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https://www.readbyqxmd.com/read/27904234/allocation-of-rehabilitation-services-for-older-adults-in-the-ontario-home-care-system
#1
Joshua J Armstrong, Joanie Sims-Gould, Paul Stolee
Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27903157/obesity-and-other-cancers
#2
Lin Yang, Bettina F Drake, Graham A Colditz
Purpose Evidence on overweight, obesity, and an increased risk of cancer continues to accumulate and was updated in the 2016 handbook on weight control from the International Agency for Research on Cancer (IARC). The underlying primary data, together with dose-response meta-analysis and, finally, pooled analysis of individual participant data, add insight into the relation between obesity and cancer risk and prognosis. We summarize the evidence for mortality from prostate cancer, hematologic malignancies, and kidney cancer...
December 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27903037/resuscitation-update-for-general-practitioners
#3
Hugh Grantham Asm, Rowena Christiansen
BACKGROUND: The latest changes to resuscitation guidelines in Australia were released in 2016. Few of the changes will have an impact on general practitioners (GPs) but there are some additional issues that they, as health professionals and leaders in the community, should be informed about. OBJECTIVE: The objective of this article is to provide an update for GPs on the current resuscitation guidelines. DISCUSSION: This article describes the latest changes in resuscitation recommendations in the fields of first aid, basic life support, advanced life support and paediatric resuscitation, with an emphasis on issues of particular relevance to GPs...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27902412/the-staff-education-to-reducing-ventilator-associated-pneumonia
#4
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation (MV) is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient's characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
October 17, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27899836/impact-of-an-advanced-cardiac-life-support-simulation-laboratory-experience-on-pharmacy-student-confidence-and-knowledge
#5
Whitney D Maxwell, Phillip L Mohorn, Jason S Haney, Cynthia M Phillips, Z Kevin Lu, Kimberly Clark, Alex Corboy, Kelly R Ragucci
Objective. To assess the impact of an advanced cardiac life support (ACLS) simulation on pharmacy student confidence and knowledge. Design. Third-year pharmacy students participated in a simulation experience that consisted of team roles training, high-fidelity ACLS simulations, and debriefing. Students completed a pre/postsimulation confidence and knowledge assessment. Assessment. Overall, student knowledge assessment scores and student confidence scores improved significantly. Student confidence and knowledge changes from baseline were not significantly correlated...
October 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/27898136/pharmacological-approaches-for-the-management-of-persistent-pain-in-older-adults-what-nurses-need-to-know
#6
Fabio Guerriero, Ruth Bolier, Janet H Van Cleave, M Cary Reid
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897967/an-observational-study-of-donor-ex-vivo-lung-perfusion-in-uk-lung-transplantation-develop-uk
#7
Andrew Fisher, Anders Andreasson, Alexandros Chrysos, Joanne Lally, Chrysovalanto Mamasoula, Catherine Exley, Jennifer Wilkinson, Jessica Qian, Gillian Watson, Oli Lewington, Thomas Chadwick, Elaine McColl, Mark Pearce, Kay Mann, Nicola McMeekin, Luke Vale, Steven Tsui, Nizar Yonan, Andre Simon, Nandor Marczin, Jorge Mascaro, John Dark
BACKGROUND: Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. OBJECTIVE: The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity. DESIGN: A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transplant outcomes between EVLP-assessed and standard donor lungs...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27897391/a-systematic-review-on-the-role-of-vitamins-minerals-proteins-and-other-supplements-for-the-treatment-of-cachexia-in-cancer-a-european-palliative-care-research-centre-cachexia-project
#8
REVIEW
Mochamat, Henning Cuhls, Milka Marinova, Stein Kaasa, Christiane Stieber, Rupert Conrad, Lukas Radbruch, Martin Mücke
We provide a systematic review to support the European Palliative Care Research Collaboration development of clinical guidelines for cancer patients suffering from cachexia. CENTRAL, MEDLINE, PsycINFO, ClinicalTrials.gov, and a selection of cancer journals have been searched up until 15 April 2016. The systematic literature research yielded 4214 publications with 21 of these included in the final evaluation. Regarding minerals, our search identified only one study examining the use of magnesium with no effect on weight loss...
