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https://www.readbyqxmd.com/read/28334558/feasibility-and-added-value-of-executive-walkrounds-in-long-term-care-organizations-in-the-netherlands
#1
Loes van Dusseldorp, Getty Huisman-de Waal, Hub Hamers, Gert Westert, Lisette Schoonhoven
BACKGROUND: Currently available tools for the management of safety in health care are largely based on quantitative management information. Executive WalkRounds (WalkRounds [WR]) seems useful as a leadership tool to detect "soft signals"-alerts of unsafe situations or practices-and to enhance the mutual trust between frontline staff and the board of directors. The majority of the research on WR has been performed in hospitals. Therefore, a study was conducted to assess how the boards of directors of long term care organizations value WR as a leadership tool to perceive soft signals, and whether soft signals are of added value to enhance patient safety...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28329172/the-obesity-paradox-is-still-there-a-risk-analysis-of-over-15-000-cardiosurgical-patients-based-on-body-mass-index
#2
Martin Hartrumpf, Ralf-Uwe Kuehnel, Johannes M Albes
OBJECTIVES: Obesity is an ever-growing problem in contemporary cardiac surgery. Although it accounts for many perioperative comorbidities, it has not been shown to increase mortality. Body mass index (BMI) is therefore not considered in the European System for Cardiac Operative Risk Evaluation (EuroSCORE). We sought to confirm whether this holds true for our own single-centre patient population. METHODS: Data from 15 314 consecutive patients receiving major cardiac surgery at our institution were analysed...
March 18, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28327082/out-of-hours-care-in-germany-high-utilization-by-adult-patients-with-minor-ailments
#3
R Leutgeb, P Engeser, S Berger, J Szecsenyi, G Laux
BACKGROUND: Family practitioners (FPs) who work in Out-Of-Hours Care (OOHC) - especially in rural areas - complain about high workload related to low urgency and potentially unnecessary patient presentations with minor ailments. The aim of this study was to describe Reasons for Encounter (RFEs) in primary OOHC taken into account the doctor's perspective in the context of high workload without knowing patients' motives for visiting an OOHC-centre. METHODS: Within this descriptive study, OOHC data from 2012 were evaluated from a German statutory health insurance company in the federal state of Baden-Wuerttemberg...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28326514/complete-response-to-acupuncture-therapy-in-female-patients-with-refractory-interstitial-cystitis-bladder-pain-syndrome
#4
Mehmet Giray Sönmez, Betül Kozanhan
OBJECTIVES: Interstitial Cystitis/Bladder Pain syndrome (IC/BPS) is a considerable issue in urology and gynecology and unfortunately, the treatment options recommended are not fully efficient. Therefore, in this study we aimed to determine the effectiveness of acupuncture treatment in patients with refractory IC/BPS. MATERIAL AND METHODS: 12 refractory IC/BPS female patients received ten sessions of acupuncture twice a week. The visual analog score (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), O'Leary-Saint symptom score (OSS), Patient Health Questionnaire (PHQ9), Pelvic pain and urgency & frequency patient symptom scale tests (PUF) and maximum voided volume (MVV) was completed in 1st, 3rd, 6th and 12th months following the treatment...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28324918/statistical-consequences-of-a-successful-lung-allocation-system-recovering-information-and-reducing-bias-in-models-for-urgency
#5
Nabihah Tayob, Susan Murray
The lung allocation system has reduced the number of waitlist deaths by ranking transplant candidates on the basis of a lung allocation score that requires estimation of the current 1-year restricted mean waitlist survival (urgency). Fewer waitlist deaths and the systematic removal of candidates from the waitlist for transplantation present statistical challenges that must be addressed when using recent waitlist data. Multiple overlapping 1-year follow-up windows are used in a restricted mean model that estimates patient urgency on the basis of updated risk factors at the start of the window...
March 21, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28323444/evaluating-driver-drowsiness-countermeasures
#6
John G Gaspar, Timothy L Brown, Chris W Schwarz, John D Lee, Julie Kang, James S Higgins
Objective Driver drowsiness contributes to a substantial number of fatal and non-fatal crashes, with recent estimates attributing up to 21% of fatal crashes to drowsiness. This paper describes recent NHTSA research on in-vehicle drowsiness countermeasures. Recent advances in technology and state detection algorithms have shown success in detecting drowsiness using a variety of data sources, including camera-based eye tracking, steering wheel position, yaw rate, and vehicle lane position. However, detection is just the first step in reducing drowsy driving crashes...
