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Quality measures emergency

Lauren L Drogos, Stephanie J Gill, Amanda V Tyndall, Jill K Raneri, Jillian S Parboosingh, Aileen Naef, Kyle D Guild, Gail Eskes, Patrick J Hanly, Marc J Poulin
BACKGROUND: It has been estimated that the prevalence of Alzheimer disease (AD) and related dementias will triple by 2035, unless effective interventions or treatments are found for the neurodegenerative disease. Understanding sleep changes as a marker for both AD risk and progression is a burgeoning area of investigation. Specifically, there is emerging evidence that both sleep disturbances and the APOE ε4 allele are associated with increased dementia risk. Previous research has suggested that in AD, individuals carrying the APOE ε4 allele have decreased sleep quality compared to individuals without the APOE ε4 allele...
October 25, 2016: Neurology
Eric P M Grist, Jennifer A Flegg, Georgina Humphreys, Ignacio Suay Mas, Tim J C Anderson, Elizabeth A Ashley, Nicholas P J Day, Mehul Dhorda, Arjen M Dondorp, M Abul Faiz, Peter W Gething, Tran T Hien, Tin M Hlaing, Mallika Imwong, Jean-Marie Kindermans, Richard J Maude, Mayfong Mayxay, Marina McDew-White, Didier Menard, Shalini Nair, Francois Nosten, Paul N Newton, Ric N Price, Sasithon Pukrittayakamee, Shannon Takala-Harrison, Frank Smithuis, Nhien T Nguyen, Kyaw M Tun, Nicholas J White, Benoit Witkowski, Charles J Woodrow, Rick M Fairhurst, Carol Hopkins Sibley, Philippe J Guerin
BACKGROUND: Artemisinin-resistant Plasmodium falciparum malaria parasites are now present across much of mainland Southeast Asia, where ongoing surveys are measuring and mapping their spatial distribution. These efforts require substantial resources. Here we propose a generic 'smart surveillance' methodology to identify optimal candidate sites for future sampling and thus map the distribution of artemisinin resistance most efficiently. METHODS: The approach uses the 'uncertainty' map generated iteratively by a geostatistical model to determine optimal locations for subsequent sampling...
October 24, 2016: International Journal of Health Geographics
Heather J Ruskin
High-throughput microarray technologies have long been a source of data for a wide range of biomedical investigations. Over the decades, variants have been developed and sophistication of measurements has improved, with generated data providing both valuable insight and considerable analytical challenge. The cost-effectiveness of microarrays, as well as their fundamental applicability, made them a first choice for much early genomic research and efforts to improve accessibility, quality and interpretation have continued unabated...
October 21, 2016: Microarrays
Christina Alliger-Horn, Peter Lutz Zimmermann, Mervyn Schmucker
BACKGROUND: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. OBJECTIVE: The purpose of this study was to examine the extent to which soldiers' PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED SELF (back then)...
October 20, 2016: Journal of Clinical Medicine
Matthew Blake, Joanna M Waloszek, Orli Schwartz, Monika Raniti, Julian G Simmons, Laura Blake, Greg Murray, Ronald E Dahl, Richard Bootzin, Paul Dudgeon, John Trinder, Nicholas B Allen
Objective: Sleep problems are a major risk factor for the emergence of mental health problems in adolescence. The aim of this study was to investigate the post intervention effects of a cognitive-behavioral/mindfulness-based group sleep intervention on sleep and mental health among at-risk adolescents. Method: A randomized controlled trial (RCT) was conducted across High schools in Melbourne, Australia. One hundred forty-four adolescents (aged 12-17 years) with high levels of anxiety and sleeping difficulties, but without past or current depressive disorder, were randomized into either a sleep improvement intervention or an active control 'study skills' intervention...
October 24, 2016: Journal of Consulting and Clinical Psychology
Tonya Deen, Theresa Terna, Elizabeth Kim, Brian Leahy, Wende Fedder
PURPOSE: The purpose of this study was to describe the impact a Stroke Nurse Navigation Program has on concurrent chart reviews and patient compliance post discharge. DESIGN: Phase I: Concurrent chart review of The Joint Commission Primary Stroke Center core measures for ischemic stroke patients. Phase II: Longitudinal study of 100 ischemic stroke patients discharged to home. METHODS: Telephone surveys were conducted at prescribed intervals posthospital discharge (Phase II)...
