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https://www.readbyqxmd.com/read/29161393/quality-safety-and-outcomes-in-anaesthesia-what-s-to-be-done-an-international-perspective
#1
C J Peden, M Campbell, G Aggarwal
This article reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. The topics were selected based on the perspective of an individual with quality and safety expertise and recent experience of the specialty in both the UK and USA. The review does not seek to be exhaustive or systematic, but to highlight current areas of concern and potential solutions. The topic is subdivided into sections where the system of health care is viewed from different levels...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159419/implementation-of-clinical-quality-management-for-rehabilitation-in-malaysia
#2
Julia Patrick Engkasan, Gerold Stucki, Sadeeq Ali, Yusniza Mohd Yusof, Hafez Hussain, Lydia Abdul Latif
In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision...
November 16, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29157956/comparative-analysis-of-fixation-and-embedding-techniques-for-optimized-histological-preparation-of-zebrafish
#3
Jean E Copper, Lynn R Budgeon, Christina A Foutz, Damian B van Rossum, Daniel J Vanselow, Margaret J Hubley, Darin P Clark, David T Mandrell, Keith C Cheng
In recognition of the importance of zebrafish as a model organism for studying human disease, we have created a web-based reference atlas of zebrafish microanatomy for comparing histology and histopathology between model systems and with humans (http://bio-atlas.psu.edu). Fixation, decalcification, embedding, and sectioning were optimized to maximize section quality. A comparison of protocols involving six fixatives showed that 10% Neutral Buffered Formalin at 21°C for 24h yielded excellent results. Sectioning of juveniles and adults requires bone decalcification; EDTA at 0...
November 17, 2017: Comparative Biochemistry and Physiology. Toxicology & Pharmacology: CBP
https://www.readbyqxmd.com/read/29157888/quality-measurement-affecting-surgical-practice-utility-versus-utopia
#4
REVIEW
Leonard R Henry, Urs W von Holzen, Michael J Minarich, Ashley N Hardy, Wilbur A Beachy, M Susan Franger, Roderich E Schwarz
The Triple Aim: improving healthcare quality, cost and patient experience has resulted in massive healthcare "quality" measurement. For many surgeons the origins, intent and strengths of this measurement barrage seems nebulous-though their shortcomings are noticeable. This article reviews the major organizations and programs (namely the Centers for Medicare and Medicaid Services) driving the somewhat burdensome healthcare quality climate. The success of this top-down approach is mixed, and far from convincing...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29157568/providing-primary-care-using-an-interprofessional-collaborative-practice-model-what-clinicians-have-learned
#5
Cynthia S Selleck, Matthew Fifolt, Heidi Burkart, Jennifer Sandson Frank, William A Curry, Lisle S Hites
This article details a nurse-led, interprofessional collaborative practice (IPCP) model that was developed to provide primary care to a medically indigent population in Birmingham, Alabama. Funding to develop and implement this project came from a federal Nurse Education, Practice, Quality and Retention award to the University of Alabama at Birmingham (UAB) School of Nursing, with additional support coming from the UAB Hospital and Health System. The clinic is housed within a local community-based, non-profit organization and all services, including supplies and pharmaceuticals, are provided free of charge to this vulnerable population...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/29157513/antipsychotic-augmentation-for-major-depressive-disorder-a-review-of-clinical-practice-guidelines
#6
REVIEW
Peter Simons, Lisa Cosgrove, Allen F Shaughnessy, Harold Bursztajn
Clinical Practice Guidelines (CPGs) are seen as the gold standard of evidence-based care. Because of their influence, these guidelines can have profound legal and economic effects. Despite their proliferation and influence, the trustworthiness and quality of guidelines have been seriously questioned and they have been implicated as drivers of overtreatment. In the U.S, augmentation with second generation antipsychotics (SGAs) is becoming an increasingly common strategy for treating major depressive disorder (MDD) when initial antidepressant treatment does not result in remission of symptoms...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29157257/patient-safety-culture-in-care-homes-for-older-people-a-scoping-review
#7
Emily Gartshore, Justin Waring, Stephen Timmons
BACKGROUND: In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29156920/supportive-palliative-interventions-in-motor-neurone-disease-what-we-know-from-current-literature
#8
Hon Wai Benjamin Cheng, Kwok Ying Chan, Yuen Kwan Judy Chung, Chun Wai Choi, Chun Hung Chan, Shuk Ching Cheng, Wan Hung Chan, Koon Sim Fung, Kar Yin Wong, Oi Man Iman Chan, Ching Wah Man
Although there is no cure for motor neurone disease (MND), the advent of supportive interventions including multidisciplinary care (MDC) has improved treatment interventions and enhanced quality of life (QOL) for MND patients and their carers. Our integrative review showed evidence-based MDC, respiratory management and disease-modifying therapy that have improved the outcomes of patients diagnosed with MND. Supportive approaches to nutritional maintenance and optimization of symptomatic treatments, including management of communication and neuropsychiatric issues, improve the QOL for MND patients...
