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https://www.readbyqxmd.com/read/29334608/factors-associated-with-prolonged-patient-attributable-delay-in-the-diagnosis-of-colorectal-cancer
#1
Irene Zarcos-Pedrinaci, Teresa Téllez, Francisco Rivas-Ruiz, María Del Carmen Padilla-Ruiz, Julia Alcaide, Antonio Rueda, María Luisa Baré, María Manuela Morales Suárez-Varela, Eduardo Briones, Cristina Sarasqueta, Nerea Fernández-Larrea, Antonio Escobar, José María Quintana, Maximino Redondo
Purpose: The delayed diagnosis of colorectal cancer (CRC) may be attributable to sociodemographic characteristics, to aspects of tumour histopathology or to the functioning of the health system. We seek to determine which of these factors most influences prolonged patient-attributable delay (PPAD) in the diagnosis and treatment of CRC. Materials and method: A prospective, multicentre observational study was conducted in 22 Spanish hospitals. In total, 1,785 patients were recruited to the study between 2010 and 2012 and underwent elective or urgent surgery...
January 2, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/29334567/pediatric-vascular-trauma-practice-patterns-and-resource-availability-a-survey-of-acs-designated-pediatric-trauma-centers
#2
Patrick C Bonasso, Lori A Gurien, Samuel D Smith, Marie E Saylors, M Sidney Dassinger
BACKGROUND: Variation exists in pediatric vascular trauma management. We aim to determine practice patterns for vascular trauma management at American College of Surgeons (ACS) verified pediatric trauma centers and evaluate the resources available for management of vascular trauma at both freestanding children's hospitals (FSCH) and pediatric hospitals within general adult hospitals (PHGAH). METHODS: Pediatric surgeons and trauma medical directors at ACS designated pediatric surgery trauma centers completed a survey designed to evaluate anticipated management of traumatic arterial injuries and resource availability...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334536/nationwide-trend-analysis-of-pediatric-inpatients-with-immune-thrombocytopenia-in-the-united-states
#3
Yusuke Okubo, Atsuhiko Handa
BACKGROUND: Several studies have reported the epidemiology of immune thrombocytopenia (ITP) among children in the United States and other countries. However, recent trends in ITP among hospitalized children and hospital course remain unknown at a national level in the United States. METHOD: Hospital discharge records of patients with ITP aged 19 years and younger were obtained for the years 2003, 2006, 2009, and 2012 using the Kids' Inpatient Database. Data were weighted to estimate the annual hospitalization rates in the United States with trend analyses...
January 12, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29334523/not-a-straight-line-patient-s-experiences-of-prostate-cancer-and-their-journey-through-the-healthcare-system
#4
Kristina Schildmeijer, Oscar Frykholm, Åsa Kneck, Mirjam Ekstedt
BACKGROUND: Cancer and its treatment can severely impact quality of life, giving rise to complex needs with respect to follow-up care. To support patient needs and increase efficiency of care with limited resources, the Swedish government has launched national reforms to redesign cancer care pathways. OBJECTIVE: The aim of this study was to explore how prostate cancer patients experience their journey through the healthcare system when their care is provided according to the standardized care pathway, as described in healthcare policy documents...
January 12, 2018: Cancer Nursing
https://www.readbyqxmd.com/read/29334516/computer-based-training-in-eating-and-nutrition-facilitates-person-centered-hospital-care-a-group-concept-mapping-study
#5
Albert Westergren, Ellinor Edfors, Erika Norberg, Anna Stubbendorff, Gita Hedin, Martin Wetterstrand, Scott R Rosas, Peter Hagell
Studies have shown that computer-based training in eating and nutrition for hospital nursing staff increased the likelihood that patients at risk of undernutrition would receive nutritional interventions. This article seeks to provide understanding from the perspective of nursing staff of conceptually important areas for computer-based nutritional training, and their relative importance to nutritional care, following completion of the training. Group concept mapping, an integrated qualitative and quantitative methodology, was used to conceptualize important factors relating to the training experiences through four focus groups (n = 43), statement sorting (n = 38), and importance rating (n = 32), followed by multidimensional scaling and cluster analysis...
