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https://www.readbyqxmd.com/read/28636854/cluster-randomized-crossover-trial-of-head-positioning-in-acute-stroke
#1
Craig S Anderson, Hisatomi Arima, Pablo Lavados, Laurent Billot, Maree L Hackett, Verónica V Olavarría, Paula Muñoz Venturelli, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Kris Rogers, Sandy Middleton, Joyce Y Lim, Denise Forshaw, C Elizabeth Lightbody, Mark Woodward, Octavio Pontes-Neto, H Asita De Silva, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj D Pandian, Gillian E Mead, Thompson Robinson, Caroline Watkins
BACKGROUND: The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS: In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28636738/impact-of-a-pediatric-anesthesiologist-on-operating-room-efficiency-during-pediatric-tonsillectomies-and-adenotonsillectomies
#2
Nicholas A Dewyer, Yoseph A Kram, Stephen Long, Marika D Russell
We conducted a retrospective case review to determine if the presence of an Accreditation Council for Graduate Medical Education (ACGME) fellowship-trained pediatric anesthesiologist improves efficiency during pediatric tonsillectomies and adenotonsillectomies in hospitals that do not have dedicated pediatric operating rooms and, if so, to determine which specific anesthesia practices might account for such a difference. We reviewed the charts of all patients aged 12 years and younger who had undergone a tonsillectomy or adenotonsillectomy from Jan...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28634517/introduction-of-a-quality-improvement-curriculum-in-the-department-of-internal-medicine-lincoln-medical-center
#3
Usha Venugopal, Moiz Kasubhai, Vikram Paruchuri
Community hospitals with limited resources struggle to engage physicians in Quality improvement initiatives. We introduced Quality Improvement (QI) curriculum for residents in response to ACGME requirements and surveyed the residents understanding of QI and their involvement in QI projects before and after the introduction of the curriculum. The current article describes our experiences with the process, the challenges and possible solutions to have a successful resident led QI initiative in a community hospital...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28633384/correlates-of-dyspnoea-and-its-association-with-adverse-outcomes-in-a-cohort-of-adults-aged-80-and-over
#4
Eralda Hegendörfer, Bert Vaes, Catharina Matheï, Gijs Van Pottelbergh, Jean-Marie Degryse
Background: adults aged 80 and over, a fast growing age-group, with increased co-morbidity and frailty have not been the focus of previous research on dyspnoea. We investigate the correlates of dyspnoea and its association with adverse outcomes in a cohort of adults aged 80 and over. Methods: about 565 community-dwelling adults aged 80 and over of the BELFRAIL prospective cohort had assessment of Medical Research Council dyspnoea scale (MRC), forced expiratory volume in 1 s (FEV1), N-terminal pro-brain natriuretic peptide (NT-proBNP), physical performance tests, grip strength, 15 items geriatric depression scale, activities of daily living (ADL), body mass index (BMI) and demographics data...
June 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28633168/integration-of-clinical-pharmacists-in-family-medicine-residency-programs
#5
Jody L Lounsbery, Jennie B Jarrett, Lori M Dickerson, Stephen A Wilson
BACKGROUND AND OBJECTIVES: Clinical pharmacists are valued educators and practitioners within family medicine residency programs (FMRPs). Since the last survey of clinical pharmacists within FMRPs, there have been significant advancements to pharmacy education and training as well as growth of interprofessional education and collaborative practice within family medicine. The objective of this study is to describe the integration of clinical pharmacists within FMRPs. METHODS: All 480 Accreditation Council for Graduate Medical Education (ACGME)-approved FMRPs were contacted to identify clinical pharmacists involved with their programs...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633155/regional-anesthesia-and-pain-medicine-us-anesthesiology-resident-training-the-year-2015
#6
Joseph M Neal, Anne Gravel Sullivan, Richard W Rosenquist, Dan J Kopacz
BACKGROUND AND OBJECTIVES: The Anesthesiology Review Committee of the Accreditation Council for Graduate Medical Education sets core requirements for residency program accreditation. We periodically report and analyze the US anesthesiology residents' training experience in regional anesthesia and pain medicine. METHODS: Resident caseload, procedure, and pain medicine evaluation data were aggregated for the resident cohort who graduated in 2015. These data were analyzed for present-day experience and compared with previous reports from years 1980, 1990, and 2000 graduates...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28632599/publication-productivity-of-orthopaedic-surgery-chairs
#7
Boris A Zelle, Michael A Weathers, Roberto J Fajardo, Varan Haghshenas, Mohit Bhandari
BACKGROUND: As academic leaders, orthopaedic chairs represent role models for scholarly activities. Despite the importance of journal publications as a measure of scholarly activity, data on the publication productivity of orthopaedic chairs remain limited. The goals of this study were to record the publication productivity of orthopaedic chairs and evaluate the extent to which they maintained their scholarly activity while serving as chairs. METHODS: The chairs of all orthopaedic residency programs in the United States were identified through the Accreditation Council for Graduate Medical Education (ACGME) web site, and were confirmed by information found on the web site of each orthopaedic program that was included in the study...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28631805/drug-therapy-for-chronic-idiopathic-axonal-polyneuropathy
#8
REVIEW
Janna Warendorf, Alexander Fje Vrancken, Ivo N van Schaik, Richard Ac Hughes, Nicolette C Notermans
