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https://www.readbyqxmd.com/read/29474938/differential-family-experience-of-palliative-sedation-therapy-in-specialised-palliative-or-critical-care-units
#1
Hui-Shan Shen, Szu-Yin Chen, Denise Shuk Ting Cheung, Shu-Yi Wang, Lee Jung Jae, Chia-Chin Lin
CONTEXT: No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings. OBJECTIVES: To examine and compare family concerns about PST use and its effect on the grief suffered by terminally ill patients' families in palliative care units (PCU) or intensive care units (ICU). METHODS: A total of 154 family members of such patients were recruited in Taiwan, of whom 143 completed the study, with 81 from the PCU and 62 from the ICU...
February 20, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29474802/exploring-perceptions-about-insulin-dependent-diabetes-mellitus-in-adolescent-patients-and-peers
#2
Katarzyna Marshall, Halley Martin, Kim Siarkowski Amer
Friends can provide encouragement and support during stressful times. Friends are even more important for children coping with chronic illness such as adolescents managing insulin dependent diabetes mellitus (IDDM). Nurses need to recognize that the knowledge and care of both the children coping with diabetes and friends can be critical. This study explored perceptions of adolescents managing diabetes and their peers. The non-affected peers and adolescents with IDDM ranged in age between 15-18 were studied using an exploratory qualitative method...
March 2018: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29474729/the-science-of-peer-support-as-applied-to-behavioral-medicine-and-the-care-of-individuals-surviving-with-cancer-a-commentary-on-peer-mentors-delivering-a-physical-activity-intervention-for-cancer-survivors-effects-among-mentors-by-pinto-et-al
#3
Christine Rini, Kristi D Graves, Suzanne C O'Neill, Kenneth P Tercyak
There is a critical gap between the resources available to promote health and wellness after cancer and services that address these public health goals. Researchers, policy makers, healthcare providers, and community stakeholders increasingly recognize the benefits of filling this gap with trained peer mentors who can provide health-promotion services to fellow cancer survivors. This commentary addresses a mixed-method study by Pinto and colleagues that investigated the responses and experiences of trained peer mentors who delivered their telephone-based physical activity intervention for breast cancer survivors...
February 21, 2018: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/29474652/monitoring-quality-of-care-in-acute-myocardial-infarction-patients-using-retrospective-registry-data
#4
Giovanni Veronesi, Antonella Zambon, John F Beltrame, Francesco Gianfagna, Giovanni Corrao, Marco M Ferrario
Background: Hospital-based registries provide a key contribution in assessing the quality of care in acute myocardial infarction (MI) patients, although some concern on selection bias of included cases has recently arisen. We investigated the feasibility of a retrospective, population-based registry of MIs in monitoring the quality of care. Methods: We identified all the hospitalizations with a diagnosis of acute MI among 35-79 years old residents in the Varese province, Northern Italy, in 2007-2008...
February 21, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29474524/hematomas-in-aesthetic-surgery
#5
Keith Hood, Nishant Ganesh Kumar, K Kye Higdon
Hematomas represent one of the most common postoperative complications in patients undergoing aesthetic surgery. Depending on the type of procedure performed, hematoma incidence and presentation can vary greatly. Understanding the risk factors for hematoma formation and the preoperative considerations to mitigate the risk is critical to provide optimal care to the aesthetic patient. Various perioperative prevention measures may also be employed to minimize hematoma incidence. The surgeon's ability to adequately diagnose and treat hematomas after aesthetic surgery is not only crucial to patient care but also minimizes the risk of further complications or long-term sequelae...
February 21, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29474506/derivation-of-outcome-based-pediatric-critical-values
#6
Hao Du, Corey Markus, Michael Metz, Mengling Feng, Tze Ping Loh
Objectives: There is currently a lack of an outcomes-based definition of critical values for the pediatric population. This has contributed to a highly heterogeneous critical value reporting practice between laboratories. Methods: Anonymized results were extracted from a laboratory information system for 10 biochemistry tests. The probability of high-dependency/intensive care unit admission (as a proxy for adverse outcomes) for each individual laboratory concentration was calculated and adjusted to fit using a polynomial function to model the probability trend...
February 21, 2018: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29474487/empirical-relationships-between-tree-fall-and-landscape-level-amounts-of-logging-and-fire
#7
David B Lindenmayer, Wade Blanchard, David Blair, Lachlan McBurney, John Stein, Sam C Banks
Large old trees are critically important keystone structures in forest ecosystems globally. Populations of these trees are also in rapid decline in many forest ecosystems, making it important to quantify the factors that influence their dynamics at different spatial scales. Large old trees often occur in forest landscapes also subject to fire and logging. However, the effects on the risk of collapse of large old trees of the amount of logging and fire in the surrounding landscape are not well understood. Using an 18-year study in the Mountain Ash (Eucalyptus regnans) forests of the Central Highlands of Victoria, we quantify relationships between the probability of collapse of large old hollow-bearing trees at a site and the amount of logging and the amount of fire in the surrounding landscape...
