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Continuous quality improvement

Glen Gawarkiewicz, Anna Malek Mercer
Engaging ocean users, including fishing fleets, in oceanographic and ecological research is a valuable method for collecting high-quality data, improving cost efficiency, and increasing societal appreciation for scientific research. As research partners, fishing fleets provide broad access to and knowledge of the ocean, and fishers are highly motivated to use the data collected to better understand the ecosystems in which they harvest. Here, we discuss recent trends in collaborative research that have increased the capacity of and access to scientific data collection...
June 20, 2018: Annual Review of Marine Science
Emma A Amissah, Julie Brown, Jane E Harding
BACKGROUND: As preterm infants do not experience the nutrient accretion and rapid growth phase of the third trimester of pregnancy, they are vulnerable to postnatal nutritional deficits, including of fat. Consequently, they require higher fat intakes compared to their full term counterparts to achieve adequate growth and development. Human milk fat provides the major energy needs of the preterm infant and also contributes to several metabolic and physiological functions. Although human milk has many benefits for this population, its fat content is highly variable and may be inadequate for their optimum growth and development...
June 19, 2018: Cochrane Database of Systematic Reviews
Clayton Dos Santos Moraes, Eliane Goldberg Rabin, Karin Viégas
OBJECTIVE: to assess potential failures in the care process with orthotics, prosthetics and special materials in a high-complexity hospital. METHOD: an intervention study conducted from March to October 2013. This process was assessed with the Failure Mode and Effects Analysis (FMEA) service tool. The data were analysed according to the risk and the corrective measures were defined. RESULTS: no failure was classified as high risk and the corrective measures indicated as low and moderate risk had the following improvement initiatives suggested: standardize the material records in the information system; create a specific form to require materials; hire specialized technical personnel and create a continuous education program...
May 2018: Revista Brasileira de Enfermagem
Jingzhe Han, Tingting Wang, Yanan Xie, Duanhua Cao, Zhilei Kang, Xueqin Song
RATIONALE: Study reported an extremely rare case of trigeminal neuralgia, vestibular paroxysmia, and hemifacial spasm successively occurring in a patient with vertebrobasilar dolichoectasia (VBD). PATIENT CONCERNS: A 66-year-old female patient presented with episodic vertigo for 20 days before she was admitted to our hospital. Vertigo suddenly occurred when the patient rotated her head 20 days ago, the symptoms of vertigo were improved after continuous 1 to 3 seconds, and similar symptoms were repeated in sleep and rest, with a frequency of 30 to 40 times per day...
June 2018: Medicine (Baltimore)
Arianne Teherani, Karen E Hauer, Alicia Fernandez, Talmadge E King, Catherine Lucey
While students entering medical schools are becoming more diverse, trainees in residency programs in competitive specialties and academic medicine faculty have not increased in diversity. As part of an educational continuous quality improvement (ECQI) process at the University of California, San Francisco, School of Medicine, the authors examined data for the classes of 2013-2016 to determine whether differences existed between underrepresented in medicine (UIM) and not-UIM students' clinical performance (clerkship director ratings and number of clerkship honors grades awarded) and honor society membership--all of which influence residency selection and academic career choices...
June 19, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
P Behm, M Gastl, A Jahn, A Rohde, S Haberkorn, S Krueger, S Weiss, B Schnackenburg, M Sager, K Düring, H Clogenson, P Horn, R Westenfeld, M Kelm, M Neizel-Wittke, F Bönner
Endomyocardial biopsy (EMB) is considered to be the diagnostic gold-standard in detection of myocardial-inflammation. EMB is usually conducted under fluoroscopy without any specific target information. Specific target-information provided by cardiovascular magnetic resonance (CMR) may improve specificity of EMB. The aim was to investigate feasibility and safety of CMR-guided and targeted EMB in a preclinical-model using passively-tracked devices. Procedures were performed on a MRI-System equipped with an Interventional Software-Platform for real-time imaging...
