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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29145708/managing-non-serious-low-back-pain-in-the-emergency-department-time-for-a-change
#2
Gustavo C Machado, Eileen Rogan, Chris G Maher
Low back pain is a common condition seen in the ED. However, its management in this setting has received relatively little attention and there have been few efforts to develop strategies to improve emergency care of low back pain. In order to ensure that care is appropriately delivered for low back pain patients in the ED, emergency physicians must understand issues of providing low-value care and consider potential solutions to the problem. In this paper, we describe the usual emergency care provided for non-serious low back pain and present possible strategies for restructuring ED practice and approaches for changing physician and patient behaviour...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#3
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145557/comparative-analysis-of-the-growth-pattern-of-thyroid-cancer-in-young-patients-screened-by-ultrasonography-in-japan-after-a-nuclear-accident-the-fukushima-health-management-survey
#4
Sanae Midorikawa, Akira Ohtsuru, Michio Murakami, Hideto Takahashi, Satoru Suzuki, Takashi Matsuzuka, Hiroki Shimura, Tetsuya Ohira, Shin-Ichi Suzuki, Seiji Yasumura, Shunichi Yamashita, Hitoshi Ohto, Koichi Tanigawa, Kenji Kamiya
Importance: Thyroid cancer generally grows at a very slow rate in adults, and overdiagnosis is a global issue. However, the detection of early-stage thyroid cancer by screening is not well described in young patients. To prevent overdiagnosis, it is essential to understand the natural course of thyroid cancer growth detection by ultrasonography screening in young patients. Objective: To evaluate the natural progression of thyroid cancer in young patients. Design, Setting, and Participants: An observational study evaluated changes in the diameter of malignant or suspected malignant thyroid tumors on 2 occasions...
November 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29145552/association-between-perceived-barriers-to-diabetes-self-management-and-diabetic-retinopathy-in-asian-patients-with-type-2-diabetes
#5
Ryan Eyn Kidd Man, Eva K Fenwick, Alfred Tau Liang Gan, Charumathi Sabanayagam, Preeti Gupta, Amudha Aravindhan, Tien Yin Wong, Gavin Siew Wei Tan, Ecosse L Lamoureux
Importance: A patient's perceived barriers to diabetes self-management (DSM) may affect his or her risk of diabetic retinopathy (DR); however, few studies have examined this association. Objective: To examine the association between perceived barriers to DSM and the severity spectrum of DR in Asian patients with type 2 diabetes. Design, Setting, and Participants: A cross-sectional clinic-based study, the Singapore Diabetes Management Project, was conducted from December 28, 2010, to March 20, 2013, at the Singapore National Eye Centre, a tertiary eye care institute...
November 16, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29145548/supported-discharge-teams-for-older-people-in-hospital-acute-care-hospital-a-randomised-controlled-trial
#6
Matthew Parsons, John Parsons, Paul Rouse, Avinesh Pillai, Sean Mathieson, Rochelle Parsons, Christine Smith, Tim Kenealy
Background: Supported Discharge Teams aim to help with the transition from hospital to home, whilst reducing hospital length-of-stay. Despite their obvious attraction, the evidence remains mixed, ranging from strong support for disease-specific interventions to less favourable results for generic services. Objective: To determine whether older people referred to a Supported Discharge Team have: (i) reduced length-of-stay in hospital; (ii) reduced risk of hospital readmission; and (iii) reduced healthcare costs...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29145407/predicting-mortality-and-hospitalization-of-older-adults-by-the-multimorbidity-frailty-index
#7
Yao-Chun Wen, Liang-Kung Chen, Fei-Yuan Hsiao
BACKGROUND: Existing operational definitions of frailty are personnel-costly and time-consuming, resulting in estimates with a small sample size that cannot be generalized to the population level. The objectives were to develop a multimorbidity frailty index using Taiwan's claim database, and to understand its ability to predict adverse event. METHODS: This is a retrospective cohort study. Subjects aged 65 to 100 years who have full National Health Insurance coverage in 2005 were included...