2018: PloS One
https://www.readbyqxmd.com/read/29474481/a-dual-boundary-classifier-for-predicting-acute-hypotensive-episodes-in-critical-care
#8
Sakyajit Bhattacharya, Vijay Huddar, Vaibhav Rajan, Chandan K Reddy
An Acute Hypotensive Episode (AHE) is the sudden onset of a sustained period of low blood pressure and is one among the most critical conditions in Intensive Care Units (ICU). Without timely medical care, it can lead to an irreversible organ damage and death. By identifying patients at risk for AHE early, adequate medical intervention can save lives and improve patient outcomes. In this paper, we design a novel dual-boundary classification based approach for identifying patients at risk for AHE. Our algorithm uses only simple summary statistics of past Blood Pressure measurements and can be used in an online environment facilitating real-time updates and prediction...
2018: PloS One
https://www.readbyqxmd.com/read/29474344/concept-based-curricula-a-national-study-of-critical-concepts
#9
Jennifer A Brussow, Karin Roberts, Matthew Scaruto, Sheryl Sommer, Christine Mills
As nursing education struggles to address a rapidly changing health care system, overcrowded curricula, and an increased focus on clinical reasoning skills, many programs have adopted or transitioned to concept-based curricula (CBCs), which are structured around key concepts and exemplars. Despite CBC's promised benefits, the process of developing a CBC framework may pose a challenge to programs. To address this barrier, a national study was conducted to develop a representative list of concepts and exemplars...
February 22, 2018: Nurse Educator
https://www.readbyqxmd.com/read/29474328/using-default-options-and-other-nudges-to-improve-critical-care
#10
Scott D Halpern
No abstract text is available yet for this article.
March 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29474326/transport-time-and-preoperating-room-hemostatic-interventions-are-important-improving-outcomes-after-severe-truncal-injury
#11
John B Holcomb
OBJECTIVES: Experience in the ongoing wars in Iraq and Afghanistan confirm that faster transport combined with effective prehospital interventions improves the outcomes of patients suffering hemorrhagic shock. Outcomes of patients with hemorrhagic shock and extremity bleeding have improved with widespread use of tourniquets and early balanced transfusion therapy. Conversely, civilian patients suffering truncal bleeding and shock have the same mortality (46%) over the last 20 years. To understand how to decrease this substantial mortality, one must first critically evaluate all phases of care from point of injury to definitive hemorrhage control in the operating room...
March 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29474319/the-association-of-icu-acuity-with-outcomes-of-patients-at-low-risk-of-dying
#12
Kelly C Vranas, Jeffrey K Jopling, Jennifer Y Scott, Omar Badawi, Michael O Harhay, Christopher G Slatore, Meghan C Ramsey, Michael J Breslow, Arnold S Milstein, Meeta Prasad Kerlin
OBJECTIVE: Many ICU patients do not require critical care interventions. Whether aggressive care environments increase risks to low-acuity patients is unknown. We evaluated whether ICU acuity was associated with outcomes of low mortality-risk patients. We hypothesized that admission to high-acuity ICUs would be associated with worse outcomes. This hypothesis was based on two possibilities: 1) high-acuity ICUs may have a culture of aggressive therapy that could lead to potentially avoidable complications and 2) high-acuity ICUs may focus attention toward the many sicker patients and away from the fewer low-risk patients...
March 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29474237/trends-in-cervical-cancer-screening-in-california-s-family-planning-program
#13
Heike Thiel de Bocanegra, Sandy K Navarro, Narissa J Nonzee, Sitaram Vangala, Xinkai Zhou, Charlene Chang, Anna-Barbara Moscicki
OBJECTIVE: Guidelines recommend 3-year cervical cancer screening intervals to avoid unnecessary invasive procedures; however, regular testing remains critical. We evaluated trends in cervical cancer screening among low-income women receiving family planning-related services and their association with patient and provider characteristics. MATERIALS AND METHODS: Using claims and enrollment data from California's publicly funded family planning program, we identified 540,026 women with a clinician visit at 216 sites between 2011 and 2015...
February 23, 2018: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/29473938/shared-decision-making-for-prostate-cancer-screening-and-treatment-a-systematic-review-of-randomised-controlled-trials
#14
Nahara Anani Martínez-González, Andreas Plate, Oliver Senn, Stefan Markun, Thomas Rosemann, Stefan Neuner-Jehle
INTRODUCTION: Men facing prostate cancer screening and treatment need to make critical and highly preference-sensitive decisions that involve a variety of potential benefits and risks. Shared decision-making (SDM) is considered fundamental for "preference-sensitive" medical decisions and it is guideline-recommended. There is no single definition of SDM however. We systematically reviewed the extent of SDM implementation in interventions to facilitate SDM for prostate cancer screening and treatment...
