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https://www.readbyqxmd.com/read/28816992/are-physician-assistants-needed-in-guatemala-a-survey-of-potential-urban-and-rural-users
#1
Claudia Luna-Asturias, Jennifer Apple, Guillermo A Bolaños, Jonathan M Bowser, Edwin J Asturias
PURPOSE: The shortage of trained health care personnel has been increasing worldwide. With the physician assistant (PA) profession, created in the United States in the 1960s, expanding globally, this study sought to ascertain whether PAs can be an innovative solution to this crisis. METHODS: We conducted a convenience sample survey to assess the need for and acceptability of future PA professionals in Guatemala. Eighty-nine doctors, nurses, and community members from rural and urban areas of Guatemala participated in the survey...
September 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28816812/caring-for-childbearing-women-in-crisis-midwife-pilgrim
#2
Lynn Clark Callister
No abstract text is available yet for this article.
September 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28815799/characterization-of-opioid-use-in-sickle-cell-disease
#3
Jin Han, Jifang Zhou, Santosh L Saraf, Victor R Gordeuk, Gregory S Calip
PURPOSE: Opioid analgesics are commonly used to treat vaso-occlusive pain episodes in sickle cell disease (SCD), but comprehensive evidence characterizing opioid use in this patient population is limited. Our objective was to characterize opioid use patterns among SCD patients using a large nationwide database. METHODS: A large, US medical claims database was utilized to identify a cohort of 3882 SCD patients, and characteristics of opioid use were analyzed. Clinical variables including age, gender, medication use, health care utilization, and medical history were evaluated for correlations with opioid use...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28811912/flexible-assertive-community-treatment-fact-model-in-specialist-psychosis-teams-an-evaluation
#4
Loopinder Sood, Andy Owen, Richard Onyon, Aarohi Sharma, Jessica Nigriello, Dominic Markham, Hannah Seabrook
Aims and method The impact of flexible assertive community treatment (FACT) has been observed in people previously supported by assertive community treatment (ACT) teams, but its effect on those previously with a community mental health team (CMHT) has not been studied in the UK. An observational study was conducted of 380 people from 3 CMHTs and 95 people from an ACT team, all with a history of psychosis, following service reconfiguration to 3 FACT teams. Results People previously with a CMHT required less time in hospital when the FACT model was introduced...
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28808427/public-engagement-in-setting-healthcare-priorities-a-ranking-exercise-in-cyprus
#5
Antonis Farmakas, Mamas Theodorou, Petros Galanis, Georgios Karayiannis, Stefanos Ghobrial, Nikos Polyzos, Evridiki Papastavrou, Eirini Agapidaki, Kyriakos Souliotis
BACKGROUND: In countries such as Cyprus the financial crisis and the recession have severely affected the funding and priority setting of the health care system. There is evidence highlighting the importance of population' preferences in designing priorities for health care settings. Although public preferences have been thorough analysed in many countries, there is a research gap in terms of simultaneously investigating the relative importance and the weight of differing and competing criteria for determining healthcare priority settings...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28806607/dissociation-in-patients-with-borderline-personality-disorder-in-acute-inpatient-care-a-latent-profile-analysis
#6
Susanne Jaeger, Tilman Steinert, Carmen Uhlmann, Erich Flammer, Dana Bichescu-Burian, Stefan Tschöke
PURPOSE: Dissociation is a common symptom in Borderline Personality disorder (BPD) and its consideration is important for the therapeutic outcome. The aim of this cross-sectional study was to scrutinize the co-occurrence of BPD symptoms and dissociative experiences. In particular, we were interested in the occurrence of specific symptom clusters characterizing qualitatively different patient groups in a clinical sample of BPD patients. BASIC PROCEDURES: We analyzed the data of 103 patients in a specialized acute inpatient care crisis intervention unit...
