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https://www.readbyqxmd.com/read/28340250/improving-safety-culture-in-hospitals-facilitators-and-barriers-to-implementation-of-systemic-falls-investigative-method-sfim
#1
Aleksandra A Zecevic, Alvin Ho-Ting Li, Charity Ngo, Michelle Halligan, Anita Kothari
Objective: The purpose of this study was to assess the facilitators and barriers to implementation of the Systemic Falls Investigative Method (SFIM) on selected hospital units. Design: A cross-sectional explanatory mixed methods design was used to converge results from a standardized safety culture survey with themes that emerged from interviews and focus groups. Findings were organized by six elements of the Ottawa Model of Research Use framework. Setting: A geriatric rehabilitation unit of an acute care hospital and a neurological unit of a rehabilitation hospital were selected purposefully due to the high frequency of falls...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#2
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339890/pennsylvania-state-core-competencies-for-education-on-opioids-and-addiction
#3
Michael A Ashburn, Rachel L Levine
Objective.:  The objective of this project was to develop core competencies for education on opioids and addiction to be used in all Pennsylvania medical schools. Methods.:  The Pennsylvania Physician General created a task force that was responsible for the creation of the core competencies. A literature review was completed, and a survey of graduating medical students was conducted. The task force then developed, reviewed, and approved the core competencies...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339843/availability-and-cost-of-extracorporeal-treatments-for-poisonings-and-other-emergency-indications-a-worldwide-survey
#4
Josée Bouchard, Valery Lavergne, Darren M Roberts, Monique Cormier, Genevieve Morissette, Marc Ghannoum
Background: Extracorporeal treatments (ECTRs) are used for different conditions, including replacement of organ function and poisoning. Current recommendations for ECTRs in various poisonings suggest that intermittent haemodialysis (IHD) is the most efficient technique. However, the practicality of these recommendations is poorly defined in view of limited information on availability and cost worldwide. Methods: A survey invitation to an Internet-based questionnaire was emailed between January 2014 and March 2015 to members of international societies to determine the availability, time to initiation and cost of ECTRs (including filters, dialysate, catheter, anticoagulant and nursing/physician salary)...
February 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#5
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339434/platelet-rich-plasma-in-musculoskeletal-pathology-a-necessary-rescue-or-a-lost-cause
#6
Annu Navani, Gang Li, Joshua Chrystal
BACKGROUND: Platelet rich plasma (PRP) has been used for decades to facilitate surgical tissue repair; therefore, the current trend of percutaneously injecting PRP to theoretically enhance tissue regeneration and repair is a logical progression. Applications include treatment of osteoarthritis, tendinopathy, chondropathy, acute and chronic soft tissue injuries, muscle or ligament tear, as well as enhancement of healing after bone or tissue reconstruction. However, there is limited evidence to support the use of PRP in the abovementioned conditions...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339313/palliative-care-in-surgery-defining-the-research-priorities
#7
Elizabeth J Lilley, Zara Cooper, Margaret L Schwarze, Anne C Mosenthal
Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet, these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care. Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social, and spiritual well-being and quality of life...
March 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28339049/kidney-and-heavy-metals-the-role-of-environmental-exposure-review
#8
Paolo Lentini, Luca Zanoli, Antonio Granata, Salvatore Santo Signorelli, Pietro Castellino, Roberto Dell'Aquila
Heavy metals are extensively used in agriculture and industrial applications such as production of pesticides, batteries, alloys, and textile dyes. Prolonged, intensive or excessive exposure can induce related systemic disorders. Kidney is a target organ in heavy metal toxicity for its capacity to filter, reabsorb and concentrate divalent ions. The extent and the expression of renal damage depends on the species of metals, the dose, and the time of exposure. Almost always acute kidney impairment differs from chronic renal failure in its mechanism and in the magnitude of the outcomes...
