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https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#1
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#2
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28229476/initial-medication-non-adherence-prevalence-and-predictive-factors-in-a-cohort-of-1-6-million-primary-care-patients
#3
I Aznar-Lou, A Fernández, M Gil-Girbau, M Fajó-Pascual, P Moreno-Peral, M T Peñarrubia-Maria, A Serrano-Blanco, A Sánchez-Niubó, M March-Pujol, A M Jové, M Rubio-Valera
INTRODUCTION: Adherence to medicines is vital in treating diseases. Initial medication non-adherence (IMNA) - defined as not obtaining a medication the first time it is prescribed - has been poorly explored. Previous studies show IMNA rates between 6 and 28% in Primary Care (PC). The aims of this study were to determine prevalence and predictive factors of IMNA in the most prescribed and expensive pharmacotherapeutic groups in the Catalan health system. METHODS: Retrospective, register-based cohort study which linked Catalan PC System (Spain) prescription and invoicing databases...
February 23, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28228138/current-management-practices-for-patients-presenting-with-low-back-pain-to-a-large-emergency-department-in-canada
#4
Matthew L Nunn, Jill A Hayden, Kirk Magee
BACKGROUND: Low back pain (LBP) is one of the leading causes of disability. Presentations to the emergency department (ED) are common and consume significant healthcare resources. However, treatment of patients with LBP is variable and highly physician dependent. Our study objective was to describe the demographic and clinical characteristics of patients presenting to the ED with LBP, the diagnostic strategies employed by ED physicians, and the subsequent management. METHODS: We conducted a retrospective study using clinical and electronic health data at the Queen Elizabeth II Health Science Center's Charles V...
February 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28224443/report-of-the-clinical-and-functional-primary-outcomes-in-men-of-the-acl-sports-trial-similar-outcomes-in-men-receiving-secondary-prevention-with-and-without-perturbation-training-1-and-2-years-after-acl-reconstruction
#5
Amelia J H Arundale, Kathleen Cummer, Jacob J Capin, Ryan Zarzycki, Lynn Snyder-Mackler
BACKGROUND: Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28224099/using-quality-improvement-methods-to-increase-use-of-pain-prevention-strategies-for-childhood-vaccination
#6
Jennifer Verrill Schurman, Amanda D Deacy, Rebecca J Johnson, Jolynn Parker, Kristi Williams, Dustin Wallace, Mark Connelly, Lynn Anson, Kevin Mroczka
AIM: To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology. METHODS: Specific intervention strategies (i.e., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28222741/the-impact-of-psychological-factors-on-condition-specific-generic-and-individualized-patient-reported-outcomes-in-low-back-pain
#7
Ida Løchting, Andrew M Garratt, Kjersti Storheim, Erik L Werner, Margreth Grotle
BACKGROUND: An individualized patient reported outcome (PRO) has recently been recommended within LBP research, but no study has evaluated this instrument with commonly applied PROs. Moreover, the impact of psychological factors has mostly been assessed for disease-specific instruments. The objective of this study was to assess the predictive value of illness perceptions, pain catastrophizing and psychological distress on 12 month outcomes assessed by specific, generic and individualized PROs recommended in low back pain (LBP)...
February 21, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28222707/comparison-of-the-swedish-start-back-screening-tool-and-the-short-form-of-the-%C3%A3-rebro-musculoskeletal-pain-screening-questionnaire-in-patients-with-acute-or-subacute-back-and-neck-pain
#8
Malin Forsbrand, Birgitta Grahn, Jonathan C Hill, Ingemar F Petersson, Charlotte Post Sennehed, Kjerstin Stigmar
BACKGROUND: Patients with back and neck pain are often seen in primary care and it is important to provide them with tailored interventions based on risk stratification/triage. The STarT Back Screening Tool (SBT) is a widely used screening questionnaire which has not yet been validated for a population with back and/or neck pain with short duration. Our aim was to compare the concurrent validity of the SBT and the short form of the ÖMPSQ including psychometric properties and clinical utility in a primary care setting...
February 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28221284/pain-interference-and-physical-function-demonstrate-poor-longitudinal-association-in-people-living-with-pain-a-promis-investigation
#9
Nicholas V Karayannis, John A Sturgeon, Ming Chih-Kao, Corinne Cooley, Sean C Mackey
A primary goal in managing pain is to reduce pain and increase physical function (PF). This goal is also tied to continuing payment for treatment services in many practice guidelines. Pain interference (PI) is often used as a proxy for measurement and reporting of PF in these guidelines. A common assumption is that reductions in PI will translate into improvement in PF over time. This assumption needs to be tested in a clinical environment. Consequently, we used the patient reported outcomes measurement information system (PROMIS) to describe the topology of the longitudinal relationship between PI in relation to PF...
