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Global Emergency Care

Dawna L Cato, John R Bowles, Veronica Carmack, Fuyang Liu, Mary T McFadden
As global leaders, US nurses will have an increasingly recognized role and responsibility in shaping health care in all countries. They should be at the forefront of changing and improving health systems to achieve universal health. Currently, a major health care reform is underway that requires a shift in the professional nursing footprint of China's nurse leaders. These leaders must garner knowledge capital to reinforce ethics, regulations, and standards; use current best practices; implement a comprehensive performance evaluation process; and capture the spirit of caring within their health care environments...
January 2019: Nursing Administration Quarterly
Elizabeth Adams
In many Western democracies, nursing consumes a comparatively large proportion of the health service budget and delivers the highest proportion of direct patient care. Therefore, identifying and representing the contribution of nurses to clinical effectiveness as well as the wider social benefit to populations and the economy is crucial. Predictive models on health and social care requirements for the next quarter of a century report a staggering shift in population age, multimorbidity, and complexity of need...
January 2019: Nursing Administration Quarterly
April D Kimmel, Rose S Bono, Olivia Keiser, Jean D Sinayobye, Janne Estill, Deo Mujwara, Olga Tymejczyk, Denis Nash
Objective: Despite widespread uptake, only half of sub-Saharan African countries have fully implemented the World Health Organization's 'treat all' policy, hindering achievement of global HIV targets. We examined literature on mathematical modelling studies that sought to inform scale-up and implementation of 'treat all' in sub-Saharan Africa. Methods: We conducted a scoping review, a research synthesis to assess emerging evidence and identify gaps, of peer-reviewed literature, extracting study characteristics on 'treat all' policies and assumptions, setting, key populations, outcomes and findings...
November 15, 2018: Journal of Virus Eradication
Corrine W Ruktanonchai, Kristine Nilsen, Victor A Alegana, Claudio Bosco, Rogers Ayiko, Andrew C Seven Kajeguka, Zöe Matthews, Andrew J Tatem
BACKGROUND: Sub-Saharan Africa continues to account for the highest regional maternal mortality ratio (MMR) in the world, at just under 550 maternal deaths per 100,000 live births in 2015, compared to a global rate of 216 deaths. Spatial inequalities in access to life-saving maternal and newborn health (MNH) services persist within sub-Saharan Africa, however, with varied improvement over the past two decades. While previous research within the East African Community (EAC) region has examined utilisation of MNH care as an emergent property of geographic accessibility, no research has examined how these spatial inequalities have evolved over time at similar spatial scales...
December 4, 2018: BMC Public Health
Martin G Seneviratne, Selen Bozkurt, Manali I Patel, Tina Seto, James D Brooks, Douglas W Blayney, Allison W Kurian, Tina Hernandez-Boussard
BACKGROUND: The collection of patient-reported outcomes (PROs) is an emerging priority internationally, guiding clinical care, quality improvement projects and research studies. After the deployment of Patient-Reported Outcomes Measurement Information System (PROMIS) surveys in routine outpatient workflows at an academic cancer center, electronic health record data were used to evaluate survey completion rates and self-reported global health measures across 2 tumor types: breast and prostate cancer...
December 4, 2018: Cancer
Patrick Magrath, Nyasha Maforo, Pierangelo Renella, Stanley F Nelson, Nancy Halnon, Daniel B Ennis
Duchenne muscular dystrophy (DMD) is a fatal inherited genetic disorder that results in progressive muscle weakness and ultimately loss of ambulation, respiratory failure and heart failure. Cardiac MRI (MRI) plays an increasingly important role in the diagnosis and clinical care of boys with DMD and associated cardiomyopathies. Conventional cardiac MRI biomarkers permit measurements of global cardiac function and presence of fibrosis, but changes in these measures are late manifestations. Emerging MRI biomarkers of myocardial function and structure include the estimation of rotational mechanics and regional strain using MRI tagging; T1-mapping; and T2-mapping, a marker of inflammation, edema and fat...
November 30, 2018: Biomarkers in Medicine
Ahsan Saleem, Kathryn J Steadman, Jasmina Fejzic
Migration, as a global phenomenon, gives rise to many challenges for healthcare professionals providing care to migrant populations. Migrants originating from diverse cultural backgrounds have unique beliefs and healthcare needs, and their utilisation of healthcare services and medicines is influenced by a number of factors. This review aims to assess the factors influencing the utilisation of healthcare services and medicines among Pakistani migrants residing in high income countries. The databases searched included PubMed/Medline, Scopus, EMBASE, Web of Science, CINAHL, and IPA...
