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Healthcare management

L Clifford McDonald, Dale N Gerding, Stuart Johnson, Johan S Bakken, Karen C Carroll, Susan E Coffin, Erik R Dubberke, Kevin W Garey, Carolyn V Gould, Ciaran Kelly, Vivian Loo, Julia Shaklee Sammons, Thomas J Sandora, Mark H Wilcox
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis...
March 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
David Sturgeon
Over the past four decades, UK governments have moved towards an increasingly pro-market model of healthcare provision. Under this system, patients are not only encouraged, but expected, to take increasing responsibility for healthcare decision-making and the risks that it might entail. This article investigate how and why patients make choices about their health care and how service providers help facilitate this. Between October 2014 and May 2015, the researcher was embedded as an emergency nurse practitioner at two minor injury units in order to undertake direct and participant observation...
March 22, 2018: British Journal of Nursing: BJN
Camila Fronzo
Improving the patient experience often involves changing aspects of service delivery. Hollister Education organised a symposium designed to help clinical nurse specialists in urology implement vitally needed change. Camila Fronzo, Editorial Project Manager and Coordinator, MA Healthcare, describes its themes.
March 1, 2018: British Journal of Nursing: BJN
Roxanne C Oriel, Julie Wang
PURPOSE OF REVIEW: The aim of this review is to describe effective management strategies in nursery or school based upon research findings. RECENT FINDINGS: The prevalence of food allergy and number of emergency department visits for food-related anaphylaxis are increasing in children and adolescents. As there is currently no cure, the most effective strategy to decrease allergic reactions is food allergen avoidance. However, allergic reactions are inevitable in both food allergic children as well as in first-time reactors...
March 20, 2018: Current Opinion in Allergy and Clinical Immunology
Mary Lavelle, Jennifer Abthorpe, Thomas Simpson, Gabriel Reedy, Fiona Little, Anita Banerjee
The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49)...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
A C L Holden
The rise and persistence of a commercial model of healthcare and the potential shift towards the commodification of dental services, provided to consumers, should provoke thought about the nature and purpose of dentistry and whether this paradigm is cause for concern. Within this article, whether dentistry is a commodity and the legitimacy of dentistry as a business is explored and assessed. Dentistry is perceived to be a commodity, dependent upon the context of how services are to be provided and the interpretation of the patient-professional relationship...
March 20, 2018: Medicine, Health Care, and Philosophy
Faisal Akhtar, Sabah Rehman
Hepatitis B and Hepatitis C have been major disease-causing agents among humans since they were discovered in the 1960s. Both cause jaundice-like symptoms initially but their prognosis and treatment are somehow different and depend upon many demographic details, such as the age and susceptibility of the patients and any other comorbid conditions. They clinically present primarily with hepatitis and can have many adverse effects or even be life-threatening at times, if not treated properly. However, their epidemiological background and findings in terms of morbidity, mortality, and case fatality rates are different...
January 16, 2018: Curēus
David M Cline, Susan Silva, Caroline E Freiermuth, Victoria Thornton, Paula Tanabe
Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis (VOC), such as a day hospital (DH) or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce 30-day readmission rates. Methods: In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD) VOC, we prospectively compared acute care encounters for utilization of 1) emergency department (ED); 2) ED observation unit; 3) DH, and 4) hospital admission, of two different patient cohorts with SCD presenting to our two study sites...
March 2018: Western Journal of Emergency Medicine
Eboni G Price-Haywood, Wanda Robinson, Jewel Harden-Barrios, Jeffrey Burton, Todd Burstain
Background: Opioid prescription drug abuse is a major public health concern. Healthcare provider prescribing patterns, especially among non-pain management specialists, are a major factor. Practice guidelines recommend what to do for safe opioid prescribing but do not provide guidance on how to implement best practices. Methods: We describe the implementation of electronic medical record clinical decision support (EMR CDS) for opioid management of chronic noncancer pain in an integrated delivery system...
2018: Ochsner Journal
Hashem B El-Serag, John Y Kao, Fasiha Kanwal, Mark Gilger, Frank LoVecchio, Steven F Moss, Sheila Crowe, Adam Elfant, Thomas Haas, Ron Hapke, David Y Graham
Despite guidelines for detection and treatment of Helicobacter pylori infection, recommendations to test patients before and after therapy are commonly not followed in the United States (US). At the Houston Consensus Conference, 11 experts on management of adult and pediatric patients with H pylori, from different geographic regions of the US, met to discuss key factors in diagnosis of H pylori infection, including identification of appropriate patients for testing, effects of antibiotic susceptibility on testing and treatment, appropriate methods for confirmation of infection and eradication, and relevant health system considerations...
March 17, 2018: Clinical Gastroenterology and Hepatology
Bas Geboers, Ellen Uiters, Sijmen A Reijneveld, Carel J M Jansen, Josué Almansa, Astrid C J Nooyens, W M Monique Verschuren, Andrea F de Winter, H Susan J Picavet
BACKGROUND: Many older adults have low levels of health literacy which affects their ability to participate optimally in healthcare. It is unclear how cognitive decline contributes to health literacy. To study this, longitudinal data are needed. The aim of this study was therefore to assess the associations of cognitive functioning and 10-years' cognitive decline with health literacy in older adults. METHODS: Data from 988 participants (mean age = 65.3) of the Doetinchem Cohort Study were analyzed...
March 20, 2018: BMC Geriatrics
Judy Tan, Anita Mehrotra, Girish N Nadkarni, John Cijiang He, Erik Langhoff, James Post, Carlos Galvao-Sobrinho, Henry C Thode, Rajeev Rohatgi
BACKGROUND: Chronic kidney disease (CKD) patients who live far (>30 miles) from their nephrologist experience lower rates of clinic visit adherence, limited access to treatment, and higher rates of hospitalization and mortality than patients who live in close proximity to their nephrologist. Strategies to minimize disparities between urban and remotely located CKD patients are needed. The purpose of this study was to determine whether adherence to clinic visits and clinical outcomes in the remote management of CKD via telenephrology is comparable to in-person conventional care...
