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https://www.readbyqxmd.com/read/28633469/a-framework-illustrating-care-seeking-among-older-adults-in-a-hospital-emergency-department
#1
Barbara J Lutz, Allyson G Hall, Sean B Vanhille, Andrea L Jones, Jessica R Schumacher, Phyllis Hendry, Jeffrey S Harman, Donna L Carden
Background and Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process. Research Design and Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care...
June 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/28632831/-antiseptics-and-disinfectants-aiming-at-rational-use-recommendations-of-the-advisory-committee-on-healthcare-associated-infections-sociedad-chilena-de-infectolog%C3%A3-a
#2
Alexis Diomedi, Eiiana Chacón, Luis Delpiano, Beatrice Hervé, M Irene Jemenao, Myriam Medel, Marcela Quintanilla, Gisela Riedel, Javier Tinoco, Marcela Cifuentes
Proper use of antiseptics and disinfectants, is an essential tool to prevent the spread of infectious agents and to control of healthcare-associated infections (HAI). Given the increasing importance of environmental aspects, as well as several advances and updates in the field of its proper use at local and intemational level, the SOCHINF HAI Advisory Committee considers that it is necessary to develop a guide for the rational use of antiseptics and disinfectants, which it will provide consistent scientific basis with that purpose...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28615355/reducing-unnecessary-imaging-for-patients-with-constipation-in-the-pediatric-emergency-department
#3
Catherine Craun Ferguson, Matthew P Gray, Melissa Diaz, Kevin P Boyd
OBJECTIVES: Constipation is a common diagnosis in the pediatric emergency department (ED). Children diagnosed with constipation may undergo an abdominal radiograph (AXR) as part of their diagnostic workup despite studies that suggest that an AXR in a patient suspected of being constipated is unnecessary and potentially misleading. We aimed to decrease the percentage of low-acuity patients aged between 6 months and 18 years diagnosed with constipation who undergo an AXR in our pediatric ED from 60% to 20% over 12 months...
June 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28614518/rationalization-and-sensemaking-in-care-management-an-experience-of-change-in-a-hospital-of-the-sus-unified-health-system
#4
Creuza da Silva Azevedo, Marilene de Castilho Sá, Marcela Cunha, Gustavo Correa Matta, Lilian Miranda, Victor Grabois
This study aimed to analyze organizational processes of change in the hospital care management by using qualitative evaluation developed in the case study. The study was developed at the Hospital Fornecedores de Cana de Piracicaba, in São Paulo State, Brazil, in September and October of 2012. There were 25 interviews with members of the senior board of directors of the hospital, managers and health professionals linked to healthcare of adults, in addition to the analysis of managerial documents and observations of some activities...
June 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28588978/improving-ebola-infection-prevention-and-control-in-primary-healthcare-facilities-in-sierra-leone-a-single-group-pretest-post-test-mixed-methods-study
#5
Ruwan Ratnayake, Lara S Ho, Rashid Ansumana, Hannah Brown, Matthias Borchert, Laura Miller, Thomas Kratz, Shannon A McMahon, Foday Sahr
BACKGROUND: Accomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops. METHODS: We conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28545456/towards-an-equitable-healthcare-in-china-evaluating-the-productive-efficiency-of-community-health-centers-in-jiangsu-province
#6
Lulin Zhou, Xinglong Xu, Henry Asante Antwi, Linna Wang
BACKGROUND: While the demand for the health service keeps escalating at the grass root or rural areas of China, a substantial portion of healthcare resources remains stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, the Deepening Health Care Reform in 2012 China was intended to flush out these discrepancies and promote a more equitable and efficient distribution of health resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight...
May 25, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28529099/the-value-of-comparative-research-in-major-day-surgery
#7
Alba Llop-Gironés, Montse Vergara-Duarte, Josep Anton Sánchez, Gemma Tarafa, Joan Benach
OBJECTIVE: To measure time trends in major day surgery rates according to hospital ownership and other hospital characteristics among the providers of the public healthcare network of Catalonia, Spain. METHOD: Data from the Statistics of Health Establishments providing Inpatient Care. A generalized linear mixed model with Gaussian response and random intercept and random slopes. RESULTS: The greatest growth in the rate of major day surgery was observed among private for-profit hospitals: 42...
