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https://www.readbyqxmd.com/read/28454012/spatial-clustering-of-childhood-leukaemia-with-the-integration-of-the-paediatric-environmental-history
#1
Alberto Cárceles-Álvarez, Juan A Ortega-García, Fernando A López-Hernández, Mayra Orozco-Llamas, Blanca Espinosa-López, Esther Tobarra-Sánchez, Lizbeth Alvarez
BACKGROUND: Leukaemia remains the most common type of paediatric cancer and its aetiology remains unknown, but considered to be multifactorial. It is suggested that the initiation in utero by relevant exposures and/or inherited genetic variants and, other promotional postnatal exposures are probably required to develop leukaemia. This study aimed to map the incidence and analyse possible clusters in the geographical distribution of childhood acute leukaemia during the critical periods and to evaluate the factors that may be involved in the aetiology by conducting community and individual risk assessments...
April 25, 2017: Environmental Research
https://www.readbyqxmd.com/read/28453985/realising-the-dream-of-becoming-a-nurse-underrepresented-bsc-nursing-students-experiences
#2
Brid O'Brien, Margaret M Graham, Deirdre O'Sullivan
BACKGROUND: This paper describes the experiences of underrepresented BSc nursing students in realising the dream of becoming a nurse in one university. In the past ten years, pre-registration nurse education has become established within higher education in Ireland. This development includes promoting access and inclusion of students from traditionally underrepresented groups in higher education. A third of nursing students currently access places on programmes through routes specifically designed for underrepresented groups...
April 18, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28453820/reliability-of-clinical-impact-grading-by-healthcare-professionals-of-common-prescribing-error-and-optimisation-cases-in-critical-care-patients
#3
Richard S Bourne, Rob Shulman, Mark Tomlin, Mark Borthwick, Will Berry, Gary H Mills
Objective: To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Design: Electronic questionnaire. Setting: 5 UK NHS Trusts. Participants: 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Intervention: Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28453540/pre-and-posttreatment-with-hydrogen-sulfide-prevents-ventilator-induced-lung-injury-by-limiting-inflammation-and-oxidation
#4
Simone Faller, Raphael Seiler, Rosa Donus, Helen Engelstaedter, Alexander Hoetzel, Sashko Gregoriev Spassov
Although essential in critical care medicine, mechanical ventilation often results in ventilator-induced lung injury. Low concentrations of hydrogen sulfide have been proven to have anti-inflammatory and anti-oxidative effects in the lung. The aim of this study was to analyze the kinetic effects of pre- and posttreatment with hydrogen sulfide in order to prevent lung injury as well as inflammatory and oxidative stress upon mechanical ventilation. Mice were either non-ventilated or mechanically ventilated with a tidal volume of 12 ml/kg for 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28453507/genetic-cancer-risk-assessment-for-breast-cancer-in-latin-america
#5
Yanin Chavarri-Guerra, Kathleen Reilly Blazer, Jeffrey Nelson Weitzel
In Latin America, breast cancer is the most common malignancy in women, and limited available data suggest that up to 15% of all breast cancer cases in the region are hereditary. Genetic cancer risk assessment and counseling is a critical component of the appropriate clinical care of patients with hereditary breast cancer and their families. Unfortunately, genetic services are underdeveloped across Latin America, and access to genetic testing and counseling is very scarce in the region. Barriers contributing to the access to genetic care are high cost and lack of insurance coverage for genetic tests, insufficient oncogenetics training or expertise, nonexistence of genetic counseling as a clinical discipline, and lack of supportive healthcare policies...
March 2017: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/28453497/rasch-analysis-of-a-behavioral-checklist-for-the-assessment-of-pain-in-critically-ill-adults
#6
Christophe Chenier, Gilles Raiche, Nadine Talbot, Bianca Carignan, Celine Gelinas
Patients hospitalized in the intensive care unit (ICU) are often unable to report their pain, which is a problem since untreated pain is associated with negative health outcomes. The use of behavioral pain scales are recommended for the detection of the presence of pain in this vulnerable population. Previous validation studies have used classical techniques, and several psychometrics properties remain unknown. In this paper, data obtained from a behavioral checklist of dichotomized items was utilized to evaluate the instrument's dimensionality, its construct validity and its capacity to distinguish between levels of pain by using Rasch measurement...