2017: PloS One
https://www.readbyqxmd.com/read/29145353/cdc-grand-rounds-improving-medication-adherence-for-chronic-disease-management-innovations-and-opportunities
#8
Andrea B Neiman, Todd Ruppar, Michael Ho, Larry Garber, Paul J Weidle, Yuling Hong, Mary G George, Phoebe G Thorpe
Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions (1). Conversely, nonadherence is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and increased health care costs (2). In the United States, 3.8 billion prescriptions are written annually (3). Approximately one in five new prescriptions are never filled, and among those filled, approximately 50% are taken incorrectly, particularly with regard to timing, dosage, frequency, and duration (4)...
November 17, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29145313/the-importance-of-family-caregiving-to-achieving-palliative-care-at-home-a-case-report-of-end-of-life-breast-cancer-in-an-area-struck-by-the-2011-fukushima-nuclear-crisis-a-case-report
#9
Akihiko Ozaki, Masaharu Tsubokura, Claire Leppold, Toyoaki Sawano, Manabu Tsukada, Tsuyoshi Nemoto, Kazuhiro Kosugi, Yoshitaka Nishikawa, Shigeaki Kato, Hiromichi Ohira
RATIONALE: The primary setting of palliative care has shifted from inpatient care to patients' residences. Family caregiving is essential for patients with life-limiting illnesses to receive palliative care at home, however little information is available regarding potential interventions to achieve palliative homecare for those without sufficient support from family members in various settings, including disasters. PATIENT CONCERNS: In March 2011, Fukushima, Japan experienced an earthquake, tsunami and nuclear disaster...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145030/the-use-of-econsults-to-improve-access-to-specialty-care-in-thrombosis-medicine
#10
Leslie Skeith, Medina Mohamed, Alan Karovitch, Clare Liddy, Amir Afkham, Douglas Archibald, Erin Keely
INTRODUCTION: Electronic consultations (eConsults) are asynchronous, consultative electronic-based communications that are aimed to improve efficient and timely access to specialist advice. Our study aim was to evaluate the use and impact of the Canadian Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service in the specialty of thrombosis medicine. METHODS: We conducted a cross-sectional study that included descriptive statistics of provider and patient demographic information and consultative-specific data...
November 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29144998/work-based-learning-in-health-care-organisations-experienced-by-nursing-staff-a-systematic-review-of-qualitative-studies
#11
REVIEW
Marja Nevalainen, Nina Lunkka, Marjo Suhonen
The aim of this review is to systematically summarise qualitative evidence about work-based learning in health care organisations as experienced by nursing staff. Work-based learning is understood as informal learning that occurs inside the work community in the interaction between employees. Studies for this review were searched for in the CINAHL, PubMed, Scopus and ABI Inform ProQuest databases for the period 2000-2015. Nine original studies met the inclusion criteria. After the critical appraisal by two researchers, all nine studies were selected for the review...
November 11, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29144894/clinical-community-partnerships-to-identify-patients-with-food-insecurity-and-address-food-needs
#12
Elizabeth A Lundeen, Karen R Siegel, Holly Calhoun, Sonia A Kim, Sandra P Garcia, Natalie M Hoeting, Diane M Harris, Laura Kettel Khan, Bryce Smith, Heidi M Blanck, Kevin Barnett, Anne C Haddix
INTRODUCTION: More than 42 million people in the United States are food insecure. Although some health care entities are addressing food insecurity among patients because of associations with disease risk and management, little is known about the components of these initiatives. METHODS: The Systematic Screening and Assessment Method was used to conduct a landscape assessment of US health care entity-based programs that screen patients for food insecurity and connect them with food resources...
