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https://www.readbyqxmd.com/read/28987982/a-qualitative-study-of-speaking-out-about-patient-safety-concerns-in-intensive-care-units
#1
Carolyn Tarrant, Myles Leslie, Julian Bion, Mary Dixon-Woods
Much policy focus has been afforded to the role of "whistleblowers" in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 h of ethnographic observation and 98 interviews across 19 English intensive care units (ICUs), we studied how personnel gave voice to concerns about patient safety or poor practice...
September 22, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28983286/inducible-expression-of-spo0a-as-a-universal-tool-for-studying-sporulation-in-clostridium-difficile
#2
Marcin Dembek, Stephanie E Willing, Huynh A Hong, Siamand Hosseini, Paula S Salgado, Simon M Cutting
Clostridium difficile remains a leading nosocomial pathogen, putting considerable strain on the healthcare system. The ability to form endospores, highly resistant to environmental insults, is key to its persistence and transmission. However, important differences exist between the sporulation pathways of C. difficile and the model Gram-positive organism Bacillus subtilis. Amongst the challenges in studying sporulation in C. difficile is the relatively poor levels of sporulation and high heterogeneity in the sporulation process...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28938218/late-life-suicide-prevention-strategies-current-status-and-future-directions
#3
REVIEW
Kim Van Orden, Charlene Deming
Late life suicide prevention differs from suicide prevention for other age groups: first, the number of older adults worldwide is on the rise; second, late-life suicide receives much less attention in all societal spheres, from the media, to federal funding agencies, to healthcare initiatives. Recent findings indicate an association between internalized ageist stereotypes and reduced will to live. Recent research also addresses the role of cognitive control as a contributor to risk and as an intervention target (e...
September 8, 2017: Current Opinion in Psychology
https://www.readbyqxmd.com/read/28887343/population-health-and-medicine-policy-and-financial-drivers
#4
Jill E Lavigne, Jack Brown, Gary R Matzke
PURPOSE: The financial and policy levers of population health and potential opportunities for pharmacists are described. SUMMARY: Three long-standing problems drive the focus on population health: (1) the United States suffers far worse population health outcomes compared with those of other developed nations that spend significantly less on healthcare, (2) the U.S. healthcare system's focus on "sick care" fails to address upstream prevention and population health improvement, and (3) financial incentives for healthcare delivery are poorly aligned with improvements in population health outcomes...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28885536/moving-upstream-in-u-s-hospital-care-toward-investments-in-population-health
#5
James W Begun, Sandra Potthoff
The root causes for most health outcomes are often collectively referred to as the social determinants of health. Hospitals and health systems now must decide how much to "move upstream," or invest in programs that directly affect the social determinants of health. Moving upstream in healthcare delivery requires an acceptance of responsibility for the health of populations. We examine responses of 950 nonfederal, general hospitals in the United States to the 2015 American Hospital Association Population Health Survey to identify characteristics that distinguish those hospitals that are most aligned with population health and most engaged in addressing social determinants of health...
September 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28682155/community-health-integration-through-pharmacy-process-and-ergonomics-redesign-chipper
#6
Michelle A Jahn, Barrett S Caldwell
As the expansion and utilization of community pharmacy systems increases, so does the risk for an adverse drug event to occur. In attempts to mitigate this risk, many community pharmacies implement health information technology (IT); however, there are challenges in integrating the wider systems components necessary for a successful implementation with minimal unintended consequences. The purpose of this paper is to introduce a Community Health Integration through Pharmacy Process and Ergonomics Redesign (CHIPPER) framework, which explores the multiple angles of health IT integration to support medication delivery processes in community pharmacy systems...
July 6, 2017: Ergonomics
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#7
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...
