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Point of care

T Kühlein, F Madlo-Thiess, V Wambach, S Schaffer
Background: Quality management (QM) became mandatory for the ambulatory sector of the German health care system 10 years ago. Objectives: The aim of this study was to find out how general practitioners (GPs) perceived the introduction of this measure, how they see it today and what they expect of the future concerning QM. Materials and Methods: In a qualitative study, interviews following a semi-structured guideline with GPs were conducted. Following transcription, interviews were coded in triangulation, first inductively, then deductively until saturation was reached...
October 25, 2016: Das Gesundheitswesen
Ramnath Subbaraman, Ruvandhi R Nathavitharana, Srinath Satyanarayana, Madhukar Pai, Beena E Thomas, Vineet K Chadha, Kiran Rade, Soumya Swaminathan, Kenneth H Mayer
BACKGROUND: India has 23% of the global burden of active tuberculosis (TB) patients and 27% of the world's "missing" patients, which includes those who may not have received effective TB care and could potentially spread TB to others. The "cascade of care" is a useful model for visualizing deficiencies in case detection and retention in care, in order to prioritize interventions. METHODS AND FINDINGS: The care cascade constructed in this paper focuses on the Revised National TB Control Programme (RNTCP), which treats about half of India's TB patients...
October 2016: PLoS Medicine
Nádia Sitoe, Rosa Macamo, Bindiya Meggi, Ocean Tobaiwa, Osvaldo Loquiha, Timothy Bollinger, Lara Vojnov, Ilesh Jani
BACKGROUND: In resource-limited countries, CD4 T-cell (CD4) testing continues to be used for determining antiretroviral therapy (ART) initiation eligibility and opportunistic infection monitoring. To support expanded access to CD4 testing, simple and robust technologies are necessary. We conducted this study to evaluate the performance of a new Point-of-Care (POC) CD4 technology, the MyT4, compared to conventional laboratory CD4 testing. METHODS: EDTA venous blood from 200 HIV-positive patients was tested in the laboratory using the MyT4 and BD FACSCalibur™...
2016: PloS One
Emma Dargie, Ronald R Holden, Caroline F Pukall
Millions suffer from chronic vulvar pain (ie, vulvodynia). Vulvodynia represents the intersection of 2 difficult subjects for health care professionals to tackle: sexuality and chronic pain. Those with chronic vulvar pain are often uncomfortable seeking help, and many who do so fail to receive proper diagnoses. The current research developed a multidimensional assessment questionnaire, the Vulvar Pain Assessment Questionnaire (VPAQ) inventory, to assist in the assessment and diagnosis of those with vulvar pain...
August 1, 2016: Pain
Alexandra B Collins, Carol Strike, Adrian Guta, Rosalind Baltzer Turje, Patrick McDougall, Surita Parashar, Ryan McNeil
BACKGROUND: Compensation for participating in research has been a fundamental element of the research apparatus despite concerns about its impact on incentivising participation. Researchers and research ethics boards acknowledge that compensation may prompt structurally vulnerable populations, such as people who use drugs (PWUD), to engage in research primarily out of financial need. Thus, institutional restrictions around compensation have been implemented. This study explores the ethical implications of compensation practices aimed at 'protecting' structurally vulnerable people living with HIV (PLHIV) who use drugs within the context of individuals' lived realities...
October 22, 2016: International Journal on Drug Policy
Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
Emmanuelle Chaléat-Valayer, Angélique Denis, Kariman Abelin-Genevois, Amélie Zelmar, Fabienne Siani-Trebern, Sandrine Touzet, Alain Bergeret, Cyrille Colin, Jean-Baptiste Fassier
OBJECTIVE: Low-back pain (LBP) is a common and recurrent condition, but the evidence is scarce about effective strategies to prevent recurrence and disability in the longer term. This study investigated the effect of a light exercise program, initiated in the workplace and continued at home, in reducing recurrence of LBP episodes among healthcare workers. METHODS: A total of 353 healthcare workers from ten hospitals were enrolled in a randomized controlled trial (RCT) and were randomized to the intervention or control groups, the latter of which received usual care...
