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https://www.readbyqxmd.com/read/28654581/improved-rates-of-immediate-breast-reconstruction-at-safety-net-hospitals
#1
Tiffany N S Ballard, Lin Zhong, Adeyiza O Momoh, Kevin C Chung, Jennifer F Waljee
BACKGROUND: Substantial federal resources have been directed toward ensuring the delivery of high-quality care at safety net hospitals. Although disparities in receipt of breast reconstruction persist at the patient level, the extent to which hospital factors contribute to these differences remains unclear. The rates of immediate breast reconstruction across safety net and non-safety net hospitals were investigated. METHODS: Women 21 years and older with breast cancer or increased risk of breast cancer undergoing immediate post-mastectomy reconstruction were identified in the Nationwide Inpatient Sample database...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28654541/caring-for-older-surgical-patients-contemporary-attitudes-knowledge-practices-and-needs-of-general-surgeons-and-residents
#2
Tyler R Chesney, George Pang, Najma Ahmed
OBJECTIVE: To gain contemporary insights from residents and surgeons regarding the care of older surgical patients. BACKGROUND DATA: With worldwide aging, efforts over the past decade have attempted to increase surgeons' abilities to care for older adults, but a current understanding of attitudes, knowledge, practices, and needs is missing. METHODS: Between July 2016 and September 2016 we conducted a national Web-based survey sampling all general surgery residents and academic general surgeons using a questionnaire designed and tested for this purpose...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28654474/excellence-in-promoting-participation-striving-for-the-10-cs-client-centered-care-consideration-of-complexity-collaboration-coaching-capacity-building-contextualization-creativity-community-curricular-changes-and-curiosity
#3
Lisa A Chiarello
Participation of children with physical disabilities is critical to optimizing their life roles and lived experiences. This perspective explores the complex and multidimensional construct of participation and presents recommendations for practice, education, and research to transform pediatric physical therapy service delivery. Two models are reviewed of participation-based service delivery grounded in client-centered care and the principles of coaching to engage clients in their rehabilitation. The roles and responsibilities of the physical therapist and the importance of team collaboration are emphasized...
July 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28654355/a-prognostic-scoring-tool-for-cesarean-organ-space-surgical-site-infections-derivation-and-internal-validation
#4
Srisuda Assawapalanggool, Nongyao Kasatpibal, Supatra Sirichotiyakul, Rajin Arora, Watcharin Suntornlimsiri
BACKGROUND: Organ/space surgical site infections (SSIs) are serious complications after cesarean delivery. However, no scoring tool to predict these complications has yet been developed. This study sought to develop and validate a prognostic scoring tool for cesarean organ/space SSIs. METHODS: Data for case and non-case of cesarean organ/space SSI between January 1, 2007 and December 31, 2012 from a tertiary care hospital in Thailand were analyzed. Stepwise multivariable logistic regression was used to select the best predictor combination and their coefficients were transformed to a risk scoring tool...
June 27, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28653615/maternal-and-neonatal-morbidity-repeat%C3%A2-cesarean-versus-a%C3%A2-trial-of-labour-after-previous%C3%A2-cesarean%C3%A2-delivery
#5
Yue-Zhou Yang, Xu-Ping Ye, Xiao-Xi Sun
PURPOSE: The purpose of this study was to perform a meta-analysis comparing the rates of uterine rupture, and other maternal and neonatal complications, between women who undergo a trial of labour (TOL) after a prior Cesarean delivery and those to undergo elective repeat Cesarean delivery (ERCD). SOURCE: Medline, Cochrane, EMBASE and Google Scholar were searched until May 6, 2015 using the keywords/phrases: trial of labour, Cesarean section, elective, repeat, pregnancy and vaginal birth...
June 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28653548/co-constructing-engagement-in-stroke-rehabilitation-a-qualitative-study-exploring-how-practitioner-engagement-can-influence-patient-engagement
#6
Felicity As Bright, Nicola M Kayes, Christine Cummins, Linda M Worrall, Kathryn M McPherson
OBJECTIVE: To explore how practitioner engagement and disengagement occurred, and how these may influence patient care and engagement. DESIGN: A qualitative study using the Voice Centred Relational Methodology. Data included interviews, focus groups and observations. SETTING: Inpatient and community stroke rehabilitation services. SUBJECTS: Eleven people experiencing communication disability after stroke and 42 rehabilitation practitioners...
