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https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#1
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27899191/genetic-predisposition-to-endocrine-tumors-diagnosis-surveillance-and-challenges-in-care
#2
REVIEW
Elisabeth Joye Petr, Tobias Else
Endocrine tumor syndromes, eg, multiple endocrine neoplasia types 1 and 2, were among the first recognized hereditary predisposition syndromes to tumor development. Over time, the number of endocrine tumor syndromes has significantly expanded, eg, with the recent inclusion of hereditary paraganglioma syndromes. Associations of non-endocrine tumors with hereditary endocrine tumor syndromes and endocrine tumors with non-classical endocrine tumor syndromes have emerged. These findings have certainly expanded the scope of care, necessitating a multidisciplinary approach by a team of medical professionals and researchers, integrating shared patient decision-making at every step of surveillance, diagnosis, and treatment...
October 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/27895842/postoperative-outcome-of-caesarean-sections-and-other-major-emergency-obstetric-surgery-by-clinical-officers-and-medical-officers-in-malawi
#3
Garvey Chilopora, Caetano Pereira, Francis Kamwendo, Agnes Chimbiri, Eddie Malunga, Staffan Bergström
BACKGROUND: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. METHODS: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27894563/administration-of-crofab-antivenom-by-a-helicopter-emergency-medical-service-team
#4
Michael T Steuerwald, Season R K Gabbard, Gillian A Beauchamp, Matthew K Riddle, Edward J Otten
The case presented here highlights an unconventional use of a helicopter emergency medical service (HEMS) to provide a specialized medication to a critically ill patient when definitive transport was delayed. A 39-year-old man presented to a rural hospital 1 hour after sustaining a copperhead envenomation. He developed severe symptoms and was intubated. Arrangements were made for transfer to a tertiary referral center by HEMS, but because of incoming weather conditions, the team would not be able to make the return flight safely...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894220/the-role-of-the-pharmacist-in-the-design-development-and-implementation-of-medication-prescription-support-systems
#5
Nuria Sola Bonada, Ana María Álvarez Díaz, Carlos Codina Jané
Clinical Decision Support Systems (CDSS) are computerized tools designed to help healthcare professionals to make clinical and therapeutic decisions, with the objective of improving patient care. Prescription-targeted CDSS have the highest impact in improving patient safety. Although there are different designs and functionalities, all these systems will combine clinical knowledge and patient information in a smart manner, in order to improve the prescription process. With the emergence of new technologies and advances in smart decision systems, the implementation of said systems can achieve an important improvement in terms of the prescription process and patient safety...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27893261/implementation-of-behavioral-health-interventions-in-real-world-scenarios-managing-complex-change
#6
Khaya D Clark, Benjamin F Miller, Larry A Green, Frank V de Gruy, Melinda Davis, Deborah J Cohen
Introduction: A practice embarks on a radical reformulation of how care is designed and delivered when it decides to integrate medical and behavioral health care for its patients and success depends on managing complex change in a complex system. We examined the ways change is managed when integrating behavioral health and medical care. Method: Observational cross-case comparative study of 19 primary care and community mental health practices. We collected mixed methods data through practice surveys, observation, and semistructured interviews...
November 28, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27891574/termination-of-pre-hospital-resuscitation-by-anaesthesiologists-causes-and-consequences-a-retrospective-study
#7
S Mikkelsen, H M Lossius, L G Binderup, C Schaffalitzky de Muckadell, P Toft, A T Lassen
AIM: Differentiating between a newly deceased patient and the lifeless patient in whom immediate resuscitation is required may be facilitated by a pre-hospital anaesthesiologist. The purpose of our study was to investigate to what extent and why the pre-hospital anaesthesiologist pronounced life extinct in situations where an emergency medical technician (EMT) would have been required to resuscitate. METHODS: All lifeless patients seen pre-hospitally by the anaesthesiologist-manned Mobile Emergency Care Unit in Odense, Denmark, from 2010 to 2014 were retrospectively studied...
November 27, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27884856/a-refugee-camp-in-the-centre-of-europe-clinical-characteristics-of-asylum-seekers-arriving-in-brussels
#8
Gerlant van Berlaer, Francisca Bohle Carbonell, Sofie Manantsoa, Xavier de Béthune, Ronald Buyl, Michel Debacker, Ives Hubloue
BACKGROUND: In the summer of 2015, the exodus of Syrian war refugees and saturation of refugee camps in neighbouring countries led to the influx of asylum-seekers in European countries, including Belgium. This study aims to describe the demographic and clinical characteristics of asylum seekers who arrived in a huddled refugee camp, in the centre of a well-developed country with all medical facilities. METHODS: Using a descriptive cross-sectional study design, physicians of Médecins du Monde prospectively registered age, gender, origin, medical symptoms and diagnoses of all patients presenting to an erected field hospital in Brussels in September 2015...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27884029/-preclinical-birth-of-an-extremely-premature-infant-a-case-report
#9
Tobias Pöhlmann, Armin Schmidt, Wolfgang Pohl
Obstetrical emergencies requiring emergency medical service are very rare. An extremely premature birth in a preclinical setting is certainly exceptional. In the following case report, the emergency medical team was unexpectedly faced with the home birth of a fetus at the 23(rd) week of gestation. Prematurity at the edge of viability poses a challenge to first care, equipment, infrastructure, expertise and clinical ethics. To the authors' knowledge, there is no comparable case report published so far.
