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Crisis Care

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https://www.readbyqxmd.com/read/28108374/strategies-to-reduce-hospitalizations-of-children-with-medical-complexity-through-complex-care-expert-perspectives
#1
Ryan J Coller, Bergen B Nelson, Thomas S Klitzner, Adrianna A Saenz, Paul G Shekelle, Carlos F Lerner, Paul J Chung
OBJECTIVES: Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. Our objective was to conduct a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. METHODS: A complex care medical home program used 1) semi-structured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations, and 2) literature review on preventing hospitalizations among CMC, to develop key drivers for lowering hospital utilization and link them with intervention strategies...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28107315/weight-management-perception-interest-and-preferences-in-adult-cancer-survivors%C3%A2
#2
Fang Fang Zhang, Susan Meagher, Susan Koch-Weser, Mary Singer, Geetika Dhaundiyal, John Erban, Edward Saltzman
BACKGROUND: Obesity in cancer survivors has been recognized as a growing crisis in cancer care, but cancer survivors may not perceive weight status as important and may not be motivated to manage weight. 
. OBJECTIVES: This study aims to evaluate survivors' perception, interest, and preferences for weight management and to identify characteristics that may affect attitudes toward weight management. 
. METHODS: This cross-sectional survey assessed cancer survivors' attitudes toward weight management with patients attending oncology outpatient clinics at Tufts Medical Center in Boston, Massachusetts...
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28106920/self-admission-to-inpatient-treatment-for-patients-with-anorexia-nervosa-the-patient-s-perspective
#3
Mattias Strand, Cynthia M Bulik, Yvonne von Hausswolff-Juhlin, Sanna A Gustafsson
The aim of the present study was to explore patients' experiences of participating in a self-admission program at a specialist eating disorders clinic. Sixteen adult program participants with a diagnosis of anorexia nervosa were interviewed at 6 months about their experiences in the self-admission program. A qualitative content analysis approach was applied to identify recurring themes. Four themes were identified: Agency and Flexibility, Functions, Barriers, and Applicability. Participants used self-admission to boost healthy behaviors, to prevent deterioration, to forestall the need for longer periods of hospitalizations, and to get a break from overwhelming demands...
January 20, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28100641/new-sources-of-value-for-health-and-care-in-a-carbon-constrained-world
#4
Kate Emma Charlesworth, Maggie Jamieson
BACKGROUND: Due to the climate crisis, it is increasingly evident that countries will have to decarbonize. Healthcare, which has a large carbon footprint and uses vast quantities of resources, will have to undergo significant transformation. In this research, we sought the ideas of leading thinkers in the field, to address the question of how health systems can provide high-quality care in a carbon-constrained world. METHODS: Semi-structured, qualitative in-depth interviews with 15 healthcare thought leaders from Australia, the UK, the USA and New Zealand...
January 17, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28100251/consensus-guideline-for-the-diagnosis-and-treatment-of-aromatic-l-amino-acid-decarboxylase-aadc-deficiency
#5
REVIEW
Tessa Wassenberg, Marta Molero-Luis, Kathrin Jeltsch, Georg F Hoffmann, Birgit Assmann, Nenad Blau, Angeles Garcia-Cazorla, Rafael Artuch, Roser Pons, Toni S Pearson, Vincenco Leuzzi, Mario Mastrangelo, Phillip L Pearl, Wang Tso Lee, Manju A Kurian, Simon Heales, Lisa Flint, Marcel Verbeek, Michèl Willemsen, Thomas Opladen
Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare, autosomal recessive neurometabolic disorder that leads to a severe combined deficiency of serotonin, dopamine, norepinephrine and epinephrine. Onset is early in life, and key clinical symptoms are hypotonia, movement disorders (oculogyric crisis, dystonia, and hypokinesia), developmental delay, and autonomic symptoms.In this consensus guideline, representatives of the International Working Group on Neurotransmitter Related Disorders (iNTD) and patient representatives evaluated all available evidence for diagnosis and treatment of AADCD and made recommendations using SIGN and GRADE methodology...
January 18, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28097987/nhs-in-crisis-health-and-care-experts-call-for-action
#6
Stephanie Jones-Berry
Royal colleges, charities and even the head of NHS England have issued warnings to prime minister Theresa May about the state of the health service.
January 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28097981/winter-crisis-increases-need-to-speak-up-about-poor-care
#7
Stephanie Jones-Berry
Nurses need to raise concerns and speak up now more than ever, the nurse who exposed appalling treatment of patients at Stafford Hospital has urged.
January 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28096009/perceptions-of-dying-well-and-distressing-death-by-acute-care-nurses
#8
Christine A Becker, Greg Wright, Kristen Schmit
AIM: This study aims to identify perceptions of nurses practicing in four adult inpatient units regarding their actions to provide quality end of life care for dying patients, their definitions of dying well, and their symptoms of distress and actions they took for relief. BACKGROUND: Nurses caring for patients who are dying want them to have the best death possible; however, many nurses are not prepared for every death which may occur. METHODS: Qualitative questionnaire data were collected from 49 nurses on four adult inpatient nursing units to analyze nurse perceptions of distressing death and dying well...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095824/community-based-health-care-is-an-essential-component-of-a-resilient-health-system-evidence-from-ebola-outbreak-in-liberia
#9
Kendra Siekmans, Salim Sohani, Tamba Boima, Florence Koffa, Luay Basil, Saïd Laaziz
BACKGROUND: Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. METHODS: A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff...
