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https://www.readbyqxmd.com/read/29651981/lamotrigine-for-people-with-borderline-personality-disorder-a-rct
#1
Mike J Crawford, Rahil Sanatinia, Barbara Barrett, Gillian Cunningham, Oliver Dale, Poushali Ganguli, Geoff Lawrence-Smith, Verity C Leeson, Fenella Lemonsky, Georgia Lykomitrou-Matthews, Alan Montgomery, Richard Morriss, Jasna Munjiza, Carol Paton, Iwona Skorodzien, Vineet Singh, Wei Tan, Peter Tyrer, Joseph G Reilly
BACKGROUND: No drug treatments are currently licensed for the treatment of borderline personality disorder (BPD). Despite this, people with this condition are frequently prescribed psychotropic medications and often with considerable polypharmacy. Preliminary studies have indicated that mood stabilisers may be of benefit to people with BPD. OBJECTIVE: To examine the clinical effectiveness and cost-effectiveness of lamotrigine for people with BPD. DESIGN: A two-arm, double-blind, placebo-controlled individually randomised trial of lamotrigine versus placebo...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29650727/a-pharmacy-led-united-states-pharmacopeia-usp-chapter-800-compliance-collaborative-at-an-academic-medical-center
#2
Bijan C Mekoba, Erin M Turingan, Patricia A Roberts, Susan Mason, Ian Willoughby, Cindy Taylor, Andrew Stivers, John Valgus
PURPOSE: One academic medical center's efforts to move toward compliance with requirements of United States Pharmacopeia ( USP ) chapter 800 through a multidepartmental collaborative initiative are described. SUMMARY: Requirements of USP general chapter 800 (enforceable as of December 2019) address the handling of hazardous drugs (HDs) throughout the entire operational and clinical cycle, from receiving to compounding, administration, and waste disposal. Due to the variety of pharmacy operational areas in which HDs are encountered at University of North Carolina Medical Center (UNCMC), multiple pharmacy managers oversee the safe handling of HDs...
April 12, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29628674/the-intensive-care-unit-perspective-of-becoming-a-level-i-trauma-center-challenges-of-strategy-leadership-and-operations-management
#3
Richard H Savel, Wess Cohen, Dena Borgia, Ronald J Simon
The primary purpose of this narrative is to elucidate the numerous significant changes that occur at the intensive care unit (ICU) level as a medical center pursues becoming a Level I trauma center. Specifically, we will focus on the following important areas: (1) leadership and strategy issues behind the decision to move forward with becoming a trauma center; (2) preparation needed to take a highly functioning surgical ICU and align it for the inevitable changes that happen as trauma go-live occurs; (3) intensivist staffing changes; (4) roles for and training of advanced practice practitioners; (5) graduate medical education issues; (6) optimizing interactions with closely related services; (7) nursing, staffing, and training issues; (8) bed allocation issues; and (9) reconciling the advantages of a "unified adult critical care service" with the realities of the central relationship between trauma and surgical critical care...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29626292/faculty-development-for-teaching-faculty-in-psychiatry-where-we-are-and-what-we-need
#4
Sallie G De Golia, Consuelo C Cagande, Mary S Ahn, Lisa M Cullins, Art Walaszek, Deborah S Cowley
OBJECTIVE: A Faculty Development Task Force surveyed the American Association of Directors of Psychiatric Residency Training membership to assess faculty development for graduate medical education faculty in psychiatry departments and barriers to seeking graduate medical education careers. METHODS: An anonymous Survey Monkey survey was emailed to 722 American Association of Directors of Psychiatric Residency Training members. The survey included questions about demographics, the current state of faculty development offerings within the respondent's psychiatry department and institution, and potential American Association of Directors of Psychiatric Residency Training faculty development programming...
April 6, 2018: Academic Psychiatry
https://www.readbyqxmd.com/read/29625597/how-do-we-incorporate-patient-views-into-the-design-of-healthcare-services-for-older-people-a-discussion-paper
#5
Paul R Brocklehurst, Gerald McKenna, Martin Schimmel, Anastassia Kossioni, Katarina Jerković-Ćosić, Martina Hayes, Cristiane da Mata, Frauke Müller
BACKGROUND: Across the European Union costs for the treatment of oral disease is expected to rise to €93 Billion by 2020 and be higher than those for stroke and dementia combined. A significant proportion of these costs will relate to the provision of care for older people. Dental caries severity and experience is now a major public health issue in older people and periodontal disease disproportionately affects older adults. Poor oral health impacts on older people's quality of life, their self-esteem, general health and diet...
