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https://www.readbyqxmd.com/read/29458361/health-services-in-trinidad-throughput-throughput-challenges-and-the-impact-of-a-throughput-intervention-on-overcrowding-in-a-public-health-institution
#1
Mandreker Bahall
BACKGROUND: Throughput might be partially responsible for sub-optimum organisational and medical outcomes. The present study examined throughput and the challenges to ensuring optimum throughput in hospitals, and determined the effectiveness of a throughput intervention in reducing overcrowding in a public healthcare institution in Trinidad and Tobago. METHODS: First, a literature review of throughput and its processes in relation to improving hospital care was conducted...
February 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29420102/family-appraisal-of-paediatric-acquired-brain-injury-a-social-work-clinical-intervention-trial
#2
Lyndal Hickey, Vicki Anderson, Stephen Hearps, Brigid Jordan
OBJECTIVE: To compare the efficacy of a new intervention 'Family Forward' with 'Usual Care' social work practice in optimising family appraisal of a child's acquired brain injury to ensure better adaptation during the inpatient rehabilitation phase of care and early transition home. RESEARCH DESIGN: Single site, prospective, sequential comparison group design. METHODS AND PROCEDURES: Families were recruited on admission to an inpatient rehabilitation service based at a tertiary paediatric hospital...
February 8, 2018: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/29323989/rapid-response-a-multiprofessional-approach-to-hospital-at-home
#3
Sara Dowell, George Moss, Katy Odedra
The provision of 'hospital at home' is not new to the 21st century but pressure from the reduction in the number of hospital beds, population growth, an ageing population and subsequent extended time living with long-term conditions means such services are increasingly necessary. However, research by the authors found services that already exist do not operate 24 hours a day or provide a single multiprofessional approach. Gloucestershire's rapid response (RR) service provides specialist, coordinated, comprehensive and supportive assessment and treatment 24 hours a day in the patient's own home...
January 11, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29310641/health-services-research-in-patients-with-breast-cancer-camiss-prospective-study-protocol-for-an-observational-prospective-study
#4
Susana García-Gutierrez, Miren Orive, Cristina Sarasqueta, Maria Jose Legarreta, Nerea Gonzalez, Maximino Redondo, Amado Rivero, Pedro Serrano-Aguilar, Xavier Castells, Jose Maria Quintana, Maria Sala
BACKGROUND: Though breast cancer remains a major health problem, there is a lack of information on health care provided to patients with this disease and associated costs. In addition, there is a need to update and validate risk stratification tools in Spain. Our purpose is to evaluate the health services provided for breast cancer in Spain, from screening and diagnosis to treatment and prognosis. METHODS: Prospective cohort study involving 13 hospitals in Spain with a follow-up period of up to 5 years after diagnostic biopsy...
January 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29229044/the-commercialization-of-patient-related-decision-making-in-hospitals
#5
Karl-Heinz Wehkamp, Heinz Naegler
BACKGROUND: Hospitals must make a profit to ensure their continued existence. The observed rises in case numbers and case-mix indices lead us to suspect that the admission, treatment, and discharge of patients are now being influenced not just by purely medical factors, but also by economic considerations with a view toward making a profit-i.e., that decision-making has become partially commercialized. In this study, we investigated whether doctors and hospital chief executive officers (CEOs) share this perception of their professional environment...
November 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29227898/responsiveness-of-the-personal-and-social-performance-scale-in-patients-with-schizophrenia
#6
En-Chi Chiu, Tsui-Mei Hung, Chiu-Min Huang, Shu-Chun Lee, Ching-Lin Hsieh
The responsiveness (ability to detect change) of the Personal and Social Performance scale (PSP) is largely unknown, limiting its use as an outcome measure. The purpose of this study was to examine both internal and external responsiveness of the PSP in patients with schizophrenia in the acute phase. Eighty patients were administered the PSP and the Clinical Global Impression-Severity scale (CGI-S) at admission and at discharge. We used the standardized effect size, the standardized response mean, and paired t-test for examining internal responsiveness...
November 27, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29223042/experiences-of-early-labour-management-from-perspectives-of-women-labour-companions-and-health-professionals-a-systematic-review-of-qualitative-evidence
#7
REVIEW
Sarah Beake Rm Ma Research Associate, Yan-Shing Chang Ba MPhil PhD Lecturer, Helen Cheyne Rm Rgn MSc PhD Professor Of Midwifery, Helen Spiby MPhil Rn Rm Professor Of Midwifery, Jane Sandall Rm MSc PhD Professor Of Social Science And Women's Health, Debra Bick
OBJECTIVES: to examine evidence of women's, labour companions' and health professionals' experiences of management of early labour to consider how this could be enhanced to better reflect women's needs. DESIGN: a systematic review of qualitative evidence. SETTING AND PARTICIPANTS: women in early labour with term, low risk singleton pregnancies, not booked for a planned caesarean birth or post-dates induction of labour, their labour companions, and health professionals responsible for early labour care (e...