October 3, 2016: Scandinavian Journal of Work, Environment & Health
Natisha Sands, Stephen Elsom, Rebecca Corbett, Sandra Keppich-Arnold, Roshani Prematunga, Michael Berk, Julie Considine
Patient safety research focussing on recognizing and responding to clinical deterioration is gaining momentum in generalist health, but has received little attention in mental health settings. The focus on early identification and prompt intervention for clinical deterioration enshrined in patient safety research is equally relevant to mental health, especially in triage and crisis care contexts, yet the knowledge gap in this area is substantial. The present study was a controlled cohort study (n = 817) that aimed to identify patient and service characteristics associated with clinical deterioration of mental state indicated by unplanned admission to an inpatient psychiatric unit following assessment by telephone-based mental health triage...
October 25, 2016: International Journal of Mental Health Nursing
Sara H Javid, Sarah O Lawrence, Danielle C Lavallee
Breast-cancer-specific tools that measure health-related quality of life (HRQOL) were developed for use in research or clinical practice, and little is known about these tools' performance ability for quality improvement. Furthermore, existing tools may not fully reflect all issues that contribute to quality care as seen by patients. Work is needed to identify and validate patient-reported outcome measures for use in quality improvement in breast cancer surgical care. We conducted an exploratory qualitative study in order to better understand what HRQOL domains and processes of care define high quality surgical care for women undergoing mastectomy for breast cancer from both the patient and clinician perspective...
October 25, 2016: Breast Journal
Trudy Klomp, Anke B Witteveen, Ank de Jonge, Eileen K Hutton, Antoine L M Lagro-Janssen
INTRODUCTION: Many pregnant women are concerned about the pain they will experience in labor and how to deal with this. This study's objective was to explore women's postpartum perception and view of how they dealt with labor pain. METHODS: Semistructured postpartum interviews were analyzed using the constant comparison method. Using purposive sampling, we selected 17 women from five midwifery practices across the Netherlands, from August 2009 to September 2010...
October 25, 2016: Journal of Psychosomatic Obstetrics and Gynaecology
Lessandro Curcio, Bruno Salama, Daniel Luis Pinto, Antonio Claudio Ahouagi
BACKGROUND: Nephron sparing surgery (NSS) is well established as the standard of care for most surgical small renal tumors when technically feasible. While the majority of sporadic renal tumors are solitary, multifocal tumors have been reported in 5.4% to 25% of patients with tumors smaller than 5cm. We present a video where we approach, through laparoscopy, four tumors on the same kidney. CASE STUDY: Male, 58y, went through a routine abdominal ultrasound which showed a 5cm left kidney nodule...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Ajit Pai, Saleh Mohamed Eftaiha, George Melich, John J Park, Pey-Yi Kevin Lin, Leela M Prasad, Slawomir J Marecik
BACKGROUND: Today, extralevator abdominoperineal resection is the standard of care for low rectal cancers with sphincter involvement or location precluding anastomosis. This procedure, while effective from an oncologic point of view, is morbid, with a high incidence of wound complications and genitourinary, and sexual dysfunction. We present a modification of this procedure via a robotic approach, which maintains the radicality while reducing the soft tissue loss and potentially the morbidity...
October 24, 2016: World Journal of Surgery
Tzu-Heng Wu, Chia-Chen Chang, Julien Vaillant, Aurélien Bruyant, Chii-Wann Lin
Smartphone camera based gold nanoparticle colorimetry (SCB-AuNP colorimetry) has shown good potential for point-of-care applications. However, due to the use of a camera as a photo-detector, there are major limitations to this technique such as a low bit resolution (∼8 bits mainstream) and a low data acquisition rate. These issues have limited the ultimate sensitivity of smartphone based colorimetry as well as the possibility to integrate efficiently a more sensitive approach such as detection based on a lock-in amplifier (LIA)...
