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Guidelines critical care

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https://www.readbyqxmd.com/read/28917629/decision-making-about-healthcare-related-tests-and-diagnostic-strategies-a-qualitative-study-with-experts-suggests-that-test-accuracy-data-alone-is-rarely-sufficient-for-decision-making
#1
Reem A Mustafa, Wojtek Wiercioch, Matthew Ventresca, Jan Brozek, Holger J Schünemann
OBJECTIVE: To identify the critical factors that determine recommendations and other decisions about health care related tests and diagnostic strategies (HCTDS). METHODS: We used a qualitative descriptive approach and conducted semi-structured in-depth interviews with 24 international experts (informants) in evidence and decisions about HCTDS. RESULTS: Although test accuracy (TA) was the factor most commonly considered by organizations when developing recommendations about HCTDS, informants agreed that TA is necessary but rarely, if ever, sufficient and may be misleading when solely considered...
September 13, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28917176/health-based-ingestion-exposure-guidelines-for-vibrio-cholerae-technical-basis-for-water-reuse-applications
#2
Annetta P Watson, Anthony Q Armstrong, George H White, Brandolyn H Thran
U.S. military and allied contingency operations are increasingly occurring in locations with limited, unstable or compromised fresh water supplies. Non-potable graywater reuse is currently under assessment as a viable means to increase mission sustainability while significantly reducing the resources, logistics and attack vulnerabilities posed by transport of fresh water. Development of health-based (non-potable) exposure guidelines for the potential microbial components of graywater would provide a logical and consistent human-health basis for water reuse strategies...
September 13, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28916353/outcomes-of-adults-with-in-hospital-cardiac-arrest-after-implementation-of-the-2010-resuscitation-guidelines
#3
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen
BACKGROUND: The 2015 guidelines for cardiopulmonary resuscitation (CPR) are based on an update of the 2010 guidelines with minor revisions. It is important to assess the 2010 guidelines to ensure their efficacy, which may help promote widespread adoption of the 2015 guidelines. METHODS: We conducted a retrospective observational study in a single center that evaluated patients with in-hospital cardiac arrest (IHCA) between 2006 and 2014. Multivariable logistic regression analysis was used to evaluate associations between independent variables and outcomes...
September 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28916246/pre-clinical-toxicology-considerations-for-vaccine-development
#4
REVIEW
Nabil Al-Humadi
Vaccine development requires pre-clinical toxicology studies, following good laboratory practice (GLP), before first in human (phase I) use. Many factors are critical in the final outcome of any pre-clinical toxicology study. The study design is one of these critical factors and should be carefully planned to avoid any false negative and/or false positive results. Preparation is another most critical factor in a successful study. Major changes in any procedure during the course of study should be avoided by all means...
September 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28916013/the-emergency-department-challenges-and-opportunities-for-suicide-prevention
#5
REVIEW
Joan Rosenbaum Asarnow, Kalina Babeva, Elizabeth Horstmann
Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28914279/blood-products-provided-to-patients-receiving-futile-critical-care
#6
Thanh H Neville, Alyssa Ziman, Neil S Wenger
The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#7
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28912836/methods-for-enhancing-the-reproducibility-of-biomedical-research-findings-using-electronic-health-records
#8
REVIEW
Spiros Denaxas, Kenan Direk, Arturo Gonzalez-Izquierdo, Maria Pikoula, Aylin Cakiroglu, Jason Moore, Harry Hemingway, Liam Smeeth
BACKGROUND: The ability of external investigators to reproduce published scientific findings is critical for the evaluation and validation of biomedical research by the wider community. However, a substantial proportion of health research using electronic health records (EHR), data collected and generated during clinical care, is potentially not reproducible mainly due to the fact that the implementation details of most data preprocessing, cleaning, phenotyping and analysis approaches are not systematically made available or shared...
2017: BioData Mining
https://www.readbyqxmd.com/read/28901343/-italian-guidelines-in-accordance-with-the-new-national-guidelines-system-critical-issues-and-perspectives
#9
Primiano Iannone, Daniela Coclite, Giuseppe Graziano, Antonello Mario Napoletano
Law No. 24/2017 on professional responsibility has assigned a fundamental role to the guidelines, giving the Istituto Superiore di Sanità, through the new Centro Nazionale per l'Eccellenza Clinica, la Qualità e la Sicurezza delle Cure (CNEC), the role of methodological guarantor and of national governance of the guidelines production process. In a scenario marked by the increasing use of defensive medicine, the adherence to guidelines recognized as reliable by an institutional body can lead to the desired reduction of the malpractice claim, as well as to considerable clinical advantages, with the improvement of the quality of healthcare and of health outcomes and the reduction of unjustified variability of clinical practices in the national territory...
