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https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#1
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28532509/barriers-and-facilitators-to-healthcare-professional-behaviour-change-in-clinical-trials-using-the-theoretical-domains-framework-a-case-study-of-a-trial-of-individualized-temperature-reduced-haemodialysis
#2
Justin Presseau, Brittany Mutsaers, Ahmed A Al-Jaishi, Janet Squires, Christopher W McIntyre, Amit X Garg, Manish M Sood, Jeremy M Grimshaw
BACKGROUND: Implementing the treatment arm of a clinical trial often requires changes to healthcare practices. Barriers to such changes may undermine the delivery of the treatment making it more likely that the trial will demonstrate no treatment effect. The 'Major outcomes with personalized dialysate temperature' (MyTEMP) is a cluster-randomised trial to be conducted in 84 haemodialysis centres across Ontario, Canada to investigate whether there is a difference in major outcomes with an individualized dialysis temperature (IDT) of 0...
May 22, 2017: Trials
https://www.readbyqxmd.com/read/28532407/socioeconomic-inequalities-in-the-uptake-of-maternal-healthcare-services-in-ethiopia
#3
Markos Mezmur, Kannan Navaneetham, Gobopamang Letamo, Hadgu Bariagaber
BACKGROUND: The progress in coverage of maternal health services in Ethiopia has been rather slow over the past decade and consequently the maternal mortality ratio was very high (673 per 100,000 live births) among the countries in Sub-Saharan Africa and remained constant during 2005-11 period. Earlier studies have mostly focused on determinants of maternal health seeking behavior in Ethiopia. However, little is known about the inequality aspects. This study intends to examine socioeconomic inequalities in the uptake of maternal health services and to identify factors that contribute to such inequalities...
May 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28532204/management-of-allergic-rhinitis-in-the-era-of-effective-over-the-counter-treatments
#4
Warner W Carr, Barbara P Yawn
Allergic rhinitis (AR) may be regarded as a trivial issue unworthy of the doctor's time, and with the availability of many different over-the-counter (OTC) treatments, up to two thirds of patients self-manage AR before seeking medical care. Yet, AR can have a significant impact on health-related quality of life and is associated with a greater detriment to work productivity than other chronic diseases such as diabetes and hypertension. For many patients, the impact on quality of life is greater than suggested by reported symptoms and should also be a focus of treatment...
May 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28531987/electrospinning-of-thermoplastic-carboxymethyl-cellulose-poly-ethylene-oxide-nanofibers-for-use-in-drug-release-systems
#5
Akbar Esmaeili, Mahsa Haseli
Polymeric delivery systems using electrospun nanofibers have been developed for many applications, notably for drug delivery and tissue engineering in the healthcare industry. In this study, a nanofiber drug carrier was fabricated via two different electrospinning processes, blend and coaxial, using a new degradable thermoplastic carboxymethyl cellulose (TCMC) and poly(ethylene oxide) (PEO). The TCMC was synthesized by graft copolymerization with methyl acrylate. Tetracycline hydrochloride served as a drug model incorporated within these nanofibers and their performance as a drug-carrier scaffold was evaluated...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531197/a-narrative-systematic-review-of-factors-affecting-diabetes-prevention-in-primary-care-settings
#6
Josie Messina, Stephen Campbell, Rebecca Morris, Emily Eyles, Caroline Sanders
BACKGROUND: Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient's primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults...
2017: PloS One
https://www.readbyqxmd.com/read/28530114/patients-and-healthcare-professionals-perceptions-of-self-management-support-interactions-systematic-review-and-qualitative-synthesis
#7
Marika Franklin, Sophie Lewis, Karen Willis, Helen Bourke-Taylor, Lorraine Smith
Objective To review studies examining the experience of self-management support in patient-provider interactions and the shaping of goals through interactions. Methods We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004-2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient-provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28530068/-newborn-discharge-letter-as-a-communication-document-for-continuity-of-care
#8
Jacob Urkin, Zachi Grossman, Gil Chapnick, Daniella Landau
AIMS: To check information items in newborn discharge letters from various delivery rooms and compare them to the expectations of community pediatricians. BACKGROUND: The newborn discharge letter is the document that supports the transition of care from the hospital stay to life at home and in the community. It usually summarizes medical information related to the baby's family, maternal pregnancies, delivery and the stay in hospital until discharge. It is primarily a communication tool between healthcare professionals...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28530002/cohort-restriction-based-on-prior-enrollment-examining-potential-biases-in-estimating-cancer-and-mortality-risk
#9
Susan M Shortreed, Eric Johnson, Carolyn M Rutter, Aruna Kamineni, Karen J Wernli, Jessica Chubak
Electronic health records and administrative databases provide rich, longitudinal data for health-related research. These data cover large, diverse populations creating excellent research opportunities, but have limitations. In particular, information is available only for individuals who are enrolled in a particular health system; thus, studies often exclude individual's with short enrollment history. Such cohort restriction may cause selection bias in absolute risk estimates for the full enrollee population...
August 2016: Observational Studies
https://www.readbyqxmd.com/read/28529119/call-for-shared-decision-making-in-china-challenges-and-opportunities
#10
Mi Yao, Samuel Finnikin, K K Cheng
China's healthcare system has undergone extensive changes over recent years and the most recent reforms are designed to shift the emphasis away from hospital based services towards a more primary care based system. There is an increasing recognition that shared decision making needs to play a central role in the delivery of healthcare in China, but there are several significant barriers to overcome before this aspiration becomes a reality. Doctor-patient relationships in China are poor, consultations are often brief transactions and levels of trust are low...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529113/integrating-natural-language-processing-expertise-with-patient-safety-event-review-committees-to-improve-the-analysis-of-medication-events
#11
Allan Fong, Nicole Harriott, Donna M Walters, Hanan Foley, Richard Morrissey, Raj R Ratwani
OBJECTIVES: Many healthcare providers have implemented patient safety event reporting systems to better understand and improve patient safety. Reviewing and analyzing these reports is often time consuming and resource intensive because of both the quantity of reports and length of free-text descriptions in the reports. METHODS: Natural language processing (NLP) experts collaborated with clinical experts on a patient safety committee to assist in the identification and analysis of medication related patient safety events...
