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https://www.readbyqxmd.com/read/28107540/impact-of-adding-a-decision-aid-to-patient-education-in-adults-with-asthma-a-randomized-clinical-trial
#1
Myriam E Gagné, France Légaré, Jocelyne Moisan, Louis-Philippe Boulet
BACKGROUND: Not providing adequate patient education interventions to asthma patients remains a major care gap. To help asthma patients and caregivers discuss inhaled controller medication use, our team has previously developed a decision aid (DA). We sought to assess whether adding this DA to education interventions improved knowledge, decisional conflict, and asthma control among adults with asthma. METHODS: A parallel clinical trial (NCT02516449). We recruited adults with asthma, aged 18 to 65 years, prescribed inhaled controller medication to optimize asthma control...
2017: PloS One
https://www.readbyqxmd.com/read/28107400/when-contact-is-not-enough-affecting-first-year-medical-students-image-towards-older-persons
#2
Sasmita Kusumastuti, Esther van Fenema, Eugenie C F Polman-van Stratum, Wilco Achterberg, Jolanda Lindenberg, Rudi G J Westendorp
CONTEXT: Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude. OBJECTIVE: To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image. DESIGN: Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives) and the Attitudes toward Old People (AOP; 34 positions) questionnaires...
2017: PloS One
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#3
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107351/high-concentrations-of-angiopoietin-like-protein-4-detected-in-serum-from-patients-with-rheumatoid-arthritis-can-be-explained-by-non-specific-antibody-reactivity
#4
Elena Makoveichuk, Toralph Ruge, Solveig Nilsson, Anna Södergren, Gunilla Olivecrona
Angiopoietin-like protein 4 (ANGPTL4) is suggested to be a master regulator of plasma triglyceride metabolism. Our aim was to study whether the previously reported high levels of ANGPTL4 detected in serum from patients with rheumatoid arthritis (RA) by ELISA was due to any specific molecular form of this protein (oligomers, monomers or fragments). ANGPTL4 levels were first determined in serum from 68 RA patients and 43 age and sex matched control subjects and the mean values differed by a factor of 5.0. Then, ANGPTL4 was analyzed after size exclusion chromatography (SEC) of serum samples...
2017: PloS One
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#5
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/28107331/adolescents-and-young-adults-addressing-needs-and-optimizing-care-with-a-clinical-nurse-specialist%C3%A2
#6
Laura Mitchell, Terri Stuart-McEwan, Hayley Panet, Abha Gupta
Adolescents and young adults (AYAs) with cancer aged 15-39 years have unique psychosocial, informational, and medical concerns compared to their older adult and pediatric counterparts. Recognizing the gaps in young adult cancer care, an AYA program was launched at a large tertiary cancer center to optimize the AYA cancer care experience. This article describes the contributions of a clinical nurse specialist in AYA program development. 
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February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107330/tell-me-about-you-experiences-teach-a-nurse-the-importance-of-listening%C3%A2
#7
Julie Beck
Unexpected cardiac issues at an early age inspired me to return to school to pursue a career in nursing. While in school, a close relationship with a family member facing a terminal cancer diagnosis gave me insight into the importance of listening as a tool for keeping patients safe and delivering the most appropriate care. These insights have shaped my career as I moved from student to RN to oncology nurse practitioner.
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107309/-delay-to-operating-room-fails-to-identify-adverse-outcomes-at-a-level-i-trauma-center
#8
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28107264/readmission-and-late-mortality-after-critical-illness-in-childhood
#9
Mary E Hartman, Mohammed J Saeed, Tellen Bennett, Katri Typpo, Renee Matos, Margaret A Olsen
OBJECTIVES: Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. DESIGN: Retrospective observational cohort study. SETTING: This study was performed using administrative claims data from 2006-2013 obtained from the Truven Health Analytics MarketScan Database...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107227/structural-level-differences-in-the-mother-to-child-hiv-transmission-rate-in-south-africa-a-multilevel-assessment-of-individual-health-facility-and-provincial-level-predictors-of-infant-hiv-transmission
#10
S Woldesenbet, D J Jackson, C J Lombard, T H Dinh, V Ramokolo, T Doherty, G G Sherman, Y Pillay, A E Goga
OBJECTIVES: In 2010, South Africa reported an early mother to child transmission (MTCT) rate of 3.5% at 4-8 weeks postpartum. Provincial early MTCT rates ranged from 1.4% (95% confidence interval [CI]: 0.1-3.4%) to 5.9% (95% CI: 3.8-8.0%). We sought to determine reasons for these geographic differences in MTCT rates. METHODS: This study employed multilevel modelling using 2010 South African PMTCT evaluation (SAPMTCTE) data from 530 facilities. Interview data and infant blood samples were collected from 3085 mother-infant pairs at 4-8 weeks postpartum...
