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https://www.readbyqxmd.com/read/29332026/medicinal-plant-materials-in-the-treatment-of-anxiety-disorders-neurobiological-aspects
#1
Miłosz Jan Gołyszny, Ewa Obuchowicz
Context • Pathological anxiety, which affects approximately one-third of the world population, is an inadequate, irrational reaction of an organism to the environment and to a potential threat. Despite advancements in pharmacotherapy for anxiety disorders, further studies are still necessary to search for new substances possessing the desired anxiolytic effects, with as few unwanted effects as possible. Objective • This study intended to examine the characteristics of medicinal plant materials that exhibit anxiolytic properties, with a special emphasis on the mechanisms of action of their active ingredients on the systems involved in the pathophysiology of anxiety...
January 15, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29325441/five-year-experience-of-an-inpatient-palliative-care-unit-at-an-academic-referral-center
#2
Myrick C Shinall, Sara F Martin, Jill Nelson, Richard S Miller, Matthew W Semler, Eli E Zimmerman, Christy C Noblit, E Wesley Ely, Mohana Karlekar
BACKGROUND: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. METHODS: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. RESULTS: Over these 5 years, there were 3321 admissions to the PCU...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29324069/evidence-based-guidelines-for-fatigue-risk-management-in-emergency-medical-services
#3
P Daniel Patterson, J Stephen Higgins, Hans P A Van Dongen, Daniel J Buysse, Ronald W Thackery, Douglas F Kupas, David S Becker, Bradley E Dean, George H Lindbeck, Francis X Guyette, Josef H Penner, John M Violanti, Eddy S Lang, Christian Martin-Gill
BACKGROUND: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an evidence-based guideline for fatigue risk management tailored to EMS operations. METHODS: Systematic searches were conducted from 1980 to September 2016 and guided by seven research questions framed in the Population, Intervention, Comparison, Outcome (PICO) framework...
January 11, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29324068/reliability-and-validity-of-survey-instruments-to-measure-work-related-fatigue-in-the-emergency-medical-services-setting-a-systematic-review
#4
P Daniel Patterson, Matthew D Weaver, Anthony Fabio, Ellen M Teasley, Megan L Renn, Brett R Curtis, Margaret E Matthews, Andrew J Kroemer, Xiaoshuang Xun, Zhadyra Bizhanova, Patricia M Weiss, Denisse J Sequeira, Patrick J Coppler, Eddy S Lang, J Stephen Higgins
BACKGROUND: This study sought to systematically search the literature to identify reliable and valid survey instruments for fatigue measurement in the Emergency Medical Services (EMS) occupational setting. METHODS: A systematic review study design was used and searched six databases, including one website. The research question guiding the search was developed a priori and registered with the PROSPERO database of systematic reviews: "Are there reliable and valid instruments for measuring fatigue among EMS personnel?" (2016:CRD42016040097)...
January 11, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29320790/-learning-in-protected-environment-implementation-in-continuing-medical-education
#5
Lion Sieg, Lars Friedrich, Hendrik Eismann
Actual concepts in continuing medical education in acute or emergency medicine contain skill training as well as simulation training. Methods and mechanisms to reduce crisis, like human factor training, shared mental models or closed-loop communication are incorporated. It is unknown which training method is optimal for individual departments in hospitals or for the individual level of education of the healthcare provider. A concept we provide is the so called "learning in protected environment": this environment protects the course participants and our patients from negative consequences of a conventional hands-on training...
January 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29318167/a-comparison-of-cervical-spine-motion-after-immobilization-with-a-traditional-spine-board-and-full-body-vacuum-mattress-splint
#6
Brian E Etier, Grant E Norte, Megan M Gleason, Dustin L Richter, Kelli F Pugh, Keith B Thomson, Lindsay V Slater, Joe M Hart, Stephen F Brockmeier, David R Diduch
Background: The National Athletic Trainers' Association (NATA) advocates for cervical spine immobilization on a rigid board or vacuum splint and for removal of athletic equipment before transfer to an emergency medical facility. Purpose: To (1) compare triplanar cervical spine motion using motion capture between a traditional rigid spine board and a full-body vacuum splint in equipped and unequipped athletes, (2) assess cervical spine motion during the removal of a football helmet and shoulder pads, and (3) evaluate the effect of body mass on cervical spine motion...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#7
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29315473/a-before-and-after-observational-study-of-a-protocol-for-use-of-the-c-mac-videolaryngoscope-with-a-frova-introducer-in-pre-hospital-rapid-sequence-intubation
#8
S Ångerman, H Kirves, J Nurmi
Results using videolaryngoscopy in pre-hospital rapid sequence intubation are mixed. A bougie is not commonly used with videolaryngoscopy. We hypothesised that using videolaryngoscopy and a bougie as core elements of a standardised protocol that includes a drugs and a laryngoscopy algorithm would result in a high first-pass tracheal intubation success rate. We employed videolaryngoscopy (C-MAC) combined with a bougie (Frova intubating introducer) in an anaesthetist-staffed helicopter emergency medical service...
