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Patient transfer quality

Marit Hegg Reime, Tone Johnsgaard, Fred Ivan Kvam, Morten Aarflot, Marit Breivik, Janecke Merethe Engeberg, Guttorm Brattebø
Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n = 262) were organized into 44 interprofessional teams...
October 13, 2016: Nurse Education in Practice
Jennifer E Adair, Timothy Waters, Kevin G Haworth, Sara P Kubek, Grant D Trobridge, Jonah D Hocum, Shelly Heimfeld, Hans-Peter Kiem
Haematopoietic stem cell (HSC) gene therapy has demonstrated potential to treat many diseases. However, current state of the art requires sophisticated ex vivo gene transfer in a dedicated Good Manufacturing Practices facility, limiting availability. An automated process would improve the availability and standardized manufacture of HSC gene therapy. Here, we develop a novel program for semi-automated cell isolation and culture equipment to permit complete benchtop generation of gene-modified CD34(+) blood cell products for transplantation...
October 20, 2016: Nature Communications
Joseph Catapano, Daniel R B Demsey, Emily S Ho, Ronald M Zuker, Gregory H Borschel
Smiling is an important aspect of emotional expression and social interaction, leaving facial palsy patients with impaired social functioning and decreased overall quality of life. Although there are several techniques available for facial reanimation, staged facial reanimation using donor nerve branches from the contralateral, functioning facial nerve connected to a cross-face nerve graft (CFNG) is the only technique that can reliably reproduce an emotionally spontaneous smile. Although CFNGs provide spontaneity, they typically produce less smile excursion than when the subsequent free functioning muscle flap is innervated with the motor nerve to the masseter muscle...
September 2016: Plastic and Reconstructive Surgery. Global Open
Sandy Middleton, Chris Levi, Simeon Dale, N Wah Cheung, Elizabeth McInnes, Julie Considine, Catherine D'Este, Dominique A Cadilhac, Jeremy Grimshaw, Richard Gerraty, Louise Craig, Verena Schadewaldt, Patrick McElduff, Mark Fitzgerald, Clare Quinn, Greg Cadigan, Sonia Denisenko, Mark Longworth, Jeanette Ward
BACKGROUND: Internationally recognised evidence-based guidelines recommend appropriate triage of patients with stroke in emergency departments (EDs), administration of tissue plasminogen activator (tPA), and proactive management of fever, hyperglycaemia and swallowing before prompt transfer to a stroke unit to maximise outcomes. We aim to evaluate the effectiveness in EDs of a theory-informed, nurse-initiated, intervention to improve multidisciplinary triage, treatment and transfer (T(3)) of patients with acute stroke to improve 90-day death and dependency...
October 18, 2016: Implementation Science: IS
Patricia Bartholomay, Daniele Maria Pelissari, Wildo Navegantes de Araujo, Zaida E Yadon, Einar Heldal
Objective To assess 1) the burden and socio-demographic and clinical characteristics of tuberculosis (TB) cases, and 2) the quality of TB care provided to patients who entered and remained within each health care service level (primary, secondary, or tertiary) and those who moved from one level to another, using process and results indicators. Methods This cross-sectional operational research study assessed new smear-positive pulmonary TB cases diagnosed in Brazilian state capitals in 2013 using TB program records and the TB surveillance system...
January 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Thomas Weber
Validation of a medical device measuring a biomarker is a complex process, involving technical aspects (What is actually measured by the device, and how is this done ? Is the measurement reproducible ? Is there a gold standard for measurement of the particular biomarker ? If yes, how accurate and how precise are the measurements by the device, compared to the gold standard ?) and clinical aspects (Do the measurements predict outcome ? If yes, is there added value, when standard clinical parameters are considered ? Is there a treatment strategy, based on the mesurements of the novel device ? Is this strategy cost-effective ?)...
