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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437780/evidence-based-practice-knowledge-attitudes-and-practice-of-online-graduate-nursing-students
#2
Wilaiporn Rojjanasrirat, Jan Rice
OBJECTIVES: This study aimed to evaluate changes in evidence-based practice (EBP) knowledge, attitudes, and practice of nursing students before and after completing an online, graduate level, introductory research/EBP course. DESIGN: A prospective one-group pretest-posttest design. SETTINGS: A private university in the Midwestern, USA. PARTICIPANTS: Sixty-three online nurse practitioner students in Master's program. METHODS: A convenient sample of online graduate nursing students who enrolled in the research/EBP course was invited to participate in the study...
April 14, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28437730/the-practice-of-prosecuting-child-maltreatment-results-of-an-online-survey-of-prosecutors
#3
Theodore P Cross, Debra Whitcomb
Despite efforts by advocates, practitioners, and legislators to alleviate the burden on child maltreatment victims in the criminal justice system, many challenges remain for prosecutors as they seek to hold offenders accountable while minimizing the emotional impact on children. More than 200 state and local prosecutors in 37 states responded to an online survey to share their perspectives on current challenges, procedures to support children in the adjudication process, and the impact of the U.S. Supreme Court opinion in Crawford v...
April 21, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28437516/a-rare-case-of-misdiagnosed-silent-lung-cancer-with-solitary-metastasis-to-the-temporomandibular-joint-condyle
#4
Luca Guarda-Nardini, Edoardo Stellini, Adolfo Di Fiore, Daniele Manfredini
This article describes the case history of a 59-year-old female patient who sought advice for temporomandibular joint (TMJ) pain and sounds but who was actually diagnosed with a primary lung cancer with metastasis to the TMJ. The patient had a history of TMJ pain and deflection in jaw movement that progressively worsened over a few months and did not improve with the usual standard of care treatment provided by an orofacial pain practitioner. Magnetic resonance and computed tomography (CT) prescribed at a tertiary clinic showed an osteolytic bone mass within the right TMJ condyle...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437490/the-diagnosis-and-initial-treatment-of-patellofemoral-disorders
#5
Alan C Merchant, John P Fulkerson, Wayne Leadbetter
Our purpose is to provide simple guidelines for the diagnosis and early care of patellofemoral disorders. Any clinician who treats knee problems, including family practitioners, rheumatologists, orthopedic surgeons, or physical therapists, must know how to make the correct diagnosis, or at least a presumptive diagnosis, at the initial visit. This can avoid unneeded and costly tests, ineffective treatment, and even damaging exercises and unnecessary surgery. The diagnosis of patellofemoral disorders is confusing because they can have many causes...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#6
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28436808/kathleen-mears-memorial-lecture-go-for-the-gold-essential-skills-for-neurodiagnostic-practitioners
#7
Jerry Morris
No abstract text is available yet for this article.
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28436587/coparenting-conflict-and-academic-readiness-in-children-of-teen-mothers-effortful-control-as-a-mediator
#8
Laudan B Jahromi, Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umaña-Taylor, Sara Douglass Bayless
Children's exposure to coparenting conflict has important implications for their developmental functioning, yet limited work has focused on such processes in families with diverse structures or ethnically and culturally diverse backgrounds. This longitudinal study examined the processes by which Mexican-origin adolescent mothers' coparenting conflict with their 3-year-old children's grandmothers and biological fathers (N = 133 families) were linked to children's academic and social skills at 5 years of age, and whether children's effortful control at 4 years of age mediated the link between coparenting conflict and indices of children's academic readiness...
April 24, 2017: Family Process
https://www.readbyqxmd.com/read/28436360/prostate-cancer-screening-practices-amongst-physicians-in-the-north-simcoe-muskoka-local-health-integration-network
#9
Thomas Burrows, A Andrew Ray, Cory Hartsburg
INTRODUCTION: The prostate-specific antigen (PSA) screening test is controversial and can result in both over-diagnosis and over-treatment. Recently, the Canadian Task Force on Preventive Health Care (CTFPHC) has recommended against routine screening for prostate cancer. We sought to determine how the CTFPHC has impacted the practice patterns among family physicians in the North Simcoe Muskoka (NSM) Local Health Integration Network (LHIN). MATERIALS AND METHODS: We surveyed all 439 family physicians within the NSM LHIN as well as 21 residents of the Family Medical Teaching Unit...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436039/nutrient-retention-values-and-cooking-yield-factors-for-three-south-african-lamb-and-mutton-cuts
#10
Salomina M van Heerden, Phillip E Strydom
BACKGROUND: Nutrient content of raw and cooked foods is important for formulation healthy diets. The retention of nutrients during cooking can be influenced by various factors including animal age, carcass characteristics and cooking method and these factors are often unique to specific countries. We studied the effects of animal age (lamb and mutton), carcass cut (shoulder, loin and leg) combined with cooking method (moist-heat and dry-heat) on yield and nutrient retention of selected nutrients of South African sheep carcasses...