February 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28653100/ethics-and-the-law
#7
Katherine Duthie, Bashir Jiwani, Duncan Steele
Health care providers' interpretation of law can have intended and unintended effects on health care delivery in Canada. At times, health care providers encounter situations where they perceive the law to conflict with their sense of what is most ethically justified. In many cases, these health care providers feel especially torn because they assume that the legal requirements must dictate the decision, and cannot be explored or questioned. We challenge this assumption: the law is not as cut-and-dried as some assume; therefore, its significance to health care decisions should be carefully considered...
June 26, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28652839/increasing-patient-safety-with-neonates-via-handoff-communication-during-delivery-a-call-for-interprofessional-health-care-team-training-across-gme-and-cme
#8
Allison A Vanderbilt, Scott M Pappada, Howard Stein, David Harper, Thomas J Papadimos
Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28652723/features-of-self-management-interventions-for-people-with-copd-associated-with-improved-health-related-quality-of-life-and-reduced-emergency-department-visits-a-systematic-review-and-meta-analysis
#9
REVIEW
James J Newham, Justin Presseau, Karen Heslop-Marshall, Sian Russell, Oladapo J Ogunbayo, Paul Netts, Barbara Hanratty, Eileen Kaner
BACKGROUND: Self-management interventions (SMIs) are recommended for individuals with COPD to help monitor symptoms and optimize health-related quality of life (HRQOL). However, SMIs vary widely in content, delivery, and intensity, making it unclear which methods and techniques are associated with improved outcomes. This systematic review aimed to summarize the current evidence base surrounding the effectiveness of SMIs for improving HRQOL in people with COPD. METHODS: Systematic reviews that focused upon SMIs were eligible for inclusion...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28652720/development-of-a-training-program-to-support-health-care-professionals-to-deliver-the-space-for-copd-self-management-program
#10
Claire Blackmore, Vicki L Johnson-Warrington, Johanna Ea Williams, Lindsay D Apps, Hannah Ml Young, Claire LA Bourne, Sally J Singh
BACKGROUND: With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals' training needs when supporting patients with COPD on self-management. AIM: This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28652226/a-hybrid-web-based-and-in-person-self-management-intervention-to-prevent-acute-to-chronic-pain-transition-after-major-lower-extremity-trauma-ipact-e-trauma-protocol-for-a-pilot-single-blind-randomized-controlled-trial
#11
Mélanie Bérubé, Céline Gélinas, Géraldine Martorella, José Côté, Nancy Feeley, George-Yves Laflamme, Dominique Rouleau, Manon Choinière
BACKGROUND: Acute pain frequently transitions to chronic pain after major lower extremity trauma (ET). Several modifiable psychological risk and protective factors have been found to contribute to, or prevent, chronic pain development. Some empirical evidence has shown that interventions, including cognitive and behavioral strategies that promote pain self-management, could prevent chronic pain. However, the efficacy of such interventions has never been demonstrated in ET patients. We have designed a self-management intervention to prevent acute to chronic pain transition after major lower extremity trauma (iPACT-E-Trauma)...
June 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28651958/conception-by-means-of-in%C3%A2-vitro-fertilization-is-not-associated-with-maternal-depressive-symptoms-during-pregnancy-or-postpartum
#12
Pietro Gambadauro, Stavros Iliadis, Emma Bränn, Alkistis Skalkidou
OBJECTIVE: To study whether conception by means of in vitro fertilization (IVF) is associated with maternal depressive symptoms during pregnancy or postpartum. DESIGN: Longitudinal observational study. SETTING: University hospital. PATIENT(S): A total of 3,283 women with singleton pregnancies receiving antenatal care and delivering in Uppsala from 2010 to 2015. INTERVENTION(S): A web-based self-administered structured questionnaire including sociodemographic, clinical and pregnancy-related items, and the Edinburgh Postnatal Depression Scale (EPDS) was delivered at 17 and 32 gestational weeks and at 6 weeks and 6 months postpartum...
June 23, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28651638/comparing-regional-models-of-congenital-bleeding-disorders-preliminary-steps-in-the-italian-context
#13
Sabina Nuti, Chiara Seghieri, Francesco Niccolai, Federica Vasta, Giuliano Grazzini
BACKGROUND: Among these diseases, congenital bleeding disorders (CBD) represent a significant societal burden in terms of high morbidity costs and health outcomes. In Italy, the organization and provision of health care is a regional responsibility and regions must assure equity and quality to all their residents. This is also true for CBD care which is provided by 54 multidisciplinary Hemophilia Treatment Centers (HTCs) distributed among the regions. With the present study, we intend to stimulate a debate on the effect that the decentralization process have in the delivery of services to CBD patients across Italy...