March 24, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28338813/antibiotic-prescribing-for-acute-respiratory-infections-in-children-in-jordan
#9
Mera A Ababneh, Sayer I Al-Azzam, Rawan Ababneh, Abeer M Rababa'h, Saddam Al Demour
Background: Most acute respiratory infections (ARIs) in children are due to viral etiology; however, over-prescribing of antibiotics for ARIs is common. The aim of this investigation was to identify antibiotic prescribing prevalence for children with ARIs and to identify predictors of broad-spectrum antibiotic prescribing. Methods: This was a prospective cross sectional study in a sample of ambulatory care settings in Jordan. Children (<18 years) presenting with ARIs were assessed in terms of patient's demographics, antibiotic prescription and clinical diagnosis...
February 24, 2017: International Health
https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#10
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28337845/nurses-attitudes-towards-the-use-of-prn-psychotropic-medications-in-acute-and-forensic-mental-health-settings
#11
Lesley Barr, Dianne Wynaden, Karen Heslop
Many countries now have national mental health policies and guidelines to decrease or eliminate the use of seclusion and restraint yet the use of Pro Re Nata (PRN) medications has received less practice evaluation. This research aimed to identify mental health nurses' attitudes towards the use of PRN medications with mental health consumers. Participants were working in forensic mental health and non-forensic acute mental health settings. The "Attitudes towards PRN medication use survey" was used and data were collected online...
March 24, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28337327/discovery-of-potent-selective-and-structurally-novel-dot1l-inhibitors-by-a-fragment-linking-approach
#12
Henrik Möbitz, Rainer Machauer, Philipp Holzer, Andrea Vaupel, Frédéric Stauffer, Christian Ragot, Giorgio Caravatti, Clemens Scheufler, Cesar Fernandez, Ulrich Hommel, Ralph Tiedt, Kim S Beyer, Chao Chen, Hugh Zhu, Christoph Gaul
Misdirected catalytic activity of histone methyltransferase Dot1L is believed to be causative for a subset of highly aggressive acute leukemias. Targeting the catalytic domain of Dot1L represents a potential therapeutic approach for these leukemias. In the context of a comprehensive Dot1L hit finding strategy, a knowledge-based virtual screen of the Dot1L SAM binding pocket led to the discovery of 2, a non-nucleoside fragment mimicking key interactions of SAM bound to Dot1L. Fragment linking of 2 and 3, an induced back pocket binder identified in earlier studies, followed by careful ligand optimization led to the identification of 7, a highly potent, selective and structurally novel Dot1L inhibitor...
March 9, 2017: ACS Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#13
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28336741/differences-between-determinants-of-in-hospital-mortality-and-hospitalisation-costs-for-patients-with-acute-heart-failure-a-nationwide-observational-study-from-japan
#14
Noriko Sasaki, Susumu Kunisawa, Hiroshi Ikai, Yuichi Imanaka
OBJECTIVES: Although current case-mix classifications in prospective payment systems were developed to estimate patient resource usage, whether these classifications reflect clinical outcomes remains unknown. The efficient management of acute heart failure (AHF) with high mortality is becoming more important in many countries as its prevalence and associated costs are rapidly increasing. Here, we investigate the determinants of in-hospital mortality and hospitalisation costs to clarify the impact of severity factors on these outcomes in patients with AHF, and examine the level of agreement between the predicted values of mortality and costs...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336679/transfer-to-high-volume-centers-associated-with-reduced-mortality-after-endovascular-treatment-of-acute-stroke
#15
Lorenzo Rinaldo, Waleed Brinjikji, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: Some have argued that it may be beneficial to expand the availability of endovascular revascularization services to lower-volume hospitals to minimize the morbidity associated with transfer to larger endovascular centers. We compared the outcomes after revascularization of patients directly admitted to a low-volume center and those transferred to a high-volume center. METHODS: We searched a national database of hospital-reported outcomes for patients who underwent endovascular revascularization for acute ischemic stroke...
