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https://www.readbyqxmd.com/read/28212590/the-july-effect-on-maternal-peripartum-complications-before-and-after-resident-duty-hour-reform-a-population-based-retrospective-cohort-study
#1
Ithan D Peltan, Crystal E Brown, Alson K Burke, Eric J Chow, Ali Rowhani-Rahbar, Matthew R Crull
Objective To compare maternal birth complications early versus late in the academic year and to evaluate the impact of resident work hour limitation on the "July effect." Study Design We conducted a retrospective, population-based cohort study of 628,414 singleton births in Washington State from 1987 to 2012 measuring the adjusted risk of maternal peripartum complications early (July/August) versus late (April/May) in the academic year. To control for seasonal outcome variation unrelated to trainees' involvement in care as well as long-term trends in maternal complications unrelated to variation in trainees' effect on outcomes across the academic year, we employed difference-in-differences methods contrasting outcomes at teaching to nonteaching hospitals for deliveries before and after restriction of resident work hours in July 2003...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28199265/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#2
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28196342/decreased-salivary-alpha-amylase-levels-are-associated-with-performance-deficits-during-sleep-loss
#3
Maja Pajcin, Siobhan Banks, Jason M White, Jill Dorrian, Gemma M Paech, Crystal Grant, Kayla Johnson, Katie Tooley, Justin Fidock, Gary H Kamimori, Chris B Della Vedova
During sleep deprivation, neurobehavioral functions requiring sustained levels of attention and alertness are significantly impaired. Discrepancies between subjective measures of sleepiness and objective performance during sustained operations have led to interest in physiological monitoring of operator performance. Alertness, vigilance, and arousal are modulated by the wake-promoting actions of the central noradrenergic system. Salivary alpha-amylase (sAA) has been proposed as a sensitive peripheral measure of noradrenergic activity, but limited research has investigated the relationship between sAA and performance...
February 1, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28196195/association-of-otolaryngology-resident-duty-hour-restrictions-with-procedure-specific-outcomes-in-head-and-neck-endocrine-surgery
#4
Aaron Smith, Lauren Braden, Jim Wan, Merry Sebelik
Importance: Graduate medical education has undergone a transformation from traditional long work hours to a restricted plan to allow adequate rest for residents. The initial goal of this restriction is to improve patient outcomes. Objective: To determine whether duty hour restrictions had any impact on surgery-specific outcomes by analyzing complications following thyroid and parathyroid procedures performed before and after duty hour reform. Design, Setting, and Participants: Retrospective cross-sectional analysis of the National Inpatient Sample (NIS)...
February 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28186478/meaningful-use-an-electronic-medical-record-tool-for-cerebrospinal-fluid-shunt-history
#5
Lance S Governale, Jeffrey M Hoffman
The care of patients with shunted hydrocephalus can be complicated. The best assessment is provided when all data are available to the neurosurgery practitioner. However, data can be time-consuming to gather, especially in the setting of a busy practice, a trainee environment with duty-hour restrictions, and an electronic medical record (EMR) not specifically designed for the needs of subspecialists. For these reasons, the complete clinical picture, especially the historical component, is sometimes not assembled...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28168797/pre-oncall-key-conditions-training-for-first-year-radiology-registrars
#6
Nicholas I Brown, Paul Leschke, Mandy Way, David D Smith, Perry Cleland
INTRODUCTION: The Royal Australian and New Zealand College of Radiology (RANZCR) recognised the importance of experience in on-call and emergency radiology for first-year registrars by introducing 'Key conditions in Year 1 training'. This list of common radiological pathologies can help to focus preparations for new registrars as they prepare for after-hours duties. METHODS: The Royal Brisbane and Women's Hospital (RBWH) implemented a 12-week formal training programme, based on this curriculum, for new registrars prior to commencing after-hours work...
February 7, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28160813/fatigue-and-on-duty-injury-among-police-officers-the-bcops-study
#7
Desta Fekedulegn, Cecil M Burchfiel, Claudia C Ma, Michael E Andrew, Tara A Hartley, Luenda E Charles, Ja K Gu, John M Violanti
INTRODUCTION: Policing involves inherent physical and psychological dangers as well as occupational stressors that could lead to chronic fatigue. Although accounts of adverse events associated with police fatigue are not scarce, literature on the association between chronic fatigue and on-duty injury are limited. METHODS: Participants were officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. A 10-item questionnaire was administered to assess how tired or energetic the officers generally felt irrespective of sleep hours or workload...
