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Clinical messaging

Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Tabor E Flickinger, Claire DeBolt, Ava Lena Waldman, George Reynolds, Wendy F Cohn, Mary Catherine Beach, Karen Ingersoll, Rebecca Dillingham
Social support can improve outcomes for people living with HIV (PLWH) and could be provided through online support groups. The Positive Links smartphone app is a multicomponent intervention that allows users to interact in a clinic-affiliated anonymous online support group. We investigated how social support was exchanged in a group of 55 participants over 8 months, using an adaptation of the Social Support Behavior Code. Participant interviews assessed their experiences and perceptions of the app. Of 840 posts analyzed, 115 (14 %) were coded as eliciting social support and 433 (52 %) as providing social support...
October 21, 2016: AIDS and Behavior
Isabelle Biseul, Romain Icick, Perrine Seguin, Frank Bellivier, Jan Scott
OBJECTIVES: We investigated the feasibility and acceptability of an integrated group therapy (called HABIT) for comorbid bipolar disorder (BD) and alcohol and substance use disorders (ASUD) (BD-ASUD), a disabling clinical presentation for which no specific treatment has been validated. The 14-session HABIT programme employs psychoeducation-oriented cognitive-behaviour therapy (CBT) followed by mindfulness-based relapse prevention (MBRP) therapy. METHOD: Potential group participants were recruited from adult clients with a DSM-IV diagnosis of BD and an ASUD who were referred by their treating clinician...
October 20, 2016: Clinical Psychology & Psychotherapy
Seda Tural Önür, Mehmet Atilla Uysal, Sinem İliaz, Sibel Yurt, Ayşe Bahadır, Didem Görgün Hattatoğlu, Mediha Gönenç Ortaköylü, Belma Akbaba Bağcı, Efsun Gonca Uğur Chousein
BACKGROUND: Using innovative and scientific methods increases the rate of quitting in smokers. Short message service (SMS) is a communication tool widely used and well integrated in many people's daily lives. To increase adherence to appointments in smoking cessation clinics (SCC), it is thought that increased compliance could be achieved by falling outside the traditional methods. SMS has been shown to increase the compliance of patients with SCC appointments. AIMS: In this study, we aimed to evaluate the effect of SMS in the compliance of patients with SCC follow-up visits and smoking cessation success...
September 2016: Balkan Medical Journal
T Thomsen, M Aadahl, N Beyer, M L Hetland, K Løppenthin, J Midtgaard, R Christensen, B A Esbensen
BACKGROUND: Patients with rheumatoid arthritis (RA) spend a high proportion of their waking time in sedentary behaviour (SB) and have an increased risk of cardiovascular disease. Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems. Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary populations. To evaluate descriptively the feasibility of recruitment, randomisation, outcome assessments, retention and the acceptability of an individually tailored, theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA...
October 18, 2016: BMC Musculoskeletal Disorders
Alan Whaley, William E Gillis
BACKGROUND: Hospitals throughout the United States establish leadership and management programs for their middle managers. Despite their pervasiveness and an increased emphasis on physician leadership, there is limited research regarding the development programs designed for clinical and nonclinical health care middle managers. PURPOSE: Using two theoretical lenses, signaling and institutional theory, this exploratory study investigates mid-sized hospital development programs from the perspective of top management team (TMT) members...
October 14, 2016: Health Care Management Review
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Michael S Businelle, Ping Ma, Darla E Kendzor, Summer G Frank, David W Wetter, Damon J Vidrine
BACKGROUND: Mobile phone‒based real-time ecological momentary assessments (EMAs) have been used to record health risk behaviors, and antecedents to those behaviors, as they occur in near real time. OBJECTIVE: The objective of this study was to determine if intensive longitudinal data, collected via mobile phone, could be used to identify imminent risk for smoking lapse among socioeconomically disadvantaged smokers seeking smoking cessation treatment. METHODS: Participants were recruited into a randomized controlled smoking cessation trial at an urban safety-net hospital tobacco cessation clinic...