July 20, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28805175/outcomes-of-a-psycho-education-and-monitoring-programme-to-prevent-compulsory-admission-to-psychiatric-inpatient-care-a-randomised-controlled-trial
#7
B Lay, W Kawohl, W Rössler
BACKGROUND: There is a need for interventions that effectively reduce compulsory admission to psychiatry. We conducted a randomised controlled trial to investigate whether an innovative intervention programme prevents compulsory re-admission in people with serious mental illness. METHODS: The programme addresses primarily patients' self-management skills. It consists of individualised psychoeducation focusing on behaviours prior to and during illness-related crises, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring...
August 14, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28804747/care-experiences-of-adults-with-a-dual-diagnosis-and-their-family-caregivers
#8
David B Nicholas, Avery Calhoun, Anne Marie McLaughlin, Janki Shankar, Linda Kreitzer, Masimba Uzande
Individuals diagnosed with developmental disability and mental illness (a "dual diagnosis") contend with multiple challenges and system-related barriers. Using an interpretive description approach, separate qualitative interviews were conducted with adults with a dual diagnosis (n = 7) and their caregiving parents (n = 8) to examine care-related experiences. Results indicate that individuals with a dual diagnosis and their families experience misunderstanding and stigma. Families provide informal complex care amid insufficient and uncoordinated services but are often excluded from formal care planning...
January 2017: Global Qualitative Nursing Research
https://www.readbyqxmd.com/read/28802695/scarce-resource-allocation-during-disasters-a-mixed-method-community-engagement-study
#9
Elizabeth Lee Daugherty Biddison, Howard S Gwon, Monica Schoch-Spana, Alan C Regenberg, Chrissie Juliano, Ruth R Faden, Eric S Toner
BACKGROUND: During a catastrophe, health care providers may face difficult questions regarding who will receive limited life-saving resources. The ethical principles that should guide decision-making have been considered by expert panels but have not been well explored with the public or front line clinicians. The objective of this study was to characterize the public's values regarding how scarce mechanical ventilators should be allocated during an influenza pandemic, with the ultimate goal of informing a statewide scare resource allocation framework...
August 9, 2017: Chest
https://www.readbyqxmd.com/read/28802377/an-innovative-approach-to-improve-ear-nose-and-throat-surgical-access-for-remote-living-cape-york-indigenous-children
#10
Susan P Jacups, Denise Newman, Deborah Dean, Ann Richards, Kate M McConnon
INTRODUCTION: On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28800256/the-critical-care-crisis-of-opioid-overdoses-in-the-united-states
#11
Jennifer P Stevens, Michael J Wall, Lena Novack, John Marshall, Douglas J Hsu, Michael D Howell
RATIONALE: Opioid abuse is increasing, but its impact on critical care resources in the United States is unknown. OBJECTIVE: We hypothesized that there would be a rising need for critical care among opioid-associated overdoses in the United States. METHODS: We analyzed all adult admissions using a retrospective cohort study from 162 hospitals in 44 states discharged between January 1, 2009 - September 31, 2015 to describe the incidence of intensive care unit (ICU) admissions for opioid overdose over this time...
August 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28799847/the-willingness-of-people-who-inject-drugs-in-boston-to-use-a-supervised-injection-facility
#12
Casey León, Lena Cardoso, Sarah Mackin, Barry Bock, Jessie M Gaeta
BACKGROUND: In Massachusetts, the number of opioid-related deaths has increased 350% since 2000. In the setting of increasing overdose deaths, one potential intervention is Supervised Injection Facilities (SIFs). This study explores willingness of people who inject drugs in Boston to use a SIF and examines factors associated with willingness. METHODS: A cross-sectional survey of a convenience sample of 237 people who inject drugs and utilize Boston's needle exchange program (NEP)...
August 11, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28792290/pearls-and-pitfalls-for-prescribing-opioids-in-a-climate-of-increased-provider-scrutiny
#13
Joanna Gedzior, Arlen Kwong
In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing "an urgent health crisis facing America: the opioid epidemic." In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.
