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https://www.readbyqxmd.com/read/29792174/perspectives-on-clinical-use-of-bioimpedance-in-hemodialysis-focus-group-interviews-with-renal-care-professionals
#1
Jenny Stenberg, Catrin Henriksson, Magnus Lindberg, Hans Furuland
BACKGROUND: Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals' perceived barriers and facilitators for use of bioimpedance in clinical practice. METHODS: Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device...
May 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29790826/free-clinics-and-the-need-for-nursing-action-in-uncertain-political-times
#2
Marie Ghazal, Betty Rambur
Free clinics have been a source of health care for uninsured and low-income Americans for half a century and serve some of the nation's most vulnerable within their home community. Despite parallels to nursing's significant involvement in the formation of free public clinics and commitment to care for all, there is paucity of nursing literature about free clinics. This article details the history of U.S. free clinics and the intersections among free clinics and value-based care, health reform, and tax reform, including the Patient Protection and Affordable Care Act of 2010 and the Tax Cuts and Jobs Act of 2017...
January 1, 2018: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/29789018/pain-clinic-definitions-in-the-medical-literature-and-u-s-state-laws-an-integrative-systematic-review-and-comparison
#3
REVIEW
Barbara Andraka-Christou, Joshua B Rager, Brittany Brown-Podgorski, Ross D Silverman, Dennis P Watson
BACKGROUND: In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called "pain clinics." Whether a clinic falls into a state's pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice...
May 22, 2018: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/29788939/nontuberculous-mycobacteria-infection-and-lung-transplantation-in-cystic-fibrosis-a-worldwide-survey-of-clinical-practice
#4
Adrien Tissot, Matthew F Thomas, Paul A Corris, Malcolm Brodlie
BACKGROUND: In people with cystic fibrosis infection with NonTuberculous Mycobacteria is of increasing prevalence. Mycobacterium abscessus complex is of particular concern and has been associated with adverse clinical outcomes. Optimal treatment usually requires multiple antibiotics for over 12 months. When considering lung transplantation for patients with NonTuberculous Mycobacteria potential benefits must be balanced against the risks of uncontrolled infection post-transplant and significant side-effects associated with treatment...
May 22, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29788774/the-standardization-of-diagnostic-criteria-for-fetal-alcohol-spectrum-disorder-fasd-implications-for-research-clinical-practice-and-population-health
#5
Jasmine M Brown, Roger Bland, Egon Jonsson, Andrew J Greenshaw
OBJECTIVE: Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD. METHODS AND RESULTS: This review seeks to analyse the discrepancies in existing diagnostic tools for FASD, and the repercussions these differences have on research, public health, and government policy...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29788396/injury-surveillance-and-reporting-for-trainees-with-bone-stress-injury-current-practices-and-recommendations
#6
Scott C Dembowski, Bradley S Tragord, Amy F Hand, Iván R Rohena-Quinquilla, Ian E Lee, David C Thoma, Joseph M Molloy
Background: Musculoskeletal injuries, including lower extremity bone stress injuries (BSI) significantly impact initial entry training (IET) in the U.S. Army due to limited duty days, trainee attrition, early medical discharge, and related financial costs. Factors complicating trainee BSI surveillance include inconsistent BSI coding practices, attrition documentation as both administrative separations and medical discharges and the inability to code for BSI grade or severity when using International Statistical Classification of Diseases and Related Health Problems 10th revision (ICD-10) codes...
May 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29787408/organ-donation-after-circulatory-death-ethical-issues-and-international-practices
#7
Barbara G Jericho
Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#8
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29781688/-he-should-feel-your-pain-patient-insights-on-patient-provider-communication-in-rwanda
#9
Vincent K Cubaka, Michael Schriver, Janvier B Kayitare, Phil Cotton, Helle T Maindal, Laetitia Nyirazinyoye, Per Kallestrup
BACKGROUND:  Patient-provider communication is an interpersonal interaction between a patient and a health care provider. OBJECTIVE:  This study explored patients' communication preferences and perceptions on what factors influence the patient-provider communication in primary health care settings in Rwanda. METHODS:  In-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used...
April 16, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29779551/emerging-roles-for-peer-providers-in-mental-health-and-substance-use-disorders
#10
Susan A Chapman, Lisel K Blash, Kimberly Mayer, Joanne Spetz
INTRODUCTION: The purpose of this study was to identify and assess states with best practices in peer provider workforce development and employment. A growing body of research demonstrates that peer providers with lived experience contribute positively to the treatment and recovery of individuals with behavioral health needs. Increased employment opportunities have led to policy concerns about training, certification, roles, and reimbursement for peer provider services. METHODS: A case study approach included a national panel of subject matter experts who suggested best practice states...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779546/state-legislative-approach-to-enumerating-behavioral-health-workforce-shortages-lessons-learned-in-new-mexico
#11
Deborah B Altschul, Caroline A Bonham, Martha J Faulkner, Amy W Farnbach Pearson, Jessica Reno, Wayne Lindstrom, Shelley M Alonso-Marsden, Annette Crisanti, Julie G Salvador, Richard Larson
Nationally, the behavioral health workforce is in crisis because of a lack of resources, culturally responsive services, quality clinical supervision, sufficient training in evidence-based practices, and targeted recruitment and retention. Disparities in access to behavioral health care are particularly significant in New Mexico, where 25% of the population live in rural areas, and behavioral health shortages are among the highest in the nation. Additionally, as a Medicaid expansion state, New Mexico providers experience increased demand for services at a time when the state is challenged with limited workforce capacity...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779300/coroners-recommendations-for-prevention-of-resident-deaths-in-aged-care-the-role-of-primary-care-providers
#12
Georgia Aitken, Athena Demosthenous, Lyndal Bugeja, Melissa Willoughby, Carmel Young, Joseph E Ibrahim
BACKGROUND AND OBJECTIVES: Currently, very little is known about how coroners consider a role for general practitioners (GPs) and registered nurses (RNs) in recommendations for the prevention of premature death. Involving these professions in recommendations generally directed towards government organisations or residential aged care providers and management may contribute to more successful broader policy changes. The aim of this article was to examine whether coroners' recommendations describe a specific role for GPs and RNs in the prevention of premature death in residential aged care settings and, if so, what domains of practice were considered...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29778039/identifying-the-trauma-recovery-needs-of-maltreated-children-an-examination-of-child-welfare-workers-effectiveness-in-screening-for-traumatic-stress
#13
Adrienne Whitt-Woosley, Ginny Sprang, David G Royse
Children in the child welfare system comprise a group characterized by exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. This study examined the trauma experiences of a sample of maltreated children and whether their child welfare workers were effective screeners of traumatic stress symptoms...