November 13, 2017: Midwifery
https://www.readbyqxmd.com/read/29184413/near-fatal-asthma-responsive-to-mepolizumab-after-failure-of-omalizumab-and-bronchial-thermoplasty
#8
Francesco Menzella, Carla Galeone, Mirco Lusuardi, Anna Simonazzi, Claudia Castagnetti, Patrizia Ruggiero, Nicola Facciolongo
Severe asthma affects between 5% and 10% of patients with asthma worldwide and requires best standard therapies at maximal doses, but there is a subgroup of patients refractory to all treatments. We share a case report of a 53-year-old woman with a history of severe allergic asthma that progressively worsened over the years despite the best therapy. She had been hospitalized 35 times, including nine admissions to the respiratory intensive care unit due to severe exacerbations. To rule out other possible diagnoses, several investigations were performed, such as computed tomography scan of the chest and neck, fiberoptic laryngoscopy, antineutrophil cytoplasmic antibodies, and complete blood cell count...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29182618/impact-of-scale-of-aggregation-on-associations-of-cardiovascular-hospitalization-and-socio-economic-disadvantage
#9
Ivan C Hanigan, Thomas Cochrane, Rachel Davey
BACKGROUND: There are numerous studies that show an increased incidence of cardiovascular disease with increasing levels of socio-economic disadvantage. Exposures that might influence the relationship include elements of the built environment and social systems that shape lifestyle risk behaviors. In Canberra (the Australian capital city) there has been a particular housing policy to create 'mixed-tenure' neighborhoods so that small pockets of disadvantage are surrounded by more affluent residences (known as a 'salt-and-pepper' pattern)...
2017: PloS One
https://www.readbyqxmd.com/read/29117024/behavioral-genetics-in-criminal-and-civil-courts
#10
Maya Sabatello, Paul S Appelbaum
Although emerging findings in psychiatric and behavioral genetics create hope for improved prevention, diagnosis, and treatment of disorders, the introduction of such data as evidence in criminal and civil proceedings raises a host of ethical, legal, and social issues. Should behavioral and psychiatric genetic data be admissible in judicial proceedings? If so, what are the various means for obtaining such evidence, and for what purposes should its admission be sought and permitted? How could-and should-such evidence affect judicial outcomes in criminal and civil proceedings? And what are the potential implications of using behavioral and psychiatric genetic evidence for individuals and communities, and for societal values of equality and justice? This article provides an overview of the historical and current developments in behavioral genetics...
November 2017: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29102693/children-with-chronic-pain-response-trajectories-following-intensive-pain-rehabilitation-treatment
#11
Laura E Simons, Christine B Sieberg, Caitlin Conroy, Edin T Randall, Julie Shulman, David Borsook, Charles Berde, Navil F Sethna, Deirdre E Logan
Intensive pain rehabilitation programs for children with chronic pain are effective for many patients. However, characteristics associated with treatment response have not been well documented. Here we report trajectories of pain and functional impairment in patients with chronic pain up to one year after intensive pain rehabilitation and examine baseline factors associated with treatment response. Patients (n=253) with chronic pain and functional disability were assessed at 5 time points (admission, discharge, 1-month, 4-month, and 12-month follow-up)...
November 1, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29090032/the-psychological-abuse-of-the-elderly-a-silent-factor-of-cardiac-decompensation
#12
Adina Carmen Ilie, Anca Iuliana Pîslaru, Ioana Dana Alexa, Adriana Pancu, Ovidiu Gavrilovici, Aliona Dronic
Abuse of the elderly is a major issue debated worldwide. The most commonly identified form of abuse is the physical abuse. It is also the most frequently studied in the medical literature. However, at least six types of elder abuse are identified, and physical abuse is found in a small proportion of the cases. The consequences of abuse are frequent and, by prolonging hospitalizations, they will be associated with high costs of medical services, and patient's lack of self-confidence which, in time, may lead to social isolation, somatization, anxiety, depression, and suicide attempts...
June 2017: Mædica
https://www.readbyqxmd.com/read/29071577/obstetric-care-quality-indicators-and-outcomes-based-on-the-degree-of-acculturation-of-immigrants-results-from-a-cross-sectional-study-in-berlin
#13
Matthias David, Theda Borde, Silke Brenne, Babett Ramsauer, Larry Hinkson, Wolfgang Henrich, Oliver Razum, Jürgen Breckenkamp
HYPOTHESIS: Acculturation is a complex, multidimensional process involving the integration of the traditional norms, values, and lifestyles of a new cultural environment. It is, however, unclear what impact the degree of acculturation has on obstetric outcomes. METHODS: Data collection was performed in 2011 and 2012 at three obstetric tertiary centers in Berlin, Germany. Standardized interviews (20-30 min.) were performed with support of evaluated questionnaires...
