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https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#1
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742681/targeting-value-driven-quality-improvement-for-laparoscopic-cholecystectomy-in-michigan
#2
Kyle H Sheetz, Brooke Kenney, James M Dupree, Darrell A Campbell, Michael J Englesbe
OBJECTIVE: The purpose of this study was to evaluate complete episode expenditures for laparoscopic cholecystectomy, a common and lower-risk operation, to characterize novel targets for value-based quality improvement. SUMMARY BACKGROUND DATA: Despite enthusiasm for improving the overall value of surgical care, most efforts have focused on high-risk inpatient surgery. METHODS: We identified 19,213 patients undergoing elective laparoscopic cholecystectomy from 2012 to 2015 using data from Medicare and a large private payer...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742329/selecting-dna-encoded-chemical-library-against-non-immobilized-proteins-using-a-ligate-crosslink-purify-strategy
#3
Bingbing Shi, Yuqing Deng, Peng Zhao, Xiaoyu Li
DNA-encoded chemical library (DEL) has recently emerged and become an important technology platform in biomedical research and drug discovery. DELs containing large numbers of compounds can be prepared and selected against biological targets to discover novel ligands and inhibitors. In practice, DELs are usually selected against purified and immobilized proteins using the typical "bind-wash-elute" protocol; however, selection methods compatible with non-immobilized proteins would be able to greatly expand the target scope of DELs beyond purified proteins to more complex and biologically relevant targets...
July 25, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/28739260/uses-and-misuses-of-albumin-during-resuscitation-and-in-the-neonatal-intensive-care-unit
#4
REVIEW
Wissam Shalish, Francois Olivier, Hany Aly, Guilherme Sant'Anna
Albumin is one of the most abundant proteins in plasma and serves many vital functions. Neonatal concentrations vary greatly with gestational and postnatal age. In critically ill neonates, hypoalbuminemia occurs due to decreased synthesis, increased losses or redistribution of albumin into the extravascular space, and has been associated with increased morbidities and mortality. For that reason, infusion of exogenous albumin as a volume expander has been proposed for various clinical settings including hypotension, delivery room resuscitation, sepsis and postoperative fluid management...
July 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28738968/exploration-of-an-allied-health-workforce-redesign-model-quantifying-the-work-of-allied-health-assistants-in-a-community-workforce
#5
Lisa Somerville, Annette Davis, Sarah Milne, Desiree Terrill, Kathleen Philip
The Victorian Assistant Workforce Model (VAWM) enables a systematic approach for the identification and quantification of work that can be delegated from allied health professionals (AHPs) to allied health assistants (AHAs). The aim of the present study was to explore the effect of implementation of VAWM in the community and ambulatory health care setting. Data captured using mixed methods from allied health professionals working across the participating health services enabled the measurement of opportunity for workforce redesign in the community and ambulatory allied health workforce...
July 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28736389/hiv-testing-experiences-and-their-implications-for-patient-engagement-with-hiv-care-and-treatment-on-the-eve-of-test-and-treat-findings-from-a-multicountry-qualitative-study
#6
Alison Wringe, Mosa Moshabela, Constance Nyamukapa, Dominic Bukenya, Ken Ondenge, William Ddaaki, Joyce Wamoyi, Janet Seeley, Kathryn Church, Basia Zaba, Victoria Hosegood, Oliver Bonnington, Morten Skovdal, Jenny Renju
OBJECTIVE: In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. METHODS: As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28735580/high-protein-goat-s-milk-diet-identified-through-newborn-screening-clinical-warning-of-a-potentially-dangerous-dietetic-practice
#7
Evelina Maines, Giorgia Gugelmo, Elisa Tadiotto, Angelo Pietrobelli, Natascia Campostrini, Andrea Pasini, Florina Ion-Popa, Monica Vincenzi, Francesca Teofoli, Marta Camilot, Andrea Bordugo
OBJECTIVE: Breast-feeding is an unequalled way of providing optimal food for infants' healthy growth and development and the WHO recommends that infants should be exclusively breast-fed for the first 6 months of life. For mothers who are unable to breast-feed or who decide not to, infant formulas are the safest alternative. Despite recommendations, it is possible that parents make potentially harmful nutritional choices for their children because of cultural beliefs or misinformation on infant nutrition...
