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https://www.readbyqxmd.com/read/27914303/a-necessary-evil-residential-placement-of-people-with-intellectual-disability-among-the-palestinian-minority-in-israel
#1
Kareem Nasser, Dalia Sachs, Amalia Sa'ar
Among the Palestinian minority in Israel, residential placement of people with intellectual disabilities [ID] is relatively new and steadily increasing, but poorly studied. A qualitative design was used to explore the process of residential placement decision by 18 parents of people with ID through semi-structured interviews. Sampling was purposive and data was analyzed thematically. Four main themes emerged representing parents' perceptions and experiences along the placement decision-making process, together indicating an experience of deeply 'conflicted parenting': (a) initial resistance to placement and its perception as abandonment and parental failure; (b) attrition following cumulative difficulties and lack of assistance; (c) resignation and reframing of placement as a necessary evil; (d) relief mixed with guilt, pain, and ambivalence following placement...
November 30, 2016: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/27913657/cost-benefit-analysis-of-telehealth-in-pre-hospital-care
#2
James R Langabeer, Tiffany Champagne-Langabeer, Diaa Alqusairi, Junghyun Kim, Adria Jackson, David Persse, Michael Gonzalez
OBJECTIVE: There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. METHODS: Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention...
December 2, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27913561/hospitals-and-patients-working-in-unity-how-r-u-protocol-for-a-prospective-feasibility-study-of-telephone-peer-support-to-improve-older-patients-quality-of-life-after-emergency-department-discharge
#3
Judy A Lowthian, Alyse Lennox, Andrea Curtis, Jeremy Dale, Colette Browning, De Villiers Smit, Gillian Wilson, Debra O'Brien, Cate Rosewarne, Lee Boyd, Cath Garner, Peter Cameron
INTRODUCTION: Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27913245/contextual-computing-a-bluetooth-based-approach-for-tracking-healthcare-providers-in-the-emergency-room
#4
Joshua Frisby, Vernon Smith, Stephen Traub, Vimla L Patel
Hospital Emergency Departments (EDs) frequently experience crowding. One of the factors that contributes to this crowding is the "door to doctor time", which is the time from a patient's registration to when the patient is first seen by a physician. This is also one of the Meaningful Use (MU) performance measures that emergency departments report to the Center for Medicare and Medicaid Services (CMS). Current documentation methods for this measure are inaccurate due to the imprecision in manual data collection...
November 29, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27913106/innovations-in-radiotherapy-technology
#5
I J Feain, L Court, J R Palta, S Beddar, P Keall
Many low- and middle-income countries, together with remote and low socioeconomic populations within high-income countries, lack the resources and services to deal with cancer. The challenges in upgrading or introducing the necessary services are enormous, from screening and diagnosis to radiotherapy planning/treatment and quality assurance. There are severe shortages not only in equipment, but also in the capacity to train, recruit and retain staff as well as in their ongoing professional development via effective international peer-review and collaboration...
November 29, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27913054/development-of-a-multi-stakeholder-partnership-to-improve-access-to-and-delivery-of-neurosurgical-services-in-ontario
#6
Sunjay Sharma, Des Bohn, Iphigenia Mikroyiannakis, Joslyn Trowbridge, Donna Thompson, Robert Bell, James Rutka
Neurosurgical emergencies require expedient access to definitive care at neurosurgical centers. Neurosurgical resources in province of Ontario are highly centralized, and subsequently, most patients with neurosurgical emergencies will present to non-neurosurgical centers. From 2000-2010, metrics demonstrated the organization of neurosurgical resources might not be optimal. In response to this a program entitled Provincial Neurosurgery Ontario (PNO)- was formed to address these issues in cooperation with neurosurgeons, hospitals and the provincial government...
