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https://www.readbyqxmd.com/read/29788906/influences-on-the-adoption-of-patient-safety-innovation-in-primary-care-a-qualitative-exploration-of-staff-perspectives
#1
Ian Litchfield, Paramjit Gill, Tony Avery, Stephen Campbell, Katherine Perryman, Kate Marsden, Sheila Greenfield
BACKGROUND: Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing complexity of patients and their care. One such intervention is the multi-strand, single platform, Patient Safety Toolkit developed to help practices provide safer care in this dynamic and pressured environment where the likelihood of adverse incidents is increasing...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29787684/trends-and-variation-in-prescribing-of-low-priority-treatments-identified-by-nhs-england-a-cross-sectional-study-and-interactive-data-tool-in-english-primary-care
#2
Alex J Walker, Helen J Curtis, Seb Bacon, Richard Croker, Ben Goldacre
Objectives NHS England recently announced a consultation seeking to discourage the use of treatments it considers to be low-value. We set out to produce an interactive data resource to show savings in each NHS general practice and to assess the current use of these treatments, their change in use over time, and the extent and reasons for variation in such prescribing. Design Cross-sectional analysis. Setting English primary care. Participants English general practices. Main outcome measures We determined the cost per 1000 patients for prescribing of each of 18 treatments identified by NHS England for each month from July 2012 to June 2017, and also aggregated over the most recent year to assess total cost and variation among practices...
January 1, 2018: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/29769553/solid-dissolution-in-a-fluid-solvent-is-characterized-by-the-interplay-of-surface-area-dependent-diffusion-and-physical-fragmentation
#3
R J Seager, Andrew J Acevedo, Fabian Spill, Muhammad H Zaman
The processes of dissolution and fragmentation have high relevance in pharmaceutical research, medicine, digestive physiology, and engineering design. Experimentally, dissolution and fragmentation are observed to occur simultaneously, yet little is known about the relative importance of each of these processes and their impact on the dissolution process as a whole. Thus, in order to better explain these phenomena and the manner in which they interact, we have developed a novel mathematical model of dissolution, based on partial differential equations, taking into consideration the two constituent processes of surface area-dependent diffusive mass removal and physical fragmentation of the solid particles, and the basic physical laws governing these processes...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29768238/one-pot-green-fabrication-of-metallic-silver-nanoscale-materials-using-crescentia-cujete-l-and-assessment-of-their-bactericidal-activity
#4
Seetharaman Prabukumar, Chandrasekaran Rajkuberan, Gnanasekar Sathishkumar, Mani Illaiyaraja, Sivaperumal Sivaramakrishnan
In this study, the leaf extract of an important medicinal plant Crescentia cujete L. (CC) was employed as a green reducing agent to synthesise highly-stable C. cujete silver nanoparticles (CCAgNPs). The reduction of Ag+ to Ag0 nanoparticles was initially observed by a colour change which generates an intense surface plasmon resonance peak at 417 nm using a UV-Vis spectrophotometer. Various optimisation factors such as temperature, pH, time and the stoichiometric proportion of the reaction mixture were performed, which influence the size, dispersity and synthesis rate of CCAgNPs...
June 2018: IET Nanobiotechnology
https://www.readbyqxmd.com/read/29738675/the-role-of-technology-and-telemetry-medicine-in-the-initial-management-of-a-st-segment-elevated-myocardial-infarction-in-a-rural-emergency-department
#5
Michael L Hood
CONTEXT: The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29728212/-admission-discharge-and-triage-guidelines-for-paediatric-intensive-care-units-in-spain
#6
Pedro de la Oliva, Francisco José Cambra-Lasaosa, Manuel Quintana-Díaz, Corsino Rey-Galán, Juan Ignacio Sánchez-Díaz, María Cruz Martín-Delgado, Juan Carlos de Carlos-Vicente, Ramón Hernández-Rastrollo, María Soledad Holanda-Peña, Francisco Javier Pilar-Orive, Esther Ocete-Hita, Antonio Rodríguez-Núñez, Ana Serrano-González, Luis Blanch
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs...
May 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29721705/knowledge-of-adverse-drug-reaction-reporting-and-the-pharmacovigilance-of-biological-medicines-a-survey-of-healthcare-professionals-in-ireland
#7
J O'Callaghan, B T Griffin, J M Morris, Margaret Bermingham
BACKGROUND: In Europe, changes to pharmacovigilance legislation, which include additional monitoring of medicines, aim to optimise adverse drug reaction (ADR) reporting systems. The legislation also makes provisions related to the traceability of biological medicines. OBJECTIVE: The objective of this study was to assess (i) knowledge and general experience of ADR reporting, (ii) knowledge, behaviours, and attitudes related to the pharmacovigilance of biologicals, and (iii) awareness of additional monitoring among healthcare professionals (HCPs) in Ireland...
