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https://www.readbyqxmd.com/read/28644781/teaching-clinical-ethics-at-the-bedside-william-osler-and-the-essential-role-of-the-hospitalist
#1
Matthew William McCarthy, Joseph J Fins
As the field of hospital medicine celebrates its twenty-first anniversary, we believe it is time to expand its mission to play an even greater role in medical education. Given hospitalists' proximity to students and clinical material, members of this growing cohort of physicians are uniquely positioned to teach normative reasoning, professionalism, communication, and medical ethics in real time to trainees on the wards. But, to do so, we must reimagine the role of the hospitalist in graduate and postgraduate medical education...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644706/advance-care-planning-and-palliative-care-integration-for-patients-undergoing-hematopoietic-stem-cell-transplantation
#2
Winnie S Wang, Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric J Roeland
PURPOSE: Advance care planning (ACP) in hematopoietic stem-cell transplantation (HSCT) is challenging, given the potential for cure despite increased morbidity and mortality risk.The aim of this study was to evaluate ACP and palliative care (PC) integration for patients who underwent HSCT. METHODS: A retrospective analysis was conducted and data were extracted from electronic medical records of patients who underwent HSCT between January 2011 and December 2015. Patients who received more than one transplant and who were younger than 18 years of age were excluded...
June 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#3
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28643666/french-family-physician-experience-concerning-the-outpatient-care-for-women-suffering-from-nausea-and-vomiting-in-pregnancy
#4
V Dochez, J Dimet, A David-Gruselle, A Le Thuaut, G Ducarme
OBJECTIVE: To explore thoughts and attitudes among French family physicians on the outpatient care for women suffering from nausea and vomiting in pregnancy (NVP). DESIGN AND SETTING: A retrospective study was conducted among family physicians who had taken care of pregnant women who gave birth in our hospital in 1 year. PATIENTS AND METHODS: Fifty-nine French family physicians responded to a questionnaire assessing their experience about outpatient care for women suffering from NVP...
April 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#5
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28643443/national-high-flow-nasal-cannula-and-bronchiolitis-survey-highlights-need-for-further-research-and-evidence-based-guidelines
#6
Paula Sokuri, Paula Heikkilä, Matti Korppi
AIM: High-flow nasal cannula (HFNC) therapy provides non-invasive respiratory support for infant bronchiolitis and its use has increased following good clinical experiences. This national study describes HFNC use in Finland during a severe respiratory syncytial virus (RSV) epidemic. METHODS: A questionnaire on using HFNC for infant bronchiolitis during the 2015-2016 RSV epidemic was sent to the head physicians of 18 Finnish children's hospitals providing inpatient care for infants: 17 hospitals answered, covering 77...
June 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28643286/identifying-primary-care-physicians-continuing-education-needs-by-examining-clinical-practices-attitudes-and-barriers-to-screening-across-multiple-cancers
#7
Brenna Lynn, Alexandra Hatry, Chloe Burnett, Lisa Kan, Tunde Olatunbosun, Bob Bluman
Population-based cancer screening for cervical, breast, and colorectal cancers improves patient outcomes, yet screening rates remain low for some cancers. Despite studies investigating physician perceptions and practices for screening, many have focused on individual cancers and lack primary care physicians' (PCPs) realities around screening for multiple cancers. We surveyed 887 PCPs in British Columbia (BC) to examine practices, beliefs, barriers, and learning needs towards cancer screening across breast, cervical, colorectal, prostate, as well as hereditary predisposition to cancer...
June 22, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#8
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28642857/healthcare-costs-of-osteoporotic-fracture-in-korea-information-from-the-national-health-insurance-claims-database-2008-2011
#9
Ha Young Kim, Yong-Chan Ha, Tae-Young Kim, Hyemin Cho, Young-Kyun Lee, Ji-Yeon Baek, Sunmee Jang
BACKGROUND: The present study estimated healthcare costs of osteoporotic fractures including spine, hip, distal radius and humerus in Koreans over 50 years of age using national claims data. METHODS: Korea National Health Insurance data between 2008 and 2011 was searched for all claims records of outpatient visits or hospital admissions of patients ≥50-year-of-age. Osteoporosis-related fractures were identified using certain the International Classification of Diseases, Tenth Revision codes and site-specific physician claims for procedures in a patient age cut-off value of 50 years...
May 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28642333/patients-and-providers-perceptions-of-the-preventability-of-hospital-readmission-a-prospective-observational-study-in-four-european-countries
#10
Louise S van Galen, Mikkel Brabrand, Tim Cooksley, Peter M van de Ven, Hanneke Merten, Ralph Kl So, Loes van Hooff, Harm R Haak, Rachel M Kidney, Christian H Nickel, John Ty Soong, Immo Weichert, Mark Hh Kramer, Christian P Subbe, Prabath Wb Nanayakkara
OBJECTIVES: Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions. DESIGN: Prospective observational study. Readmitted patients, their carers, and treating professionals were surveyed during readmission to assess the discharge process and the predictability and preventability of the readmission...
June 22, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28642218/the-effectiveness-of-information-technology-supported-shared-care-for-patients-with-chronic-disease-a-systematic-review
#11
Laura Kooij, Wim G Groen, Wim H van Harten
BACKGROUND: In patients with chronic disease, many health care professionals are involved during treatment and follow-up. This leads to fragmentation that in turn may lead to suboptimal care. Shared care is a means to improve the integration of care delivered by various providers, specifically primary care physicians (PCPs) and specialty care professionals, for patients with chronic disease. The use of information technology (IT) in this field seems promising. OBJECTIVE: Our aim was to systematically review the literature regarding the effectiveness of IT-supported shared care interventions in chronic disease in terms of provider or professional, process, health or clinical and financial outcomes...
