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https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#1
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28817394/drivers-of-continuing-education-learning-preferences-for-veterans-affairs-women-s-health-primary-care-providers
#2
Jessica L Zuchowski, Alison B Hamilton, Donna L Washington, Arthur G Gomez, Laure Veet, Kristina M Cordasco
INTRODUCTION: Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest...
August 16, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28817330/readiness-to-vaccinate-critical-personnel-during-an-influenza-pandemic-united-states-2015
#3
Danielle L Moulia, Stephanie A Dopson, Sara J Vagi, Thomas J Fitzgerald, Amy Parker Fiebelkorn, Samuel B Graitcer
OBJECTIVES: To assess the readiness to vaccinate critical infrastructure personnel (CIP) involved in managing public works, emergency services, transportation, or any other system or asset that would have an immediate debilitating impact on the community if not maintained. METHODS: We analyzed self-reported planning to vaccinate CIP during an influenza pandemic with data from 2 surveys: (1) the Program Annual Progress Assessment of immunization programs and (2) the Pandemic Influenza Readiness Assessment of public health emergency preparedness programs...
August 17, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28817209/huntington-s-disease-a-clinical-review
#4
Peter McColgan, Sarah J Tabrizi
Huntington's disease (HD) is a fully penetrant neurodegenerative disease caused by a dominantly inherited CAG trinucleotide repeat expansion in the huntingtin gene on chromosome 4. In Western populations HD has a prevalence of 10.6-13.7 individuals per 100,000. It is characterised by cognitive, motor and psychiatric disturbance. At the cellular level mutant huntingtin results in neuronal dysfunction and death through a number of mechanisms, including disruption of proteostasis, transcription and mitochondrial function and direct toxicity of the mutant protein...
August 17, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28817071/topological-interference-management-for-k-user-downlink-massive-mimo-relay-network-channel
#5
Poongundran Selvaprabhu, Sunil Chinnadurai, Jun Li, Moon Ho Lee
In this paper, we study the emergence of topological interference alignment and the characterizing features of a multi-user broadcast interference relay channel. We propose an alternative transmission strategy named the relay space-time interference alignment (R-STIA) technique, in which a K -user multiple-input-multiple-output (MIMO) interference channel has massive antennas at the transmitter and relay. Severe interference from unknown transmitters affects the downlink relay network channel and degrades the system performance...
August 17, 2017: Sensors
https://www.readbyqxmd.com/read/28816890/improving-timeliness-of-%C3%AE-agonist-and-corticosteroid-administration-in-patients-with-acute-wheezing
#6
Mandisa McIver, William Stoudemire, Cherrelle Smith-Ramsey, Mousumee Panigrahi, Christine Walsh-Kelly
OBJECTIVE: Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METHODS: Our multidisciplinary team identified key contributing factors to timeliness, developed key driver diagrams, implemented and refined a management pathway, designed and executed rapid cycle improvements, and implemented interventions...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28816629/a-cascade-model-of-mentorship-for-frontline-health-workers-in-rural-health-facilities-in-eastern-uganda-processes-achievements-and-lessons
#7
Judith Ajeani, Richard Mangwi Ayiasi, Moses Tetui, Elizabeth Ekirapa-Kiracho, Gertrude Namazzi, Ronald Muhumuza Kananura, Suzanne Namusoke Kiwanuka, Jolly Beyeza-Kashesya
BACKGROUND: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. OBJECTIVES: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model...
August 2017: Global Health Action
https://www.readbyqxmd.com/read/28816605/end-of-life-in-disney-and-pixar-films-an-opportunity-for-engaging-in-difficult-conversation
#8
Kelly E Tenzek, Bonnie M Nickels
This study expanded upon previous scholarship by examining end-of-life (EOL) depictions and messages of death within Disney and Pixar animated films. We argue Disney and Pixar depictions of EOL and death can provide critical opportunities for discussing death and dying processes with children and adults alike. A content analysis of 57 movies resulted in a total of 71 character deaths. These instances of death became the discourse used for analysis. The EOL discourse was coded based on five categories (character status, depiction of death, death status, emotional reaction, and causality)...
January 1, 2017: Omega
https://www.readbyqxmd.com/read/28816524/from-the-abstract-to-the-concrete-implementation-of-an-innovative-tool-in-home-care
#9
Anu Kajamaa, Klaus-Peter Schulz
Background The implementation of innovations in practice is a critical factor for change and development processes in health and home care. We therefore analyze how an innovative tool - a mobility agreement to maintain physical mobility of home care clients - was implemented in Finnish home care. Methods Our study involves ethnographic research of 13 home care visits, two years after the mobility agreement was implemented. We analyze the emergence of contradictions, the motives of the actors and the use of artifacts supporting or inhibiting the implementation...
January 1, 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28816211/a-study-of-events-between-the-onset-of-symptoms-and-hospital-admission-in-patients-with-acute-abdomen
#10
Shubhada Khanapure, Sanjay Nagral, Aditya J Nanavati
BACKGROUND: Acute abdomen is a common surgical emergency. Prompt investigation and treatment, including surgical intervention, is critical in reducing morbidity and mortality. METHODS: We carried out a prospective observational study at a large urban secondary healthcare centre in India. Patients with surgical acute abdomen were consecutively enrolled in the study over a period of 2 years. Data were collected regarding the onset of symptoms, time of presentation to the hospital and events in the intervening period...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28816119/clinical-presentation-and-management-of-dyskinetic-cerebral-palsy
#11
REVIEW
Elegast Monbaliu, Kate Himmelmann, Jean-Pierre Lin, Els Ortibus, Laura Bonouvrié, Hilde Feys, R Jeroen Vermeulen, Bernard Dan
Cerebral palsy is the most frequent cause of severe physical disability in childhood. Dyskinetic cerebral palsy (DCP) is the second most common type of cerebral palsy after spastic forms. DCP is typically caused by non-progressive lesions to the basal ganglia or thalamus, or both, and is characterised by abnormal postures or movements associated with impaired tone regulation or movement coordination. In DCP, two major movement disorders, dystonia and choreoathetosis, are present together most of the time. Dystonia is often more pronounced and severe than choreoathetosis, with a major effect on daily activity, quality of life, and societal participation...
