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https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#1
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431301/diversity-training-for-the-community-aged-care-workers-a-conceptual-framework-for-evaluation
#2
Arti Appannah, Claudia Meyer, Rajna Ogrin, Sally McMillan, Elizabeth Barrett, Colette Browning
Older Australians are an increasingly diverse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding diversity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers...
March 23, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28430978/culture-matters-indigenizing-patient-safety-in-bhutan
#3
Rinchen Pelzang, Megan-Jane Johnstone, Alison M Hutchinson
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan's traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan's traditional cultural values on staff attitudes towards patient safety and quality care...
April 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28430830/assessment-of-global-kidney-health-care-status
#4
Aminu K Bello, Adeera Levin, Marcello Tonelli, Ikechi G Okpechi, John Feehally, David Harris, Kailash Jindal, Babatunde L Salako, Ahmed Rateb, Mohamed A Osman, Bilal Qarni, Syed Saad, Meaghan Lunney, Natasha Wiebe, Feng Ye, David W Johnson
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN...
April 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28430725/awareness-regarding-perineal-protection-obstetric-anal-sphincter-injury-and-episiotomy-among-obstetrics-and-gynecology-residents-effects-of-an-educational-workshop
#5
Anna M Stecher, Jennifer Yeung, Catrina C Crisp, Rachel N Pauls
OBJECTIVES: Appropriate perineal protection may reduce rates of obstetric anal sphincter injuries (OASIS). We sought to investigate the knowledge and attitudes of obstetrics and gynecology residents concerning perineal protection, OASIS, and episiotomy before and after an educational workshop. METHODS: This was an institutional review board-approved cross-sectional survey study of obstetrics and gynecology residents. Two experts in perineal protection, whose methods have been shown to reduce OASIS by 50%, provided 1 week of education...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430675/identifying-risk-factors-leading-to-unanticipated-postoperative-readmission
#6
Peter A Felice, David T Kerekes, Bruce A Mast
INTRODUCTION: Unanticipated postoperative readmissions are a grading metric directly linked to both the quality of patient care and physician reimbursement. However, little data exist to define factors responsible for these readmissions in the plastic surgery patient population. This study aims to identify patient risk factors contributing to unanticipated postoperative readmissions to optimize perioperative patient care and mitigate negative financial impact upon providers. METHODS: We present an institutional review board-approved study retrospective review of 819 plastic surgery patients undergoing operative procedures performed at our institution between January 1, 2013, and December 31, 2014...
April 20, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28430021/family-perspectives-on-telemedicine-for-pediatric-subspecialty-care
#7
Kristin N Ray, Laura Ellen Ashcraft, Ateev Mehrotra, Elizabeth Miller, Jeremy M Kahn
BACKGROUND: Children often have difficulty accessing subspecialty care, and telemedicine may improve access to subspecialty care, but information is lacking on how best to implement telemedicine programs to maximize acceptance and, ultimately, maximize impact for patients and their families. METHODS AND MATERIALS: To understand how subspecialty telemedicine is perceived and to identify design elements with the potential to improve telemedicine uptake and impact, we conducted and analyzed semi-structured interviews with 21 informants, including parents and caregivers of children with subspecialty care needs and adolescent and young adult patients with subspecialty care needs...
April 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28429977/are-some-areas-more-equal-than-others-socioeconomic-inequality-in-potentially-avoidable-emergency-hospital-admissions-within-english-local-authority-areas
#8
Jessica Sheringham, Miqdad Asaria, Helen Barratt, Rosalind Raine, Richard Cookson
Objectives Reducing health inequalities is an explicit goal of England's health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000)...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429886/patients-experiences-of-consultations-with-physician-associates-in-primary-care-in-england-a-qualitative-study
#9
Mary Halter, Vari M Drennan, Louise M Joly, Jonathan Gabe, Heather Gage, Simon de Lusignan
BACKGROUND: Physician associates are new to English general practice and set to expand in numbers. OBJECTIVE: To investigate the patients' perspective on consulting with physician associates in general practice. DESIGN: A qualitative study, using semi-structured interviews, with thematic analysis. SETTING AND PARTICIPANTS: Thirty volunteer patients of 430 who had consulted physician associates for a same-day appointment and had returned a satisfaction survey, in six general practices employing physician associates in England...
April 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28429869/importance-of-prenatal-care-in-reducing-stillbirth
#10
Robert L Goldenberg, Elizabeth M McClure
The concept of screening for complications prior to delivery originated more than 100 years ago. Initially, prenatal care focused on detecting preeclampsia to reduce maternal mortality with visits weighted toward the third trimester. This, together with increasing hospitalization and early delivery for women with preeclampsia, markedly reduced maternal mortality and reduced stillbirths as well. This article is protected by copyright. All rights reserved.