October 25, 2016: Lab on a Chip
Tyler Shelby, Tuhina Banerjee, Jyothi Kallu, Shoukath Sulthana, Irene Zegar, Santimukul Santra
Rapid detection and diagnosis of pathogenic strains of influenza is necessary for expedited treatment and quicker resolutions to the ever-rising flu pandemics. Considering this, we propose the development of novel magnetic relaxation nanosensors (MRnS) for the rapid detection of influenza through targeted binding with hemagglutinin. 2,6- and 2,3-sialic acid ligands and entry blocker peptides are conjugated to iron oxide nanoparticles to create functional MRnS. Positive detection of various hemagglutinin variants (H1 and H5) is possible with protein concentrations as little as 1...
October 25, 2016: Nanoscale
Cristen P Page, Alfred Reid, Catherine L Coe, Martha Carlough, Daryl Rosenbaum, Janalynn Beste, Blake Fagan, Erika Steinbacher, Geoffrey Jones, Warren P Newton
BACKGROUND : Implementation of the educational milestones benefits from mobile technology that facilitates ready assessments in the clinical environment. We developed a point-of-care resident evaluation tool, the Mobile Medical Milestones Application (M3App), and piloted it in 8 North Carolina family medicine residency programs. OBJECTIVE : We sought to examine variations we found in the use of the tool across programs and explored the experiences of program directors, faculty, and residents to better understand the perceived benefits and challenges of implementing the new tool...
October 2016: Journal of Graduate Medical Education
Greg Ogrinc, Emily S Cohen, Robertus van Aalst, Beth Harwood, Ellyn Ercolano, Karyn D Baum, Adam J Pattison, Anne C Jones, Louise Davies, Al West
BACKGROUND : Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. OBJECTIVE : We sought to determine the clinical and educational impact of an integrated QI curriculum. METHODS : This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum...
October 2016: Journal of Graduate Medical Education
Mohamed A Daw, Abdallah El-Bouzedi, Mohamed O Ahmed, Aghnyia A Dau, Mohamed M Agnan, Aisha M Drah, Ali O Deake
Immigrants have become an important focus point of research nowadays particularly as they are prone to certain viral infections and diseases. This will be reflected greatly on the health care system of both the traverse and resettlement countries. African immigrants from North and Sub-Saharan countries accounted for the majority of immigrants to European Union particularly after the recent armed conflict in Libya. Here in we report on the prevalence of Human Immune Deficiency Virus in African immigrants resided in Libya before reaching their final destiny in EU...
October 21, 2016: Travel Medicine and Infectious Disease
William R Doucette, Julia J Rippe, Caroline A Gaither, David H Kreling, David A Mott, Jon C Schommer
OBJECTIVES: To describe services provided by community pharmacies and to identify factors associated with services being provided in community pharmacies. DESIGN: Cross-sectional national mail survey. SETTING AND PARTICIPANTS: Pharmacists actively practicing in community pharmacies (independent, chain, mass merchandisers, and supermarkets). OUTCOME MEASURES: Frequency and type of pharmacy services available in a community pharmacy, including medication therapy management, immunization, adjusting medication therapy, medication reconciliation, disease state management, health screening or coaching, complex nonsterile compounding, and point-of-care testing...
October 21, 2016: Journal of the American Pharmacists Association: JAPhA
Matthieu Parmier, Bénédicte Gourieux, Thierry Krummel, Dorothée Bazin-Kara, Anne Dory, Thierry Hannedouche
The treatment of end-stage renal disease requires a significant number of drug treatments. At patient level, daily management is somewhat difficult: Number of prescribed pills, medication side effects, treatment of asymptomatic diseases… The objective of the study was to investigate the effect of guidance tailored to each patient receiving hemodialysis, performed by the pharmacist (educational interventions). Adult haemodialysis patients with hyperphosphatemia despite phosphate binders were eligible for study entry...
October 21, 2016: Néphrologie & Thérapeutique
Sameera Khan, Reza Hamedy, Yuejuan Lei, Rikke S Ogawa, Shane N White
INTRODUCTION: Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes. Dental anxiety has been associated with pain, fear, care avoidance, and more invasive treatments including nonsurgical root canal treatment (NSRCT). The very words root canal are deeply embedded in societal consciousness. Better understanding of dental anxiety may prevent treatment avoidance. The purpose of this study was to conduct a systematic review of NSRCT-associated anxiety...
October 21, 2016: Journal of Endodontics
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