keyword
MENU ▼
Read by QxMD icon Read
search

Clinical decision unit

keyword
https://www.readbyqxmd.com/read/28647160/a-clinical-decision-rule-to-predict-zygomatico-maxillary-fractures
#1
Simon Haworth, Anthony Bates, Andrea Beech, Greg Knepil
Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation...
May 25, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28646876/not-all-waits-are-equal-an-exploratory-investigation-of-emergency-care-patient-pathways
#2
Dawn Swancutt, Sian Joel-Edgar, Michael Allen, Daniel Thomas, Heather Brant, Jonathan Benger, Richard Byng, Jonathan Pinkney
BACKGROUND: Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Stream Mapping (VSM) to investigate care processes and delays in patient journeys at four contrasting hospitals...
June 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28645982/a-multicentre-randomised-controlled-non-inferiority-trial-comparing-nasal-high-flow-with-nasal-continuous-positive-airway-pressure-as-primary-support-for-newborn-infants-with-early-respiratory-distress-born-in-australian-non-tertiary-special-care-nurseries
#3
Brett J Manley, Calum T Roberts, Gaston R B Arnolda, Ian M R Wright, Louise S Owen, Kim M Dalziel, Jann P Foster, Peter G Davis, Adam G Buckmaster
INTRODUCTION: Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. METHODS AND ANALYSIS: The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645969/protocol-for-the-residents-in-action-pilot-cluster-randomised-controlled-trial-riat-evaluating-a-behaviour-change-intervention-to-promote-walking-reduce-sitting-and-improve-mental-health-in-physically-inactive-older-adults-in-retirement-villages
#4
Cecilie Thøgersen-Ntoumani, Ashlene Wright, Eleanor Quested, Elissa Burton, Keith D Hill, Ester Cerin, Stuart J H Biddle, Nikos Ntoumanis
INTRODUCTION: Ageing is accompanied by increased risks of chronic disease, declined functioning and increased dependency. Physical activity is critical to retaining health and independence, but the majority of older people are insufficiently physically active to achieve these benefits and have high levels of sedentary (sitting) time. Activity programmes are often offered in retirement villages; however, their uptake is limited. Furthermore, although the physical environment in and around these villages can play an important role in decisions to be physically active, its role is often overlooked by research in these settings...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28640510/paediatric-intensive-care-nurses-decision-making-around-gastric-residual-volume-measurement
#5
Lyvonne N Tume, Lynne Latten, Lindsay Kenworthy
BACKGROUND: Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS: We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS: This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK...
June 22, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28639944/clinical-impact-and-efficacy-of-bedside-echocardiography-on-patient-management-in-pediatric-intensive-care-units-picus-a-prospective-study
#6
Sanliay Şahin, Mutlu Uysal Yazıcı, Ganime Ayar, Tülin Köksal, İbrahim İlker Çetin, Filiz Ekici, Abdullah Kocabaş
OBJECTIVE: To determine the indication and necessity of echocardiographic assessment and therapeutic interventions in critically ill children. METHODS: A total of 140 children, including 75 mechanically ventilated (MV) and 65 spontaneously breathing (SB) children, who were admitted consecutively from March to August 2013 were evaluated prospectively. Data regarding the indication for echocardiography and therapeutic approaches used were documented. For evaluating disease severity, the Pediatric Risk of Mortality Score III (PRISM) was ascertained...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28639478/relation-between-capacity-and-performance-in-paediatric-upper-limb-prosthesis-users
#7
Helen Lindner, Ayako Hiyoshi, Liselotte Hermansson
BACKGROUND: The International Classification of functioning, disability and health refers capacity to what an individual can do in a standardised environment and describes performance as what an individual really does and whether the individual encounters any difficulty in the real-life environment. Measures of capacity and performance can help to determine if there is any gap between them that may restrict participation. The aim of this study was to explore the relationship between capacity scores obtained in a standardised clinical setting and proportional ease of performance obtained from a real-life environment...
