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https://www.readbyqxmd.com/read/28742779/a-novel-method-of-evaluating-key-factors-for-success-in-a-multifaceted-critical-care-fellowship-using-data-envelopment-analysis
#1
Vikram Tiwari, Avinash B Kumar
BACKGROUND: The current system of summative multi-rater evaluations and standardized tests to determine readiness to graduate from critical care fellowships has limitations. We sought to pilot the use of data envelopment analysis (DEA) to assess what aspects of the fellowship program contribute the most to an individual fellow's success. DEA is a nonparametric, operations research technique that uses linear programming to determine the technical efficiency of an entity based on its relative usage of resources in producing the outcome...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28686124/influence-of-an-intratumoral-cyst-on-drug-distribution-by-convection-enhanced-delivery-case-report
#2
Iryna Ivasyk, Peter F Morgenstern, Eva Wembacher-Schroeder, Mark M Souweidane
Convection-enhanced delivery (CED) uses positive pressure to induce convective flow of molecules and maximize drug distribution. Concerns have been raised about the effect of cystic structures on uniform drug distribution with CED. The authors describe the case of a patient with a diffuse intrinsic pontine glioma (DIPG) with a large cyst and examine its effect on drug distribution after CED with a radiolabeled antibody. The patient was treated according to protocol with CED of (124)I-8H9 to the pons for nonprogressive DIPG after radiation therapy as part of a Phase I trial (clinical trial registration no...
July 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28685947/drawing-on-antiracist-approaches-toward-a-critical-antidiscriminatory-pedagogy-for-nursing
#3
Amélie Blanchet Garneau, Annette J Browne, Colleen Varcoe
Although nursing has a unique contribution to advancing social justice in health care practices and education, and although social justice has been claimed as a core value of nursing, there is little guidance regarding how to enact social justice in nursing practice and education. In this paper, we propose a critical antidiscriminatory pedagogy (CADP) for nursing as a promising path in this direction. We argue that because discrimination is inherent to the production and maintenance of inequities and injustices, adopting a CADP offers opportunities for students and practicing nurses to develop their capacity to counteract racism and other forms of individual and systemic discrimination in health care, and thus promote social justice...
July 7, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28680710/periodontal-and-endodontic-pathology-delays-extraction-socket-healing-in-a-canine-model
#4
Jung-Hoon Kim, Ki-Tae Koo, Joseph Capetillo, Jung-Ju Kim, Jung-Min Yoo, Heithem Ben Amara, Jung-Chul Park, Frank Schwarz, Ulf M E Wikesjö
PURPOSE: The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. METHODS: The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls...
June 2017: Journal of Periodontal & Implant Science
https://www.readbyqxmd.com/read/28679909/real-time-process-analytics-in-emergency-healthcare
#5
Vassiliki Koufi, Flora Malamateniou, Adrianna Prentza, George Vassilacopoulos
Emergency medical systems (EMS) are considered to be amongst the most crucial systems as they involve a variety of activities which are performed from the time of a call to an ambulance service till the time of patient's discharge from the emergency department of a hospital. These activities are closely interrelated so that collaboration and coordination becomes a vital issue for patients and for emergency healthcare service performance. The utilization of standard workflow technology in the context of Service Oriented Architecture can provide an appropriate technological infrastructure for defining and automating EMS processes that span organizational boundaries so that to create and empower collaboration and coordination among the participating organizations...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28659023/-powerlessness-or-doing-the-right-thing-moral-distress-among-nursing-home-staff-caring-for-residents-at-the-end-of-life-an-interpretive-descriptive-study
#6
Amanda Young, Katherine Froggatt, Sarah G Brearley
BACKGROUND: Caring for dying people can contribute to moral distress experienced by healthcare professionals. Moral distress can occur when this caring is restricted by organisational processes, resources or the provision of futile care. These factors apply to end of life care in nursing homes but research is lacking. AIM: To describe how nursing home staff experience moral distress when caring for residents during and at the end of life. METHODS: An interpretive descriptive design, using the critical incident technique in semi-structured interviews to collect data from nursing home staff...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28649932/a-web-of-gaps-a-discussion-of-research-strands-concerning-global-south-families-with-a-disabled-child
#7
Xanthe Hunt, Brian Watermeyer
BACKGROUND: In low- and middle-income countries (LMICs), limited access to a range of supports means that families often carry primary responsibility for the care of a disabled child. The impact of this responsibility is poorly understood. OBJECTIVE: To present a selective review, critique, and comparison of the prominent areas of research aimed at understanding families with disabled children in the Global South. DESIGN: We compare and critically discuss prominent bodies of literature concerning the family-disability-poverty nexus in LMICs...
