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https://www.readbyqxmd.com/read/28728194/-relevance-of-living-wills-during-post-resuscitation-care
#1
Martin Christ, Katharina Isabel von Auenmüller, Martin Grett, Scharbanu Amirie, Michael Brand, Hans-Joachim Trappe
Background There is hardly any evidence about the influence of living wills on acute life-threatening disease like out-of-hospital cardiac-arrest (OHCA). We therefore initiated this study to quantify the percentage of victims of OHCA who's living wills are available during post-resuscitation care. Methods All victims of OHCA who were admitted to our hospital between January 1(st) 2008 and July 31(th) 2016 were identified by analysis of our central admission register. Data from individual patients were collected from the patient's health records and anonymously stored on a central database...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28728114/variation-in-receipt-of-pharmacotherapy-for-alcohol-use-disorders-across-racial-ethnic-groups-a-national-study-in-the-u-s-veterans-health-administration
#2
Emily C Williams, Shalini Gupta, Anna D Rubinsky, Joseph E Glass, Rhonda Jones-Webb, Kara M Bensley, Alex H S Harris
OBJECTIVE: Pharmacologic treatment is recommended for alcohol use disorders (AUD), but most patients do not receive it. Although racial/ethnic minorities have greater AUD consequences than whites, whether AUD medication receipt varies across race/ethnicity is unknown. We evaluate this in a national sample. METHODS: Electronic health records data were extracted for all black, Hispanic, and/or white patients who received care at the U.S. Veterans Health Administration (VA) during Fiscal Year 2012 and had a documented AUD diagnosis...
July 11, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28727714/3d-morphometric-analysis-of-normal-sacroiliac-joints-a-new-classification-of-surface-shape-variation-and-the-potential-implications-in-pain-syndromes
#3
Mary Kristen Jesse, Christopher Kleck, Adam Williams, Brian Petersen, Deborah Glueck, Kimberly Lind, Vikas Patel
BACKGROUND: Normal sacroiliac (SI) joints vary widely in shape, and it is unclear whether SI joint morphology plays a role in the development of pain. To answer this question, we used 3D-CT surface rendering to image healthy study participants and used the resulting images to develop a classification system for SI joint morphology. In a case-control study comparing health research participants to patients with SI pain, we assessed whether the classification of SI joint morphology was associated with pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28725487/expectations-of-persons-with-paraplegia-regarding-their-care-in-india-a-qualitative-study
#4
Nalina Gupta, Kavitha Raja
STUDY DESIGN: A qualitative study. OBJECTIVE: The aim of this study was to understand expectations of persons with paraplegia in India regarding their care. SETTING: India. METHODS: This study used a qualitative methodology to have a focus group interview of persons with paraplegia in India. Focus group consisted of two to four participants with paraplegia. Adults with level T6 and below, complete injury, duration of at least 6 months post injury and those living in the community were included...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28725259/cardiovascular-disease-risk-and-prevention-amongst-syrian-refugees-mixed-methods-study-of-m%C3%A3-decins-sans-fronti%C3%A3-res-programme-in-jordan
#5
Dylan R J Collins, Kiran Jobanputra, Thomas Frost, Shoaib Muhammed, Alison Ward, Abed Alrazzaq Shafei, Taissir Fardous, Sadeq Gabashneh, Carl Heneghan
BACKGROUND: The growing burden of non-communicable diseases (NCDs) presented new challenges for medical humanitarian aid and little was known about primary health care approaches for these diseases in humanitarian response. We aimed to evaluate Médecins Sans Frontières (MSF's) use of total CVD risk based prevention strategies amongst Syrian refugees in northern Jordan to identify opportunities to improve total CVD risk based guidance for humanitarian settings. METHODS: We evaluated CVD risk assessment and management in two outpatient NCD clinics in the Irbid governorate of Jordan using a mixed methods design with qualitative and quantitative strands of equal priority, integrated during data collection and interpretation...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28721080/a-cost-analysis-of-a-broad-spectrum-antibiotic-therapy-in-the-empirical-treatment-of-health-care-associated-infections-in-cirrhotic-patients
#6
Cristina Lucidi, Vincenza Di Gregorio, Giancarlo Ceccarelli, Mario Venditti, Oliviero Riggio, Manuela Merli
BACKGROUND: Early diagnosis and appropriate treatment of infections in cirrhosis are crucial. As new guidelines in this context, particularly for health care-associated (HCA) infections, would be needed, we performed a trial documenting whether an empirical broad-spectrum antibiotic therapy is more effective than the standard one for these infections. Because of the higher daily cost of broad-spectrum than standard antibiotics, we performed a cost analysis to compare: 1) total drug costs, 2) profitability of hospital admissions...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28720625/developing-electronic-health-record-ehr-strategies-related-to-health-center-patients-social-determinants-of-health
#7
Rachel Gold, Erika Cottrell, Arwen Bunce, Mary Middendorf, Celine Hollombe, Stuart Cowburn, Peter Mahr, Gerardo Melgar
