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https://www.readbyqxmd.com/read/28351063/from-communication-skills-to-skillful-communication-a-longitudinal-integrated-curriculum-for-critical-care-medicine-fellows
#1
Amanda L Roze des Ordons, Christopher J Doig, Philippe Couillard, Jason Lord
PROBLEM: Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. APPROACH: In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350638/short-term-impact-of-meaningful-use-stage-1-implementation-a-comparison-of-health-outcomes-in-2-primary-care-clinics
#2
Anna M Afonso, Susana Alfonso, Toyosi O Morgan
We studied a primary care clinic transitioning to Meaningful Use stage 1 and a comparison clinic within the same health system. In the 6 months following implementation, after adjusting for confounders, mean systolic blood pressure worsened (+3.3 mm Hg; P = .004) in the intervention clinic compared with the comparison clinic. We did not see a change in the mean or proportion of patients meeting target goals for diabetes (hemoglobin A1c) or obesity (body mass index). Our findings suggest that the worsening of systolic blood pressure associated with Meaningful Use implementation is likely due to distractions of system changes negatively impacting health outcomes...
March 27, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28346946/association-between-a-virtual-glucose-management-service-and-glycemic-control-in-hospitalized-adult-patients-an-observational-study
#3
Robert J Rushakoff, Mary M Sullivan, Heidemarie Windham MacMaster, Arti D Shah, Alvin Rajkomar, David V Glidden, Michael A Kohn
Background: Inpatient hyperglycemia is common and is linked to adverse patient outcomes. New methods to improve glycemic control are needed. Objective: To determine whether a virtual glucose management service (vGMS) is associated with improved inpatient glycemic control. Design: Cross-sectional analyses of three 12-month periods (pre-vGMS, transition, and vGMS) between 1 June 2012 and 31 May 2015. Setting: 3 University of California, San Francisco, hospitals...
March 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28345977/spinal-cord-injuries-overcoming-barriers-to-seamless-care-for-patients
#4
Lorraine Donovan, Lee Francis, Paula Muter, Sheila Nevin, Rebecca Warren
Patients with spinal cord injuries (SCIs) often have complex needs that require multidisciplinary support in specialist centres. Optimal management depends on seamless transitions between service providers. Delays at any point potentially compromise clinical outcomes and efficient resource utilisation. The Spinal Advisory Working Group aims to develop and implement practical initiatives to improve SCI care, initially focusing on admission and discharge. A literature review identified few relevant papers. In addition, the generalisability of the findings of these papers to SCI centres in the UK is unclear...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28345341/positron-annihilation-spectroscopic-investigation-on-the-origin-of-temperature-dependent-electrical-response-in-methylammonium-lead-iodide-perovskite
#5
Joydeep Dhar, Sayantan Sil, Arka Dey, Partha Pratim Ray, Dirtha Sanyal
Organic-inorganic hybrid perovskite has appeared as one of the leading materials for realizing solution based high performing optoelectronic devices. The charge properties in this class of material are quite intriguing and still need to be carefully investigated. The temperature dependent electrical property of methylammonium lead iodide (CH3NH3PbI3) has been investigated by employing positron annihilation spectroscopy (PAS) which unambiguously reveals the gradual formation of open volume defects with the enhancement in temperature...
March 27, 2017: Journal of Physical Chemistry Letters
https://www.readbyqxmd.com/read/28344713/exploring-the-experience-of-residents-during-the-first-six-months-of-family-medicine-residency-training
#6
Dawn Martin, Louise Nasmith, Susan Glover Takahashi, Bart J Harvey
BACKGROUND: The shift from undergraduate to postgraduate education signals a new phase in a doctor's training. This study explored the resident's perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. METHODS: Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28344600/staged-reconstruction-brachytherapy-has-lower-overall-cost-in-recurrent-soft-tissue-sarcoma
#7
Arash O Naghavi, Ricardo J Gonzalez, Jacob G Scott, Youngchul Kim, Yazan A Abuodeh, Tobin J Strom, Michelle Echevarria, John E Mullinax, Kamran A Ahmed, Louis B Harrison, Daniel C Fernandez
PURPOSE: Adjuvant brachytherapy (AB) with immediate (IR) and staged reconstruction (SR) are distinct treatment modalities available for patients with recurrent soft tissue sarcoma (STS). Although SR may offer local control and toxicity benefit, it requires additional upfront procedures, and there is no evidence that it improves overall survival. With the importance of value-based care, our goal is to identify which technique is more cost effective. MATERIAL AND METHODS: A retrospective review of 22 patients with recurrent extremity STS treated with resection followed by AB alone...
