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https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#1
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822253/clout-or-doubt-perspectives-on-an-infant-mental-health-service-for-young-children-placed-in-foster-care-due-to-abuse-and-neglect
#2
Fiona Turner-Halliday, Gary Kainth, Genevieve Young-Southward, Richard Cotmore, Nicholas Watson, Lynn McMahon, Helen Minnis
Despite knowledge about the profound effects of child abuse and neglect, we know little about how best to assess whether maltreated children should return home. The effectiveness of the New Orleans Intervention Model (NIM) is being tested in a randomized controlled trial where the comparison is social work 'services as usual.' The future trial results will tell us which approach produces the best outcomes for children; meanwhile qualitative process evaluation is generating intriguing findings about the perceived impact of NIM on decision-making about childrens' futures...
August 16, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28822109/consumer-attitudes-towards-the-establishment-of-a-national-australian-familial-cancer-research-database-by-the-inherited-cancer-connect-iccon-partnership
#3
Laura Forrest, Gillian Mitchell, Letitia Thrupp, Lara Petelin, Kate Richardson, Lyon Mascarenhas, Mary-Anne Young
Clinical genetics units hold large amounts of information which could be utilised to benefit patients and their families. In Australia, a national research database, the Inherited Cancer Connect (ICCon) database, is being established that comprises clinical genetic data held for all carriers of mutations in cancer predisposition genes. Consumer input was sought to establish the acceptability of the inclusion of clinical genetic data into a research database. A qualitative approach using a modified nominal group technique was used to collect data through consumer forums conducted in three Australian states...
August 18, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28821988/presentation-and-management-of-symptomatic-central-bone-cement-embolization
#4
Ahmed Samir Barakat, Tamer Owais, Mohamed Alhashash, Mootaz Shousha, Hesham El Saghir, Bernward Lauer, Heinrich Boehm
BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...
August 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28821421/exploring-canadian-physicians-experiences-with-diabetes-care-for-indigenous-patients
#5
Lynden Lindsay Crowshoe, Rita I Henderson, Michael E Green, Kristen M Jacklin, Leah M Walker, Betty Calam
OBJECTIVES: The perspectives of physicians caring for Indigenous patients with diabetes offer important insights into the provision of health-care services. The purpose of this study was to describe Canadian physicians' perspectives on diabetes care of Indigenous patients, a preliminary step in developing a continuing medical education intervention described elsewhere. METHODS: Through in-depth semistructured interviews, Canadian family physicians and specialists with sizeable proportions of Indigenous clientele shared their experiences of working with Indigenous patients who have type 2 diabetes...
August 15, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28821408/is-late-life-dependency-increasing-or-not-a-comparison-of-the-cognitive-function-and-ageing-studies-cfas
#6
Andrew Kingston, Pia Wohland, Raphael Wittenberg, Louise Robinson, Carol Brayne, Fiona E Matthews, Carol Jagger
BACKGROUND: Little is known about how the proportions of dependency states have changed between generational cohorts of older people. We aimed to estimate years lived in different dependency states at age 65 years in 1991 and 2011, and new projections of future demand for care. METHODS: In this population-based study, we compared two Cognitive Function and Ageing Studies (CFAS I and CFAS II) of older people (aged ≥65 years) who were permanently registered with a general practice in three defined geographical areas (Cambridgeshire, Newcastle, and Nottingham; UK)...
August 14, 2017: Lancet
https://www.readbyqxmd.com/read/28820644/national-estimates-of-genetic-testing-in-women-with-a-history-of-breast-or-ovarian-cancer
#7
Christopher P Childers, Kimberly K Childers, Melinda Maggard-Gibbons, James Macinko
Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey...
August 18, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28820620/care-providers-integration-of-family-requests-in-end-of-life-communication-understanding-what-to-do-and-why-to-do-it
#8
Paula Hopeck
End-of-life situations are fraught with challenges for patients, family members, and individuals working at the patient's bedside. Care workers must address needs of the patient, as well as his or her distressed family members. This article is an inductive investigation of care workers' (nurses, patient advocates, and clergy) experiences with end-of-life discussions when the family asks to "do everything." Participants also noted resistance to hospice in some of these encounters based on pre-existing connotations of hospice held by the family members...
August 18, 2017: Health Communication
https://www.readbyqxmd.com/read/28820610/asthma-treatment-and-outcomes-for-children-in-the-emergency-department-and-hospital
#9
Rupali Drewek, Lucia Mirea, Peter Touresian, Philip David Adelson
OBJECTIVE: To describe and compare the treatment of acute asthma exacerbations in children seen in the emergency department (ED) and admitted to acute care floor in the hospital or intensive care unit (ICU). METHODS: Retrospective chart review of visits for acute exacerbation of asthma treated at Phoenix Children's Hospital between January 1, 2014 and December 31, 2016. RESULTS: A total of 287 asthma exacerbation cases were identified including 106 (37%) ED visits, 134 (47%) hospital floor and 47 (16%) ICU admissions...
August 18, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28820518/living-with-hepatocellular-carcinoma-near-the-end-of-life-family-caregivers-perspectives
#10
Lissi Hansen, Susan J Rosenkranz, Kathleen Wherity, Anna Sasaki
PURPOSE/OBJECTIVES: To explore family caregivers' perspectives of caring for patients with terminal hepatocellular carcinoma (HCC) as patients approached the end of life.
. RESEARCH APPROACH: Longitudinal, qualitative descriptive design.
. SETTING: Oregon Health and Science University in Portland and Veterans Affairs Portland Health Care System in Oregon.