May 16, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29777966/determinants-of-choice-of-delivery-place-testing-rational-choice-theory-and-habitus-theory
#14
Anja Broda, Juliane Krüger, Stephanie Schinke, Andreas Weber
OBJECTIVE: The current study uses two antipodal social science theories, the rational choice theory and the habitus theory, and applies these to describe how women choose between intraclinical (i.e., hospital-run birth clinics) and extraclinical (i.e., midwife-led birth centres or home births) delivery places. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: Data were collected in a cross-sectional questionnaire-based survey among 189 women. A list of 22 determinants, conceptualized to capture the two theoretical concepts, were rated on a 7-point Likert scale with 1 = unimportant to 7 = very important...
May 7, 2018: Midwifery
https://www.readbyqxmd.com/read/29777334/patient-engagement-in-community-health-center-leadership-how-does-it-happen
#15
Anjana E Sharma, Beatrice Huang, Margae Knox, Rachel Willard-Grace, Michael B Potter
Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs...
May 18, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29776979/ethical-challenges-raised-by-opennotes-for-pediatric-and-adolescent-patients
#16
Fabienne C Bourgeois, Catherine M DesRoches, Sigall K Bell
Sharing clinic notes online with patients and parents may yield many potential benefits to patients and providers alike, but the unprecedented transparency and accessibility to notes afforded by patient portals has also raised a number of unique ethical and legal concerns. As the movement toward transparent notes (OpenNotes) grows, clinicians and health care organizations caring for pediatric and adolescent patients wrestle with how to document confidential and sensitive information, including issues such as reproductive health, misattributed paternity, or provider and parent disagreements...
May 18, 2018: Pediatrics
https://www.readbyqxmd.com/read/29773478/preventive-strategies-for-mental-health
#17
REVIEW
Celso Arango, Covadonga M Díaz-Caneja, Patrick D McGorry, Judith Rapoport, Iris E Sommer, Jacob A Vorstman, David McDaid, Oscar Marín, Elena Serrano-Drozdowskyj, Robert Freedman, William Carpenter
Available treatment methods have shown little effect on the burden associated with mental health disorders. We review promising universal, selective, and indicated preventive mental health strategies that might reduce the incidence of mental health disorders, or shift expected trajectories to less debilitating outcomes. Some of these interventions also seem to be cost-effective. In the transition to mental illness, the cumulative lifetime effect of multiple small effect size risk factors progressively increases vulnerability to mental health disorders...
May 14, 2018: Lancet Psychiatry
https://www.readbyqxmd.com/read/29772739/dutch-health-council-advisory-report-on-myalgic-encephalomyelitis-and-chronic-fatigue-syndrome-taking-the-wrong-turn
#18
Frank Twisk
Recently, the Dutch Health Council published their advisory report on Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) which is meant to determine the medical policy with regard to ME in the Netherlands. The Health Council briefly discusses several diagnostic criteria and proposes to use new diagnostic criteria for "ME/CFS" in research and clinical practice in the future. The advisory report then summarizes organic abnormalities observed in the last decades and concludes that "ME/CFS" is a "serious, chronic, multisystem disease"...
May 16, 2018: Diagnostics
https://www.readbyqxmd.com/read/29770960/interventions-for-increasing-fruit-and-vegetable-consumption-in-children-aged-five-years-and-under
#19
REVIEW
Rebecca K Hodder, Kate M O'Brien, Fiona G Stacey, Rebecca J Wyse, Tara Clinton-McHarg, Flora Tzelepis, Erica L James, Kate M Bartlem, Nicole K Nathan, Rachel Sutherland, Emma Robson, Sze Lin Yoong, Luke Wolfenden
BACKGROUND: Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. OBJECTIVES: To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29770086/critical-appraisal-toolkit-cat-for-assessing-multiple-types-of-evidence
#20
D Moralejo, T Ogunremi, K Dunn
Healthcare professionals are often expected to critically appraise research evidence in order to make recommendations for practice and policy development. Here we describe the Critical Appraisal Toolkit (CAT) currently used by the Public Health Agency of Canada. The CAT consists of: algorithms to identify the type of study design, three separate tools (for appraisal of analytic studies, descriptive studies and literature reviews), additional tools to support the appraisal process, and guidance for summarizing evidence and drawing conclusions about a body of evidence...
September 7, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
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