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https://www.readbyqxmd.com/read/29149903/improving-access-to-school-health-services-as-perceived-by-school-professionals
#1
Janine Bezem, Debbie Heinen, Ria Reis, Simone E Buitendijk, Mattijs E Numans, Paul L Kocken
BACKGROUND: The organisation of health assessments by preventive health services focusing on children's health and educational performance needs to be improved due to evolving health priorities such as mental health problems, reduced budgets and shortages of physicians and nurses. We studied the impact on the school professionals' perception of access to school health services (SHS) when a triage approach was used for population-based health assessments in primary schools. The triage approach involves pre-assessments by SHS assistants, with only those children in need of follow-up being assessed by a physician or nurse...
November 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29149357/recommendations-for-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke-a%C3%A2-clinical-guide-by-the-hellenic-stroke-organization
#2
REVIEW
Panagiotis Papanagiotou, George Ntaios, Vasileios Papavasileiou, Klearchos Psychogios, Marios Psychogios, Anastasios Mpotsaris, Timolaos Rizos, Konstantinos Spengos, Miltiadis Gravanis, Sofia Vassilopoulou, Christos Gkogkas, Petros Zampakis, Panagiotis Zis, Apostolos Karantanas, Michail Karygiannis, Georgios Karydas, Eleni Korompoki, Konstantinos Makaritsis, Konstantinos Marmagkiolis, Haralambos Milionis, Dimos Mitsikostas, Dimitrios Nikas, Androniki Plomaritoglou, Maria Politi, Nikolaos Ptochis, Christos Savopoulos, Konstantinos Takis, Nikolaos Tsamopoulos, Dimitrios Tsetis, Adam Hatzidakis, Achilleas Chatziioannou, Apostolos Hatzitolios, Konstantinos Vemmos
This document presents the consensus recommendations of the Hellenic Stroke Organization which can be of assistance to the treating stroke physicians.
November 17, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29149154/philosophical-issues-and-psychological-variables-that-influence-the-determination-of-opioid-effectiveness-a-narrative-review
#3
Daniel Michael Doleys
BACKGROUND: The prescribing of opioids in the chronic pain setting is often based on the pharmacodynamics, pharmacokinetics, and pharmacogenetics of the drug obtained during development and clinical trials. However, the effectiveness of opioids varies widely and often appears to bear no relationship to the aforementioned variables. The impact of philosophical issues and psychological factors on determining how clinically effective opioid therapy is has often been over looked. OBJECTIVES: This manuscript provides a selective review and narrative summary of the philosophical issues and psychological factors which can influence opioid effectiveness...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29145772/do-primary-care-physicians-help-the-bereaved-with-their-suicide-losses-loss-survivor-perceptions-of-helpfulness-from-physicians
#4
William Feigelman, Rebecca L Sanford, Julie Cerel
Several previous studies suggested that primary care physicians can provide important bereavement assistance to survivors of suicide, yet no study has investigated whether suicide-bereaved patients perceive their physicians as helpful. Contacting bereavement communities on social media, we collected online survey data from 146 bereaved respondents reporting suicides causing them severe emotional distress. Data analysis suggested that nearly half (48%) of the respondents encountered positive, help-offering responses from physicians, compared to 10% whose responses were deemed as negative...
January 1, 2017: Omega
https://www.readbyqxmd.com/read/29141664/prevalence-and-prognosis-of-acutely-ill-patients-with-organ-failure-at-arrival-to-hospital-protocol-for-a-systematic-review
#5
Peter Bank Pedersen, Asbjorn Hrobjartsson, Daniel Lykke Nielsen, Daniel Pilsgaard Henriksen, Mikkel Brabrand, Annmarie Touborg Lassen
BACKGROUND: Acutely ill patients are a heterogeneous group, and some of these suffer from organ failure. As the prognosis of organ failure improves with early treatment, it is important to identify these patients as early as possible. Most studies on organ failure have been performed in intensive care settings, or on selected groups of patients, where a high prevalence and mortality have been reported. Before patients arrive to the intensive care unit, or the general ward, most of them have passed through the emergency department (ED), where diagnosis and treatment has been initiated...
November 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29141653/test-of-a-workforce-development-intervention-to-expand-opioid-use-disorder-treatment-pharmacotherapy-prescribers-protocol-for-a-cluster-randomized-trial
#6
Todd Molfenter, Hannah K Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden
BACKGROUND: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations' efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications...