February 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28344514/australia-s-first-transition-to-professional-practice-in-primary-care-program-for-graduate-registered-nurses-a-pilot-study
#8
Christina Aggar, Jacqueline Bloomfield, Tamsin H Thomas, Christopher J Gordon
BACKGROUND: Increases in ageing, chronic illness and complex co-morbidities in the Australian population are adding pressure to the primary care nursing workforce. Initiatives to attract and retain nurses are needed to establish a sustainable and skilled future primary care nursing workforce. We implemented a transition to professional practice program in general practice settings for graduate nurses and evaluated graduate nurse competency, the graduate nurse experience and program satisfaction...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28344147/evaluation-of-deprescribing-amiodarone-after-new-onset-atrial-fibrillation-in-critical-illness
#9
Areerut Leelathanalerk, Wannisa Dongtai, Yvonne Huckleberry, Brian Kopp, John Bloom, Joseph Alpert
BACKGROUND: Recent studies have shed light on the continued prescription of inpatient medications upon hospital discharge despite the original intent of short-term inpatient therapy. Amiodarone, an antiarrhythmic associated with significant adverse effects with long-term use, is commonly used for new-onset atrial fibrillation in critical illness (NAFCI). While it is often preferred in this setting of hemodynamic instability, a prescription for long-term use should be carefully considered, preferably by a cardiologist...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28343444/a-pilot-study-for-antimicrobial-stewardship-post-discharge
#10
Justin M Jones, Nathan D Leedahl, Ashley Losing, Paul J Carson, David D Leedahl
PURPOSE: Lack of patient follow-up is a major concern during care transitions, and the role of an antimicrobial stewardship program (ASP) in assessing antimicrobial regimens after hospital discharge is not well described. We implemented an expanded ASP to include patients recently discharged from the hospital and measured its impact on inappropriate antimicrobial therapy 72 hours after inpatient culture data were finalized. METHODS: A prospective cohort study was conducted at a 583-bed tertiary care center in the Upper Midwest of America...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28343443/lacosamide-induced-recurrent-ventricular-tachycardia-in-the-acute-care-setting
#11
Theodore J Berei, Matthew P Lillyblad, Adrian K Almquist
Lacosamide is a new-generation antiepileptic drug (AED) most commonly used adjunctively in the setting of partial-onset seizures refractory to traditional therapy. We describe the first case report, to our knowledge, of a patient who developed recurrent, sustained ventricular tachycardia with multiple administrations of lacosamide in an acute setting. A 70-year-old woman with a history significant for valvular heart disease was admitted to the inpatient cardiology service for worsening heart failure. On hospital day 7, she received a bioprosthetic aortic valve...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28342833/a-high-density-cho-s-transient-transfection-system-comparison-of-expicho-and-expi293
#12
Nina K Jain, Susan Barkowski-Clark, Richard Altman, Krista Johnson, Fang Sun, Jonathan Zmuda, Chao Yan Liu, Adriana Kita, Ryan Schulz, Alyssa Neill, Robert Ballinger, Rekha Patel, Jian Liu, Alinafe Mpanda, Brian Huta, Henry Chiou, Walter Voegtli, Tadas Panavas
Chinese Hamster Ovary (CHO) cells are the principal mammalian host used for stable cell line generation and biotherapeutic protein production. Until recently, production of milligrams to grams of protein in CHO transient systems was challenging. As such, Human Embryonic Kidney (HEK293) cells are the most common mammalian cell type used for transient transfection. The post-translational modifications (PTMs) of a protein are dictated in part by the cell line used for expression, and changes in PTMs have been shown to affect both the activity and biophysical properties of proteins...
