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https://www.readbyqxmd.com/read/28549480/improving-the-appropriateness-of-antipsychotic-prescribing-in-nursing-homes-a-mixed-methods-process-evaluation-of-an-academic-detailing-intervention
#1
L Desveaux, M Saragosa, J Rogers, L Bevan, H Loshak, A Moser, S Feldman, L Regier, L Jeffs, N M Ivers
BACKGROUND: In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appropriate prescribing of APM in nursing homes in a cluster-randomized trial. This mixed-methods study aimed to explore how and why the AD intervention may have resulted in changes in the nursing home context...
May 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28549459/-a-steep-learning-curve-junior-doctor-perspectives-on-the-transition-from-medical-student-to-the-health-care-workplace
#2
Nancy Sturman, Zachary Tan, Jane Turner
BACKGROUND: The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition...
May 26, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28548368/developing-minimum-clinical-standards-for-physiotherapy-in-south-african-icus-a-qualitative-study
#3
Heleen van Aswegen, Shane Patman, Natascha Plani, Susan Hanekom
RATIONALE, AIMS, AND OBJECTIVES: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients...
May 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28545572/intensive-case-management-for-addiction-to-promote-engagement-with-care-of-people-with-severe-mental-and-substance-use-disorders-an-observational-study
#4
Stéphane Morandi, Benedetta Silva, Philippe Golay, Charles Bonsack
BACKGROUND: Co-occurring severe mental and substance use disorders are associated with physical, psychological and social complications such as homelessness and unemployment. People with severe mental and substance use disorders are difficult to engage with care. The lack of treatment worsens their health and social conditions and increases treatment costs, as emergency department visits arise. Case management has proved to be effective in promoting engagement with care of people with severe mental and substance use disorders...
May 25, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28538140/comparison-of-policies-for-recognising-and-responding-to-clinical-deterioration-across-five-victorian-health-services
#5
Julie Considine, Anastasia F Hutchison, Helen Rawson, Alison M Hutchinson, Tracey Bucknall, Trisha Dunning, Mari Botti, Maxine M Duke, Maryann Street
Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia.Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes.Results In all, 22 guidance documents and five graphic observation and response charts were reviewed...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28530773/efficiency-of-instant-messaging-applications-in-coordination-of-emergency-calls-for-combat-injuries-a-pilot-study
#6
Sami Eksert, Mehmet Burak Aşık, Sinan Akay, Kenan Keklikçi, Fevzi Nuri Aydın, Mehmet Çoban, Ali Kantemir, Onur Güngör, Beyazıt Garip, Mustafa Suphi Turgut, Kenan Olcay
BACKGROUND: Coordination of an emergency response team is an important determinant of prompt treatment for combat injuries in hospitals. The authors hypothesized that instant messaging applications for smartphones could be appropriate tools for notifying emergency response team members. The objective of this study was to investigate the efficiency of a commercial instant messaging application (WhatsApp, Mountain View, CA) as a communication tool for the emergency team in a level-I trauma center...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530041/hiv-healthcare-transition-outcomes-among-youth-in-north-america-and-europe-a-review
#7
Vicki Tepper, Stefanie Zaner, Patrick Ryscavage
INTRODUCTION: The transition from paediatric to adult care poses risks to the health of young adults living with HIV if unsuccessful, including interruptions in care and poor health outcomes. Evolving best practices in HIV healthcare transition should ideally be informed by real-world qualitative and quantitative clinical healthcare transition outcomes. There has been a recent proliferation of HIV healthcare transition outcome research, largely from Europe and North America. METHODS: A literature search was undertaken using the online databases PubMed, Web of Science, and Google Scholar...
May 16, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28528247/china-medical-team-medical-rescue-for-4-25-nepal-earthquake
#8
REVIEW
Xi Lin, Ke-Jia Liu, Yong-Gui Zhang, Yang Dan, Dian-Guo Xing, Li Chen, Ding-Yuan Du
In recent years, global natural disasters have been frequent and resulted in great casualties and property loss. Since Wenchuan earthquake, the disaster emergency rescue system of China has obtained considerable development in various aspects including team construction, task scheduling, personnel training, facilities and equipments, logistics, etc. On April 25, 2015, an earthquake that measured 8.1 on the Richter scale attacked Nepal. Chinese government firstly organized a medical team, named China Medical Team, and sent it to the attacked region in Nepal to implement medical rescue...