May 2, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#8
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29699643/admission-discharge-and-triage-guidelines-for-paediatric-intensive-care-units-in-spain
#9
Pedro de la Oliva, Francisco José Cambra-Lasaosa, Manuel Quintana-Díaz, Corsino Rey-Galán, Juan Ignacio Sánchez-Díaz, María Cruz Martín-Delgado, Juan Carlos de Carlos-Vicente, Ramón Hernández-Rastrollo, María Soledad Holanda-Peña, Francisco Javier Pilar-Orive, Esther Ocete-Hita, Antonio Rodríguez-Núñez, Ana Serrano-González, Luis Blanch
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs...
May 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29691915/statistical-mixture-design-investigation-for-extraction-and-quantitation-of-aporphine-alkaloids-from-the-leaves-of-unonopsis-duckei-r-e-fr-by-hplc-ms-ms
#10
Pablo R N Rocha, Flávio A de Freitas, Célio F F Angolini, Lucas-Smith F Vasconcelos, Alaíde L B da Silva, Emmanoel V Costa, Felipe M A da Silva, Marcos N Eberlin, Giovana A Bataglion, Patrícia K Soares, Hector H F Koolen
INTRODUCTION: Alkaloids-derived drugs are a billionaire world-market and several phytochemical investigations aim the identification of new sources and/or structures. Thus, improving the way of extracting and methods to quantify them are of utmost importance. OBJECTIVE: To quantify isoquinoline-derived alkaloids in Unonopsis duckei R.E. Fr. through a new validated high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) method in combination with a statistical mixture design that aimed a proper direct extraction of these compounds from leaves...
April 24, 2018: Phytochemical Analysis: PCA
https://www.readbyqxmd.com/read/29676618/cancer-risk-from-paediatric-computed-tomography-scanning-implications-for-radiation-protection-in-medicine
#11
A Kesminiene, E Cardis
The use of computed tomography (CT) imaging is clearly beneficial for millions of patients. However, the potential adverse health effects, particularly cancer, of ionising radiation exposure from CT early in life are an issue of growing concern in the radiological protection, medical, and public health communities. Although efforts to quantify these effects have been conducted, the precision and accuracy of reported risks needs confirmation. EPI-CT, a European collaborative epidemiological study, was set up to quantify risks from paediatric CT to optimise paediatric diagnostic protocol...
January 1, 2018: Annals of the ICRP
https://www.readbyqxmd.com/read/29674514/pharmacokinetic-studies-in-children-recommendations-for-practice-and-research
#12
REVIEW
Charlotte I S Barker, Joseph F Standing, Lauren E Kelly, Lauren Hanly Faught, Allison C Needham, Michael J Rieder, Saskia N de Wildt, Martin Offringa
Optimising the dosing of medicines for neonates and children remains a challenge. The importance of pharmacokinetic (PK) and pharmacodynamic (PD) research is recognised both in medicines regulation and paediatric clinical pharmacology, yet there remain barriers to undertaking high-quality PK and PD studies. While these studies are essential in understanding the dose-concentration-effect relationship and should underpin dosing recommendations, this review examines how challenges affecting the design and conduct of paediatric pharmacological studies can be overcome using targeted pharmacometric strategies...
April 19, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29672265/report-formatting-in-laboratory-medicine-a-call-for-harmony
#13
Graham R D Jones, Michael Legg
The results of medical laboratory testing are only useful if they lead to appropriate actions by medical practitioners and/or patients. An underappreciated component of the medical testing process is the transfer of the information from the laboratory report into the reader's brain. The format of laboratory reports can be determined by the testing laboratory, which may issue a formatted report, or by electronic systems receiving information from laboratories and controlling the report format. As doctors can receive information from many laboratories, interpreting information from reports in a safe and rapid manner is facilitated by having similar report layouts and formats...
April 19, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29655612/practical-application-of-ligand-efficiency-metrics-in-lead-optimisation
#14
James S Scott, Michael J Waring
The use of composite metrics that normalise biological potency values in relation to markers of physicochemical properties, such as size or lipophilicity, has gained a significant amount of traction with many medicinal chemists in recent years. However, there is no consensus on best practice in the area and their application has attracted some criticism. Here we present our approach to their application in lead optimisation projects, provide an objective discussion of the principles we consider important and illustrate how our use of lipophilic ligand efficiency enabled the progression of a number of our successful drug discovery projects...
