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https://www.readbyqxmd.com/read/28318462/the-epidemiology-of-operation-stress-during-continuing-promise-2011-a-humanitarian-response-and-disaster-relief-mission-aboard-a-us-navy-hospital-ship
#1
William T Scouten, Melissa L Mehalick, Elizabeth Yoder, Andrea McCoy, Tracy Brannock, Mark S Riddle
Introduction Operational stress describes individual behavior in response to the occupational demands and tempo of a mission. The stress response of military personnel involved in combat and peace-keeping missions has been well-described. The spectrum of effect on medical professionals and support staff providing humanitarian assistance, however, is less well delineated. Research to date concentrates mainly on shore-based humanitarian missions. Problem The goal of the current study was to document the pattern of operational stress, describe factors responsible for it, and the extent to which these factors impact job performance in military and civilian participants of Continuing Promise 2011 (CP11), a ship-based humanitarian medical mission...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28301245/prevalence-of-taxa-of-pasteurellaceae-among-populations-of-healthy-captive-psittacine-birds
#2
M Bisgaard, Di Xin, M F Bertelsen, A M Bojesen, H Christensen
Sixty-two strains of Pasteurellaceae-like bacteria were isolated from the tracheas of 87 clinically healthy psittacine birds in two Danish zoos. The isolates were identified by a combination of rpoB and 16S rRNA gene sequencing and by matrix-assisted laser desorption-ionization time of flight. Twenty-eight strains belonged to the genus Volucribacter or were related to this genus and to the unnamed taxon 34 of Bisgaard, and 28 strains were related to the unnamed taxon 44 of Bisgaard. Four strains were identified as Pasteurella multocida , two isolates were classified with the related taxon 45 of Bisgaard, and a single isolate was classified as Pasteurella sp...
March 2017: Avian Diseases
https://www.readbyqxmd.com/read/28299789/menstrual-management-in-developmentally-delayed-adolescent-females
#3
Irene Chuah, Alexandra McRae, Kim Matthews, Ann M Maguire, Katharine Steinbeck
BACKGROUND: Requests for assistance in menstrual management and menstrual suppression are a common, emotive and sometimes controversial aspect of adolescent disability care. AIMS: To review the uptake and outcomes of menstrual suppression among adolescent patients with developmental delay. METHODS: A retrospective review of the medical records of adolescent females with intellectual disability referred for menstrual management to the Paediatric and Adolescent Gynaecology Clinic, Children's Hospital at Westmead, Sydney, for the three-year period between January 1, 2010 and January 1, 2013...
March 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28298544/can-consideration-of-the-microbiome-improve-antimicrobial-utilization-and-treatment-outcomes-in-the-oncology-patient
#4
Jessica R Galloway-Pena, Robert R Jenq, Samuel A Shelburne
The need to provide effective and timely antimicrobial treatment to cancer patients with infections is well-recognized, but tempered by preliminary, but accumulating, evidence that antibiotic-induced microbiome dysbiosis affects cancer therapy response, non-infectious toxicities, and infectious complications. Given only a minority of empirically treated cancer patients are proven to have a true bacterial infection, it is important to consider the potential negative consequences of extensive broad-spectrum antimicrobial use on the commensal microbiota...
March 15, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28293900/enhancing-the-connection-between-the-classroom-and-the-clinical-workplace-a%C3%A2-systematic-review
#5
REVIEW
Sanne Peters, Geraldine Clarebout, Agnes Diemers, Nicolas Delvaux, An Verburgh, Bert Aertgeerts, Ann Roex
INTRODUCTION: Although medical students are increasingly exposed to clinical experiences as part of their training, these often occur parallel with, rather than connected to, their classroom-based learning experiences. Additionally, students seem to struggle with spontaneously making the connection between these spheres of their training themselves. Therefore, this systematic review synthesized the existing evidence about educational interventions that aim to enhance the connection between learning in the classroom and its application in the workplace...
March 14, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28292507/opioid-exit-plan-a-pharmacist-s-role-in-managing-acute-postoperative-pain
#6
Cheryl Genord, Timothy Frost, Deeb Eid
OBJECTIVES: The benefits of a pharmacist's involvement in medication reconciliation and discharge counseling are well documented in the literature as improving patient outcomes. In contrast, no studies have focused on the initiation of a pharmacist-led opioid exit plan (OEP) for acute postoperative pain management. This paper summarizes a pharmacist-led OEP practice model and the potential role that pharmacists and student pharmacists can have at the point of admission, during postoperative recovery, and on discharge in acute pain management patients...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#7
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28291571/the-los-angeles-county-hub-and-provider-network-for-promoting-the-sustained-use-of-extended-release-naltrexone-xr-ntx-in-los-angeles-county-2010-2015
#8
Sarah J Cousins, Desirée Crèvecoeur-MacPhail, Tina Kim, Richard A Rawson
Extended-release naltrexone (XR-NTX) is a medication-assisted treatment (MAT) that is used in conjunction with psychosocial treatment for substance use disorder. It is associated with a reduction in the number of days that patients use alcohol or opioids, in cravings and drug-seeking behaviors, and in healthcare utilization costs, as well as improved medication adherence rates for patients in substance use disorder (SUD) treatment programs and improved quality of life. Despite the clinical effectiveness of XR-NTX, its clinical use has been slow to develop...