September 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28600800/women-weight-poverty-and-menopause-understanding-health-practices-in-a-context-of-chronic-disease-prevention
#8
Mélisa Audet, Alex Dumas, Rachelle Binette, Isabelle J Dionne
Socioeconomic inequalities in health persist despite major investments in illness prevention campaigns and universal healthcare systems. In this context, the increased risks of chronic diseases of specific sub-groups of vulnerable populations should be further investigated. The objective of this qualitative study is to examine the interaction between socioeconomic status (SES) and body weight in order to understand underprivileged women's increased vulnerability to chronic diseases after menopause. By drawing specifically on Pierre Bourdieu's sociocultural theory of practice, 20 semi-structured interviews were conducted from May to December of 2013 to investigate the health practices of clinically overweight, postmenopausal women living an underprivileged life in Canada...
June 10, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28583176/nurse-led-navigation-to-provide-early-palliative-care-in-rural-areas-a-pilot-study
#9
Barbara Pesut, Brenda Hooper, Marnie Jacobsen, Barbara Nielsen, Miranda Falk, Brian P O 'Connor
BACKGROUND: Few services are available to support rural older adults living at home with advancing chronic illness. The objective of this project was to pilot a nurse-led navigation service to provide early palliative support for rural older adults and their families living at home with advancing chronic illness. METHODS: Twenty-five older adults and 11 family members living with advancing chronic illness received bi-weekly home visits by a nurse navigator over a 2-year period...
June 5, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28472598/supportive-cardiology-moving-palliative-care-upstream-for-patients-living-with-advanced-heart-failure
#10
Warren Harris Lewin, Wendy Cheung, A Nina Horvath, Shana Haberman, Archna Patel, Dorothy Sullivan
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL)...
October 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28441870/protein-nanocellulose-interactions-in-paper-filters-for-advanced-separation-applications
#11
Simon Gustafsson, Levon Manukyan, Albert Mihranyan
Protein-based pharmaceutics are widely explored for healthcare applications, and 6 out of 10 best-selling drugs today are biologicals. The goal of this work was to evaluate the protein nanocellulose interactions in paper filter for advanced separation applications such as virus removal filtration and bioprocessing. The protein recovery was measured for bovine serum albumin (BSA), γ-globulin, and lysozyme using biuret total protein reagent and polyacrylamide gel electrophoresis (PAGE), and the throughput was characterized in terms of flux values from fixed volume filtrations at various protein concentrations and under worst-case experimental conditions...
May 3, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/27997996/oral-health-interventions-in-australian-aboriginal-communities-a-review-of-the-literature
#12
J Patel, A Durey, L Hearn, L M Slack-Smith
Aboriginal Australians experience significant disparities in oral health with even poorer outcomes reported in rural and remote areas. The high rates of preventable dental disease in Aboriginal communities are a serious concern from a social standpoint and in terms of service provision and health care expenditure. In this review, primary research literature was comprehensively reviewed. Papers were selected if they reported designing or implementing an intervention or oral health programme specific to the needs of Aboriginal communities...
December 20, 2016: Australian Dental Journal
https://www.readbyqxmd.com/read/27729662/-coronary-sinus-reducer-implantation-a-new-treatment-for-chronic-refractory-angina
#13
Francesco Giannini, Andrea Aurelio, Alaide Chieffo
Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease not improved by either optimal medical therapy and/or percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy. However, rehospitalization rates are high. In this subgroup of patients there is thus a clinical need for new therapies targeting an improvement of symptoms but taking into account the potential impact in terms of healthcare and costs...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27598629/the-role-of-the-genetic-elements-bla-oxa-and-is-aba-1-in-the-acinetobacter-calcoaceticus-acinetobacter-baumannii-complex-in-carbapenem-resistance-in-the-hospital-setting
#14
Vanessa Cristine Kobs, Jéssica Augustini Ferreira, Thaís Alexandra Bobrowicz, Leslie Ecker Ferreira, Roseneide Campos Deglmann, Glauco Adrieno Westphal, Paulo Henrique Condeixa de França
INTRODUCTION: Members of the Acinetobacter genus are key pathogens that cause healthcare-associated infections, and they tend to spread and develop new antibiotic resistance mechanisms. Oxacillinases are primarily responsible for resistance to carbapenem antibiotics. Higher rates of carbapenem hydrolysis might be ascribed to insertion sequences, such as the ISAba1 sequence, near bla OXA genes. The present study examined the occurrence of the genetic elements bla OXA and ISAba1 and their relationship with susceptibility to carbapenems in clinical isolates of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex...