September 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28816059/atherothrombosis-and-oxidative-stress-mechanisms-and-management-in-elderly
#12
Francesco Violi, Lorenzo Loffredo, Roberto Carnevale, Pasquale Pignatelli, Daniele Pastori
SIGNIFICANCE The incidence of cardiovascular events increases by aging, representing the main cause of death in old population. Aging is associated with over-production of reactive oxygen species (ROS), which may affect clotting and platelet activation, and impair endothelial function so predisposing elderly patients to thrombotic complications. RECENT ADVANCES There are increasing evidences to suggest that aging is associated with an imbalance between oxidative stress and antioxidant status. Thus, up-regulation of ROS-producing enzymes such as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and myeloperoxidase, along with down-regulation of antioxidant enzymes, such as superoxide dismutase and glutathione peroxidase, occur during aging...
August 17, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28816031/do-you-see-what-i-see-a-mother-s-plea
#13
Kees Nydam, Rebecca Soole
There is sometimes dissonance between the medical services that the general public expects an ED to provide and the acute critical care that emergency clinicians hope to provide. One explanation for this is that the ED is both a territory and a meeting place for a cornucopia of clinicians, some of whom are not ED clinicians themselves. Roles are sometimes ambiguous and location-specific. Recently, one Queensland mother believed that her son's suicide could have been prevented had emergency staff been better educated...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28816011/lessons-learnt-from-incidents-involving-the-airway-and-breathing-reported-from-australasian-emergency-departments
#14
Carmel Crock, Kim Hansen, Toby Fogg, Angela Cahill, Anita Deakin, William B Runciman
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28815823/ten-years-of-simulation-based-training-in-pediatric-anesthesia-the-inception-evolution-and-dissemination-of-the-managing-emergencies-in-paediatric-anaesthesia-mepa-course
#15
Tobias C Everett, Ralph MacKinnon, David de Beer, Matthew Taylor, Matthew Dylan Bould
2016 marked the 10-year anniversary of the inception of the Managing Emergencies in Paediatric Anaesthesia (MEPA) course. This simulation-based program was originally created to allow trainees in pediatric anesthesia to experience operating room emergencies which although infrequent, would be considered key competencies for any practicing anesthetist with responsibility for providing care to children. Since its original manifestation, the course has evolved in content, scope, and worldwide availability, such that it is now available at over 60 locations on five continents...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28815796/new-graduate-nurses-preparation-for-recognition-and-prevention-of-failure-to-rescue-a-qualitative-study
#16
Elizabeth K Herron
AIM AND OBJECTIVE: To explore new graduate nurses' experiences with recognition and prevention of failure to rescue. BACKGROUND: Failure to rescue is recognized as a quality of care indicator, a core measure of nursing care in hospitals, and a determinant for staffing in acute care facilities. Clinical reasoning is an essential component in preventing failure to rescue and should be emphasized in nursing education and new graduate orientation. Many nurses graduate without the ability to use clinical reasoning in providing patient care which can lead to adverse patient outcomes...
August 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28815736/the-diagnosis-and-management-of-contact-lens-related-microbial-keratitis
#17
REVIEW
Nicole Carnt, Chameen Samarawickrama, Andrew White, Fiona Stapleton
Contact lens-associated microbial keratitis poses a diagnostic dilemma for optometrists on two fronts. The distinction between sterile inflammation and microbial infection is often blurred. In addition, there is a requirement with nearly 50 per cent of the Australian and New Zealand optometric profession being therapeutically endorsed, to distinguish between cases of infection that can be managed in the community verses those that require escalation to public hospitals that have access to laboratory diagnostic tools and advanced imaging techniques, such as in vivo confocal microscopy...
August 16, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/28815727/gender-disparities-among-patients-with-peripheral-arterial-disease-treated-via-endovascular-approach-a-propensity-score-matched-analysis
#18
Rajkumar Doshi, Priyank Shah, Perwaiz Meraj
BACKGROUND: Remarkable improvement in the treatment of Peripheral Arterial Disease (PAD) has led to changes in revascularization strategies from traditional open surgery to less invasive endovascular management. However, few studies are available on gender disparities in patients with PAD treated via an endovascular approach. This study was designed to analyze gender related differences with respect to in-hospital outcomes in PAD patients. METHODS: Our data was obtained from National Inpatient Sample (NIS) 2012 through 2014...
August 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#19
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28815416/what-is-the-evidence-for-paediatric-adolescent-bariatric-surgery
#20
REVIEW
Natalie Durkin, Ashish P Desai
PURPOSE OF REVIEW: In spite of the increasing prevalence of severe and complex obesity in children, surgery as a potential management option is still not widely accepted. The purpose of this review is to examine the evidence for surgical options in the severely obese paediatric population. Increasing evidence supports early rather than later use of bariatric surgery in the treatment of extreme obesity. RECENT FINDINGS: Prior to 2007, the feasibility and safety of surgery have been reported by predominantly small, sporadic single-centre retrospective case series...
August 16, 2017: Current Obesity Reports
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