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https://www.readbyqxmd.com/read/28086869/evaluation-of-an-aged-care-nurse-practitioner-service-quality-of-care-within-a-residential-aged-care-facility-hospital-avoidance-service
#1
Trudy Dwyer, Alison Craswell, Dolene Rossi, Darren Holzberger
BACKGROUND: Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28081582/-expert-evidence-in-whiplash-injury
#2
Florin M Bucur, Martin Schwarze, Marcus Schiltenwolf
The assessment of cervical spine injuries is not a problem - provided full evidence of primary physical damage can be ensured. MRI examinations of the cervical spine carried out soon after the accident provide the best evidence. The assessment is more difficult if only clinical abnormalities are documented by the doctors after the accident in the diagnosis of cervical spine distortion, as functional results of this type are not specific and are also common in the general population. The legal rules of evidence must be taken into account in the summary assessment of the consequences of cervical spine injuries...
January 12, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28061781/exploring-the-implementation-of-an-electronic-record-into-a-maternity-unit-a-qualitative-study-using-normalisation-process-theory
#3
Arabella Scantlebury, Laura Sheard, Ian Watt, Paul Cairns, John Wright, Joy Adamson
BACKGROUND: To explore the benefits, barriers and disadvantages of implementing an electronic record system (ERS). The extent that the system has become 'normalised' into routine practice was also explored. METHODS: Qualitative semi-structured interviews were conducted with 19 members of NHS staff who represented a variety of staff groups (doctors, midwives of different grades, health care assistants) and wards within a maternity unit at a NHS teaching hospital...
January 7, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28051893/shame-in-medical-education-a-randomized-study-of-the-acquisition-of-intimate-examination-skills-and-its-effect-on-subsequent-performance
#4
Wolf E Hautz, Therese Schröder, Katja A Dannenberg, Maren März, Henrike Hölzer, Olaf Ahlers, Anke Thomas
THEORY: Although medical students are exposed to a variety of emotions, the impact of emotions on learning has received little attention so far. Shame-provoking intimate examinations are among the most memorable events for students. Their emotions, however, are rarely addressed during training, potentially leading to withdrawal and avoidance and, consequently, performance deficits. However, emotions of negative valance such as shame may be particularly valuable for learning, as they might prompt mental rehearsal...
January 4, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28050392/paediatric-prescription-analysis-in-a-primary-health-care-institution
#5
Jinish Jose, Denny Devassykutty
INTRODUCTION: Paediatric prescription analysis was done by vari-ous studies in tertiary care centers but not much published data, at primary care level. The Medical Council of India introduced new prescription format and also antibiotic stewardship program was launched by Government of Kerala in the year 2015. So in these contexts this study was conducted. AIM: To analyse the patterns of prescriptions and drug dis-pensing in pediatric patients using WHO core drug use indicators and parameters in the prescription format prescribed by Medical Council of India...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28032571/readmissions-after-general-surgery-a-prospective-multicenter-audit
#6
Matthew J Lee, Sarah L Daniels, Jonathan R L Wild, Timothy R Wilson
BACKGROUND: Readmission rates after surgical procedures are viewed as a marker of quality of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated. However, readmissions are not wholly avoidable. The aim of this study was to develop a regional overview of readmissions to determine the proportion that might be avoidable and to examine predictors of readmissions at a unit level. METHODS: We undertook a prospective multicenter audit of readmissions following National Health Service funded general surgical procedures in five National Health Service hospitals and three independent sector providers over a 2-wk period...