July 2016: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/27587042/approaches-to-reducing-photon-dose-calculation-errors-near-metal-implants
#15
Jessie Y Huang, David S Followill, Rebecca M Howell, Xinming Liu, Dragan Mirkovic, Francesco C Stingo, Stephen F Kry
PURPOSE: Dose calculation errors near metal implants are caused by limitations of the dose calculation algorithm in modeling tissue/metal interface effects as well as density assignment errors caused by imaging artifacts. The purpose of this study was to investigate two strategies for reducing dose calculation errors near metal implants: implementation of metal-based energy deposition kernels in the convolution/superposition (C/S) dose calculation method and use of metal artifact reduction methods for computed tomography (CT) imaging...
September 2016: Medical Physics
https://www.readbyqxmd.com/read/27507157/using-systems-thinking-to-identify-workforce-enablers-for-a-whole-systems-approach-to-urgent-and-emergency-care-delivery-a-multiple-case-study
#16
Kim Manley, Anne Martin, Carolyn Jackson, Toni Wright
BACKGROUND: Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. METHODS: A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27436466/ges-11-producing-acinetobacter-baumannii-clinical-isolates-from-tunisian-hospitals-long-term-dissemination-of-ges-type-carbapenemases-in-north-africa
#17
H Chihi, R A Bonnin, A Bourouis, S Mahrouki, S Besbes, M Ben Moussa, O Belhadj, T Naas
Acinetobacter baumannii is an emerging threat in healthcare facilities owing to its ability to be multidrug-resistant (MDR) and to be involved in outbreaks. GES-type extended-spectrum β-lactamases (ESBLs) have been increasingly identified in A. baumannii. In this study, clinical A. baumannii isolates were characterised using standard biochemical methods and antibiotic susceptibility testing. Antibiotic resistance genes were sought by PCR and sequencing. Genetic support was characterised using S1 nuclease pulsed-field gel electrophoresis (PFGE) mapping, conjugation and electroporation assays...
June 2016: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27432017/impact-of-medication-reconciliation-at-discharge-on-continuity-of-patient-care-in-france
#18
RANDOMIZED CONTROLLED TRIAL
Mélanie Van Hollebeke, Sarah Talavera-Pons, Aurélien Mulliez, Valérie Sautou, Gilles Bommelaer, Armand Abergel, Anne Boyer
Background Care transitions from hospital to community have been identified as risk points for the continuity of patient care. Without upstream information, the community pharmacist (CP) cannot ensure error-free drug dispensing. A hospital-to-community records transmission process would enable CPs to guarantee that all prescription drugs are ready to pick up at hospital discharge, and to improve their responses to patient health inquiries. Objective To evaluate the impact of a hospital-to-CP medication records scheme on post-discharge continuity of patient treatment...
October 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27348837/public-engagement-and-nanotechnology-in-australia
#19
Sally Dalton-Brown
Upstream engagement is commonly regarded as necessary for the smooth implementation of new technologies, particularly when there is an impact on health. Is the healthcare context in Australia geared toward such public engagement? There are established engagement practices for issues of healthcare resourcing, for example; however, the situation becomes more complex with the introduction of a new technology such as nanomedicine.
July 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/27347772/psychiatric-disorders-the-psychiatrist-s-contribution-to-sport
#20
Alan Currie, Allan Johnston
Athletes experience a range of mental health problems with at least an equivalent prevalence to the general population. This chapter explores the psychiatrist's role in sport, along a pathway of mental healthcare from 'upstream' prevention, screening, and early detection of mental stress to 'downstream' assessment, treatment, rehabilitation, and recovery from mental illness. At each stage on this pathway the psychiatrist has a broad spectrum of bio-psycho-social strategies to employ in clinical practice. Upstream, the importance of psychological resilience is described along with the concept of mental 'pre-habilitation' (a term usually associated with the prevention of physical injury)...
June 27, 2016: International Review of Psychiatry
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