BACKGROUND: Chronic idiopathic axonal polyneuropathy (CIAP) is an insidiously progressive sensory or sensorimotor polyneuropathy that affects elderly people. Although severe disability or handicap does not occur, CIAP reduces quality of life. CIAP is diagnosed in 10% to 25% of people referred for evaluation of polyneuropathy. There is a need to gather and review emerging evidence on treatments, as the number of people affected is likely to increase in ageing populations. This is an update of a review first published in 2004 and previously updated in 2006, 2008, 2011 and 2013...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630886/review-of-the-current-status-of-radiation-protection-in-diagnostic-radiology-in-africa
#9
REVIEW
Wilbroad Muhogora, Madan M Rehani
The aim of this paper is to review the available published studies from African countries on patient doses and medical radiation protection and identify strengths, weaknesses, and challenges. Papers on radiation doses to patients published until 2016 pertaining to studies in African countries were reviewed. Radiography, interventional radiology, computed tomography (CT), and mammography modalities were covered. In radiography, the entrance surface air kerma values were below the established diagnostic reference levels (DRLs) provided by the International Atomic Energy Agency, European Commission, and National Council on Radiation Protection and Measurements...
July 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28630551/exploring-legal-restrictions-regulatory-reform-and-geographic-disparities-in-abortion-access-in-thailand
#10
Grady Arnott, Grace Sheehy, Orawee Chinthakanan, Angel M Foster
Despite decades of advocacy among Thai governmental and nongovernmental actors to remove abortion from the country's 1957 Criminal Code, this medically necessary service remains significantly legally restricted. In 2005, in the most recent regulatory reform to date, the Thai Medical Council established regulatory measures to allow a degree of physician interpretation within the confines of the existing law. Drawing on findings from a review of institutional policies and legislative materials, key informant interviews, and informal discussions with health service providers, government representatives, and nonprofit stakeholders, this article explores how legal reforms and health policies have shaped the abortion landscape in Thailand and influenced geographic disparities in availability and accessibility...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28630258/realization-of-entry-to-practice-milestones-by-canadians-who-studied-medicine-abroad-and-other-international-medical-graduates-a-retrospective-cohort-study
#11
Maria Mathews, Rima Kandar, Steve Slade, Yanqing Yi, Sue Beardall, Ivy Bourgeault
BACKGROUND: International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. METHODS: Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28629438/an-output-evaluation-of-a-health-research-foundation-s-enhanced-grant-review-process-for-new-investigators
#12
Gregory W Hammond, Mê-Linh Lê, Tannis Novotny, Stephanie P B Caligiuri, Grant N Pierce, John Wade
BACKGROUND: We assessed the ability of the Manitoba Medical Service Foundation (MMSF, a small not-for-profit foundation affiliated with Manitoba Blue Cross) to determine the best candidates for selection to receive research funding support among new researchers applying to the Research Operating Grants Programme (ROGP). METHODS: Using bibliometric and grants funding analyses, we retrospectively compared indices of academic outputs from five cohorts of MMSF-funded and not MMSF-funded applicants to the annual MMSF ROGP over 2008 to 2012, from 1 to 5 years after having received evaluation decisions from the MMSF enhanced grant review process...
June 19, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28628549/a-classification-system-to-guide-physical-therapy-management-in-huntington-disease-a-case-series
#13
Nora E Fritz, Monica Busse, Karen Jones, Hanan Khalil, Lori Quinn
BACKGROUND AND PURPOSE: Individuals with Huntington disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council framework provides a schema that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature, are helpful in guiding physical therapy management across the stages of HD...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628531/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#14
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28628519/comparative-efficacy-of-lifestyle-intervention-strategies-on-weight-outcomes-in-people-with-psychosis-a-systematic-review-and-network-meta-analysis-protocol
#15
Doreen W Mucheru, Mary-Claire Hanlon, Mark McEvoy, Lesley MacDonald-Wicks
REVIEW QUESTION/OBJECTIVE:: (i) To systematically review and rank the efficacy of different types of lifestyle intervention strategies on weight outcomes (weight, body mass index [BMI], waist circumference and waist-to-hip ratio) in people with psychosis. (The efficacy of different types of lifestyle intervention strategies will be ranked by comparing the effect size on weight outcomes in people with psychotic disorders.) (ii) To stratify lifestyle interventions that target weight outcomes (weight, BMI, waist circumference and waist-to-hip ratio) in people with psychosis, according to their inclusion of dietary information that adheres with Australian Dietary Guidelines (National Health and Medical Research Council...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28627415/examination-to-assess-the-clinical-exam-and-documentation-of-spine-pathology-among-orthopaedic-residents
#16
Jack M Haglin, John L Zeller, Kenneth A Egol, Donna P Phillips
BACKGROUND: The Accreditation Council of Graduate Medical Education (ACGME) guidelines require residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. In order to assess the progress of orthopaedic interns' skills in performing a history, physical exam, and documentation of the encounter for a standardized patient with spinal stenosis, a Structured Objective Clinical Examination (OSCE) was conducted for 13 orthopaedic intern residents, following a one month boot camp that included communications skills and curriculum in history and physical examination...
