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https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#1
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913918/new-technique-to-prevent-prolonged-air-leak-use-of-tachosuture-technique
#2
Tatsuya Nishida, Iwao Mikami, Yoshitaka Fujii
Prolonged air leak (defined as air leak >7 days), caused by pulmonary resection or alveolar-pleural fistula, increases postoperative morbidity, prolongs hospital stay and increases healthcare costs. We describe a new technique ('Tachosuture' technique) to prevent prolonged air leak. The key point of this new technique is that air leak is classified into three types and an absorbable suture is added to a TachoSil(®) patch in each type to prevent detachment from the lung parenchyma. Between August 2013 and March 2016, 40 patients underwent thoracoscopic surgery using 'Tachosuture' technique...
December 2, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27913914/tragedy-in-moral-case-deliberation
#3
Benita Spronk, Margreet Stolper, Guy Widdershoven
In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants...
December 2, 2016: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/27913320/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#4
Ioannis Vlachos, Balu Krishnan, David Treiman, Konstantinos Tsakalis, Dimitris Kugiumtzis, Leon Iassemidis
GOAL: Accurate determination of the epileptogenic focus is of paramount diagnostic and therapeutic importance in epilepsy. The current gold standard for focus localization is from ictal (seizure) onset and thus requires the occurrence and recording of multiple typical seizures of a patient. Localization of the focus from seizure-free (interictal) periods remains a challenging problem, especially in the absence of interictal epileptiform activity. METHODS: By exploring the concept of effective inflow, we developed a focus localization algorithm (FLA) based on directed connectivity between brain sites...
November 29, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#5
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed, whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai healthcare context, as compared to continued medical treatment without VEEG. METHODS: Total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities, were collected from Thai patients in a specialized hospital...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913159/assessing-functional-performance-using-computer-based-simulations-of-everyday-activities
#6
Sara J Czaja, David A Loewenstein, Chin Chin Lee, Shih Hua Fu, Philip D Harvey
Current functional capacity (FC) measures for patients with schizophrenia typically involve informant assessments or are in paper and pencil format, requiring in-person administration by a skilled assessor. This approach presents logistic problems and limits the possibilities for remote assessment, an important issue for these patients. This study evaluated the feasibility of using a computer-based assessment battery, including simulations of everyday activities. The battery was compared to in-person standard assessments of cognition and FC with respect to baseline convergence and sensitivity to group differences...
November 29, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27912946/addressing-holistic-healthcare-needs-of-oncology-patients-implementation-and-evaluation-of-a-complementary-and-alternative-medicine-cam-course-within-an-elective-module-designed-for-healthcare-professionals
#7
Nadja Klafke, Angelika Homberg, Katharina Glassen, Cornelia Mahler
BACKGROUND: Patients, and especially oncology patients, increasingly demand information and application of complementary therapies to supplement their conventional medical treatment and follow-up care. Due to the widespread interest in holistic treatment opportunities in oncology populations, healthcare professionals need to be prepared in differentiating evidence-based methods of the complementary and alternative medicine (CAM) spectrum and how to consult with patients about it. OBJECTIVE: This paper reports on the implementation and evaluation of a newly designed module "Complementary and Alternative Medicine in oncological healthcare" in the bachelor degree program Interprofessional Health Care (B...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27912783/exploring-levers-and-barriers-to-accessing-primary-care-for-marginalised-groups-and-identifying-their-priorities-for-primary-care-provision-a-participatory-learning-and-action-research-study
#8
Patrick O'Donnell, Edel Tierney, Austin O'Carroll, Diane Nurse, Anne MacFarlane
BACKGROUND: The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care...
December 3, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27912763/global-health-partnership-for-student-peer-to-peer-psychiatry-e-learning-lessons-learned
#9
REVIEW
Roxanne C Keynejad
BACKGROUND: Global 'twinning' relationships between healthcare organizations and institutions in low and high-resource settings have created growing opportunities for e-health partnerships which capitalize upon expanding information technology resources worldwide. E-learning approaches to medical education are increasingly popular but remain under-investigated, whilst a new emphasis on global health teaching has coincided with university budget cuts in many high income countries. RESULTS: King's Somaliland Partnership (KSP) is a paired institutional partnership health link, supported by Tropical Health and Education Trust (THET), which works to strengthen the healthcare system and improve access to care through mutual exchange of skills, knowledge and experience between Somaliland and King's Health Partners, UK...
December 3, 2016: Globalization and Health
https://www.readbyqxmd.com/read/27911935/the-impact-of-healthcare-insurance-on-the-utilisation-of-facility-based-delivery-for-childbirth-in-the-philippines
#10
Hebe N Gouda, Andrew Hodge, Raoul Bermejo, Willibald Zeck, Eliana Jimenez-Soto
OBJECTIVES: In recent years, the government of the Philippines embarked upon an ambitious Universal Health Care program, underpinned by the rapid scale-up of subsidized insurance coverage for poor and vulnerable populations. With a view of reducing the stubbornly high maternal mortality rates in the country, the program has a strong focus on maternal health services and is supported by a national policy of universal facility-based delivery (FBD). In this study, we examine the impact that recent reforms expanding health insurance coverage have had on FBD...