February 2017: Journal of Safety Research
https://www.readbyqxmd.com/read/28152699/development-of-an-infusion-nurse-staffing-model-for-outpatient-chemotherapy-centers
#8
(no author information available yet)
: 103 Background: Nursing roles and responsibilities within ambulatory oncology infusion suites across our health system are not clearly defined and it is not understood what the appropriate staffing ratio should be per site. It is not clear if employees are working to the highest level of their licensure or skill, and if the appropriate activities are performed by the correct department. A standard staffing model to provide efficiency of clinical services and patient safety does not exist, and nursing roles are variable between the sites...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28128788/a-workplace-modified-duty-program-for%C3%A2-employees-in-an-oncology-center
#9
Elpidoforos S Soteriades
BACKGROUND: Workplace modified duty programs may provide reasonable accommodations to employees who have partial temporary job disability and could work on duty accommodations until they fully recover. However, little is known about the implementation barriers and effectiveness of such programs. OBJECTIVE: This study is aimed at evaluating the implementation of a modified duty program for employees in an oncology center. METHODS: A modified duty program for employees working at the Bank of Cyprus Oncology Center, a non profit organization with 200 employees located in the Republic of Cyprus was evaluated based on the health records of the occupational medicine department...
January 23, 2017: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/28121687/the-impact-of-administrative-burden-on-academic-physicians-results-of-a-hospital-wide-physician-survey
#10
Sandhya K Rao, Alexa B Kimball, Sara R Lehrhoff, Michael K Hidrue, Deborah G Colton, Timothy G Ferris, David F Torchiana
PURPOSE: To determine the characteristics of clinically active academic physicians most affected by administrative burden; the correlation between administrative burden, burnout, and career satisfaction among academic physicians; and the relative value and burden of specific administrative tasks. METHOD: The authors analyzed data from the 2014 Massachusetts General Physicians Organization Survey. Respondents reported the percentage of time they spent on patient-related administrative duties and rated the value and burden associated with specific administrative tasks...
February 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28118548/the-nasal-fracture-algorithm
#11
Alexander Lanigan, Joshua Lospinoso, Sarah N Bowe, Adrienne M Laury
Since the initiation of resident duty hour restrictions, significant controversy has arisen regarding its impact on surgical resident training. We reviewed a singular facet of the otolaryngology residency experience, nasal bone fracture management, to identify if treatment standardization would improve care and efficiency. For 1 year, otolaryngology consults for isolated nasal fractures were analyzed to assess consultation trends, rate of intervention, and resident work hour utilization. Following a review of the literature, an evidence-based algorithm for management of nasal fractures was developed...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28118249/the-clinical-learning-environment-review-cler-program-moving-beyond-duty-hours
#12
Brian C Drolet, Jonathan P Brower
No abstract text is available yet for this article.
February 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28114415/managing-neonatal-and-early-childhood-syndromic-sepsis-in-sub-district-hospitals-in-resource-poor-settings-improvement-in-quality-of-care-through-introduction-of-a-package-of-interventions-in-rural-bangladesh
#13
Ahmed Ehsanur Rahman, Afrin Iqbal, D M Emdadul Hoque, Md Moinuddin, Sojib Bin Zaman, Qazi Sadeq-Ur Rahman, Tahmina Begum, Atique Iqbal Chowdhury, Rafiqul Haider, Shams El Arifeen, Niranjan Kissoon, Charles P Larson
INTRODUCTION: Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments...
2017: PloS One
https://www.readbyqxmd.com/read/28095953/reported-back-pain-in-army-aircrew-in-relation-to-airframe-gender-age-and-experience
#14
Amanda M Kelley, Jason MacDonnell, Deahndra Grigley, John Campbell, Steven J Gaydos
INTRODUCTION: Back pain has remained an issue of significance among aircraft crewmembers for decades, occurring in the majority of military helicopter pilots with potential deleterious effects on performance, safety, and operational readiness. This exploratory, correlational survey study was designed to evaluate the presence of patterns and relationships that may require further examination to understand causal factors. METHODS: The study population consisted of U...
