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https://www.readbyqxmd.com/read/28101880/family-emergency-plan-and-preparedness-among-medical-practitioners-in-zaria-nigeria
#1
Jerry Godfrey Makama, Istifanus Anekoson Joshua, Elizabeth Jerry Makama
BACKGROUND: There has been an increase in the incidence of disasters in many parts of the world. Similarly, Nigeria has witnessed a recent increase of man-made disaster events such as plane crash, fire incidents, flood, and building collapse, including bomb blast orchestrated by terrorists that often create emergency situations. Therefore, the aim of the study was to evaluate family emergency plan and preparedness among medical practitioners in Zaria. METHODS: This was a cross-sectional descriptive study (May-July, 2013) of medical practitioners in Zaria, Nigeria...
November 2016: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28100438/high-dose-rifampicin-moxifloxacin-and-sq109-for-treating-tuberculosis-a-multi-arm-multi-stage-randomised-controlled-trial
#2
Martin J Boeree, Norbert Heinrich, Rob Aarnoutse, Andreas H Diacon, Rodney Dawson, Sunita Rehal, Gibson S Kibiki, Gavin Churchyard, Ian Sanne, Nyanda E Ntinginya, Lilian T Minja, Robert D Hunt, Salome Charalambous, Madeleine Hanekom, Hadija H Semvua, Stellah G Mpagama, Christina Manyama, Bariki Mtafya, Klaus Reither, Robert S Wallis, Amour Venter, Kim Narunsky, Anka Mekota, Sonja Henne, Angela Colbers, Georgette Plemper van Balen, Stephen H Gillespie, Patrick P J Phillips, Michael Hoelscher
BACKGROUND: Tuberculosis is the world's leading infectious disease killer. We aimed to identify shorter, safer drug regimens for the treatment of tuberculosis. METHODS: We did a randomised controlled, open-label trial with a multi-arm, multi-stage design. The trial was done in seven sites in South Africa and Tanzania, including hospitals, health centres, and clinical trial centres. Patients with newly diagnosed, rifampicin-sensitive, previously untreated pulmonary tuberculosis were randomly assigned in a 1:1:1:1:2 ratio to receive (all orally) either 35 mg/kg rifampicin per day with 15-20 mg/kg ethambutol, 20 mg/kg rifampicin per day with 400 mg moxifloxacin, 20 mg/kg rifampicin per day with 300 mg SQ109, 10 mg/kg rifampicin per day with 300 mg SQ109, or a daily standard control regimen (10 mg/kg rifampicin, 5 mg/kg isoniazid, 25 mg/kg pyrazinamide, and 15-20 mg/kg ethambutol)...
January 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28097296/long-term-postprocedural-outcomes-of-palliative-emergency-stenting-vs-stoma-in-malignant-large-bowel-obstruction
#3
Jonathan S Abelson, Heather L Yeo, Jialin Mao, Jeffrey W Milsom, Art Sedrakyan
Importance: Colonic stenting was introduced for palliation of malignant large-bowel obstruction (MLBO) more than 20 years ago but remains controversial. Objective: To compare outcomes after palliative stenting vs stoma creation in patients with MLBO requiring emergency management. Design, Setting, and Participants: This observational cohort study assessed 345 patients from New York State with an urgent or emergency admission to the hospital for obstruction secondary to colorectal cancer and who underwent stenting or stoma creation from October 1, 2009, through December 31, 2013...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28091333/an-ecological-approach-to-reducing-potentially-inappropriate-medication-use-canadian-deprescribing-network
#4
Cara Tannenbaum, Barbara Farrell, James Shaw, Steve Morgan, Johanna Trimble, Jane Currie, Justin Turner, Paula Rochon, James Silvius
Polypharmacy is growing in Canada, along with adverse drug events and drug-related costs. Part of the solution may be deprescribing, the planned and supervised process of dose reduction or stopping of medications that may be causing harm or are no longer providing benefit. Deprescribing can be a complex process, involving the intersection of patients, health care providers, and organizational and policy factors serving as enablers or barriers. This article describes the justification, theoretical foundation, and process for developing a Canadian Deprescribing Network (CaDeN), a network of individuals, organizations, and decision-makers committed to promoting the appropriate use of medications and non-pharmacological approaches to care, especially among older people in Canada...