September 2016: Journal of Hypertension
Jing Zhang, Lei Sun, Yu Liu, Hongyi Wang, Ningling Sun, Jia Yu, Yao He, Sijin Yan, Puhong Zhang
OBJECTIVE: To evaluate the feasibility and acceptability of a mobile device based electronical data capture (mEDC) system applied in one randomized clinical trial (RCT). DESIGN AND METHOD: The mEDC, an android smartphone-based application, was developed to support real-time data capture, project management and quality control in a multicenter randomized double-blinded parallel controlled pharmaceutical trial. Four user interfaces are shown in Figure 1. The RCT is to evaluate the efficacy of telmisartan (40mg) and hydrochlorothiazide (25mg) monotherapy in high sodium intake patients with mild to moderate hypertension in 14 hospitals, including one baseline survey and three follow-ups...
September 2016: Journal of Hypertension
Sangita Sharma, Abha Majumdar
Objective. To determine the optimal duration of progesterone supplementation prior to transfer of cryopreserved embryos and its impact on implantation and pregnancy rates. Study Design. Prospective randomised study. Materials and Methods. In an IVF unit of a tertiary centre, sixty-six patients undergoing cryopreserved embryo transfer cycles were included. Endometrial preparation was done with estradiol valerate. Once it reached a minimum of 7 mm, patients were allocated randomly into group I (n = 39) and group II (n = 27)...
2016: International Journal of Reproductive Medicine
Lawrence Lechuga, Georg A Weidlich
A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities-fan beam and cone beam-was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation...
September 12, 2016: Curēus
Amira Mustafa, Samar Mahgoub
Delays in the discharge of hospital patients cause a backlog for new admissions from the Emergency Departments (ED), outpatient clinics, and transfers from the Intensive Care Units (ICU). A variety of initiatives have been reported on previously which aim to tackle this problem with variable success. In this quality improvement project, we aimed to increase the proportion of discharged patients who leave the paediatric unit by 12:00 Noon from 7% to 30% by May 2015. A baseline discharge process map was studied to understand the possible causes of the delays...
2016: BMJ Quality Improvement Reports
Juan Herrera-Tejedor
The preferences of the very elderly are not taken into account in healthcare planning. For this reason, a medical literature review was performed in order to fill the gap in appropriate information on this issue. The majority of them think that they receive good healthcare. They favour building a trusting relationship, with the physician handling their decision-making. They also maximise their quality of life at the expense of quantity, and give great importance to comfort and safety. Most of them express the wish to be cared for and die at home...
October 14, 2016: Revista Española de Geriatría y Gerontología
Alireza Bolourian, Zahra Mojtahedi
Mammalian target of rapamycin (mTOR) inhibitors are strong anti-tumor drugs; however, they have adverse immunosuppressive side effects in some cancer patients. Animal studies have provided evidence that mTOR inhibitors improved tumor-specific T-cells adoptive transfer in which the quality of CD8+ T-cells is a major factor for predicting success. Interestingly, mTOR inhibitors are capable of stimulating cytotoxic CD8+ T-cell if their dose/duration is adjusted. Rapamycin-induced CD8+ T-cells have also been associated with tumor immunity in animal models...
July 2016: Archives of Medical Research
Ana V Ferreira, Ilana Perelshtein, Nina Perkas, Aharon Gedanken, Joana Cunha, Artur Cavaco-Paulo
Chronic wound fluids have elevated concentration of human neutrophil elastase (HNE) which can be used as inflammation/infection marker. Our goal is to develop functional materials for fast diagnosis of wound inflammation/infection by using HNE as a specific marker. For that, fluorogenic peptides with a HNE-specific cleavage sequence were incorporated into traditional textile dressings, to allow real-time detection of the wound status. Two different fluorogenic approaches were studied in terms of intensity of the signal generated upon HNE addition: a fluorophore 7-amino-4-trifluormethylcoumarin (AFC) conjugated to a HNE-specific peptide and two fluorophore/quencher pairs (FAM/Dabcyl and EDANS/Dabcyl) coupled to a similar peptide as a Förster resonance energy transfer (FRET) strategy...