June 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28633409/the-effect-of-pd-l1-testing-on-the-cost-effectiveness-and-economic-impact-of-immune-checkpoint-inhibitors-for-the-second-line-treatment-of-nsclc
#8
P N Aguiar, L Perry, J Penny-Dimr, H Babiker, H Tadokoro, R A de Mello, G L Lopes
Background: Immune checkpoint inhibitors improve outcomes compared to chemotherapy in lung cancer. Tumor PD-L1 receptor expression is being studied as a predictive biomarker. The objective of this study was to assess the cost-effectiveness and economic impact of second-line treatment with nivolumab, pembrolizumab, and atezolizumab with and without the use of PD-L1 testing for patient selection. Design: We developed a decision-analytic model to determine the cost-effectiveness of PD-L1 assessment and second-line immunotherapy versus docetaxel...
June 15, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28625374/change-the-management-of-patients-with-heart-failure-rationale-and-design-of-the-champ-hf-registry
#9
Adam D DeVore, Laine Thomas, Nancy M Albert, Javed Butler, Adrian F Hernandez, J Herbert Patterson, John A Spertus, Fredonia B Williams, Stuart J Turner, Wing W Chan, Carol I Duffy, Kevin McCague, Xiaojuan Mi, Gregg C Fonarow
Heart failure (HF) with reduced ejection fraction (HFrEF) is a common and costly condition that diminishes patients' health status and confers a poor prognosis. Despite the availability of multiple guideline-recommended pharmacologic and cardiac device therapies for patients with chronic HFrEF, outcomes remain suboptimal. Currently, there is limited insight into the rationale underlying clinical decisions by health care providers and patient factors that guide the use and intensity of outpatient HF treatments...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28624294/patient-decision-aids-for-patients-considering-total-joint-replacement-a-cost-effectiveness-analysis-alongside-a-randomised-controlled-trial-rct
#10
L Trenaman, D Stacey, S Bryan, M Taljaard, G Hawker, G Dervin, P Tugwell, N Bansback
BACKGROUND: Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether to undergo total joint arthroplasty (TJA). Patient decision aids can support SDM; however, they may incur an upfront cost. We aimed to estimate the health and economic effects of patient decision aids for TJA. METHODS: A cost-effectiveness analysis of a randomised controlled trial (RCT) with 2-year follow-up...
June 15, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28618868/appropriate-use-criteria-for-hyaluronic-acid-in-the-treatment-of-knee-osteoarthritis-in-the-united-states
#11
Arup K Bhadra, Roy Altman, Vinod Dasa, Karen Myrick, Jeffrey Rosen, Vijay Vad, Peter Vitanzo, Michelle Bruno, Hillary Kleiner, Caryn Just
OBJECTIVE: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. METHODS: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy...
July 2017: Cartilage
https://www.readbyqxmd.com/read/28617950/effect-of-cross-linked-vs-non-cross-linked-collagen-membranes-on-bone-a-systematic-review
#12
REVIEW
J Jiménez Garcia, S Berghezan, J M M Caramês, M M Dard, D N S Marques
The aim of this study was to conduct a systematic review to compare the clinical outcomes of two different resorbable collagen membranes in terms of regenerated bone volume, postoperative complications and membrane degradation during bone regeneration procedures. Randomized controlled trials (RCT) or controlled trials (CT) that compared both techniques were reviewed on four electronic databases up to December 2015, a manual search was performed on the bibliography of the collected articles and the authors were contacted for additional references if undetected on the electronic and manual search...
