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https://www.readbyqxmd.com/read/28440124/perspectives-on-advance-care-planning-among-patients-recently-requiring-non-invasive-ventilation-for-acute-respiratory-failure-a-qualitative-study-using-thematic-analysis
#1
Tracy A Smith, Rebecca T Disler, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
BACKGROUND: Patients requiring non-invasive ventilation for acute-on-chronic respiratory failure due to chronic obstructive pulmonary disease or heart failure exacerbations may have a poor prognosis underscoring the importance of advance care planning. AIM: We aimed to describe attitudes to, and experiences of, discussing the future among patients recently treated with non-invasive ventilation. DESIGN: Qualitative research using thematic analysis...
June 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28439447/the-development-of-a-veterans-health-administration-emergency-management-research-agenda
#2
Aram Dobalian, Maria Claver, Deborah Riopelle, Tamar Wyte-Lake, Ismelda Canelo
INTRODUCTION: The Veterans Health Administration (VHA), the largest integrated healthcare delivery system in the United States, is charged with ensuring timely access to high-quality care for veterans during disasters, and supporting national, state, local, and tribal emergency management and homeland security efforts. In 2008, the VHA Office of Public Health (OPH) sponsored the first VHA Emergency Management Research Agenda-setting conference to develop research priorities that address the needs of veterans and to position VHA as a national leader in emergency management by having VHA serve as a "laboratory" for the development of evidence-based emergency management practices...
March 23, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28439376/-back-to-bedside-residents-and-fellows-perspectives-on-finding-meaning-in-work
#3
Dustin M Hipp, Kristy L Rialon, Kathryn Nevel, Anai N Kothari, Lcdr Dinchen A Jardine
BACKGROUND: Physician burnout is common and associated with significant consequences for physicians and patients. One mechanism to combat burnout is to enhance meaning in work. OBJECTIVE: To provide a trainee perspective on how meaning in work can be enhanced in the clinical learning environment through individual, program, and institutional efforts. METHODS: "Back to Bedside" resulted from an appreciative inquiry exercise by 37 resident and fellow members of the ACGME's Council of Review Committee Residents (CRCR), which was guided by the memoir When Breath Becomes Air by Paul Kalanithi...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439134/pharmacy-dashboard-an-innovative-process-for-pharmacy-workload-and-productivity
#4
Ashley Kinney, Quyen Bui, Jane Hodding, Jennifer Le
Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28438523/predictors-of-early-childbirth-among-female-adolescents-in-foster-care
#5
Bryn King, Melissa Van Wert
PURPOSE: Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care. METHODS: A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010...
April 21, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28435745/a-consult-service-to-support-and-promote-community-based-research-tracking-and-evaluating-a-community-based-research-consult-service
#6
Clara M Pelfrey, Katrice D Cain, Mary Ellen Lawless, Earl Pike, Ashwini R Sehgal
PURPOSE: This study describes the design, operation and evaluation of a community-based research (CBR) consult service within the setting of a Clinical and Translational Science Award (CTSA) institution. To our knowledge, there are no published evaluations of a CBR consult service at a CTSA hub. METHODS: A community-based research Consult Service was created to support faculty, health care providers/research coordinators, trainees, community-based organizations and community members...
February 2017: J Clin Transl Sci
https://www.readbyqxmd.com/read/28433444/risk-of-ocular-hypertension-in-adults-with-noninfectious-uveitis
#7
Ebenezer Daniel, Maxwell Pistilli, Srishti Kothari, Naira Khachatryan, R Oktay Kaçmaz, Sapna S Gangaputra, H Nida Sen, Eric B Suhler, Jennifer E Thorne, C Stephen Foster, Douglas A Jabs, Robert B Nussenblatt, James T Rosenbaum, Grace A Levy-Clarke, Nirali P Bhatt, John H Kempen
PURPOSE: To describe the risk and risk factors for ocular hypertension (OHT) in adults with noninfectious uveitis. DESIGN: Retrospective, multicenter, cohort study. PARTICIPANTS: Patients aged ≥18 years with noninfectious uveitis seen between 1979 and 2007 at 5 tertiary uveitis clinics. METHODS: Demographic, ocular, and treatment data were extracted from medical records of uveitis cases. MAIN OUTCOME MEASURES: Prevalent and incident OHT with intraocular pressures (IOPs) of ≥21 mmHg, ≥30 mmHg, and increase of ≥10 mmHg from documented IOP recordings (or use of treatment for OHT)...