2016: PloS One
https://www.readbyqxmd.com/read/27911667/barriers-and-benefits-in-telemedicine-arising-between-a-high-technology-hospital-service-provider-and-remote-public-healthcare-units-a-qualitative-study-in-brazil
#11
Carlos Henrique Amaral de Souza, Renata Albaladejo Morbeck, Milton Steinman, Cora Pereira Hors, Mario Maia Bracco, Elisa H Kozasa, Eliseth Ribeiro Leão
BACKGROUND: In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. MATERIALS AND METHODS: We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants...
December 2, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#12
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#13
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911347/smartphone-applications-for-immersive-virtual-reality-therapy-for-internet-addiction-and-internet-gaming-disorder
#14
Melvyn W B Zhang, Roger C M Ho
There have been rapid advances in technologies over the past decade and virtual reality technology is an area which is increasingly utilized as a healthcare intervention in many disciplines including that of Medicine, Surgery and Psychiatry. In Psychiatry, most of the current interventions involving the usage of virtual reality technology is limited to its application for anxiety disorders. With the advances in technology, Internet addiction and Internet gaming disorders are increasingly prevalent. To date, these disorders are still being treated using conventional psychotherapy methods such as cognitive behavioural therapy...
November 25, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/27910721/care-delivery-considerations-for-widespread-and-equitable-implementation-of-inherited-cancer-predisposition-testing
#15
Deborah Cragun, Anita Y Kinney, Tuya Pal
DNA sequencing advances through next-generation sequencing (NGS) and several practice changing events, have led to shifting paradigms for inherited cancer predisposition testing. These changes necessitated a means by which to maximize health benefits without unnecessarily inflating healthcare costs and exacerbating health disparities. Areas covered: NGS-based tests encompass multi-gene panel tests, whole exome sequencing, and whole genome sequencing, all of which test for multiple genes simultaneously, compared to prior sequencing practices through which testing was performed sequentially for one or two genes...
December 2, 2016: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/27910175/postanesthesia-evaluation-of-emotional-and-psychological-satisfaction-in-a-hispanic-population
#16
Angela Zauner, Alvaro Pinilla, Daniel Benitez, Alejandra Tellez, David Romero, Ana Suarez, Vanessa López, Eduardo Hermida
BACKGROUND: Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish...
December 2, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27909944/using-an-analysis-of-behavior-change-to-inform-effective-digital-intervention-design-how-did-the-primit-website-change-hand-hygiene-behavior-across-8993-users
#17
B Ainsworth, M Steele, B Stuart, J Joseph, S Miller, L Morrison, P Little, L Yardley
BACKGROUND: In designing digital interventions for healthcare, it is important to understand not just whether interventions work but also how and for whom-including whether individual intervention components have different effects, whether a certain usage threshold is required to change behavior in each intervention and whether usage differs across population subgroups. PURPOSE: We investigated these questions using data from a large trial of the digital PRimary care trial of a website based Infection control intervention to Modify Influenza-like illness and respiratory tract infection Transmission) (PRIMIT) intervention, which aimed to reduce respiratory tract infections (RTIs) by increasing hand hygiene behavior...
December 1, 2016: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/27909792/exploring-the-rationale-experience-and-impact-of-using-cancer-information-and-support-cis-services-an-international-qualitative-study
#18
Anna Boltong, Martin Ledwick, Kevin Babb, Clare Sutton, Anna Ugalde
PURPOSE: The aim of this study was to develop an in-depth understanding of the rationale, experiences, evaluation and outcomes of using Cancer Information and Support (CIS) services in Australia, the UK and USA. METHODS: Semi-structured interviews were used to gather data between November 2015 and January 2016. Telephone interviews were recorded, de-identified, transcribed and thematically analysed. Ten users from each of three international CIS services (n = 30 in total) were recruited...
December 1, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27909603/analyzing-exposures-to-electromagnetic-fields-in-an-intensive-care-unit
#19
Necati Gökmen, Sabri Erdem, Kadir Atilla Toker, Elvan Öçmen, Başak Ilgım Gökmen, Ahmet Özkurt
OBJECTIVE: In this study, we conducted a numerical analysis of exposure to electromagnetic fields (EMFs) in a hospital's intensive care unit that is one of the most crucial one in terms of hazardous areas among all service units. This is a new study for measuring exposure to EMFs in an intensive care unit as well as other healthcare services in Turkey. METHODS: We measured the EMFs in the intensive care unit with a SRM-3006 (selective radiation metre), which was used for measurement of the absolute and the limit values of high frequency EMFs...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27909568/implementation-of-minimal-invasive-gynaecological-surgery-certification-will-challenge-gynaecologists-with-new-legal-and-ethical-issues
#20
V Tanos, R Socolov, P Demetriou, M Kyprianou, A Watrelot, Y Van Belle, R Campo
The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve surgical performance, patient's safety and outcome. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES) provides a structured learning path, recognising different pillars of competence. In order to achieve a high level of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme reflecting the surgical competence...
June 27, 2016: Facts, Views & Vision in ObGyn
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