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https://www.readbyqxmd.com/read/28425103/remains-of-care-opioid-substitution-treatment-in-the-post-welfare-state
#1
Anna Leppo, Riikka Perälä
This article examines how the amplified role of pharmaceutical substances in addiction treatment affects the everyday realisation of care, particularly the relationship between workers and patients, in so called austere environments. Theoretically the article draws firstly on the literature that links pharmaceuticalisation to the neoliberal undoing of central public structures and institutions of care, and secondly on Anne-Marie Mol's concept of the logic of care. Based on an ethnographic analysis of the everyday life at a Finnish opioid substitution treatment clinic we show the mechanisms through which the realisation of pharmacotherapy can, in the current political climate, result in a very narrow understanding of drug problems and minimal human contact between patients and professionals...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28417841/benign-episodic-unilateral-mydriasis-in-a-flight-nurse
#2
Anthony Schiemer
BACKGROUND: Benign episodic unilateral mydriasis is one cause of anisocoria. This phenomenon is thought to be related to an imbalance between the sympathetic and parasympathetic nervous systems. There is a documented association with migraines, but asymptomatic cases have also been reported. A challenge with all cases is the level of investigation required to exclude more sinister causes of nervous system dysfunction. In a dynamic flight environment, additional considerations need to be made, such as varying light levels and use of night vision devices...
May 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28411938/medicolegal-issues-in-expedition-and-wilderness-medicine
#3
REVIEW
Valerie A Dobiesz, William Sullivan
There is increased participation in wilderness expeditions to remote and austere environments, which increases the likelihood of an accident and/or medical emergency and the professional liability risks for trip organizers. Trip organizers, outfitters, tour guides, and health care providers must understand the medicolegal liabilities involved in and the legal protection and immunity available when rendering care in austere and challenging settings to mitigate risks and prepare for the level of medical care that may be required...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28411936/is-there-a-doctor-onboard-medical-emergencies-at-40-000-feet
#4
REVIEW
Howard J Donner
It is estimated 2.75 billion people travel aboard commercial airlines every year and 44,000 in-flight medical emergencies occur worldwide each year. Wilderness medicine requires a commonsense and improvisational approach to medical issues. A sudden call for assistance in the austere and unfamiliar surroundings of an airliner cabin may present the responding medical professional with a "wilderness medicine" experience. From resource management to equipment, this article sheds light on the unique conditions, challenges, and constraints of the flight environment...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28411935/point-of-care-ultrasound-in-austere-environments-a-complete-review-of-its-utilization-pitfalls-and-technique-for-common-applications-in-austere-settings
#5
REVIEW
Laleh Gharahbaghian, Kenton L Anderson, Viveta Lobo, Rwo-Wen Huang, Cori McClure Poffenberger, Phi D Nguyen
With the advent of portable ultrasound machines, point-of-care ultrasound (POCUS) has proven to be adaptable to a myriad of environments, including remote and austere settings, where other imaging modalities cannot be carried. Austere environments continue to pose special challenges to ultrasound equipment, but advances in equipment design and environment-specific care allow for its successful use. This article describes the technique and illustrates pathology of common POCUS applications in austere environments...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28411934/tactical-combat-casualty-care-and-wilderness-medicine-advancing-trauma-care-in-austere-environments
#6
REVIEW
Frank K Butler, Brad Bennett, Colonel Ian Wedmore
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. Military units that have trained all of their unit members in TCCC have now documented the lowest incidence of preventable deaths in the history of modern warfare and TCCC is now the standard for battlefield trauma care in the US Military. TCCC and wilderness medicine share the goal of optimizing care for patients with trauma in austere environments that impose significant challenges in both equipment and evacuation capability...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28396930/initial-management-of-complex-hand-injuries-in-military-or-austere-environments-how-to-defer-and-prepare-for-definitive-repair
#7
Camille Choufani, Olivier Barbier, Antoine Grosset, James Charles Murison, Didier Ollat, Sylvain Rigal, Laurent Mathieu
INTRODUCTION: The damage control orthopedics (DCO) concept is a sequential surgical management strategy indicated when ideal primary treatment is not possible or suitable. DCO principles are routinely applied to hand traumas in wartime practice, but could also be useful in a civilian setting when immediate specialized management cannot be carried out. METHODS: The authors report three typical observations of soldiers treated for a complex hand trauma on the field by orthopedic surgeons from the French Military Health Service (FMHS)...