October 31, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156443/ensuring-quality-pharmacokinetic-analyses-in-antimicrobial-drug-development-programs
#9
REVIEW
Elizabeth A Lakota, Justin C Bader, Christopher M Rubino
Pharmacokinetic studies and analyses can be expensive, time consuming, and labor intensive. However, it is crucial to understand that much of what happens in antimicrobial drug development, such as dose-selection and clinical study design, can be optimized with a strong understanding of the underlying pharmacokinetics of an agent. In this way, pharmacokinetics forms the bedrock of a pharmacometric approach to antimicrobial development. Thus, pharmacokinetic analyses must be considered an integral part of a drug's development strategy and studies must be planned and designed accordingly...
November 17, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29155956/associations-between-parental-ses-and-children-s-health-related-quality-of-life-the-role-of-objective-and-subjective-social-status
#10
Kay W Kim, Jan L Wallander, Melissa Peskin, Paula Cuccaro, Marc N Elliott, Mark A Schuster
Objective: We examined (1) the relationship that parental objective social status (OSS) and subjective social status (SSS) have with children's health-related quality of life (HRQOL), (2) whether SSS mediates the association between OSS and HRQOL, and (3) whether these associations differ among Black, Latino, and White children. Method: Data came from 4,824 Black, Latino, and White 5th graders in the Healthy PassagesTM study. OSS was measured as parent educational attainment and net equivalent household income...
November 15, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29155825/poverty-and-health-among-cdc-plantation-labourers-in-cameroon-perceptions-challenges-and-coping-strategies
#11
Valerie Makoge, Lenneke Vaandrager, Harro Maat, Maria Koelen
Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs), by investigating how Cameroon Development Corporation (CDC) camp dwellers respond to diseases that adversely affect their health and wellbeing. Living in plantation camps is associated with poverty, overcrowding, poor sanitation and the rapid spread of diseases. In a survey of 237 CDC camp dwellers in Cameroon, we used the health belief model to understand the drivers (perceived threats, benefits and cues for treatment seeking) of reported responses...
November 20, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29154713/sex-differences-in-the-psychometric-properties-of-the-pittsburgh-sleep-quality-index
#12
Jonna L Morris, Jeffrey Rohay, Eileen R Chasens
BACKGROUND: The Pittsburgh Sleep Quality Index (PSQI) is a well-known, validated, and reliable instrument used to measure the clinical construct of sleep quality. Little research has been done to measure its psychometric properties by sex. Previous researchers have established the validity of a three-factor structure, but it is unknown whether it applies to both men and women equally. MATERIALS AND METHODS: This study examined 198 participants; women (n = 104), men (n = 94) who were participants in the Diabetes Sleep Treatment Trial, an ongoing study examining the effect of continuous positive airway pressure on glycemic control in people with type 2 diabetes...
November 20, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29154157/efficacy-of-antidepressants-on-measures-of-workplace-functioning-in-major-depressive-disorder-a-systematic-review
#13
REVIEW
Yena Lee, Joshua D Rosenblat, JungGoo Lee, Nicole E Carmona, Mehala Subramaniapillai, Margarita Shekotikhina, Rodrigo B Mansur, Elisa Brietzke, Jae-Hon Lee, Roger C Ho, Samantha J Yim, Roger S McIntyre
INTRODUCTION: Work-related disability and productivity loss in Major Depressive Disorder (MDD) are critical determinants of patient quality of life and contribute significantly to the human and economic costs of MDD. Notwithstanding the return to work and pre-morbid levels of functioning as a critical therapeutic objective among individuals with MDD, it is unclear whether antidepressant treatment significantly and reliably improves measures of workplace functioning. Herein, we investigate to what extent antidepressant treatment improves workplace functioning among adults with MDD...