October 24, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
E M M Hoytema van Konijnenburg, J H van der Lee, A H Teeuw, R Lindeboom, S N Brilleslijper-Kater, T Sieswerda-Hoogendoorn, J B van Goudoever, R J L Lindauer
BACKGROUND: High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. METHODS: A cross-sectional study was conducted in six hospitals...
October 23, 2016: Child: Care, Health and Development
Miguel Anaya, Juan P Correa-Baena, Gabriel Lozano, Michael Saliba, Pablo Anguita, Bart Roose, Antonio Abate, Ullrich Steiner, Michael Grätzel, Mauricio E Calvo, Anders Hagfeldt, Hernán Míguez
Organic-inorganic perovskite structures in which lead is substituted by tin are exceptional candidates for broadband light absorption. Herein we present a thorough analysis of the optical properties of CH3NH3Sn x Pb1-x I3 films, providing the field with definitive insights about the possibilities of these materials for perovskite solar cells of superior efficiency. We report a user's guide based on the first set of optical constants obtained for a series of tin/lead perovskite films, which was only possible to measure due to the preparation of optical quality thin layers...
August 7, 2016: Journal of Materials Chemistry. A, Materials for Energy and Sustainability
Afnan Ben Gassem, Richard Foxton, Dirk Bister, Tim Newton
OBJECTIVES: To devise and assess the psychometric properties of a measure that investigates hypodontia patients' expectations of the process and outcome of combined orthodontic/restorative treatment. SETTING: Specialised secondary care facility for individuals with hypodontia. MATERIALS AND METHODS: Mixed research design with three phases: (a) Thematic analysis of data from individual interviews with 25 hypodontia patients/16 parents to generate the questionnaire items...
October 20, 2016: Journal of Dentistry
Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi
BACKGROUND: Traditionally, emergency department (ED) physicians rely on their clinical examination to differentiate between cellulitis and abscess when evaluating skin and soft tissue infections (SSTI). Management of an abscess requires incision and drainage, whereas cellulitis generally requires a course of antibiotics. Misdiagnosis often results in unnecessary invasive procedures, sedations (for incision and drainage in pediatric patients), or a return ED visit for failed antibiotic therapy...
October 21, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Nicole M Orr, Rebecca S Boxer, Mary A Dolansky, Larry A Allen, Daniel E Forman
Skilled nursing facilities (SNF) have emerged as an integral component of care for older adults with heart failure (HF). Despite their prominent role, poor clinical outcomes for the medically complex patients with HF managed in SNFs are common. Barriers to providing quality care include poor transitional care during hospital-to-SNF and SNF-to-community discharges, lack of HF training among SNF staff, and a lack of a standardized care process among SNF facilities. While no evidence-based practice standards have been established, various measures and tools designed to improve HF management in SNFs are being investigated...
October 18, 2016: Journal of Cardiac Failure
Lucy Handscomb, Deborah A Hall, Gillian W Shorter, Derek J Hoare
Purpose: The purpose of this article is to describe data collection considerations, methods, and response rates for a survey available both online and on paper. Methodological issues in the design of online data collection, and advantages and disadvantages of different data collection methods are discussed. Method: A survey was compiled that included 9 full or partial clinical questionnaires designed to measure different components relevant to tinnitus distress...
October 1, 2016: American Journal of Audiology
Michael D Cusimano, Iryna Pshonyak, Michael Y Lee, Gabriela Ilie
OBJECTIVE The 30-day readmission rate has emerged as an important marker of the quality of in-hospital care in several fields of medicine. This review aims to summarize available research reporting readmission rates after cranial procedures and to establish an association with demographic, clinical, and system-related factors and clinical outcomes. METHODS The authors conducted a systematic review of several databases; a manual search of the Journal of Neurosurgery, Neurosurgery, Acta Neurochirurgica, Canadian Journal of Neurological Sciences; and the cited references of the selected articles...