January 18, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28107168/the-natriuretic-peptide-mr-proanp-predicts-all-cause-mortality-and-adverse-outcome-in-community-patients-a-10-year-follow-up-study
#11
Jonas Odermatt, Lara Hersberger, Rebekka Bolliger, Lena Graedel, Mirjam Christ-Crain, Matthias Briel, Heiner C Bucher, Beat Mueller, Philipp Schuetz
BACKGROUND: The precursor peptide of atrial natriuretic peptide (MR-proANP) has a physiological role in fluid homeostasis and is associated with mortality and adverse clinical outcomes in heart failure patients. Little is known about the prognostic potential of this peptide for long-term mortality prediction in community-dwelling patients. We evaluated associations of MR-proANP levels with 10-year all-cause mortality in patients visiting their general practitioner for a respiratory tract infection...
January 20, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28107122/evaluating-the-impact-of-pharmacists-on-reducing-use-of-sedative-hypnotics-for-treatment-of-insomnia-in-long-term-care-facility-residents
#12
Maria Grazia Gemelli, Katherine Yockel, Kenneth C Hohmeier
OBJECTIVE: To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting. DESIGN: A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents. SETTING: Eleven regional long-term care facilities in Northeastern Tennessee. PARTICIPANTS: Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts...
November 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#13
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#14
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28106851/workplace-violence-against-health-care-workers-in-north-chinese-hospitals-a-cross-sectional-survey
#15
Peihang Sun, Xue Zhang, Yihua Sun, Hongkun Ma, Mingli Jiao, Kai Xing, Zheng Kang, Ning Ning, Yapeng Fu, Qunhong Wu, Mei Yin
This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire...
January 19, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28106706/intravitreal-ocriplasmin-in-clinical-practice-predictors-of-success-visual-outcomes-and-complications
#16
Henry L Feng, Daniel B Roth, Aisha Hasan, Howard F Fine, H Matthew Wheatley, Jonathan L Prenner, Sumit P Shah, Kunjal K Modi, William J Feuer
PURPOSE: To investigate predictors of success, visual outcomes, and complications of intravitreal ocriplasmin for the treatment of symptomatic vitreomacular adhesion in a clinical care setting. METHODS: Retrospective chart review of 49 consecutive eyes of 47 patients who received intravitreal ocriplasmin. Spectral domain optical coherence tomography scans were examined for vitreomacular traction (VMT) release, full-thickness macular hole (FTMH) closure, and other changes in retinal anatomy...
January 18, 2017: Retina
https://www.readbyqxmd.com/read/28106705/repair-of-orbital-floor-fracture-with-modified-transnasal-endoscopic-approach-through-anterior-space-to-nasolacrimal-duct
#17
Motohiko Suzuki, Yoshihisa Nakamura, Shinya Ozaki, Makoto Yokota, Shingo Murakami
OBJECTIVES: Endoscopic approach provides excellent magnification and visualization, and a purely transnasal approach is minimally invasive method. However, it is very difficult to repair anterior and lateral fractures with the previous transnasal endoscopic approaches, since repair of orbital fractures is managed through the middle meatus and ostium from the posterior side of the nasolacrimal duct with side-viewing endoscope and curved instruments. Therefore, the authors used modified transnasal endoscopic approach as an alternative for repair of orbital floor fractures in order to effectively reach the lateral or anterior fracture of the orbital floor with straight endoscope and instruments endoscopically...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28106669/translational-studies-identify-long-term-impact-of-prior-neonatal-pain-experience
#18
Suellen M Walker
Pain sensitivity and risk of chronic pain can be influenced by past experience. Childhood stress/adversity has been associated with chronic pain, mood disorders, and altered disease vulnerability decades later. As the rate of preterm birth and survival at earlier gestational ages increases, and advances in peri-operative care and surgery allow more complex surgical interventions to be performed in neonates, evaluation of treatment 'success' must extend beyond acute morbidity and mortality to encompass effects on subsequent neurodevelopmental outcome, and also sensory, cognitive and behavioral responses to pain in later life...
January 12, 2017: Pain
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#19
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106650/trends-in-ambulatory-management-of-urinary-incontinence-in-women-in-the-united-states
#20
James C Forde, Bilal Chughtai, Meagan Cea, Benjamin V Stone, Alexis Te, Tara F Bishop
OBJECTIVES: Urinary incontinence (UI) is a common condition, but despite the availability of guidelines, variations exist in the care of patients. We sought to assess the changes in assessment and management of women with UI over time in the United States. METHODS: The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey are annual surveys from a nationally representative sample of visits to physicians. From 1999 through 2010, we identified visits by women to physicians where the chief complaint was UI using reason-for-visit and International Classification of Diseases, Ninth Revision codes...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
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