April 26, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28521656/oral-feeding-difficulties-in-children-with-short-bowel-syndrome-a-narrative-review
#9
Judy Hopkins, Sharon A Cermak, Russell J Merritt
Children with short bowel syndrome (SBS) with associated intestinal failure may be unable to absorb sufficient nutrients to sustain life. Improvements in the medical management of SBS, including use of parenteral nutrition, has significantly increased life expectancy. Independence from parenteral nutrition further improves quality of life. However, children living with SBS often develop oral aversions and feeding difficulties. There is limited research and information on which to base interventions that will preserve and develop oral motor and feeding skills...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28517038/do-trainees-feel-that-they-belong-to-a-team
#10
Sophie Price, Rosie Lusznat
BACKGROUND: Postgraduate medical education has undergone significant reorganisation in recent years, with changes to the traditional apprenticeship model and an increasing reliance on shift working. The importance of teamwork in clinical care is well established; however, there is little literature on the extent to which trainees actually feel part of a team in the context of current working patterns. METHOD: This is a qualitative study using semi-structured interviews of medical and surgical trainees...
May 18, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#11
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#12
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#13
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28513616/complementariness-between-medical-geneticists-and-genetic-counsellors-its-added-value-in-genetic-services-in-europe
#14
Milena Paneque, Clara Serra-Juhé, Rebecka Pestoff, Christophe Cordier, João Silva, Ramona Moldovan, Charlotta Ingvoldstad
Clinical genetic services have progressed significantly the last few decades. This has led to the need for non-medical health-care professionals working as genetic counsellors in Europe and worldwide. However, there is no unified approach to genetic counsellors' role in health-care services in Europe, as in most countries the profession is still emerging and the educational backgrounds diverge noticeably, within and between countries. This qualitative study aims to describe the potential added value of genetic counsellors in clinical genetics teams and to explore their tasks and responsibilities in different European countries...
May 17, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28506976/implementation-of-postdischarge-follow-up-telephone-calls-at-a-comprehensive-cancer-center
#15
Shrina D Patel, Phuoc Anh Anne Nguyen, Melissa Bachler, Bradley Atkinson
PURPOSE: The development and implementation of a pharmacy-driven, postdischarge follow-up telephone call program to assess medication adherence, provide education, and address medication-related concerns are discussed. SUMMARY: Many readmissions are avoidable through effective discharge planning and patient follow-up after hospitalization. However, there is limited information on how to effectuate this process. To address this barrier, a team consisting of a clinical pharmacy specialist, a clinical pharmacy manager, a postgraduate year 1 pharmacy resident, and an education specialist at The University of Texas MD Anderson Cancer Center collaborated to create a postdischarge telephone call program within a transitions-of-care (TOC) pilot program...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#16
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28498004/a-sequential-implementation-model-for-workforce-development-a-case-study-of-medical-residency-training-for-substance-use-concerns
#17
Patricia S O'Sullivan, Patrick Yuan, Derek D Satre, Maria Wamsley, Jason Satterfield
PROBLEM: In graduate medical education, residency programs are often educationally isolated from each other, with varying needs and patient populations, so strategies are needed when attempting to implement training in evidence-based practices across multiple residencies. INTERVENTION: Using implementation science as a guide, we adapted a community development model to sequentially implement an evidence-based intervention, Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and drug use problems, across internal medicine, pediatrics, emergency medicine, psychiatry, and obstetrics and gynecology residency programs...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28494806/what-makes-weekend-allied-health-services-effective-and-cost-effective-or-not-in-acute-medical-and-surgical-wards-perceptions-of-medical-nursing-and-allied-health-workers
#18
Lisa O'Brien, Deb Mitchell, Elizabeth H Skinner, Romi Haas, Marcelle Ghaly, Fiona McDermott, Kerry May, Terry Haines
BACKGROUND: There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards. METHODS: This qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28490923/multigene-expression-profile-testing-in-breast-cancer-is-there-a-role-for-family-physicians
#19
M A O'Brien, J C Carroll, D P Manca, B Miedema, P A Groome, T Makuwaza, J Easley, N Sopcak, L Jiang, K Decker, M L McBride, R Moineddin, J A Permaul, R Heisey, E A Eisenhauer, M K Krzyzanowska, S Pruthi, C Sawka, N Schneider, J Sussman, R Urquhart, C Versaevel, E Grunfeld
BACKGROUND: Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing. METHODS: We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28490914/assessment-of-residency-program-outcomes-via-alumni-surveys
#20
Sonja Lüer, Christoph Aebi
BACKGROUND: One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals' acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR) data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland. METHODS: Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback) were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages), and 2 alumni surveys (S1, S2)...
2017: Advances in Medical Education and Practice
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