2017: Global Health Action
https://www.readbyqxmd.com/read/28643399/distributed-health-literacy-among-people-living-with-type-2-diabetes-in-portugal-defining-levels-of-awareness-and-support
#8
Liliana Abreu, João Arriscado Nunes, Peter Taylor, Susana Silva
This study embraces a patient-centred and narrative-oriented notion of health literacy, exploring how social networks and personal experiences constitute distributed health literacy (DHL) by mapping out health literacy mediators of each individual and how they enable self-management skills and knowledge of health conditions. Semi-structured interviews with 26 patients with type 2 diabetes were conducted in a Primary Care Center of Porto (Portugal) from October 2014 to December 2015. Data were collected based on McGill Illness Narrative Interview (MINI)...
June 22, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28640683/the-public-health-practitioner-of-the-future
#9
Paul Campbell Erwin, Ross C Brownson
The requisite capacities and capabilities of the public health practitioner of the future are being driven by multiple forces of change, including public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, globalized travel, and the repercussions of the Affordable Care Act. We describe five critical capacities and capabilities that public health practitioners can build on to successfully prepare for and respond to these forces of change: systems thinking and systems methods, communication capacities, an entrepreneurial orientation, transformational ethics, and policy analysis and response...
August 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28632931/iowa-model-of-evidence-based-practice-revisions-and-validation
#10
Kathleen C Buckwalter, Laura Cullen, Kirsten Hanrahan, Charmaine Kleiber, Ann Marie McCarthy, Barbara Rakel, Victoria Steelman, Toni Tripp-Reimer, Sharon Tucker
BACKGROUND: The Iowa Model is a widely used framework for the implementation of evidence-based practice (EBP). Changes in health care (e.g., emergence of implementation science, emphasis on patient engagement) prompted the re-evaluation, revision, and validation of the model. METHODS: A systematic multi-step process was used capturing information from the literature and user feedback via an electronic survey and live work groups. The Iowa Model Collaborative critically assessed and synthesized information and recommendations before revising the model...
June 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28601323/readability-complexity-and-suitability-analysis-of-online-lymphedema-resources
#11
Bao Ngoc N Tran, Mansher Singh, Bernard T Lee, Rima Rudd, Dhruv Singhal
BACKGROUND: Over 72% of Americans use online health information to assist in health care decision-making. Previous studies of lymphedema literature have focused only on reading level of patient-oriented materials online. Findings indicate they are too advanced for most patients to comprehend. This, more comprehensive study, expands the previous analysis to include critical elements of health materials beyond readability using assessment tools to report on the complexity and density of data as well as text design, vocabulary, and organization...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601133/assessment-and-management-of-toxidromes-in-the-critical-care-unit
#12
REVIEW
J J Rasimas, Courtney M Sinclair
The most important diagnostic factor in uncovering a toxic etiology for delirium or critical illness is the clinician's openness to the possibility of its existence. Therefore, a consulting psychiatrist, already prepared to perform the detail-oriented work of sorting out behavioral manifestations of disease, can be a vital asset at the bedside if also attuned to the role of purposeful, accidental, and iatrogenic exposures in the intensive care unit. This article summarizes the presentation, evaluation, and treatment of toxidromes relevant to the work of acute psychosomatic medicine...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28601130/neurobehavioral-management-of-traumatic-brain-injury-in-the-critical-care-setting-an-update
#13
REVIEW
Earl De Guzman, Andrea Ament
Traumatic brain injury (TBI) is an alteration in brain function, or other evidence of brain pathology, caused by an external force. TBI is a major cause of disability and mortality worldwide. Post-traumatic amnesia, or the interval from injury until the patient is oriented and able to form and later recall new memories, is an important index of TBI severity and functional outcome. This article will discuss the updates in the epidemiology, definition and classification, pathophysiology, diagnosis, and management of common acute neuropsychiatric sequelae of traumatic brain injury that the critical care specialist may encounter...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28582994/which-primary-care-model-a-qualitative-analysis-of-ward-based-outreach-teams-in-south-africa
#14
Tessa S Marcus, Jannie Hugo, Champak C Jinabhai
Globally, models of extending universal health coverage through primary care are influenced by country-specific systems of health care and disease management. In 2015 a rapid assessment of the ward-based outreach component of primary care reengineering was commissioned to understand implementation and rollout challenges. AIM: This article aims to describe middle- and lower-level managers' understanding of ward-based outreach teams (WBOTs) and the problems of authority, jurisdiction and practical functioning that arise from the way the model is constructed and has been operationalised...