September 19, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28028284/-revision-of-medical-fee-system-for-treatment-at-nursing-homes-the-influential-consideration-of-the-introduction-of-one-patient-per-visit-method-on-the-welfare-of-elderly-patients-at-nursing-homes
#7
Seiji Kondo, Yasuko Kondo, Minako Fuse
The 2014 revision of the medical fee system includes the introduction of a one-patient-per-visit method at nursing homes, which should be followed to avoid a drastic reduction in medical fees. We followed the new method, resulting in much more frequent visits to nursing homes(For example, we visit a facilitythree times per week instead of the previous two times per month). Frequent visits to multiple facilities are time- and effort-consuming on our side as a clinic, but, on the other hand, patients have more opportunities to see a doctor when theyare sick even if theyare not scheduled to do so...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28003693/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-anticipated-difficult-extubation
#8
Pankaj Kundra, Rakesh Garg, Apeksh Patwa, Syed Moied Ahmed, Venkateswaran Ramkumar, Amit Shah, Jigeeshu Vasishtha Divatia, Sumalatha Radhakrishna Shetty, Ubaradka S Raveendra, Jeson R Doctor, Dilip K Pawar, Ramesh Singaravelu, Sabyasachi Das, Sheila Nainan Myatra
Extubation has an important role in optimal patient recovery in the perioperative period. The All India Difficult Airway Association (AIDAA) reiterates that extubation is as important as intubation and requires proper planning. AIDAA has formulated an algorithm based on the current evidence, member survey and expert opinion to incorporate all patients of difficult extubation for a successful extubation. The algorithm is not designed for a routine extubation in a normal airway without any associated comorbidity...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28001135/a-survey-of-physicians-attitudes-toward-decision-making-authority-for-initiating-and-withdrawing-va-ecmo-results-and-ethical-implications-for-shared-decision-making
#9
Ellen C Meltzer, Natalia S Ivascu, Meredith Stark, Alexander V Orfanos, Cathleen A Acres, Paul J Christos, Thomas Mangione, Joseph J Fins
OBJECTIVE: Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians' attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27996354/different-perceptions-of-interprofessional-collaboration-and-factors-influencing-the-one-stop-service-for-sexual-assault-victims-in-taiwan
#10
Lih-Chu Tien, Yi-Ling Wu, Tsai-Wen Lin, Samuel Shih-Chih Wang
The purpose of interprofessional collaboration is to bring better services for sexual assault victims. In order to avoid secondary victimisation and improve the quality of forensic examination and prosecution rate, a one-stop service has been developed recently in Taiwan. However, whether the collaboration is successful may depend on participants' professional backgrounds and personal experiences and can be influenced by a number of factors. This study used the Index of Interdisciplinary Collaboration to examine the different perceptions of collaboration in team members and the related influences on collaboration...
January 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27990834/-the-challenges-of-diagnostic-reasoning-or-how-doctors-think
#11
Marek Štefan, Aleš Chrdle
Basic overview of diagnostic errors with particular focus on cognitive biases and strategies to minimize or avoid them.
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27986978/-triggers-of-exanthematous-drug-eruptions-stop-intake-treat-through-or-desensitization
#12
REVIEW
M Absmaier, T Biedermann, K Brockow
Drug hypersensitivity reactions affect over 7% of the population and are problematic both for patients and doctors. They frequently occur in the form of exanthematous drug eruptions. The clinical manifestation of delayed hypersensitivity reactions is very variable ranging from localized fixed drug eruptions to life-threatening, severe bullous mucocutaneous eruptions or systemic drug hypersensitivity syndromes. In the case of suspicion of an exanthematous drug eruption, the causality should initially be assessed according to the proposed algorithm...
January 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27973965/tracking-multiple-surgical-instruments-in-a-near-infrared-optical-system
#13
Ken Cai, Rongqian Yang, Qinyong Lin, Zhigang Wang
Surgical navigation systems can assist doctors in performing more precise and more efficient surgical procedures to avoid various accidents. The near-infrared optical system (NOS) is an important component of surgical navigation systems. However, several surgical instruments are used during surgery, and effectively tracking all of them is challenging. A stereo matching algorithm using two intersecting lines and surgical instrument codes is proposed in this paper. In our NOS, the markers on the surgical instruments can be captured by two near-infrared cameras...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27966420/-work-related-stress-urticaria
#14
Nadia Lander Landex
A medical doctor occasionally experienced itching papular exanthema during work hours. Careful history taking and a diary of symptoms demonstrated an association between the urticaria and stressful work situations. Urticaria can have many triggers, and stress is among the well-known triggers. The usual treatment of urticaria consists of avoiding triggers and, if necessary, antihistamines. Whereas it might be difficult to follow these recommendations in the case of work-related urticaria, the disorder may be perceived as a reminder of work situations which are going awry...