2017: Journal of Applied Measurement
https://www.readbyqxmd.com/read/28453400/what-s-love-got-to-do-with-it-investigating-consumer-commitment-in-health-care
#7
Elyria Kemp, Sonja Martin Poole
Building relationships with patients to create patient-centered care is critical to the success of health care organizations. A core element in relationships is commitment. Commitment may be based on affect and emotions, perceived costs, and even obligation. This research proposes that three types of commitment-affective, continuance, and normative commitment-differentially impact consumer purchase loyalty, attitudinal loyalty, and advocacy for a health care provider. To examine the impact of commitment type on consumer relationships, exploratory data were garnered and surveys were administered...
April 28, 2017: Health Marketing Quarterly
https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#8
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449491/characteristics-and-provision-of-care-of-patients-with-the-acute-respiratory-distress-syndrome-descriptive-findings-from-the-dacapo-cohort-baseline-and-comparison-with-international-findings
#9
Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Sebastian Blecha, Michael Quintel, Steffen Weber-Carstens, Stefan Kluge, Patrick Meybohm, Caroline Rolfes, Björn Ellger, Friedhelm Bach, Tobias Welte, Thomas Muders, Kathrin Thomann-Hackner, Thomas Bein, Christian Apfelbacher
BACKGROUND: Little is known about the characteristics and real world life circumstances of ARDS (acute respiratory distress syndrome) patient populations. This knowledge is essential for transferring evidence-based therapy into routine healthcare. The aim of this study was to report socio-demographic and clinical characteristics in an unselected population of ARDS patients and to compare these results to findings from other large ARDS cohorts. METHODS: A German based cross-sectional observational study was carried out...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449321/a-review-of-associated-controversies-surrounding-glucocorticoid-use-in-veterinary-emergency-and-critical-care
#10
Maya A Aharon, Jennifer E Prittie, Kate Buriko
OBJECTIVE: To review the literature in human and veterinary medicine regarding the indications for, efficacy of, and controversies surrounding glucocorticoid (GC) administration in the emergency and critical care (ECC) setting, and to provide an overview of the most commonly used synthetic GC formulations. MEDICATIONS: Synthetic GCs vary in GC and mineralocorticoid potency, hypothalamic pituitary axis suppression, duration of action, route of administration, and clinical indication for use...
April 27, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28449296/frailty-index-intensive-care-unit-complications-in-head-and-neck-oncologic-regional-and-free-flap-reconstruction
#11
Nicholas B Abt, Yanjun Xie, Sidharth V Puram, Jeremy D Richmon, Mark A Varvares
BACKGROUND: Head and neck extirpations requiring reconstruction are challenging surgeries with high postoperative complication risk. METHODS: Regional and free flap reconstructions of head and neck defects were collected from the 2006-2013 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The modified frailty index was made of 15 variables, with increasing index scores indicative of frailer patients. Intensive care unit (ICU)-level complications were defined by Clavien-Dindo classification IV and analyzed with multivariable logistic regression...
April 27, 2017: Head & Neck
https://www.readbyqxmd.com/read/28449225/transfusion-research-priorities-for-blood-services-in-sub-saharan-africa
#12
REVIEW
Imelda Bates, Oliver Hassall, Tonderai Mapako
Evidence to support many blood transfusion policies and practices in sub-Saharan Africa (SSA) is weak or lacking. SSA cannot extrapolate from wealthy countries' research findings because its environment, users and structures are very different and SSA has critical blood shortages. SSA needs to generate its own evidence but research funds are very scarce and need to be carefully targeted to match need. This study aimed to define this need by determining research priorities for blood services in SSA. Thirty-five stakeholders representing diverse blood services' interests and expertise participated in a workshop...
April 27, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28449107/the-role-of-dyadic-confidence-on-engagement-in-heart-failure-care-behaviors
#13
Karen S Lyons, Jill M Gelow, Shirin O Hiatt, James O Mudd, Jonathan Auld, Christopher V Chien, Christopher S Lee
Background and Objectives: Increasingly, older adults and their families are expected to manage complex conditions with little support. In the case of heart failure (HF), symptom monitoring and management are critical in preventing acute exacerbations and poor clinical outcomes. The current study examined the role of dyadic confidence on engagement in HF care behaviors by patients and their spouses. Research Design and Methods: A cross-sectional design was used to examine 60 couples living with HF...