February 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28076965/predictors-of-burnout-and-health-status-in-samaritans-listening-volunteers
#15
Adeline Roche, Jane Ogden
Samaritan listening volunteers provide emotional support to people in distress or suicidal. Samaritans' has high volunteer turnover, which may be due to burnout. This study evaluated the role of demographic and psychosocial factors in predicting Samaritans listening volunteers' burnout and health status. Samaritans' listening volunteers (n = 216) from seven branches across UK completed an online survey to assess their levels of burnout (emotional exhaustion, depersonalisation, personal accomplishment), subjective health status, coping, empathy and social support...
January 11, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28064236/when-caregiving-ends-the-experiences-of-former-family-caregivers-of-people-with-dementia
#16
Kristin L Corey, Mary K McCurry
PURPOSE OF THE STUDY: Numerous adverse physiological and psychological effects of family caregiving are documented in the literature. However, there is little knowledge about family caregivers after caregiving ends. The purpose of this study is to examine the health of former family caregivers and describe their experiences following the death of a care recipient with dementia. METHODS: Eight former family caregivers were recruited using convenience sampling. Each caregiver participated in one semi-structured interview ranging from 45 minutes to 3 hours in length...
January 7, 2017: Gerontologist
https://www.readbyqxmd.com/read/28054913/interrupted-monosyllabic-words-the-effects-of-ten-interruption-locations-on-recognition-performance-by-older-listeners-with-sensorineural-hearing-loss
#17
Richard H Wilson, Kadie C Sharrett
BACKGROUND: Two previous experiments from our laboratory with 70 interrupted monosyllabic words demonstrated that recognition performance was influenced by the temporal location of the interruption pattern. The interruption pattern (10 interruptions/sec, 50% duty cycle) was always the same and referenced word onset; the only difference between the patterns was the temporal location of the on- and off-segments of the interruption cycle. In the first study, both young and older listeners obtained better recognition performances when the initial on-segment coincided with word onset than when the initial on-segment was delayed by 50 msec...
January 2017: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/28048774/su-f-j-215-non-thermal-pulsed-high-intensity-focused-ultrasound-therapy-combined-with-5-aminolevulinic-acid-an-in-vivo-pilot-study
#18
B Wang, W He, D Cvetkovic, L Chen, C Ma
PURPOSE: It has recently been shown that non-thermal pulsed high intensity focused ultrasound (pHIFU) has a cell-killing effect. The purpose of the study is to investigate the sonosensitizing effect of 5-Aminolevulinic Acid (5-ALA) in non-thermal pHIFU cancer therapy. METHODS: FaDu human head and neck squamous cell carcinoma cells were injected subcutaneously in the flanks of nude mice. After one to two weeks, the tumors reached the volume of 112 ± 8 mm3 and were assigned randomly into a non-thermal pHIFU group (n=9) and a non-thermal sonodynamic therapy (pHIFU after 5-ALA administration) group (n=7)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045348/the-impact-of-increasing-staff-resources-on-patient-flow-in-a-psychiatric-emergency-service
#19
Lara Chepenik, Edieal Pinker
OBJECTIVE: The study illustrates the use of approaches based on queuing theory to understand bottlenecks in patient flow. A queuing simulation was used to predict the potential benefits of additional clinical personnel on patient flow through a psychiatric emergency service (PES). METHODS: A discrete-event simulation model was calibrated on the basis of two months of data collected in a PES. This model examined the effects of adding between .5 (half-time) and three additional providers to the 8 a...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28034981/a-preliminary-examination-of-the-comparative-efficacy-of-intravenous-vs-oral-acetaminophen-in-the-treatment-of-perioperative-pain
#20
Anthony Plunkett, Chelsey Haley, Amy McCoart, Thomas Beltran, Krista Beth Highland, Cristobal Berry-Caban, Sherry Lamberth, Michael Bartoszek
: OBJECTIVE : The management of postoperative pain is a major health care issue. While the cost of intravenous acetaminophen (IVA) is significantly greater than its oral acetaminophen (OA) counterpart, less is known regarding comparative effectiveness of these routes. The purpose of this study was to determine whether perioperative IVA is equivalent in reducing postoperative pain compared with perioperative OA for laparoscopic cholecystectomy (LapChole). DESIGN:  Double-blinded, prospective, randomized placebo-controlled trial...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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