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https://www.readbyqxmd.com/read/29775692/exploring-canadian-physicians-experiences-providing-medical-assistance-in-dying-a-qualitative-study
#1
Narges Khoshnood, Marie-Clare Hopwood, Bhadra Lokuge, Allison Kurahashi, Anastasia Tobin, Sarina Isenberg, Amna Husain
CONTEXT: MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. OBJECTIVES: To explore the professional challenges faced by Canadian physicians who provide MAiD...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29775088/an-assessment-of-the-uk-inpatient-care-for-heart-failure-patients-with-diabetes
#2
Lihua Wu, Jackie Cleator, Mamas Mamas, Christi Deaton
BACKGROUND: Diabetes is a common co-morbidity for patients with heart failure. Diabetes as a co-morbidity means that inpatient care should focus on both conditions to maximize the treatment regimen. However, this pressing issue is not widely researched and so it is unclear whether the acute care management needs of these patients are being met. AIMS: (1) To assess the differences in the number of hospital readmissions between patients with heart failure and patients with heart failure-diabetes; (2) to assess the use of integrated care approach for patients with heart failure-diabetes during the index heart failure-related admission; (3) to explore patient experiences of admissions...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#3
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29770975/regulation-of-access-to-the-hospital-care-network-for-children-in-cear%C3%A3-brazil
#4
Maria de Fátima Vasques Monteiro, Maria Auxiliadora F Vertamatti, Maria Nina Morais Alves, Amanda Cordeiro de Oliveira Carvalho, Maria Nizete Tavares Alves, Caio Parente Barbosa
Regulation is a state management tool to ensure that networked health services and goods comply with the principles of universality of access and integrality of care in the Unified Health System. To describe the regulatory actions of access to children's health services in the hospital setting, a descriptive, documentary study was performed to address data on the regulation of access to hospital health-care points for children from January to October 2015. The sample consisted of 2485 hospitalization procedures and regulated transfers in children between 0 and 15 years old living in the Juazeiro do Norte Health Region in the State of Ceará...
May 17, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29770198/recent-advances-in-managing-understanding-meningioma
#5
REVIEW
Nawal Shaikh, Karan Dixit, Jeffrey Raizer
Meningiomas are the most common adult primary intracranial tumor. Despite their higher incidence, there have not-until recently-been as many advances in understanding and managing meningiomas. Thus far, two broad classes of meningiomas have emerged on the basis of their mutational profile: those driven by neurofibromatosis 2 (NF2) inactivation and those with non-NF2 driver gene alterations, such as mammalian target of rapamycin and Hedgehog, Wingless/b-catenin, Notch, transforming growth factor-b receptor, mitogen-activated protein kinase, and phospholipase C pathway alterations...
2018: F1000Research
https://www.readbyqxmd.com/read/29770082/first-reported-case-of-multidrug-resistant-candida-auris-in-canada
#6
I S Schwartz, G W Hammond
Candida auris is a fungal pathogen that has recently emerged as a global threat to public health. It was first described in Japan in 2009 and has since been reported in 17 countries on five continents. This case report describes the first reported case of multidrug-resistant C. auris in Canada. In May 2017, a 64-year-old individual was evaluated for chronic otitis externa. Past medical history included a recent hospitalization in India for elective oral surgery that was complicated by an odontogenic brain abscess...
July 6, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29769059/a-mooc-as-an-immediate-strategy-to-train-health-personnel-in-the-cholera-outbreak-in-mexico
#7
Laura Magaña-Valladares, Cynthia Rosas-Magallanes, Alejandra Montoya-Rodríguez, Guillermo Calvillo-Jacobo, Celia Mercedes Alpuche-Arande, Sebastían García-Saisó
BACKGROUND: In September 2013, two cases of cholera were reported in Mexico; 1 week later, a new outbreak was reported in the Huasteca region of Hidalgo. Upon the determination that the diagnostic and therapeutic interventions implemented by health personnel overlooked predefined procedures, the National Institute of Public Health, in coordination with the Ministry of Health, immediately designed the massive open online course "Proper cholera containment and management measures" to strengthen and standardize basic prevention and control practices...