November 22, 2016: Health Policy
https://www.readbyqxmd.com/read/27912895/risk-management-abilities-in-multimodal-maritime-supply-chains-visibility-and-control-perspectives
#7
Jyri Vilko, Paavo Ritala, Jukka Hallikas
Supply chain complexity and disintegration lead to increased uncertainty from a stakeholders' perspective, which is emerging as one of the major challenges of risk management. The ability to identify risks has weakened, as the responsibility of supply chain risk management is handed over to outside service providers. Regardless, the risks, their visibility and their impact depend on the position of the companies in the supply chain. The actors in the chain must therefore collaborate to create effective risk management conditions...
November 29, 2016: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/27912778/medical-priority-dispatch-codes-comparison-with-national-early-warning-score
#8
Marko Hoikka, Sami Länkimäki, Tom Silfvast, Tero I Ala-Kokko
BACKGROUND: In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories-from A (highest risk) to D (lowest risk)-following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient's condition assessed by emergency medical services on the scene using an early warning risk assessment tool...
December 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27911959/barriers-to-timely-and-safe-blood-transfusion-for-pph-patients-evidence-from-a-qualitative-study-in-dhaka-bangladesh
#9
Sadika Akhter, Iqbal Anwar, Rashida Akter, Feroza Akhter Kumkum, Monjura Khatun Nisha, Fatema Ashraf, Ferdousi Islam, Nazneen Begum, Mahbub Elahi Chowdhury, Anne Austin, Syed Shariful Islam, Aminur Rahman
BACKGROUND AND OBJECTIVES: In Bangladesh, postpartum hemorrhage (PPH) is the leading cause of maternal mortality accounting for 31% of all blood transfusions in the country. Although safe blood transfusion is one of the 8 signal functions of Comprehensive Emergency Obstetric Care (CEmOC) strategy, most of the designated public sector CEmOC facilities do not have on-site blood storage system. Emergent blood is mainly available from external blood banks. As a result, emergent patients are to rely on an unregulated network of brokers for blood which may raise question about blood safety...
2016: PloS One
https://www.readbyqxmd.com/read/27911891/severe-carbamazepine-intoxication-in-children-analysis-of-a-40-case-series
#10
Mehmet Acikgoz, M Sukru Paksu, Ahmet Guzel, Abdurrahman Alacam, Fatma Alacam
BACKGROUND We compared the factors that might impact the severity and the prognosis of carbamazepine (CBZ) intoxication in children, as well as the efficacy levels of the treatment options. MATERIAL AND METHODS Demographic information and clinical and laboratory findings for 40 patients were evaluated retrospectively. Predictive parameters for the development of serious complications were studied. RESULTS Median age of patients was 14 years; 65% of the patients were female. The most common pathological clinical finding and laboratory abnormality were inability to awaken the patient and hyperglycemia (45% and 60%, respectively)...
December 2, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27911770/the-right-incentives-enable-ocean-sustainability-successes-and-provide-hope-for-the-future
#11
Jane Lubchenco, Elizabeth B Cerny-Chipman, Jessica N Reimer, Simon A Levin
Healthy ocean ecosystems are needed to sustain people and livelihoods and to achieve the United Nations Sustainable Development Goals. Using the ocean sustainably requires overcoming many formidable challenges: overfishing, climate change, ocean acidification, and pollution. Despite gloomy forecasts, there is reason for hope. New tools, practices, and partnerships are beginning to transform local fisheries, biodiversity conservation, and marine spatial planning. The challenge is to bring them to a global scale...
December 2, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27911667/barriers-and-benefits-in-telemedicine-arising-between-a-high-technology-hospital-service-provider-and-remote-public-healthcare-units-a-qualitative-study-in-brazil
#12
Carlos Henrique Amaral de Souza, Renata Albaladejo Morbeck, Milton Steinman, Cora Pereira Hors, Mario Maia Bracco, Elisa H Kozasa, Eliseth Ribeiro Leão
BACKGROUND: In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. MATERIALS AND METHODS: We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants...
December 2, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#13
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27909851/brief-report-knowledge-and-confidence-of-emergency-medical-service-personnel-involving-treatment-of-an-individual-with-autism-spectrum-disorder
#14
David Wachob, Louis J Pesci
In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD...