April 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28392170/translating-tactical-combat-casualty-care-lessons-learned-to-the-high-threat-civilian-setting-tactical-emergency-casualty-care-and-the-hartford-consensus
#8
REVIEW
David W Callaway
Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Committee for Tactical Emergency Casualty Care (C-TECC) adapted the lessons of TCCC to the civilian high-threat environment and provided important all-hazards response principles for austere, dynamic, and resource-limited environments...
April 6, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28392011/rationing-hepatitis-c-treatment-in-the-context-of-austerity-policies-in-france-and-cameroon-a-transnational-perspective-on-the-pharmaceuticalization-of-healthcare-systems
#9
Fanny Chabrol, Pierre-Marie David, Gaëlle Krikorian
New powerful drugs against hepatitis C can cure the disease, but they are not widely distributed because their exorbitant prices are destabilizing healthcare systems in both African and European countries. This article takes access to hepatitis C treatments since 2013 in France and in Cameroon as a lens to analyze the rationing of pharmaceutical treatments in relation to recent transformations of health systems. Access to these treatments is analyzed thanks to ethnographic observation and interviews lead in Paris and Yaoundé, with patients, associations, health professionals and public health experts...
March 28, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28390649/abbreviated-closure-for-remote-damage-control-laparotomy-in-extreme-environments-a-randomized-trial-of-sutures-versus-wound-clamps-comparing-terrestrial-and-weightless-conditions
#10
Andrew W Kirkpatrick, Jessica Lynn McKee, Colonel Homer Tien, Anthony J LaPorta, Kit Lavell, Tim Leslie, Paul B McBeth, Derek J Roberts, Chad G Ball
INTRODUCTION: Far-Forward Damage Control Laparotomies (DCLs) might provide direct-compression of visceral hemorrhage, however, suturing is a limiting factor, especially for non-physicians. We thus compared abbreviated skin closures comparing skin-suture (SS) versus wound-clamp (WC), on-board a research aircraft in weightlessness (0g) and normal gravity (1g). METHODS: Surgeons conducted DCLs on a surgical-simulator; onboard the hangered-aircraft (1g), or during parabolic flight (0g), randomized to either WC or SS...
March 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28388310/exploring-barriers-to-primary-care-for-migrants-in-greece-in-times-of-austerity-perspectives-of-service-providers
#11
Maria Papadakaki, Christos Lionis, Aristoula Saridaki, Christopher Dowrick, Tomas de Brún, Mary O'Reilly-de Brún, Catherine A O'Donnell, Nicola Burns, Evelyn van Weel-Baumgarten, Maria van den Muijsenbergh, Wolfgang Spiegel, Anne MacFarlane
BACKGROUND: Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants. OBJECTIVES: To identify service providers' views on the barriers to migrant healthcare...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28383477/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-tele-mentoring-tele-diagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#12
Andrew W Kirkpatrick, Jessica McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather Wright-Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of post-traumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or Resuscitative-surgery in austere-environments. Revolutions in technology for remote-mentoring of ultrasound and surgery may enhance capabilities to utilize the skill-sets of non-physicians. Thus, our Research-Collaborative explored remote-mentoring to empower non-physicians to address junctional and torso hemorrhage-control in Austere-environments...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28381224/informing-primary-care-reform-in-greece-patient-expectations-and-experiences-the-qualicopc-study
#13
Christos Lionis, Sophia Papadakis, Chrysanthi Tatsi, Antonis Bertsias, George Duijker, Prodromos-Bodosakis Mekouris, Wienke Boerma, Willemijn Schäfer
BACKGROUND: Primary health care is the cornerstone of a high quality health care system. Greece has been actively attempting to reform health care services in order to improve heath outcomes and reduce health care spending. Patient-centered approaches to health care delivery have been increasingly acknowledged for their value informing quality improvement activities. This paper reports the quality of primary health care services in Greece as perceived by patients and aspects of health care delivery that are valued by patients...
