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https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#1
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28214991/efficiency-analysis-of-an-interoperable-healthcare-operations-platform
#2
Thomas F Osborne, Reese H Clark, Jason Blackowiak, Patrick J Williamson, Shannon M Werb, Benjamin W Strong
(1) Develop an enterprise platform to unify isolated information, software applications and team members. (2) Assess the efficiency of one benefit of the platform through comparative testing of employee document retrieval times. (3) Evaluate the level of satisfaction among our target audience. We developed an infrastructure to integrate information throughout our practice and make it available on a unified, secure, and remotely accessible platform. We solicited our practice for volunteers to test the new system...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28214722/when-high-pressure-system-constraints-and-a-social-justice-mission-collide-a-socio-structural-analysis-of-emergency-department-social-work-services
#3
Megan Moore, Margaret Cristofalo, Danae Dotolo, Nicole Torres, Alexandra Lahdya, Leyna Ho, Mia Vogel, Mollie Forrester, Bonnie Conley, Susan Fouts
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10)...
February 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#4
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214449/-they-treated-me-like-crap-and-i-know-it-was-because-i-was-native-the-healthcare-experiences-of-aboriginal-peoples-living-in-vancouver-s-inner-city
#5
Ashley Goodman, Kim Fleming, Nicole Markwick, Tracey Morrison, Louise Lagimodiere, Thomas Kerr
There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver's inner city...
January 26, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214431/simulation-in-undergraduate-paediatric-nursing-curriculum-evaluation-of-a-complex-ward-for-a-day-education-program
#6
Andree S Gamble
Simulation in health education has been shown to increase confidence, psychomotor and professional skills, and thus positively impact on student preparedness for clinical placement. It is recognised as a valuable tool to expose and engage students in realistic patient care encounters without the potential to cause patient harm. Although inherent challenges exist in the development and implementation of simulation, variability in clinical placement time, availability and quality dictates the need to provide students with learning opportunities they may otherwise not experience...
February 4, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28214321/pr%C3%A3-und-perioperative-aspekte-der-versorgung-dermatochirurgischer-patienten
#7
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Die Dermatochirurgie nimmt hinsichtlich vieler Punkte eine Sonderstellung unter den operativen Fächern ein. Hierzu gehört in erster Linie die Tatsache, dass bis auf wenige Ausnahmen fast alle Eingriffe traditionell in Lokal- bzw. Regionalanästhesie und oft auch in räumlich-infrastruktureller Trennung von den großen Zentral-Operationssälen stattfinden können. Die peri- und postoperative Überwachung obliegt dabei dem dermatochirurgischen Operationsteam. Das sui generis kleinere OP-Team hat somit eine ganze Reihe perioperativer Notwendigkeiten zu beachten, um die sich in den "großen" chirurgischen Fächern eine Vielzahl verschiedener beteiligter Fachgruppen gemeinsam kümmern...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28214316/pre-and-perioperative-aspects-of-dermatosurgery
#8
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28214254/normothermia-in-arthroplasty
#9
REVIEW
Mark W Allen, David J Jacofsky
Since the initial design of surgical theaters, the thermal environment of the operating suite itself has been an area of concern and robust discussion. In the 1950s, correspondence in the British Medical Journal discussed the most suitable design for a surgeon's cap to prevent sweat from dripping onto the surgical field. These deliberations stimulated questions about the effects of sweat-provoking environments on the efficiency of the surgical team, not to mention the effects on the patient. Although these benefits translate to implant-based orthopedic surgery, they remain poorly understood and, at times, ignored...
January 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214150/self-efficacy-for-deprescribing-a-survey-for-health-care-professionals-using-evidence-based-deprescribing-guidelines
#10
Barbara Farrell, Lisa Richardson, Lalitha Raman-Wilms, David de Launay, Mhd Wasem Alsabbagh, James Conklin
BACKGROUND: Although polypharmacy is associated with significant morbidity, deprescribing can be challenging. In particular, clinicians express difficulty with their ability to deprescribe (i.e. reduce or stop medications that are potentially inappropriate). Evidence-based deprescribing guidelines are designed to help clinicians take action on reducing or stopping medications that may be causing more harm than benefit. OBJECTIVES: Determine if implementation of evidence-based guidelines increases self-efficacy for deprescribing proton pump inhibitor (PPI), benzodiazepine receptor agonist (BZRA) and antipsychotic (AP) drug classes...
January 28, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28214098/is-perceived-athlete-leadership-quality-related-to-team-effectiveness-a-comparison-of-three-professional-sports-teams
#11
Katrien Fransen, S Alexander Haslam, Clifford J Mallett, Niklas K Steffens, Kim Peters, Filip Boen
OBJECTIVES: Researchers have argued that leadership is one of the most important determinants of team effectiveness. The present study examined the extent to which the perceived quality of athlete leadership was related to the effectiveness of elite sports teams. DESIGN: Three professional football teams (N=135) participated in our study during the preparation phase for the Australian 2016 season. METHODS: Players and coaching staff were asked to assess players' leadership quality in four leadership roles (as task, motivational, social, and external leader) via an online survey...