December 12, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27955853/-palliativer-medicine-in-surgery
#15
César Gutiérrez Samperio, Raúl Ruiz Canizales, Salvador Arellano Rodríguez, Hilda Romero Zepeda, Robert T Hall, Bernardo García Camino
The concepts and background of palliative medicine, the patient-health team relationship and the right of the patients to receive palliative care, its application in surgery, the criterion defining the terminally ill, proportionate and disproportionate measures, where it is applied and what this consists of, drugs and procedures used, who should administrate them and for how long, the requirements for advanc directives and avoidance of therapeutic obstinacy, were reviewed. It describes and reflects their ethical and legal bases...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27938629/-struggle-to-obtain-redress-women-s-experiences-of-living-with-symptoms-attributed-to-dental-restorative-materials-and-or-electromagnetic-fields
#16
Lena Mårell, Monica Lindgren, Kerstin Ternulf Nyhlin, Christina Ahlgren, Anders Berglund
The aim of this study was to explore the experiences of illness and the encounters with health care professionals among women who attributed their symptoms and illness to either dental restorative materials and/or electromagnetic fields, despite the fact that research on health effects from dental fillings or electricity has failed to substantiate the reported symptoms. Thirteen women (aged 37-63 years) were invited to the study and a qualitative approach was chosen as the study design, and data were collected using semi-structured interviews...
2016: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/27927183/art-access-related-barriers-faced-by-hiv-positive-persons-linked-to-care-in-southern-ghana-a-mixed-method-study
#17
Augustine Ankomah, John Kuumuori Ganle, Margaret Yaa Lartey, Awewura Kwara, Priscilla Awo Nortey, Michael Perry Kweku Okyerefo, Amos Kankponang Laar
BACKGROUND: Timely and enduring access to antiretroviral therapy (ART) by HIV-infected individuals has been shown to substantially reduce HIV transmission risk, HIV-related morbidity and mortality. However, there is evidence that in addition to limited supply of antiretrovirals (ARVs) and linkage to ART in many low-income countries, HIV+ persons often encounter barriers in accessing ART-related services even in contexts where these services are freely available. In Ghana, limited research evidence exists regarding the barriers HIV+ persons already linked to ART face...
December 7, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27926450/changing-health-behavior-motivation-from-i-must-to-i-want
#18
S Knecht, P Kenning
In the past, medicine was dominated by acute diseases. Since treatments were unknown to patients they followed their medical doctors´ directives-at least for the duration of the disease. Behavior was thus largely motivated by avoiding expected costs associated with alternative behaviors (I-must). The health challenges prevailing today are chronic conditions resulting from the way we chose to live. Traditional directive communication has not been successful in eliciting and maintaining appropriate lifestyle changes...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27906740/a-new-method-of-measuring-the-occipitocervical-angle-that-could-be-applied-as-an-intraoperative-indicator-during-occipitocervical-fusion
#19
Shingo Nagashima, Masateru Nagae, Yuji Arai, Hitoshi Tonomura, Ryota Takatori, Tsuyoshi Sukenari, Hiroyoshi Fujiwara, Koshiro Sawada, Yasuo Mikami, Toshikazu Kubo
STUDY DESIGN: A method for measuring occipitocervical angle. OBJECTIVE: To develop a new method of measurement for assessing the occipitocervical angle using intraoperative fluoroscopic imaging, and to examine its reliability. SUMMARY OF BACKGROUND DATA: To avoid postoperative complications following occipitocervical fusion, it is vital to obtain a suitable fusion angle between the occipital bone and the upper cervical spine. MATERIALS AND METHODS: The subjects were 30 cases with occipito-atlanto-axial lesions and 30 healthy volunteers...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27890051/medication-and-treatment-adherence-following-hospital-discharge
#20
Claudia Greißing, Peter Buchal, Hans-Joachim Kabitz, Marcus Schuchmann, Niko Zantl, Susanne Schiek, Thilo Bertsche
BACKGROUND: Patients' drug regimens often need to be changed when they pass from one care sector to another, but these changes sometimes pose a safety risk. To avoid such risks, a new inter-sector transition concept was developed incorporating discharge medication plans and counseling modules for the patients themselves and the doctors receiving them into their care. METHODS: A prospective interventional trial was carried out in two internal medicine wards of a general hospital...
November 4, 2016: Deutsches Ärzteblatt International
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