January 8, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313504/anesthetic-activities-provided-by-the-french-forward-surgical-team-in-abidjan-ivory-coast-four-year-retrospective-analysis
#9
B Prunet, S Schmitt, J Le Gouellec, J Schmitt, J Cotte, C Nguyen, P Esnault, E Meaudre
The aims of this study were to review and quantify the types of anesthetic procedures performed by anesthesiologists assigned to the forward surgical team (FST) deployed in Abidjan, Ivory Coast. The study includes all patients undergoing surgery by the FST from July 2012 through July 2016. The activity was retrospectively analyzed and divided according to demographics, surgical specialties, emergency versus elective surgery, types of anesthetic and post-operative analgesic procedures, and transfusion aspects...
November 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29311170/integrating-community-health-workers-into-medical-homes
#10
Elizabeth A Rogers, Sarah Turcotte Manser, Joan Cleary, Anne M Joseph, Eileen M Harwood, Kathleen T Call
PURPOSE: Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29309483/effect-of-the-school-based-telemedicine-enhanced-asthma-management-sb-team-program-on-asthma-morbidity-a-randomized-clinical-trial
#11
Jill S Halterman, Maria Fagnano, Reynaldo S Tajon, Paul Tremblay, Hongyue Wang, Arlene Butz, Tamara T Perry, Kenneth M McConnochie
Importance: Poor adherence to recommended preventive asthma medications is common, leading to preventable morbidity. We developed the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program to build on school-based supervised therapy programs by incorporating telemedicine at school to overcome barriers to preventive asthma care. Objective: To evaluate the effect of the SB-TEAM program on asthma morbidity among urban children with persistent asthma...
January 8, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29305076/system-level-process-change-improves-communication-and-follow-up-for-emergency-department-patients-with-incidental-radiology-findings
#12
Steven J Baccei, Sneha A Chinai, Martin Reznek, Scott Henderson, Kevin Reynolds, D Eric Brush
The appropriate communication and management of incidental findings on emergency department (ED) radiology studies is an important component of patient safety. Guidelines have been issued by the ACR and other medical associations that best define incidental findings across various modalities and imaging studies. However, there are few examples of health care facilities designing ways to manage incidental findings. Our institution aimed to improve communication and follow-up of incidental radiology findings in ED patients through the collaborative development and implementation of system-level process changes including a standardized loop-closure method...
January 3, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29303946/use-of-rapid-response-teams-in-psychiatry-variables-that-impact-safety
#13
Ryan Greytak, Joanna Y Wang, Yea-Jen Hsu, Jill Marsteller, Geetha Jayaram
OBJECTIVE: The addition of rapid response teams (RRTs) has emerged as a treatment option for medically deteriorating psychiatric inpatients. The goal of this study was to identify risk factors for use of RRTs at the time of initial psychiatric evaluation and develop measures to predict use of this emergent medical intervention. We have not located any studies that have previously addressed this issue. METHODS: We studied the use of RRTs and code teams (CTs) on inpatient general and specialty psychiatric services in a large urban academic psychiatric hospital...
November 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29297981/primary-biliary-cholangitis-in-british-columbia-first-nations-clinical-features-and-discovery-of-novel-genetic-susceptibility-loci
#14
Sirisha Asuri, Sarah McIntosh, Valerie Taylor, Andrew Rokeby, James Kelly, Karey Shumansky, L Leigh Field, Eric M Yoshida, Laura Arbour
BACKGROUND AND AIMS: Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease characterized by destruction of intrahepatic bile ducts, portal inflammation, and cirrhosis. Although rare in most populations, it is prevalent and often familial in British Columbia First Nations. We hypothesized that major genetic factors increased the risk in First Nations. METHODS: 44 individuals with PBC and 61 unaffected relatives from 32 First Nations families participated...