June 15, 2017: Journal of Periodontal Research
https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#13
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28616747/criteria-for-failure-and-worsening-after-surgery-for-lumbar-disc-herniation-a-multicenter-observational-study-based-on-data-from-the-norwegian-registry-for-spine-surgery
#14
David A T Werner, Margreth Grotle, Sasha Gulati, Ivar M Austevoll, Greger Lønne, Øystein P Nygaard, Tore K Solberg
PURPOSE: In clinical decision-making, it is crucial to discuss the probability of adverse outcomes with the patient. A large proportion of the outcomes are difficult to classify as either failure or success. Consequently, cutoff values in patient-reported outcome measures (PROMs) for "failure" and "worsening" are likely to be different from those of "non-success". The aim of this study was to identify dichotomous cutoffs for failure and worsening, 12 months after surgical treatment for lumbar disc herniation, in a large registry cohort...
June 14, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28611873/the-economics-of-an-admissions-holding-unit
#15
Kraftin E Schreyer, Richard Martin
INTRODUCTION: With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED) are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care. METHODS: This was a three-phase study at a busy urban teaching center with significant walkout rate...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28603881/early-palliative-care-for-adults-with-advanced-cancer
#16
REVIEW
Markus W Haun, Stephanie Estel, Gerta Rücker, Hans-Christoph Friederich, Matthias Villalobos, Michael Thomas, Mechthild Hartmann
BACKGROUND: Incurable cancer, which often constitutes an enormous challenge for patients, their families, and medical professionals, profoundly affects the patient's physical and psychosocial well-being. In standard cancer care, palliative measures generally are initiated when it is evident that disease-modifying treatments have been unsuccessful, no treatments can be offered, or death is anticipated. In contrast, early palliative care is initiated much earlier in the disease trajectory and closer to the diagnosis of incurable cancer...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28599817/user-centered-design-to-improve-clinical-decision-support-in-primary-care
#17
Julian Brunner, Emmeline Chuang, Caroline Goldzweig, Cindy L Cain, Catherine Sugar, Elizabeth M Yano
BACKGROUND: A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations...
August 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28599216/fuzzy-risk-stratification-and-risk-assessment-model-for-clinical-monitoring-in-the-icu
#18
Albion Dervishi
BACKGROUND: The decisions that clinicians make in intensive care units (ICUs) based on monitored parameters reflecting physiological deterioration are of major medical and biomedical engineering interest. These parameters have been investigated and assessed for their usefulness in risk assessment. METHODS: Totally, 127 ICU adult patients were studied. They were selected from a MIMIC II Waveform Database Matched Subset and had continuous monitoring of heart rate, invasive blood pressure, and oxygen saturation...
June 2, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28595613/developing-and-evaluating-multimedia-information-resources-to-improve-engagement-of-children-adolescents-and-their-parents-with-trials-treca-study-study-protocol-for-a-series-of-linked-randomised-controlled-trials
#19
Jacqueline Martin-Kerry, Peter Bower, Bridget Young, Jonathan Graffy, Rebecca Sheridan, Ian Watt, Paul Baines, Catherine Stones, Jennifer Preston, Steven Higgins, Carrol Gamble, Peter Knapp
BACKGROUND: Randomised controlled trials are widely established as the best method for testing health interventions whilst minimising bias. However, recruitment and subsequent retention of children and adolescents in healthcare trials is challenging. Participant information sheets are often lengthy and difficult to read and understand. Presenting key information using multimedia may help to overcome these limitations and better support young people and their parents in deciding whether to participate in a clinical trial...
June 8, 2017: Trials
https://www.readbyqxmd.com/read/28594213/assessing-credible-fear-a-psychometric-examination-of-the-trauma-symptom-inventory-2-in-the-context-of-immigration-court-evaluations
#20
Sarah Filone, David DeMatteo
Recent immigration trends indicate that the United States is home to a remarkably diverse and rapidly growing population of displaced persons. Many of these individuals have survived exceptional trauma and are thus particularly vulnerable to trauma-related behavioral health disorders. Mental health professionals are commonly asked to assess immigrants within this population in the service of immigration court decision making. These assessments present a variety of challenges for clinicians, including the assessment and documentation of trauma-related symptoms across cultural bounds...
June 2017: Psychological Assessment
keyword
keyword
53961
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"