. PARTICIPANTS: 13 family caregivers with a mean age of 56 years (range = 22-68 years)...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28820454/personal-hygiene-practices-among-urban-homeless-persons-in-boston-ma
#11
Jessica H Leibler, Daniel D Nguyen, Casey León, Jessie M Gaeta, Debora Perez
Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA (n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population...
August 18, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28818629/hospice-she-yelped-examining-the-quantity-and-quality-of-decision-support-available-to-patient-and-families-considering-hospice
#12
Grace Finnigan-Fox, Dan D Matlock, Channing E Tate, Christopher E Knoepke, Larry A Allen
BACKGROUND: Whether to engage hospice is one of the most difficult medical decisions patients and families make. Meanwhile, misperceptions about hospice persist. Within this context, the breadth and depth of patient decision support materials for hospice is unknown. OBJECTIVE: Identify available patient decision aids (PtDAs) relating information about hospice care and compare that information to the informational needs expressed by real-world healthcare consumers...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818438/cancer-risks-and-survival-in-patients-with-multiple-primary-melanomas-association-with-family-history-of-melanoma-and-germline-cdkn2a-mutation-status
#13
Hildur Helgadottir, Rainer Tuominen, Håkan Olsson, Johan Hansson, Veronica Höiom
BACKGROUND: Worse outcomes have been noted in patients with multiple primary melanomas (MPMs) than in patients with single primary melanomas. OBJECTIVE: We investigated how family history of melanoma and germline CDKN2A mutation status of MPM patients affects risks of developing subsequent melanomas and other cancers and survival outcomes. METHODS: Comprehensive data on cancer diagnoses and deaths of MPM patients, their first-degree relatives, and matched controls were obtained through Swedish national health care and population registries...
August 14, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28817709/assessment-of-physicians-awareness-and-knowledge-of-familial-hypercholesterolemia-in-saudi-arabia-is-there-a-gap
#14
Mohammed Ali Batais, Turky H Almigbal, Aref A Bin Abdulhak, Hani B Altaradi, Khalid F AlHabib
BACKGROUND: The scarcity of familial hypercholesterolemia (FH) cases reported in Saudi Arabia might be indicative of a lack of awareness of this common genetic disease among physicians. OBJECTIVE: To assess physicians' awareness, practice, and knowledge of FH in Saudi Arabia. METHODS: This is a cross-sectional study conducted among physicians at four tertiary hospitals in Riyadh, Saudi Arabia between March 2016 and May 2016 using a self-administered questionnaire...
2017: PloS One
https://www.readbyqxmd.com/read/28817654/investigating-spousal-concordance-of-diabetes-through-statistical-analysis-and-data-mining
#15
Jong-Yi Wang, Chiu-Shong Liu, Chi-Hsuan Lung, Ya-Tun Yang, Ming-Hung Lin
OBJECTIVE: Spousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data. METHODS: A total of 22,572 individuals identified from the 2002-2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM)...
2017: PloS One
https://www.readbyqxmd.com/read/28817507/comparison-of-consent-models-in-a-randomized-trial-of-corticosteroids-in-pediatric-septic-shock
#16
Kusum Menon, Katharine O'Hearn, James Dayre McNally, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVES: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years inclusive admitted to PICU with suspected septic shock between July 2014 and March 2016...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28817499/nurse-practitioner-lead-pediatric-baclofen-pump-program-impact-on-safety-and-quality-of-care
#17
Kristin Buxton, Ann Morgan, Jayne Rogers
Children with cerebral palsy experience spasticity that can be debilitating and cause significant pain and contractures. Intrathecal baclofen (ITB) therapy can help relieve this spasticity and improve the quality of life for these patients, but it comes with risk. Withdrawal from the medication in case of abrupt discontinuation of delivery can be life-threatening. Regular maintenance of the system is mandatory. Having a program in place to manage the device and support patients helps to ensure their safety...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28817359/developing-the-storyline-for-an-advance-care-planning-video-for-surgery-patients-patient-centered-outcomes-research-engagement-from-stakeholder-summit-to-state-fair
#18
Rebecca A Aslakson, Anne L R Schuster, Thomas J Lynch, Matthew J Weiss, Lydia Gregg, Judith Miller, Sarina R Isenberg, Norah L Crossnohere, Alison M Conca-Cheng, Angelo E Volandes, Thomas J Smith, John F P Bridges
BACKGROUND: Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. OBJECTIVE: The objective is to develop and test acceptability of an ACP video storyline...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817304/medical-education-and-leadership-in-breastfeeding-medicine
#19
Julie Scott Taylor, Esther Bell
Physicians' experience with high quality training in breastfeeding during their medical education is historically varied. The process of becoming a board-certified physician entails more than 20 years of education, and although medical school and residency training timelines and courses are relatively standardized across the United States and even internationally, breastfeeding education varies greatly across schools and programs. The Academy of Breastfeeding Medicine (ABM) exists, in part, because historically, physicians have received too little clinical training in breastfeeding and infant nutrition...
August 17, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28817114/trauma-informed-care-in-the-newborn-intensive-care-unit-promoting-safety-security-and-connectedness
#20
M R Sanders, S L Hall
Both babies and their parents may experience a stay in the newborn intensive care unit (NICU) as a traumatic or a 'toxic stress,' which can lead to dysregulation of the hypothalamic-pituitary-adrenal axis and ultimately to poorly controlled cortisol secretion. Toxic stresses in childhood or adverse childhood experiences (ACEs) are strongly linked to poor health outcomes across the lifespan and trauma-informed care is an approach to caregiving based on the recognition of this relationship. Practitioners of trauma-informed care seek to understand clients' or patients' behaviors in light of previous traumas they have experienced, including ACEs...
August 17, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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