October 17, 2016: Journal of Medical Internet Research
Tadaaki Arizumi, Kazuomi Ueshima, Mina Iwanishi, Tomohiro Minami, Hirokazu Chishina, Masashi Kono, Masahiro Takita, Satoshi Kitai, Tatsuo Inoue, Norihisa Yada, Satoru Hagiwara, Yasunori Minami, Hiroshi Ida, Toshiharu Sakurai, Masayuki Kitano, Naoshi Nishida, Masatoshi Kudo
BACKGROUND: The standard treatment option that is available for patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) is transarterial chemoembolization (TACE). However, the condition of the patients with BCLC stage B disease is heterogeneous showing different tumor statuses and Child-Pugh scores; treatment strategies other than TACE are frequently employed for the patients in this stage. Based on the subclassification system proposed by Bolondi et al...
2016: Digestive Diseases
Naoshi Nishida, Masashi Kono, Tomohiro Minami, Hirokazu Chishina, Tadaaki Arizumi, Masahiro Takita, Norihisa Yada, Hiroshi Ida, Satoru Hagiwara, Yasunori Minami, Kazuomi Ueshima, Tashiharu Sakurai, Masatoshi Kudo
BACKGROUND: An interferon-free regimen including sofosbuvir and ribavirin (RBV) for patients with hepatitis C virus (HCV) genotype 2 (G2) infection leads to a drastic improvement of sustained virological response (SVR). However, the safety, tolerability, and efficacy in patients aged 75 or older have not been completely understood. SUMMARY: Fifty-six patients with HCV G2 infection who were treated with sofosbuvir and weight-based dose of RBV were enrolled. Thirty-seven patients aged ≥75 and 19 patients aged ≤74 were classified as the aged and non-aged groups, respectively...
2016: Digestive Diseases
Matthew J Mimiaga, Elizabeth F Closson, Shanice Battle, Jeffrey H Herbst, Damian Denson, Nicole Pitts, Jeremy Holman, Stewart Landers, Gordon Mansergh
Men who have sex with men (MSM) of color are disproportionately affected by HIV in the United States. Pre-exposure prophylaxis (PrEP) using antiretroviral medications is a newer biomedical prevention modality with established efficacy for reducing the risk of acquiring HIV. We conducted formative qualitative research to explore audience reactions and receptivity to message concepts on PrEP as part of the development of prevention messages to promote PrEP awareness among black and Latino MSM in the United States...
October 2016: AIDS Patient Care and STDs
Andrew A M Ibey, Derek Andrews, Barb Ferreira
The authors present a case in which a physical anomaly with an infusion pump resulted in an unforeseen fault that the nurse's attempts to resolve unknowingly exacerbated. This case study presents the first report in the literature to detail the difficulty in recreating a patient safety event using smart pump logs, support server continuous quality improvement (CQI) data, and the drug order entry system to elucidate the clinical scenario. A 75-year-old male patient presented to a major teaching hospital and was admitted to the intensive care unit (ICU) with a massive gastrointestinal bleed and myocardial infarction, then stabilized...
December 2016: Drug Saf Case Rep
Megan Simmons, Lucia Guerra-Reyes, Beth Meyerson, Kristin Adams, Stephanie Sanders
BACKGROUND: In 2014, the Centers for Disease Control and Prevention and the Office of Population Affairs released a document entitled Providing Quality Family Planning Services (QFP), which outlined recommendations for delivery of family planning services using a client-centered approach. These aimed to standardize service provision and address numerous reproductive health challenges. To date, little is known about QFP implementation or the factors influencing its adoption by clinicians...
October 13, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
A Vince, C Clarke, E L Wolverson
BACKGROUND: Literature indicates that people's experiences of receiving a diagnosis of dementia can have a lasting impact on well-being. Psychiatrists frequently lead in communicating a diagnosis but little is known about the factors that could contribute to potential disparities between actual and best practice with regard to diagnostic disclosure. A clearer understanding of psychiatrists' subjective experiences of disclosure is therefore needed to improve adherence to best practice guidelines and ensure that diagnostic disclosure facilitates living well with dementia...
