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Critical Care*

H Bruce Vogt, Jennifer Tinguely, Jill Franken, Shelly Ten Napel
Community health centers (CHCs) are a critical component of the healthcare safety network. The modern era of CHCs began in the mid-1960s although their origin can be traced back as far as the first two decades of the 20th century. Over 24 million people receive their healthcare in CHCs. North and South Dakota are home to nine centers and provided care to nearly 110,000 medical and dental patients in 2017. All CHCs use a uniform data set to report annually on demographics, scope of practice, and clinical measures to assure that they remain true to their original mission to provide quality healthcare to the most vulnerable of our population...
August 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Daniel J Owens, Craig Twist, James N Cobley, Glyn Howatson, Graeme L Close
Exercise-induced muscle damage (EIMD) is characterized by symptoms that present both immediately and for up to 14 days after the initial exercise bout. The main consequence of EIMD for the athlete is the loss of skeletal muscle function and soreness. As such, numerous nutrients and functional foods have been examined for their potential to ameliorate the effects of EIMD and accelerate recovery, which is the purpose of many nutritional strategies for the athlete. However, the trade-off between recovery and adaptation is rarely considered...
August 15, 2018: European Journal of Sport Science
Desirée Mena-Tudela, Víctor Manuel González-Chordá, Agueda Cervera-Gasch, María Loreto Maciá-Soler, María Isabel Orts-Cortés
OBJECTIVES: to evaluate the effectiveness of an educational intervention on the knowledge, skills and attitudes of evidence-based practice among second-year nursing students. METHOD: a quasi-experimental before-and-after study. The study population consisted of 120 students enrolled in the Nursing Care in Healthcare Processes course. The educational intervention was based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship...
August 9, 2018: Revista Latino-americana de Enfermagem
Daniella Yamada Baragatti, Diene Monique Carlos, Maria Neto da Cruz Leitão, Maria das Graças Carvalho Ferriani, Eliete Maria Silva
OBJECTIVE: To know and analyze the critical path followed by women subjected to intimate partner violence until reaching a Reference Center of a Brazilian city, from the perspective of these women. METHOD: Qualitative research, based on the concept of critical path. Participant observations of the support group of the Reference Center and interviews with ten women in situations of violence who were followed up in this service. RESULTS: the motivating factors for women to seek help were the increase in the severity of the aggressions, the impact of the violence on their children and support from their family...
August 9, 2018: Revista Latino-americana de Enfermagem
Joel Cameron Balmer, Christopher G Pretty, Shaun Davidson, Thomas Desaive, Shun Kamoi, Antoine Pironet, Philippe Morimont, Nathalie Janssen, Bernard Lambermont, Geoffrey M Shaw, J Geoffrey Chase

 Pulse wave velocity measurements are an indicator of arterial stiffness and possible cardiovascular dysfunction. It is usually calculated by measuring the pulse transit time (PTT) over a known distance through the arteries. In animal studies, reliable PTT measures can be obtained using two pressure catheters. However, such direct, invasive methods are undesirable in clinical settings. A less invasive alternative measure of PTT is pulse arrival time (PAT), the time between the Q-wave of an electrocardiogram (ECG) and the arrival of the foot of the beats pressure waveform at one pressure catheter...
August 15, 2018: Physiological Measurement
Tim Lahm, Ivor S Douglas, Stephen L Archer, Harm J Bogaard, Naomi C Chesler, Francois Haddad, Anna R Hemnes, Steven M Kawut, Jeffrey A Kline, Todd M Kolb, Stephen C Mathai, Olaf Mercier, Evangelos D Michelakis, Robert Naeije, Rubin M Tuder, Corey E Ventetuolo, Antoine Vieillard-Baron, Norbert F Voelkel, Anton Vonk-Noordegraaf, Paul M Hassoun
BACKGROUND: Right ventricular (RV) adaptation to acute and chronic pulmonary hypertensive syndromes is a significant determinant of short- and long-term outcomes. Although remarkable progress has been made in the understanding of RV function and failure since the meeting of the NIH Working Group on Cellular and Molecular Mechanisms of Right Heart Failure in 2005, significant gaps remain at many levels in the understanding of cellular and molecular mechanisms of RV responses to pressure and volume overload, in the validation of diagnostic modalities, and in the development of evidence-based therapies...
