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https://www.readbyqxmd.com/read/28634517/introduction-of-a-quality-improvement-curriculum-in-the-department-of-internal-medicine-lincoln-medical-center
#1
Usha Venugopal, Moiz Kasubhai, Vikram Paruchuri
Community hospitals with limited resources struggle to engage physicians in Quality improvement initiatives. We introduced Quality Improvement (QI) curriculum for residents in response to ACGME requirements and surveyed the residents understanding of QI and their involvement in QI projects before and after the introduction of the curriculum. The current article describes our experiences with the process, the challenges and possible solutions to have a successful resident led QI initiative in a community hospital...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28587139/is-housing-a-health-insult
#2
Emma Baker, Andrew Beer, Laurence Lester, David Pevalin, Christine Whitehead, Rebecca Bentley
In seeking to understand the relationship between housing and health, research attention is often focussed on separate components of people's whole housing 'bundles'. We propose in this paper that such conceptual and methodological abstraction of elements of the housing and health relationship limits our ability to understand the scale of the accumulated effect of housing on health and thereby contributes to the under-recognition of adequate housing as a social policy tool and powerful health intervention. In this paper, we propose and describe an index to capture the means by which housing bundles influence health...
May 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28509667/evaluation-of-hippocampal-infolding-angle-and-incomplete-hippocampal-inversion-in-pediatric-patients-with-epilepsy-and-febrile-seizures
#3
Mehtap Beker Acay, Reşit Köken, Ebru Ünlü, Emre Kaçar, Çınar Balçık
PURPOSE: We aimed to investigate the frequency of incomplete hippocampal inversion (IHI) and the hippocampal infolding angle (HIA) in pediatric patients with no additional abnormal findings in the brain. METHODS: Pediatric brain magnetic resonance imaging (MRI) examinations conducted between September 2012 and February 2015 were screened and 83 patients with epilepsy, 49 patients with febrile convulsion, and 74 control patients were included in this retrospective study...
May 16, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28490372/erratum-to-does-a-quality-improvement-campaign-accelerate-take-up-of-new-evidence-a-ten-state-cluster-randomized-controlled-trial-of-the-ihi-s-project-joints
#4
Eric C Schneider, Melony E Sorbero, Ann Haas, M Susan Ridgely, Dmitry Khodyakov, Claude M Setodji, Gareth Parry, Susan S Huang, Deborah S Yokoe, Don Goldmann
No abstract text is available yet for this article.
May 10, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28457021/clinical-effects-of-a-pharmacist-intervention-in-acute-wards-a-randomised-controlled-trial
#5
Trine R H Nielsen, Per H Honoré, Mette Rasmussen, Stig E Andersen
The purpose of the study was to investigate the clinical effect of a clinical pharmacist (CP) intervention upon admission to hospital on in-patient harm and to assess a potential educational bias. Over16 months, 593 adult patients taking ≥ 4 medications daily were included from three Danish acute medicine wards. Patients were randomised to 'either the CP intervention or the usual care (prospective control). To assess a potential educational bias or educational bias, a retrospective control group was formed by randomisation...
April 29, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28381485/developmental-profile-of-motor-cortex-transcallosal-inhibition-in-children-and-adolescents
#6
Patrick Ciechanski, Ephrem Zewdie, Adam Kirton
Transcallosal fibers facilitate interhemispheric networks involved in motor tasks. Despite their clinical relevance, interhemispheric motor control systems have not been completely defined in the developing brain. The objective of this study was to examine the developmental profile of transcallosal inhibition in healthy children and adolescents. Nineteen typically-developing right-handed participants were recruited. Two transcranial magnetic stimulation (TMS) paradigms assessed transcallosal inhibition: ipsilateral silent periods (iSP) and paired-pulse interhemispheric inhibition (IHI)...
April 5, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28379721/adverse-events-in-hospitalised-cancer-patients-a-comparison-to-a-general-hospital-population
#7
Ellinor Christin Haukland, Christian von Plessen, Carsten Nieder, Barthold Vonen
BACKGROUND: Patients with cancer are often treated by many healthcare providers, receive complex and potentially toxic treatments that can increase the risk for iatrogenic harm. The aim of this study is to investigate whether hospitalised cancer patients are at higher risk of adverse events (AEs) compared to a general hospital population. MATERIAL AND METHODS: A total of 6720 patient records were retrospectively reviewed comparing AEs in hospitalised cancer patients to a general hospital population in Norway, using the IHI Global Trigger Tool method...