March 20, 2018: American Journal of Nephrology
Peter J Carr, Niall S Higgins, Marie L Cooke, Gabor Mihala, Claire M Rickard
BACKGROUND: Most people admitted to hospitals worldwide require a vascular access device (VAD). Hundreds of millions of VADs are inserted annually in the USA with reports of over a billion peripheral intravenous catheters used annually worldwide. Numerous reports suggest that a team approach for the assessment, insertion, and maintenance of VADs improves clinical outcomes, the patient experience, and healthcare processes. OBJECTIVES: To compare the use of the vascular access specialist team (VAST) for VAD insertion and care to a generalist model approach for hospital or community participants requiring a VAD in terms of insertion success, device failure, and cost-effectiveness...
March 20, 2018: Cochrane Database of Systematic Reviews
Alessandro di Luca, Giuseppe Vetrugno, Vincenzo Lorenzo Pascali, Antonio Oliva, Al Ozonoff
OBJECTIVES: Italy is experiencing a crisis of malpractice litigation with important repercussions on the insurance industry (e.g., lower profits), physicians (e.g., defensive medicine), and the courts (e.g., work backlog, lengthy proceedings). We searched for common ground between legal systems in Italy and the United States and considered the implications for international collaborations in patient safety. METHODS: We examined the judicial frameworks of medical malpractice litigation in two countries with different legal foundations: the United States (a public-private system governed by common law) and Italy (a publicly financed healthcare system governed by civil law)...
March 19, 2018: Journal of Patient Safety
Rashi I Mehta, Rupal I Mehta
Hydrophilic polymers are ubiquitously applied as surface coatings on catheters and intravascular medical technologies. Recent clinical literature has heightened awareness on the complication of hydrophilic polymer embolism, the phenomenon wherein polymer coating layers separate from catheter and device surfaces, and may be affiliated with a range of unanticipated adverse reactions. Significant system barriers have limited and delayed reporting on this iatrogenic complication, the full effects of which remain underrecognized by healthcare providers and manufacturers of various branded devices...
March 19, 2018: Journal of Patient Safety
Aine Cafferkey, Elizabeth Coyle, David Greaney, Sinead Harte, Niamh Hayes, Miriam Langdon, Birgitt Straub, Crina Burlacu
BACKGROUND: Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. AIMS: Describe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants' feedback...
March 20, 2018: Irish Journal of Medical Science
Abdurrazaq Olanrewaju Taiwo, Ramat Oyebunmi Braimah, Adebayo Aremu Ibikunle, Mutiat Feyisetan Obileye, Nma Muhammed Jiya, Saddiku Malami Sahabi, Idris Kabiru Jaja
Background: Maxillofacial tumours in children and adolescents have been documented worldwide; however, few studies were reported from Africa, especially sub-Saharan Africa. In Nigeria, most of the studies emanated from the Southwest region. Aim: To present an audit of clinicopathologic features and treatment of orofacial tumours in children and adolescents in Sokoto, Northwest Nigeria. Patients and Methods: Clinicopathologic records of the Departments of Dental and Maxillofacial Surgery, Paediatrics and Histopathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, were reviewed for all the oral and maxillofacial tumours managed in children <19 years from January 2011 to December 2015...
July 2017: African Journal of Paediatric Surgery: AJPS
M Ruggeri, M Basile, C Drago, F R Rolli, A Cicchetti
BACKGROUND: Until very recently the only therapeutic alternative for the management of patients affected by gout/hyperuricemia that did not respond to a first-line treatment based on allopurinol alone or who cannot tolerate allopurinol was febuxostat, a xanthine oxidase non-purine-selective inhibitor. Lately, however, a new therapeutic alternative has become available for the management of this pathology: lesinurad, a urate transporter inhibitor. OBJECTIVE: To objective of this study was to evaluate the cost effectiveness of lesinurad/allopurinol in comparison with febuxostat as a second-line therapeutic strategy for the management of patients affected by gout and hyperuricemia that did not respond to a first-line therapy based on allopurinol alone...
March 19, 2018: PharmacoEconomics
Eloise M Biggs, Niladri Gupta, Sukanya D Saikia, John M A Duncan
This article provides summary data regarding tea production in Assam, India. Questionnaires were completed by tea producers and focus group discussions undertaken with tea workers. These data are presented for the four main tea growing regions of the state (Cachar, North Bank, South Bank and Upper Assam). Tables detail tea production characteristics of the tea plantations for both large- (> 10 ha) and small- (< 10 ha) holders. Figures provide supplementary information for research by Biggs et al. [1] regarding fertilizer application, landscape management strategies, healthcare provisioning and educational facilities within plantations, as well as detailing the livelihood dimensions of tea workers...
April 2018: Data in Brief
Mitchell Kuss, Jiyoung Kim, Dianjun Qi, Shaohua Wu, Yuguo Lei, Soonkyu Chung, Bin Duan
Obesity and its related health complications cause billions of dollars in healthcare costs annually in the United States, and there are yet to be safe and long-lasting anti-obesity approaches. Using brown adipose tissue (BAT) is a promising approach, as it uses fats for energy expenditure. However, the effect of the microenvironment on human thermogenic brown adipogenesis and how to generate clinically relevant sized and functioning BAT are still unknown. In our current study, we evaluated the effects of endothelial growth medium exposure on brown adipogenesis of human brown adipose progenitors (BAP)...
March 16, 2018: Acta Biomaterialia
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