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https://www.readbyqxmd.com/read/28340247/usability-testing-of-the-iphone-app-to-improve-pain-assessment-for-older-adults-with-cognitive-impairment-prehospital-setting-a-qualitative-study
#1
Rachael E Docking, Matthew Lane, Pat A Schofield
Objectives. : Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339828/single-session-of-functional-electrical-stimulation-assisted-walking-produces-corticomotor-symmetry-changes-related-to-changes-in-poststroke-walking-mechanics
#2
Jacqueline A Palmer, HaoYuan Hsiao, Tamara Wright, Stuart A Binder-Macleod
Background: Recent research demonstrated that symmetry of corticomotor drive to paretic and nonparetic plantarflexor muscles are related to the biomechanical ankle moment strategy that individuals with chronic stroke used to achieve their greatest walking speeds. Rehabilitation strategies that promote corticomotor balance could potentially improve post-stroke walking mechanics and enhance functional ambulation. Objective: To 1) test the effectiveness of a single session of gait training using functional electrical stimulation (FES) to improve plantarflexor corticomotor symmetry and plantarflexion ankle moment symmetry and 2) determine if changes in corticomotor symmetry relate to changes in ankle moment symmetry within the session...
February 23, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339320/basic-life-support-access-to-injectable-epinephrine-across-the-united-states
#3
Ian D Brasted, Michael W Dailey
BACKGROUND:  Aggressive epinephrine administration has growing support in the treatment of anaphylaxis, a life-threatening allergic reaction. Emergency Medical Services (EMS) providers are frequently in a position to provide the first care to someone experiencing an anaphylactic reaction. Intramuscular injection of epinephrine is the definitive pharmacologic treatment for many associated symptoms. While easy to use, epinephrine autoinjectors (EAI) are prohibitively expensive, having increased in price ten-fold in ten years...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28334811/causes-and-predictors-of-neonatal-post-neonatal-and-maternal-deaths-in-india-analysis-of-a-nationwide-district-level-household-survey-4-dlhs-4-2012-13
#4
Jaya P Tripathy, Sanskruti Mishra
Introduction: There is lack of reliable mortality estimates in India about maternal, neonatal and infant deaths. As we move towards achieving the targets under Sustainable Development Goals, information on cause of death is essential to prioritize our resources and planning. Therefore, the present study describes the causes and characteristics of neonatal, post-neonatal and maternal deaths in India. Methods: The study analysed nationwide District-Level Household Survey-4 conducted by the Ministry of Health and Family Welfare, Government of India, in 2014...
March 2, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28331931/cranial-thoracic-vertebral-canal-stenosis-in-three-juvenile-large-breed-brachycephalic-dogs-treated-by-unilateral-hemilaminectomy
#5
Amanda Miller, Andrew Marchevsky
OBJECTIVE: To describe the surgical treatment and outcome for juvenile dogs with cranial thoracic vertebral canal stenosis treated by unilateral hemilaminectomy. STUDY DESIGN: Case series. ANIMALS: Three large-breed brachycephalic dogs of various breeds (Dogue de Bordeaux, Australian Bulldog, Boerboel) with neurological signs consistent with a myelopathy of the third thoracic (T) to third lumbar (L) spinal cord segment. METHODS: Information on clinical presentation, diagnostic imaging, surgical procedures, postoperative complications, recovery and outcome is described...
March 23, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28326162/trauma-informed-care-for-children-in-the-ambulance-international-survey-among-pre-hospital-providers
#6
Eva Alisic, Mark P Tyler, Melita J Giummarra, Rahim Kassam-Adams, Juul Gouweloos, Markus A Landolt, Nancy Kassam-Adams
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28325485/the-effects-of-interprofessional-education-self-reported-professional-competence-among-prehospital-emergency-care-nursing-students-on-the-point-of-graduation-a-cross-sectional-study
#7
M Castrèn, M Mäkinen, J Nilsson, V Lindström
The aim of the study was to investigate whether interprofessional education (IPE) and interprofessional collaboration (IPC) during the educational program had an impact on prehospital emergency care nurses' (PECN) self-reported competence towards the end of the study program. A cross-sectional study using the Nurse Professional Competence (NPC) Scale was conducted. A comparison was made between PECN students from Finland who experienced IPE and IPC in the clinical setting, and PECN students from Sweden with no IPE and a low level of IPC...