May 16, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29768417/what-are-the-implications-for-practice-that-arise-from-studies-of-medication-taking-a-systematic-review-of-qualitative-research
#8
Mohammed Ahmed Rashid, Nadia Llanwarne, Natalie Heyns, Fiona Walter, Jonathan Mant
BACKGROUND: Despite several decades of evidence supporting the benefits of taking medications in various diseases and healthcare settings, a significant proportion of prescribed treatments are not taken. This review sought to synthesise qualitative research exploring experiences of medication taking around the world, and to determine whether there were consistent messages arising from these studies. METHODS AND FINDINGS: 5 databases (MEDLINE, PsycINFO, EMBASE, SCOPUS, CINAHL) were systematically searched to identify published research papers using qualitative methodologies, which explored medication-taking experiences in patients, citizens, carers, relatives and clinicians...
2018: PloS One
https://www.readbyqxmd.com/read/29768315/angiography-guided-multivessel-percutaneous-coronary-intervention-versus-ischemia-guided-percutaneous-coronary-intervention-versus-medical-therapy-in-the-management-of-significant-disease-in-non-infarct-related-arteries-in-st-elevation-myocardial-infarction
#9
Dhanuka Perera, Tom Crake, Victor Lee
BACKGROUND: In ST-elevation myocardial infarction (STEMI) patients with multivessel (MV) disease, after primary percutaneous coronary intervention (PCI), emerging evidence suggests that significant disease in non-infarct-related coronary arteries (IRAs) should be routinely stented. Whether this procedure should be guided by angiography alone or ischemia testing is unclear. METHODS: All STEMI patients treated with primary PCI between January 1, 2005, and December 31, 2012, at a tertiary cardiology center were reviewed retrospectively...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768291/quality-of-the-triage-of-children-with-anaphylaxis-at-the-emergency-department
#10
Esozia Arroabarren, Jorge Alvarez-Garcia, Marta Anda, Montserrat de Prada, Maria Carmen Ponce, Miriam Palacios
OBJECTIVE: Early recognition of symptoms is essential in anaphylaxis management. The Canadian Paediatric Emergency Triage and Acuity Scale prioritizes anaphylaxis to level I or II (resuscitation or emergency). We analyzed the accuracy of pediatric anaphylaxis triage. METHODS: This was a retrospective review of the triage charts (adaptation of the Canadian Paediatric Emergency Triage and Acuity Scale) of 137 children attended for anaphylaxis at our pediatric emergency department...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#11
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29765580/predictive-factors-associated-with-mortality-and-discharge-in-intensive-care-units-a-retrospective-cohort-study
#12
Mohammad Ghorbani, Haleh Ghaem, Abbas Rezaianzadeh, Zahra Shayan, Farid Zand, Reza Nikandish
Background and aim: Accurate prediction of prognosis of patients admitted to intensive care units (ICUs) is very important for the clinical management of the patients. The present study aims to identify independent factors affecting death and discharge in ICUs using competing risk modeling. Methods: This retrospective cohort study was conducted on enrolling 880 patients admitted to emergency ICU in Namazi hospital, Shiraz University of Medical Sciences, Shiraz, Iran during 2013-2015...
March 2018: Electronic Physician
https://www.readbyqxmd.com/read/29765259/shadowing-emergency-medicine-residents-by-medical-education-specialists-to-provide-feedback-on-non-medical-knowledge-based-acgme-sub-competencies
#13
Anna L Waterbrook, Karen C Spear Ellinwood, T Gail Pritchard, Karen Bertels, Ariel C Johnson, Alice Min, Lisa R Stoneking
Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29765242/claims-based-proxies-of-patient-instability-among-commercially-insured-adults-with-schizophrenia
#14
Charles Ruetsch, Hyong Un, Heidi C Waters
Objective: Schizophrenia (Sz) patients are among the highest utilizers of hospital-based services. Prevention of relapse is in part a treatment goal in order to reduce hospital admissions. However, predicting relapse is a challenge, particularly for payers and disease management firms with only access to claims data. Understandably, such organizations have had little success predicting relapse. A tool that allows payers to identify patients at elevated risk of relapse could facilitate targeted interventions prior to relapse and avoid rehospitalization...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29764524/a-qualitative-examination-of-the-factors-related-to-the-development-and-maintenance-of-insomnia-in-cancer-survivors
#15
Sheila N Garland, Frances K Barg, Brigid Cakouros, Philip Gehrman, Katherine N DuHamel, Jun J Mao
OBJECTIVE: Insomnia is underrecognized and inadequately managed, with close to 60% of cancer survivors experiencing insomnia at some point in the treatment trajectory. The objective of this study was to further understand predisposing, precipitating, and perpetuating factors in the development and maintenance of insomnia in cancer survivors. METHOD: A heterogeneous sample of 63 patients who had completed active treatment was recruited. Participants were required to have a score >7 on the Insomnia Severity Index and meet the diagnostic criteria for insomnia disorder...