July 20, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27890016/the-inflammatory-response-to-extracorporeal-membrane-oxygenation-ecmo-a-review-of-the-pathophysiology
#9
REVIEW
Jonathan E Millar, Jonathon P Fanning, Charles I McDonald, Daniel F McAuley, John F Fraser
Extracorporeal membrane oxygenation (ECMO) is a technology capable of providing short-term mechanical support to the heart, lungs or both. Over the last decade, the number of centres offering ECMO has grown rapidly. At the same time, the indications for its use have also been broadened. In part, this trend has been supported by advances in circuit design and in cannulation techniques. Despite the widespread adoption of extracorporeal life support techniques, the use of ECMO remains associated with significant morbidity and mortality...
November 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27887750/chronic-kidney-disease
#10
REVIEW
Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence...
November 22, 2016: Lancet
https://www.readbyqxmd.com/read/27885821/exploring-simulation-in-the-internal-medicine-clerkship
#11
Brian Kwan, Glory Bui, Paul Jain, Nilesh Shah, Derek Juang
BACKGROUND: Simulation-based medical education has been shown to produce substantial educational benefits; however, the integration and effectiveness of high-fidelity simulation within the internal medicine (IM) clerkship remains largely unexplored. Investigators sought to determine the effectiveness of simulation in improving student confidence in acute coronary syndrome (ACS) and the Advanced Cardiac Life Support (ACLS) curriculum. Secondary goals included examining student perceptions of the role of simulation in medical education...
November 25, 2016: Clinical Teacher
https://www.readbyqxmd.com/read/27878511/new-challenges-in-the-treatment-of-patients-with-left-ventricular-support-lvad-thrombosis
#12
REVIEW
Ann B Nguyen, Nir Uriel, Sirtaz Adatya
Mechanical circulatory support has revolutionized the treatment of heart failure, affording patients significantly improved survival and quality of life. However, further advancements in this technology have been hindered by adverse events, particularly gastrointestinal bleeding, driveline infection, stroke, and device thrombosis. Recently, there has been a renewed focus on device thrombosis as the reported incidence has increased. This review focuses on an update on the diagnostic modalities and current treatment algorithms of this serious complication...
November 22, 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27872117/protocol-for-a-multicentre-randomised-feasibility-trial-evaluating-early-surgery-alone-in-low-rectal-cancer-sailor
#13
Dean A Harris, Kymberley Thorne, Hayley Hutchings, Saiful Islam, Gail Holland, Olivia Hatcher, Sarah Gwynne, Ian Jenkins, Peter Coyne, Michael Duff, Melanie Feldman, Des C Winter, Simon Gollins, Phil Quirke, Nick West, Gina Brown, Deborah Fitzsimmons, Alan Brown, John Beynon
INTRODUCTION: There are 11 500 rectal cancers diagnosed annually in the UK. Although surgery remains the primary treatment, there is evidence that preoperative radiotherapy (RT) improves local recurrence rates. High-quality surgery in rectal cancer is equally important in minimising local recurrence. Advances in MRI-guided prediction of resection margin status and improvements in abdominoperineal excision of the rectum (APER) technique supports a reassessment of the contribution of preoperative RT...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27871512/case-report-management-of-differential-diagnosis-and-treatment-of-severe-anaphylaxis-in-the-setting-of-spinal-anesthesia
#14
Brian M Osman, Joni M Maga, Sebastian M Baquero
The purpose of this case report is to educate fellow anesthesiologists of a complicated differential diagnosis for sudden cardiovascular collapse after spinal anesthesia. We report a case where anaphylaxis occurred while under spinal anesthesia and resulted in difficult resuscitation. A 58-year-old woman undergoing bilateral knee replacements under spinal anesthesia experienced sudden seizure and cardiovascular collapse from acute anaphylactic shock while administering a cephalosporin. Local anesthetic toxicity, high spinal, and anaphylaxis were considered due to overlapping of symptoms...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#15
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#16
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27866783/characterizing-cardiac-arrest-in-children-undergoing-cardiac-surgery-a-single-center-study
#17
Punkaj Gupta, Andrew Wilcox, Tommy R Noel, Jeffrey M Gossett, Stephanie R Rockett, Brian K Eble, Mallikarjuna Rettiganti
OBJECTIVES: To characterize cardiac arrest in children undergoing cardiac surgery using single-center data from the Society of Thoracic Surgeons and Pediatric Advanced Life Support Utstein-Style Guidelines. METHODS: Patients aged 18 years or less having a cardiac arrest for 1 minute or more during the same hospital stay as heart operation qualified for inclusion (2002-2014). Patients having a cardiac arrest both before or after heart operation were included. Heart operations were classified on the basis of the first cardiovascular operation of each hospital admission (the index operation)...