February 23, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29473698/a-proof-of-concept-pilot-randomized-comparative-trial-of-brief-internet-based-compassionate-mind-training-and-cognitive-behavioral-therapy-for-perinatal-and-intending-to-become-pregnant-women
#15
Alex R Kelman, Benjamin S Evare, Alinne Z Barrera, Ricardo F Muñoz, Paul Gilbert
OBJECTIVE: Depression is a prevalent and costly mental health problem that affects women as well as their larger communities, with substantial impacts on mother and infant during childbearing years. Face-to-face care has not adequately addressed this global concern due to difficulties in scaling these resources. Internet interventions, which can provide psychological tools to those lacking adequate access, show promise in filling this void. METHOD: We conducted a 2-condition proof-of-concept pilot randomized trial comparing brief Internet-based cognitive behavioural therapy (CBT) and brief Internet-based compassionate mind training (CMT) for women who are currently pregnant, became pregnant within the last year, and intend to become pregnant in the future...
February 23, 2018: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/29473523/drug-induced-qt-interval-prolongation-in-the-intensive-care-unit
#16
Cecilia Villa Etchegoyen, Guillermo Alberto Keller, Sebastian Mrad, Sixuan Cheng, Guillermo DiGirolamo
Drug-induced QT interval prolongation is the most frequent cause of Long QT syndrome (LQTS) in the clinical practice. This electrophysiological entity, produced by an extended duration of the myocardial repolarization and reflected as a prolonged QT interval in the superficial electrocardiogram (EKG), increases the risk of polymorphic ventricular tachycardia (Torsades de Pointes) appearance and sudden death. Certain antiarrhythmic drugs such as amiodarone, sotalol, quinidine, procainamide, verapamil and diltiazem are known as drugs that, due to their mechanism of action, prolong the QT interval, demanding constant monitorization...
February 23, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29473297/promoting-collaboration-in-emergency-medicine
#17
Shobhana Nagraj, Juliet Harrison, Lawrence Hill, Lesley Bowker, Susanne Lindqvist
BACKGROUND: Collaborative practice between paramedics and medical staff is essential for ensuring the safe handover of patients. Handover of care is a critical time in the patient journey, when effective communication and collaborative practice are central to promoting patient safety and to avoiding medical error. To encourage effective collaboration between paramedic and medical students, an innovative, practice-based simulation exercise, known as interprofessional clinical skills (ICS) was developed at the University of East Anglia, UK...
February 23, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29473290/estimating-gestational-age-at-birth-from-fundal-height-and-additional-anthropometrics-a-prospective-cohort-study
#18
Sarah J Pugh, Ana M Ortega-Villa, William Grobman, Roger B Newman, John Owen, Deborah A Wing, Paul S Albert, Katherine L Grantz
OBJECTIVE: Accurate assessment of gestational age is critical to pediatric care, yet is limited in developing countries without access to ultrasound. Our objectives were to assess the accuracy of gestational age at birth (GA) prediction and preterm birth (PTB) classification using routinely collected anthropometry measures. DESIGN: Prospective cohort study. SETTING: United States. POPULATION OR SAMPLE: 2334 non-obese and 468 obese pregnant women...
February 23, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29473174/variation-in-red-cell-transfusion-decisions-in-the-intensive-care-unit-a-nationwide-survey-in-the-netherlands
#19
F J Kranenburg, S A Willems, S Le Cessie, P J Marang-van de Mheen, J G van der Bom, M S Arbous
BACKGROUND AND OBJECTIVES: Most guidelines recommend a restrictive transfusion trigger of 7 g/dl. It is unclear whether this resulted in more uniform transfusion practices. The primary objective was to uncover the extent of variation in transfusion decisions within four scenarios of critically ill patients among critical care physicians in the Netherlands. MATERIALS AND METHODS: An online survey comprising four different hypothetical clinical scenarios was sent to all members of the Dutch Society of Intensive Care...
February 23, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29472708/no-question-too-small-development-of-a-question-prompt-list-for-parents-of-critically-ill-infants
#20
Monica E Lemmon, Pamela K Donohue, Erin P Williams, Debra Brandon, Peter A Ubel, Renee D Boss
OBJECTIVE: To develop a question prompt list tailored to the needs of parents of critically ill infants at risk of neurodevelopmental impairment. STUDY DESIGN: Question content was derived from audio-recorded neonatal intensive care unit family meetings and interviews with parents of infants treated with therapeutic hypothermia. Question content was refined using clinician focus groups. Acceptability testing was performed with parents and clinicians caring for infants in the neonatal intensive care unit...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
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