January 12, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29334515/facilitating-adoption-of-an-electronic-documentation-system
#6
Nazarine T Jones, Charlotte Seckman
Best practice recommends the integration of clinical documentation into the hospital electronic health record to support safe, efficient, and timely patient care. A major barrier to successful adoption and optimization of computerized documentation systems is user satisfaction. The purpose of this descriptive, performance improvement initiative was to implement and evaluate user satisfaction with an electronic documentation system to facilitate successful adoption. The Clinical Procedure Flowsheets application was implemented in a geriatric extended care unit of a large healthcare system...
January 12, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29334351/integrating-third-party-telehealth-records-with-the-general-practice-electronic-medical-record-system-a-solution
#7
Mary Paterson, Alison McAulay, Brian McKinstry
BACKGROUND: The implementation of telemonitoring at scale has been less successful than anticipated, often hindered by clinicians' perceived increase in workload. One important factor has been the lack of integration of patient generated data (PGD) with the electronic medical record (EMR). Clinicians have had problems accessing PGD on telehealth systems especially in patient consultations in primary care. OBJECTIVE: To design a method to produce a report of PGD that is available to clinicians through their routine EMR system...
November 17, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29334334/mortality-after-endovascular-treatment-of-infrarenal-abdominal-aortic-aneurysms-the-newer-the-better
#8
Aspasia Tzani, Ilias P Doulamis, Ioannis Katsaros, Eirini Martinou, Dimitrios Schizas, Konstantinos P Economopoulos
Although endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) presents a delicate alternative treatment for abdominal aortic aneurysms (AAA) with lower perioperative mortality, its long-term efficacy remains a matter of concern. The purpose of this study was to evaluate the currently reported mortality evidence after EVAR and to examine the possible effect of aneurysm status and the study period on mortality rates. The PubMed and Cochrane bibliographical databases were thoroughly searched for studies reporting on more than 1 000 patients with non-ruptured or ruptured infrarenal AAA, treated with EVAR from August 1991 to September 2016...
January 15, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29334277/validation-of-dpoae-screening-conducted-by-village-health-workers-in-a-rural-community-with-real-time-click-evoked-tele-auditory-brainstem-response
#9
Vidya Ramkumar, C S Vanaja, James W Hall, K Selvakumar, Roopa Nagarajan
OBJECTIVE: This study assessed the validity of DPOAE screening conducted by village health workers (VHWs) in a rural community. Real-time click evoked tele-auditory brainstem response (tele-ABR) was used as the gold standard to establish validity. DESIGN: A cross-sectional design was utilised to compare the results of screening by VHWs to those obtained via tele-ABR. Study samples: One hundred and nineteen subjects (0 to 5 years) were selected randomly from a sample of 2880 infants and young children who received DPOAE screening by VHWs...
January 15, 2018: International Journal of Audiology
https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#10
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29333821/opioid-treatment-for-mixed-pain-in-pediatric-patients-assisted-by-the-palliative-care-team-five-years-of-experience
#11
María L Yazde Puleio, Karina V Gómez, Ana Majdalani, Vilma Pigliapoco, Gisella Santos Chocler
Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Depending on its pathophysiological mechanism, it may be classified into nociceptive, neuropathic, and mixed pain. If pain is moderate to severe, a strong opioid should be administered and, when this is the case, morphine is the drug of choice. If morphine is ineffective or causes intolerable adverse effects, opioid rotation is recommended. Our objective was to describe the drug management for mixed pain used in patients assisted by the Palliative Care team of Hospital General de Niños Pedro de Elizalde between August 2011 and September 2015...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333820/osteomyelitis-in-burn-children-ten-years-of-experience
#12
María T Rosanova, Carla Voto, Susana Carnovale, Nidia Tramonti, Jimena Lema, José L Pinheiro, Adela Isasmendi, Verónica Alvarez, Rosa M Villasboas, Santiago Laborde, Hugo Basílico
INTRODUCTION: Osteomyelitis is uncommon among burn patients. OBJECTIVE: To describe the clinical, microbiological, and evolutionary characteristics of burn children with osteomyelitis hospitalized in a tertiary care facility. METHODS: Retrospective and descriptive study conducted between January 2007 and January 2017. RESULTS: Out of 600 burn children, 12 developed osteomyelitis (incidence: 2%). Eleven patients had a burn caused by direct fire...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333811/neonatal-mortality-and-associated-factors-in-newborn-infants-admitted-to-a-neonatal-care-unit