April 5, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28334921/internal-hydrolysis-indicator-for-sample-specific-monitoring-of-%C3%AE-glucuronidase-activity
#8
Lacy L Taylor, Noah A Flint, Vinh Ma, Brandy M Hill, Chantry J Clark, Frederick G Strathmann
Metabolized forms of benzodiazepines (benzos) can cause issues with mass spectrometry identification. Benzodiazepines undergo a process called glucuronidation during metabolism that attaches a glucuronic acid for increased solubility. Often in clinical testing an enzymatic hydrolysis step is implemented to increase the sensitivity of benzodiazepines by hydrolyzing β-D-glucuronic acid from benzodiazepine-glucuronide conjugates in urine samples using the β-Glucuronidase enzyme. In this study resorufin β-D-glucuronide, a substrate of the β-Glucuronidase enzyme, was added to patient samples to determine if proper hydrolysis had occurred...
June 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28219315/near-peers-improve-patient-safety-training-in-the-preclinical-curriculum
#9
Sally R Raty, Cayla R Teal, Elizabeth A Nelson, Anne C Gill
BACKGROUND: Accrediting bodies require medical schools to teach patient safety and residents to develop teaching skills in patient safety. We created a patient safety course in the preclinical curriculum and used continuous quality improvement to make changes over time. OBJECTIVE: To assess the impact of resident teaching on student perceptions of a Patient Safety course. DESIGN: Using the Institute for Healthcare Improvement patient safety curriculum as a frame, the course included the seven IHI modules, large group lectures and small group facilitated discussions...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28091708/the-effect-of-motor-overflow-on-bimanual-asymmetric-force-coordination
#10
David A Cunningham, Sarah M Roelle, Didier Allexandre, Kelsey A Potter-Baker, Vishwanath Sankarasubramanian, Jayme S Knutson, Guang H Yue, Andre G Machado, Ela B Plow
Motor overflow, typically described in the context of unimanual movements, refers to the natural tendency for a 'resting' limb to move during movement of the opposite limb and is thought to be influenced by inter-hemispheric interactions and intra-cortical networks within the 'resting' hemisphere. It is currently unknown, however, how motor overflow contributes to asymmetric force coordination task accuracy, referred to as bimanual interference, as there is need to generate unequal forces and corticospinal output for each limb...
April 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28017318/defective-interhemispheric-inhibition-in-drug-treated-focal-epilepsies
#11
Gionata Strigaro, Erica Matino, Lina Falletta, Chiara Pizzamiglio, Giacomo Tondo, Radwa Badawy, Roberto Cantello
BACKGROUND: Focal epilepsies (FEs) arise from a lateralized network, while in generalized epilepsies (GEs) there is a bilateral involvement from the outset. Intuitively, the corpus callosum is the anatomical substrate for interhemispheric spread. OBJECTIVE: We used transcranial magnetic stimulation (TMS) to explore whether there are any physiological differences in the corpus callosum of drug-treated patients with FE and those with genetic GE (GGE), compared to healthy subjects (HS)...
May 2017: Brain Stimulation
https://www.readbyqxmd.com/read/27995060/hippocampal-volume-predicts-antidepressant-efficacy-in-depressed-patients-without-incomplete-hippocampal-inversion
#12
Romain Colle, Claire Cury, Marie Chupin, Eric Deflesselle, Patrick Hardy, Ghaidaa Nasser, Bruno Falissard, Denis Ducreux, Olivier Colliot, Emmanuelle Corruble
BACKGROUND: Incomplete hippocampal inversion (IHI), also called malrotation, is a frequent atypical anatomical pattern of the hippocampus. Because of the crucial implication of the hippocampus in Major Depressive Disorder (MDD) and the neurodevelopmental hypothesis of MDD, we aimed to assess the prevalence of IHI in patients with MDD, the link of IHI with hippocampal volume (HV) and the impact of IHI on the predictive value of HV for response and remission after antidepressant treatment...
2016: NeuroImage: Clinical
https://www.readbyqxmd.com/read/27993820/adaptation-to-leftward-shifting-prisms-alters-motor-interhemispheric-inhibition
#13
Elisa Martín-Arévalo, Selene Schintu, Alessandro Farnè, Laure Pisella, Karen T Reilly
Adaptation to rightward shifting prisms (rightward prism adaptation, RPA) ameliorates neglect symptoms in patients while adaptation to leftward shifting prisms (leftward prism adaptation, LPA) induces neglect-like behaviors in healthy subjects. It has been hypothesized that prism adaptation (PA) modulates interhemispheric balance between the parietal cortices by inhibiting the posterior parietal cortex (PPC) contralateral to the prismatic deviation, but PA's effects on interhemispheric inhibition (IHI) have not been directly investigated...
