Read by QxMD icon Read

Clinical governance

Daniel J Beckett, Elaine Thomson, Lindsay Em Reid, Robert C Lloyd
Although there are national recommendations on the function of Acute Medicine Units (AMUs), there is no single agreed best model of care. Additionally, robust data is not always available to determine whether system changes have resulted in improvement. We designed an Excel file to interface with the hospital patient management system to provide real-time data on a number of metrics including AMU length of stay (AMULOS), mortality and readmissions. This demonstrated that improving consultant continuity of care was associated with a reduction in AMULOS and reduced variation in AMULOS...
2016: Acute Medicine
Michaela Archer, Yasmine Lau, Faisil Sethi
Aims and method Recent policy guidelines published by the Department of Health highlight the need to develop gender-sensitive psychiatric services. However, very little is currently known about the specific characteristics and needs of female patients entering acute psychiatric wards, particularly psychiatric intensive care units. This article aims to review the current literature on what is known about this group of patients. PubMed, Embase and PsycINFO were systematically searched using a number of key terms...
October 2016: BJPsych Bulletin
Jaeyong Shin, Young Choi, Sang Gyu Lee, Tae Hyun Kim, Eun-Cheol Park
Unnecessary use of high-quality resources in general hospitals hinders treatment of patients with urgent and complicated conditions. Thus, the Korean Government has sought to reduce general hospital visiting of patients with 52 mild diseases, including hypertension. The higher cost sharing for medical expenses and medications from general hospitals were enacted in 2009 and 2011, respectively.We determined whether these regulations were effective through evaluating changing trends in first-visited healthcare organizations and defined the first visiting healthcare organization level (primary clinics, hospital, and general hospital) as an outcome measure...
October 2016: Medicine (Baltimore)
A B Sudeep, Y K Gurav, V P Bondre
Chandipura virus (CHPV) (Vesiculovirus: Rhabdoviridae) garnered global attention as an emerging neurotropic pathogen inflicting high mortality in children within 24 h of commencement of symptoms. The 2003-2004 outbreaks in Central India witnessed case fatality rates ranging from 56-75 per cent in Andhra Pradesh and Gujarat with typical encephalitic symptoms. Due to the acute sickness and rapid deterioration, the precise mechanism of action of the virus is still unknown. Recent studies have shown increased expression of CHPV phosphoprotein upto 6 h post infection (PI) demonstrating CHPV replication in neuronal cells and the rapid destruction of the cells by apoptosis shed light on the probable mechanism of rapid death in children...
June 2016: Indian Journal of Medical Research
Natalie K Bradford, Liam J Caffery, Anthony C Smith
INTRODUCTION: With the escalating costs of health care, issues with recruitment and retention of health practitioners in rural areas, and poor economies of scale, the question of delivering people to services or services to people is a dilemma for health authorities around the world. People living in rural areas have poorer health outcomes compared to their urban counterparts, and the problem of how to provide health care and deliver services in rural locations is an ongoing challenge...
October 2016: Rural and Remote Health
Barbara Nussbaumer-Streit, Berlinda Yeoh, Ursula Griebler, Lisa M Pfadenhauer, Laura K Busert, Stefan K Lhachimi, Szimonetta Lohner, Gerald Gartlehner
BACKGROUND: Lead poisoning is associated with physical, cognitive and neurobehavioural impairment in children, and trials have tested many household interventions to prevent lead exposure. This is an update of the original review, first published in 2008. OBJECTIVES: To assess the effects of household interventions for preventing or reducing lead exposure in children, as measured by improvements in cognitive and neurobehavioural development, reductions in blood lead levels and reductions in household dust lead levels...
October 16, 2016: Cochrane Database of Systematic Reviews
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
Etienne Karita, Sabin Nsanzimana, Felix Ndagije, Kristin M Wall, Jeannine Mukamuyango, Placidie Mugwaneza, Eric Remera, Pratima L Raghunathan, Roger Bayingana, Kayitesi Kayitenkore, Brigitte Bekan-Homawoo, Amanda Tichacek, Susan Allen
BACKGROUND: Couples' voluntary HIV counseling and testing (CVCT) is a WHO-recommended intervention for prevention of heterosexual HIV transmission which very few African couples have received. We report the successful nationwide implementation of CVCT in Rwanda. METHODS: From 1988 to 1994 in Rwanda, pregnant and postpartum women were tested for HIV and requested testing for their husbands. Partner testing was associated with more condom use and lower HIV and sexually transmitted infection rates, particularly among HIV-discordant couples...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
M Bricout, J Rezzouk
When implanting the Maia(®) trapeziometacarpal prosthesis, surgeons will be faced with a variety of complications they must be able to recognize and anticipate. Their ability to deal with these complications and possibly even failures is governed by their knowledge of the right steps to take. The aim of this retrospective study was to assess the incidence of complications reported during implantation of the Maia(®) prosthesis, to describe their nature and potential predisposing factors, and to study failures and their outcomes...
June 2016: Hand Surgery and Rehabilitation
Thandeka T T Dlamini-Simelane, Eileen Moyer
Through various campaigns and strategies, more women are being tested for HIV in countries with a high prevalence of the virus. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining access to treatment. Drawing on two individual case studies selected from a larger study of the so-called leaky cascade in Swaziland, we illustrate the protracted journeys married women undertake to initiate treatment...