May 16, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29764278/eating-well-living-well-and-weight-management-a-co-produced-semi-qualitative-study-of-barriers-and-facilitators-experienced-by-adults-with-intellectual-disabilities
#16
A J Doherty, S P Jones, U Chauhan, Jme Gibson
Adults with intellectual disabilities in England experience health inequalities. They are more likely than their non-disabled peers to be obese and at risk of serious medical conditions such as heart disease, stroke and type 2 diabetes. This semi-qualitative study engaged adults with intellectual disabilities in a co-production process to explore their perceived barriers and facilitators to eating well, living well and weight management. Nineteen participants with intellectual disabilities took part in four focus groups and one wider group discussion...
January 1, 2018: Journal of Intellectual Disabilities: JOID
https://www.readbyqxmd.com/read/29763411/characteristics-and-health-care-resource-use-of-subjects-with-copd-in-the-year-before-initiating-lama-monotherapy-or-lama-laba-combination-therapy-a-u-s-database-study
#17
Saurabh Nagar, Jeetvan Patel, Richard H Stanford
PURPOSE: To characterize subjects with chronic obstructive pulmonary disease (COPD) newly initiated on long-acting muscarinic antagonists (LAMA) or dual LAMA/long-acting β2-adrenergic agonist (LABA) therapy. DESIGN: This pilot/preliminary analysis was a retrospective crosssectional study of subjects with COPD from the Optum Impact National Managed Care Benchmark Database. METHODOLOGY: Subjects with at least one LAMA prescription in the index period (July 2008-June 2009) were included and stratified by treatment...
May 2018: Managed Care
https://www.readbyqxmd.com/read/29763388/how-should-trauma-patients-informed-consent-or-refusal-be-regarded-in-a-trauma-bay-or-other-emergency-settings
#18
Ashley Suah, Peter Angelos
The precipitous and unexpected nature of trauma requires training health care practitioners to think and act quickly, according to the best medical interest of the patient. The urgency of treatment for trauma patients, who frequently have temporary alterations in their abilities to make autonomous and competent decisions, often results in presumed consent for medically necessary treatment. Academic trauma centers use protocol-based management of injuries to facilitate their simultaneous evaluation by multiple clinicians and to avoid delays in treatment, ensuring that trauma patients receive the best possible care...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29762507/m-health-lessons-learned-by-m-experiences
#19
José Bravo, Ramón Hervás, Jesús Fontecha, Iván González
m-Health is an emerging area that is transforming how people take part in the control of their wellness condition. This vision is changing traditional health processes by discharging hospitals from the care of people. Important advantages of continuous monitoring can be reached but, in order to transform this vision into a reality, some factors need to be addressed. m-Health applications should be shared by patients and hospital staff to perform proper supervised health monitoring. Furthermore, the uses of smartphones for health purposes should be transformed to achieve the objectives of this vision...
May 15, 2018: Sensors
https://www.readbyqxmd.com/read/29761676/planned-re-laparotomy-in-a-non-trauma-setting-a-single-center-experience
#20
Yehuda Hershkovitz, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov
BACKGROUND: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. OBJECTIVES: To evaluate our experience with planned re-laparotomy (PRL) in non-trauma patients and compare it to other reports. METHODS: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed...
May 2018: Israel Medical Association Journal: IMAJ
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