March 21, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28321473/clinical-epidemiological-insights-into-urinary-incontinence
#7
Vatché A Minassian, Tony Bazi, Walter F Stewart
INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is very common and heterogeneous among women with limited knowledge of progression or prognosis. Evidence based on clinical epidemiology can help to better understand the natural history of UI. METHODS: We examine the challenges of UI definition and its subtypes, its impact on quality of life and health-seeking behavior. We review the proposed pathophysiology of UI subtypes and known risk factors as they relate to our current knowledge of the disease state...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#8
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319594/long-term-cardiovascular-autonomic-and-clinical-changes-after-immunoglobulin-g-immunoadsorption-therapy-in-autoimmune-autonomic-ganglionopathy
#9
Franca Barbic, Franca Dipaola, Francesca Andreetta, Enrico Brunetta, Laura Dalla Vecchia, Renato Mantegazza, Raffaello Furlan, Carlo Antozzi
A 63-year-old male was diagnosed with autoimmune autonomic ganglionopathy based on the finding of plasma antibodies to the nicotinic acetylcholine receptor (nAChR) of autonomic ganglia. He complained of mouth and eye dryness, dysphagia, severe constipation, erectile dysfunction, urgency, frequent urination, habitual orthostatic syncope and presyncope. A remarkable symptomatic orthostatic hypotension without changes in heart rate was present. We here describe the 3-year time course of the changes in spectral indices of cardiovascular autonomic control LF/HF and LFSAP, dysautonomia symptoms intensity and anti-nAChR antibodies following repetitive selective immunoadsorptions...
March 17, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28319169/high-meld-score-and-extended-operating-time-predict-prolonged-initial-icu-stay-after-liver-transplantation-and-influence-the-outcome
#10
Panagiota Stratigopoulou, Andreas Paul, Dieter P Hoyer, Stylianos Kykalos, Fuat H Saner, Georgios C Sotiropoulos
BACKGROUND: The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it. PATIENTS AND METHODS: We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function. RESULTS: Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay...
2017: PloS One
https://www.readbyqxmd.com/read/28318348/impulsivity-and-problem-drinking-in-college-examining-the-mediating-role-of-sex-related-alcohol-expectancies-and-alcohol-use-at-sex
#11
Devin E Banks, Tamika C B Zapolski
BACKGROUND: Dispositional impulsivity has been consistently implicated as a risk factor for problem drinking among college students and research suggests that this relationship may be explained in part by alcohol expectancies. A subset of alcohol expectancies, sex-related alcohol expectancies, is particularly linked to problem drinking among college students. The acquired preparedness model of risk postulates that people with dispositional impulsivity develop stronger sex-related alcohol expectancies, are subsequently more likely to drink at problematic levels in sexual situations, and thus, engage in more problem drinking...
March 20, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28316762/mesalazine-has-no-effect-on-mucosal-immune-biomarkers-in-patients-with-diarrhea-dominant-irritable-bowel-syndrome-referred-to-shariati-hospital-a-randomized-double-blind-placebo-controlled-trial
#12
Mohammad Reza Ghadir, Mehri Poradineh, Masoud Sotodeh, Reza Ansari, Shadi Kolahdoozan, Ahmad Hormati, Mohammad Hosein Yousefi, Samaneh Mirzaei, Homayoon Vahedi
BACKGROUND Intestinal mast cells may cause gastrointestinal symptoms in patients with diarrhea-dominant irritable bowel syndrome (IBS). The objective of this study was to determine the effect of mesalazine on the number of lamina propria mast cells and clinical manifestations of patients with diarrhea-dominant IBS referred to Shariati Hospital affiliated to Tehran University of Medical Sciences. METHODS This was a randomized placebo-controlled double-blind trial conducted on 49 patients with diarrhea-dominant IBS...
January 2017: Middle East Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28315994/urgency-and-austerity-as-drivers-of-success
#13
Terry R Stouch
This piece describes the approach by which even a small CADD (Computer-Aided Drug Design) group with limited resources and limited time can achieve substantial success given short budgets and the compressed, urgent environment of a biotech. Some comparisons are made with CADD operations in big pharma.
