-preparing-residents-for-the-new-american-board-of-anesthesiology-applied-certification-examination
#12
Robert S Isaak, Fei Chen, Harendra Arora, Susan M Martinelli, David A Zvara, Marjorie P Stiegler
BACKGROUND: Anesthesiology residency programs may need new simulation-based programs to prepare residents for the new Objective Structured Clinical Examination (OSCE) component of the American Board of Anesthesiology (ABA) Primary Certification process. The design of such programs may require significant resources, including faculty time, expertise, and funding, as are currently needed for structured oral examination (SOE) preparation. This survey analyzed the current state of US-based anesthesiology residency programs regarding simulation-based educational programming for SOE and OSCE preparation...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632195/towards-a-long-term-strategy-for-voluntary-based-internal-radiation-contamination-monitoring-representativeness-of-the-monitoring-results-in-fukushima-japan
#13
Shuhei Nomura, Masaharu Tsubokura, Michio Murakami, Kyoko Ono, Yoshitaka Nishikawa, Tomoyoshi Oikawa
Following Japan's 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10-40 km from the Fukushima nuclear plant. Of approximately 70,000 individuals who were residing in Minamisoma City before the incident, a total of 19,263 residents (aged ≥21 years) participated in the monitoring from 1 October 2011 to 31 March 2015...
June 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28632004/behavioral-interventions-to-reduce-infections-in-pediatric-long-term-care-facilities-the-keep-it-clean-for-kids-trial
#14
Elaine L Larson, Meghan T Murray, Bevin Cohen, Edwin Simpser, Marianne Pavia, Olivia Jackson, Haomiao Jia, R Gordon Hutcheon, Linda Mosiello, Natalie Neu, Lisa Saiman
Children in pediatric long-term care facilities (pLTCF) represent a highly vulnerable population and infectious outbreaks occur frequently, resulting in significant morbidity, mortality, and resource use. The purpose of this quasi-experimental trial using time series analysis was to assess the impact of a 4-year theoretically based behavioral intervention on infection prevention practices and clinical outcomes in three pLTCF (288 beds) in New York metropolitan area including 720 residents, ages 1 day to 26 years with mean lengths of stay: 7...
March 3, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28631910/-prevalence-and-risk-factors-for-nephrolithiasis-among-young-rural-residents
#15
A V Sin'kov, I N Volosatova, G M Sin'kova, L A Nikolaeva
AIM: To determine the prevalence of nephrolithiasis, assess the significance of known risk factors, and identify new risk factors for nephrolithiasis among young rural residents. MATERIALS AND METHODS: This cross-sectional study was conducted in 5 settlements of the Irkutsk rural district of the Irkutsk region and involved 408 inhabitants (93 men, 315 women) aged from 18 to 47 years. The selection of candidates for the study was randomized. The response of the population was 81...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28631889/microrna-containing-extracellular-vesicles-released-from-endothelial-colony-forming-cells-modulate-angiogenesis-during-ischaemic-retinopathy
#16
Margaret Dellett, Eoin D Brown, Jasenka Guduric-Fuchs, Anna O'Connor, Alan W Stitt, Reinhold J Medina, David A Simpson
Endothelial colony-forming cells (ECFCs) are a defined subtype of endothelial progenitors that modulate vascular repair and promote perfusion in ischaemic tissues. Their paracrine activity on resident vasculature is ill-defined, but mediated, at least in part, by the transfer of extracellular vesicles (EVs). To evaluate the potential of isolated EVs to provide an alternative to cell-based therapies, we first performed a physical and molecular characterization of those released by ECFCs. Their effects upon endothelial cells in vitro and angiogenesis in vivo in a model of proliferative retinopathy were assessed...
June 20, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28631732/skillful-prediction-of-northern-climate-provided-by-the-ocean
#17
Marius Årthun, Tor Eldevik, Ellen Viste, Helge Drange, Tore Furevik, Helen L Johnson, Noel S Keenlyside
It is commonly understood that a potential for skillful climate prediction resides in the ocean. It nevertheless remains unresolved to what extent variable ocean heat is imprinted on the atmosphere to realize its predictive potential over land. Here we assess from observations whether anomalous heat in the Gulf Stream's northern extension provides predictability of northwestern European and Arctic climate. We show that variations in ocean temperature in the high latitude North Atlantic and Nordic Seas are reflected in the climate of northwestern Europe and in winter Arctic sea ice extent...
June 20, 2017: Nature Communications
https://www.readbyqxmd.com/read/28631423/pet-ownership-increases-human-risk-of-encountering-ticks
#18
E H Jones, A F Hinckley, S A Hook, J I Meek, B Backenson, K J Kugeler, K A Feldman
We examined whether pet ownership increased the risk for tick encounters and tickborne disease among residents of three Lyme disease-endemic states as a nested cohort within a randomized controlled trial. Information about pet ownership, use of tick control for pets, property characteristics, tick encounters and human tickborne disease were captured through surveys, and associations were assessed using univariate and multivariable analyses. Pet-owning households had 1.83 times the risk (95% CI = 1.53, 2.20) of finding ticks crawling on and 1...
June 19, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28631376/scale-of-human-mobility-in-the-southern-andes-argentina-and-chile-a-new-framework-based-on-strontium-isotopes
#19
Ramiro Barberena, Víctor A Durán, Paula Novellino, Diego Winocur, Anahí Benítez, Augusto Tessone, María N Quiroga, Erik J Marsh, Alejandra Gasco, Valeria Cortegoso, Gustavo Lucero, Carina Llano, Kelly J Knudson
OBJECTIVES: The goal of this article is to assess the scale of human paleomobility and ecological complementarity between the lowlands and highlands in the southern Andes during the last 2,300 years. By providing isotope results for human bone and teeth samples, we assess a hypothesis of "high residential mobility" suggested on the basis of oxygen isotopes from human remains. METHODS: We develop an isotopic assessment of human mobility in a mountain landscape combining strontium and oxygen isotopes...
June 20, 2017: American Journal of Physical Anthropology
https://www.readbyqxmd.com/read/28630770/knowledge-on-irradiation-medical-imaging-prescriptions-and-clinical-imaging-referral-guidelines-among-physicians-in-a-sub-saharan-african-country-cameroon
#20
Boniface Moifo, Ulrich Tene, Jean Roger Moulion Tapouh, Odette Samba Ngano, Justine Tchemtchoua Youta, Augustin Simo, Joseph Gonsu Fotsin
BACKGROUND: Clinical imaging guidelines (CIGs) are suitable tools to enhance justification of imaging procedures. OBJECTIVE: To assess physicians' knowledge on irradiation, their self-perception of imaging prescriptions, and the use of CIGs. MATERIALS AND METHODS: A questionnaire of 21 items was self-administered between July and August 2016 to 155 referring physicians working in seven university-affiliated hospitals in Yaoundé and Douala (Cameroon)...
2017: Radiology Research and Practice
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