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https://www.readbyqxmd.com/read/29075929/marijuana-use-and-organ-transplantation-a-review-and-implications-for-clinical-practice
#1
REVIEW
Harinder Singh Rai, Gerald Scott Winder
PURPOSE OF REVIEW: Physicians of all disciplines must rapidly adjust their clinical practices following the expansion of marijuana legalization across the country. Organ transplantation teams are uniquely struggling in this gray zone with eight states having passed laws explicitly banning the denial of transplant listing based on a patient's use of medical marijuana. In this review, we examine the clinical evidence of marijuana use in transplant patients to enable psychiatric providers to meaningfully contribute to the relevant medical and psychiatric aspects of this issue in a unique patient population...
October 27, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29071048/changes-in-antimicrobial-prescribing-behavior-after-the-introduction-of-the-antimicrobial-stewardship-program-a-pre-and-post-intervention-survey
#2
Ruchir Chavada, Harry N Walker, Deborah Tong, Amy Murray
The introduction of an antimicrobial stewardship (AMS) program is associated with a change in antimicrobial prescribing behavior. A proposed mechanism for this change is by impacting the prescribing etiquette described in qualitative studies. This study sought to detect a change in prescribing attitudes 12 months after the introduction of AMS and gauge utility of various AMS interventions. Surveys were distributed to doctors in two regional Australian hospitals on a convenience basis 6 months before, and 12 months after, the introduction of AMS...
October 2, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/29068278/an-investigation-of-antifungal-stewardship-programmes-in-england
#3
Christianne Micallef, Diane Ashiru-Oredope, Sejal Hansraj, David W Denning, Samir G Agrawal, Rohini J Manuel, Silke Schelenz, Rebecca Guy, Berit Muller-Pebody, Rakhee Patel, Philip Howard, Susan Hopkins, Elizabeth Johnson, David A Enoch
PURPOSE: We sought to explore the current status of antifungal stewardship (AFS) initiatives across National Health Service (NHS) Trusts within England, the challenges and barriers, as well as ways to improve current AFS programmes. METHODOLOGY: An electronic survey was sent to all 155 acute NHS Trusts in England. A total of 47 Trusts, corresponding to 30 % of English acute Trusts, responded to the the survey; 46 Trusts (98 %) had an antimicrobial stewardship (AMS) programme but only 5 (11 %) had a dedicated AFS programme...
October 25, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29063523/evaluation-of-existing-and-desired-antimicrobial-stewardship-activities-and-strategies-in-swiss-hospitals
#4
M Osthoff, Julia Belicki, Andreas F-X Widmer, For Swissnoso
Antimicrobial stewardship (AMS) is an important component in the fight against antimicrobial resistance. Currently, few hospitals have an ongoing institutional AMS programme. Swissnoso - the national centre for infection prevention - has launched a national Swiss AMS initiative supported by the office of public health. To guide AMS priorities and resources, current AMS activities in Switzerland were assessed. We distributed an internet-based questionnaire directed mainly to board-certified infectious diseases specialists and, if not available, senior internal medicine staff...
October 24, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29048921/infrastructures-required-for-the-expansion-of-family-physician-program-to-urban-settings-in-iran
#5
Leila Doshmangir, Mohammad Bazyar, Parinaz Doshmangir, Hakimeh Mostafavi, Amirhossein Takian
INTRODUCTION: Following the implementation of Family Physician (FP) Program in rural areas and cities with populations under 20000 in 2005, the Iranian Ministry of Health and Medical Education in 2012 decided to implement urban FP in large cities with populations more than 20000. Along with the development and implementation of urban FP in Iran, local websites and newspapers reflected the viewpoints of experts in various levels of health system regarding the various stages of Family Medicine (FM) development (from agenda setting to initial stages of implementation)...
September 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29017750/trends-and-relationship-between-antimicrobial-resistance-and-antibiotic-use-in-xinjiang-uyghur-autonomous-region-china-based-on-a-3-year-surveillance-data-2014-2016
#6
Haishaerjiang Wushouer, Zhao-Xia Zhang, Jian-Hua Wang, Ping Ji, Qing-Fang Zhu, Renagu Aishan, Lu-Wen Shi
PURPOSES: The objective of the study was to identify the trends and relations between antimicrobial resistance (AMR) and antibiotic use in the Xinjiang Uyghur Autonomous Region in Western China from 2014 to 2016. METHODS: A retrospective, descriptive analysis of AMR prevalence, and trends and relations between AMR and antibiotic use during the 3-year period was performed. RESULTS: Third-generation cephalosporin-resistant Escherichia coli was the most prevalent resistant pathogen in terms of both resistance density and resistance proportion...