November 29, 2018: Journal of Immigrant and Minority Health
Sukanya Sudhaharan, Padmaja Kanne, Lakshmi Vemu, Aparna Bhaskara
BACKGROUND: Infection with Salmonella has become an increasing problem worldwide. Recently, nontyphoid Salmonella (NTS) has become a global concern causing threat to the health of human. It causes gastrointestinal infection which may be self-limiting, but invasive infections may be fatal, requiring appropriate therapy. This study was done to analyze the spectrum of NTS infections causing extraintestinal infections and its susceptibility pattern from a tertiary care center in India. MATERIALS AND METHODS: The medical records of 27 patients whose cultures were positive for NTS between the years 2013-2016 were included in this retrospective study...
October 2018: Journal of Laboratory Physicians
Thomas Jensen, Amanda Wieland, Melanie Cree-Green, Kristen Nadeau, Shelby Sullivan
Nonalcoholic fatty liver disease (NAFLD) is quickly emerging as a global epidemic in parallel with the rise in obesity and the Metabolic Syndrome. NAFLD, once seen simply as a passive consequence of the Metabolic Syndrome (MetS), has been found to interact with other features of MetS to exacerbate insulin resistance, diabetes, and cardiovascular disease. NAFLD is also becoming the top indication for liver transplant and an important risk factor for hepatocellular carcinoma. Treatment of this disorder is limited mainly to lifestyle modifications to promote weight loss along with consideration for off-label use of certain medications, but recent progression in clinical trials means more effective treatments are on the horizon...
November 29, 2018: Postgraduate Medicine
Wai-Kay Seto, Ying-Ru Lo, Jean-Michel Pawlotsky, Man-Fung Yuen
Chronic hepatitis B virus infection is a global public health threat that causes considerable liver-related morbidity and mortality. It is acquired at birth or later via person-to-person transmission. Vaccination effectively prevents infection and chronic hepatitis B virus carriage. In chronically infected patients, an elevated serum hepatitis B virus DNA concentration is the main risk factor for disease progression, although there are other clinical and viral parameters that influence disease outcomes. In addition to liver biochemistry, virological markers, and abdominal ultrasonography, non-invasive assessment of liver fibrosis is emerging as an important assessment modality...
November 24, 2018: Lancet
Bianca Lauria-Horner, Tara Beaulieu, Stephanie Knaak, Rivian Weinerman, Helen Campbell, Scott Patten
BACKGROUND: Depression affects over 400 million people globally. The majority are seen in primary care. Barriers in providing adequate care are not solely related to physicians' knowledge/skills deficits, but also time constraints, lack of confidence/avoidance, which need to be addressed in mental health-care redesign. We hypothesized that family physician (FP) training in the Adult Mental Health Practice Support Program (AMHPSP) would lead to greater improvements in patient depressive symptom ratings (a priori primary outcome) compared to treatment as usual...
November 28, 2018: BMC Family Practice
Monica Pedrazza, Sabrina Berlanda, Federica De Cordova, Marta Fraizzoli
In this paper, we are going to address job satisfaction and perceived self-efficacy withinthe context of residential child-care. A joint report from the European Foundation for the Improvement on Living and Working Conditions and the European Agency for Safety and Health at Work revealed that managers in the field of health and education were the most concerned about the psychosocial risk of their employees, although concern is not automatically translated into tools to face the risk and to manage it. So, measuring and improving employees' job satisfaction and self-efficacy can be an important means for organizations to prevent the outcomes of psychosocial risk, and supporting high quality performance of workers...
2018: Frontiers in Psychology
Xin Wang, Xizhuo Sun, Fangfang Gong, Yixiang Huang, Lijin Chen, Yong Zhang, Stephen Birch
Introduction: Emerging from the epidemiological transition and accelerated aging process, China's fragmentated healthcare systems struggle to meet the demands of the population. On Sept 1st 2017, China's National Health and Family Planning Commission encouraged all cities to learn from the Luohu model of integration adopted in Luohu as an approach to meeting these challenges. In this paper, we study the integration process, analyze the core mechanisms, and conduct preliminary evaluations of integrated policy development in the Luohu model...