March 22, 2017: Protein Expression and Purification
https://www.readbyqxmd.com/read/28342775/the-cash-and-counseling-model-of-self-directed-long-term-care-effectiveness-with-young-adults-with-disabilities
#13
Melissa L Harry, Kevin J Mahoney, Ellen K Mahoney, Ce Shen
BACKGROUND: Young adults with disabilities face numerous barriers to independence and achieving markers of adulthood. Qualitative evidence suggests that flexible, self-directed budgets for purchasing home and community-based services might help fill an identified service gap and help improve the transition to adulthood for this group. OBJECTIVE: Our aim was to evaluate the effectiveness of the Cash and Counseling model of self-directed budgets for young adults with long-term care disabilities by analyzing secondary data from the Cash and Counseling Demonstration and Evaluation randomized control trial...
March 10, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28342709/transitioning-from-pediatric-to-adult-care-after-thoracic-transplantation
#14
Adam Putschoegl, Anne I Dipchand, Heather Ross, Cecilia Chaparro, Jonathan N Johnson
With improving outcomes after thoracic transplantation, more children are surviving to adulthood and requiring specialized adult care. A systematic and effective program is essential to transition these patients from a pediatric to adult health care setting. In this review, we discuss the concept of transition and the factors leading to an effective transfer to an adult care provider, including administrative support, patient/provider preparation, and the navigation of potential barriers. Notably, there is a paucity of data for many details of transition, making this a significant opportunity for future research...
February 28, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28342621/how-nurse-led-practices-perceive-implementation-of-the-patient-centered-medical-home
#15
Rosemary Frasso, A Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-McArthur, Michelle Miller-Day, Robert Gabbay, Peter F Cronholm
PURPOSE: The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. METHODS: Data were collected through in-depth interviews with providers and staff in nurse-led practices...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342618/a-realist-synthesis-of-social-connectivity-interventions-during-transition-to-parenthood-the-value-of-relationships
#16
Claudine T Bennett, Judy L Buchan, Nicole Letourneau, Stuart G Shanker, Anne Fenwick, Brenda Smith-Chant, Cyndi Gilmer
BACKGROUND: Social connections are important during the transition to parenthood. A wide body of literature suggests that these connections enhance health and contribute to wellbeing. In the case of parents and families, social connections can influence child development. Nurses and public health agencies are in a unique position to advocate for resources and approaches to enhance social connectivity for parents during this important life transition. OBJECTIVES: The aim of this review was to identify the universal social connectivity interventions that work, and the conditions that foster social connections for parents and enhance child development...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342132/endoscopic-mucosal-resection-versus-esophagectomy-for-intramucosal-adenocarcinoma-in-the-setting-of-barrett-s-esophagus
#17
Chao Li, Denise Tami Yamashita, Jeffrey David Hawel, Drew Bethune, Harry Henteleff, James Ellsmere
BACKGROUND: Esophagectomy has been the standard of care for patients with intramucosal adenocarcinoma (IMC) in the setting of Barrett's esophagus. It is, however, associated with significant post-operative morbidity and mortality. Endoscopic mucosal resection (EMR) offers a minimally invasive approach with lesser morbidity. This study investigates the transition from esophagectomy to EMR for IMC with respect to eradication rates, post-operative morbidity, and long-term survival. METHODS: Patients diagnosed with IMC from 2005 to 2013 were identified retrospectively...
March 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28341689/designing-a-physical-activity-intervention-for-children-with-asthma-a-qualitative-study-of-the-views-of-healthcare-professionals-parents-and-children-with-asthma
#18
Russell Jago, Aidan Searle, A John Henderson, Katrina M Turner
OBJECTIVES: Qualitative methods were used to examine: (1) the attitudes of health professionals to promoting physical activity for children with asthma; (2) reasons why children with asthma are less active and (3) how a physical activity programme for children with asthma could be designed. DESIGN: Semistructured interviews were conducted with health professionals, children with asthma and their parents between October 2015 and March 2016. Interviews were transcribed verbatim and thematically analysed...
March 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28341615/design-and-usability-of-a-heart-failure-mhealth-system-a-pilot-study
#19
Nagla Alnosayan, Samir Chatterjee, Ala Alluhaidan, Edward Lee, Linda Houston Feenstra
BACKGROUND: Despite the advances in mobile health (mHealth) systems, little is known about patients' and providers' experiences using a new mHealth system design. OBJECTIVE: This study aimed to understand challenges and provide design considerations for a personalized mHealth system that could effectively support heart failure (HF) patients after they transition into the home environment. METHODS: Following exploratory interviews with nurses and preventive care physicians, an mHealth system was developed...
March 24, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#20
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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