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https://www.readbyqxmd.com/read/28543882/risk-factors-for-burnout-among-caregivers-working-in-nursing-homes
#1
Nadia Kandelman, Thierry Mazars, Antonin Levy
AIMS AND OBJECTIVES: Our objectives were a) to assess the level of burnout in nursing home caregivers within a unique healthcare network in France and b) to evaluate potential risk factors in this population. BACKGROUND: Burnout syndrome occurs frequently among nursing home caregivers, and has strong detrimental effects on the quality of health care for residents. DESIGN: We used an observational survey to study burnout in nursing home caregivers...
May 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28538458/continuous-femoral-nerve-catheters-decrease-opioid-related-side-effects-and-increase-home-disposition-rates-among-geriatric-hip-fracture-patients
#2
Diren Arsoy, Michael J Gardner, Derek F Amanatullah, James I Huddleston, Stuart B Goodman, William J Maloney, Julius A Bishop
OBJECTIVE: To evaluate the effect of continuous femoral nerve catheter (CFNC) for postoperative pain control in geriatric proximal femur fractures compared with standard analgesia (SA) treatment. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 trauma center. PATIENTS/PARTICIPANTS: We retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment. INTERVENTION: One hundred forty-nine patients were treated with standard analgesia without nerve catheter whereas 116 patients received an indwelling CFNC...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#3
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28532889/effect-of-self-myofascial-release-on-myofascial-pain-muscle-flexibility-and-strength-a-narrative-review
#4
Leonid Kalichman, Chen Ben David
BACKGROUND: Numerous techniques have been employed to treat myofascial pain syndrome. Self-myofascial release (SMFR) is a relatively new technique of soft tissue mobilization. The simplicity and portability of the SMFR tools allow it to be easily implemented in any type of fitness or rehabilitation program. It is an active method and can be used by anyone at home or at the workplace. OBJECTIVE: To review the current methods of SMFR, their mechanisms, and efficacy in treating myofascial pain, improving muscle flexibility and strength...
April 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/28532443/resourse-use-and-disease-couse-in-dementia-nursing-home-redic-nh-a-longitudinal-cohort-study-design-and-patient-characteristics-at-admission-to-norwegian-nursing-homes
#5
Irene Røen, Geir Selbæk, Øyvind Kirkevold, Knut Engedal, Ingelin Testad, Sverre Bergh
BACKGROUND: Earlier studies of nursing home patients show a high prevalence of dementia, neuropsychiatric symptoms (NPS), pain, and dependency in activities of daily living. The REDIC-NH cohort was set up to study the disease course and the resources used in patients with dementia in Norway. The aim of this paper was to describe the methods and the data collection, and to present selected data about patients at admission to a nursing home. METHODS: We included 696 patients at admission to a nursing home and followed them with biannual assessments until death...
May 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28527552/postoperative-instructions-preoperatively-evaluating-the-effectiveness-of-a-teaching-model-on-patient-satisfaction-regarding-instructions-for-home-care
#6
Jennifer Hovsepian, Cheryl McGah, Claire O'Brien
Patients in the ambulatory setting often receive home care instructions, primarily in the postoperative phase. Patient's retention and understanding of these instructions is one determinant of postoperative outcomes. This article highlights how we designed and implemented a teaching strategy to better prepare patients for discharge from an ambulatory surgical setting. Our methods included developing a day of surgery plan for teaching patients their discharge instructions upon arrival, creating on-line teaching videos, and revising post discharge pain medication instructions...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28522283/-standardised-pain-assessment-in-cognitively-impaired-nursing-home-residents-comparing-the-use-of-assessment-tools-in-dementia-care-units-and-in-integrated-care-units
#7
Rebecca Palm, Erika Sirsch, Bernhard Holle, Sabine Bartholomeyczik