April 23, 2017: Journal of the Science of Food and Agriculture
https://www.readbyqxmd.com/read/28435842/is-individual-smoking-behaviour-influenced-by-area-level-ethnic-density-a-cross-sectional-electronic-health-database-study-of-inner-south-east-london
#11
Rohini Mathur, Peter Schofield, Dianna Smith, Alexander Gilkes, Patrick White, Sally Hull
Tobacco smoking remains one of the greatest public health problems facing the UK today. It varies significantly by ethnic group. This study aimed to determine whether ethnic differences in smoking behaviour are related to neighbourhood-level, own-group ethnic density across south and east London. The association between ethnic density and individual smoking behaviour was assessed by multilevel logistic regression using the electronic health records of 688 397 general practitioner-registered patients. Restricted cubic splines were created to explore whether the effect of ethnic density on smoking behaviour was nonlinear...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#12
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435753/does-hawai-i-have-enough-psychiatrists-assessing-mental-health-workforce-versus-demand-in-the-aloha-state
#13
Alexandra Aaronson, Kelley Withy
National data reports the number of adults with any diagnosable mental disorder within a given year is nearly 1 in 5. Hawai'i, along with the rest of the nation, faces a serious shortage of mental health providers. This article describes the research undertaken to create a more accurate assessment of the current mental health provider workforce in Hawai'i through developing an estimation strategy to appraise local mental health workforce needs. The results indicate the supply of psychiatrists for Hawai'i's 2010 census population was found to be 161...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435420/qualitative-evaluation-of-the-implementation-of-an-integrated-care-delivery-model-for-chronic-patients-with-multi-morbidity-in-the-basque-country
#14
María Luz Jauregui, Carmen Silvestre, Pedro Valdes, Idoia Gaminde
INTRODUCTION: The objective of this study was to assess a model for improving healthcare integration for patients with multiple chronic diseases in an integrated healthcare organisation in the Basque Country and to propose areas for improvement. METHODS: We organised four nominal groups composed of representatives from different categories of clinicians involved in the development of an integrated healthcare organisation and in the integrated care of patients with multiple diseases, namely, internists, general practitioners, and primary care and hospital nurses...
August 19, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28435418/-you-never-know-what-happens-next-young-adult-service-users-experience-with-mental-health-care-and-treatment-through-one-year
#15
Marian Ådnanes, Sissel Steihaug
Fragmented services are a well-known problem in the mental health sector. Mental health service users' experiences of treatment and care can provide knowledge for developing more user-oriented continuity of care. We followed nine young adults with mental health illnesses and complex needs, conducting four interviews with each informant in the course of a year. The aim was to capture their experiences and views about treatment and care, focusing on (dis)continuities and episodes occurring through that year. The users' experiences were affected by shifts and transitions between institutions, units and practitioners while their need was predictability and stability...
July 22, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28435415/the-gold-coast-integrated-care-model
#16
Martin Connor, Helen Cooper, Anne McMurray
This article outlines the development of the Australian Gold Coast Integrated Care Model based on the elements identified in contemporary research literature as essential for successful integration of care between primary care, and acute hospital services. The objectives of the model are to proactively manage high risk patients with complex and chronic conditions in collaboration with General Practitioners to ultimately reduce presentations to the health service emergency department, improve the capacity of specialist outpatients, and decrease planned and unplanned admission rates...
July 8, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28435340/stress-and-its-predictors-in-pregnant-women-a-study-in-saudi-arabia
#17
Anwar E Ahmed, Alhanouf N Albalawi, Asmaa A Alshehri, Rand M AlBlaihed, Majid A Alsalamah
BACKGROUND: Although stress during pregnancy has negative effects on children's development and pregnant women's health, no study has assessed stress and its predictors among pregnant Saudi women. The aim of this study was to assess stress and identify its predictors in a sample of pregnant Saudi women. METHODS: A correlational study was carried out at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia, on 438 pregnant women who attended the obstetrics/gynecology clinic...
2017: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/28435313/evidence-and-consensus-recommendations-for-the-pharmacological-management-of-pain-in-india
#18
REVIEW
Gur Prasad Dureja, Rajagopalan N Iyer, Gautam Das, Jaishid Ahdal, Prashant Narang
Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#19
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28434483/what-imaging-techniques-should-be-used-in-primary-versus-secondary-prevention-for-further-risk-stratification
#20
François Schiele, Eliano Pio Navarese, Adriana Visoná, Kausik Ray
BACKGROUND AND AIMS: An accurate assessment of the cardiovascular (CV) risk of an individual is key for guiding the appropriate treatment strategy for cardiovascular disease (CVD). Although conventional risk factors for CVD are well established, there can be substantial variation in the extent of atherosclerosis between patients. The use of a variety of imaging modalities can be beneficial in the primary prevention stage and in the classification of an individual's CV risk. Therefore, appropriate implementation of these imaging techniques for risk assessment purposes, in line with clinical guidelines, can influence the outcomes of CVD prevention...
April 2017: Atherosclerosis. Supplements
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