March 18, 2017: Journal of Computer-aided Molecular Design
https://www.readbyqxmd.com/read/28315972/emotional-health-and-self-esteem-among-adolescents-in-malaysian-orphanages
#14
Marjan Mohammadzadeh, Hamidin Awang, Hayati Kadir Shahar, Suriani Ismail
This study aimed to assess the prevalence and risk factors of depression, anxiety, stress and low self-esteem among institutional Malaysian adolescents. This cross-sectional descriptive study included 287 adolescents aged 12-18 years living in six selected orphan homes. Study's instruments included Socio-demographic questionnaire, validated Malay version of Depression Anxiety Stress Scale-21 and Rosenberg Self-Esteem Scale. The findings revealed that 85.2, 80.1 and 84.7% of participants had depression, anxiety and stress respectively...
March 18, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28315811/variant-two-stage-ileal-pouch-anal-anastomosis-an-innovative-and-effective-alternative-to-standard-resection-in-ulcerative-colitis
#15
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
BACKGROUND: Ulcerative colitis patients have been historically treated with standard single, two and three stage operative approaches. We perform a variant two-stage procedure beginning with total abdominal colectomy and end ileostomy followed by completion proctectomy and ileal pouch-anal anastomosis without a diverting loop ileostomy. The present study evaluates the effectiveness of this innovative alternative. STUDY DESIGN: Patients with ulcerative colitis admitted to UNC Hospital between 2003 and 2010 for IPAA were eligible for inclusion...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28315496/remeex-device-external-mechanical-regulator-for-female-stress-urinary-incontinence-a-critical-review-of-a-single-operator-long-term-experience-on-implants-and-readjustments
#16
Franco Mantovani
OBJECTIVE: A single-operator, long-term (15 years) experience on a sling technique that allows a postoperative adjustment of its tension is presented to retrospectively report the objective and subjective outcomes in the treatment of female stress urinary incontinence (SUI). The readjustment option prevents the need of a reoperation in case of relapse with great compliance of the patients. MATERIALS AND METHODS: Indications for surgical tratment of SUI by ReMeEx included patients affected with not only true intrinsic sphyncteric deficency (ISD) and fixed urethra but also mild urethral hypermobility, previous incontinence surgery and relapsing conditions such as diabetes and obesity...
March 18, 2017: Urologia
https://www.readbyqxmd.com/read/28306673/hypertensive-crisis-an-update-on-clinical-approach-and-management
#17
Emrah Ipek, Ahmet Afşin Oktay, Selim R Krim
PURPOSE OF REVIEW: Here, we review current concepts on hypertensive crisis (HTN-C) with a focus on epidemiology, causes, pathophysiology and prognosis. We also offer a practical approach to the management of HTN-C. RECENT FINDINGS: HTN-C is characterized by a severe and abrupt increase in blood pressure (BP) with impending or progressive acute end-organ damage (EOD). HTN-C can be divided into hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U) based on the presence or absence of acute EOD, respectively...
March 16, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#18
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
March 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306592/bridging-the-gap-in-heart-transplantation
#19
Jacqueline M Smits, Undine Samuel, Guenther Laufer
PURPOSE OF REVIEW: Countries in Europe and in the USA are proclaiming their need for an objective allocation system that can cope with distribution of a scarce resource in a changing environment of an older donor and recipient population and of an increased number of patients on mechanical circulatory support, whose prospects are increasing. RECENT FINDINGS: The current heart allocation systems in Eurotransplant, France and the USA are all urgency tier systems, where within the same tier a first-come, first-served principle is applied...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28304143/anal-function-after-endoluminal-loco-regional-resection-by-transanal-endoscopic-microsurgery-and-radiotherapy-for-rectal-cancer
#20
Ivano Biviano, Andrea Balla, Danilo Badiali, Silvia Quaresima, Giancarlo D'Ambrosio, Emanuele Lezoche, Enrico Corazziari, Alessandro M Paganini
AIM: In patients with rectal cancer, surgery and chemo-radiotherapy may affect the anal sphincter function. Few studies evaluated the ano-rectal function after neoadjuvant chemo-radiotherapy (n-CRT) and/or Transanal Endoscopic Microsurgery (TEM). The aim of this study was to evaluate the effects of n-CRT and TEM on ano-rectal function. METHOD: Thirty-seven patients with rectal cancer underwent ano-rectal manometry and Wexner score for faecal incontinence at baseline, after n-CRT (cT2-T3N0 cancer) and at 4 and 12 months after surgery...
March 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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