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https://www.readbyqxmd.com/read/29443716/time-for-an-acute-focus-on-chronic-care-in-undergraduate-medical-education
#1
Connie R Shi, Vinod E Nambudiri
As the burdens of chronic disease rise in the United States, both undergraduate and graduate medical education must adapt to adequately equip future physicians with the skills to manage the increasingly complex health needs affecting the population. However, traditional models of undergraduate medical education (UME) have made focusing on chronic care education challenging. In this Invited Commentary, the authors advocate for strengthening UME based upon five approaches to engage trainees in learning about chronic care across both the preclinical and clinical phases of their education: (1) introducing chronic care in the preclinical years; (2) prioritizing chronic care education across all specialties; (3) maximizing the fourth year of medical school through a chronic care focus; (4) creating chronic disease-focused advanced clerkships; and (5) leveraging technology for education...
February 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29443439/complexity-of-the-relationships-of-pain-posttraumatic-stress-and-depression-in-combat-injured-populations-an-integrative-review-to-inform-evidence-based-practice
#2
Nicholas A Giordano, Christine Bader, Therese S Richmond, Rosemary C Polomano
BACKGROUND: Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature. AIM: This integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans...
February 14, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29440289/neo212-inhibits-migration-and-invasion-of-glioma-stem-cells
#3
Nagore I Marín-Ramos, Thu Zan Thein, Hee-Yeon Cho, Stephen D Swenson, Weijun Wang, Axel H Schönthal, Thomas C Chen, Florence M Hofman
Glioblastoma multiforme is a malignant brain tumor noted for its extensive vascularity, aggressiveness, and highly invasive nature, suggesting that cell migration plays an important role in tumor progression. The poor prognosis in GBM is associated with a high rate of tumor recurrence, and resistance to the standard of care chemotherapy, temozolomide (TMZ). The novel compound NEO212, a conjugate of TMZ and perillyl alcohol (POH), has proven to be 10 fold more cytotoxic to glioma stem cells (GSCs) than TMZ, and is active against TMZ-resistant tumor cells...
February 13, 2018: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/29439480/appropriate-handling-processing-and-analysis-of-blood-samples-is-essential-to-avoid-oxidation-of-vitamin-c-to-dehydroascorbic-acid
#4
Juliet M Pullar, Simone Bayer, Anitra C Carr
Vitamin C (ascorbate) is the major water-soluble antioxidant in plasma and its oxidation to dehydroascorbic acid (DHA) has been proposed as a marker of oxidative stress in vivo. However, controversy exists in the literature around the amount of DHA detected in blood samples collected from various patient cohorts. In this study, we report on DHA concentrations in a selection of different clinical cohorts (diabetes, pneumonia, cancer, and critically ill). All clinical samples were collected into EDTA anticoagulant tubes and processed at 4 °C prior to storage at -80 °C for subsequent analysis by HPLC with electrochemical detection...
February 11, 2018: Antioxidants (Basel, Switzerland)
https://www.readbyqxmd.com/read/29439083/psychological-outcomes-following-a-nurse-led-preventative-psychological-intervention-for-critically-ill-patients-poppi-protocol-for-a-cluster-randomised-clinical-trial-of-a-complex-intervention
#5
Alvin Richards-Belle, Paul R Mouncey, Dorothy Wade, Chris R Brewin, Lydia M Emerson, Richard Grieve, David A Harrison, Sheila Harvey, David Howell, Monty Mythen, Zia Sadique, Deborah Smyth, John Weinman, John Welch, Kathryn M Rowan
INTRODUCTION: Acute psychological stress, as well as unusual experiences including hallucinations and delusions, are common in critical care unit patients and have been linked to post-critical care psychological morbidity such as post-traumatic stress disorder (PTSD), depression and anxiety. Little high-quality research has been conducted to evaluate psychological interventions that could alleviate longer-term psychological morbidity in the critical care unit setting. Our research team developed and piloted a nurse-led psychological intervention, aimed at reducing patient-reported PTSD symptom severity and other adverse psychological outcomes at 6 months, for evaluation in the POPPI trial...
February 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29437537/impact-of-comprehensive-medication-management-on-hospital-readmission-rates
#6
Holly Budlong, Amanda Brummel, Adam Rhodes, Hannah Nici
In 2012, the Fairview Health System implemented a formal care transitions process that included referrals to outpatient services provided by medication therapy management (MTM) pharmacists, among other clinical services. This analysis evaluates the impact of the MTM-provided comprehensive medication management (CMM) service on readmission rates. Retrospective electronic medical record (EMR) data were used to identify hospital admissions between December 1, 2012, and July 31, 2015. Thirty- and 60-day readmission rates were calculated in both a CMM and comparator cohort...