October 15, 2016: Applied Microbiology and Biotechnology
Matthew J Scheffel, Gina Scurti, Patricia Simms, Elizabeth Garrett-Mayer, Shikhar Mehrotra, Michael I Nishimura, Christina Voelkel-Johnson
Although adoptive transfer of autologous tumor antigen-specific T-cell immunotherapy can produce remarkable clinical efficacy, most patients do not achieve durable complete responses. We hypothesized that reducing susceptibility of T cells to activation-induced cell death (AICD), which increases during the rapid in vitro expansion of therapeutic T cells before their infusion, might improve the persistence of adoptively transferred cells. Our investigations revealed that repetitive stimulation of the T-cell receptor (TCR) induced AICD, as a result of activating the DNA damage response pathway through ATM-mediated Ser15 phosphorylation of p53...
October 15, 2016: Cancer Research
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Andrew Gratzon, Jerette Schultz, Kristine Secrest, Kenneth Lee, Jeffrey Feiner, Richard D Klein
ABSTARCT: BACKGROUND: Secondary lymphedema following breast cancer therapy remains a major problem. Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema that has shown promising results, but limited studies in the United States have investigated outcomes for single-stage VLNT to the axilla. The goal of this prospective, ongoing study was to investigate the clinical, psychosocial, and functional outcomes of patients who underwent VLNT for the treatment of upper extremity lymphedema after breast cancer therapy...
October 12, 2016: Annals of Surgical Oncology
Sarah Bigi
The paper discusses the role of argumentative competencies for the achievement of patient engagement through communication in doctor-patient consultations. The achievement of patient engagement is being proposed by recent studies as a condition that can facilitate in particular patient adherence, which involves behavior change. One obstacle to behavior change that has been observed is reactance, i.e., resistance to persuasive messages when a threat to freedom is perceived. In the medical field, reactance theory has been mostly applied in the field of mental health, less frequently to understand non-adherence in general...
2016: Frontiers in Psychology
Piriyatharisini Thamilselvan, Krishna Raj Muthuraman, Jharna Mandal, Subash Chandra Parija
INTRODUCTION: Taenia solium is a common two-host parasitic cestode, residing in both humans (definitive) and pigs (intermediate). Invasion of this parasitic cyst into central nervous system leads to a condition known as neurocysticercosis (NCC). The World Health Organization (WHO) considers NCC as one of the "most neglected" tropical zoonotic diseases. The disease is presented with pleomorphic clinical manifestations, of which epilepsy is the most common. Diagnosis of NCC is carried out by serological tests and imaging methods...
July 2016: Tropical Parasitology
Tiago Teixeira, Tarik Hafyane, Nikola Stikov, Cansu Akdeniz, Andreas Greiser, Matthias G Friedrich
BACKGROUND: T1 mapping based on cardiovascular magnetic resonance (CMR) is a novel approach using the magnetic relaxation T1 time as a quantitative marker for myocardial tissue composition. Various T1 mapping sequences are being used, with different strengths and weaknesses. Data comparing different sequences head to head however are sparse. METHODS: We compared three T1 mapping sequences, ShMOLLI, MOLLI and SASHA in phantoms and in a mid-ventricular slice of 40 healthy individuals (mean age 59 ± 7 years, 45 % male) with low (68 %) or moderate cardiovascular risk...
October 4, 2016: Journal of Cardiovascular Magnetic Resonance
Jigal Haas, Jim Meriano, Carl Laskin, Yaakov Bentov, Eran Barzilay, Robert F Casper, Ken Cadesky
PURPOSE: The aim of this study was to compare the pregnancy rates between good quality blastocysts vitrified on day 6 versus blastocysts vitrified on day 5 after fertilization. METHODS: This is a retrospective cohort study of 791 freeze-thaw cycles of blastocysts vitrified either on day 5 or on day 6 and transferred between January 2012 and October 2015. Five hundred and thirty-seven cycles included blastocysts vitrified on day 5, and 254 cycles included blastocysts vitrified on day 6...
October 6, 2016: Journal of Assisted Reproduction and Genetics
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