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https://www.readbyqxmd.com/read/29784868/delivering-a-primary-care-based-social-prescribing-initiative-a-qualitative-study-of-the-benefits-and-challenges
#1
Kathryn Skivington, Mathew Smith, Nai Rui Chng, Mhairi Mackenzie, Sally Wyke, Stewart W Mercer
BACKGROUND: Social prescribing is a collaborative approach to improve inter-sectoral working between primary health care and community organisations. The Links Worker Programme (LWP) is a social prescribing initiative in areas of high deprivation in Glasgow, Scotland, that is designed to mitigate the negative impacts of the social determinants of health. AIM: To investigate issues relevant to implementing a social prescribing programme to improve inter-sectoral working to achieve public health goals...
May 21, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29784570/research-gaps-in-wilderness-medicine
#2
Daniel Tritz, Kody Dormire, Travis Brachtenbach, Joshua Gordon, Donald Sanders, David Gearheart, Julia Crawford, Matt Vassar
INTRODUCTION: Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. METHODS: We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations...
May 18, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29764915/remote-physiological-monitoring-in-an-austere-environment-a-future-for-battlefield-care-provision
#3
Matthew J Smyth, J A Round, A J Mellor
Wearable technologies are making considerable advances into the mainstream as they become smaller and more user friendly. The global market for such devices is forecasted to be worth over US$5 billion in 2018, with one in six people owning a device. Many professional sporting teams use self-monitoring to assess physiological parameters and work rate on the pitch, highlighting the potential utility for military command chains. As size of device reduces and sensitivity improves, coupled with remote connectivity technology, integration into the military environment could be relatively seamless...
May 14, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29760854/peritoneal-dialysis-in-austere-environments-an-emergent-approach-to-renal-failure-management
#4
REVIEW
Chad Gorbatkin, John Bass, Fredric O Finkelstein, Steven M Gorbatkin
Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available life-saving measure for acute kidney injury (AKI) or ESRD...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29739548/austerity-in-spain-time-to-loosen-the-grip
#5
EDITORIAL
The Lancet
No abstract text is available yet for this article.
May 5, 2018: Lancet
https://www.readbyqxmd.com/read/29718928/enteral-resuscitation-with-oral-rehydration-solution-to-reduce-acute-kidney-injury-in-burn-victims-evidence-from-a-porcine-model
#6
Belinda I Gómez, Matthew K McIntyre, Jennifer M Gurney, Kevin K Chung, Leopoldo C Cancio, Michael A Dubick, David M Burmeister
Intravenous (IV) resuscitation of burn patients has greatly improved outcomes and become a cornerstone of modern burn care. However, the heavy fluids and vascular access required may not be feasible in austere environments, mass casualty, or delayed transport scenarios. Enteral resuscitation has been proposed for these situations; we sought to examine the effectiveness of this strategy on improving burn-induced kidney injury. Anesthetized Yorkshire swine sustaining 40% TBSA full-thickness contact burns were randomized to three groups (n = 6/group): fluid deprivation, ad libitum water access, or 70 mL/kg/d Oral Rehydration Salt solution (ORS)...
2018: PloS One
https://www.readbyqxmd.com/read/29628662/prehospital-ultrasound-in-trauma-a-review-of-current-and-potential-future-clinical-applications
#7
REVIEW
Tharwat El Zahran, Mazen J El Sayed
Ultrasound (US) is an essential tool for evaluating trauma patients in the hospital setting. Many previous in-hospital studies have been extrapolated to out of hospital setting to improve diagnostic accuracy in prehospital and austere environments. This review article presents the role of prehospital US in blunt and penetrating trauma management with emphasis on its current clinical applications, challenges, and future implications of such use.
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29625956/video-outpatient-consultations-a-case-study-of-real-world-implementation-at-macro-meso-and-micro-level
#8
Trish Greenhalgh, Sara Shaw, Joseph Wherton, Shanti Vijayaraghavan, Joanne Morris, Satya Bhattacharya, Philippa Hanson, Desirée Campbell-Richards, Seendy Ramoutar, Anna Collard, Isabel Hodkinson
BACKGROUND: There is much interest in virtual consultations using video technology. Randomized controlled trials have shown video consultations to be acceptable, safe, and effective in selected conditions and circumstances. But this model has rarely been mainstreamed and sustained in real-world settings. OBJECTIVE: The study sought to (1) define good practice and inform implementation of video outpatient consultations and (2) generate transferable knowledge about challenges to scaling up and routinizing this service model...
February 19, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29620714/austere-surgical-care-in-the-era-of-specialization
#9
Robert L Sheridan
No abstract text is available yet for this article.
April 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29617228/health-under-austerity-in-greece
#10
Talha Burki
No abstract text is available yet for this article.
February 10, 2018: Lancet
https://www.readbyqxmd.com/read/29615073/advanced-airway-management-in-hoist-and-longline-operations-in-mountain-hems-considerations-in-austere-environments-a-narrative-review-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#11
REVIEW
Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips, Simon Rauch
BACKGROUND: Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations. METHODS: We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS...