April 19, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28431844/health-care-associated-infections-studies-project-an-american-journal-of-infection-control-and-national-healthcare-safety-network-data-quality-collaboration
#8
Henrietta Smith, Janet E Brooks, Denise Leaptrot, Katherine Allen-Bridson, Angela Anttila, Cindy Gross, Joan N Hebden, Georganne Ryan, Eileen Scalise, Marc-Oliver Wright
This case study is part of a series centered on the Centers for Disease Control and Prevention's National Healthcare Safety Network's (NHSN) health care-associated infection (HAI) surveillance definitions. The intent of the case study series is to foster standardized application of the NHSN's HAI surveillance definitions among infection preventionists and accurate determination of HAI events. This specific case study focuses on the definitions found within the surgical site infection (SSI) protocol. It aims to reflect the real life and complex patient scenario surrounding a bloodstream infection that is secondary to an SSI and the application of the Present at the Time of Surgery event detail...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#9
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28430568/reflection-based-learning-for-professional-ethical-formation
#10
William T Branch, Maura George
One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and present two case examples of our preferred method, guided group reflection using narratives. This method fosters moral development alongside professional identity formation in students and advanced learners...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28429984/partnering-to-improve-care-the-case-of-the-veterans-health-administration-s-quality-enhancement-research-initiative
#11
Alicia A Bergman, Deborah M Delevan, Isomi M Miake-Lye, Lisa V Rubenstein, David A Ganz
Background Within many large health care organizations, researchers and operations partners (i.e., policymakers, managers, clinical leaders) join to conduct studies to improve the quality of patient care. Yet optimal approaches to conducting partnership research and evaluation are only beginning to be clearly defined. The Veterans' Health Administration (VA) Quality Enhancement Research Initiative (QUERI), funded by operations leaders and administered by the VA's research service, now has nearly two decades of experience in fostering research-operations partnerships for improving quality of VA care...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#12
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28427366/network-analysis-of-global-tobacco-control-collaboration-data-from-the-world-conference-on-tobacco-or-health-wctoh
#13
Scott J Leischow, Janet Okamoto, Scott McIntosh, Deborah J Ossip, Harry A Lando
BACKGROUND: The World Conference on Tobacco or Health (WCTOH) is held every three years to foster communication and collaboration on global tobacco control. Very little is known about the nature of interactions between WCTOH attendees and their linkages to tobacco control organizations, so knowing this information could help improve tobacco control efforts. METHODS: At the 2015 WCTOH, we implemented an online survey to assess barriers to global tobacco control activities, which information sources they use for tobacco control information, and with whom they interact regarding tobacco control...
April 20, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28426909/nursing-and-pharmacy-students-use-of-emotionally-intelligent-behaviours-to-manage-challenging-interpersonal-situations-with-staff-during-clinical-placement-a-qualitative-study
#14
Andrea McCloughen, Kim Foster
AIMS AND OBJECTIVES: To identify challenging interpersonal interactions experienced by nursing and pharmacy students during clinical placement, and strategies used to manage those situations. BACKGROUND: Healthcare students and staff experience elevated stress when exposed to dynamic clinical environments, complex care, and challenging professional relationships. Emotionally intelligent behaviours are associated with appropriate recognition and management of emotions evoked by stressful experiences, and development of effective relationships...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28424052/using-implementation-facilitation-to-foster-clinical-practice-quality-and-adherence-to-evidence-in-challenged-settings-a-qualitative-study
#15
Mona J Ritchie, Louise E Parker, Carrie N Edlund, JoAnn E Kirchner
BACKGROUND: We evaluated a facilitation strategy to help clinical sites likely to experience challenges implement evidence-based Primary Care-Mental Health Integration (PC-MHI) care models within the context of a Department of Veterans Affairs (VA) initiative. This article describes our assessment of whether implementation facilitation (IF) can foster development of high quality PC-MHI programs that adhere to evidence, are sustainable and likely to improve clinical practices and outcomes...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28423928/engaging-parents-to-promote-children-s-nutrition-and-health
#16
Dipti A Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent McBride, Deepa Srivastava, Ashleigh Murriel, Chrisa Arcan, Anna M Adachi-Mejia
PURPOSE: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers' (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children's health. DESIGN: Qualitative. SETTING: State-licensed center-based childcare programs. PARTICIPANTS: Full-time childcare providers (n = 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience...
March 2017: American Journal of Health Promotion: AJHP
https://www.readbyqxmd.com/read/28422816/why-not-wait-eight-institutions-share-their-experiences-moving-united-states-medical-licensing-examination-step-1-after-core-clinical-clerkships
#17
Michelle Daniel, Amy Fleming, Colleen O'Conner Grochowski, Vicky Harnik, Sibel Klimstra, Gail Morrison, Arnyce Pock, Michael L Schwartz, Sally Santen
The majority of medical students complete the United States Medical Licensing Examination Step 1 after their foundational sciences; however, there are compelling reasons to examine this practice. This article provides the perspectives of eight MD-granting medical schools that have moved Step 1 after the core clerkships, describing their rationale, logistics of the change, outcomes, and lessons learned. The primary reasons these institutions cite for moving Step 1 after clerkships are to foster more enduring and integrated basic science learning connected to clinical care and to better prepare students for the increasingly clinical focus of Step 1...
April 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#18
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28420945/controversies-and-recent-developments-of-the-low-fodmap-diet
#19
Peta Hill, Jane G Muir, Peter R Gibson
The low-fermentable oligo-, di-, and monosaccharide and polyol (FODMAP) diet is a 2-phased intervention, with strict reduction of all slowly absorbed or indigestible short-chain carbohydrates (ie, FODMAPs) followed by reintroduction of specific FODMAPs according to tolerance. The efficacy of the elimination phase of the FODMAP diet is well established, but the success of maintaining this diet has been shown in only a few observational studies. How the efficacy of the low-FODMAP diet compares with that of other therapies has received limited attention, but recent studies have shown this diet to be comparable or superior to diets that address eating style and choice of food as well as to gut hypnotherapy...
January 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28420438/distance-traveled-for-medicaid-covered-abortion-care-in-california
#20
Nicole E Johns, Diana Greene Foster, Ushma D Upadhyay
BACKGROUND: Access to abortion care in the United States is limited by the availability of abortion providers and their geographic distribution. We aimed to assess how far women travel for Medicaid-funded abortion in California and identify disparities in access to abortion care. METHODS: We obtained data on all abortions reimbursed by the fee-for-service California state Medicaid program (Medi-Cal) in 2011 and 2012 and examined distance traveled to obtain abortion care by several demographic and abortion-related factors...
April 19, 2017: BMC Health Services Research
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