April 6, 2018: BMC Oral Health
https://www.readbyqxmd.com/read/29621071/back-to-basics-adherence-with-guidelines-for-glucose-and-temperature-control-in-an-american-comprehensive-stroke-center-sample
#6
Anne W Alexandrov, Paola Palazzo, Sharon Biby, Abbigayle Doerr, Wendy Dusenbury, Rhonda Young, Anne Lindstrom, Mary Grove, Georgios Tsivgoulis, Sandy Middleton, Andrei V Alexandrov
BACKGROUND: Variance from guideline-directed care for glucose and temperature control remains unknown in the United States at a time when priorities have shifted to ensure rapid diagnosis and treatment of acute stroke patients. However, protocol-driven nursing surveillance for control of hyperglycemia and hyperthermia has been shown to improve patient outcomes. METHODS: We conducted an observational pilot study to assess compliance with American guidelines for glucose and temperature control and association with discharge outcomes in consecutive acute stroke patients admitted to 5 US comprehensive stroke centers...
April 4, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29619383/-foamems-engaging-paramedics-with-free-online-open-access-education
#7
Paige Mason, Alan M Batt
BACKGROUND AND AIM: Twitter® use among paramedics and other prehospital care clinicians is on the rise and is increasingly being used as a platform for continuing education and international collaboration. In 2014, the hashtag #FOAMems was registered. It is used for the sharing of emergency medical services, paramedicine, and prehospital care-related content. It is a component of the 'free open-access meducation' (FOAM) movement. The aim of this study was to characterize and evaluate the content of #FOAMems tweets since registration...
2018: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/29618639/hospital-level-care-coordination-strategies-associated-with-better-patient-experience
#8
Jose F Figueroa, Yevgeniy Feyman, Xiner Zhou, Karen Joynt Maddox
BACKGROUND: Patient experience is a key measure of hospital quality and is increasingly contained in value-based payment programmes. Understanding whether strategies aimed at improving care transitions are associated with better patient experience could help clinical leaders and policymakers seeking to improve care across multiple dimensions. OBJECTIVE: To determine the association of specific hospital care coordination and transition strategies with patient experience...
April 4, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29618112/critical-care-in-the-military-health-system-a-survey-based-summary-of-critical-care-services
#9
Jason J Nam, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Ferdinand Bacomo, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Introduction: Critical care is an important component of in-patient and combat casualty care, and it is a major contributor to U.S. healthcare costs. Regular exposure to critically ill and injured patients may directly contribute to wartime skills retention for military caregivers. Data describing critical care services in the Military Health System (MHS), however, is lacking. This study was undertaken to describe MHS critical care services, their resource utilization, and differences in care practices amongst military treatment facilities (MTFs)...
March 29, 2018: Military Medicine
https://www.readbyqxmd.com/read/29616202/pediatric-critical-care-in-resource-limited-settings-overview-and-lessons-learned
#10
REVIEW
Tina M Slusher, Andrew W Kiragu, Louise T Day, Ashley R Bjorklund, Arianna Shirk, Colleen Johannsen, Scott A Hagen
Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU) and high dependency areas...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29610899/sex-differences-in-academic-rank-and-publication-rate-at-top-ranked-us-neurology-programs
#11
Mollie McDermott, Douglas J Gelb, Kelsey Wilson, Megan Pawloski, James F Burke, Anita V Shelgikar, Zachary N London
Importance: Women are underrepresented in academic neurology, and the reasons for the underrepresentation are unclear. Objective: To explore potential sex differences in top-ranked academic neurology programs by comparing the number of men and women at each academic faculty rank and how many articles each group has published. Design, Setting, and Participants: Twenty-nine top-ranked neurology programs were identified by combining the top 20 programs listed on either the 2016 or 2017 Doximity Residency Navigator tool with the top 20 programs listed in the US News and World Report ranking of Best Graduate Schools...
April 2, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29602867/medical-education-partnership-initiative-mepi-in-zimbabwe-outcomes-and-challenges
#12
James G Hakim, Midion M Chidzonga, Margaret Z Borok, Kusum J Nathoo, Jonathan Matenga, Edward Havranek, Frances Cowan, Melanie Abas, Eva Aagaard, Susan Connors, Sanele Nkomani, Chiratidzo E Ndhlovu, Antony Matsika, Michele Barry, Thomas B Campbell
BACKGROUND: Sub-Saharan Africa has an inadequate number of health professionals, leading to a reduced capacity to respond to health challenges, including HIV/AIDS. From 2010 to 2015, the Medical Education Partnership Initiative (MEPI)-sponsored by the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) and the National Institutes of Health (NIH)-was enthusiastically taken up by the University of Zimbabwe College of Health Sciences (UZCHS) and 12 other sub-Saharan African universities to develop models of training to improve medical education and research capacity...