BACKGROUND: A large number of nursing home residents with cognitive impairments (CI) suffer from chronic pain, which is also discussed as a reason for challenging behavior. To assess pain in people with severe CI, the use of an observational pain instrument is recommended; for people without or with mild CI the gold standard is a self-rating instrument. It is unknown whether in German nursing homes pain assessment in residents with severe CI is actually conducted using observational instruments and which instruments are used...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28521750/data-for-improvement-and-clinical-excellence-a-report-of-an-interrupted-time-series-trial-of-feedback-in-home-care
#8
Kimberly D Fraser, Anne E Sales, Melba Andrea B Baylon, Corinne Schalm, John J Miklavcic
BACKGROUND: There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28521010/prospective-audit-of-a-pathway-for-in-patient-pain-management-of-chronic-abdominal-pain-a-novel-and-cost-effective-strategy
#9
Gopinath Niraj, Sanjay Chaudhri
Background.:  Unexplained abdominal pain is a common cause of hospital admission and utilizes significant resource. Current in-patient pain management of acute exacerbation of chronic abdominal pain is primarily directed at pharmacological and psychological management strategies in this group of complex patients. We adopted a novel approach that proved to be both clinically effective and cost-effective. Design.:  Adult patients admitted to a surgical ward with acute exacerbation of chronic abdominal pain referred to in-patient pain management were prospectively audited over a two-year period at a single tertiary centre...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28520648/a-longitudinal-study-of-the-influence-of-comorbidities-and-lifestyle-factors-on-low-back-pain-in-older-men
#10
P Parreira, C G Maher, M L Ferreira, G C Machado, F M Blyth, V Naganathan, L M Waite, M J Seibel, D Handelsman, R G Cumming
Older adults are largely under-represented in to LBP research. In light of the ageing population, it is crucial to understand the influence of comorbidities and lifestyle factors on the risk and prognosis of LBP in older adults. The aims of this study were to describe the course of LBP in older men; to investigate if comorbidities/ lifestyle factors can predict the course of LBP in older men; to assess if comorbidities/ lifestyle factors increase the risk of developing LBP in older men. The study sample comprised 1,685 older men living in suburban Sydney, Australia...
May 16, 2017: Pain
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#11
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28515414/mediastinal-solitary-fibrous-tumor-diagnosed-by-endobronchial-ultrasound-directed-biopsy
#12
Alaina J Webb, Ahmed S Yassin, Ali Saeed, Hemang Yadav, James P Utz
BACKGROUND Solitary fibrous tumors of the middle mediastinal space are uncommon and often not discovered until symptoms secondary to compression of adjacent structures occur. Diagnosis requires surgical biopsy and histological tissue analysis. We describe the ECHO appearance of the solitary fibrous tumor and successful non-invasive EBUS diagnosis. This method of diagnosis allowed for surgical planning for resection and allowed us to exclude non-surgical diseases, such as small cell carcinoma. CASE REPORT A 32-year-old man presented to his primary care physician with worsening intermittent chronic chest pain with recent progressive dysphagia, cough, and dyspnea...
May 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28500089/an-exploration-of-patients-experiences-of-participation-in-a-randomised-controlled-trial-of-the-manchester-acute-coronary-syndromes-macs-decision-rule
#13
Patricia van den Berg, Sarah Kendal, Helen V Alderson, Richard Body
BACKGROUND: As an important part of a pilot study to determine the feasibility of a large randomised controlled trial (RCT) comparing use of the Manchester Acute Coronary Syndromes (MACS) decision rule with standard care, we aimed to explore patient attitudes and potential barriers to participation in a trial of this nature. METHODS: We conducted a qualitative study nested within a pilot RCT comparing use of the MACS rule (which could enable some patients with chest pain to be discharged earlier) with standard care...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28497520/nitrous-oxide-for-procedural-analgesia-at-home-in-a-child-with-epidermolysis-bullosa
#14
Pablo Ingelmo, Andrew Wei, Gonzalo Rivera
Epidermolysis bullosa comprises a range of conditions characterized by fragile skin with painful blistering induced by minor trauma and friction. The Dowling-Meara variant is a severe form characterized by disseminated painful blistering requiring lifelong skin and wound care. The natural history of the disease is characterized by a chronic course that tends to improve with advancing age. Various multimodal analgesic strategies have been proposed for painful procedures in children with epidermolysis bullosa...