December 1, 2016: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/27909850/a-rural-urban-comparison-in-emergency-department-visits-for-u-s-children-with-autism-spectrum-disorder
#15
Wanqing Zhang, Ashley E Mason, Brian Boyd, Linmarie Sikich, Grace Baranek
We examined rural-urban differences in emergency department visits, and child and clinical characteristics associated with visits for U.S. children aged 3-17 years with autism spectrum disorder (ASD). Rural children with ASD were twice more likely to have emergency department visits in urban hospitals than rural children without ASD. The children with ASD in rural areas were economically disadvantaged and concentrated in the South and Midwest regions. Rural children diagnosed with ASD and multiple comorbidities during emergency department visits were 1...
December 1, 2016: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/27909849/monitoring-contaminants-of-emerging-concern-from-tertiary-wastewater-treatment-plants-using-passive-sampling-modelled-with-performance-reference-compounds
#16
Tamanna Sultana, Craig Murray, M Ehsanul Hoque, Chris D Metcalfe
The Lake Simcoe watershed in Ontario, Canada is an important recreational area and a recharge zone for groundwater resources. Lake Simcoe is a relatively shallow lotic system that has been impacted by urban development, recreation, industry and agriculture. As part of a watershed management plan, six wastewater treatment plants (WWTPs) located in this catchment basin were selected to measure the inputs of contaminants of emerging concern (CECs) of wastewater origin. These WWTPs were recently upgraded to tertiary treatment for phosphorus removal...
December 2016: Environmental Monitoring and Assessment
https://www.readbyqxmd.com/read/27909374/cardiorespiratory-physiotherapy-around-the-clock-experience-at-a-university-hospital
#17
Marianne Devroey, Catherine Buyse, Michelle Norrenberg, Anne-Marie Ros, Jean-Louis Vincent
Purpose: To document and describe the use of a hospital-wide, 24-hour cardiorespiratory physiotherapy service run by an intensive care unit (ICU) team of physiotherapists. Methods: We prospectively collected data on all non-ICU hospital patients who used the 24-hours-per-day cardiorespiratory physiotherapy service over a 1-year period between July 2013 and June 2014. The ICU physiotherapists documented the reason, origin of referral, time of call, and type and frequency of treatment of each patient. Results: Over the 1-year period, the ICU physiotherapists administered 2,192 out-of-hours cardiorespiratory physiotherapy treatments (n=685 patients) outside the ICU...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27909267/comparison-of-green-pit-viper-and-agkistrodon-halys-antivenom-in-inhibition-of-coagulopathy-due-to-trimeresurus-albolabris-venom-an-in-vitro-study-using-human-plasma
#18
S K Lam, S F Yip, P Crow, H T Fung, J Mh Cheng, K S Tan, O F Wong, D Yt Yeung, Y K Wong, K M Poon, G Ades
INTRODUCTION: There are two antivenoms that may be administered in Hong Kong following a bite by Trimeresurus albolabris: the green pit viper antivenom from the Thai Red Cross Society in Thailand and the Agkistrodon halys antivenom from the Shanghai Institute of Biological Products in China. Both are recommended by the Central Coordinating Committee of Accident and Emergency Services of the Hospital Authority for treating patients with a bite by Trimeresurus albolabris. The choice of which antivenom to use is based on physician preference...
December 2, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#19
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909067/concept-and-evaluation-of-the-german-war-surgery-course-einsatzchirurgie-kurs-der-bundeswehr
#20
David A Back, K Waldmann, T Hauer, N Huschitt, M W Bowyer, U Wesemann, A Lieber, C Willy
INTRODUCTION: Military surgeons must be prepared to care for severe and complex life-threatening injuries rarely seen in the civilian setting. Typical civilian training and practice do not provide adequate exposure to the broad set of surgical skills required. The German Bundeswehr Medical Service has developed and refined the War Surgery Course (WSC) to meet this training gap. This article describes the recent experience with this readiness curriculum. METHODS: Run annually since 1998, WSC consists nowadays of 5 days with 20 theoretical modules...
December 1, 2016: Journal of the Royal Army Medical Corps
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