July 24, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/28734490/preconception-peer-educators-exploratory-outreach-to-the-bahamas-a-foundation-for-an-international-service-learning-initiative
#8
Gail H Wade, Mary B DeLashmutt, Anne DeCaire, Emily Boyce
A service learning outreach was undertaken to assess the feasibility of adapting the Preconception Peer Educator (PPE) program to Bahamian youth. By focusing on preconception health, the PPE program is a logical step toward ensuring age sensitive and developmentally appropriate education to improve potential birth outcomes and decrease infant mortality rates (IMR) associated with the complex societal problems on Grand Bahama. Concerned with the prevalence of adolescent pregnancy, lack of social support, depression, and failure to complete high school, a nurse midwife invited PPEs from a School of Nursing to meet with stakeholders to introduce the PPE program to Bahamian youth...
July 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28734046/effect-of-a-community-based-service-learning-experience-in-geriatrics-on-internal-medicine-residents-and-community-participants
#9
Rachel K Miller, Jennifer Michener, Phyllis Yang, Karen Goldstein, Jennine Groce-Martin, Gala True, Jerry Johnson
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources...
July 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28731702/drude-polarizable-force-field-for-molecular-dynamics-simulations-of-saturated-and-unsaturated-zwitterionic-lipids
#10
Hui Li, Janamejaya Chowdhary, Lei Huang, Xibing He, Alexander D MacKerell, BenoƮt Roux
Additive force fields are designed to account for induced electronic polarization in a mean-field average way using effective empirical fixed charges. The limitation of this approximation is cause for serious concerns, particularly in the case of lipid membranes, where the molecular environment undergoes dramatic variations over microscopic length scales. A polarizable force field based on the classical Drude oscillator offers a practical and computationally efficient framework for an improved representation of electrostatic interactions in molecular simulations...
July 21, 2017: Journal of Chemical Theory and Computation
https://www.readbyqxmd.com/read/28731086/microfluidic-and-nanofluidic-phase-behaviour-characterization-for-industrial-co2-oil-and-gas
#11
REVIEW
Bo Bao, Jason Riordon, Farshid Mostowfi, David Sinton
Microfluidic systems that leverage unique micro-scale phenomena have been developed to provide rapid, accurate and robust analysis, predominantly for biomedical applications. These attributes, in addition to the ability to access high temperatures and pressures, have motivated recent expanded applications in phase measurements relevant to industrial CO2, oil and gas applications. We here present a comprehensive review of this exciting new field, separating microfluidic and nanofluidic approaches. Microfluidics is practical, and provides similar phase properties analysis to established bulk methods with advantages in speed, control and sample size...
July 21, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/28728804/pharmacy-technician-self-efficacies-insight-to-aid-future-education-staff-development-and-workforce-planning
#12
Shane P Desselle, Ryan Hoh, Erin R Holmes, Amanpreet Gill, Lemuel Zamora
BACKGROUND: The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. OBJECTIVES: The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles...
July 15, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28728768/maintaining-integrity-how-nurses-navigate-boundaries-in-pediatric-palliative-care
#13
Alyssa Erikson, Betty Davies
PURPOSE: To explore how nurses manage personal and professional boundaries in caring for seriously ill children and their families. DESIGN AND METHODS: Using a constructivist grounded theory approach, a convenience sample of 18 registered nurses from four practice sites was interviewed using a semi-structured interview guide. RESULTS: Nurses across the sites engaged in a process of maintaining integrity whereby they integrated two competing, yet essential, aspects of their nursing role - behaving professionally and connecting personally...
July 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28728554/the-rise-and-fall-of-dental-therapy-in-canada-a-policy-analysis-and-assessment-of-equity-of-access-to-oral-health-care-for-inuit-and-first-nations-communities
#14
Victoria Leck, Glen E Randall
BACKGROUND: Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities...