BACKGROUND: "Social determinants of heath" (SDHs) are nonclinical factors that profoundly affect health. Helping community health centers (CHCs) document patients' SDH data in electronic health records (EHRs) could yield substantial health benefits, but little has been reported about CHCs' development of EHR-based tools for SDH data collection and presentation. METHODS: We worked with 27 diverse CHC stakeholders to develop strategies for optimizing SDH data collection and presentation in their EHR, and approaches for integrating SDH data collection and the use of those data (eg, through referrals to community resources) into CHC workflows...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28716585/ascertainment-of-alaska-native-stroke-incidence-2005-2009-lessons-for-assessing-the-global-burden-of-stroke
#8
Bernadette Boden-Albala, James Allen, Eric T Roberts, Lisa Bulkow, Brian Trimble
BACKGROUND: Stroke is a critical public health issue in the United States and globally. System models to optimally capture stroke incidence in rural and culturally diverse communities are needed. The epidemiological transition to a western lifestyle has been associated with an increased burden of vascular risk factors among Alaska Native (AN) people. The burden of stroke in AN communities remains understudied. METHODS: The Alaska Native Stroke Registry (ANSR) was designed to screen and capture all stroke cases between 2005 and 2009 through its integration into the existing single-payer Alaska Tribal Health System infrastructure...
July 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#9
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28714833/patients-expectations-and-solutions-for-improving-primary-diabetes-care
#10
Brigitte Vachon, Ai-Thuy Huynh, Mylaine Breton, Louise Quesnel, Michel Camirand, Jeannette Leblanc, Sylvie Tardif
Purpose The purpose of this paper is to document health care needs expressed by people living with diabetes, describe the solutions they envisaged for improving the quality of primary care (PC) services and empower them to make better use of PC services. Design/methodology/approach A participatory research approach was used. Six workshops were organised to provide diabetes patients with knowledge on available services and to engage them in sharing their experience. Group discussions were recorded. Data were analysed using the thematic analysis method...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28714196/impact-of-an-electronic-health-record-alert-in-primary-care-on-increasing-hepatitis-c-screening-and-curative-treatment-for-baby-boomers
#11
Monica A Konerman, Mary Thomson, Kristen Gray, Meghan Moore, Hetal Choxi, Elizabeth Seif, Anna Sf Lok
Despite effective treatment for chronic hepatitis C (CHC), deficiencies in diagnosis and access preclude disease elimination. Screening of baby boomers remains low. The aims of this study were to assess the impact of an electronic health record (EHR) based prompt on HCV screening rates in baby boomers in primary care, and access to specialty care and treatment among those newly diagnosed. We implemented an EHR based "Best Practice Advisory" (BPA) that prompted primary care providers (PCPs) to perform HCV screening for patients seen in primary care clinic: 1) born between 1945-1965; 2) lacked a prior diagnosis of HCV infection; and 3) lacked prior documented anti-HCV testing...
July 17, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28712645/comparison-of-qsofa-score-and-sirs-criteria-as-screening-mechanisms-for-emergency-department-sepsis
#12
Samir Haydar, Matthew Spanier, Patricia Weems, Samantha Wood, Tania Strout
OBJECTIVES: The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28712608/a-custom-developed-emergency-department-provider-electronic-documentation-system-reduces-operational-efficiency
#13
Joshua Feblowitz, Sukhjit S Takhar, Michael J Ward, Ryan Ribeira, Adam B Landman
STUDY OBJECTIVE: Electronic health record implementation can improve care, but may also adversely affect emergency department (ED) efficiency. We examine how a custom, ED provider, electronic documentation system (eDoc), which replaced paper documentation, affects operational performance. METHODS: We analyzed retrospective operational data for 1-year periods before and after eDoc implementation in a single ED. We computed daily operational statistics, reflecting 60,870 pre- and 59,337 postimplementation patient encounters...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28712604/-sometimes-you-feel-like-the-freak-show-a%C3%A2-qualitative-assessment-of-emergency-care-experiences-among-transgender-and-gender-nonconforming-patients
#14
Elizabeth A Samuels, Chantal Tape, Naomi Garber, Sarah Bowman, Esther K Choo
STUDY OBJECTIVE: Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28712086/pilot-study-investigating-ambient-air-toxics-emissions-near-a-canadian-kraft-pulp-and-paper-facility-in-pictou-county-nova-scotia
#15
Emma Hoffman, Judith R Guernsey, Tony R Walker, Jong Sung Kim, Kate Sherren, Pantelis Andreou
Air toxics are airborne pollutants known or suspected to cause cancer or other serious health effects, including certain volatile organic compounds (VOCs), prioritized by the US Environmental Protection Agency (EPA). While several EPA-designated air toxics are monitored at a subset of Canadian National Air Pollution Surveillance (NAPS) sites, Canada has no specific "air toxics" control priorities. Although pulp and paper (P&P) mills are major industrial emitters of air pollutants, few studies quantified the spectrum of air quality exposures...