April 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#12
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29610927/distress-and-burnout-in-young-medical-researchers-before-and-during-the-greek-austerity-measures-forerunner-of-a-greater-crisis
#13
Dimitra Sifaki-Pistolla, Vasiliki-Eirini Chatzea, Evangelos Melidoniotis, Enkeleint-Aggelos Mechili
PURPOSE: Distress and burnout are strongly correlated with austerity and financial recessions. Aim of this study was to assess distress and burnout among young medical researchers (YMR) in Greece before and during the financial crisis. METHODS: In total 2050 YMR affiliated in all the nursing and medical departments of Greece were enrolled (1025 in Period A: 2008 and 1025 in Period B: 2017). Distress and burnout were measured via DASS-21 and Maslach Burnout Inventory (MBI) questionnaires...
April 2, 2018: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/29609521/extended-operating-times-are-more-efficient-save-money-and-maintain-a-high-staff-and-patient-satisfaction
#14
Jonathan Blair Thomas Herron, Rachel French, Andrew Douglas Gilliam
Current public sector austerity measures necessitate efficiency savings throughout the NHS. Performance targets have resulted in activity being performed in the private sector, waiting list initiative lists and requests for staff to work overtime. This has resulted in staff fatigue and additional agency costs. Adoption of extended operating theatre times (0800-1800 hours) may improve productivity and efficiency, with potentially significant financial savings; however, implementation may adversely affect staff morale and patient compliance...
January 1, 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29606676/an-occupational-paradox-why-do-we-love-really-tough-jobs
#15
Penny F Pierce, Margaret M McNeill, Susan F Dukes
BACKGROUND: Sometimes we come upon unexpected or counterfactual results during research that make us wonder and lead us into unknown territory. Such was the experience of a team of Air Force researchers exploring aeromedical evacuation crew members' experiences of safety and patient care concerns throughout the en route care system. OBJECTIVE: To explore what it is about the aeromedical evacuation crew members' occupation that generates a strong motivation to the mission despite the demands it places on its workers...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29606086/the-brazilian-public-health-in-contemporary-capitalism
#16
Virgínia Junqueira, Áquilas N Mendes
This article examines some political and economic facts that led to an intensification of austerity measures by the Brazilian government, including ones against the Unified Health System (SUS) and its progressive dismantling. In a country where fundamental human rights were never fully respected, nowadays social and labor rights are under severe attacks. The deepening of the capital crisis and the rise of interest-bearing capital dominance have been causing unemployment, social insecurity growth, and resulting public fund appropriation by the private capital...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/29601609/withstanding-austerity-equity-in-health-services-utilisation-in-the-first-stage-of-the-economic-recession-in-southern-spain
#17
Juan Antonio Córdoba-Doña, Antonio Escolar-Pujolar, Miguel San Sebastián, Per E Gustafsson
Scant research is available on the impact of the current economic crisis and austerity policies on inequality in health services utilisation in Europe. This study aimed to describe the trends in horizontal inequity in the use of health services in Andalusia, Spain, during the early years of the Great Recession, and the contribution of demographic, economic and social factors. Consultation with a general practitioner (GP) and specialist, hospitalisation and emergency care were studied through the Andalusian Health Survey 2007 (pre-crisis) and 2011-2012 (crisis), using a composite income index as socioeconomic status (SES) indicator...
2018: PloS One
https://www.readbyqxmd.com/read/29589329/tactical-neurocritical-care
#18
Julio A Chalela, Patrick E Britell
Neurocritical care is usually practiced in the comfort of an intensive care unit within a tertiary care medical center. Physicians deployed to the frontline with the US military or allied military are required to use their critical care skills and their neurocritical skills in austere environments with limited resources. Due to these factors, tactical critical care and tactical neurocritical care differ significantly from traditional critical care. Operational constraints, the tactical environment, and resource availability dictate that tactical neurocritical care be practiced within a well-defined, mission-constrained framework...
March 27, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29589042/-hemostyptics-for-treatment-of-junctional-vascular-injuries-management-of-traumatic-vascular-injuries-at-the-transition-from-trunk-to-extremities
#19
REVIEW
D C Hinck, S Wipper, E S Debus
BACKGROUND: Uncontrolled post-traumatic bleeding is still the leading cause of death among trauma patients. In situations of mass casualty incidents (MASCAL) and military conflicts the treatment of uncontrolled critical bleeding is a challenge and associated with a worse outcome due to the austere environment; however, even under optimal treatment circumstances in situations of individual medicine the severity of vascular trauma is underestimated. As a consequence, this leads to a poorer prognosis for patients with (vascular) injuries...
March 27, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29580648/ageing-with-a-learning-disability-care-and-support-in-the-context-of-austerity
#20
Andrew Power, Ruth Bartlett
Recent work in geography has begun to look at the opportunities for care from siblings, friends and neighbours alongside parents and spouses. This paper examines the daily relationships that middle to older age adults with a learning disability have with remaining kin members, friends, and neighbours, within the context of declining formal day services. Adults with learning disabilities are more likely to have different life course experiences and be living on low incomes and in poor housing than the rest of the population as they have had less opportunity to work and save money through their lives...
March 17, 2018: Social Science & Medicine
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