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https://www.readbyqxmd.com/read/29792461/teamwork-in-the-intensive-care-unit
#1
Jennifer N Ervin, Jeremy M Kahn, Taya R Cohen, Laurie R Weingart
Intensive care units (ICUs) provide care to the most severely ill hospitalized patients. Although ICUs increasingly rely on interprofessional teams to provide critical care, little about actual teamwork in this context is well understood. The ICU team is typically comprised of physicians or intensivists, clinical pharmacists, respiratory therapists, dieticians, bedside nurses, clinical psychologists, and clinicians-in-training. ICU teams are distinguished from other health care teams in that they are low in temporal stability, which can impede important team dynamics...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792242/testing-a-stepped-care-model-for-binge-eating-disorder-a-two-step-randomized-controlled-trial
#2
Giorgio A Tasca, Diana Koszycki, Agostino Brugnera, Livia Chyurlia, Nicole Hammond, Kylie Francis, Kerri Ritchie, Iryna Ivanova, Genevieve Proulx, Brian Wilson, Julie Beaulac, Hany Bissada, Erin Beasley, Nancy Mcquaid, Renee Grenon, Benjamin Fortin-Langelier, Angelo Compare, Louise Balfour
BACKGROUND: A stepped care approach involves patients first receiving low-intensity treatment followed by higher intensity treatment. This two-step randomized controlled trial investigated the efficacy of a sequential stepped care approach for the psychological treatment of binge-eating disorder (BED). METHODS: In the first step, all participants with BED (n = 135) received unguided self-help (USH) based on a cognitive-behavioral therapy model. In the second step, participants who remained in the trial were randomized either to 16 weeks of group psychodynamic-interpersonal psychotherapy (GPIP) (n = 39) or to a no-treatment control condition (n = 46)...
May 24, 2018: Psychological Medicine
https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#3
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29790271/correlation-between-neonatal-outcomes-of-twins-depends-on-the-outcome-secondary-analysis-of-twelve-randomised-controlled-trials
#4
Lisa N Yelland, Ewoud Schuit, Javier Zamora, Philippa F Middleton, Arianne C Lim, Anwar H Nassar, Line Rode, Vicente Serra, Elizabeth A Thom, Christophe Vayssière, Ben Wj Mol, Simon Gates
OBJECTIVE: To estimate the magnitude of the correlation between neonatal outcomes of twins and demonstrate how this information can be used in the design of randomised controlled trials (RCTs) in women with twin pregnancies. DESIGN: Secondary analysis of data from 12 RCTs. SETTING: Obstetric care in multiple countries, 2004-2012. POPULATION OR SAMPLE: 4504 twin pairs born to women who participated in RCTs to assess treatments given during pregnancy...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29790212/dopamine-in-transplantation-written-off-or-comeback-with-novel-indication
#5
REVIEW
Peter Schnuelle, Urs Benck, Benito A Yard
Renal-dose dopamine has fallen out of favor in the intensive care unit (ICU) during past years due to its ineffectiveness to prevent impending or to ameliorate overt renal failure in the critically ill. By contrast, growing evidence indicates that low-dose dopamine administered to the stable organ donor after brain death confirmation improves the clinical course of transplanted organs after kidney and heart transplantation. Ensuring a thorough monitoring for potential circulatory side effects, employment of dopamine at a dose of 4 μg/kg per minute is safe in the deceased donor...
May 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29790142/-application-of-care-bundles-to-reduce-medical-device-related-pressure-injury-mdrpi-incidence-in-a-coronary-care-unit
#6
Shu-Ling Wang, Pao-Yu Chuang, Wan-Chuan Su
BACKGROUND & PROBLEMS : Pressure injuries increase the cost of medical care and prolong hospitalization. The incidence of pressure injury at the target coronary care unit (CCU) from January to August 2016 was 1.1%, which was significantly higher than the 0.4% defined in the 2015 Taiwan Clinical Performance Indicators (TCPI) system. Medical device related pressure injury (MDRPI) accounted for 73.1% of the pressure injuries (incidence: 0.8%). The main causes of the high incidence of MDRPI were: (1) inadequate decompression dressing and restraint equipment, (2) incomplete implementation of prevention interventions in the CCU, (3) inadequate knowledge of MDRPI prevention among nurses, (4) deficient standards for preventing MDRPI, (5) ineffective MDRPI-related education, and (6) insufficient auditing frequencies...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29790141/-using-trm-to-enhance-the-accuracy-of-ventilator-associated-pneumonia-preventive-measures-implemented-by-neonatal-intensive-care-unit-medical-staffs
#7
Yu-Ting Huang, Chao-Ya Huang, Hsiu-Ya Su, Chen-Te Ma
BACKGROUND & PROBLEMS: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the neonatal intensive care unit (NICU). The average VAP infection density was 4.7‰ in our unit between June and August 2015. The results of a status survey indicated that in-service education lacked specialization, leading to inadequate awareness among staffs regarding the proper care of newborns with VAP and a lack of related care guides. This, in turn, resulted in inconsistencies in care measures for newborns with VAP...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789995/you-can-t-take-your-baby-home-yet-a-longitudinal-study-of-psychological-symptoms-in-mothers-of-infants-hospitalized-in-the-nicu
#8
Jenny H Lotterman, John M Lorenz, George A Bonanno
Evidence suggests that mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) experience elevated rates of psychological symptoms. However, previous studies of this population have been mainly cross-sectional and have focused on very preterm infants. Although moderate- to late-preterm infants generally thrive, the possible psychological toll on their mothers has not yet been sufficiently examined. In the current study, we used a longitudinal design to investigate whether mothers of moderate- to late-preterm infants experience elevated rates of psychological symptoms during the infant's hospitalization in the NICU and 6 months later...