July 15, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28707149/long-term-quality-of-life-and-outcomes-following-robotic-assisted-tapp-inguinal-hernia-repair
#16
Andrew Iraniha, Joshua Peloquin
Laparoscopic TAPP inguinal hernia repair is an established alternative to open hernia repair, which offers equivalent outcomes with less postoperative pain and faster recovery. Unfortunately, it remains technically challenging, requiring advanced laparoscopic skills which have limited its popularity among surgeons. The robotic platform has the potential to overcome these challenges. The objective of this study was to examine the long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair, since these data have not been reported up to now...
July 13, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28705223/improving-preventive-health-care-in-aboriginal-and-torres-strait-islander-primary-care-settings
#17
Jodie Bailie, Veronica Matthews, Alison Laycock, Rosalie Schultz, Christopher P Burgess, David Peiris, Sarah Larkins, Ross Bailie
BACKGROUND: Like other colonised populations, Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Preventable chronic disease is the largest contributor to the health differential between Indigenous and non-Indigenous Australians, but recommended best-practice preventive care is not consistently provided to Indigenous Australians. Significant improvement in health care delivery could be achieved through identifying and minimising evidence-practice gaps...
July 14, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28704156/quality-of-life-in-patients-with-leg-ulcers-results-from-challenge-a-double-blind-randomised-controlled-trial
#18
S Meaume, A Dompmartin, C Lok, I Lazareth, M Sigal, F Truchetet, A Sauvadet, S Bohbot
OBJECTIVE: We recently showed the superiority of a matrix metalloproteinase (MMP) modulating dressing (foam impregnated with NOSF, nano-oligosaccharide factor) compared with a lipidocolloid matrix (TLC) control dressing in median wound area reduction (WAR). Here we report the results from the same study assessing the performance and safety of TLC-NOSF in the local management of venous leg ulcers (VLUs) or mixed leg ulcers and determining its impact on the patient's health-related quality of life (HRQoL)...
July 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28701162/does-the-ingestion-of-a-24%C3%A2-hour-low-glycaemic-index-asian-mixed-meal-diet-improve-glycaemic-response-and-promote-fat-oxidation-a-controlled-randomized-cross-over-study
#19
Stefan Gerardus Camps, Bhupinder Kaur, Rina Yu Chin Quek, Christiani Jeyakumar Henry
BACKGROUND: The health benefits of consuming a low glycaemic index (GI) diet to reduce the risk of type 2 Diabetes are well recognized. In recent years the GI values of various foods have been determined. Their efficacy in constructing and consuming a low GI diet over 24 h in modulating glycaemic response has not been fully documented. The translation of using single-point GI values of foods to develop a 24 h mixed meal diet can provide valuable information to consumers, researchers and dietitians to optimize food choice for glycaemic control...
July 12, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28697524/-health-science-research-with-primary-care-routine-data-from-electronic-patient-records-the-beonet-registry
#20
Heidrun Lingner, Ines Aumann, Margarethe Wacker, Michael Kreuter, Reiner Leidl, J-Matthias Graf von der Schulenburg, Tobias Welte
Reliable current information is needed for daily patient care and the health system, but comprehensive data, especially from primary care, are scarce and/or hard to access. The BeoNet Register-Database (BNR) aims to depict quality of medical care in Germany using routine data and with no additional documentation or costs for GPs. Registry design, data structure and database use will be demonstrated using chronic obstructive lung disease (COPD) as an example. The BNR is moving through pilot- and roll-out phases...
July 11, 2017: Das Gesundheitswesen
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