April 26, 2017: Gerontologist
https://www.readbyqxmd.com/read/28448942/assessing-knowledge-of-symptoms-and-first-aid-care-of-epilepsy-in-grenada-west-indies
#14
Sean C Cofano, Disep Ojukwu, Natasha Mozumdar, Zainab Raza, Shipra Saigal, Shashank Musku, Safwan Zar, Michael Merolla, Tuula O Jalonen
Epilepsy is a chronic neurological disorder that is increasingly prevalent in developing countries. It is critical to provide appropriate support to patients during seizures in order to prevent injuries. False beliefs regarding the etiology or pathogenesis of the epilepsy and inadequate health information may put patients with epilepsy or other seizure disorders at increased risk of injury. Our objective was to assess the level of epilepsy awareness amongst the general population in Grenada and educate the participants regarding proper first-aid measures...
April 24, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28448775/exploring-electronic-medical-record-and-self-administered-medication-risk-screening-tools-in-a-primary-care-clinic
#15
Mark J Makowsky, Ken Cor, Tat Wong
BACKGROUND: Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. OBJECTIVES: To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448697/national-trends-in-antidepressant-benzodiazepine-and-other-sedative-hypnotic-treatment-of-older-adults-in-psychiatric-and-primary-care
#16
Donovan T Maust, Frederic C Blow, Ilse R Wiechers, Helen C Kales, Steven C Marcus
OBJECTIVE: To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥ 65 years) has changed over time among visits to primary care providers and psychiatrists. METHODS: Data were from the National Ambulatory Medical Care Survey (years 2003-2005 and 2010-2012), a nationally representative cross-section of outpatient physician visits. Analysis focused on visits to primary care providers (n = 14,282) and psychiatrists (n = 1,095) at which an antidepressant, benzodiazepine, or other anxiolytic/sedative-hypnotic was prescribed, which were stratified by demographic and clinical characteristic (including ICD-9-CM diagnosis) and compared across study intervals...
April 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28448689/trends-and-factors-associated-with-insomnia-and-sleep-apnea-in-all-united-states-military-service-members-from-2005-to-2014
#17
John A Caldwell, Joseph J Knapik, Harris R Lieberman
Sleep disorders are a critical issue for the military, as they impact operational readiness, personnel health, wellbeing and health-care costs. The incidence of insomnia and obstructive sleep apnea (OSA) are increasing in the United States civilian population, and rates in military personnel exceed those of civilians. Using a comprehensive database, rates of medical encounters for insomnia and OSA were investigated and their associations with various demographic factors examined in the total US military population [1,381,406 ± 25,123, mean ± standard deviation (SD) personnel per year] from 2005 to 2014...
April 27, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28448328/hospice-or-community-network-choices-in-end-of-life-care-in-jamaica
#18
Roger Lee Mendoza
AIM: National and international healthcare agencies and organizations typically attribute slow or haphazard growth in hospice and palliative care in developing countries to various resource constraints. This study provides evidence of the substantial and widening gap between policy advocacy and individual decision-making concerning end-of-life care. It does so by establishing the incentives and risks that underlie choices of patients and providers against the relative scarcity of hospices in these countries...
April 26, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28448303/predictability-of-interruptions-during-medication-administration-with-related-behavioral-management-strategies
#19
Maree Johnson, Gabrielle Weidemann, Rebecca Adams, Elizabeth Manias, Tracy Levett-Jones, Vicki Aguilar, Bronwyn Everett
The aim of this qualitative study was to examine the nature of interruptions during medication administration. Focus groups were conducted with medical/surgical nurses (n = 15), critical care nurses (n = 13), and nurse managers/educators/specialists (n = 6). Most interruptions (78%) were predictable. Nurse-adopted strategies included blocking, engaging, mediating, multitasking, and preventing. Educational content was developed that relates behavioral strategies to respond to predictable and unpredictable interruptions...
April 26, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28447664/efficient-design-of-clinical-trials-and-epidemiological-research-is-it-possible
#20
REVIEW
Michael S Lauer, David Gordon, Gina Wei, Gail Pearson
Randomized clinical trials and large-scale, cohort studies continue to have a critical role in generating evidence in cardiovascular medicine; however, the increasing concern is that ballooning costs threaten the clinical trial enterprise. In this Perspectives article, we discuss the changing landscape of clinical research, and clinical trials in particular, focusing on reasons for the increasing costs and inefficiencies. These reasons include excessively complex design, overly restrictive inclusion and exclusion criteria, burdensome regulations, excessive source-data verification, and concerns about the effect of clinical research conduct on workflow...
April 27, 2017: Nature Reviews. Cardiology
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