April 5, 2018: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/29645063/realisation-of-small-molecule-libraries-based-on-frameworks-distantly-related-to-natural-products
#15
Anthony Aimon, George Karageorgis, Jacob Masters, Mark Dow, Philip G E Craven, Martin Ohsten, Anthony Willaume, Rémy Morgentin, Nicolas Ruiz-Llamas, Hugues Lemoine, Tuomo Kalliokoski, Andrew J Eatherton, Daniel J Foley, Stephen P Marsden, Adam Nelson
The availability of high-quality screening compounds is of paramount importance for the discovery of innovative new medicines. Natural product (NP) frameworks can inspire the design of productive compound libraries. Here, we describe the design and synthesis of four compound libraries based on scaffolds that have broad NP-like features, but that are only distantly related to specific NPs. The optimisation of syntheses of the scaffolds using [5 + 2] cycloaddition chemistry is detailed, together with methods to yield exemplar decorated screening compounds...
April 12, 2018: Organic & Biomolecular Chemistry
https://www.readbyqxmd.com/read/29644334/objective-measurement-in-routine-care-of-people-with-parkinson-s-disease-improves-outcomes
#16
Parisa Farzanehfar, Holly Woodrow, Michelle Braybrook, Sarah McGregor, Andrew Evans, Frank Nicklason, Malcolm Horne
It is common in medicine to titrate therapy according to target ranges of objectively measured parameters. Objective measurement of motor function is available for Parkinson's Disease (PD), making it possible to optimise therapy and clinical outcomes. In this study, an accelerometry based measurement and predefined target ranges were used to assess motor function in a Northern Tasmania PD cohort managed by a Movement Disorder clinic. Approximately 40% ( n  = 103) of the total PD population participated in this study and motor scores were within target in 22%...
2018: NPJ Parkinson's Disease
https://www.readbyqxmd.com/read/29627926/the-burden-of-adverse-drug-reactions-due-to-artemisinin-based-antimalarial-treatment-in-selected-ugandan-health-facilities-an-active-follow-up-study
#17
Helen Byomire Ndagije, Victoria Nambasa, Leonard Manirakiza, Donna Kusemererwa, Dan Kajungu, Sten Olsson, Niko Speybroeck
INTRODUCTION: Uganda has rapidly increased access to antimalarial medicines in an effort to address the huge malaria disease burden. Pharmacovigilance information is important to guide policy decisions. OBJECTIVES: The purpose of this study was to establish the burden of adverse drug reactions (ADRs) and associated risk factors for developing ADRs to artemisinin-based antimalarial treatment in Uganda. METHODS: An active follow-up study was conducted between April and July 2017 in a cohort of patients receiving treatment for uncomplicated malaria in the Iganga, Mayuge, and Kampala districts...
April 7, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29622502/chronic-pain-medication-management-of-older-populations-key-points-from-a-national-conference-and-innovative-opportunities-for-pharmacy-practice
#18
Julia Fiona-Maree Gilmartin-Thomas, J Simon Bell, Danny Liew, Carolyn A Arnold, Rachelle Buchbinder, Colin Chapman, Flavia Cicuttini, Malcolm Dobbin, Stephen J Gibson, Melita J Giummarra, Jenny Gowan, Benny Katz, Dan I Lubman, Matthew McCrone, Jennifer Pilgrim, Anneliese Synnot, Eleanor van Dyk, Barbara Workman, John McNeil
OBJECTIVE: Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In the pursuit of educating pharmacists, physicians, allied healthcare professionals, researchers, academics and the public facing the challenges of chronic pain medication management, 'The Inaugural Monash University School of Public Health and Preventive Medicine (SPHPM) Best Practice in Chronic Pain Medication Management Day Conference' was held in December 2016 at the Alfred Medical Research and Education Precinct (Melbourne, Australia)...
March 19, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29582099/-paths-to-the-professional-and-responsible-use-of-antibiotics
#19
REVIEW
Marianne Abele-Horn, Ellen Pantke, Tim Eckmanns
Germany's position on prescribing antibiotics is among the lower third in Europe. There are some countries that prescribe remarkably fewer antibiotics. In Germany, the number of out-patient antibiotic prescriptions is too high for patients with low-grade infections and non-bacterial infections. Often, broad-spectrum antibiotics are prescribed instead of narrow-spectrum antibiotics. For in-patients, perioperative prophylaxis is given for too long.In this article, different ways to reduce antibiotic prescriptions are introduced...
March 26, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29567205/innovative-pharmaceutical-pricing-agreements-in-five-european-markets-a-survey-of-stakeholder-attitudes-and-experience
#20
William C N Dunlop, Alexandra Staufer, Pierre Levy, Guy J Edwards
BACKGROUND: Innovative pricing agreements for medicines have been used in European markets for more than 20 years, and offer an opportunity for payers and pharmaceutical companies to align on value, optimise speed to patients, and share risk. Developing successful agreements requires alignment between key stakeholders, yet there is a lack of summative data on how current innovative agreements are used in the real-world (e.g. the level of realised access to medicines, and rebates and discounts, which are often non-transparent)...
March 8, 2018: Health Policy
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