August 15, 2018: American Journal of Respiratory and Critical Care Medicine
Andrew C McKown, Jonathan D Casey, Derek W Russell, Aaron M Joffe, David R Janz, Todd W Rice, Matthew W Semler
RATIONALE: Hypoxemia is a common complication during tracheal intubation of critically ill adults and is a frequently used endpoint in airway management research. Identifying patients likely to experience low oxygen saturations during tracheal intubation may be useful for clinical practice and clinical trials. OBJECTIVE: To identify risk factors for lower oxygen saturations and severe hypoxemia during tracheal intubation of critically ill adults and develop prediction models for lowest oxygen saturation and hypoxemia...
August 15, 2018: Annals of the American Thoracic Society
Heinz Katschnig
As a clinician, I can easily agree with the author that a person's own reality of being healthy is independent of physical evidence or clinical categories and that this perspective should be considered to improve clinical care. However, I cannot follow the assumptions about the nature and working of modern medicine and psychiatry as typically using "black box" and one-size-fits-all treatments in daily practice. I outline several working contexts of doctors where this criticism does only marginally apply or not at all and wonder whether the author might wish, if possible at all from a philosophical viewpoint, to differentiate her concepts with regard to these different contexts...
August 15, 2018: Journal of Evaluation in Clinical Practice
Jennifer W Hill, Carol F Elias
A minimum amount of energy is required for basic physiological processes, such as protein biosynthesis, thermoregulation, locomotion, cardiovascular function, and digestion. However, for reproductive function and survival of the species, extra energy stores are necessary. Production of sex hormones and gametes, pubertal development, pregnancy, lactation, and parental care all require energy reserves. Thus the physiological systems that control energy homeostasis and reproductive function coevolved in mammals to support both individual health and species subsistence...
October 1, 2018: Physiological Reviews
Mònica Castellà-Creus, Pilar DELGado-Hito, Isabel Andrés-Martínez, Maria-Eulàlia Juvé-Udina
AIM: To understand the individualization process of the standardized care plan that nurses design for hospitalized patients. BACKGROUND: To apply the nursing process, it is advisable to use standardized care plans to standardize the diagnosis, planning and assessment stages. However, the fundamental element of this methodology is the individualization of the care plan. DESIGN: A qualitative study, framed within the constructivist paradigm and applying the Grounded Theory method, in accordance with Strauss and Corbin's approach...
August 14, 2018: Journal of Advanced Nursing
Cassandra Formeck, Agnieszka Swiatecka-Urban
Atypical hemolytic uremic syndrome (aHUS) is a rare and complex disease resulting from abnormal alternative complement activation with a wide range of clinical presentations. Extra-renal manifestations of aHUS can involve many organ systems, including the peripheral and central nervous, gastrointestinal, cardiovascular, integumentary, pulmonary, as well as the eye. While some of these extra-renal manifestations occur in the acute phase of aHUS, some can also occur as long-term sequelae of unopposed complement activation...
August 14, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Sarah Armenia, Loka Thangamathesvaran, Akia D Caine, Neil King, Anastasia Kunac, Aziz M Merchant
Introduction  High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact. Methods  The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula...
July 2018: Surgery Journal
Imran Ali, Mohammad Nadeem Lone, Haasan Y Aboul-Enein
Cancer is a black spot on the face of humanity in this era of science and technology. Presently, several classes of anticancer drugs are available in the market, but issues such as toxicity, low efficacy and solubility have decreased the overall therapeutic indices. Thus, the search for new promising anticancer agents continues, and the battle against cancer is far from over. Imidazole is an aromatic diazole and alkaloid with anticancer properties. There is considerable interest among scientists in developing imidazoles as safe alternatives to anticancer chemotherapy...
September 1, 2017: MedChemComm
Amanda Baskwill
Massage therapy education programs are responsible for preparing graduates for complex professional environments, while also ensuring graduates can access the profession by passing the regulatory body's standardized certification or licensing examination. Massage therapists are regulated health care professionals in four Canadian provinces. They are autonomous practitioners and an integral part of the health care regime for patients with complicated health presentations. As such, they must think critically about patients' presentations and determine the most appropriate care...
