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https://www.readbyqxmd.com/read/28817392/minimum-operational-standards-for-24-7-available-emergency-departments-in-the-netherlands-a-first-step-taken-by-emergency-physicians-using-an-e-delphi-approach
#1
Menno I Gaakeer, Rebekka Veugelers, Peter Patka, Robbert Huijsman
OBJECTIVE: The objective of this study was to effectuate a consensus of emergency physicians on minimum requirements for facility, diagnostic, and medical specialist availability as a first step toward minimum operational standards for 24/7 available emergency departments (EDs) in the Netherlands. PATIENTS AND METHODS: A two-part e-Delphi through online survey was performed between January 2015 and May 2016, using a panel of 20 experts in emergency medicine. The aim of part I was to reach an agreement on a list of possible ED elements and their definitions...
August 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28817167/body-mass-index-50-kg-m2-and-beyond-perioperative-care-of-pregnant-women-with-superobesity-undergoing-cesarean-delivery
#2
Marcela Carolina Smid, Sarah K Dotters-Katz, Robert M Silver, Jeffrey A Kuller
Importance: Superobesity, defined as body mass index 50 kg/m(2) or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. Objective: To review evidence of perioperative care during cesarean delivery among superobese women. Evidence Acquisition: We performed an evidence-based review of maternal and neonatal risks of cesarean delivery and of intraoperative management and immediate postpartum care of superobese pregnant women...
August 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28816754/health-care-services-in-ibd-factors-associated-with-service-utilization-and-preferences-for-service-options-for-routine-and-urgent-care
#3
Matthew T Bernstein, John R Walker, Tarun Chhibba, Melony Ivekovic, Harminder Singh, Laura E Targownik, Charles N Bernstein
BACKGROUND: We aimed to explore factors associated with health service utilization and preference for services, including alternatives to attending the emergency department (ED) when experiencing mild to moderate or severe symptoms. METHODS: A total of 1143 persons (46% response rate) aged 18 to 65 years in the population-based University of Manitoba IBD Research Registry participated in the survey. RESULTS: Although 61% had a gastroenterologist, when experiencing active symptoms, only 29% felt they could call their gastroenterologist for an urgent appointment, and 42% could call their gastroenterologist for telephone advice...
September 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28816750/health-care-services-in-ibd-factors-associated-with-service-utilization-and-preferences-for-service-options-for-routine-and-urgent-care
#4
Matthew T Bernstein, John R Walker, Tarun Chhibba, Melony Ivekovic, Harminder Singh, Laura E Targownik, Charles N Bernstein
BACKGROUND: We aimed to explore factors associated with health service utilization and preference for services, including alternatives to attending the emergency department (ED) when experiencing mild to moderate or severe symptoms. METHODS: A total of 1143 persons (46% response rate) aged 18 to 65 years in the population-based University of Manitoba IBD Research Registry participated in the survey. RESULTS: Although 61% had a gastroenterologist, when experiencing active symptoms, only 29% felt they could call their gastroenterologist for an urgent appointment, and 42% could call their gastroenterologist for telephone advice...
August 14, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28815727/gender-disparities-among-patients-with-peripheral-arterial-disease-treated-via-endovascular-approach-a-propensity-score-matched-analysis
#5
Rajkumar Doshi, Priyank Shah, Perwaiz Meraj
BACKGROUND: Remarkable improvement in the treatment of Peripheral Arterial Disease (PAD) has led to changes in revascularization strategies from traditional open surgery to less invasive endovascular management. However, few studies are available on gender disparities in patients with PAD treated via an endovascular approach. This study was designed to analyze gender related differences with respect to in-hospital outcomes in PAD patients. METHODS: Our data was obtained from National Inpatient Sample (NIS) 2012 through 2014...
August 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28814373/convenience-quality-and-choice-patient-and-service-provider-perspectives-for-treating-primary-care-complaints-in-urgent-care-settings
#6
David Sturgeon
AIM: To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. BACKGROUND: Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers...
August 14, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28813502/addressing-the-challenge-of-high-priced-prescription-drugs-in-the-era-of-precision-medicine-a-systematic-review-of-drug-life-cycles-therapeutic-drug-markets-and-regulatory-frameworks
#7
Toon van der Gronde, Carin A Uyl-de Groot, Toine Pieters
CONTEXT: Recent public outcry has highlighted the rising cost of prescription drugs worldwide, which in several disease areas outpaces other health care expenditures and results in a suboptimal global availability of essential medicines. METHOD: A systematic review of Pubmed, the Financial Times, the New York Times, the Wall Street Journal and the Guardian was performed to identify articles related to the pricing of medicines. FINDINGS: Changes in drug life cycles have dramatically affected patent medicine markets, which have long been considered a self-evident and self-sustainable source of income for highly profitable drug companies...
2017: PloS One
https://www.readbyqxmd.com/read/28812821/-re-making-the-procrustean-bed-standardization-and-customization-as-competing-logics-in-healthcare
#8
EDITORIAL
Russell Mannion, Mark Exworthy
Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by 'standardization' and 'customization' in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics - the socially constructed rules, practices and beliefs which perpetuate institutional behaviour...
March 28, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28811039/twenty-years-of-staffing-practice-environment-and-outcomes-research-in-military-nursing
#9
Patricia A Patrician, Lori A Loan, Mary S McCarthy, Pauline Swiger, Sara Breckenridge-Sproat, Laura Ruse Brosch, Bonnie Mowinski Jennings
BACKGROUND: Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. PURPOSE: This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. METHOD: This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research...