June 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28626830/overweight-obesity-and-risk-of-cardiometabolic-multimorbidity-pooled-analysis-of-individual-level-data-for-120%C3%A2-813-adults-from-16-cohort-studies-from-the-usa-and-europe
#17
Mika Kivimäki, Eeva Kuosma, Jane E Ferrie, Ritva Luukkonen, Solja T Nyberg, Lars Alfredsson, G David Batty, Eric J Brunner, Eleonor Fransson, Marcel Goldberg, Anders Knutsson, Markku Koskenvuo, Maria Nordin, Tuula Oksanen, Jaana Pentti, Reiner Rugulies, Martin J Shipley, Archana Singh-Manoux, Andrew Steptoe, Sakari B Suominen, Töres Theorell, Jussi Vahtera, Marianna Virtanen, Peter Westerholm, Hugo Westerlund, Marie Zins, Mark Hamer, Joshua A Bell, Adam G Tabak, Markus Jokela
BACKGROUND: Although overweight and obesity have been studied in relation to individual cardiometabolic diseases, their association with risk of cardiometabolic multimorbidity is poorly understood. Here we aimed to establish the risk of incident cardiometabolic multimorbidity (ie, at least two from: type 2 diabetes, coronary heart disease, and stroke) in adults who are overweight and obese compared with those who are a healthy weight. METHODS: We pooled individual-participant data for BMI and incident cardiometabolic multimorbidity from 16 prospective cohort studies from the USA and Europe...
June 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28626829/socioeconomic-status-as-an-effect-modifier-of-alcohol-consumption-and-harm-analysis-of-linked-cohort-data
#18
Srinivasa Vittal Katikireddi, Elise Whitley, Jim Lewsey, Linsay Gray, Alastair H Leyland
BACKGROUND: Alcohol-related mortality and morbidity are high in socioeconomically disadvantaged populations compared with individuals from advantaged areas. It is unclear if this increased harm reflects differences in alcohol consumption between these socioeconomic groups, reverse causation (ie, downward social selection for high-risk drinkers), or a greater risk of harm in individuals of low socioeconomic status compared with those of higher status after similar consumption. We aimed to investigate whether the harmful effects of alcohol differ by socioeconomic status, accounting for alcohol consumption and other health-related factors...
June 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28626828/contribution-of-risk-factors-to-excess-mortality-in-isolated-and-lonely-individuals-an-analysis-of-data-from-the-uk-biobank-cohort-study
#19
Marko Elovainio, Christian Hakulinen, Laura Pulkki-Råback, Marianna Virtanen, Kim Josefsson, Markus Jokela, Jussi Vahtera, Mika Kivimäki
BACKGROUND: The associations of social isolation and loneliness with premature mortality are well known, but the risk factors linking them remain unclear. We sought to identify risk factors that might explain the increased mortality in socially isolated and lonely individuals. METHODS: We used prospective follow-up data from the UK Biobank cohort study to assess self-reported isolation (a three-item scale) and loneliness (two questions). The main outcomes were all-cause and cause-specific mortality...
June 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28624567/results-of-operative-treatment-of-brachial-plexus-injury-resulting-from-shoulder-dislocation-a-study-with-a-long-term-follow-up
#20
Olga Gutkowska, Jacek Martynkiewicz, Sylwia Mizia, Michał Bąk, Jerzy Gosk
BACKGROUND: Injury to the infraclavicular brachial plexus is an uncommon but serious complication of shoulder dislocation. This work aims to determine the effectiveness of operative treatment in patients with this type of injury. METHODS: Thirty-three patients (26 males,7 females; mean age 45 years 3 months) treated operatively for brachial plexus injury resulting from shoulder dislocation between the years 2000-2013 were included in this retrospective case series...
June 14, 2017: World Neurosurgery
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