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Emergency Planning

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https://www.readbyqxmd.com/read/27926621/accountable-care-organization-implementation-experiences-and-rural-participation-considerations-for-nurses
#1
Matt Thomas Bagwell, Angeline Bushy, Judith Ortiz
BACKGROUND: Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs). METHODS: Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations, and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics, and emerging themes from the ACO executive responses was identified...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27925108/urgent-and-emergency-care-for-pedestrians-injured-in-brazilian-traffic
#2
Liana Wernersbach Pinto, Adalgisa Peixoto Ribeiro, Camila Alves Bahia, Mariana Gonçalves de Freitas
This paper aimed to describe the epidemiological profile of pedestrians injured in traffic accidents treated at urgent and emergency facilities participating in the 2014VIVA Survey and the characterization of these events and consequences for these victims. This is a cross-sectional study conducted in the period from September to November 2014 in 24 Brazilian state capitals and the Federal District. We analyzed variables that characterize the victim, the accident and its severity and case outcome. We calculated simple and relative frequencies and performed a bivariate analysis by gender and age group...
December 2016: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#3
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27924107/newborn-healthcare-in-urban-india
#4
REVIEW
J Sharma, D Osrin, B Patil, S B Neogi, M Chauhan, R Khanna, R Kumar, V K Paul, S Zodpey
The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#5
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27923113/characteristics-and-outcomes-of-young-adults-who-suffered-an-out-of-hospital-cardiac-arrest-ohca
#6
Michael Yih-Chong Chia, Qing Shu Lu, Nik Hisamuddin Rahman, Nausheen Edwin Doctor, Tatsuya Nishiuchi, Benjamin Sieu-Hon Leong, Lai Peng Tham, E-Shaun Goh, Ling Tiah, Apichaya Monsomboon, Marcus Eng Hock Ong
BACKGROUND: There is paucity of data examining the incidence and outcomes of young OHCA adults. The aim of this study is to determine the outcomes and characteristics of young adults who suffered an OHCA and identify factors that are associated with favourable neurologic outcomes. METHODS: All EMS-attended OHCA adults between the ages of 16 and 35 years in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry were analysed. The primary outcome was favourable neurologic outcome (Cerebral Performance Category 1 or 2) at hospital discharge or at 30th day post OHCA if not discharged...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27919450/development-and-validation-of-a-prediction-model-for-patients-discharged-to-post-acute-care-after-colorectal-cancer-surgery
#7
Elizabeth A Bailey, Rebecca L Hoffman, Christopher Wirtalla, Giorgos Karakousis, Rachel R Kelz
BACKGROUND: As payment shifts toward bundled reimbursement, decreasing unnecessary inpatient care may provide cost savings. This study examines the association between discharge status, hospital duration of stay, and cost for colorectal operation patients without complications and uses risk factors to predict the need for post-acute care. METHODS: We used the New York Statewide Planning and Research Cooperative System and the California Healthcare Cost and Utilization Project State Inpatient Databases to identify all patients who underwent operative resection for colorectal cancer in 2009-2010 and were discharged to home or post-acute care...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27919281/incidence-causes-and-consequences-of-preventable-adverse-drug-events-protocol-for-an-overview-of-reviews
#8
Brian Hutton, Salmaan Kanji, Erika McDonald, Fatemeh Yazdi, Dianna Wolfe, Kednapa Thavorn, Sally Pepper, Laurie Chapman, Becky Skidmore, David Moher
BACKGROUND: Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings...
December 5, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27919145/-development-of-a-predictive-model-of-death-or-urgent-hospitalization-to-identify-frail-elderly
#9
Paolo Pandolfi, Natalina Collina, Paolo Marzaroli, Elisa Stivanello, Muriel Assunta Musti, Chiara Giansante, Vincenza Perlangeli, Lorenzo Pizzi, Sara De Lisio, Fausto Francia
OBJECTIVES: to develop and validate a predictive model of mortality or emergency hospitalization in all subjects aged 65 years and over. DESIGN: cohort study based on 9 different databases linked with each other. SETTING AND PARTICIPANTS: the model was developed on the population aged 65 years and over resident at 01.01.2011 for at least two years in the city of Bologna (Emilia-Romagna Region, Northern Italy); 96,000 persons were included...
November 2016: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/27918958/drivers-of-airborne-human-to-human-pathogen-transmission
#10
REVIEW
Sander Herfst, Michael Böhringer, Basel Karo, Philip Lawrence, Nicola S Lewis, Michael J Mina, Charles J Russell, John Steel, Rik L de Swart, Christian Menge
Airborne pathogens - either transmitted via aerosol or droplets - include a wide variety of highly infectious and dangerous microbes such as variola virus, measles virus, influenza A viruses, Mycobacterium tuberculosis, Streptococcus pneumoniae, and Bordetella pertussis. Emerging zoonotic pathogens, for example, MERS coronavirus, avian influenza viruses, Coxiella, and Francisella, would have pandemic potential were they to acquire efficient human-to-human transmissibility. Here, we synthesize insights from microbiological, medical, social, and economic sciences to provide known mechanisms of aerosolized transmissibility and identify knowledge gaps that limit emergency preparedness plans...