September 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28899842/identifying-which-urban-children-with-asthma-benefit-most-from-clinician-prompting-sub-analyses-from-the-pair-up-trial
#10
Nicolas P N Goldstein, Sean M Frey, Maria Fagnano, Sande O Okelo, Jill S Halterman
OBJECTIVE: Clinician prompts increase the likelihood of guideline-recommended corrective actions (preventive medication prescription, dose change, and/or adherence promotion) for symptomatic children with poorly controlled or persistent asthma in the primary care setting, but it is unclear if all children benefit equally. The objectives of this study were to identify whether asthma severity, visit type, and current preventive medication use were predictive of corrective actions during visits for children with symptomatic asthma, and determine whether these factors modified the impact of a prompting intervention...
September 9, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28894480/patient-participation-in-ers-guidelines-and-research-projects-the-embarc-experience
#11
REVIEW
James D Chalmers, Alan Timothy, Eva Polverino, Marta Almagro, Thomas Ruddy, Pippa Powell, Jeanette Boyd
The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration dedicated to improving research and clinical care for people with bronchiectasis. EMBARC has created a European Bronchiectasis Registry, funded by the ERS and by the European Union (EU) Innovative Medicines Initiative Programme. From the outset, EMBARC had the ambition to be a patient-focussed project. In contrast to many respiratory diseases, however, there are no specific patient charities or European patient organisations for patients with bronchiectasis and no existing infrastructure for patient engagement...
September 2017: Breathe
https://www.readbyqxmd.com/read/28893726/a-web-based-lifestyle-medicine-curriculum-facilitating-education-about-lifestyle-medicine-behavioral-change-and-health-care-outcomes
#12
Elizabeth Pegg Frates, Ryan C Xiao, Deepa Sannidhi, Yasamina McBride, Tracie McCargo, Theodore A Stern
BACKGROUND: Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors...
September 11, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28886738/gaps-in-care-for-patients-with-memory-deficits-after-stroke-views-of-healthcare-providers
#13
Eugene Yee Hing Tang, Christopher Price, Blossom Christa Maree Stephan, Louise Robinson, Catherine Exley
BACKGROUND: Stroke is a common cause of physical disability but is also strongly associated with cognitive impairment and a risk for future dementia. Despite national clinical guidelines, the service provided for stroke survivors with cognitive and memory difficulties varies across localities. This study critically evaluated the views of healthcare professionals about barriers and facilitators to their care. METHODS: Seventeen semi-structured individual interviews were conducted by a single interviewer with both primary and secondary care clinicians in regular contact with stroke-survivors...
September 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28885922/management-of-acute-diarrheal-illness-during-deployment-a-deployment-health-guideline-and-expert-panel-report
#14
Mark S Riddle, Gregory J Martin, Clinton K Murray, Timothy H Burgess, Patrick Connor, James D Mancuso, Elizabeth R Schnaubelt, Timothy P Ballard, Jamie Fraser, David R Tribble
BACKGROUND: Acute diarrheal illness during deployment causes significant morbidity and loss of duty days. Effective and timely treatment is needed to reduce individual, unit, and health system performance impacts. METHODS: This critical appraisal of the literature, as part of the development of expert consensus guidelines, asked several key questions related to self-care and healthcare-seeking behavior, antibiotics for self-treatment of travelers' diarrhea, what antibiotics/regimens should be considered for treatment of acute watery diarrhea and febrile diarrhea and/or dysentery, and when and what laboratory diagnostics should be used to support management of deployment-related travelers' diarrhea...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885765/reducing-hospital-acquired-pressure-ulcers-using-bundle-methodology-in-pediatric-and-neonatal-patients-receiving-extracorporeal-membrane-oxygenation-therapy-an-integrative-review-and-call-to-action
#15
Suzanne E Courtwright, Kari A Mastro, Christa Preuster, Navid Dardashti, Sandra McGill, Myrlene Madelon, Donna Johnson
PURPOSE: This review focuses on identifying (1) evidence of the effectiveness of care bundle methodology to reduce hospital-acquired pressure ulcers (HAPUs) in pediatric and neonatal patients receiving extracorporeal membrane oxygenation (ECMO) therapy and (2) barriers to implementing HAPU care bundles in this at-risk population. DESIGN AND METHODS: An integrative review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
September 8, 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/28885390/epidemiology-of-admissions-from-the-emergency-department-among-febrile-infants-younger-than-90-days-in-the-united-states-2002-to-2012
#16
Diana K Nguyen, Ross J Fleischman, Scott Friedlander, Kenneth M Zangwill
BACKGROUND AND OBJECTIVES: Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. Our objective was to determine the likelihood of admission and associated complications of care for such infants, particularly those at lowest risk for SBI. METHODS: This is a retrospective cohort study including multisite emergency department (ED) visits using administrative data from the Pediatric Emergency Care Applied Research Network Core Data Project...