May 11, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28528585/why-patients-should-be-involved-in-health-technology-assessment
#12
Janet Wale, Anna Mae Scott, Bjørn Hofmann, Sarah Garner, Eric Low, Lloyd Sansom
OBJECTIVES: Some countries make considerable effort to involve patients and patient groups in their health technology assessment (HTA) processes; others are only just considering or are yet to consider patient involvement in HTA. METHODS: This commentary offers four arguments why patient involvement should be prioritized by those HTA agencies that do not yet involve patients: (1) from a patients' rights perspective, (2) based on patient and community values, (3) centering on evidentiary contributions, and (4) from a methodological perspective...
May 22, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#13
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28528526/communication-between-low-income-hispanic-patients-and-their-healthcare-providers-regarding-physical-activity-and-healthy-eating
#14
Aliyah Gauri, Xeniamaria Rodriguez, Patricia Gaona, Stephanie Maestri, Noella Dietz, Mark Stoutenberg
U.S. Hispanics disproportionately show health burdens that may be decreased by discussing physical activity (PA) and healthy eating with their healthcare providers (HCPs). We examined the perceptions of both HCPs and low-income Hispanic patients regarding the dynamics of these communications. We surveyed 295 low-income Hispanic patients and interviewed 14 HCPs at three community health clinics. Patients were asked about their comfort level with HCPs, how often their HCP discussed PA and healthy eating, and the likelihood of following advice on PA and healthy eating...
May 20, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28527687/cost-effectiveness-analysis-of-typhoid-conjugate-vaccines-in-five-endemic-low-and-middle-income-settings
#15
Marina Antillón, Joke Bilcke, A David Paltiel, Virginia E Pitzer
BACKGROUND: Typhoid fever remains endemic in low- and middle-income countries. Programmatic use of existing vaccines is limited, but upcoming typhoid conjugate vaccines (TCVs) could warrant wider use. We evaluated the cost-effectiveness of five TCV delivery strategies in three urban areas (Delhi and Kolkata, India and Nairobi, Kenya) and two rural settings (Lwak, Kenya and Dong Thap, Vietnam) with varying incidence. METHODS AND FINDINGS: We evaluated routine infant vaccination with and without catch-up campaigns among older individuals...
May 17, 2017: Vaccine
https://www.readbyqxmd.com/read/28527637/the-state-of-shared-decision-making-in-malaysia
#16
Yew Kong Lee, Chirk Jenn Ng
Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527520/recent-advances-in-smart-biotechnology-hydrogels-and-nanocarriers-for-tailored-bioactive-molecules-depot
#17
REVIEW
Gesmi Milcovich, Stefania Lettieri, Filipe E Antunes, Bruno Medronho, Ana C Fonseca, Jorge F J Coelho, Paolo Marizza, Francesca Perrone, Rossella Farra, Barbara Dapas, Gabriele Grassi, Mario Grassi, Silvia Giordani
Over the past ten years, the global biopharmaceutical market has remarkably grown, with ten over the top twenty worldwide high performance medical treatment sales being biologics. Thus, biotech R&D (research and development) sector is becoming a key leading branch, with expanding revenues. Biotechnology offers considerable advantages compared to traditional therapeutic approaches, such as reducing side effects, specific treatments, higher patient compliance and therefore more effective treatments leading to lower healthcare costs...
May 9, 2017: Advances in Colloid and Interface Science
https://www.readbyqxmd.com/read/28526169/the-second-victim-a-review
#18
REVIEW
B Coughlan, D Powell, M F Higgins
Amongst the lay and media population there is a perception that pregnancy, labour and delivery is always physiological, morbidity and mortality should be "never events" and that error is the only cause of adverse events. Those working in maternity care know that it is an imperfect art, where adverse outcomes and errors will occur. When errors do occur, there is a domino effect with three groups being involved - the patient (first victim), the staff (second victims) and the organization (third victims). If the perceived expectation of patients on all clinicians is that of perfection, then clinicians may suffer the consequences of adverse outcomes in isolation and silence...
June 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28526039/influences-on-patient-satisfaction-in-healthcare-centers-a-semi-quantitative-study-over-5%C3%A2-years
#19
Ruth D Thornton, Nicole Nurse, Laura Snavely, Stacey Hackett-Zahler, Kenice Frank, Robert A DiTomasso
BACKGROUND: Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. METHODS: A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28524616/how-to-implement-live-video-recording-in-the-clinical-environment-a-practical-guide-for-clinical-services
#20
Adam Lloyd, Alistair Dewar, Simon Edgar, Dave Caesar, Paul Gowens, Gareth Clegg
BACKGROUND: The use of video in healthcare is becoming more common, particularly in simulation and educational settings. However, video recording live episodes of clinical care is far less routine. AIM: To provide a practical guide for clinical services to embed live video recording. MATERIALS AND METHODS: Using Kotter's 8-step process for leading change, we provide a 'how to' guide to navigate the challenges required to implement a continuous video-audit system based on our experience of video recording in our emergency department resuscitation rooms...
May 19, 2017: International Journal of Clinical Practice
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