December 2, 2016: Current Opinion in Virology
https://www.readbyqxmd.com/read/27918408/full-practice-authority-for-nurse-practitioners
#11
Deborah Dillon, Faye Gary
Implementation of the Affordable Care Act (2010) enabled more than 30 million people to have new access to primary care services. On the basis of current utilization patterns, demand for primary care providers is expected to grow more rapidly than physician supply. This imbalance is expected to worsen, as the aging population requires more health care resources. In addition, more patients are requiring critical care services and physician numbers are not keeping with this growing need. Restrictions on resident physician practice hours have impacted inpatient care as well...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#12
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27914822/effects-of-sodium-thiosulfate-versus-observation-on-development-of-cisplatin-induced-hearing-loss-in-children-with-cancer-accl0431-a-multicentre-randomised-controlled-open-label-phase-3-trial
#13
David R Freyer, Lu Chen, Mark D Krailo, Kristin Knight, Doojduen Villaluna, Bonnie Bliss, Brad H Pollock, Jagadeesh Ramdas, Beverly Lange, David Van Hoff, Michele L VanSoelen, John Wiernikowski, Edward A Neuwelt, Lillian Sung
BACKGROUND: Sodium thiosulfate is an antioxidant shown in preclinical studies in animals to prevent cisplatin-induced hearing loss with timed administration after cisplatin without compromising the antitumour efficacy of cisplatin. The primary aim of this study was to assess sodium thiosulfate for prevention of cisplatin-induced hearing loss in children and adolescents. METHODS: ACCL0431 was a multicentre, randomised, open-label, phase 3 trial that enrolled participants at 38 participating Children's Oncology Group hospitals in the USA and Canada...
November 30, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27914193/coaching-a-new-model-for-academic-and-career-achievement
#14
Nicole M Deiorio, Patricia A Carney, Leslie E Kahl, Erin M Bonura, Amy Miller Juve
BACKGROUND: Individualized education is emerging as an innovative model for physician training. This requires faculty coaching to guide learners' achievements in academic performance, competency development, and career progression. In addition, coaching can foster self-reflection and self-monitoring using a data-guided approach to support lifelong learning. CONTEXT: Coaching differs from mentoring or advising, and its application in medical education is novel. Because of this, definitions of the concept and the constructs of coaching as applied to medical education are needed to accurately assess the coaching relationship and coaching processes...
2016: Medical Education Online
https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#15
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913998/immunotherapy-for-breast-cancer-past-present-and-future
#16
Alison Spellman, Shou-Ching Tang
Immunotherapy has shown promise in many solid tumors including melanoma and non-small cell lung cancer with an evolving role in breast cancer. Immunotherapy encompasses a wide range of therapies including immune checkpoint inhibition, monoclonal antibodies, bispecific antibodies, vaccinations, antibody-drug conjugates, and identifying other emerging interventions targeting the tumor microenvironment. Increasing efficacy of these treatments in breast cancer patients requires identification of better biomarkers to guide patient selection; recognizing when to initiate these therapies in multi-modality treatment plans; establishing novel assays to monitor immune-mediated responses; and creating combined systemic therapy options incorporating conventional treatments such as chemotherapy and endocrine therapy...
December 2, 2016: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/27913106/innovations-in-radiotherapy-technology
#17
I J Feain, L Court, J R Palta, S Beddar, P Keall
Many low- and middle-income countries, together with remote and low socioeconomic populations within high-income countries, lack the resources and services to deal with cancer. The challenges in upgrading or introducing the necessary services are enormous, from screening and diagnosis to radiotherapy planning/treatment and quality assurance. There are severe shortages not only in equipment, but also in the capacity to train, recruit and retain staff as well as in their ongoing professional development via effective international peer-review and collaboration...
November 29, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27912247/molecular-evolution-in-insect-societies-an-eco-evo-devo-synthesis
#18
Amy L Toth, Sandra M Rehan
The evolution of eusociality is a perennial issue in evolutionary biology, and genomic advances have fueled steadily growing interest in the genetic changes underlying social evolution. Along with a recent flurry of research on comparative and evolutionary genomics in different eusocial insect groups (bees, ants, wasps, and termites), several mechanistic explanations have emerged to describe the molecular evolution of eusociality from solitary behavior. These include solitary physiological ground plans, genetic toolkits of deeply conserved genes, evolutionary changes in protein-coding genes, cis regulation, and the structure of gene networks, epigenetics, and novel genes...
November 28, 2016: Annual Review of Entomology
https://www.readbyqxmd.com/read/27911770/the-right-incentives-enable-ocean-sustainability-successes-and-provide-hope-for-the-future
#19
Jane Lubchenco, Elizabeth B Cerny-Chipman, Jessica N Reimer, Simon A Levin
Healthy ocean ecosystems are needed to sustain people and livelihoods and to achieve the United Nations Sustainable Development Goals. Using the ocean sustainably requires overcoming many formidable challenges: overfishing, climate change, ocean acidification, and pollution. Despite gloomy forecasts, there is reason for hope. New tools, practices, and partnerships are beginning to transform local fisheries, biodiversity conservation, and marine spatial planning. The challenge is to bring them to a global scale...
December 2, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27911025/effect-of-balloon-expandable-transcatheter-aortic-valve-replacement-positioning-a-patient-specific-numerical-model
#20
Matteo Bianchi, Gil Marom, Ram P Ghosh, Harold A Fernandez, James R Taylor, Marvin J Slepian, Danny Bluestein
Transcatheter aortic valve replacement (TAVR) has emerged as a life-saving and effective alternative to surgical valve replacement in high-risk, elderly patients with severe calcific aortic stenosis. Despite its early promise, certain limitations and adverse events, such as suboptimal placement and valve migration, have been reported. In the present study, it was aimed to evaluate the effect of various TAVR deployment locations on the procedural outcome by assessing the risk for valve migration. The deployment of a balloon-expandable Edwards SAPIEN valve was simulated via finite element analysis in a patient-specific calcified aortic root, which was reconstructed from CT scans of a retrospective case of valve migration...
December 2016: Artificial Organs
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