August 2018: International Journal of Therapeutic Massage & Bodywork
Francesco Chiappelli, Nicole Balenton, Allen Khakshooy
Novel developments in bioinformation, bioinformatics and biostatistics, including artificial intelligence (AI), play a timely and critical role in translational care. Case in point, the extent to which viral immune surveillance is regulated by immune cells and soluble factors, and by non-immune factors informs the administration of health care. The events by which health is regained following viral infection is an allostatic process, which can be modeled using Hilbert's and Volterra's mathematical biology criteria, and biostatistical methodologies such as linear multiple regression...
2018: Bioinformation
Camille Maringe, Bernard Rachet, Georgios Lyratzopoulos, Francisco Javier Rubio
BACKGROUND: Reducing hospital emergency admissions is a key target for all modern health systems. METHODS: We analysed colon cancer patients diagnosed in 2011-13 in England. We screened their individual Hospital Episode Statistics records in the 90 days pre-diagnosis, the 90 days post-diagnosis, and the 90 days pre-death (in the year following diagnosis), for the occurrence of hospital emergency admissions (HEAs). RESULTS: Between a quarter and two thirds of patients experience HEA in the three 90-day periods examined: pre-diagnosis, post-diagnosis and before death...
August 15, 2018: British Journal of Cancer
Lucia De Martino, Nadya Yousef, Rafik Ben-Ammar, Francesco Raimondi, Shivani Shankar-Aguilera, Daniele De Luca
BACKGROUND AND OBJECTIVES: There are several lung ultrasound scores (LUS) for evaluating lung aeration in critically ill adults with restrictive lung disorders. A modified LUS adapted for neonates correlates well with oxygenation and is able to be used to predict the need for surfactant in preterm neonates with respiratory distress syndrome (RDS). However, no data are available for extremely preterm neonates for whom timely surfactant administration is especially important. We hypothesized that LUS might be reliable in extremely preterm neonates with RDS who are treated with continuous positive airway pressure...
August 14, 2018: Pediatrics
Sally S Chan, Thomas H Gindling, Nancy A Miller
PURPOSE: This study examined the impact of the 2010 Affordable Care Act's dependent coverage provision on gaps in insurance coverage for young adults with special healthcare needs (YASHCN). METHODS: We used the 2008 Survey on Income and Program Participation, a longitudinal survey covering 2008-2013. Our sample was comprised of 3,316 YASHCN ages 19-29. We used a difference-in-difference regression approach to assess the effect of the dependent coverage provision on the probability that a YASHCN experienced a gap in insurance coverage...
August 11, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Britton D Rink, Jeffrey A Kuller
Prenatal care providers are faced with a myriad of decisions about how to offer genetic screening and testing in ways that are appropriate to their patient population and their workflow. Among the critical issues brought to the forefront of rapidly advancing genetic and genomic technologies is the importance of pre- and post-test counseling. This document is a synthesis of proceedings of a workshop sponsored by the American College of Obstetricians and Gynecologists, the American College of Medical Genetics and Genomics, and the Society for Maternal-Fetal Medicine, on January 24-25, 2017, during which invited experts discussed required components of pre- and post-test counseling and associated concerns in the provision of prenatal care...
July 26, 2018: Seminars in Perinatology
Kathy Goggin, Emily A Hurley, Jolly Beyeza-Kashesya, Violet Gwokyalya, Sarah Finocchario-Kessler, Josephine Birungi, Deborah Mindry, Rhoda K Wanyenze, Glenn J Wagner
BACKGROUND: About 40% of HIV-positive women in sub-Saharan Africa become pregnant post-diagnosis. Despite about half of their pregnancies being planned, safer conception methods (SCM) are underutilized among serodiscordant couples, partially due to the fact that safer conception counseling (SCC) has not been integrated into routine HIV family planning (FP) services. METHODS: Our Choice is a comprehensive FP intervention that promotes unbiased childbearing consultations to ensure clients receive SCC or contraception services to achieve their desired reproductive goals...
August 14, 2018: Implementation Science: IS
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