March 16, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28322177/prevalence-estimate-of-cerebral-palsy-in-northern-alberta-births-2008-2010
#8
Charlene M T Robertson, M Florencia Ricci, Kathleen O'Grady, Maryam Oskoui, Helly Goez, Jerome Y Yager, John C Andersen
OBJECTIVES: The objectives of this study were to determine prevalence estimates of cerebral palsy (CP) among 5-year-old children in northern Alberta; to provide congenital, gestational age- and birth weight-specific, and postneonatal CP rates; and to describe motor subtypes and function. METHODS: This population-based prevalence estimate study, part of the Canadian Cerebral Palsy Registry, reports confirmed CP diagnoses at age 5 years made by pediatric rehabilitation and child neurology specialists...
March 21, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28321590/extreme-climatic-conditions-and-health-service-utilisation-across-rural-and-metropolitan-new-south-wales
#9
Edward Jegasothy, Rhydwyn McGuire, John Nairn, Robert Fawcett, Benjamin Scalley
Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality...
March 20, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/28320369/breathlessness-and-presentation-to-the-emergency-department-a-survey-and-clinical-record-review
#10
Ann Hutchinson, Alistair Pickering, Paul Williams, J Martin Bland, Miriam J Johnson
BACKGROUND: Breathlessness is a frequently occurring symptom of cardiorespiratory conditions and is a common cause of emergency department presentation. The aim of this study was to estimate the prevalence of acute-on-chronic breathlessness as a cause for presentation to the major emergencies area of the emergency department. METHODS: A prospective patient self-report survey and clinical record review of consecutive attendees to the major emergencies area of the emergency department in a single tertiary hospital between 12/5/14 and 29/5/14 was conducted...
March 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28320357/outcome-of-neurological-early-rehabilitation-patients-carrying-multi-drug-resistant-bacteria-results-from-a-german-multi-center-study
#11
J D Rollnik, M Bertram, C Bucka, M Hartwich, M Jöbges, G Ketter, B Leineweber, M Mertl-Rötzer, D A Nowak, T Platz, K Scheidtmann, R Thomas, F von Rosen, C W Wallesch, H Woldag, P Peschel, J Mehrholz, M Pohl
BACKGROUND: Colonization or infection with multi-drug resistant (MDR) bacteria is considered detrimental to the outcome of neurological and neurosurgical early rehabilitation patients. METHODS: In a German multi-center study, 754 neurological early rehabilitation patients were enrolled and and reviewed in respect to MDR status, length of stay (LOS) and the following outcome variables: Barthel Index (BI), Early Rehabilitation Index (ERI), Glasgow Outcome Score Extended (GOSE), Coma Remission Scale (CRS), Functional Ambulation Categories (FAC)...
March 20, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28320228/living-as-a-person-using-a-lower-limb-prosthesis-in-nepal
#12
Anna Järnhammer, Beatrice Andersson, Prakash Raj Wagle, Lina Magnusson
PURPOSE: The purpose of this study is to explore experiences of persons in Nepal using lower-limb prostheses, in relation to specific articles in the Convention on the Rights of Persons with Disabilities that consider mobility, education, health, rehabilitation, and work and employment. METHOD: Qualitative interviews were conducted with 16 persons using lower limb prostheses. Content analysis was applied to the data. RESULTS: Six themes emerged: The lower-limb prosthesis is essential for mobility and daily life; Limited mobility in challenging terrain and request for reduced pain when using prosthesis; Difficulties in finding and sustaining employment emphasized the importance of vocational training; Appreciation of comprehensive rehabilitation together with other persons with amputations, but covering related costs is a struggle; Satisfied with health care, but concerned that it creates debt and dependence upon others; and finally, Limited ability creates negative self-image and varied attitudes in other people...