June 19, 2018: International Journal of Cardiovascular Imaging
James E Frampton
Lisdexamfetamine dimesylate (lisdexamfetamine; Elvanse® ; Tyvense® ), an orally-active dexamfetamine prodrug, is indicated in the EU for the treatment of attention-deficit hyperactivity disorder (ADHD) in children aged ≥ 6 years (including adolescents) when the response to previous methylphenidate (MPH) treatment is clinically inadequate. The original approval of the drug was based on the results of phase III trials in children and adolescents with ADHD who had an inadequate response to previous pharmacotherapy (e...
June 19, 2018: Drugs
Reza Monfaredi, Kevin Cleary, Karun Sharma
Magnetic resonance imaging (MRI) provides high-quality soft-tissue images of anatomical structures and radiation free imaging. The research community has focused on establishing new workflows, developing new technology, and creating robotic devices to change an MRI room from a solely diagnostic room to an interventional suite, where diagnosis and intervention can both be done in the same room. Closed bore MRI scanners provide limited access for interventional procedures using intraoperative imaging. MRI robots could improve access and procedure accuracy...
June 19, 2018: Annals of Biomedical Engineering
Thomas P Lillicrap, Christopher R Levi, Elizabeth Holliday, Mark William Parsons, Andrew Bivard
Background: The phase-II modafinil in debilitating fatigue after stroke trial demonstrated that modafinil improves fatigue and quality of life in severely fatigued stroke survivors. For this study, we sought to examine the interaction between fatigue and quality of life after stroke and determine whether reducing fatigue resulted in improved quality of life. In addition, we followed up a subset of patients 12-months after the trial to assess the long-term outcomes of modafinil therapy...
2018: Frontiers in Neurology
James Ds Jackson, Sarah E Cotton, Sara Bruce Wirta, Catia C Proenca, Milun Zhang, Raquel Lahoz, Frederico J Calado
Purpose: Family and friends play a pivotal role in caring for patients with heart failure (HF); however, evidence of the impact of caregiving is limited. The objectives of this study were to describe the burden of caregiving on informal caregivers of patients with chronic HF in China. Materials and methods: A cross-sectional survey of cardiologists, their patients with HF, and those patients' caregivers was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients...
2018: Drug Design, Development and Therapy
Giulio Pioli, Chiara Bendini, Paolo Pignedoli, Andrea Giusti, David Marsh
A high proportion of patients with fragility fracture, mainly hip fracture, have a variable degree of comorbidity and show some degree of dependence in basic or more complex activities of daily living. Evaluating these patents following the geriatric concept of frailty, about one third of hip fracture patients may be categorised as frail with high risk of poor outcomes and prolonged length of stay, one third as not frail, and about one third with an intermediate condition. Due to the high vulnerability, combined with the hip fracture event and surgical repair procedures, a multidisciplinary approach that includes geriatric competencies becomes essential to improve short and long-term outcomes after hip fracture...
April 20, 2018: Injury
H Jiang, B Q Wang, Z H Gao, K Y Song
At present, laryngeal cancer is more common in otolaryngology and head and neck surgery malignancies. Patients such as hoarseness, difficulty swallowing, ear pain, cough or cough, phlegm, dyspnea and other symptoms. which brings severe physical and psychological trauma to the patients and brings a heavy burden to the families and families of patients.Laryngeal cancer patients often take surgery, radiotherapy and other treatment methods, but these methods often cause patients with speech and speech disorders,patients with adverse psychological effects...
June 5, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Jeppe Madura Larsen, Katrine Lindholm Bøgh
Food allergy is an adverse reaction to otherwise harmless proteins in food. The disease is a major health problem of growing concern, affecting approximately 5-8% of young children and 2-4% of adults. No accepted strategy exists for prevention and treatment of food allergy, and strict avoidance of the offending food is presently the only viable management option. Living with food avoidance may have a huge impact on the quality of life of food allergic patients, with daily fear of serious or even fatal reactions...