October 17, 2016: International Psychogeriatrics
Alvin Rajkomar, Joanne Wing Lan Yim, Kevin Grumbach, Ami Parekh
BACKGROUND: Characterizing patient complexity using granular electronic health record (EHR) data regularly available to health systems is necessary to optimize primary care processes at scale. OBJECTIVE: To characterize the utilization patterns of primary care patients and create weighted panel sizes for providers based on work required to care for patients with different patterns. METHODS: We used EHR data over a 2-year period from patients empaneled to primary care clinicians in a single academic health system, including their in-person encounter history and virtual encounters such as telephonic visits, electronic messaging, and care coordination with specialists...
October 14, 2016: JMIR Medical Informatics
Julie Redfern, Karla Santo, Genevieve Coorey, Jay Thakkar, Maree Hackett, Aravinda Thiagalingam, Clara K Chow
INTRODUCTION: Many studies have now demonstrated the efficacy of text messaging in positively changing behaviours. We aimed to identify features and factors that explain the effectiveness of a successful text messaging program in terms of user engagement, perceived usefulness, behavior change and program delivery preferences. METHODS: Mixed methods qualitative design combining four data sources; (i) analytic data extracted directly from the software system, (ii) participant survey, (iii) focus groups to identify barriers and enablers to implementation and mechanisms of effect and (iv) recruitment screening logs and text message responses to examine engagement...
2016: PloS One
N M Rankin, D McGregor, E Stone, P N Butow, J M Young, K White, T Shaw
Lung cancer is a significant international health problem. Aligning clinical practice with evidence-based guideline recommendations has the potential to improve patient outcomes. This scoping review describes evidence-practice gaps across the diagnostic and management care pathway for lung cancer. We conducted searches of online databases Medline, PsychInfo, Cinahl and the Cochrane Library to identify studies published between 2008 and 2012. Of 614 articles screened, 65 met inclusion criteria. We identified seven evidence-practice gaps: (1) delays in timely diagnosis and referral; (2) curative and (3) palliative treatments are under-utilised; (4) older age and co-morbidities influence the use of treatments; (5) the benefits of multidisciplinary team review are not available to all lung cancer patients; (6) psychosocial needs are unmet; and (7) early referral to palliative care services is under-utilised...
October 13, 2016: European Journal of Cancer Care
Zubin J Daruwalla, Jing L Loh, Chaoyan Dong
BACKGROUND: The Personal Data Protection Act (PDPA) of Singapore was first passed in 2012, with subsequent enforcement regulations effective in 2014. Although medical education via digital platforms is not often used in medical schools in Singapore as of yet, many current means of communication at all levels in the medical community from medical schools to clinics to hospitals are unsecure and noncompliant with the PDPA. OBJECTIVE: This pilot study will assess the effectiveness of MyDoc, a secure, mobile telehealth application and messaging platform, as an educational tool, secure communications tool, and a tool to raise awareness of the PDPA...
August 9, 2016: JMIR Med Educ
Himmatrao Saluba Bawaskar
Daily, I receive 3-4 social media messages regarding the diagnosis, management or clinical dilemmas of acute timelimiting medical emergencies due to snake bite and scorpion sting poisoning. I respond to the caller who has shared clinical signs and symptoms. I also follow up on the progress of the victim. I send pdf files of my publications on scorpion and snake bite.
October 2016: Indian Journal of Medical Ethics
K Kent, K E Charlton, M Netzel, K Fanning
BACKGROUND: Preclinical evidence suggests that the anthocyanins, which comprise a subclass of dietary flavonoids providing the purple and red pigmentation in plant-based foods, may have a beneficial impact on cognitive outcomes. METHODS: A systematic review was conducted to identify the published literature on food-based anthocyanin consumption and cognitive outcomes in human intervention trials. The literature search followed PRISMA guidelines and included six databases, as well as additional hand searching...
October 11, 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
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