September 5, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28877109/the-efficacy-of-a-viscoelastic-foam-overlay-on-prevention-of-pressure-injury-in-acutely-ill-patients-a-prospective-randomized-controlled-trial
#17
Kyung Hee Park, Joohee Park
PURPOSE: The purpose of this study was to compare a viscoelastic foam overlay (VEFO) to a standard hospital mattress for pressure injury (PI) prevention. We also compared interface pressures (IPs) of the VEFO to our facility's standard hospital mattress. DESIGN: Prospective, randomized controlled trial. SUBJECTS AND SETTING: Data analysis was based on 110 participants (55 in each group) who were 19 years or older, had a Braden Scale for Pressure Sore Risk score of 16 or less, and were cared for on a neurology, oncology, or pulmonology inpatient care unit...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28877095/hip-surveillance-for-children-with-cerebral-palsy-a-survey-of-the-posna-membership
#18
Benjamin J Shore, Michael W Shrader, Unni Narayanan, Freeman Miller, H Kerr Graham, Kishore Mulpuri
BACKGROUND: Currently, hip surveillance programs for children with cerebral palsy exist in Europe, Australasia, and parts of Canada, but a neuromuscular hip surveillance program has yet to be adopted in the United States. The purpose of this study was to report the current orthopaedic practice of hip surveillance in children with cerebral palsy, identify areas of practice variation, and suggest steps moving forward to generate guidelines for national neuromuscular hip surveillance. METHODS: The entire membership of the Pediatric Orthopaedic Society of North America (POSNA) was surveyed in 2016 for information regarding their practice for hip surveillance in children with cerebral palsy...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28874610/the-2017-global-initiative-for-chronic-obstructive-lung-disease-report-and-practice-implications-for-the-respiratory-therapist
#19
Michael W Hess
Since 1998, the Global Initiative for Obstructive Lung Disease (GOLD) has worked with health care professionals, medical researchers, and public health officials around the world to optimize the prevention, treatment, and management of COPD. GOLD has continually worked to ensure COPD management strategy recommendations are aligned with current published research. The 2017 GOLD report represents a major revision to GOLD strategy guidelines, the first such major revision in the last 5 years. As such, the 2017 report has significant implications for the diagnosis of COPD, the management of stable disease, and the treatment of exacerbations...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28870776/consensus-report-by-palisi-and-pbmtc-joint-working-committees-supportive-care-guidelines-for-management-of-vod-in-children-and-adolescents-part-3-focus-on-cardio-respiratory-dysfunction-infections-liver-dysfunction-and-delirium
#20
Nadia Ovchinsky, Warren Frazier, Jeffery J Auletta, Christopher C Dvorak, Monica Ardura, Enkyung Song, Jennifer McArthur, Asumthia Jeyapalan, Robert Tamburro, Kris M Mahadeo, Chani Traube, Christine N Duncan, Rajinder P S Bajwa
Some patients with veno-occlusive disease (VOD) have multi-organ dysfunction (MOD) and multiple teams are involved in their daily care in the pediatric intensive care units (PICU). Cardio-respiratory dysfunction is critical in these patients as it needs immediate action. Whether to use non-invasive or invasive ventilation strategy may be a difficult decision in the setting of mucositis or other comorbidities in patients with VOD. Similarly monitoring of their organ functions could be very challenging; they may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections...
September 1, 2017: Biology of Blood and Marrow Transplantation
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