May 31, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28555565/threat-of-shock-increases-excitability-and-connectivity-of-the-intraparietal-sulcus
#15
Nicholas L Balderston, Elizabeth Hale, Abigail Hsiung, Salvatore Torrisi, Tom Holroyd, Frederick W Carver, Richard Coppola, Monique Ernst, Christian Grillon
Anxiety disorders affect approximately 1 in 5 (18%) Americans within a given 1 year period, placing a substantial burden on the national health care system. Therefore, there is a critical need to understand the neural mechanisms mediating anxiety symptoms. We used unbiased, multimodal, data-driven, whole-brain measures of neural activity (magnetoencephalography) and connectivity (fMRI) to identify the regions of the brain that contribute most prominently to sustained anxiety. We report that a single brain region, the intraparietal sulcus (IPS), shows both elevated neural activity and global brain connectivity during threat...
May 30, 2017: ELife
https://www.readbyqxmd.com/read/28554932/the-role-of-academic-health-centres-in-building-equitable-health-systems-a-systematic-review-protocol
#16
Alexandra Edelman, Judy Taylor, Pavel V Ovseiko, Stephanie M Topp
INTRODUCTION: Academic health centres (AHCs) are complex organisations often defined by their 'tripartite' mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28552003/-i-m-only-dealing-with-the-acute-issues-how-medical-ward-busyness-constrains-care-of-the-dying
#17
Lisa S Chan, Mary Ellen Macdonald, Franco A Carnevale, S Robin Cohen
Acute hospital units are a common location of death. Curative characteristics of the acute medical setting make it difficult to provide adequate palliative care; these characteristics include an orientation to life-prolonging treatment, an emphasis on routine or task-oriented care and a lack of priority on emotional engagement with patients. Indeed, research shows that dying patients in acute medical units often experience unmet needs at the end of life, including uncontrolled symptoms (e.g. pain, breathlessness), inadequate emotional support and poor communication...
May 1, 2017: Health (London)
https://www.readbyqxmd.com/read/28502219/towards-an-ethics-for-telehealth
#18
Carlo Botrugno
Over the last two decades, a public rationale for the implementation of telehealth has emerged at the interplay of specialised literature and political orientations. Despite the lack of consistent findings on the magnitude of its benefits, telehealth is nowadays presented as a worthy solution both for patients and healthcare institutions. Far from denying the potential advantages of telehealth, the main objective of this work is to provide a critical assessment on the spread of the remote services as a vector of positive transformation of contemporary health systems...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28502218/recommendations-to-reduce-inequalities-for-lgbt-people-facing-advanced-illness-accesscare-national-qualitative-interview-study
#19
Katherine Bristowe, Matthew Hodson, Bee Wee, Kathryn Almack, Katherine Johnson, Barbara A Daveson, Jonathan Koffman, Linda McEnhill, Richard Harding
BACKGROUND: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. AIM: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28497934/cerebral-autoregulation-monitoring-in-acute-traumatic-brain-injury-what-s-the-evidence
#20
Leanne A Calviello, Joseph Donnelly, Frederick A Zeiler, Eric P Thelin, Peter Smielewski, Marek Czosnyka
Cerebral autoregulation is conceptualized as a vascular self-regulatory mechanism within the brain. Controlled by elusive relationships between various biophysical processes, it functions to protect the brain against potential damages caused by sudden changes in cerebral perfusion pressures and flow. Following events such as traumatic brain injuries (TBI), autoregulation may be compromised, potentially leading to an unfavorable outcome. In spite of its complexity, autoregulation has been able to be quantified non-invasively within the neuro-critical care setting with the aid of transcranial Doppler...
May 12, 2017: Minerva Anestesiologica
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