July 20, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28728057/integrating-the-microbiome-as-a-resource-in-the-forensics-toolkit
#15
Thomas H Clarke, Andres Gomez, Harinder Singh, Karen E Nelson, Lauren M Brinkac
The introduction of DNA fingerprinting to forensic science rapidly expanded the available evidence that could be garnered from a crime scene and used in court cases. Next generation sequencing technologies increased available genetic data that could be used as evidence by orders of magnitude, and as such, significant additional genetic information is now available for use in forensic science. This includes DNA from the bacteria that live in and on humans, known as the human microbiome. Next generation sequencing of the human microbiome demonstrates that its bacterial DNA can be used to uniquely identify an individual, provide information about their life and behavioral patterns, determine the body site where a sample came from, and estimate postmortem intervals...
June 27, 2017: Forensic Science International. Genetics
https://www.readbyqxmd.com/read/28728056/sequence-based-diversity-of-23-autosomal-str-loci-in-koreans-investigated-using-an-in-house-massively-parallel-sequencing-panel
#16
Eun Hye Kim, Hwan Young Lee, So Yeun Kwon, Eun Young Lee, Woo Ick Yang, Kyoung-Jin Shin
As DNA databases continue to grow and international cooperation increases, forensic STR loci have expanded to increase the discriminatory power and inter-database compatibility. Current capillary electrophoresis (CE) and/or massively parallel sequencing (MPS)-based commercial STR analysis systems reflect such changing trends of expanding STR loci. Due to the general gains of larger multiplexing and the detection of sequence variation, the application of MPS technology to STR analysis has further improved discrimination and is expected to aid in mixture interpretation by increasing the effective number of alleles...
July 9, 2017: Forensic Science International. Genetics
https://www.readbyqxmd.com/read/28726168/cognitive-interventions-for-cognitively-healthy-mildly-impaired-and-mixed-samples-of-older-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Catherine M Mewborn, Cutter A Lindbergh, L Stephen Miller
Cognitive interventions may improve cognition, delay age-related cognitive declines, and improve quality of life for older adults. The current meta-analysis was conducted to update and expand previous work on the efficacy of cognitive interventions for older adults and to examine the impact of key demographic and methodological variables. EBSCOhost and Embase online databases and reference lists were searched to identify relevant randomized-controlled trials (RCTs) of cognitive interventions for cognitively healthy or mildly impaired (MCI) older adults (60+ years)...
July 19, 2017: Neuropsychology Review
https://www.readbyqxmd.com/read/28726059/professional-ethics-for-digital-age-psychiatry-boundaries-privacy-and-communication
#18
REVIEW
James E Sabin, Jonathan Clark Harland
PURPOSE OF REVIEW: Internet and social media use continue to expand rapidly. Many patients and psychiatrists are bringing digital technologies into the treatment process, but relatively little attention has been paid to the ethical challenges in doing this. This review presents ethical guidelines for psychiatry in the digital age. RECENT FINDINGS: Surveys demonstrate that patients are eager to make digital technologies part of their treatment. Substantial numbers search for professional and personal information about their therapists...
September 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28724326/sting-signalling-an-emerging-common-pathway-in-autoimmunity-and-cancer
#19
David McCaffary
The equipoise between the disease states of cancer and autoinflammation has perhaps been underappreciated in clinical practice and biomedical research. However, since the discover of STING (stimulator of interferon genes) as an integral regulator of innate immunity, a wealth of information has implicated this signaling pathway in both of these diseases. Under cellular homeostasis, STING serves to detect - and promote immune defense against - DNA viruses and intracellular bacteria, as described in its initial discovery...
July 20, 2017: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/28724087/nitrate-leaching-from-winter-cereal-cover-crops-using-undisturbed-soil-column-lysimeters
#20
John J Meisinger, Kristin A Ricigliano
Cover crops are important management practices for reducing nitrogen (N) leaching, especially in the Chesapeake Bay watershed, which is under total maximum daily load (TMDL) restraints. Winter cereals are common cool-season crops in the Bay watershed, but studies have not directly compared nitrate-N (NO-N) leaching losses from these species. A 3-yr cover crop lysimeter study was conducted in Beltsville, MD, to directly compare NO-N leaching from a commonly grown cultivar of barley ( L.), rye ( L.), and wheat ( L...
May 2017: Journal of Environmental Quality
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