June 19, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Pamela Martyn-Nemeth, Shane A Phillips, Dan Mihailescu, Sarah S Farabi, Chang Park, Rebecca Lipton, Esema Idemudia, Laurie Quinn
AIMS: To examine sleep quality and its associations with glycemic control, glycemic variability and fear of hypoglycemia in adults with type 1 diabetes. BACKGROUND: Poor sleep quality has negative health consequences and is a frequent complaint among adults with type 1 diabetes. Sleep quality in adults with type 1 diabetes is likely affected by glucose levels as well as stressors associated with managing a chronic condition. DESIGN: A retrospective secondary analysis of pooled data from two previous cross-sectional studies was conducted...
June 19, 2018: Journal of Advanced Nursing
Amy J Spooner, Wendy Chaboyer, Leanne M Aitken
BACKGROUND: Interruptions during handover may compromise continuity of care and patient safety. LOCAL PROBLEM: Interruptions occur frequently during handovers in the intensive care unit. METHODS: A quality improvement study was undertaken to improve nursing team leader handover processes. The frequency, source, and reason interruptions occurred were recorded before and after a handover intervention. INTERVENTIONS: The intervention involved relocating handover from the desk to bedside and using a printed version of an evidence-based electronic minimum data set...
June 18, 2018: Journal of Nursing Care Quality
Liya Lu, Jennifer Deane, Linda Sharp
PURPOSE OF REVIEW: The number of cancer survivors is growing due to population ageing, earlier detection and more effective therapies. Routinely collected data (RCD), generally cancer registry data, has been used to investigate survivors' needs and outcomes. We reviewed uses of RCD since 2017, identifying novel findings and research directions. RECENT FINDINGS: Survival is improving internationally but continues to vary between subgroups. Longitudinal survivor surveys suggest malignancy-specific temporal patterns in unmet needs and health-related quality-of-life (HRQoL)...
June 18, 2018: Current Opinion in Supportive and Palliative Care
Gunnar Nordin
BACKGROUND: The accuracy and trueness of results from a laboratory test, such as the HbA1c test, should not be taken for granted but must be checked continuously. A tool for this is the participation in external quality assessment (EQA) for all laboratories performing the HbA1c-test. An additional possibility to detect changes in trueness is to monitor variations in patient cohort mean or median values that is not explained by changes in treatment or selection of patients. METHODS: Results reported to an EQA scheme for HbA1c during 20 years have been extracted from Equalis database...
June 1, 2018: Journal of Diabetes Science and Technology
Silvia Rossi Ferrario, Gianluigi Balestroni, Chiara Gattoni, Giovanna Omarini, Pierangela Omarini, Paola Cerutti, Massimo Pistono
OBJECTIVES: Patients implanted with a Left Ventricular Assist Device (LVAD) constitute a new population of chronic heart failure (HF) patients requiring continuous medical support and representing heavy costs - both direct and indirect - for the healthcare system. If there is consensus about the increased survival, the psychosocial outcomes, in terms of psychological wellbeing, behavioral and social functioning of both patients and caregivers, are still unclear. Overall, it is not clear if local health and social services are equipped to support them in their needs...
November 2017: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Andrea Poscia, Elena Azzolini, Pasquale Cacciatore, Antonio Giulio de Belvis, Massimo Volpe, Andrea Cambieri, Gianfranco Damiani, Walter Ricciardi, Maria Lucia Specchia
BACKGROUND: Clinical Governance (CG) is a validated framework for continuous quality improvement in health care settings. Quality medical records may reflect the quality of care delivered and are a viable tool to implement CG skills. AIM: Aim of this study is to investigate the correlation between the level of implementation of CG dimensions and the quality of medical records. MATERIAL AND METHODS: A cross-sectional study was carried out in an Italian Teaching Hospital...
April 2018: Annali Dell'Istituto Superiore di Sanità
Spencer E Harpe, Lisa B Phipps
BACKGROUND: Pharmacy schools must encourage a culture of inquiry so future pharmacists approach practice in a scholarly fashion. OBJECTIVES: To develop an instrument measuring intentions to engage in various scholarly activities. METHODS: Items representing scholarly activities relevant to pharmacists were developed. Exploratory factor analysis (EFA) was used to refine the list and identify underlying factors. Internal consistency was examined using Cronbach's alpha...
January 1, 2018: Journal of Pharmacy Practice
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