March 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28318860/a-prospective-randomized-trial-comparing-liposomal-bupivacaine-vs-fascia-iliaca-compartment-block-for-postoperative-pain-control-in-total-hip-arthroplasty
#13
Molly A McGraw-Tatum, Michael T Groover, Nicole E George, John S Urse, Victor Heh
BACKGROUND: Increasing demand for total hip arthroplasty (THA) in a climate of increasing focus on clinical outcomes, patient satisfaction, and cost has created a need for better acute postoperative pain control for patients. An ideal pain control method would have few side effects, decreased opioid consumption, improved pain control, early ambulation, and decreased hospital length of stay (LOS). METHODS: We performed a prospective randomized, controlled study involving 79 patients undergoing elective THA between June 2015 and February 2016...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318816/use-of-electromyography-to-optimize-lokomat-%C3%A2-settings-for-subject-specific-gait-rehabilitation-in-post-stroke-hemiparetic-patients-a-proof-of-concept-study
#14
Yosra Cherni, Mickael Begon, Hicham Chababe, Florent Moissenet
OBJECTIVES: While generic protocols exist for gait rehabilitation using robotic orthotics such as the Lokomat(®), several settings - guidance, body-weight support (BWS) and velocity - may be adjusted to individualize patient training. However, no systematic approach has yet emerged. Our objective was to assess the feasibility and effects of a systematic approach based on electromyography to determine subject-specific settings with application to the strengthening of the gluteus maximus muscle in post-stroke hemiparetic patients...
March 16, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/28318779/infection-control-implications-of-the-laundering-of-ambulance-staff-uniforms-and-reusable-mops
#15
W G Mackay, S Whitehead, N Purdue, M Smith, N Redhead, C Williams, S Wilson
There is a lack of published studies on laundering in ambulance services. We performed bacterial culture on soiled and unsoiled uniforms and reusable mop heads artificially contaminated with Escherichia coli, Staphylococcus aureus, and Clostridium difficile spores. Current laundering processes used for routine cleans in the ambulances appears, from our simulations, to be effective at reducing vegetative pathogenic bacteria to undetectable levels, <3.398log10 colony-forming units (S. aureus and E. coli)...
February 22, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28318461/the-event-chain-of-survival-in-the-context-of-music-festivals-a-framework-for-improving-outcomes-at-major-planned-events
#16
Adam Lund, Sheila Turris
Despite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs)...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28316964/the-fixation-method-according-to-the-fracture-type-of-the-greater-trochanter-in-unstable-intertrochanteric-fractures-undergoing-arthroplasty
#17
Doohoon Sun, Byeong-Seop Park, Gun-Il Jang, Bongjoo Lee
PURPOSE: We conducted a study on patients who underwent hip joint arthroplasty because of unstable femur intertrochanteric fractures with greater trochanter bony fragments. After dividing patients into three groups depending on their fracture patterns, we evaluated the clinical and radiological outcomes of different operation methods applied to each of these groups. MATERIALS AND METHODS: Using Evan's classification, we defined an unstable intertrochanteric fracture as those characterized as stage 4 or 5...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316962/wiring-techniques-for-the-fixation-of-trochanteric-fragments-during-bipolar-hemiarthroplasty-for-femoral-intertrochanteric-fracture-clinical-study-and-technical-note
#18
Joong-Myung Lee, Yongsuk Cho, Junhyun Kim, Dong-Won Kim
PURPOSE: Femoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation. MATERIALS AND METHODS: From September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316464/peritoneal-nebulization-of-ropivacaine-during-laparoscopic-cholecystectomy-dose-finding-and-pharmacokinetic-study
#19
Massimo Allegri, Martina Ornaghi, Catherine E Ferland, Dario Bugada, Yash Meghani, Serena Calcinati, Manuela De Gregori, Federica Lovisari, Krishnaprabha Radhakrishnan, Maria Cusato, Stefano Scalia Catenacci, Marta Somaini, Guido Fanelli, Pablo Ingelmo
Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28315728/can-ambulance-telephone-triage-using-nhs-pathways-accurately-identify-paediatric-cardiac-arrest
#20
Charles D Deakin, Simon England, Debbie Diffey, Ian Maconochie
BACKGROUND: Most out-of-hospital paediatric cardiac arrests (CA) are not identified until a call is made to the emergency medical services. Accurate identification increases overall survival by enabling immediate ambulance dispatch and delivery of bystander CPR. European ambulance services use a variety of didactic telephone scripts to interrogate the caller and rapidly identify paediatric CA. The performance of these scripts has not been reported. This study aims to evaluate the diagnostic accuracy of the NHS Pathways as a telephone triage tool to identify patients less than 16 years age in cardiac arrest...
March 15, 2017: Resuscitation
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