November 7, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29153827/compassion-satisfaction-and-fatigue-a-cross-sectional-survey-of-australian-intensive-care-nurses
#14
Samantha Jakimowicz, Lin Perry, Joanne Lewis
BACKGROUND: Compassion satisfaction and compassion fatigue influence nurses' intention to stay or leave nursing. Identification of compassion satisfaction or fatigue in critical care nurses is important in this high turnover workforce. OBJECTIVES: The aim of this study was to examine factors predicting and contributing to compassion satisfaction and compassion fatigue experienced by critical care nurses in Australian intensive care units. METHODS: A self-reported cross-sectional survey using an established tool collected data from critical care nurses of two adult Australian intensive care units...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153298/barriers-to-optimal-pain-management-in-aged-care-facilities-an-australian-qualitative-study
#15
Felicity Veal, Mackenzie Williams, Luke Bereznicki, Elizabeth Cummings, Angus Thompson, Gregory Peterson, Tania Winzenberg
Up to 80% of residents in aged care facilities (ACFs) experience pain, which is often suboptimally managed. To characterize pain management in ACFs and identify the barriers to optimal pain management. An exploratory descriptive qualitative study using semistructured interviews. Five Southern Tasmania, Australian ACFs. 23 staff members (18 nurses and 5 facility managers). Interviews were conducted from September to November 2015. Interviews included questions about how pain was measured or assessed, what happened if pain was identified, barriers to pain management, and potential ways to overcome these barriers...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152594/-blaming-shaming-humiliation-stigmatising-medical-interactions-among-people-with-non-epileptic-seizures
#16
Catherine Robson, Olaug S Lian
Background: People with non-epileptic seizures (NES) describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods: Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants' texts from a social-constructionist perspective on health and illness...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/29151815/how-should-we-evaluate-research-on-counselling-and-the-treatment-of-depression-a-case-study-on-how-the-national-institute-for-health-and-care-excellence-s-draft-2018-guideline-for-depression-considered-what-counts-as-best-evidence
#17
Michael Barkham, Naomi P Moller, Joanne Pybis
Background: Health guidelines are developed to improve patient care by ensuring the most recent and 'best available evidence' is used to guide treatment recommendations. The National Institute for Health and Care Excellence's (NICE's ) guideline development methodology acknowledges that evidence needed to answer one question (treatment efficacy) may be different from evidence needed to answer another (cost-effectiveness, treatment acceptability to patients). This review uses counselling in the treatment of depression as a case study, and interrogates the constructs of 'best' evidence and 'best' guideline methodologies...
December 2017: Couns Psychother Res
https://www.readbyqxmd.com/read/29151569/what-kind-of-incision-should-be-made-to-reduce-the-risk-of-incisional-hernia-in-kidney-transplantation
#18
Ihsan Yildız, Yavuz Savas Koca
BACKGROUND The incidence of incisional hernia following renal transplantation is 1.1% to 3.8%. The risk factors are immunosuppressive medications, impaired tissue quality, neuromuscular trauma due to the operation, and denervation. The incidence has been decreasing based on the shift from hockey-stick incision method to inguinal oblique incision method. The aim of this study was to minimize the development of incisional hernias due to renal transplantation. MATERIAL AND METHODS Twenty-four patients who underwent renal transplantation in 2015-2017 were retrospectively examined...
November 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29151432/implementing-a-6-day-physiotherapy-service-in-rehabilitation-exploring-staff-perceptions
#19
Erin L Caruana, Suzanne S Kuys, Jane Clarke, Sandra G Brauer
Objective Australian weekend rehabilitation therapy provision is increasing. Staff engagement optimises service delivery. The present mixed-methods process evaluation explored staff perceptions regarding implementation of a 6-day physiotherapy service in a private rehabilitation unit.Methods All multidisciplinary staff working in the rehabilitation unit were surveyed regarding barriers, facilitators and perceptions of the effect of a 6-day physiotherapy service on length of stay (LOS) and patient goal attainment at three time points: before and after implementation, as well as after modification of a 6-day physiotherapy service...
November 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29150474/core-outcome-sets-in-miscarriage-trials-cosmist-study-a-study-protocol
#20
Paul Smith, Natalie Cooper, Rima Dhillon-Smith, Emily O'Toole, T Justin Clark, Arri Coomarasamy
INTRODUCTION: 'Core outcome sets' are an agreed, standardised set of outcomes based on what key stakeholders (clinicians, patients, their partners, researchers, service developers, funding organisations and so on) consider the important outcomes in the management or prevention of a condition. This paper describes the rationale and design for the development of Core Outcome Sets for Miscarriage Trials. METHODS AND ANALYSIS: Systematic reviews, interviews and focus groups with patients and their partners will be conducted to identify potential core outcomes that will be introduced into a modified Delphi survey...
November 16, 2017: BMJ Open
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