March 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28790518/coordinated-management-of-academic-health-centers
#14
Jeffrey R Balser, William W Stead
Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28782309/study-of-seminal-fluid-parameters-and-fertility-of-male-sickle-cell-disease-patients-and-potential-impact-of-hydroxyurea-treatment
#15
Lulup Kumar Sahoo, Bipin Kishore Kullu, Siris Patel, Nayan Kumar Patel, Pragyan Rout, Prasanta Purohit, Satyabrata Meher
INTRODUCTION: Male Sickle cell disease (SCD) patients often have moderate to severe hypogonadism resulting in abnormal seminal fluid parameters due to testicular dysfunction. Hydroxyurea (HU), the only drug found to be effective in preventing morbidity and mortality in sickle cell disease patients has been found to further aggravate the testicular dysfunction. MATERIAL AND METHODS: This was a prospective study done at a tertiary care hospital over 26 months between September 2011 to October 2013...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28782308/a-prospective-observational-study-to-determine-the-prevalence-and-clinical-profile-of-patients-of-hypertensive-crisis-in-a-tertiary-care-hospital
#16
Santosh B Salagre, Shobha M Itolikar, Kapil Gedam
BACKGROUND: Hypertension can present in crisis form as 'hypertensive urgency'(HU) or as 'hypertensive emergency' (HE). Both the conditions are associated with significant morbidity and mortality. AIM: To evaluate the clinical characteristics, course of illness, end-organ damage and survival outcome in patients with hypertensive crisis. METHODOLOGY: This prospective observational year-long study was conducted after due ethical considerations on 120 adult non-pregnant patients who presented with blood pressure of >180/120 mm Hg in the emergency medical services of a tertiary care hospital...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28779818/understanding-frailty-a-nurse-s-guide
#17
REVIEW
Cathy A Maxwell, Jinjiao Wang
Frailty is a public health crisis for an aging society. As a concept and condition, frailty is poorly understood and underrecognized in clinical settings. Nurses play an important role as frontline providers who care for aging adults. The aim of this article is to raise awareness among nurses about frailty and to discuss the recognition and management of this prevailing condition. The authors present conceptual definitions and models of frailty, a brief discussion of the underlying biological mechanisms and evidence-based interventions for frailty identification, and approaches to delay and decrease the burden of frailty...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28775221/in-situ-medical-simulation-for-pre-implementation-testing-of-clinical-service-in-a-regional-hospital-in-hong-kong
#18
P P Chen, N Tk Tsui, A Sw Fung, A Hf Chiu, W Cw Wong, H T Leong, P Sf Lee, J Yw Lau
The implementation of a new clinical service is associated with anxiety and challenges that may prevent smooth and safe execution of the service. Unexpected issues may not be apparent until the actual clinical service commences. We present a novel approach to test the new clinical setting before actual implementation of our endovascular aortic repair service. In-situ simulation at the new clinical location would enable identification of potential process and system issues prior to implementation of the service...
August 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28770597/can-differentiated-care-models-solve-the-crisis-in-hiv-treatment-financing-analysis-of-prospects-for-38-countries-in-sub-saharan-africa
#19
Catherine Barker, Arin Dutta, Kate Klein
INTRODUCTION: Rapid scale-up of antiretroviral therapy (ART) in the context of financial and health system constraints has resulted in calls to maximize efficiency in ART service delivery. Adopting differentiated care models (DCMs) for ART could potentially be more cost-efficient and improve outcomes. However, no study comprehensively projects the cost savings across countries. We model the potential reduction in facility-level costs and number of health workers needed when implementing two types of DCMs while attempting to reach 90-90-90 targets in 38 sub-Saharan African countries from 2016 to 2020...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28767813/-new-changes-old-systems-health-policies-in-mexico-and-colombia-in-the-21st-century
#20
Monica Uribe-Gómez
Recent years have witnessed discussion on the need for changes in the health systems of Latin America. This initiative, spearheaded once again by the World Bank as Universal Health Coverage, focuses on strategies for protection against financial risks and unified access to essential services and medicines. Although the World Bank approaches have been incorporated in different ways by the region's countries since the 1980s, there have also been important breaks with this trend, for example in Argentina, Brazil, Uruguay, and Ecuador, which have sought at different times to implement policies and programs emphasizing non-market-driven values...
July 27, 2017: Cadernos de Saúde Pública
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