April 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28359581/health-inequities-in-the-age-of-austerity-the-need-for-social-protection-policies
#14
Arne Ruckert, Ronald Labonté
This commentary assesses the impacts of the global austerity drive on health inequities in the aftermath of the global financial crisis of 2008. In doing so, it first locates the origins of austerity within the 40 year history of neoliberal economic orthodoxy. It then describes the global diffusion of austerity since 2008, and its key policy tenets. It next describes the already visible impacts of austerity-driven welfare reform on trends in health equity, and documents how austerity has exacerbated health inequities in countries with weak social protection policies...
March 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28356325/return-on-investment-of-public-health-interventions-a-systematic-review
#15
REVIEW
Rebecca Masters, Elspeth Anwar, Brendan Collins, Richard Cookson, Simon Capewell
BACKGROUND: Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these proposed disinvestments in public health, we set out to determine the return on investment (ROI) from a range of existing public health interventions. METHODS: We conducted systematic searches on all relevant databases (including MEDLINE; EMBASE; CINAHL; AMED; PubMed, Cochrane and Scopus) to identify studies that calculated a ROI or cost-benefit ratio (CBR) for public health interventions in high-income countries...
March 29, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/28352517/hidden-renal-artery-pseudoaneurysm-the-need-for-repeat-angiographic-intervention-in-a-symptomatic-patient
#16
Ankur Doshi, Madeleine G Manka, Christian Pavlovich, Martin Auster
Renal artery pseudoaneurysm (RAP) is a well-known and life-threatening complication of partial nephrectomies. Angioembolization is the preferred intervention, allowing for visualization, diagnosis, and treatment in 96% of cases. We report a case of a pseudoaneurysm that was difficult to diagnose even with optimal technique, requiring repeat imaging and additional angiographic intervention. Our case shows that RAP after partial nephrectomies may be difficult to diagnose even with high suspicion and appropriate technique...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28351261/nurses-will-continue-to-bear-the-brunt-of-austerity-as-pay-cap-remains-in-scotland
#17
(no author information available yet)
The pay increase for NHS staff in Scotland for 2017-18 will be capped at 1% for those earning over £22,000, the Scottish Government announced.
March 29, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28349207/trends-in-national-institutes-of-health-funded-congenital-heart-disease-research-from-2005-to-2015
#18
Kristin M Burns, Victoria L Pemberton, Charlene A Schramm, Gail D Pearson, Jonathan R Kaltman
In an era of ongoing need for research to enable evidence-based care for the expanding population with congenital heart disease (CHD), economic fluctuations have impacted research funding. We characterize trends in NIH-funded CHD research from 2005 to 2015. We searched the NIH RePORTER database from 2005 to 2015 using the terms "congenital heart" and "cardiac morphogenesis". Projects were characterized by year, institute, mechanism, costs, type and topic, and funding trends were analyzed. From 2005 to 2015, NIH funded 633 CHD research projects with total costs of $991 million...
March 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28338599/volumetric-control-of-whole-blood-collection-in-austere-environments
#19
Michael A Meledeo, Andrew D Fisher, Grantham C Peltier, Ethan A Miles, William B Muse, Win B Kerr, Shawn C Nessen, Andrew P Cap
INTRODUCTION: Fresh whole blood transfusions are a powerful tool in prehospital care; however, the lack of equipment such as a scale in field situations frequently leads to collections being under- or overfilled, leading to complications for both patient and donor. This study describes two methods for simple, rapid control of collection bag volume: (1) a length of material to constrict the bag, and (2) folding/clamping the bag. METHOD: Whole blood collection bags were allowed to fill with saline via gravity...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328909/what-price-will-science-pay-for-austerity
#20
Ichiko Fuyuno
No abstract text is available yet for this article.
March 22, 2017: Nature
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