February 13, 2018: Population Health Management
https://www.readbyqxmd.com/read/29437531/improving-population-health-among-uninsured-patients-with-diabetes
#7
Michele H Talley, Shea Polancich, Jason B Williamson, Jennifer S Frank, William Curry, John F Russell, Cynthia Selleck
Diabetes is a leading cause of morbidity and mortality; prevalence of diabetes is especially high in the southeastern United States among minority populations and those from lower socioeconomic sectors without access to health care services. The purpose of this project was to evaluate the clinical and financial outcomes of a nurse-led, interprofessional collaborative practice model that provides care coordination and transitional care for uninsured patients with diabetes. Data for this study were collected and evaluated from medical records of patients seen at the Providing Access to Health Care (PATH) Clinic between August 1, 2015, through May 30, 2017...
February 13, 2018: Population Health Management
https://www.readbyqxmd.com/read/29436700/-a-valid-quality-system-for-mental-health-care-from-accountability-and-control-in-institutionalised-settings-to-co-creation-in-small-areas-and-a-focus-on-community-vital-signs
#8
J van Os, P H Delespaul
In a given year, around 25% of the Dutch population may experience significant mental health problems, much more than the mental health service can attend to, given a maximum capacity of 6% of the population per year. Due to the lack of a public mental health system, there is fierce competition over who gets to receive care from mental health services and little control over how the level of needs can be matched with the appropriate intensity of care. As a result, resources are being wasted and both overtreatment and undertreatment are prevalent...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29434539/sleep-and-sedative-states-induced-by-targeting-the-histamine-and-noradrenergic-systems
#9
REVIEW
Xiao Yu, Nicholas P Franks, William Wisden
Sedatives target just a handful of receptors and ion channels. But we have no satisfying explanation for how activating these receptors produces sedation. In particular, do sedatives act at restricted brain locations and circuitries or more widely? Two prominent sedative drugs in clinical use are zolpidem, a GABA A receptor positive allosteric modulator, and dexmedetomidine (DEX), a selective α2 adrenergic receptor agonist. By targeting hypothalamic neuromodulatory systems both drugs induce a sleep-like state, but in different ways: zolpidem primarily reduces the latency to NREM sleep, and is a controlled substance taken by many people to help them sleep; DEX produces prominent slow wave activity in the electroencephalogram (EEG) resembling stage 2 NREM sleep, but with complications of hypothermia and lowered blood pressure-it is used for long term sedation in hospital intensive care units-under DEX-induced sedation patients are arousable and responsive, and this drug reduces the risk of delirium...
2018: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/29434513/hybrid-integral-transforms-for-flow-development-in-ducts-partially-filled-with-porous-media
#10
Kleber Marques Lisboa, Renato Machado Cotta
A hybrid numerical-analytical solution is developed for laminar flow development in a parallel plate duct partially filled with porous media. The integral transform method is employed in combination with a single domain reformulation strategy for representing the heterogeneous media within the channel. A novel eigenfunction expansion basis is proposed, including abrupt spatial variations of physical properties due to the domain transitions. The introduction of the new basis allows for a solution with similar convergence rates as in previous applications with simpler formulations, as demonstrated through a careful convergence analysis of the expansions...
January 2018: Proceedings. Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/29434419/physical-activity-of-icu-survivors-during-acute-admission-agreement-of-the-activpal-with-observation
#11
Claire E Baldwin, Kylie N Johnston, Alex V Rowlands, Marie T Williams
Purpose: We estimated the agreement of a thigh-worn accelerometer, the activPAL, used to measure activity and sedentary parameters, with observed mobility assessments of intensive care unit (ICU) survivors. Method: We prospectively compared activPAL measurements with direct observation during assessments at discharge from the ICU or acute hospital in eight participants with a median age of 56 (1st-3rd quartile 48-65) years and an Acute Physiology and Chronic Health Evaluation II score of 23 (1st-3rd quartile 17-24)...
2018: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/29434012/reducing-sedentary-time-for-obese-older-adults-protocol-for-a-randomized-controlled-trial
#12
Dori E Rosenberg, Amy K Lee, Melissa Anderson, Anne Renz, Theresa E Matson, Jacqueline Kerr, David Arterburn, Jennifer B McClure
BACKGROUND: Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes...
February 12, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29433699/the-health-care-experiences-of-lesbian-women-becoming-mothers
#13
REVIEW
Isabel Gregg
As modern family composition shifts-for many, away from a heteronormative nuclear family-so, too, must the health care that families receive. Lesbian women and their families face particular difficulties with maternity care in the United States and internationally, because many care providers lack an understanding of this population's specific health care needs. In this article, I examine the challenges faced by lesbian women during the transition period to new motherhood and recommend improvements that can be made by individual providers and the health care system as a whole to better provide culturally competent health care for this population...