November 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29141473/development-of-a-nomogram-for-prediction-of-successful-membrane-sweeping
#7
Rani Haj Yahya, Yossef Ezra, Vincenzo Berghella, Shmuel Herzberg, Myriam Safrai, Adi Reuveni Salzman, Weissam Abu Ahmad, Doron Kabiri
OBJECTIVE: To evaluate the association of obstetric, maternal, and fetal variables with successful membrane sweeping and to develop a calculator that can predict spontaneous delivery within 24 hours of membrane sweeping. METHODS: This secondary analysis of the STRIP-G Study included all singleton term parturients who underwent membrane sweeping in a tertiary center in October 2011 - July 2013. Primary end point was a 24-hour time interval from sweeping to delivery...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29140836/pyoderma-gangrenosum-a-critical-appraisal
#8
Eran Shavit, Afsaneh Alavi, R Gary Sibbald
GENERAL PURPOSE: To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to: ABSTRACT: Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities...
December 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29140450/smoking-cessation-delivery-by-general-practitioners-in-crete-greece
#9
Charis Girvalaki, Sophia Papadakis, Constantine Vardavas, Eleni Petridou, Andrew Pipe, Christos Lionis
Background: Tobacco dependence treatment in clinical settings is of prime public health importance, especially in Greece, a country experiencing one of the highest rates of tobacco use in Europe. Methods: Our study aimed to examine the characteristics of tobacco users and document rates of tobacco treatment delivery in general practice settings in Crete, Greece. A cross-sectional sample of patients (n = 2, 261) was screened for current tobacco use in 25 general practices in Crete, Greece in 2015/16...
November 13, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/29138593/intrathecal-pain-management-a-team-based-approach
#10
REVIEW
Jeremy A Adler, Neona M Lotz
Objective: Physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs) provide professional services on pain management teams. This review provides an overview of the practical management of chronic pain with intrathecal (IT) therapy using an interprofessional approach (eg, physicians and other health care professionals), with a focus on the contributions of PAs, NPs, and RNs. Methods: Narrative review based on literature searches of the Medline database and treatment guidelines on the use of IT therapy in the management of patients with chronic pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29138217/effectiveness-of-interprofessional-education-in-renal-physiology-curricula-for-health-sciences-graduate-students
#11
Lisa M Harrison-Bernard, Mihran V Naljayan, Jane M Eason, Donald E Mercante, Tina P Gunaldo
The primary purpose of conducting an interprofessional education (IPE) experience during the renal physiology block of a graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students with an opportunity to work as a team in the diagnosis, treatment, and collaborative care of a patient with acute kidney injury. The secondary purpose was to enhance the understanding of basic renal physiology principles with a patient case presentation of renal pathophysiology...
December 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/29138172/framework-for-building-primary-care-capacity-to-address-the-social-determinants-of-health
#12
Andrew D Pinto, Gary Bloch
PROBLEM ADDRESSED: Family physicians have long understood that social factors influence the health of individuals and communities; however, most primary care organizations have yet to develop the capacity to specifically address these social determinants of health (SDOH). OBJECTIVE OF PROGRAM: To support SDOH interventions and foster an organizational culture in which addressing SDOH is considered part of high-quality primary care. PROGRAM DESCRIPTION: An academic family health team in Toronto, Ont, established a committee comprising a diverse group of health professionals focused on the SDOH...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29138153/deprescribing-antihyperglycemic-agents-in-older-persons-evidence-based-clinical-practice-guideline
#13
Barbara Farrell, Cody Black, Wade Thompson, Lisa McCarthy, Carlos Rojas-Fernandez, Heather Lochnan, Salima Shamji, Ross Upshur, Manon Bouchard, Vivian Welch
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper, stop, or switch antihyperglycemic agents in older adults. METHODS: We focused on the highest level of evidence available and sought input from primary care professionals in guideline development, review, and endorsement processes. Seven clinicians (2 family physicians, 3 pharmacists, 1 nurse practitioner, and 1 endocrinologist) and a methodologist comprised the overall team; members disclosed conflicts of interest...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29137972/circulating-tumoral-dna-preanalytical-validation-and-quality-control-in-a-diagnostic-laboratory
#14
Sergey Nikolaev, Laure Lemmens, Thibaud Koessler, Jean-Louis Blouin, Thierry Nouspikel
We present the results of our technical validation process in establishing the analysis of circulating tumor DNA (ctDNA) as a diagnostic tool. Like most cells in our body, tumor cells shed DNA in the blood flow. Analysis of ctDNA mutational content can provide invaluable information on the genetic makeup of a tumor, and assist oncologists in deciding on therapy, or in following residual disease. However, low absolute amounts of circulating DNA and low tumor fraction constitute formidable analytical challenges...