July 10, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#10
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28808506/the-knowledge-concerns-and-healthcare-practices-among-physicians-regarding-electronic-cigarettes
#11
Venkatkiran Kanchustambham, Swetha Saladi, Jonathan Rodrigues, Hermina Fernandes, Setu Patolia, Sadhashiv Santosh
Background: Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver aerosolized nicotine. With easy access and over-the-counter availability, many patients consider using electronic cigarettes for smoking cessation. Few studies have looked at long-term safety/efficacy and physician knowledge/attitudes toward e-cigarettes. Physicians have insufficient guidelines for advising their patients about e-cigarettes. Objective: 1) To identify knowledge and attitude of health care practitioners toward electronic cigarettes...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28807973/prevention-of-delayed-referrals-through-the-champlain-base-econsult-service
#12
Clare Liddy, Paul Drosinis, Adam Fogel, Erin Keely
OBJECTIVE: To identify the proportion and evaluate the content of eConsults (electronic consultations) in which the Champlain BASE (Building Access to Specialists through eConsultation) eConsult process prompted a referral to a specialist that was not originally contemplated by the primary care provider (PCP). DESIGN: Cross-sectional study of all eConsults submitted between April 15, 2011, and January 31, 2015. SETTING: Champlain Local Health Integration Network, a large health region in eastern Ontario...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28807425/clinical-outcome-of-dual-colistin-and-carbapenem-resistant-klebsiella-pneumoniae-bloodstream-infections-a-single-center-retrospective-study-of-75-cases-in-india
#13
Amarjeet Kaur, Sumanth Gandra, Priyanka Gupta, Yatin Mehta, Ramanan Laxminarayan, Sharmila Sengupta
In this study, we retrospectively evaluated clinical outcomes of 75 patients with dual colistin- and carbapenem-resistant Klebsiella pneumoniae bloodstream infections over a 5-year period in a single tertiary care hospital in India. We observed a high in-hospital mortality rate of 69.3%. Our findings indicate the urgent need for new antibiotics to treat these infections.
August 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28807192/does-compliance-with-antibiotic-prophylaxis-in-pediatric-simple-appendicitis-matter
#14
Krislynn M Mueck, Luke R Putnam, Kathryn T Anderson, Kevin P Lally, KuoJen Tsao, Lillian S Kao
BACKGROUND: Institutional protocols for preincisional antibiotic prophylaxis can standardize care and improve outcomes. However, challenges remain in compliance with such protocols for urgent or emergent operations. We hypothesized that compliance with an institutional protocol for antibiotic prophylaxis for appendectomy for appendicitis in pediatric patients results in reduced surgical site infections (SSIs) after simple appendectomy. METHODS: This retrospective study assessed all pediatric patients (≤18 y) who underwent appendectomy for confirmed simple appendicitis at a tertiary children's hospital between 2012 and 2015...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28806396/inhibiting-myc-binding-to-the-e-box-dna-motif-by-me47-decreases-tumour-xenograft-growth
#15
L C Lustig, D Dingar, W B Tu, C Lourenco, M Kalkat, I Inamoto, R Ponzielli, W C W Chan, J A Shin, L Z Penn
Developing therapeutics to effectively inhibit the MYC oncoprotein would mark a key advance towards cancer patient care as MYC is deregulated in over 50% of human cancers. MYC deregulation is correlated with aggressive disease and poor patient outcome. Despite strong evidence in mouse models that inhibiting MYC would significantly impact tumour cell growth and patient survival, traditional approaches have not yet yielded the urgently needed therapeutic agents that directly target MYC. MYC functions through its interaction with MAX to regulate gene transcription by binding to E-box DNA response elements of MYC target genes...
August 14, 2017: Oncogene
https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#16
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806324/comparison-of-the-quality-of-informal-care-of-community-dwelling-taiwanese-older-people
#17
Chia-Yi Chiao, Yen-Ju Lin, Chiu-Yueh Hsiao
BACKGROUND: With social structures changing and the average life-span of individuals increasing, Taiwan is experiencing a steady rise in its elderly population. Thus, caring for older parentsis an urgent problem. Many foreign caregivers have been hired tocare for older parents.However, measuring the quality ofinformal care has not yet been fully explored in Taiwan, particularly among older people who are cared for by foreign caregivers in home settings. PURPOSE: The purposes of this study were to understand the differences in quality of care for older Taiwanese and to explore the predictors of quality of care in two types of caregiving...
August 12, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28805702/study-on-the-status-of-health-service-utilization-among-caregivers-of-left-behind-children-in-poor-rural-areas-of-hunan-province-a-baseline-survey
#18
Meimei Ji, Yefu Zhang, Jiaojiao Zou, Tong Yuan, Amber Tang, Jing Deng, Lina Yang, Mingzhi Li, Jihua Chen, Hong Qin, Qian Lin
BACKGROUND: The caregivers of left-behind children (CLBC) in China's poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their health service utilization and to provide a scientific basis for guiding effective implementation of health policy in rural Hunan. METHODS: Random cluster sampling was used to survey CLBC in two rural counties...
August 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28805590/nonmotor-fluctuations-in-parkinson-s-disease
#19
Christiana Franke, Alexander Storch
The advanced stage of Parkinson's disease (PD) is characterized by motor complications such as motor fluctuations and dyskinesias induced by long-term levodopa treatment. Recent clinical research provides growing evidence that various nonmotor symptoms such as neuropsychiatric, autonomic, and sensory symptoms (particularly pain) also show fluctuations in patients with motor fluctuations (called nonmotor fluctuations or NMF). However, NMF have not yet been adequately considered in routine care of advanced PD patients and only few therapeutic studies are available...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#20
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
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