October 13, 2016: Health Policy and Planning
Valdester Cavalcante Pinto, Rodrigo Cardoso Cavalcante, Klébia Magalhães P Castello Branco, Candice Torres de Melo Bezerra Cavalcante, Isabel Cristina Leite Maia, Nayana Maria Gomes de Souza, Kiarelle Lourenço Penaforte, Juan Alberto Cosquillo Mejia, Waldemiro Carvalho
The perspective of the integrated health system has a network of care with multiple integration dimensions among subsystems as nuclear representation, relating the clinical aspects and governance to the representations and collective values. The normative integration aims to ensure coherence between the system of representations and values of society simultaneously with the interfaces of clinical and functional integration. It builds a bridge with governance, which allows, through their skills, management of all system components, encouraging cooperation, communication and information, in order to ensure the population under their responsibility to access excellence services, exceeding their expectations...
May 2016: Brazilian Journal of Cardiovascular Surgery
Caroline Se Homer
There has been substantial reform in the past decade in the provision of maternal and child health services, and specifically regarding models of maternity care. Increasingly, midwives are working together in small groups to provide midwife-led continuity of care. This article reviews the current evidence for models of maternity care that provide midwifery continuity of care, in terms of their impact on clinical outcomes, the views of midwives and childbearing women, and health service costs. A systematic review of midwife-led continuity of care models identified benefits for women and babies, with no adverse effects...
October 17, 2016: Medical Journal of Australia
Yves Bergevin, Bettina Habib, Keesa Elicksen-Jensen, Stephen Samis, Jean Rochon, Jean-Louis Denis, Denis Roy
A study on the impact of regionalization on the Triple Aim of Better Health, Better Care and Better Value across Canada in 2015 identified major findings including: (a) with regard to the Triple Aim, the Canadian situation is better than before but variable and partial, and Canada continues to underperform compared with other industrialized countries, especially in primary healthcare where it matters most; (b) provinces are converging toward a two-level health system (provincial/regional); (c) optimal size of regions is probably around 350,000-500,000 population; d) citizen and physician engagement remains weak...
2016: HealthcarePapers
Xi Fang, Matthew J Stroud, Kunfu Ouyang, Li Fang, Jianlin Zhang, Nancy D Dalton, Yusu Gu, Tongbin Wu, Kirk L Peterson, Hsien-Da Huang, Ju Chen, Nanping Wang
Adipose tissue is a key endocrine organ that governs systemic homeostasis. PPARγ is a master regulator of adipose tissue signaling that plays an essential role in insulin sensitivity, making it an important therapeutic target. The selective PPARγ agonist rosiglitazone (RSG) has been used to treat diabetes. However, adverse cardiovascular effects have seriously hindered its clinical application. Experimental models have revealed that PPARγ activation increases cardiac hypertrophy. RSG stimulates cardiac hypertrophy and oxidative stress in cardiomyocyte-specific PPARγ knockout mice, implying that RSG might stimulate cardiac hypertrophy independently of cardiomyocyte PPARγ...
October 6, 2016: JCI Insight
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Abdallah Ibrahim, Sidua Hor, Ozge S Bahar, Duah Dwomoh, Mary M McKay, Reuben K Esena, Irene A Agyeponge
BACKGROUND: The process to seek for care by patients who experience episodes of mental disorders may determine how and where they receive the needed treatment. This study aimed to understand the pathways that people with mental disorders traversed for psychiatric services, particularly where these individuals will first seek treatment and the factors that influence such pathways to mental health care. METHODS: A cross-sectional study conducted at Pantang psychiatric hospital in Accra, Ghana involving 107 patients of ages 18 and older and their family members...
2016: International Journal of Mental Health Systems
Chisato Hamashima, Rei Goto
In 2015, the Japanese government decided to introduce endoscopic screening for gastric cancer as a national program. To provide endoscopic screening nationwide, we estimated the proportion of increase in the number of endoscopic examinations with the introduction of endoscopic screening based on a national survey. The total number of endoscopic examinations has increased, particularly in clinics. Based on the national survey, the total number of participants in gastric cancer screening was 3,784,967. If 30% of the participants are switched from radiographic screening to endoscopic screening, about 1 million additional endoscopic examinations are needed...
October 11, 2016: Cancer Science
K Pernelle, L Imbert, C Bosser, J-C Auregan, M Cruel, A Ogier, P Jurdic, T Hoc
Human cortical bone permanently remodels itself resulting in a haversian microstructure with heterogeneous mechanical and mineral properties. Remodeling is carried out by a subtle equilibrium between bone formation by osteoblasts and bone degradation by osteoclasts. The mechanisms regulating osteoclast activity were studied using easy access supports whose homogeneous microstructures differ from human bone microstructure. In the current study, we show that human osteoclasts resorb human cortical bone non-randomly with respect to this specific human bone microstructural heterogeneity...
October 7, 2016: Bone
C H Stillson, H Okatch, R Frasso, L Mazhani, T David, T Arscott-Mills, M Matlhare, A P Steenhoff
SETTING: Government-funded public health clinics in and around Gaborone, Botswana. OBJECTIVE: To explore the challenges faced by care givers of children on treatment for tuberculosis (TB) to inform a more child-friendly approach to Botswana's National TB Programme (NTP) strategy. DESIGN: Qualitative study using 28 in-depth interviews with care givers of children receiving anti-tuberculosis treatment. RESULTS: Care givers identified five main challenges: long delays in their child's diagnosis, difficulty attending clinic for daily treatment, difficulty administering TB medications, stock-outs of TB medications leading to treatment interruptions, and inadequate TB education...
October 2016: International Journal of Tuberculosis and Lung Disease
Janine Margarita Dizon, Karen Grimmer, Shingai Machingaidze, Pam McLaren, Quinette Louw
BACKGROUND: Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant...
October 10, 2016: Health Research Policy and Systems
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"