February 16, 2017: Pain
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#10
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220574/selective-use-of-the-electrocardiogram-in-pediatric-preparticipation-athletic-examinations-among-pediatric-primary-care-providers
#11
Bradley C Clark, Joshua M Hayman, Charles I Berul, Kristin M Burns, Jonathan R Kaltman
OBJECTIVES: Recent literature examining insurance administrative data suggests that a selective approach, with concurrent history and physical exam (H&P), for obtaining an electrocardiogram (ECG) as a part of a preparticipation examination (PPE) for pediatric athletes is commonly used in the primary care setting demonstrating a high rate of disease detection. We sought to understand practice patterns of providers with regard to usage of ECG as a part of PPE. METHODS: Utilizing an online survey, we queried primary care providers regarding their practice patterns, rationale, and concerns regarding use of ECGs as a part of the PPE...
February 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28218561/scandcleft-randomised-trials-of-primary-surgery-for-unilateral-cleft-lip-and-palate-3-descriptive-study-of-postoperative-nursing-care-following-first-stage-cleft-closure
#12
Patricia Bannister, Nina Lindberg, Karin Jeppesen, Ulla Elfving-Little, Ann-Margritt Semmingsen, Anna Paganini, Annica Gustavsson, Emma Slevin, Gry Jacobsen, Phil Eyres, Gunvor Semb
BACKGROUND: Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery. MATERIALS AND METHODS: A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials...
February 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#13
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217724/quality-of-life-among-female-cancer-survivors-in-africa-an-integrative-literature-review
#14
REVIEW
Rhoda Suubi Muliira, Anna Santos Salas, Beverley O'Brien
Quality of life (QOL) has been studied extensively among cancer populations in high income countries where cancer care resources are available to many. Little is known concerning the QOL of cancer groups residing in Africa where resources can be scarce. The integrative review of the literature explored and critically examined studies that had addressed QOL in female cancer survivors in Africa. The extent to which QOL studies incorporated a cultural perspective was also examined. Research studies published between 2005 and 2015 were retrieved from five databases: CINAHL, MEDLINE, SCOPUS, ProQuest dissertations and Theses full text, and GlobalHealth...
January 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#15
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216312/bone-marrow-lesions-on-magnetic-resonance-imaging-in-hand-osteoarthritis-are-associated-with-pain-and-interact-with-synovitis
#16
R Liu, W Damman, M Reijnierse, J L Bloem, F R Rosendaal, M Kloppenburg
OBJECTIVE: To determine the association between bone marrow lesions (BMLs) and (teno)synovitis as assessed on magnetic resonance (MR) imaging in patients with pain in hand osteoarthritis (OA). METHODS: In 105 consecutive primary hand OA patients (83% women, mean age 59 years), who were diagnosed by rheumatologists and included in the HOSTAS (Hand OSTeoArthritis in Secondary care) cohort, contrast-enhanced MR imaging of right distal and proximal interphalangeal joints were obtained...
February 12, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28216232/safety-and-efficacy-of-a-nav1-7-selective-sodium-channel-blocker-in-patients-with-trigeminal-neuralgia-a-double-blind-placebo-controlled-randomised-withdrawal-phase-2a-trial
#17
Joanna M Zakrzewska, Joanne Palmer, Valerie Morisset, Gerard Mp Giblin, Mark Obermann, Dominik A Ettlin, Giorgio Cruccu, Lars Bendtsen, Mark Estacion, Dominique Derjean, Stephen G Waxman, Gary Layton, Kevin Gunn, Simon Tate
BACKGROUND: Current standard of care for trigeminal neuralgia is treatment with the sodium channel blockers carbamazepine and oxcarbazepine, which although effective are associated with poor tolerability and the need for titration. BIIB074, a Nav1.7-selective, state-dependent sodium-channel blocker, can be administered at therapeutic doses without titration, and has shown good tolerability in healthy individuals in phase 1 studies. We therefore assessed the safety and efficacy of BIIB074 in patients with trigeminal neuralgia in a phase 2a study...
February 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28214234/reablement-reactivation-rehabilitation-and-restorative-interventions-with-older-adults-in-receipt-of-home-care-a-systematic-review
#18
REVIEW
Joanie Sims-Gould, Catherine E Tong, Lutetia Wallis-Mayer, Maureen C Ashe
OBJECTIVE: To systematically review the impact of reablement, reactivation, rehabilitation, and restorative (4R) programs for older adults in receipt of home care services. DESIGN: Systematic review. DATA SOURCES: We searched the following electronic bibliographic databases: MEDLINE, EMBASE, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), SPORTDiscus and The Cochrane Library and reference lists. STUDY SELECTION: Randomized controlled trials that describe original data on the impact of home-based rehabilitative care and were written in English...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#19
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28209195/qualitative-exploration-of-why-people-repeatedly-attend-emergency-departments-for-alcohol-related-reasons
#20
Tom Parkman, Joanne Neale, Ed Day, Colin Drummond
BACKGROUND: Understanding why people repeatedly attend Emergency Departments (EDs) for alcohol-related reasons is an important prerequisite to identifying ways of reducing any unnecessary demands on hospital resources. We use Andersen's Behavioural Model of Health Services Use to explore factors that contributed to repeat ED attendances. METHODS: Qualitative interviews were conducted with 30 people who repeatedly attended EDs for alcohol-related reasons (≥10 attendances in the past 12 months)...
February 16, 2017: BMC Health Services Research
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