May 19, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28527285/-genetic-diversity-of-extraintestinal-escherichia-coli-strains-producers-of-beta-lactamases-tem-shv-and-ctx-m-associated-with-healthcare
#8
Yasmin Varela, Beatriz Millán, María Araque
INTRODUCTION: There are few reports from Venezuela describing the genetic basis that sustains the pathogenic potential and phylogenetics of Escherichia coli extraintestinal strains isolated in health care units. OBJECTIVE: To establish the genetic diversity of extraintestinal E. coli strains producers of betalactamases TEM, SHV and CTX-M associated with healthcare. MATERIALS AND METHODS: We studied a collection of 12 strains of extraintestinal E...
June 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28502402/decisionmaking-in-practice-the-dynamics-of-muddling-through
#9
John M Flach, Markus A Feufel, Peter L Reynolds, Sarah Henrickson Parker, Kathryn M Kellogg
An alternative to conventional models that treat decisions as open-loop independent choices is presented. The alterative model is based on observations of work situations such as healthcare, where decisionmaking is more typically a closed-loop, dynamic, problem-solving process. The article suggests five important distinctions between the processes assumed by conventional models and the reality of decisionmaking in practice. It is suggested that the logic of abduction in the form of an adaptive, muddling through process is more consistent with the realities of practice in domains such as healthcare...
September 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28489132/patient-adherence-to-ischemic-heart-disease-treatment
#10
Moacyr Roberto Cuce Nobre, Rachel Zanetta de Lima Domingues
Introduction: The effectiveness of the treatment of chronic diseases depends on the participation of the patient, influenced by different sociocultural factors, which are not fully recognized by the treatment routine. Objective: To search for some of these factors that hinder or facilitate adherence to treatment and use of healthcare resources, approaching patients with ischemic heart disease. Method: A cross-sectional study was conducted using face-to-face interviews...
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28465306/high-adherence-to-the-wise-list-treatment-recommendations-in-stockholm-a-15-year-retrospective-review-of-a-multifaceted-approach-promoting-rational-use-of-medicines
#11
Jaran Eriksen, Lars L Gustafsson, Kristina Ateva, Pia Bastholm-Rahmner, Marie-Louise Ovesjö, Malena Jirlow, Maria Juhasz-Haverinen, Gerd Lärfars, Rickard E Malmström, Björn Wettermark, Eva Andersén-Karlsson
OBJECTIVES: To present the 'Wise List' (a formulary of essential medicines for primary and specialised care in Stockholm Healthcare Region) and assess adherence to the recommendations over a 15-year period. DESIGN: Retrospective analysis of all prescription data in the Stockholm Healthcare Region between 2000 and 2015 in relation to the Wise List recommendations during the same time period. SETTING: All outpatient care in the Stockholm Healthcare Region...
May 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28449262/predictive-mechanisms-linking-brain-opioids-to-chronic-pain-vulnerability-and-resilience
#12
REVIEW
Anthony Kenneth Peter Jones, Christopher Andrew Brown
Chronic pain is a major global healthcare problem that is currently inadequately treated. In addition, the current use of opioids for treatment has reached far beyond the paucity of evidence for long-term benefits relative to risks. Benefit-risk models for opioid and non-opioid treatments would benefit from a rational, mechanism-based understanding of neuroplastic and neurochemical contributions to chronic pain. Here, we evaluate the findings and limitations of representative research investigating brain neuroplasticity and neurochemistry in chronic pain...
April 27, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28392011/rationing-hepatitis-c-treatment-in-the-context-of-austerity-policies-in-france-and-cameroon-a-transnational-perspective-on-the-pharmaceuticalization-of-healthcare-systems
#13
Fanny Chabrol, Pierre-Marie David, Gaëlle Krikorian
New powerful drugs against hepatitis C can cure the disease, but they are not widely distributed because their exorbitant prices are destabilizing healthcare systems in both African and European countries. This article takes access to hepatitis C treatments since 2013 in France and in Cameroon as a lens to analyze the rationing of pharmaceutical treatments in relation to recent transformations of health systems. Access to these treatments is analyzed thanks to ethnographic observation and interviews lead in Paris and Yaoundé, with patients, associations, health professionals and public health experts...