June 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28651637/early-postnatal-care-use-by-postpartum-mothers-in-mundri-east-county-south-sudan
#14
Jonathan Izudi, Grace Denise Akwang, Dinah Amongin
BACKGROUND: Globally, most maternal and newborn deaths are within the first week of delivery. Early postnatal-care (EPNC) visits between 2 and 7 days detects early morbidity and averts deaths. However, there is scarcity of information on use of EPNC in Mundri East County, South Sudan. This study investigated factors associated with EPNC use among postpartum mothers in Mundri East County, South Sudan. METHODS: This was an analytical cross-sectional study of 385 postpartum mothers from 13 health facilities...
June 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28651611/adolescent-deliveries-in-semi-urban-cameroon-prevalence-and-adverse-neonatal-outcomes
#15
Tsi Njim, Valirie Ndip Agbor
OBJECTIVES: Adolescent pregnancies are high risk due to the increased probability of adverse outcomes; as adolescents are usually considered to be ill-equipped to deal with the burden of pregnancy. We sought to determine the prevalence of adolescent deliveries in a secondary-level care hospital in semi-urban Cameroon-Bamenda, the adverse neonatal outcomes and to assess if previous obstetric history could preclude adolescents from having adverse outcomes in their present pregnancy. RESULTS: The prevalence of adolescent deliveries was 8...
June 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28651589/behavioural-activation-by-mental-health-nurses-for-late-life-depression-in-primary-care-a-randomized-controlled-trial
#16
Noortje Janssen, Marcus J H Huibers, Peter Lucassen, Richard Oude Voshaar, Harm van Marwijk, Judith Bosmans, Mirjam Pijnappels, Jan Spijker, Gert-Jan Hendriks
BACKGROUND: Depressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) protocols are less complicated and more easy to train than other psychological therapies, making them very suitable for delivery by less specialised therapists...
June 26, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28651581/patients-satisfaction-towards-radiological-service-and-associated-factors-in-hawassa-university-teaching-and-referral-hospital-southern-ethiopia
#17
Teshome Mulisa, Fasil Tessema, Hailu Merga
BACKGROUND: Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. METHODS: An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique...
June 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28651507/protein-delivery-and-clinical-outcomes-in-the-critically-ill-a-systematic-review-and-meta-analysis
#18
Michael L Davies, Lee-Anne S Chapple, Marianne J Chapman, John L Moran, Sandra L Peake
OBJECTIVES: Protein is a fundamental component of critical care nutrition, but there has been uncertainty about the optimal amount. We undertook this systematic review and meta-analysis to examine the relationship between delivered protein and mortality in randomised controlled trials (RCTs) of nutritional interventions involving critically ill adults. Secondary outcomes included the effect of protein dose on lengths of stay, mechanical ventilation and incidence of infections. METHODS: We reviewed the relevant English-language literature published between 1966 and 2015 and identified RCTs comparing different strategies of nutritional support lasting at least 48 hours in critically ill adults...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651448/adverse-pregnancy-outcomes-in-deliveries-prior-to-at-and-beyond-39%C3%A2-weeks-low-and-high-risk-women
#19
Hind N Moussa, Susan Hosseini Nasab, Farah H Amro, Jennifer Hoayek, Ziad A Haidar, Sean C Blackwell, Baha M Sibai
BACKGROUND: Hypertensive disorders are associated with maternal and neonatal complications. Though they are more common in women with history of prior preeclampsia, they can occur in uncomplicated pregnancies. OBJECTIVE: To determine the proportion of adverse pregnancy outcomes in deliveries prior to or at ≥39 weeks, in uncomplicated singleton nulliparous women (low-risk), as well as women with history of preeclampsia in a prior gestation (high-risk). STUDY DESIGN: This was a secondary analysis from the multicenter trials of low dose aspirin for preeclampsia prevention in low and high-risk pregnancies...
June 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28651351/applying-a-theory-driven-framework-to-guide-quality-improvement-efforts-in-nursing-homes-the-lock-model
#20
Whitney L Mills, Camilla B Pimentel, Jennifer A Palmer, A Lynn Snow, Nancy J Wewiorski, Rebecca S Allen, Christine W Hartmann
Purpose of the Study: Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. Design and development: The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning...
June 23, 2017: Gerontologist
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