October 7, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28985300/focus-on-early-career-gps-qualitative-evaluation-of-a-multi-faceted-educational-intervention-to-improve-antibiotic-prescribing
#7
Laura Deckx, Sibyl Anthierens, Parker J Magin, Simon Morgan, Lawrie McArthur, Lucy Yardley, Anthea Dallas, Paul Little, Mieke L van Driel
Background: We conducted an educational intervention emphasizing rational antibiotic prescribing in early-career General Practitioners (GP) in vocational training (trainees). The intervention consisted of an online introduction module, an online communication training module, face-to-face workshops, and cases to be discussed one-on-one by the trainee-supervisor dyad during regular scheduled education sessions. Objectives: To explore the participants' experiences with the intervention...
July 17, 2017: Family Practice
https://www.readbyqxmd.com/read/28968666/stewardship-of-primary-care-physicians-to-contain-cost-in-health-care-an-international-cross-sectional-survey
#8
Philip J Van der Wees, Joost J G Wammes, Patrick P T Jeurissen, Gert P Westert
Purpose: Physician stewardship towards cost control is potentially important in enhancing the financial sustainability of health care systems. Objective: Aim of this study was to identify the level of stewardship of cost containment of primary care physicians (PCPs) and to assess the associations between stewardship and characteristics of PCPs and health care systems. Methods: Secondary analysis of data from a cross-sectional survey among 10 countries: Australia, Canada, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, UK and USA...
August 31, 2017: Family Practice
https://www.readbyqxmd.com/read/28954899/optimizing-test-utilization-in-the-clinical-microbiology-laboratory-tools-and-opportunities
#9
Bobbi S Pritt
Optimal laboratory test utilization is important for providing high quality clinical care and efficiently using limited health care resources. While microbiologists have long been advocates for appropriate laboratory test utilization, the wide-spread availability of electronic medical records capable of supporting clinician order entry and clinical decision support tools (CDSTs) have provided expanded opportunities for implementing effective, automated test stewardship protocols. In this issue of the Journal of Clinical Microbiology, D...
September 27, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28947624/development-and-application-of-an-objective-staffing-calculator-for-antimicrobial-stewardship-programs-in-the-veterans-health-administration
#10
Kelly Echevarria, Julie Groppi, Allison A Kelly, Anthony P Morreale, Melinda M Neuhauser, Gary A Roselle
PURPOSE: The development and validation of a staffing calculator and its use in creating staffing guidance for antimicrobial stewardship programs (ASPs) in Veterans Health Administration (VHA) facilities are described. METHODS: The Tools and Resources Work Group of the Antimicrobial Stewardship Task Force and PBM Clinical Pharmacy Practice Office of the Department of Veterans Affairs developed, tested, and validated a staffing calculator to track patient care and ASP management activities needed to maintain a comprehensive ASP...
September 25, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28937345/practical-implications-of-the-minimally-conscious-state-diagnosis-in-adults
#11
Karola V Kreitmair, Katherine E Kruse
This article addresses questions surrounding the minimally conscious state (MCS) from the perspective of adult clinical ethics. It describes the background of the MCS diagnosis, analyzes phenomenological ambiguities inherent in the nature of MCS, and raises epistemological concerns surrounding its diagnosis. It argues that in many cases, the burdens of prolonging treatment for people who have sustained certain severe brain injuries (SBI) outweigh the benefits, even if they are in or have the prospect of entering into MCS...
October 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28935515/template-for-an-antibiotic-stewardship-policy-for-post-acute-and%C3%A2-long-term-care-settings
#12
Robin L P Jump, Swati Gaur, Morgan J Katz, Christopher J Crnich, Ghinwa Dumyati, Muhammad S Ashraf, Elizabeth Frentzel, Steven J Schweon, Philip Sloane, David Nace
In response to a rising concern for multidrug resistance and Clostridium difficile infections, the Centers for Medicare and Medicaid services (CMS) will require all long-term care (LTC) facilities to establish an antibiotic stewardship program by November 2017. Thus far, limited evidence describes implementation of antibiotic stewardship in LTC facilities, mostly in academic- or hospital-affiliated settings. To support compliance with CMS requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at AMDA-The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the LTC setting...
November 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28911324/leadership-and-governance-of-community-health-worker-programmes-at-scale-a-cross-case-analysis-of-provincial-implementation-in-south-africa
#13
Helen Schneider, Nonhlanhla Nxumalo
BACKGROUND: National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28903514/impact-of-an-antimicrobial-stewardship-program-on-antibiotic-use-at-a-nonfreestanding-children-s-hospital
#14
R Brigg Turner, Elena Valcarlos, Ann M Loeffler, Michael Gilbert, Dominic Chan
Background: Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. Methods: In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28887290/individual-feedback-to-reduce-inappropriate-antimicrobial-prescriptions-for-treating-acute-upper-respiratory-tract-infections-in-an-outpatient-setting-of-a-thai-university-hospital
#15
Pinyo Rattanaumpawan, Nuttagarn Chuenchom, Visanu Thamlikitkul
BACKGROUND: Excessive antimicrobial use for acute Upper Respiratory InfectionBackground Excessive antimicrobial use for acute Upper Respiratory Infections (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections.s (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections. METHODS: During a 9-month study period (June 2014-February 2015), we conducted a quasi-experimental (pre/post) study among internal medicine residents and fellows in an outpatient setting of Siriraj Hospital, Thailand...