October 12, 2018: International Journal of Integrated Care
Benjamin Y Urick, Stefanie P Ferreri, Charles Shasky, Trista Pfeiffenberger, Troy Trygstad, Joel F Farley
INTRODUCTION: As value-based and alternative payment models proliferate, there is growing interest in measuring pharmacy performance. However, little research has explored the development and implementation of systems to measure pharmacy performance. Additionally, systems that currently exist rely on process and surrogate outcome measures that are not always relevant to patients and payers. PROGRAM DESCRIPTION: This article describes the process used to design and implement a performance measurement program for a group of enhanced services pharmacies in North Carolina...
December 2018: Journal of Managed Care & Specialty Pharmacy
Ian Howard, Bernard Pillay, Nicholas Castle, Loua Al Shaikh, Robert Owen, David Williams
BACKGROUND: Emergency Care has previously been identified as an area of significant concern regarding the prevalence of Adverse Events (AEs). However, the majority of this focus has been on the in-hospital setting, with little understanding of the identification and incidence of AEs in the prehospital environment. METHOD: The early development and testing of Emergency Medical Services (EMS) specific triggers for the identification of AEs and Harm has been previously described...
November 26, 2018: BMC Emergency Medicine
Rajesh Meena, Alok Hemal, Shilpa Khanna Arora
Background: With improving standards of care of children living with HIV (CLHIV), pediatric HIV related mortality rates are declining. New challenges like HIV status disclosure are emerging which need to be addressed to ensure their smooth transition into adulthood. Poor disease disclosure rates are observed in CLHIV globally. Aims: This study was done to assess the prevalence of HIV disclosure in North Indian CLHIV, know the perceptions of caregivers regarding disclosure, and evaluate the impact of disclosure on CLHIV...
2018: AIDS Research and Treatment
Becky Inkster, Shubhankar Sarda, Vinod Subramanian
BACKGROUND: A World Health Organization 2017 report stated that major depression affects almost 5% of the human population. Major depression is associated with impaired psychosocial functioning and reduced quality of life. Challenges such as shortage of mental health personnel, long waiting times, perceived stigma, and lower government spends pose barriers to the alleviation of mental health problems. Face-to-face psychotherapy alone provides only point-in-time support and cannot scale quickly enough to address this growing global public health challenge...
November 23, 2018: JMIR MHealth and UHealth
Alexander P Underwood, Melanie R Walker, Nicholas A Brasher, Auda A Eltahla, Lisa Maher, Fabio Luciani, Andrew R Lloyd, Rowena A Bull
Despite recent advances in curative therapy, hepatitis C virus (HCV) still remains a global threat. In order to achieve global elimination, a prophylactic vaccine should be considered high priority. Previous immunogens used to induce broad neutralising antibodies (BnAbs) have been met with limited success. To improve immunogen design, factors associated with the early development of BnAbs in natural infection must first be understood. In this study, 43 subjects identified with acute HCV were analysed longitudinally using a panel of heterogeneous HCV pseudoparticles (HCVpp), to understand the emergence of BnAbs...
November 21, 2018: Viruses
Tyson Schwab, John Langell
BACKGROUND: The rapid adoption of smartphones and software applications (apps) has become prevalent worldwide, making these technologies nearly universally available. Low-cost mobile health (M-health) platforms are being rapidly adopted in both developed and emerging markets and have transformed the health care delivery landscape. Human factors optimization is critical to the safe and sustainable adoption of M-health solutions. The overall goal of engaging human factors requirements in the software app design process is to decrease patient safety risks while increasing usability and productivity for the end user...
November 22, 2018: Surgical Innovation
Elizabeth Lumley, Patrick Phillips, Ahmed Aber, Helen Buckley-Woods, Georgina L Jones, Jonathan A Michaels
AIM: To identify the symptoms and quality of life impacts that are important from the perspective of patients with varicose veins, and to compare identified themes to items in varicose vein Patient Reported Outcome Measures (PROMs). BACKGROUND: Varicose veins are common worldwide, and are considered a chronic condition with implications for quality of life. Treatment is predominantly conservative, therefore understanding patients' experiences' of living with varicose veins is important to inform the provision of clinical care...
November 21, 2018: Journal of Clinical Nursing
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