November 16, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#13
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144591/is-it-time-to-abandon-care-planning-in-mental-health-services-a-qualitative-study-exploring-the-views-of-professionals-service-users-and-carers
#14
Helen L Brooks, Karina Lovell, Penny Bee, Caroline Sanders, Anne Rogers
BACKGROUND: It has been established that mental health-care planning does not adequately respond to the needs of those accessing services. Understanding the reasons for this and identifying whose needs care plans serve requires an exploration of the perspectives of service users, carers and professionals within the wider organizational context. OBJECTIVE: To explore the current operationalization of care planning and perceptions of its function within mental health services from the perspectives of multiple stakeholders...
November 16, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29144194/an-integrative-behavioral-health-care-model-using-automated-sbirt-and-care-coordination-in-community-health-care
#15
Ronald Dwinnells, Lauren Misik
Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99...
November 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#16
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29143901/combined-vertebral-augmentation-and-radiofrequency-ablation-in-the-management-of-spinal-metastases-an-update
#17
REVIEW
Ning Mao Kam, Julian Maingard, Hong Kuan Kok, Dinesh Ranatunga, Duncan Brooks, William C Torreggiani, Peter L Munk, Michael J Lee, Ronil V Chandra, Hamed Asadi
Spinal metastases are the most commonly encountered tumour of the spine, occurring in up to 40% of patients with cancer. Each year, approximately 5% of cancer patients will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with spinal metastases experience severe and frequently debilitating pain, which often decreases their remaining quality of life. With a median survival of less than 1 year, the goals of treatment in spinal metastases are reducing pain, improving or maintaining level of function and providing mechanical stability...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29143900/an-innovative-mobile-health-system-to-improve-and-standardize-antenatal-care-among-underserved-communities-a-feasibility-study-in-an-italian-hosting-center-for-asylum-seekers
#18
Lucia Borsari, Giovanna Stancanelli, Laura Guarenti, Teresa Grandi, Serena Leotta, Lucia Barcellini, Paola Borella, Anne Caroline Benski
Innovative migrant-friendly tools are needed to assist health personnel manage the high number of pregnancies within reception centers. This study tests functionality and acceptability of a new mHealth system in providing antenatal care amongst migrants. The study, carried out between 2014 and 2016, involved 150 pregnant women residing in the largest European migrant reception center in Sicily. A ticket tracking system assessed the system's functionality and a questionnaire assessed women's acceptability. The system facilitated the collection of clinical data, enabling the creation of electronic patient records and identifying 10% of pregnancies as high-risk...
November 16, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/29143899/headache-in-resource-limited-settings
#19
REVIEW
Yohannes W Woldeamanuel
PURPOSE OF REVIEW: This review summarizes the unmet need of headache burden and management in resource-limited settings. It provides a general overview of the nuances and peculiarities of headache disorders in resource-limited settings. The review delivers perspectives and explanations for the emerging burden of both primary and secondary headache disorders. Important discussion on demographic and epidemiologic transition pertinent to low-resource settings is included. A critical analysis of headache disorders is made within the context of growing burden non-communicable disorders in low-resource countries...
November 16, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29143893/the-role-of-systemic-therapy-in-resectable-gastric-and-gastro-oesophageal-junction-cancer
#20
REVIEW
Elizabeth Cartwright, David Cunningham
Approximately 20% of patients with cancer of the stomach or gastro-oesophageal junction (GOJ) present with resectable disease. Long-term outcome after surgery alone in these patients is poor, and a combined treatment approach is the standard of care. The two approaches to managing patients with cancer of the GOJ are perioperative chemotherapy or preoperative chemoradiotherapy. Based upon the most recent evidence, patients treated with a perioperative approach and deemed suitable for a triplet regimen should be considered for pre- and post-operative FLOT (5-fluorouracil [5-FU], leucovorin, oxaliplatin and docetaxel) and those suitable for a doublet regimen should be considered for a fluoropyrimidine/platinum combination such as capecitabine and oxaliplatin...
November 16, 2017: Current Treatment Options in Oncology
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