September 5, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28874573/redefining-community-based-on-place-attachment-in-a-connected-world
#16
Georgina G Gurney, Jessica Blythe, Helen Adams, W Neil Adger, Matthew Curnock, Lucy Faulkner, Thomas James, Nadine A Marshall
The concept of community is often used in environmental policy to foster environmental stewardship and public participation, crucial prerequisites of effective management. However, prevailing conceptualizations of community based on residential location or resource use are limited with respect to their utility as surrogates for communities of shared environment-related interests, and because of the localist perspective they entail. Thus, addressing contemporary sustainability challenges, which tend to involve transnational social and environmental interactions, urgently requires additional approaches to conceptualizing community that are compatible with current globalization...
September 19, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28861524/deep-sequencing-of-rna-from-blood-and-oral-swab-samples-reveals-the-presence-of-nucleic-acid-from-a-number-of-pathogens-in-patients-with-acute-ebola-virus-disease-and-is-consistent-with-bacterial-translocation-across-the-gut
#17
Miles W Carroll, Sam Haldenby, Natasha Y Rickett, Bernadett Pályi, Isabel Garcia-Dorival, Xuan Liu, Gary Barker, Joseph Akoi Bore, Fara Raymond Koundouno, E Diane Williamson, Thomas R Laws, Romy Kerber, Daouda Sissoko, Nóra Magyar, Antonino Di Caro, Mirella Biava, Tom E Fletcher, Armand Sprecher, Lisa F P Ng, Laurent Rénia, N'faly Magassouba, Stephan Günther, Roman Wölfel, Kilian Stoecker, David A Matthews, Julian A Hiscox
In this study, samples from the 2013-2016 West African Ebola virus outbreak from patients in Guinea with Ebola virus disease (EVD) were analyzed to discover and classify what other pathogens were present. Throat swabs were taken from deceased EVD patients, and peripheral blood samples were analyzed that had been taken from patients when they presented at the treatment center with acute illness. High-throughput RNA sequencing (RNA-seq) and bioinformatics were used to identify the potential microorganisms. This approach confirmed Ebola virus (EBOV) in all samples from patients diagnosed as acute positive for the virus by quantitative reverse transcription-PCR in deployed field laboratories...
July 2017: MSphere
https://www.readbyqxmd.com/read/28853035/expanding-antimicrobial-stewardship-to-urgent-care-centers-through-a-pharmacist-led-culture-follow-up-program
#18
Lisa E Dumkow, Thomas S Beuschel, Kasey L Brandt
INTRODUCTION: Urgent care centers represent a high-volume outpatient setting where antibiotics are prescribed frequently but resources for antimicrobial stewardship may be scarce. In 2015, our pharmacist-led Emergency Department (ED) culture follow-up program was expanded to include two urgent care (UC) sites within the same health system. The UC program is conducted by ED and infectious diseases clinical pharmacists as well as PGY1 pharmacy residents using a collaborative practice agreement (CPA)...
September 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28851265/post-operative-fever-in-orthopaedic-surgery-how-effective-is-the-fever-workup
#19
Blair Ashley, David A Spiegel, Patrick Cahill, Divya Talwar, Keith D Baldwin
BACKGROUND: Defining the appropriate threshold at which to initiate a fever workup is imperative to promote patient safety, appropriate resource utilization, and antibiotic stewardship. Our group performed a systematic review of the available literature on perioperative fever (POF) workups in orthopaedic patients to evaluate the frequency, timing and utility of blood cultures (BC) and other investigations in the POF workup, to determine the clinical relevance of any infections and to evaluate their cost effectiveness...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28842518/formalization-of-an-antimicrobial-stewardship-program-in-a-small-community-hospital
#20
Alexa R Lockwood, Nicole S Bolton, Mark D Winton, Jean T Carter
PURPOSE: Results of a study to formalize an antimicrobial stewardship program (ASP) in a small community hospital are presented. METHODS: The formalization process began with a gap analysis of the hospital's antimicrobial services, followed by the development of a fully integrated, multipharmacist ASP. The impact was studied with an institutional review board-approved study design. Retrospective pre-ASP data were pulled from March 1 to June 30, 2012 and 2013 patient records; prospective post-ASP data were collected for March 1 to June 30, 2015...
September 1, 2017: American Journal of Health-system Pharmacy: AJHP
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