January 24, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28214093/educating-religious-leaders-to-promote-uptake-of-male-circumcision-in-tanzania-a-cluster-randomised-trial
#12
Jennifer A Downs, Agrey H Mwakisole, Alphonce B Chandika, Shibide Lugoba, Rehema Kassim, Evarist Laizer, Kinanga A Magambo, Myung Hee Lee, Samuel E Kalluvya, David J Downs, Daniel W Fitzgerald
BACKGROUND: Male circumcision is being widely deployed as an HIV prevention strategy in countries with high HIV incidence, but its uptake in sub-Saharan Africa has been below targets. We did a study to establish whether educating religious leaders about male circumcision would increase uptake in their village. METHODS: In this cluster randomised trial in northwest Tanzania, eligible villages were paired by proximity (<60 km) and the time that a free male circumcision outreach campaign from the Tanzanian Ministry of Health became available in their village...
February 14, 2017: Lancet
https://www.readbyqxmd.com/read/28213955/the-skin-barrier-function-gene-spink5-is-associated-with-challenge-proven-ige-mediated-food-allergy-in-infants
#13
Sarah E Ashley, Hern-Tze Tina Tan, Peter Vuillermin, Shyamali C Dharmage, Mimi L K Tang, Jennifer Koplin, Lyle C Gurrin, Adrian Lowe, Caroline Lodge, Anne-Louise Ponsonby, John Molloy, Pamela Martin, Melanie C Matheson, Richard Saffery, Katrina J Allen, Justine A Ellis, David Martino
BACKGROUND: A defective skin barrier is hypothesised to be an important route of sensitisation to dietary antigens, and may lead to food allergy in some children. Missense mutations in the Serine peptidase inhibitor kazal type 5 (SPINK5) skin barrier gene have previously been associated with allergic conditions. OBJECTIVE: To determine whether genetic variants in and around SPINK5 are associated with IgE mediated food allergy. METHOD: We genotyped 71 'tag' single nucleotide polymorphisms (tag-SNPs) within a region spanning ~263 kilobases (kb) including SPINK5 (~61kb) in n=722 (n=367 food allergic, n=199 food sensitised, tolerant and n=156 non-food allergic controls) 12-month infants (discovery sample) phenotyped for food allergy with the gold standard oral food challenge (OFC)...
February 18, 2017: Allergy
https://www.readbyqxmd.com/read/28213928/problem-solving-phase-transitions-during-team-collaboration
#14
Travis J Wiltshire, Jonathan E Butner, Stephen M Fiore
Multiple theories of problem-solving hypothesize that there are distinct qualitative phases exhibited during effective problem-solving. However, limited research has attempted to identify when transitions between phases occur. We integrate theory on collaborative problem-solving (CPS) with dynamical systems theory suggesting that when a system is undergoing a phase transition it should exhibit a peak in entropy and that entropy levels should also relate to team performance. Communications from 40 teams that collaborated on a complex problem were coded for occurrence of problem-solving processes...
February 18, 2017: Cognitive Science
https://www.readbyqxmd.com/read/28213837/brief-report-meeting-the-needs-of-medically-hospitalized-adults-with-autism-a-provider-and-patient-toolkit
#15
Jocelyn Carter, Sarabeth Broder-Fingert, Ann Neumeyer, Ann Giauque, Ann Kao, Christiana Iyasere
In an effort to meet the needs of adults with autism spectrum disorder (ASD) while hospitalized, a team of experts and providers from Massachusetts General Hospital (MGH), MGH for Children as well as parents of individuals with ASD was sparked in 2013. This became a multidisciplinary collaborative, the MGH Autism Care Collaborative, to improve adult care for inpatients with ASD. The collaborative was created with three goals in mind: (1) to educate internal medicine adult inpatient providers and staff on the unique needs of adults with ASD when hospitalized; (2) to create ASD specific resources for internal medicine adult inpatient providers; (3) to optimize patient care from admission to discharge among adults with ASD admitted to internal medicine services...
February 17, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28213659/profiles-of-mental-health-care-professionals-based-on-work-role-performance
#16
Marie-Pierre Markon, Jean-Marie Bamvita, François Chiocchio, Marie-Josée Fleury
The worldwide burden of mental disorders is considerable, and on the rise, putting pressure on health care systems. Current reforms aim to improve the efficiency of mental health care systems by increasing service integration in communities and strengthening primary mental health care. In this context, mental health care professionals (MHPs) are increasingly required to work on interdisciplinary teams in a variety of settings. Little is known, however, about the profiles of MHPs in relation to their perceived work role performance...
February 18, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28213461/team-based-primary-care-with-integrated-mental-health-is-associated-with-higher-quality-of-care-lower-usage-and-lower-payments-received-by-the-delivery-system
#17
Aimee F English
No abstract text is available yet for this article.
February 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28213382/pharmacist-involvement-on-a-rapid-response-team
#18
Joel Feih, William J Peppard, Michael Katz
PURPOSE: The effect of a pharmacist on a rapid response team (RRT) was investigated. METHODS: This study evaluated 234 patients before and 157 patients after pharmacist involvement on an RRT. The primary outcome was time to medication administration, with a goal turnaround time of less than 30 minutes. Secondary outcomes included most frequently used medications, readmissions to the intensive care unit (ICU) within 48 hours, number of rapid responses that resulted in ICU admission, length of hospital stay, and survival to hospital discharge...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#19
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28213083/-health-promotion-and-logic-models
#20
Cecile Marie Dupin
The first phase of interventional research in the health of populations is the development of its conceptual basis. Programme logic models are used to describe the way in which the results should be generated. The programme theory is used to develop intermediary objectives and to increase the chances of success of public health actions. This approach requires the coproduction of knowledge between researchers and partners. The teams can benefit from the application of evaluation to the theory in order to clarify the results obtained...
January 2017: Soins; la Revue de Référence Infirmière
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