October 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29061222/international-multicentre-randomised-controlled-trial-of-improvisational-music-therapy-for-children-with-autism-spectrum-disorder-time-a-study
#14
Mike J Crawford, Christian Gold, Helen Odell-Miller, Lavanya Thana, Sarah Faber, Jörg Assmus, Łucja Bieleninik, Monika Geretsegger, Claire Grant, Anna Maratos, Stephan Sandford, Amy Claringbold, Helen McConachie, Morag Maskey, Karin Antonia Mössler, Paul Ramchandani, Angela Hassiotis
BACKGROUND: Preliminary studies have indicated that music therapy may benefit children with autism spectrum disorders (ASD). OBJECTIVES: To examine the effects of improvisational music therapy (IMT) on social affect and responsiveness of children with ASD. DESIGN: International, multicentre, three-arm, single-masked randomised controlled trial, including a National Institute for Health Research (NIHR)-funded centre that recruited in London and the east of England...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29026384/clinical-and-cranial-computed-tomography-scan-findings-in-adults-following-road-traffic-accidents-in-kampala-uganda
#15
Geoffrey Erem, Samuel Bugeza, Elsie Kiguli Malwadde
BACKGROUND: Globally, road traffic accidents are a major cause of death and disability. The developing countries bear a disproportionately large share of the RTAs which account for about 85% of the deaths. Most of these RTAs result in head injury, which globally, most scholars and medical practitioners consider a significant economic, social and medical problem. In Mulago National referral hospital, RTA is the leading cause of surgical admission. OBJECTIVE: To describe the cranial computed tomography (CT) scan findings in adults following RTA in Mulago hospital...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29025136/predictors-of-responsivity-to-interdisciplinary-pain-management
#16
Melissa A Day, Melissa Brinums, Nathan Craig, Laurence Geffen, Saul Geffen, Miriam Lovai, Gina Geffen
Objective: This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes. Design: Repeated measures prospective study of consecutive admissions to a two-week IPM program. Setting: Brisbane Pain Rehabilitation Service in Brisbane, Australia. Subjects: A total of 163 adults referred for chronic pain management...
July 25, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28965811/frequent-users-of-mental-health-liaison-services-within-emergency-departments
#17
Alison Beck, Emma Sanchez-Walker, Lauren J Evans, Victoria Harris, Ruth Pegler, Sean Cross
This study aimed to use nuanced statistical methods in a large UK sample to identify and explore the factors associated with different types of frequent user of Emergency Departments (EDs) who are referred to Mental Health Liaison Services (MHLS). A retrospective 5-year longitudinal study was conducted of all attenders (n = 23,718) of four London EDs who were referred to their MHLS. Longitudinal group-based trajectory analysis of monthly MHLS referrals enabled identification of factors which may contribute to membership of the resulting groups...
December 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28953066/maryland-s-all-payer-health-care-system-a-light-at-the-end-of-a-tunnel
#18
Lama Bakhamis, Taeko Matsumoto, Mary Tran, David P Paul, Alberto Coustasse
The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing...
September 26, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28939010/-evaluation-of-the-prescription-of-proton-pump-inhibitors-in-persons-aged-75years-and-older-in-a-geriatric-acute-care-unit
#19
Mélanie Dipanda, Laureline Pioro, Maxime Buttard, Philippe d'Athis, Sanaa Asgassou, Sophie Putot, Martha Deïdda, Caroline Laborde, Alain Putot, Patrick Manckoundia
INTRODUCTION AND OBJECTIVES: Proton pump inhibitors (PPI) are widely prescribed in France and could be responsible for adverse drug reactions especially in elderly persons (EP). In order to reduce the misuse of PPI and the excess cost to the Social Security Agency, the French health authorities (Haute Autorité de santé [HAS]) have published strict guidelines for their prescription. We conducted a study in EP to determine the proportion of PPI prescriptions outside HAS guidelines. METHOD: This was a prospective, single-centre observational study in persons aged≥75 years admitted to a geriatric acute-care unit over a period of 6months...
July 29, 2017: Thérapie
https://www.readbyqxmd.com/read/28904675/von-willebrand-s-disease-case-report-and-review-of-literature
#20
REVIEW
Hanae Echahdi, Brahim El Hasbaoui, Mohamed El Khorassani, Aomar Agadr, Mohamed Khattab
Von Willebrand Disease (VWD) is the most common human inherited bleeding disorder due to a defect of Von Willebrand Factor (VWF), which a glycoprotein crucial for platelet adhesion to the subendothelium after vascular injury. VWD include quantitative defects of VWF, either partial (type 1 with VWF levels < 50 IU/dL) or virtually total (type 3 with undetectable VWF levels) and also qualitative defects of VWF (type 2 variants with discrepant antigenic and functional VWF levels). The most bleeding forms of VWD usually do not concern type 1 patients with the mildest VWF defects (VWF levels between 30 and 50IU/dL)...
2017: Pan African Medical Journal
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