March 21, 2018: Global Health, Science and Practice
https://www.readbyqxmd.com/read/29602745/implementation-of-a-pharmacist-led-pharmacogenomics-service-for-the-program-of-all-inclusive-care-for-the-elderly-pharm-genome-pace
#13
Kevin T Bain, Emily J Schwartz, Orsula V Knowlton, Calvin H Knowlton, Jacques Turgeon
OBJECTIVES: To determine the feasibility of implementing a pharmacist-led pharmacogenomics (PGx) service for the Program of All-Inclusive Care for the Elderly (PACE). SETTING: A national centralized pharmacy providing PGx services to community-based PACE centers. PRACTICE DESCRIPTION: Individuals 55 years of age and older enrolled in PACE who underwent PGx testing as part of their medical care (n = 296). PRACTICE INNOVATION: Pharmacist-led PGx testing, interpreting, and consulting...
March 27, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29596709/leadership-in-nursing-homes-directors-of-nursing-aligning-practice-with-regulations
#14
Elena O Siegel, Kristen Bettega, Debra Bakerjian, Suzanne Sikma
Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice...
March 29, 2018: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29590426/taking-charge-moving-from-peer-to-supervisor
#15
Joshua D Hartzell, Raj Singaraju
Leadership transitions occur frequently, and these times can be challenging for the individual and those they lead. Leaders must develop new knowledge and skills required of the position. Leaders also assume a new formal leadership role over prior peers. This can be a difficult task for junior leaders. The following article illustrates an example case faced by a junior Navy Medical Corps Officer and how one might respond.
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29580243/factors-associated-with-the-use-of-cognitive-aids-in-operating-room-crises-a-cross-sectional-study-of-us-hospitals-and-ambulatory-surgical-centers
#16
Shehnaz Alidina, Sara N Goldhaber-Fiebert, Alexander A Hannenberg, David L Hepner, Sara J Singer, Bridget A Neville, James R Sachetta, Stuart R Lipsitz, William R Berry
BACKGROUND: Operating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood...
March 26, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29579487/factors-affecting-the-delivery-of-healthcare-on-a-humanitarian-operation-in-west-africa-a-qualitative-study
#17
Di Lamb
INTRODUCTION: Medical personnel in the UK Armed Forces are highly trained to deploy in support of military operations that assist humanitarian, peacekeeping, counter-terrorism and environmental catastrophes anywhere in the world. Such environments are often austere and successful outcomes demand an individual is highly resilient and able to adapt quickly to any situation. This qualitative study aimed to determine the factors that affect healthcare delivery on such missions by capturing the personal experiences of the first military personnel deployed on a humanitarian operation in support of the Ebola outbreak in West Africa between October 2014 and January 2015...
April 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29570738/the-author-who-wasn-t-there-fairness-and-attribution-in-publications-following-access-to-population-biobanks
#18
Erika Kleiderman, Amy Pack, Pascal Borry, Ma'n Zawati
We conducted a document analysis that explored publication ethics and authorship in the context of population biobanks from both a theoretical (e.g. normative documents) and practical (e.g. biobank-specific documentation) perspective. The aim was to provide an overview of the state of authorship attribution in population biobanks and attempt to fill the gap in discussions around the issue. Our findings demonstrate that the most common approach adopted in both the normative and biobank-specific documentation is acknowledgment...
2018: PloS One
https://www.readbyqxmd.com/read/29567864/systems-thinking-and-leadership-how-nephrologists-can-transform-dialysis-safety-to-prevent-infections
#19
REVIEW
Leslie P Wong
Infections are the second leading cause of death for patients with ESKD. Despite multiple efforts, nephrologists have been unable to prevent infections in dialysis facilities. The American Society of Nephrology and the Centers for Disease Control and Prevention have partnered to create Nephrologists Transforming Dialysis Safety to promote nephrologist leadership and engagement in efforts to "Target Zero" preventable dialysis infections. Because traditional approaches to infection control and prevention in dialysis facilities have had limited success, Nephrologists Transforming Dialysis Safety is reconceptualizing the problem in the context of the complexity of health care systems and organizational behavior...
March 22, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29565108/white-book-on-physical-and-rehabilitation-medicine-prm-in-europe-chapter-7-the-clinical-field-of-competence-prm-in-practice
#20
(no author information available yet)
In the context of the White Book on Physical and Rehabilitation Medicine (PRM) in Europe this paper deals with the scope and competencies of PRM starting from its definition as the "medicine of functioning." PRM uses the rehabilitative health strategy as its core strategy together with the curative strategy. According to the complexity of disabling health conditions, PRM also refers to prevention and maintenance and provides information to the patients and other caregivers. The rehabilitation process according to the so-called rehabilitation cycle including an assessment and definition of the (individual) rehabilitation goals, assignment to the rehabilitation program evaluation of individual outcomes...
April 2018: European Journal of Physical and Rehabilitation Medicine
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