November 11, 2017: Analytical Biochemistry
https://www.readbyqxmd.com/read/29137860/quality-of-anthropometric-measurements-in-spanish-intensive-care-units-the-camies-study
#15
M A García-Martínez, T Cherednichenko, Y Hidalgo Encinas, A I Catalá Espinosa, A Arrascaeta Llanes, J A Acosta Escribano
INTRODUCTION: Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the clinical practice guides. OBJECTIVE: To describe anthropometric quality in CIP, health professional perception of such quality, and its influencing factors...
November 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29137723/the-promise-and-problems-of-non-physician-practitioners-in-general-surgery-education-results-of-a-multi-center-mixed-methods-study-of-faculty
#16
James E Coverdill, Jeff Scott Shelton, Adnan Alseidi, David C Borgstrom, Daniel L Dent, Russell Dumire, Jonathan Fryer, Thomas H Hartranft, Steven B Holsten, M Timothy Nelson, Mohsen M Shabahang, Stanley R Sherman, Paula M Termuhlen, Randy J Woods, John D Mellinger
BACKGROUND: Nurse Practitioners and Physician Assistants - called non-physician practitioners or NPPs - are common, but little is known about their educational promise and problems. METHODS: General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns...
November 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29137035/enteral-nutrition-tube-placement-assisted-by-ultrasonography-in-patients-with-severe-acute-pancreatitis-a-novel-method-for-quality-improvement
#17
Gang Li, Yiyuan Pan, Jing Zhou, Zhihui Tong, Lu Ke, Weiqin Li
To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP).Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137007/prognostic-role-of-pretreatment-neutrophil-to-lymphocyte-ratio-in-breast-cancer-patients-a-meta-analysis
#18
Xu Liu, Jing-Kun Qu, Jia Zhang, Yan Yan, Xi-Xi Zhao, Ji-Zhao Wang, Hang-Ying Qu, Lin Liu, Jian-Sheng Wang, Xiao-Yi Duan
BACKGROUND: Inflammation and cancer are closely related to each other. As a parameter that can reflect inflammation and host immune reaction, elevated blood neutrophil to lymphocyte ratio (NLR) has been confirmed to be correlated with poor prognosis in a variety of cancers. However, this remains controversial in breast cancer. Thus, we performed this updated meta-analysis to further clarify whether high NLR could be a predictor of survival in breast cancer patients. METHODS: We searched on PubMed Database and Cochrane Library...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136189/serum-omega-3-fatty-acids-and-treatment-outcomes-among-women-undergoing-assisted-reproduction
#19
Y-H Chiu, A E Karmon, A J Gaskins, M Arvizu, P L Williams, I Souter, B R Rueda, R Hause, J E Chavarro
STUDY QUESTION: Are serum polyunsaturated fatty acids (PUFA) concentrations, including omega-3 (ω3-PUFA) and omega-6 (ω6-PUFA), related to ART outcomes? SUMMARY ANSWER: Serum levels of long-chain ω3-PUFA were positively associated with probability of live birth among women undergoing ART. WHAT IS KNOWN ALREADY: Intake of ω3-PUFA improves oocyte and embryo quality in animal and human studies. However, a recent cohort study found no relation between circulating ω3-PUFA levels and pregnancy rates after ART...
November 10, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29136154/the-number-of-oocytes-retrieved-during-ivf-a-balance-between-efficacy-and-safety
#20
Åsa Magnusson, Karin Källen, Ann Thurin-Kjellberg, Christina Bergh
STUDY QUESTION: What is the relationship between the number of oocytes collected in fresh IVF treatments and the likelihood of cumulative delivery rate (fresh and frozen) per oocyte aspiration, severe ovarian hyperstimulation syndrome (OHSS) and thromboembolic events? SUMMARY ANSWER: Cumulative delivery rate per aspiration increases up to 20 oocytes retrieved and then evens out while the incidence of severe OHSS increases more rapidly from around 18 oocytes and thromboembolic events, although rare, occurs in particular if 15 or more oocytes are retrieved...
November 10, 2017: Human Reproduction
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