October 21, 2016: Journal of Neurosurgery
Lei Sun, Sarah S Park, Dennis Sheberla, Mircea Dinca
Electrically conductive metal-organic frameworks (MOFs) are emerging as a subclass of porous materials that can have a transformative effect on electronic and renewable energy devices. Systematic advances in these materials depend critically on the accurate and reproducible characterization of their electrical properties. This is made difficult by the numerous techniques available for electrical measurements and the dependence of metrics on device architecture and numerous external variables. These challenges, common to all types of electronic materials and devices, are especially acute for porous materials, whose high surface area make them even more susceptible to interactions with contaminants in the environment...
October 21, 2016: Journal of the American Chemical Society
Antonella Caivano, Francesco La Rocca, Vittorio Simeon, Marco Girasole, Simone Dinarelli, Ilaria Laurenzana, Angelo De Stradis, Luciana De Luca, Stefania Trino, Antonio Traficante, Giovanni D'Arena, Giovanna Mansueto, Oreste Villani, Giuseppe Pietrantuono, Luca Laurenti, Luigi Del Vecchio, Pellegrino Musto
PURPOSE: The use of extracellular vesicles (EVs) from body fluids as "liquid biopsies" is emerging as a promising approach for the diagnosis, prognosis and therapeutic monitoring of cancer patients. MicroRNA-155 (miR155), a non-coding transcript of the B-cell integration cluster (BIC) gene, has been reported to play a critical role in the pathogenesis of several types of hematologic malignancies (HMs) in which high miR155 levels have been found. At yet, however, the EV miR155 level and its putative clinical relevance in sera of HM patients have not been reported...
October 19, 2016: Cellular Oncology (Dordrecht)
Gemma L Buckland Merrett, Gerald Bloom, Annie Wilkinson, Hayley MacGregor
The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. This is a particular challenge for low and middle-income countries with pluralistic health systems where antibiotics are available in a number of different markets. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective...
2016: Journal of Pharmaceutical Policy and Practice
Camilla Callegari, Lorenza Bertù, Melissa Lucano, Marta Ielmini, Elena Braggio, Simone Vender
BACKGROUND: In recent years resilience has gained clinical relevance in sociological, psychological, and medical disciplines, and a lot of scales measuring resilience have been developed and have been utilized in the western countries. The aim of the study was to assess the psychometric properties of the Italian version of the 14-item Resilience Scale (RS-14), by describing its validity and reliability. As agreed with the authors of the original English version of the RS-14, it was translated into Italian...
2016: Psychology Research and Behavior Management
Sandy Middleton, Chris Levi, Simeon Dale, N Wah Cheung, Elizabeth McInnes, Julie Considine, Catherine D'Este, Dominique A Cadilhac, Jeremy Grimshaw, Richard Gerraty, Louise Craig, Verena Schadewaldt, Patrick McElduff, Mark Fitzgerald, Clare Quinn, Greg Cadigan, Sonia Denisenko, Mark Longworth, Jeanette Ward
BACKGROUND: Internationally recognised evidence-based guidelines recommend appropriate triage of patients with stroke in emergency departments (EDs), administration of tissue plasminogen activator (tPA), and proactive management of fever, hyperglycaemia and swallowing before prompt transfer to a stroke unit to maximise outcomes. We aim to evaluate the effectiveness in EDs of a theory-informed, nurse-initiated, intervention to improve multidisciplinary triage, treatment and transfer (T(3)) of patients with acute stroke to improve 90-day death and dependency...
October 18, 2016: Implementation Science: IS
Rebecca DeVries, David Kriebel, Susan Sama
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) contribute greatly to increased morbidity, mortality and diminished quality of life. Recent studies report moderately strong positive associations between exposures to several air pollutants and COPD-related emergency department (ED) visits and hospital admissions (HA). Studies that use clinically defined exacerbations rather than counting ED visits and HA may be more sensitive to environmental triggers like air pollution, but very few such studies exist...
October 18, 2016: Environmental Health: a Global Access Science Source
Zaheed Damani, Gail MacKean, Eric Bohm, Brie DeMone, Brock Wright, Tom Noseworthy, Jayna Holroyd-Leduc, Deborah A Marshall
BACKGROUND: Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba...
October 18, 2016: Health Research Policy and Systems
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