November 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27883873/doctors
#10
Gaya Sritharan, Amber C Mills, Michele R Levinson, Anthea L Gellie
Objectives The aims of the present study were to investigate doctors' attitudes regarding the discussion and writing of not for resuscitation (NFR) orders and to identify potential barriers to the completion of these orders.Methods A questionnaire-based convenience study was undertaken at a tertiary hospital. Likert scales and open-ended questions were directed to issues surrounding the discussion, timing, understanding and writing of NFR orders, including legal and personal considerations.Results Doctors thought the presence of an NFR order both should and does alter care delivered by nursing staff, particularly delivery of pain relief, nursing observations and contacting the medical emergency team...
November 25, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27875821/are-hiv-infected-older-adults-aging-differently
#11
Stephen E Karpiak, Richard Havlik
With increasing success in treating HIV, infected persons are living longer, and a new challenge has emerged - the need to understand how HIV-infected adults are aging. What are the similarities with typical aging and what are the unique aspects that may have resulted from HIV infection, interacting with characteristic life style factors and other comorbid conditions? Are specific diseases and conditions (comorbidities), typically seen as part of the aging process, occurring at accelerated rates or with higher frequency (accentuated) in HIV-infected adults? At this juncture, conclusions should be tentative...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27875600/finding-the-words-medical-students-reflections-on-communication-challenges-in-clinic
#12
Genna Braverman, Janine S Bruce, Gregory Makoul, Erika Schillinger
BACKGROUND AND OBJECTIVES: Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. METHODS: Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27873299/using-the-manchester-triage-system-for-refusing-nonurgent-patients-in-the-emergency-department-a-30-day-outcome-study
#13
Roger Daglius Dias, Izabel Cristina Rios, Carlos Luis Benites Canhada, Maria Dolores Galinanes Otero Fernandes, Leila Suemi Harima Letaif, Eloisa Bonfá, Maria Beatriz Moliterno Perondi
OBJECTIVE: To evaluate the long-term outcomes and satisfaction of nonurgent patients who seek care in the emergency department (ED) and are diverted to primary health services (PHS). METHODS: Data were collected from 264 nonurgent patients diverted from the ED of a tertiary public university hospital in São Paulo, Brazil. The nonurgent patient definition was performed by Manchester triage system version II (MTS-II) associated to medical interview in the triage service...
September 2016: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/27871594/obstetric-team-simulation-program-challenges
#14
A S Bullough, S Wagner, T Boland, T P Waters, K Kim, W Adams
OBJECTIVE: To describe the challenges associated with the development and assessment of an obstetric emergency team simulation program. DESIGN: The goal was to develop a hybrid, in-situ and high fidelity obstetric emergency team simulation program that incorporated weekly simulation sessions on the labor and delivery unit, and quarterly, education protected sessions in the simulation center. All simulation sessions were video-recorded and reviewed. SETTING: Labor and delivery unit and simulation center...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27864201/precision-medicine-in-oncology-new-practice-models-and-roles-for-oncology-pharmacists
#15
Christine Walko, Patrick J Kiel, Jill Kolesar
PURPOSE: Three different precision medicine practice models developed by oncology pharmacists are described, including strategies for implementation and recommendations for educating the next generation of oncology pharmacy practitioners. SUMMARY: Oncology is unique in that somatic mutations can both drive the development of a tumor and serve as a therapeutic target for treating the cancer. Precision medicine practice models are a forum through which interprofessional teams, including pharmacists, discuss tumor somatic mutations to guide patient-specific treatment...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27862527/prevalence-of-head-injury-and-medically-diagnosed-concussion-in-junior-level-community-based-australian-rules-football
#16
Mark D Hecimovich, Doug King
AIM: For junior-level Australian Rules Football there is a paucity of head injury and concussion surveillance data; thus, the primary aim was to document head injury and concussion incidence in participants aged 9-17 years with a secondary aim to identify the mechanism-of-injury. METHODS: A prospective cohort study in which a designated representative for each of the 41 teams recorded on a weekly basis the number of head injuries suspected of being a concussion, diagnosed concussions and the mechanism-of-injury during competition games over the course of a 12-game season...
November 10, 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27856021/interdisciplinary-development-of-an-improved-emergency-department-procedural-work-surface-through-iterative-design-and-use-testing-in-simulated-and-clinical-environments
#17
Xiao C Zhang, Ana M Bermudez, Pranav M Reddy, Ravi R Sarpatwari, Darin B Chheng, Taylor J Mezoian, Victoria R Schwartz, Quinneil J Simmons, Gregory D Jay, Leo Kobayashi
STUDY OBJECTIVE: A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care...
November 14, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27849742/62-machine-learning-can-pre-identify-instability-risk-for-a-medical-emergency-team-call
#18
Marilyn Hravnak, Lujie Chen, Artur Dubrawski, Gilles Clermont, Michael Pinsky
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849646/team-based-primary-care-the-medical-assistant-perspective
#19
Bethany Sheridan, Alyna T Chien, Antoinette S Peters, Meredith B Rosenthal, Joanna Veazey Brooks, Sara J Singer
BACKGROUND: Team-based care has the potential to improve primary care quality and efficiency. In this model, medical assistants (MAs) take a more central role in patient care and population health management. MAs' traditionally low status may give them a unique view on changing organizational dynamics and teamwork. However, little empirical work exists on how team-based organizational designs affect the experiences of low-status health care workers like MAs. PURPOSES: The aim of this study was to describe how team-based primary care affects the experiences of MAs...
November 15, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27849499/trauma-resuscitation-evaluation-times-and-correlating-human-patient-simulation-training-differences-what-is-the-standard
#20
Timothy J Bonjour, Grigory Charny, Robert E Thaxton
BACKGROUND: Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. OBJECTIVES: The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center...
November 2016: Military Medicine
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