December 18, 2016: Cerebral Cortex
https://www.readbyqxmd.com/read/27857687/transcranial-alternating-current-stimulation-at-beta-frequency-lack-of-immediate-effects-on-excitation-and-interhemispheric-inhibition-of-the-human-motor-cortex
#14
Viola Rjosk, Elisabeth Kaminski, Maike Hoff, Christopher Gundlach, Arno Villringer, Bernhard Sehm, Patrick Ragert
Transcranial alternating current stimulation (tACS) is a form of noninvasive brain stimulation and is capable of influencing brain oscillations and cortical networks. In humans, the endogenous oscillation frequency in sensorimotor areas peaks at 20 Hz. This beta-band typically occurs during maintenance of tonic motor output and seems to play a role in interhemispheric coordination of movements. Previous studies showed that tACS applied in specific frequency bands over primary motor cortex (M1) or the visual cortex modulates cortical excitability within the stimulated hemisphere...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27832594/high-frequency-neuromuscular-electrical-stimulation-modulates-interhemispheric-inhibition-in-healthy-humans
#15
Nicolas Gueugneau, Sidney Grosprêtre, Paul Stapley, Romuald Lepers
High-frequency neuromuscular electrical stimulation (HF NMES) induces muscular contractions through neural mechanisms that partially match physiological motor control. Indeed, a portion of the contraction arises from central mechanisms, whereby spinal motoneurons are recruited through the evoked sensory volley. However, the involvement of supraspinal centers of motor control during such stimulation remains poorly understood. Therefore, we tested whether a single HF NMES session applied to the upper limb influences interhemispheric inhibition (IHI) from left to right motor cortex (M1)...
January 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27631712/collaborative-learning-in-the-texas-medicaid-1115-waiver-program
#16
Lee Revere, Adele Semaan, Nicole Lievsay, Jessica Hall, Zheng M Wang, Charles Begley
The Texas Medicaid 1115 Transformation Waiver reforms the state's safety net systems by creating a Delivery System Reform Incentive Payment incentive pool for innovative healthcare delivery. The Waiver supports the design and implementation of transformative projects. As part of the Waiver requirements, regions created Learning Collaboratives to collaborate on project implementation and outcomes. This paper describes the experience of one region in adapting the Institute for Healthcare Improvement Breakthrough Series (IHI BTS) model, as a framework for their Learning Collaborative...
November 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27618086/developing-responsive-indicators-of-indigenous-community-health
#17
Jamie Donatuto, Larry Campbell, Robin Gregory
How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is "at risk" is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results...
September 9, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27611772/adverse-events-at-baseline-in-a-chinese-general-hospital-a-pilot-study-of-the-global-trigger-tool
#18
Xiao-Di Xu, Yi-Jie Yuan, Li-Ming Zhao, Yang Li, Hui-Zhen Zhang, Hua Wu
OBJECTIVE: To investigate adverse events (AEs) at baseline in a Chinese general hospital using the Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT) and discuss the feasibility of this tool to detect AEs in China. METHODS: A total of 10 inpatient records from the hospital were sampled randomly half a month in 2014. The records were reviewed to identify AEs according to the second edition of the IHI GTT for measuring AEs. Triggers and AEs were analyzed using Microsoft Excel 2007...
September 8, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27559472/improving-pediatric-inflammatory-bowel-disease-ibd-follow-up
#19
Dana Dykes, Elizabeth Williams, Peter Margolis, Jennifer Ruschman, Julianne Bick, Shehzad Saeed, Lisa Opipari
Standardization of Inflammatory Bowel Disease (IBD) care through participation in the ImproveCareNow (ICN) Network has improved outcomes for pediatric patients with IBD, but under the current care model, our improvements have plateaued. Current ICN model care guidelines recommend health supervision visits every six months. We identified a gap in our practice's ability to ensure either a routine six month follow-up or a rapid follow-up after a disease flare, and a significant number of patients with active disease status during a six month period lacked timely reassessment after interventions or medication changes...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27559470/a-project-to-reduce-the-rate-of-central-line-associated-bloodstream-infection-in-icu-patients-to-a-target-of-zero
#20
Muhammad Yaseen, Fahad Al-Hameed, Khalid Osman, Mansour Al-Janadi, Majid Al-Shamrani, Asim Al-Saedi, Abdulhakeem Al-Thaqafi
Central venous catheters (CVCs) are life-saving and the majority of patients in intensive care units (ICUs) have them placed in order to receive medicine and fluids. However, the use of these catheters can result in serious bloodstream infections. The rate of Central Line Associated Blood Stream Infection (CLABSI) in Adult Intensive Care Units (ICUs) at King Abdulaziz Medical City Jeddah (KAMC-J) at the start of the project was 2.0/1000 line days in 2008. The Central Line (CL) Bundle by the Institute of Healthcare Improvement (IHI) was implemented at the same time with monitoring of compliance to the CL Bundle...
2016: BMJ Quality Improvement Reports
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