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https://www.readbyqxmd.com/read/27925381/doctors-use-of-mobile-devices-in-the-clinical-setting-a-mixed-methods-study
#1
Arany Nerminathan, Amanda Harrison, Megan Phelps, Karen M Scott
AIM: To explore how doctors use mobile devices in the clinical setting and understand drivers for use. METHODS: A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. RESULTS: The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27923389/the-importance-of-albumin-infusion-rate-for-plasma-volume-expansion-following-major-abdominal-surgery-air-study-protocol-for-a-randomised-controlled-trial
#2
Svajunas Statkevicius, Johan Bonnevier, Björn P Bark, Erik Larsson, Carl M Öberg, Päivi Kannisto, Bobby Tingstedt, Peter Bentzer
BACKGROUND: Administration of fluids to restore normovolaemia is one of the most common therapeutic interventions performed peri-operatively and in the critically ill, but no study has evaluated the importance of infusion rate for the plasma volume-expanding effect of a resuscitation fluid. The present study is designed to test the hypothesis that a slow infusion of resuscitation fluid results in better plasma volume expansion than a rapid infusion. METHODS/DESIGN: The study is a single-centre, assessor-blinded, parallel-group, randomised prospective study...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27922778/developing-an-outcomes-framework-for-the-dietetic-service
#3
Victoria Prendiville
Demonstrating our value as individual practitioners and services is a key priority. Developing robust process and outcome measures supports us to achieve this. Outcomes also enable us to provide the highest level of patient-centred care by helping us to re-model the relationship between user and provider through capturing and using patient-related experience and outcome measures to inform service development. This article discusses our journey as a dietetic service in developing and implementing an outcomes framework utilising quality improvement methodology...
December 2, 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27921426/-gestational-diabetes-mellitus
#4
Hana Krejčí
The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27921130/-does-the-certification-according-to-endocert-lead-to-a%C3%A2-better-quality-of-treatment
#5
P Weber, A C Paulus, D Hallmen, A Steinbrück, F Schmidutz, V Jansson
BACKGROUND: Certification according to EndoCert in the field of arthroplasty in Germany aims at standardization of treatment and with this optimization of its quality. However, huge capital investment and efforts are necessary. There are currently more than 400 certified centres in Germany. Our Department of Orthopaedics at a German medical school was certified in the pilot phase. The aim of this study was to analyse whether there was a difference in the quality in the year after the certification...
December 5, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27920244/are-the-registry-data-reliable-an-audit-of-a-regional-trauma-registry-in-the-netherlands
#6
E E Horton, P Krijnen, H M Molenaar, I B Schipper
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27920120/effects-of-an-intervention-s%C3%A3-kl%C3%A3-k-on-prescription-of-potentially-inappropriate-medication-in-elderly-patients
#7
Cecilia Lenander, Åsa Bondesson, Nina Viberg, Ulf Jakobsson, Anders Beckman, Patrik Midlöv
BACKGROUND: Polypharmacy is known to increase the risk for drug-related problems, and some drugs, potentially inappropriate medications (PIMs), are especially troublesome. OBJECTIVE: To analyse the effects on prescription of PIMs of the SÄKLÄK project, an intervention model created to improve medication safety for elderly patients in primary care. METHOD: The SÄKLÄK project was a multiprofessional intervention in primary care consisting of self-assessment, peer review, feedback and written agreements for change...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27920036/clinical-relevance-of-pharmacist-intervention-in-an-emergency-department
#8
Maria Antonia Pérez-Moreno, Juan Manuel Rodríguez-Camacho, Beatriz Calderón-Hernanz, Bernardino Comas-Díaz, Jordi Tarradas-Torras
OBJECTIVES: To evaluate the clinical relevance of pharmacist intervention on patient care in emergencies, to determine the severity of detected errors. Second, to analyse the most frequent types of interventions and type of drugs involved and to evaluate the clinical pharmacist's activity. METHODS: A 6-month observational prospective study of pharmacist intervention in the Emergency Department (ED) at a 400-bed hospital in Spain was performed to record interventions carried out by the clinical pharmacists...
December 5, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27919369/informing-the-development-of-an-internet-based-chronic-pain-self-management-program
#9
Amédé Gogovor, Regina Visca, Claudine Auger, Lucie Bouvrette-Leblanc, Iphigenia Symeonidis, Lise Poissant, Mark A Ware, Yoram Shir, Natacha Viens, Sara Ahmed
BACKGROUND: Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. OBJECTIVE: To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27917770/evaluating-point-of-care-testing-for-glycosylated-haemoglobin-in-public-sector-primary-care-facilities-in-the-western-cape-south-africa
#10
R Mash, A Ugoagwu, C Vos, M Rensburg, R Erasmus
BACKGROUND: Diabetes mellitus contributes significantly to the burden of disease in South Africa (SA). Monitoring of glycaemic control with glycosylated haemoglobin (HbA1c) is recommended, even though current laboratory-based testing does not support immediate clinical decision-making. OBJECTIVES: To evaluate the costs and consequences for quality of care by introducing point-of-care (POC) testing for HbA1c for patients with type 2 diabetes at community health centres in Cape Town, SA...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917662/validating-a-benchmarking-tool-for-audit-of-early-outcomes-after-operations-for-head-and-neck-cancer
#11
D Tighe, I Sassoon, M McGurk
INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917505/might-constraint-be-compatible-with-care-home-care-as-a-situational-ethics
#12
Antoine Hennion, Pierre A Vidal-Naquet
Respecting the autonomy and will of people has legitimately led to strictly control the use of constraint in care activities, and promote a care ethics centred around people's needs and wills. But constraint is underlying in any action aiming at making people do something, even with their consent, especially when their ability to evaluate what is best for them may be altered. Ceaselessly present in care, this ordinary, silent constraint should not be only deemed as a necessary evil to be prevented. In contrast with this legally-based view, the paper adopts a pragmatic perspective...