February 2018: Nursing for Women's Health
https://www.readbyqxmd.com/read/29433698/barriers-to-and-interventions-that-increase-nurses-and-parents-compliance-with-safe-sleep-recommendations-for-preterm-infants
#14
REVIEW
Mary Rose Naugler, Kristine DiCarlo
The purpose of this integrative review was to identify interventions that increase compliance of nurses and of parents with safe sleep recommendations for premature infants. Ten studies were included in the final sample, including three studies with a prospective descriptive design, five quality improvement initiatives with an interventional research design, one secondary analysis, and one retrospective medical chart review. Study samples included neonatal nurses and parents of premature infants in NICUs and transitional care nurseries in Massachusetts, Missouri, New York, North Carolina, Ohio, Pennsylvania, and Texas...
February 2018: Nursing for Women's Health
https://www.readbyqxmd.com/read/29433576/barriers-and-facilitators-to-the-implementation-of-a-paediatric-palliative-care-team
#15
Lisa M Verberne, Marijke C Kars, Sasja A Schepers, Antoinette Y N Schouten-van Meeteren, Martha A Grootenhuis, Johannes J M van Delden
BACKGROUND: Over the last decade, paediatric palliative care teams (PPCTs) have been introduced to support children with life-limiting diseases and their families and to ensure continuity, coordination and quality of paediatric palliative care (PPC). However, implementing a PPCT into an organisation is a challenge. The objective of this study was to identify barriers and facilitators reported by healthcare professionals (HCPs) in primary, secondary or tertiary care for implementing a newly initiated multidisciplinary PPCT to bridge the gap between hospital and home...
February 12, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29432554/measuring-care-transitions-in-sweden-validation-of-the-care-transitions-measure
#16
Maria Flink, Mesfin Tessma, Milada Cvancarova Småstuen, Marléne Lindblad, Eric A Coleman, Mirjam Ekstedt
Objective: To translate and assess the validity and reliability of the original American Care Transitions Measure, both the 15-item and the shortened 3-item versions, in a sample of people in transition from hospital to home within Sweden. Design: Translation of survey items, evaluation of psychometric properties. Setting: Ten surgical and medical wards at five hospitals in Sweden. Participants: Patients discharged from surgical and medical wards...
February 8, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29432396/gathering-tips-from-carers-to-support-people-with-dementia-an-adaptation-of-the-top-5-program-for-community-use
#17
Kerrie Westaway, Oliver Frank, Russell Shute, Anna Moffat, Vanessa LeBlanc, Debra Rowett, Natalie Blacker, Elizabeth Roughead
AIM: Behavioral and psychological symptoms of dementia are often managed inappropriately with antipsychotic medicines. The TOP 5 program, which involves recording up to five relevant and meaningful tips that assist in personalizing care for the person with dementia, has been tested in the hospital setting and transitions of care in Australia, and has been found to be useful. Our study aimed to adapt the TOP 5 program as a strategy to support people with dementia in a primary care setting and to test the acceptability of our adapted TOP 5 program materials...
February 9, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29432247/transition-from-pediatric-to-adult-neurologic-care
#18
Ann H Tilton, Claudio Melo de Gusmao
PURPOSE OF REVIEW: With advances in medical care, the number of youths surviving with medically complex conditions has been steadily increasing. Inadequate transition planning and execution can lead to gaps in care, unexpected emergency department visits, and an increase in health care costs and patient/caregiver anxiety. Many barriers that prevent adequate transition have been identified, including insufficient time or staff to provide transition services, inadequate reimbursement, resistance from patients and caregivers, and a dearth of accepting adult providers...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29432230/youth-friendly-services-and-differentiated-models-of-care-are-needed-to-improve-outcomes-for-young-people-living-with-hiv
#19
Lindsey K Reif, Margaret L McNairy, Matthew R Lamb, Ruby Fayorsey, Batya Elul
PURPOSE OF REVIEW: Outcomes among young people living with HIV (YPLWH) remain disturbingly poor. We summarize recent research on youth-friendly services (YFS) and adolescent-specific differentiated care models, which may improve outcomes across the HIV care continuum for this vulnerable population. We further emphasize unique complexities that characterize the transition from childhood through adolescence to adulthood which must be considered when caring for YPLWH. RECENT FINDINGS: Studies suggest that YFS may improve outcomes in some but not all steps of the HIV care continuum...
February 9, 2018: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/29432041/qualitative-evaluation-of-the-coach-training-within-a-community-paramedicine-care-transitions-intervention
#20
Hunter Singh Lau, Matthew M Hollander, Jeremy T Cushman, Eva H DuGoff, Courtney M C Jones, Amy J H Kind, Michael T Lohmeier, Eric A Coleman, Manish N Shah
OBJECTIVE: The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition...
February 12, 2018: Prehospital Emergency Care
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