May 22, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29789798/the-relation-between-sarcopenia-and-mortality-in-patients-at-intensive-care-unit
#9
Mehmet Toptas, Mazhar Yalcin, İbrahim Akkoc, Eren Demir, Cagatay Metin, Yildiray Savas, Muhsin Kalyoncuoglu, Mehmet Mustafa Can
Background and Aim: Psoas muscle area (PMA) can reflect the status of skeletal muscle in the whole body. It has been also reported that decreased PMA was associated with postoperative mortality or morbidity after several surgical procedures. In this study, we aimed to investigate the relation between PMA and mortality in all age groups in intensive care unit (UNIT). Materials and Method: The study consists of 362 consecutive patients. The demographic characteristics of patients, indications for ICU hospitalization, laboratory parameters, and clinical parameters consist of mortality and length of stay, and surgery history was obtained from intensive care archive records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29789465/efficacy-safety-and-usability-of-remifentanil-as-premedication-for-insure-in-preterm-neonates
#10
Hadiyah Y Audil, Sara Tse, Chad Pezzano, Amy Mitchell-van Steele, Joaquim M B Pinheiro
Background : We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives : To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil's safety and usability in a teaching hospital context. Methods : Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU)...
May 22, 2018: Children
https://www.readbyqxmd.com/read/29788912/association-between-troponin-i-levels-and-outcome-in-critically-ill-patients-admitted-to-non-cardiac-intensive-care-unit-with-high-prevalence-of-cardiovascular-risk-factors
#11
Abdulaleem Alatassi, Mohamad Habbal, Hani Tamim, Musharaf Sadat, Eman Al Qasim, Yaseen M Arabi
BACKGROUND: The association of troponin-I levels and outcome in medical-surgical ICU patients has been studied before in populations with low to moderate prevalence of cardiovascular risk factors. The objective in this article is to examine the association of troponin-I levels with hospital mortality in patients with high prevalence of cardiovascular risk factors who were admitted with medical-surgical indications to a non-cardiac intensive care unit. METHODS: This was a retrospective study of adult patients admitted to a tertiary medical-surgical ICU between July 2001 and November 2011...
May 22, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29788460/general-principles-for-pial-synangiosis-in-pediatric-moyamoya-patients-2-dimensional-operative-video
#12
David L Penn, Kyle C Wu, Kayla R Presswood, Coleman P Riordan, R Michael Scott, Edward R Smith
Pial synangiosis is a method of indirect surgical revascularization developed at our institution for the treatment of moyamoya disease in pediatric patients. Similar surgical principles are employed in adult cases, often performed because of lack of an adequate donor vessel. Standardized protocols, including preadmission for preoperative intravenous hydration and aspirin administration, as well as intraoperative electroencephalography, are routinely employed to minimize operative risk. Perioperative heparinization is not required...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29786719/energy-transfer-chemiluminescence-for-ratiometric-ph-imaging
#13
Weiwei An, Ralph P Mason, Alexander R Lippert
Chemiluminescence imaging offers a low background and high sensitivity approach to imaging analytes in living cells and animals. Intensity-based measurements have been developed, but require careful consideration of kinetics, probe localization, and fluctuations in quantum yield, all of which complicate quantification. Here, we report a ratiometric strategy for quantitative chemiluminescence imaging of pH. The strategy relies on an energy transfer cascade of chemiluminescence emission from a spiroadamantane 1,2-dioxetane to a ratiometric pH indicator via fluorescent dyes in Enhancer solutions...