March 23, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28336527/a-phase-i-clinical-trial-of-single-agent-selinexor-in-acute-myeloid-leukemia
#16
Ramiro Garzon, Michael Savona, Rachid Baz, Michael Andreeff, Nashat Gabrail, Martin Gutierrez, Lynn Savoie, Morten Mau-Sorensen, Nina Wagner-Johnston, Karen Yee, T J Unger, Jean Richard Saint-Martin, Robert Carlson, Tami Rashal, Trinayan Kashyap, Boris Klebanov, Sharon Shacham, Michael Kauffman, Richard Stone
Selinexor is a novel, first-in-class, Selective Inhibitor of Nuclear Export (SINE) compound, which blocks XPO1 function, leads to nuclear accumulation of tumor suppressor proteins (TSPs) and induces cancer cell death. A phase I dose-escalation study was initiated to examine the safety and efficacy of selinexor in patients with advanced hematological malignancies. Ninety-five patients with relapsed or refractory acute myeloid leukemia (AML) were enrolled between January 2013 and June 2014 to receive 4, 8 or 10 doses of selinexor in 21- or 28-day cycle...
March 23, 2017: Blood
https://www.readbyqxmd.com/read/28336289/prospective-case-crossover-study-investigating-the-possible-association-between-nonarteritic-anterior-ischemic-optic-neuropathy-naion-and-phosphodiesterase-type-5-inhibitor-pde5i-exposure
#17
Evelyn M Flahavan, Hu Li, Komal Gupte-Singh, Rosemary T Rizk, Dustin D Ruff, Jennie Lin Francis, Kraig S Kinchen
OBJECTIVE: To evaluate association between intermittent phosphodiesterase type 5 inhibitor (PDE5i) exposure and risk of acute Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) using a case-crossover design. METHODS: Male adults with suspected NAION were enrolled at 41 US ophthalmology sites from 2010-2015 and interviewed regarding risk factors for NAION, medical history, and PDE5i use before NAION onset (index of onset [IDO]). An adjudication committee confirmed NAION cases...
March 20, 2017: Urology
https://www.readbyqxmd.com/read/28336042/acute-hematogenous-osteomyelitis-in-children-pathogenesis-diagnosis-and-treatment
#18
REVIEW
Shawn S Funk, Lawson A B Copley
Acute hematogenous osteomyelitis (AHO) in children is an ideal condition to study due to its representation of a wide spectrum of disorders that comprise pediatric musculoskeletal infection. Proper care for children with AHO is multidisciplinary and collaborative. AHO continues to present a significant clinical challenge due to evolving epidemiology and complex pathogenesis. A guideline-driven, multidisciplinary approach has been introduced and shown to effectively reduce hospital stay, improve the timing and selection of empirical antibiotic administration, reduce delay to initial MRI, reduce the rate of readmission, and shorten antibiotic duration...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336037/deep-vein-thrombosis-and-pulmonary-embolism-considerations-in-orthopedic-surgery
#19
REVIEW
Jasmine Saleh, Mouhanad M El-Othmani, Khaled J Saleh
Patients undergoing orthopedic surgery have an increased risk for deep venous thrombosis (DVT) and pulmonary embolism (PE). These complications are considered detrimental, as they cause major postoperative morbidity and mortality and lead to a substantial health care burden. Because of the high incidence and serious nature of these complications, it is essential for orthopedic surgeons to have a comprehensive knowledge of the risk factors, diagnosis, and treatment of acute DVT and PE. Perioperative management of orthopedic patients to prevent postoperative DVT and PE and optimize postoperative outcomes is also discussed in this review...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336024/postoperative-pain-self-management-behavior-in-patients-who-underwent-total-knee-or-hip-arthroplasty
#20
Ning-Ning Zhu, Pei-Pei Xu, Ting-Ting Lei, Ting Sun, Sally Wai-Chi Chan
The self-management of acute postoperative pain is not well researched. This cross-sectional study investigates postoperative pain and pain self-management behavior. We recruited 127 patients who underwent total knee or total hip arthroplasty in an acute care hospital. We measured postoperative pain intensity and pain self-management behavior for three postoperative days. The results showed that the participants experienced mild and moderate pain intensity and perceived moderate to severe pain interference, which influenced their mood, sleep patterns, ability to walk, and performance of general activities and rehabilitation exercises...
April 2017: AORN Journal
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