April 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28429643/emergency-department-staff-priorities-for-improving-palliative-care-provision-for-older-people-a-qualitative-study
#11
Rebecca J Wright, Karen Lowton, Glenn Robert, Corita R Grudzen, Patricia Grocott
BACKGROUND: Emergency department-based palliative care services are increasing, but research to develop these services rarely includes input from emergency clinicians, jeopardizing the effectiveness of subsequent palliative care interventions. AIM: To collaboratively identify with emergency clinicians' improvement priorities for emergency department-based palliative care for older people. DESIGN: This was one component of an experience-based co-design project, conducted using semi-structured interviews and feedback sessions...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28429641/indoor-air-temperature-and-agitation-of-nursing-home-residents-with-dementia
#12
Federico Tartarini, Paul Cooper, Richard Fleming, Marijka Batterham
This study aimed to determine the specific correlation between indoor air temperature and agitation of nursing home residents with dementia. Agitated behaviors of 21 residents, living in 1 nursing home, were assessed for a 10-month period using the Cohen-Mansfield Agitation Inventory (CMAI). The CMAI Total Frequency scores were found to increase significantly when indoor average temperatures deviated from 22.6°C. In addition, cumulative exposure to temperatures higher than 26°C and lower than 20°C was linearly correlated with CMAI Total Frequency scores...
January 1, 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28429527/balancing-health-care-education-and-patient-care-in-the-uk-workplace-a-realist-synthesis
#13
Sarah Sholl, Rola Ajjawi, Helen Allbutt, Jane Butler, Divya Jindal-Snape, Jill Morrison, Charlotte Rees
CONTEXT: Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic...
April 20, 2017: Medical Education
https://www.readbyqxmd.com/read/28429283/use-of-hormones-tissue-factors-and-bioengineering-in-the-management-of-hypospadias
#14
Aparajita Mitra, Yogesh Kumar Sarin
Hypospadiology is a rapidly evolving field. Progress in the understanding of how hormonal therapy affects the growth of the phallus has allowed surgeons to optimize the tissues for surgery. But conflicting data from a number of studies and a lack of consensus on drugs, their dosing, mode of delivery and timing of use means that the creation of protocols is unlikely to happen in the near future. Nonetheless, there is a hope and the standardization of scientific reporting will make it easier to compare data at the global level...
April 21, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28429143/how-to-treat-lumbar-disc-herniation-in-pregnancy-a-systematic-review-on-current-standards
#15
REVIEW
Alberto Di Martino, Fabrizio Russo, Luca Denaro, Vincenzo Denaro
PURPOSE: In this systematic review, we aim to illustrate the current and safe concepts in the assessment, diagnosis and management of herniated lumbar disc (HLD) during pregnancy. METHODS: A systematic review and reporting on the diagnosis, treatment and clinical results of HLD during pregnancy is performed. RESULTS: The MRI represents the first level and safest diagnostic tool for pregnant women affected by spinal problems allowing for a noninvasive and detailed radiological examination of the spine...
April 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28428728/randomized-face-to-face-vs-home-exercise-interventions-in-pregnant-women-with-gestational-diabetes
#16
Danielle Symons Downs, Jennifer M Dinallo, Leann L Birch, Ian M Paul, Jan S Ulbrecht
OBJECTIVES: Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). DESIGN: Randomized control trial with two intervention arms and control (standard care). METHOD: Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery...
May 2017: Psychology of Sport and Exercise
https://www.readbyqxmd.com/read/28428124/induction-of-labour-at-term-in-breech-presentations-experience-of-a-french-level-ii-b-maternity-unit
#17
Adélaïde Jarniat, Vinciane Eluard, Olivia Matz, Pascal Calmelet, Astrid Calmelet, Patrick Dellinger, Paul Sagot
Data from the literature on induction of labour in breech presentation are rare and no conclusions can be drawn for this procedure. OBJECTIVES: To evaluate obstetrical and neonatal prognosis following induced labour in breech deliveries at term (37 to 42 weeks of gestation). METHODS: We conducted a single-centre retrospective case-control study in a level II B maternity unit from 1(st) January 2012 to 31(st) December 2015. The inclusion criteria were a singleton pregnancy and a breech presentation...
April 17, 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28428122/challenges-in-the-management-of-chagas-disease-in-latin-american-migrants-in-europe
#18
REVIEW
B Monge-Maillo, R López-Vélez
 Chagas disease (CD) is endemic in Latin America. Due to migration, the infection has crossed borders and it is estimated that 68 000-120 000 people with CD are currently living in Europe and 30% of them may develop visceral involvement. However, up to 90% of CD cases in Europe remain undiagnosed. The challenges which have to be overcome in CD are related to screening, diagnostic tools and therapeutic management in non-endemic countries. AIMS : The aim of this review is to highlight how healthcare management for Latin American migrants with CD in Europe may be improved...
April 17, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28428112/experiences-and-unmet-needs-of-women-with-physical-disabilities-for-pain-relief-during-labor-and-delivery
#19
Linda Long-Bellil, Monika Mitra, Lisa I Iezzoni, Suzanne C Smeltzer, Lauren D Smith
BACKGROUND: Childbirth is widely acknowledged as one of the most painful experiences most women will undergo in their lifetimes. Alleviating labor and delivery pain for women with physical disabilities can involve an additional level of complexity beyond that experienced by most women, but little research has explored their experiences. OBJECTIVE/HYPOTHESIS: The purpose of this study was to explore the experiences of women with physical disabilities with respect to pain relief during labor and delivery with the goal of informing their care...
April 6, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#20
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
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