December 5, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27915265/the-ethics-of-unilateral-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-with-defibrillator-deactivation-patient-perspectives
#13
Margaret Daeschler, Ralph J Verdino, James N Kirkpatrick
AIMS: Decisions about deactivation of implantable cardioverter defibrillators (ICDs) are complicated. Unilateral do-not-resuscitate (DNR) orders (against patient/family wishes) have been ethically justified in cases of medical futility. Unilateral deactivation of ICDs may be seen as a logical extension of a unilateral DNR order. However, the ethical implications of unilateral ICD deactivation have not been explored. METHODS AND RESULTS: Sixty patients who had an ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were interviewed at a quaternary medical centre outpatient electrophysiology practice...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27915082/the-heart-failure-pandemic-the-clinical-and-economic-burden-in-greece
#14
P Stafylas, D Farmakis, G Kourlaba, G Giamouzis, K Tsarouhas, N Maniadakis, J Parissis
BACKGROUND: The objective of this study was to identify the epidemiological and clinical characteristics of heart failure (HF) patients in Greece as well as the economic burden and the distribution of costs for the management of the disease. METHODS: Eight Greek secondary and tertiary cardiology centres from different cities have participated in a prospective, observational survey, the ESC HF Pilot Survey. 307 patients with HF, 177 hospitalised and 130 outpatients, have been recruited and monitored for 12months...
October 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27914856/occult-hiv-1-drug-resistance-to-thymidine-analogues-following-failure-of-first-line-tenofovir-combined-with-a-cytosine-analogue-and-nevirapine-or-efavirenz-in-sub-saharan-africa-a-retrospective-multi-centre-cohort-study
#15
John Gregson, Pontiano Kaleebu, Vincent C Marconi, Cloete van Vuuren, Nicaise Ndembi, Raph L Hamers, Phyllis Kanki, Christopher J Hoffmann, Shahin Lockman, Deenan Pillay, Tulio de Oliveira, Nathan Clumeck, Gillian Hunt, Bernhard Kerschberger, Robert W Shafer, Chunfu Yang, Elliot Raizes, Rami Kantor, Ravindra K Gupta
BACKGROUND: HIV-1 drug resistance to older thymidine analogue nucleoside reverse transcriptase inhibitor drugs has been identified in sub-Saharan Africa in patients with virological failure of first-line combination antiretroviral therapy (ART) containing the modern nucleoside reverse transcriptase inhibitor tenofovir. We aimed to investigate the prevalence and correlates of thymidine analogue mutations (TAM) in patients with virological failure of first-line tenofovir-containing ART...
November 30, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27914830/dermatophagoides-pteronyssinus-changes-in-sensitisation-in-the-past-11-years-and-comparison-with-other-centres-in-mexico
#16
E M Navarrete-Rodríguez, J R Fernández-Soto, B E Del Rio-Navarro, O J Saucedo-Ramírez, J J L Sienra-Monge
BACKGROUND: House dust mites are a ubiquitous air allergen in the human habitat. It has been shown that exposure to them is a fundamental factor in sensitisation and development of atopic disease. The objective of the study was to analyse changes in sensitisation to Dermatophagoides pteronyssinus (Der p.) in children treated in a tertiary level care hospital in Mexico City for a period of 11 years and compare with other studies carried out in Mexico. METHODS: A retrospective study was performed at the Hospital Infantil de México Federico Gómez (HIMFG)...
November 30, 2016: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#17
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27914157/-prevalence-of-dental-caries-in-type-1-diabetic-patients-treated-with-insulin-pump
#18
Rosana Garcia, Ana Coelho, Anabela Paula, Manuel Marques Ferreira, Francisco Caramelo, Luísa Barros, Carla Batista, Miguel Melo, Mário Jorge Silva, Eunice Carrilho
INTRODUCTION: Type 1 diabetes mellitus and oral health are strictly related on a reciprocal basis, and an increased susceptibility to a wide variety of oral diseases is recognised in these patients. The aim of the present study was to establish a relationship between the prevalence of dental caries in Type 1 diabetic patients treated with insulin pump and that of non-diabetic patients. MATERIAL AND METHODS: An observational clinical study of analytical and cross-sectional nature was conducted...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913562/relationship-between-maternal-hypoglycaemia-and-small-for-gestational-age-infants-according-to-maternal-weight-status-a-retrospective-cohort-study-in-two-hospitals
#19
Satoshi Shinohara, Yuzo Uchida, Mitsuo Hirai, Shuji Hirata, Kohta Suzuki
OBJECTIVE: The relationship between pre-pregnancy body mass index (BMI) and low glucose challenge test (GCT) results by maternal weight status has not been examined. This study aimed to clarify the relationship between a low GCT result and small for gestational age (SGA) by maternal weight status. DESIGN: A retrospective cohort study in 2 hospitals. SETTING: This study evaluated the obstetric records of women who delivered in a general community hospital and a tertiary perinatal care centre...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27913269/the-structure-organisation-and-perioperative-management-of-ambulatory-surgery-and-anaesthesia-in-france-methodology-of-the-sfar-opera-study
#20
Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean Luc Bosson, Claude Ecoffey
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French Society of Anaesthesia and Intensive Care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation PERiopératoire de l'anesthésie en chirurgie Ambulatoire). From among all of the ambulatory surgery centres listed by the Agences Régionales de Santé [Regional Health Agencies, France], 206 public and private centres were randomly selected...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
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