January 16, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28087052/contraceptive-practices-of-women-with-complex-congenital-heart-disease
#5
Pamela D Miner, Mary M Canobbio, Dorothy D Pearson, Mary Schlater, Yvonne Balon, Kathryn J Junge, Ami Bhatt, Deena Barber, Michelle J Nickolaus, Adrienne H Kovacs, Philip Moons, Kate Shaw, Susan M Fernandes
Understanding the contraceptive practices of women with complex congenital heart disease (CHD) and providing them individualized contraception counseling may prevent adverse events and unplanned high-risk pregnancies. Given this, we sought to examine the contraceptive practices in women with CHD, describe adverse events associated with contraceptive use, and describe the provision of contraception counseling. Women >18 years were recruited from 2011 to 2014 from 9 adult CHD (ACHD) centers throughout North America...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28086976/impact-of-a-tailored-program-on-the-implementation-of-evidence-based-recommendations-for-multimorbid-patients-with-polypharmacy-in-primary-care-practices-results-of-a-cluster-randomized-controlled-trial
#6
Cornelia Jäger, Tobias Freund, Jost Steinhäuser, Christian Stock, Johannes Krisam, Petra Kaufmann-Kolle, Michel Wensing, Joachim Szecsenyi
BACKGROUND: Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previously identified determinants of practice. The aim of this study was to assess the effect of a tailored program to improve the implementation of three important processes of care for this patient group: (a) structured medication counseling including brown bag reviews, (b) the use of medication lists, and (c) structured medication reviews to reduce potentially inappropriate medication...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28079394/the-positive-emotions-after-acute-coronary-events-behavioral-health-intervention-design-rationale-and-preliminary-feasibility-of-a-factorial-design-study
#7
Jeffery C Huffman, Ariana M Albanese, Kirsti A Campbell, Christopher M Celano, Rachel A Millstein, Carol A Mastromauro, Brian C Healy, Wei-Jean Chung, James L Januzzi, Linda M Collins, Elyse R Park
BACKGROUND: Positive psychological constructs, such as optimism, are associated with greater participation in cardiac health behaviors and improved cardiac outcomes. Positive psychology interventions, which target psychological well-being, may represent a promising approach to improving health behaviors in high-risk cardiac patients. However, no study has assessed whether a positive psychology intervention can promote physical activity following an acute coronary syndrome. OBJECTIVE: In this article we will describe the methods of a novel factorial design study to aid the development of a positive psychology-based intervention for acute coronary syndrome patients and aim to provide preliminary feasibility data on study implementation...
November 1, 2016: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28073946/a-randomized-phase-iii-trial-of-comparing-two-dose-fractionations-stereotactic-body-radiotherapy-sbrt-for-medically-inoperable-stage-ia-non-small-cell-lung-cancer-or-small-lung-lesions-clinically-diagnosed-as-primary-lung-cancer-japan-clinical-oncology-group
#8
EDITORIAL
Tomoki Kimura, Yasushi Nagata, Junko Eba, Shuichi Ozawa, Satoshi Ishikura, Taro Shibata, Yoshinori Ito, Masahiro Hiraoka, Yasumasa Nishimura
A randomized Phase III trial commenced in Japan in February 2016. Currently, 42 Gy in four fractions of stereotactic body radiotherapy prescribed at the D95% of the planning target volume, which is considered equal to the commonly used 48 Gy in four fractions at the isocenter using an old dose calculation algorithm, is the standard treatment in Japan for medically inoperable Stage IA non-small cell lung cancer and small lung lesions clinically diagnosed as primary lung cancer. This study aims to examine the superiority of 55 Gy in four fractions over 42 Gy in four fractions...
January 9, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28069027/reliability-of-health-related-quality-of-life-assessments-made-by-older-adults-and-significant-others-for-health-states-of-increasing-cognitive-impairment
#9
Gina Bravo, Modou Sene, Marcel Arcand
BACKGROUND: Older adults are encouraged by many organizations to engage in advance care planning in the event of decisional incapacity. Planning for future health care often involves anticipating health-related quality of life (HRQoL) in states of reduced cognitive functioning. No study has yet examined whether anticipated HRQoL is stable over time. The accuracy with which significant others can predict how an older adult envisions HRQoL in a future state of cognitive impairment is also unknown...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28065833/standardizing-abortion-research-outcomes-star-a-protocol-for-developing-disseminating-and-implementing-a-core-outcome-set-for-medical-and-surgical-abortion
#10
Katherine C Whitehouse, Caron R Kim, Bela Ganatra, James M N Duffy, Jennifer Blum, Dalia Brahmi, Mitchell D Creinin, Teresa DePiñeres, Kristina Gemzell-Danielsson, Daniel Grossman, Beverly Winikoff, A Metin Gülmezoglu
BACKGROUND: Abortion is one of the most common events in women's healthcare worldwide. Currently there is no standardization for the selection and reporting of outcomes in abortion clinical trials. This heterogeneity in clinical trials can make it difficult to draw meaningful conclusions across studies. OBJECTIVE: We aim to develop, disseminate, and implement a core outcome set (COS) for medical and surgical abortion trials. MATERIALS & METHODS: To guide this project, we have assembled a local study management team and an international advisory group including abortion providers, researchers, methodologists, and abortion clients...