March 10, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28277214/pediatric-minimum-speech-test-battery
#9
Kristin Uhler, Andrea Warner-Czyz, Rene Gifford, Pmstb Working Group
BACKGROUND: Assessment of patient outcomes and documentation of treatment efficacy serves as an essential component of (re)habilitative audiology; however, no standardized protocol exists for the assessment of speech perception abilities for children with hearing loss. This presents a significant challenge in tracking performance of children who utilize various hearing technologies for within-subjects assessment, between-subjects assessment, and even across different facilities. PURPOSE: The adoption and adherence to a standardized assessment protocol could help facilitate continuity of care, assist in clinical decision making, allow clinicians and researchers to define benchmarks for an aggregate clinical population, and in time, aid with patient counseling regarding expectations and predictions regarding longitudinal outcomes...
March 2017: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/28275069/atrial-arrhythmias-and-electroanatomical-remodeling-in-patients-with-left-ventricular-assist-devices
#10
Amrish Deshmukh, Gene Kim, Martin Burke, Emeka Anyanwu, Valluvan Jeevanandam, Nir Uriel, Roderick Tung, Cevher Ozcan
BACKGROUND: The incidence, predictors, and impact of atrial arrhythmias along with left atrial structural changes in patients with left ventricular assist devices (LVADs) remain undetermined. METHODS AND RESULTS: All patients who underwent LVAD implantation from 2008 to 2015 at the University of Chicago Medical Center were included. Electronic medical records, electrocardiograms, echocardiograms, and cardiac electrical device interrogations were reviewed. The association of arrhythmias and clinical covariates with survival was evaluated by Kaplan-Meier and Cox proportional hazards analyses...
March 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28270255/a-qualitative-analysis-of-the-spontaneous-volunteer-response-to-the-2013-sudan-floods-changing-the-paradigm
#11
Amin Albahari, Carl H Schultz
Introduction While the concept of community resilience is gaining traction, the role of spontaneous volunteers during the initial response to disasters remains controversial. In an attempt to resolve some of the debate, investigators examined the activities of a spontaneous volunteer group called Nafeer after the Sudan floods around the city of Khartoum in August of 2013. Hypothesis Can spontaneous volunteers successfully initiate, coordinate, and deliver sustained assistance immediately after a disaster? METHODS: This retrospective, descriptive case study involved: (1) interviews with Nafeer members that participated in the disaster response to the Khartoum floods; (2) examination of documents generated during the event; and (3) subsequent benchmarking of their efforts with the Sphere Handbook...
March 8, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28270167/sedation-and-analgesia-practices-at-italian-neonatal-intensive-care-units-results-from-the-europain-study
#12
Paola Lago, Anna Chiara Frigo, Eugenio Baraldi, Roberta Pozzato, Emilie Courtois, Jérôme Rambaud, Kanwaljeet J S Anand, Ricardo Carbajal
BACKGROUND: We aimed to examine current bedside analgesia/sedation (A/S) and pain assessment (PA) practices in Italian neonatal intensive care units (NICUs) in relation to the findings of an epidemiological European study and recently-introduced national guidelines. METHODS: We analyzed the Italian data from the EUROPAIN (EUROpean-Pain-Audit-In-Neonates) prospective observational study on A/S practices that involved 6680 newborns admitted to tertiary-level NICUs in 18 European countries...
March 7, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28268253/paediatric-horse-related-trauma
#13
Jane E Theodore, Sigrid G Theodore, Kellie A Stockton, Roy M Kimble
AIM: This retrospective cohort study reported on the epidemiology of horse-related injuries for patients presenting to the only tertiary paediatric trauma hospital in Queensland. The secondary outcome was to examine the use of helmets and adult supervision. Traumatic brain injury (TBI) was examined in relation to helmet use. Morbidity and mortality were also recorded. METHODS: Included were all patients presenting with any horse-related trauma to the Royal Children's Hospital in Brisbane from January 2008 to August 2014...
March 7, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28255789/-incidental-findings-evaluation-management-recommendations-and-legal-considerations
#14
P Mildenberger
Incidental findings are part of the routine radiological reporting workflow and describe findings which are not primarily the focus of the clinical context or the request of the referring physician. The clinical implications of such incidental findings can be very different, for example simple renal cysts or space-occupying lesions suspected of being tumors. A categorization of clinical findings according to the clinical relevance is therefore recommended. Documentation and communication of clinically relevant incidental findings are a part of the radiological reporting process and essential for reduction of the medicolegal risk...