May 11, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28495661/virtual-reality-as-an-adjunct-home-therapy-in-chronic-pain-management-an-exploratory-study
#15
Bernie Garrett, Tarnia Taverner, Paul McDade
BACKGROUND: Virtual reality (VR) therapy has been successfully used as an adjunct therapy for the management of acute pain in adults and children, and evidence of potential efficacy in other health applications is growing. However, minimal research exists on the value of VR as an intervention for chronic pain. OBJECTIVE: This case series examined the value of VR to be used as an adjunctive therapy for chronic pain patients in their own homes. METHODS: An exploratory approach using a case series and personal interviews was used...
May 11, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28495360/fractures-and-osteomalacia-in-a-patient-treated-with-frequent-home-hemodialysis
#16
Mark R Hanudel, Larry Froch, Barbara Gales, Harald Jüppner, Isidro B Salusky
Bone deformities and fractures are common consequences of renal osteodystrophy in the dialysis population. Persistent hypophosphatemia may be observed with more frequent home hemodialysis regimens, but the specific effects on the skeleton are unknown. We present a patient with end-stage renal disease treated with frequent home hemodialysis who developed severe bone pain and multiple fractures, including a hip fracture and a tibia-fibula fracture complicated by nonunion, rendering her nonambulatory and wheelchair bound for more than a year...
May 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28495031/a-pilot-mobile-integrated-healthcare-program-for-frequent-utilizers-of-emergency-department-services
#17
Vicki A Nejtek, Subhash Aryal, Deepika Talari, Hao Wang, Liam O'Neill
PURPOSE: To examine whether or not a mobile integrated health (MIH) program may improve health-related quality of life while reducing emergency department (ED) transports, ED admissions, and inpatient hospital admissions in frequent utilizers of ED services. METHODS: A small retrospective evaluation assessing pre- and post-program quality of life, ED transports, ED admissions, and inpatient hospital admissions was conducted in patients who frequently used the ED for non-emergent or emergent/primary care treatable conditions...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28494607/scn9a-channelopathy-associated-autosomal-recessive-congenital-indifference-to-pain-a-case-report
#18
S Rajasekharan, L Martens, L Domingues, R Cauwels
BACKGROUND: Congenital Indifference to Pain (CIP) is a rare condition that inhibits the ability of patients to perceive physical pain but otherwise keeps normal sensory modalities. The condition has been mapped to an autosomal recessive trait to chromosome 2q 24.3 with mutations on the SCN9A gene. CASE REPORT: A 2 year old Caucasian female presented with CIP. Bite injuries, tongue wounds and unaccounted dental trauma episodes were frequently reported. Preventive instructions and possible treatment modalities were discussed with the parents...
March 2017: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28492816/enhanced-recovery-after-surgery-program-implementation-in-2-surgical-populations-in-an-integrated-health-care-delivery-system
#19
Vincent X Liu, Efren Rosas, Judith Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Derrick C Lee, Alex Mustille, Patricia Kipnis, Stephen Parodi
Importance: Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. Objective: To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. Design, Setting, and Participants: A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery)...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28489007/-frequency-of-symptoms-and-drug-treatment-among-dying-patients-in-the-last-24-hours-of-life-at-landspitali-the-national-university-hospital-of-iceland-and-in-nursing-homes
#20
Svandis Iris Halfdanardottir, Kristin Lara Olafsdottir, Valgerdur Sigurdardottir
INTRODUCTION: The purpose of this study was to evaluate the frequency of 5 common symptoms and drug treatments prescribed and given in the last 24 hours of life in 11 medical units at Landspitali National University Hospital of Iceland (LUH) and in 7 nursing homes (NH). MATERIAL AND METHODS: Data was collected retrospectively from 232 charts of patients who died in 2012, using documentation in the Liverpool Care Pathway (LCP) and the medication management system...
May 2017: Læknablađiđ
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