June 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28642108/investing-in-new-technology-in-pulmonary-medicine-navigating-the-tortuous-path-to-success
#12
REVIEW
Robert Kruklitis, Kim French, Michael Joseph Cangelosi, Kevin L Kovitz
The introduction of new technologies offer the promise to advance medicine. This occurs alongside improved efforts to control costs of healthcare by hospital administrators, Center for Medicare and Medicaid Services' (CMS) pivot to value programs, and commercial payers' efforts to reduce reimbursement. These trends present a challenge for the pulmonologist, among others, who must navigate increasingly complex and highly scrutinized evaluation processes used to secure new technologies. Healthcare providers are turning toward value assessments, while simultaneously tasked with a mission of offering state-of-the art technologies and services...
June 19, 2017: Chest
https://www.readbyqxmd.com/read/28641586/access-education-and-policy-awareness-predictors-of-influenza-vaccine-acceptance-among-vha-healthcare-workers
#13
Jennifer Lipkowitz Eaton, David C Mohr, Kathleen M McPhaul, Richard A Kaslow, Richard A Martinello
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts...
June 23, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28641585/cancer-bereaved-siblings-positive-and-negative-memories-and-experiences-of-illness-and-death-a-nationwide-follow-up
#14
Mary-Elizabeth Bradley Eilertsen, Malin Lövgren, Alexandra Eilegård Wallin, Ulrika Kreicbergs
OBJECTIVE: Our aim was to explore bereaved siblings' positive and negative memories and experiences of their brother's or sister's illness and death. METHOD: In our nationwide Swedish study, 174 of 240 (73%) bereaved siblings participated, and 70% responded to two open-ended statements, which focused on siblings' positive and negative memories and experiences of illness and death. The data were analyzed using systematic text condensation. RESULTS: The bereaved siblings' responses were categorized into four different themes: (1) endurance versus vulnerability, (2) family cohesion versus family conflicts, (3) growth versus stagnation, and (4) professional support versus lack of professional support...
June 23, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28641385/development-of-an-electronic-medical-record-based-child-physical-abuse-alert-system
#15
Rachel P Berger, Richard A Saladino, Janet Fromkin, Emily Heineman, Srinivasan Suresh, Tom McGinn
Objective: Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes. Methods: Triggers to identify children < 2 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center...
June 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28641352/-do-general-surgeons-feel-adequately-prepared-for-the-complex-questions-associated-with-the-handling-of-multi-resistant-pathogens-results-of-the-mr2-survey
#16
Matthias May, Philipp J Spachmann, Steffen Lebentrau, Harald Schumacher, Christian Gilfrich, Hans-Martin Fritsche, Malte Vetterlein, Sabine Brookman-May, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Alexander Novotny, Robert Obermaier
Background At the present time, there is no evidence available as to the knowledge of general surgeons regarding multi-resistant pathogens (MRP) and the rational use of antibiotic medication (antibiotic stewardship/ABS) compared with physicians from other disciplines. Methods As part of the MR2 survey (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focussing on German hospitals), a questionnaire comprising 4 + 35 items was distributed to urologists, internists, gynaecologists and general surgeons in 18 hospitals...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641281/complementary-and-alternative-medicine-a-clinical-study-in-1-016-hematology-oncology-patients
#17
Marina Hierl, Jochen Pfirstinger, Reinhard Andreesen, Ernst Holler, Stephanie Mayer, Daniel Wolff, Martin Vogelhuber
INTRODUCTION: Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. PATIENTS AND METHODS: A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital...
June 23, 2017: Oncology
https://www.readbyqxmd.com/read/28641275/a-case-series-of-surgically-diagnosed-idiopathic-aortitis-in-a-canadian-centre-a-retrospective-study
#18
Diane L Murzin, Eric C Belanger, John P Veinot, Nataliya Milman
BACKGROUND: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. METHODS: We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28641035/hypoglycemia-patients-and-transport-by-ems-in-alameda-county-2013-15
#19
Howard H Moffet, E Margaret Warton, Lee Siegel, Karl Sporer, Kasia J Lipska, Andrew J Karter
OBJECTIVE: To estimate the rate, characteristics, and dispositions of hypoglycemia events among persons who received care from Alameda County, California, Emergency Medical Services (EMS). METHODS: This study was based on data for 601,077 Alameda County EMS encounters during 2013-15. Subjects were defined as having hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dl or "unspecified low"). The outcome of interest was patient transport or non-transport to an emergency department or other care setting; we excluded 33,177 (6%) encounters which lacked clear disposition outcomes...
June 22, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28640946/physicians-non-uniform-approach-to-prescribing-drugs-to-older-patients-a-qualitative-study
#20
Line Due Christensen, Janne Petersen, Ove Andersen, Susanne Kaae
Multi-morbidity and polypharmacy are common in older patients and increase their susceptibility to adverse drug events and hospitalizations. Rational drug prescription is critical, however, little is known about physicians' perspectives on how to prescribe drugs for older patients. The aim of this study was to explore physicians' approach to prescribe drugs to older patients, including identifying the drugs that physicians perceive to be risk drugs for older patients and comparing them with established lists of potentially inappropriate medications...
June 22, 2017: Basic & Clinical Pharmacology & Toxicology
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