January 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28093421/gp-views-on-strategies-to-cope-with-increasing-workload-a-qualitative-interview-study
#10
Rebecca Fr Fisher, Caroline Hd Croxson, Helen F Ashdown, Fd Richard Hobbs
BACKGROUND: The existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative. AIM: To explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each. DESIGN AND SETTING: Semi-structured, qualitative interviews with GPs working within NHS England...
January 16, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28090165/challenges-and-solutions-in-reducing-opioid-misuse-and-abuse
#11
Peter Sonnenreich, Linda Geisler
We present some of the approaches to and challenges of the opioid crisis that emerged from thought-leaders at an Academy of Managed Care Pharmacy symposium.
January 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28088602/aggressive-surgical-approach-to-the-management-of-neuroendocrine-tumors-a-report-of-1-000-surgical-cytoreductions-by-a-single-institution
#12
Eugene A Woltering, Brianne A Voros, David T Beyer, Yi-Zarn Wang, Ramcharan Thiagarajan, Pamela Ryan, Anne Wright, Robert A Ramirez, M Jennifer Ricks, J Philip Boudreaux
BACKGROUND: Neuroendocrine tumors (NETs) are rare neoplasms. Our group has treated over 2,000 NET patients and has performed over 1,000 surgical cytoreductive procedures. STUDY DESIGN: Records of 834 NET patients who underwent surgical cytoreduction at our institution were reviewed. Demographic information, intraoperative findings, extent of disease, complications, and survival rates were calculated. RESULTS: 800 patients underwent 1,001 cytoreductive surgeries...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28087812/long-term-effects-of-youth-unemployment-on-mental-health-does-an-economic-crisis-make-a-difference
#13
Emelie Thern, Jeroen de Munter, Tomas Hemmingsson, Finn Rasmussen
BACKGROUND: Ill health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates. METHODS: A register-linked population-based cohort study was conducted including individuals aged 17-24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991-1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983-1986)...
January 13, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/28081339/management-of-acute-postoperative-hypertension-for-reducing-cardiovascular-complications-in-cancer-patients-when-and-how-aggressively
#14
Ning Lou, Daofeng Wang, Zhi Wang, Wenfeng Ye, Xiao Liu
BACKGROUND/AIM: We sought to determine what factors cardiovascular complications (CVCs) correlate with in cancer patients with acute postoperative hypertension (APH) and to define when and how aggressively to treat this disorder in the present study. MATERIALS AND METHODS: A retrospective observational study of cancer patients with postoperative hypertension at a single intensive care unit between July 2007 and June 2013 was conducted. The outcome of interest was the incidence of a CVC...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#15
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28077451/the-increasing-use-of-cannabis-among-older-americans-a-public-health-crisis-or-viable-policy-alternative
#16
Brian Kaskie, Padmaja Ayyagari, Gary Milavetz, Dan Shane, Kanika Arora
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor...
January 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28075363/maternal-and-child-health-of-internally-displaced-persons-in-ukraine-a-qualitative-study
#17
Svitlana Nidzvetska, Jose M Rodriguez-Llanes, Isabelle Aujoulat, Julita Gil Cuesta, Hannah Tappis, Joris A F van Loenhout, Debarati Guha-Sapir
Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to healthcare, caring practices, food security, and overall financial situation of mothers and young children displaced by the conflict in Ukraine. This is a qualitative study, which collected data through semi-structured in-depth interviews with nine IDP mothers via Skype and Viber with a convenience sample of participants selected through snowball technique...
January 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28075223/the-statistical-crisis-in-science-how-is-it-relevant-to-clinical-neuropsychology
#18
Andrew Gelman, Hilde M Geurts
There is currently increased attention to the statistical (and replication) crisis in science. Biomedicine and social psychology have been at the heart of this crisis, but similar problems are evident in a wide range of fields. We discuss three examples of replication challenges from the field of social psychology and some proposed solutions, and then consider the applicability of these ideas to clinical neuropsychology. In addition to procedural developments such as preregistration and open data and criticism, we recommend that data be collected and analyzed with more recognition that each new study is a part of a learning process...
January 11, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28075067/national-implementation-of-a-mental-health-service-model-a-survey-of-crisis-resolution-teams-in-england
#19
Brynmor Lloyd-Evans, Bethan Paterson, Steve Onyett, Ellie Brown, Hannah Istead, Richard Gray, Claire Henderson, Sonia Johnson
In response to pressures on mental health inpatient beds and a perceived 'crisis in acute care', Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions...
January 11, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28066851/analysis-of-smartphone-interruptions-on-academic-general-internal-medicine-wards-frequent-interruptions-may-cause-a-crisis-mode-work-climate
#20
Alon Vaisman, Robert C Wu
INTRODUCTION: Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. METHODS: We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014...
January 4, 2017: Applied Clinical Informatics
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