January 5, 2017: Contraception
https://www.readbyqxmd.com/read/28057607/the-value-of-electronic-medical-record-implementation-in-mental-health-care-a-case-study
#11
Sanaz Riahi, Ilan Fischler, Melanie I Stuckey, Philip E Klassen, John Chen
BACKGROUND: Electronic medical records (EMR) have been implemented in many organizations to improve the quality of care. Evidence supporting the value added to a recovery-oriented mental health facility is lacking. OBJECTIVE: The goal of this project was to implement and customize a fully integrated EMR system in a specialized, recovery-oriented mental health care facility. This evaluation examined the outcomes of quality improvement initiatives driven by the EMR to determine the value that the EMR brought to the organization...
January 5, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28048281/th-b-brc-00-how-to-identify-and-resolve-potential-clinical-errors-before-they-impact-patients-treatment-lessons-learned
#12
Indra Das
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047986/su-f-t-234-quality-improvements-in-the-electronic-medical-record-of-patients-treated-with-high-dose-rate-brachytherapy
#13
T Diener, D Wilkinson
PURPOSE: To improve workflow efficiency and patient safety by assessing the quality control documentation for HDR brachytherapy within our Electronic Medical Record System (Mosaiq). METHODS: A list of parameters based on NRC regulations, our quality management program (QMP), recommendations of the ACR and the American Brachytherapy Society, and HDR treatment planning risks identified in our previous FMEA study was made. Next, the parameter entries were classified according to the type of data input-manual, electronic, or both...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047635/th-b-brc-01-how-to-identify-and-resolve-potential-clinical-errors
#14
I Das
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047308/tu-ab-brc-09-fast-dose-averaged-let-and-biological-dose-calculations-for-proton-therapy-using-graphics-cards
#15
H Wan, Chan Tseung, C Beltran
PURPOSE: To demonstrate fast and accurate Monte Carlo (MC) calculations of proton dose-averaged linear energy transfer (LETd) and biological dose (BD) on a Graphics Processing Unit (GPU) card. METHODS: A previously validated GPU-based MC simulation of proton transport was used to rapidly generate LETd distributions for proton treatment plans. Since this MC handles proton-nuclei interactions on an event-by-event using a Bertini intranuclear cascade-evaporation model, secondary protons were taken into account...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046984/th-b-brc-02-troubleshooting-issues-with-linear-accelerator
#16
S Sutlief
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046324/th-b-brc-03-measurement-and-calibration-discrepancy-advanced-warning-guidance
#17
D Followill
Radiation treatment consists of a chain of events influenced by the quality of machine operation, beam data commissioning, machine calibration, patient specific data, simulation, treatment planning, imaging and treatment delivery. There is always a chance that the clinical medical physicist may make or fail to detect an error in one of the events that may impact on the patient's treatment. In the clinical scenario, errors may be systematic and, without peer review, may have a low detectability because they are not part of routine QA procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045940/applying-the-integrated-practice-unit-concept-to-a-modified-virtual-ward-model-of-care-for-patients-at-highest-risk-of-readmission-a-randomized-controlled-trial
#18
Lian Leng Low, Shu Yun Tan, Matthew Joo Ming Ng, Wei Yi Tay, Lee Beng Ng, Kanchana Balasubramaniam, Rachel Marie Towle, Kheng Hock Lee
BACKGROUND: Emerging evidence from the virtual ward care model showed that multidisciplinary case management are inadequate to reduce readmissions or death for high risk patients. There is consensus that interventions should encompass both pre-hospital discharge and post-discharge transitional care to be effective. Integrated practice units (IPU) had been proposed as an approach of restructuring the organization and work processes of multidisciplinary teams to achieve value in healthcare...
2017: PloS One
https://www.readbyqxmd.com/read/28038509/engaging-college-undergraduates-in-advance-care-planning
#19
Sara Sanders, Erin L Robinson
Advance care planning (ACP) is a critical part of long-term health-care planning, as no one knows when the ability to make personal medical decisions may be impaired. Many assume ACP is only necessary for older adults or those with life-threatening health conditions; however, there are growing discussions about healthy, young adults also engaging in ACP, as they too suffer from unexpected medical events that limit their ability to make medical decisions. The current study examined the reactions of college students following the completion of their advance care plans and then sharing these plans with friends and family...
February 2017: Omega
https://www.readbyqxmd.com/read/28025925/contemporary-trends-in-oral-antiplatelet-agent-use-in-patients-treated-with-percutaneous-coronary-intervention-for-acute-coronary-syndrome
#20
Kibum Kim, Todd A Lee, Daniel R Touchette, Robert J DiDomenico, Amer K Ardati, Surrey M Walton
BACKGROUND: Recent trials demonstrated the efficacy of prasugrel and ticagrelor compared with clopidogrel in the reduction of cardiovascular complications in patients with acute coronary syndrome (ACS). However, it is unclear how use of the 3 antiplatelet medications has changed in commercially insured patients since the advent of the new agents. OBJECTIVES: To (a) describe the adoption of prasugrel and ticagrelor in patients who received percutaneous coronary intervention (PCI) for the onset of ACS and (b) explore patient factors associated with the selection of the drug to provide insight into utilization patterns of these antiplatelet agents...
January 2017: Journal of Managed Care & Specialty Pharmacy
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