May 22, 2018: Organic & Biomolecular Chemistry
https://www.readbyqxmd.com/read/29785228/evaluating-the-utility-of-a-structured-clinical-protocol-for-reducing-the-impact-of-behavioural-and-psychological-symptoms-of-dementia-in-progressive-neurological-diseases-a-pilot-study
#14
Nicholas P Ryan, Laura Scott, Maryanne McPhee, Susan Mathers, Marie-Claire Davis, Roxanne Maule, Fiona Fisher
Objectives: Behavioural and psychological symptoms of dementia (BPSD) cause significant distress to both aged care residents and staff. Despite the high prevalence of BPSD in progressive neurological diseases (PNDs) such as multiple sclerosis, Huntington's disease, and Parkinson's disease, the utility of a structured clinical protocol for reducing BPSD has not been systematically evaluated in PND populations. Method: Staff ( n = 51) and individuals with a diagnosis of PND ( n = 13) were recruited into the study, which aimed to evaluate the efficacy of a PND-specific structured clinical protocol for reducing the impact of BPSD in residential aged care (RAC) and specialist disability accommodation (SDA) facilities...
2018: Behavioural Neurology
https://www.readbyqxmd.com/read/29784237/quality-of-life-and-well-being-following-inpatient-and-partial-hospitalization-treatment-for-opioid-use-disorder
#15
Claire E Blevins, Ana M Abrantes, Megan E Kurth, Alan L Gordon, Michael D Stein
Treatment of opioid use disorder often begins with brief intensive inpatient or outpatient programs. Given the high relapse rates following intensive treatment, it is important to determine factors that lead to success post-discharge. Incorporating assessment during and early post-discharge may help determine such factors. The current study evaluated changes in quality of life among individuals during and after discharge from inpatient and partial hospitalization opiate treatment programs. Participants (n = 143) were recruited while in the programs and were re-assessed one month later (n = 113)...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29783818/-continuous-renal-replacement-therapy-combined-with-extracorporeal-membrane-oxygenation-for-pediatric-cardiopulmonary-failure
#16
Y P Zhou, J Y Shi, F Wang, Y Cui, T T Xu, C X Wang, Y C Zhang
Objective: To explore the effectiveness and safety of continuous renal replacement therapy (CRRT) combined with extracorporeal membrane oxygenation (ECMO) on rescuing pediatric patients with cardiopulmonary failure. Methods: The medical records of patients treated with ECMO admitted to pediatric intensive care unit (PICU) in Shanghai Children's Hospital from December 2015 to November 2017 were retrospectively extracted. There were 14 patients treated with ECMO combined with CRRT (ECMO+ CRRT group) due to acute kidney injury (AKI) or fluid overload, while 11 cases treated with ECMO only...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29782464/use-of-probiotics-in-the-prevention-of-nosocomial-infections
#17
Ivana Trivić, Iva Hojsak
Nosocomial, hospital-acquired or health care-associated infections occur worldwide, affecting both developed and developing countries. This results in a prolonged hospital stay, increased antimicrobial resistance, increased mortality rate, and significant financial burden on the health care system. Routine preventive measures have led to the decrease in infection spreading; however, it cannot successfully prevent all of them, making a place for the development of new strategies, including probiotics. The aim of this review was to summarize available evidence of the role of probiotics in the prevention of nosocomial infections in children...
May 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29782437/skin-injuries-and-chlorhexidine-gluconate-based-antisepsis-in-early-premature-infants-a-case-report-and-review-of-the-literature
#18
Valentina Vanzi, Rosanna Pitaro
Early premature infants are subjected to many invasive procedures in neonatal intensive care units, and effective skin antisepsis is an essential step in caring for these vulnerable patients. Nevertheless, preterm infants have an anatomically and physiologically immature skin and preserving their skin integrity is essential to avoid the risk of local and systemic complications. Skin particularities of newborns reduce the list of available antiseptics in neonatology. Chlorhexidine gluconate (CHG) has excellent antiseptic properties and its antimicrobial efficacy cannot be understated, but there is great concern about its use for premature infants, referring to the risk of development skin injuries, such as skin erythema, burns, and blisters...
May 17, 2018: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#19
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781923/going-beyond-clinical-care-to-reduce-health-care-spending-findings-from-the-j-chip-community-based-population-health-management-program-evaluation
#20
Shannon M E Murphy, Douglas E Hough, Martha L Sylvia, Melissa Sherry, Linda J Dunbar, Raymond Zollinger, Regina Richardson, Scott A Berkowitz, Kevin D Frick
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants...
May 17, 2018: Medical Care
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