March 28, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28388301/procalcitonin-biomarker-algorithm-reduces-antibiotic-prescriptions-duration-of-therapy-and-costs-in-chronic-obstructive-pulmonary-disease-a-comparison-in-the-netherlands-germany-and-the-united-kingdom
#14
Marloes E van der Maas, Gertjan Mantjes, Lotte M G Steuten
Antibiotics are often recommended as treatment for patients with chronic obstructive pulmonary disease (COPD) exacerbations. However, not all COPD exacerbations are caused by bacterial infections and there is consequently considerable misuse and overuse of antibiotics among patients with COPD. This poses a severe burden on healthcare resources such as increased risk of developing antibiotic resistance. The biomarker procalcitonin (PCT) displays specificity to distinguish bacterial inflammations from nonbacterial inflammations and may therefore help to rationalize antibiotic prescriptions...
April 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28382804/optical-coherence-tomography-guided-therapy-of-in-stent-restenosis-for-peripheral-arterial-disease
#15
REVIEW
Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD). The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty with or without a drug coated balloon (DCB), atherectomy (rotational, directional, orbital or laser), and stenting. The development of next generation peripheral stents and drug-coated stents have led to the improved treatment of complex superficial femoral artery (SFA) lesions, and consequently increased their usage...
August 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28376907/incidence-of-venous-thromboembolism-and-bleeding-events-in-patients-with-lower-extremity-orthopedic-surgery-a-retrospective-analysis-of-a-japanese-healthcare-database
#16
Takeshi Fuji, Masao Akagi, Yasuyuki Abe, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: Orthopedic surgeries of lower extremities such as total knee arthroplasty (TKA), total hip arthroplasty (THA), and hip fracture surgery (HFS) are widely considered to carry a high risk of developing deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE). Growing attention to epidemiological studies using a healthcare database led us to quantify the risks using a Japanese database to reveal recent medical care for such events. METHODS: The study comprised 36,947 patients who had undergone orthopedic surgeries of the lower extremities and whose medical information from April 2008 to September 2013 was available...
April 4, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28345742/a-qualitative-exploration-of-chronic-pain-and-opioid-treatment-among-hiv-patients-with-drug-use-disorders
#17
Sarina R Isenberg, Allysha C Maragh-Bass, Kathleen Ridgeway, Mary C Beach, Amy R Knowlton
OBJECTIVE: The study explored high-risk participants' experiences with pain management regarding clinical access to and use of prescription opioids. DESIGN: Qualitative semistructured interviews and focus groups. SETTING: Data were collected August 2014 to May 2015 at an urban community-based research facility in Baltimore City, MD. PARTICIPANTS: HIV participants with chronic pain and a history of illicit drug use. METHODS: Qualitative coding and analysis used an iterative, inductive, and thematic approach and coders achieved inter-coder consistency...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#18
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28343258/variation-of-antibiotic-consumption-and-its-correlated-factors-in-turkey
#19
Ayfer Sahin, Ahmet Akici, Volkan Aydin, Bahar Melik, Mesil Aksoy, Ali Alkan
BACKGROUND: Presentation of antibiotic utilization data by reliable and comparable analyses constitutes an important way of ensuring rational use of antibiotics. This study aimed to evaluate antibiotic consumption (AC) of Turkey by each city/region and to investigate any association of such consumption with socio-economic factors. METHOD: For 81 provinces and 12 regions in Turkey, AC data from IMS (Intercontinental Medical Statistics) in 2011 was analyzed in accordance with "ATC/DDD, DID" (Anatomical Therapeutic Chemical/Defined Daily Doses, DID = DDD/1000 inhabitants/day) methodology supported by World Health Organization...
March 25, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28324793/bureaucratization-and-medical-professionals-values-a-cross-national-analysis
#20
Girts Racko
Understanding the impact of the bureaucratization of governance systems on the occupational values of medical professionals is a fundamental concern of the sociological research of healthcare professions. While previous studies have examined the impact of bureaucratized management, organizations, and healthcare fields on medical professionals' values, there is a lack of cross-national research on the normative impact of the bureaucratized systems of national governance. Using the European Social Survey data for 29 countries, this study examines the impact of the bureaucratization of national governance systems on the occupational values of medical professionals...
May 2017: Social Science & Medicine
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