October 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27866314/factors-associated-with-health-related-quality-of-life-hrqol-in-adults-with-short-stature-skeletal-dysplasias
#18
Nitasha Dhiman, Alia Albaghdadi, Cheryl K Zogg, Meesha Sharma, Julie E Hoover-Fong, Michael C Ain, Adil H Haider
INTRODUCTION: Numerous factors associate with health disparities. The extent to which such factors influence health-related quality of life (HRQOL) among adults with short stature skeletal dysplasias (SD) is unknown. In an effort to update and clarify knowledge about the HRQOL of adults with SD, this study aimed to quantify HRQOL scores relative to the American average and assess whether specific indicators are associated with lower scores. METHODS: Members (>18 years) of Little People of America were invited to complete an online survey assessing HRQOL using the SF-12 supplemented with indicator-specific questions...
November 19, 2016: Quality of Life Research
https://www.readbyqxmd.com/read/27863475/spanish-modified-version-of-the-palliative-care-outcome-scale-symptoms-renal-cross-cultural-adaptation-and-validation
#19
Daniel Gutiérrez-Sánchez, Juan P Leiva-Santos, Rosa Sánchez-Hernández, Domingo Hernández-Marrero, Antonio I Cuesta-Vargas
BACKGROUND: Patients with chronic kidney disease (CKD) have a high symptoms burden that is related to a poor health-related quality of life (HRQoL) and high costs of care. Validated instruments may be useful for assessing the symptoms and monitoring outcomes in these patients. The Palliative care Outcome Scale-Symptoms Renal (POS-S Renal) is a patient-reported outcome measure for assessing symptoms in CKD stage 4-5. This study is the first cross-cultural adaptation and psychometric analysis of this clinical tool...
November 18, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27863194/pomalidomide-for-symptomatic-kaposi-s-sarcoma-in-people-with-and-without-hiv-infection-a-phase-i-ii-study
#20
Mark N Polizzotto, Thomas S Uldrick, Kathleen M Wyvill, Karen Aleman, Cody J Peer, Margaret Bevans, Irini Sereti, Frank Maldarelli, Denise Whitby, Vickie Marshall, Priscila H Goncalves, Vikram Khetani, William D Figg, Seth M Steinberg, Jerome B Zeldis, Robert Yarchoan
Purpose Kaposi's sarcoma (KS) is a multicentric tumor caused by Kaposi's sarcoma-associated herpesvirus. Unmet needs include therapies that are oral, anthracycline sparing, and deliverable in resource-limited settings. We evaluated pomalidomide, an oral immune modulatory agent, in patients with symptomatic KS. Methods The primary objectives were to assess tolerability, pharmacokinetics, and activity. Initial dosage level was 5 mg once per day for 21 days per 28-day cycle, with a de-escalated level of 3 mg if not tolerable, and aspirin 81 mg once per day thromboprophylaxis...
December 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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