March 2, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28254596/robot-assisted-stereotactic-biopsy-of-diffuse-intrinsic-pontine-glioma-a-single-centre-experience
#15
Andrea Carai, Angela Mastronuzzi, Alessandro De Benedictis, Raffaella Messina, Antonella Cacchione, Evelina Miele, Franco Randi, Giacomo Esposito, Andrea Trezza, Giovanna Stefania Colafati, Alessandra Savioli, Franco Locatelli, Carlo Efisio Marras
BACKGROUND: Diffuse Intrinsic Pontine Glioma (DIPG) is a childhood tumor with dismal prognosis. Emerging molecular signatures have paved the way for stereotactic biopsy in selected Centers. We present our experience in DIPG stereotactic needle biopsy using the Robotic Stereotactic Assisted system (ROSA™) in a consecutive pediatric series. METHODS: All stereotactic biopsy procedures for DIPG performed during the last year at our Institution were considered. All procedures were carried out using the ROSA™ surgical assistant through a precoronary approach...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28252207/quality-of-nursing-intensity-data-inter-rater-reliability-of-the-patient-classification-after-two-decades-in-clinical-use
#16
Pia Liljamo, Ulla-Mari Kinnunen, Pasi Ohtonen, Kaija Saranto
AIMS: To measure the inter-rater reliability of the Oulu Patient Classification (OPCq) and to discuss existing methods of reliability testing. BACKGROUND: The OPCq, part of the RAFAELA(®) System, has been developed to assist nursing managers with the proper allocation of nursing resources. Due to the increased intensity of inpatient care during recent years, there is a need for the reliability testing of the classification, which has been in clinical use for 20 years...
March 2, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28249543/initial-single-center-experience-radiofrequency-ablation-assisted-vertebroplasty-and-osteoplasty-using-a-bipolar-device-in-the-palliation-of-bone-metastases
#17
Elizabeth David, Sagi Kaduri, Albert Yee, Edward Chow, Arjun Sahgal, Stephanie Chan, Ramez Hanna
BACKGROUND: To assess the safety and clinical outcomes of bipolar radiofrequency ablation (RFA) assisted vertebroplasty (VP) and osteoplasty (OP) in pathological and insufficiency fractures. The insufficiency fractures were in patients who sustained demineralization secondary to cancer treatment. METHODS: Patients referred for symptomatic malignant or insufficiency fractures for VP or OP from January 2011 to May 2015 were retrospectively reviewed. Bipolar RFA was performed (Osteocool RF ablation system, Baylis Medical) reaching a constant temperature of 70 ℃ over 7 to 15 minutes followed by cement injection...
January 16, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28244573/the-impact-of-trained-volunteer-mealtime-assistants-on-the-dietary-intake-of-older-female-in-patients-the-southampton-mealtime-assistance-study
#18
H C Roberts, A L Pilgrim, K A Jameson, C Cooper, A A Sayer, S Robinson
OBJECTIVE: Malnutrition among older hospital inpatients is common and is associated with poor clinical outcomes. Time-pressured staff may struggle to provide mealtime assistance. This study aimed to evaluate the impact of trained volunteer mealtime assistants on the dietary intake of older inpatients. DESIGN: Quasi-experimental two year pre and post- test study of the introduction of volunteer mealtime assistants to one acute medical female ward, with contemporaneous comparison with a control ward...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28243479/robotic-assisted-laparoscopic-prostatectomy-after-high-intensity-focused-ultrasound-failure
#19
Leon Telis, Seyed Behzad Jazayeri, David B Samadi
Background. Prostate cancer is the most common cancer diagnosed in men. As new focal therapies become more popular in treatment of prostate cancer, failure cases requiring salvage therapy with either surgical or other techniques are being reported. Objective. To report the options in treatment of prostate cancer after recurrence or failure of the primary treatment modality. Methods. We report a salvage robotic assisted laparoscopic radical prostatectomy (RALP) for prostate cancer recurrence following high intensity focused ultrasound treatment (HIFU) in the United States...
2017: Case Reports in Urology
https://www.readbyqxmd.com/read/28240961/gender-parity-in-critical-care-medicine
#20
Sangeeta Mehta, Karen E A Burns, Flavia R Machado, Alison E Fox-Robichaud, Deborah J Cook, Carolyn S Calfee, Lorraine B Ware, Ellen L Burnham, Niranjan Kissoon, John C Marshall, Jordi Mancebo, Simon Finfer, Christiane Hartog, Konrad Reinhart, Kathryn Maitland, Renee D Stapleton, Arthur Kwizera, Pravin Amin, Fekri Abroug, Orla Smith, Jon H Laake, Gentle S Shrestha, Margaret S Herridge
Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. These documents inform and shape patient care around the world. In this perspective we discuss the importance of diversity on guideline panels, the disproportionately low representation of women on critical care guideline panels, and existing initiatives to increase the representation of women in corporations, universities and government...
February 27, 2017: American Journal of Respiratory and Critical Care Medicine
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