#13
Juan C Lona Reyes, René O Pérez Ramírez, Leonardo Llamas Ramos, Larissa M Gómez Ruiz, Edith A Benítez Vázquez, Virginia Rodríguez Patino
INTRODUCTION: The increasing survival rate of preterm infants has altered the epidemiology of neonatal diseases; however, neonatal mortality is still the main component of child mortality. The objective of this study was to evaluate neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit. MATERIAL AND METHODS: Prospective cohort study conducted between January 2016 and January 2017 at Hospital Civil de Guadalajara "Dr. Juan I...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#14
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29333500/improving-the-written-medical-handover
#15
Rhys Martin, Melanie Huddart, Cara Garbett, Wendell Storr, Olivia Watts, Sanjeev Gupta
The handover of large numbers of medical patients, during on call periods when staffing levels are reduced, is a challenge for all acute medical services. At the Royal Cornwall Hospital, a large district general hospital, we identified that foundation doctors were reviewing medical inpatients during weekend on call periods with limited written handover information. We chose to address this problem by developing an intervention, a weekend handover sticker, and piloting it. We used the review of documentation to measure improvement and feedback from users to assess the processes involved...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333499/sick-note-to-fit-note-one-trust-s-project-to-improve-usage-by-hospital-clinicians
#16
Amy Moran, Cathryn Mainwaring, Oliver Keane, Thomas Sanctuary, Kathryn Watson, Tunji Lasoye
Introduction: In April 2010, the government introduced a new Statement of Fitness to Work or 'Fit Note' for patients requiring time off of work or adaptations to their work due to illness. Responsibility to issue these documents has shifted from primary to secondary care. Hospital clinicians are required to issue for inpatients and for outpatients where clinical responsibility has not been taken over by the general practitioner (GP). However, awareness of this change is lacking. Misdirecting patients to their GP for the sole purpose of receiving a 'Fit Note' is an unnecessary use of appointment time and negatively impacts on patients...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#17
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333486/ethical-considerations-when-delivering-behavior-analytic-services-for-problem-behavior-via-telehealth
#18
Patrick W Romani, Kelly M Schieltz
Delivery of healthcare services via telehealth has been growing in popularity, and work completed by behavior analytic researchers and practitioners have supported this trend. Behavior analysts at the University of Iowa Children's Hospital (UICH) developed a telehealth model of service delivery to build upon their already established in-clinic and in-home services. Results from their telehealth studies showed positive effects. Social functions were identified for most children, and problem behavior decreased by an average of 94...
November 2017: Behavior Analysis (Washington, D.C.)
https://www.readbyqxmd.com/read/29333012/squamous-cell-carcinoma-lung-with-skeletal-muscle-involvement-a-8-year-study-of-a-tertiary-care-hospital-in-kashmir
#19
Javvid Muzamil, Shumail Bashir, Faisal R Guru, Firdousa Nabi, Gull Mohammad Bhat
Aims: Lung cancer is the most common malignancy throughout the world. Nonsmall cell lung cancer (NSCLC) is the most common type, and squamous cell type is most common in India. Mostly, patients present with chest-related symptoms and signs. Isolated skeletal muscle metastasis (ISMM) is rarely seen. The aim was to see muscle metastasis and its prognosis. Materials and Methods: We are presenting our data of 8 years about this common malignancy with relation to muscle metastasis, either alone or with other system metastasis...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29333011/oral-verrucous-carcinoma-ten-year-experience-from-a-tertiary-care-hospital-in-india
#20
Joshua Franklyn, Rajinikanth Janakiraman, Amit J Tirkey, Cecil Thankachan, John Muthusami
Background: Verrucous carcinoma of the oral cavity (OVC) is an uncommon variant of oral squamous cell carcinoma (OSCC). The clinical presentation and surgical outcomes of OVC are unique; however, the management protocols for OVC are largely extrapolated from OSCC. Objectives: The aim is to study the clinical, histopathological demographics, and outcome of OVC at a tertiary care referral hospital in South India. To study the need for lymph node dissection and the role of adjuvant therapy for close resection margins...
October 2017: Indian Journal of Medical and Paediatric Oncology
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