January 3, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29281665/designing-a-more-efficient-effective-and-safe-medical-emergency-team-met-service-using-data-analysis
#15
Christoph Bergmeir, Irma Bilgrami, Christopher Bain, Geoffrey I Webb, Judit Orosz, David Pilcher
INTRODUCTION: Hospitals have seen a rise in Medical Emergency Team (MET) reviews. We hypothesised that the commonest MET calls result in similar treatments. Our aim was to design a pre-emptive management algorithm that allowed direct institution of treatment to patients without having to wait for attendance of the MET team and to model its potential impact on MET call incidence and patient outcomes. METHODS: Data was extracted for all MET calls from the hospital database...
2017: PloS One
https://www.readbyqxmd.com/read/29280907/a-quality-improvement-initiative-to-reduce-out-of-icu-cardiopulmonary-arrests-in-a-tertiary-care-hospital-in-india-a-2-year-learning-experience
#16
Vidya P Menon, Preetha Prasanna, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Rajesh D Pai, Sanjeev Singh
QUALITY PROBLEM OR ISSUE: To assess impact of medical emergency team (MET) in reducing "out-of-ICU" cardiopulmonary arrests and identify barriers to its optimal utilization. INITIAL ASSESSMENT: Frequently observed critical clinical signs and laboratory values of "out-of-ICU" crashes were used to develop Amrita Early Warning Criteria. CHOICE OF SOLUTION: A physician-led MET was established to respond to code MET, activated by a primary nurse...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29276268/improved-outcomes-and-cost-savings-associated-with-pharmacist-presence-in-the-emergency-department
#17
Matthew W McAllister, Joshua G Chestnutt
Purpose: The study sought to determine whether the inclusion of a pharmacist on the emergency department (ED) resuscitation team was associated with improved compliance with the Advanced Cardiac Life Support (ACLS) guidelines and patient survival. The study also evaluated cost avoidance associated with a pharmacist providing clinical services to the ED. Methods: Cardiac arrest event records were evaluated for compliance with ACLS guidelines as well as for whether or not a pharmacist was involved as a member of the resuscitation team...
June 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276030/the-impact-of-prehospital-assessment-and-ems-transport-of-acute-aortic-syndrome-patients
#18
Akira Yamashita, Tetsuo Maeda, Yoshihito Kita, Satoru Sakagami, Yasuhiro Myojo, Yukihiro Wato, Yutaka Yoshita, Hideo Inaba
BACKGROUND: The quality of acute aortic syndrome (AAS) assessment by emergency medical service (EMS) and the incidence and prehospital factors associated with 1-month survival remain unclear. METHODS: We retrospectively analyzed the data collected for 94,468 patients with non-traumatic medical emergency excluding out-of-hospital cardiac arrest during the period of 2011-2014. RESULTS: Of these transported by EMS, 22,075 had any of the AAS-related symptoms, and 330 had an EMS-assessed risk for AAS; of these, 195 received an in-hospital AAS diagnosis...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29275386/chickenpox-an-ageless-disease
#19
Annalan Mathew Dwight Navaratnam, Nan Ma, Maria Farrukh, Aza Abdulla
A 97-year-old woman presented with 4-day history of vesicular rash, initially at the feet but then spread up to the thighs bilaterally, abdomen and trunk. The initial differentials included bullous pemphigus and cellulitis by the emergency department. She was then managed as bullous pemphigus by the acute medical team and started on high-dose steroids, with no other differentials considered. When her care was taken over by the general medical team, varicella zoster virus (VZV) infection was suspected. After confirmation by the dermatology team regarding the clinical diagnosis and the positive VZV DNA swabs, she was started on acyclovir...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29273040/multiple-constraints-compromise-decision-making-about-implantable-medical-devices-for-individual-patients-qualitative-interviews-with-physicians
#20
Anna R Gagliardi, Ariel Ducey, Pascale Lehoux, Thomas Turgeon, Jeremy Kolbunik, Sue Ross, Patricia Trbovich, Anthony Easty, Chaim Bell, David R Urbach
BACKGROUND: Little research has examined how physicians choose medical devices for treating individual patients to reveal if interventions are needed to support decision-making and reduce device-associated morbidity and mortality. This study explored factors that influence choice of implantable device from among available options. METHODS: A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites...
December 22, 2017: BMC Medical Informatics and Decision Making
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