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https://www.readbyqxmd.com/read/28720241/the-physician-nurse-collaboration-in-feeding-critically-ill-patients-a-multicenter-survey
#1
Binbin Mei, Wenting Wang, Meifen Shen, Feifei Cui, Zunjia Wen, Jianping Ding
AIMS: Describe physician-nurse collaboration in feeding critically ill patients and explore the influence factors related to this collaboration, which can provide information for clinical practice and future studies. BACKGROUND: Appropriate nutrition support is essential and significant for critically ill patients, and the importance of physician-nurse collaboration in other fields has been confirmed, yet there are limited studies put insights into the status of physician-nurse collaboration in feeding critically ill patients...
August 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28716149/transition-into-adult-care-factors-associated-with-level-of-preparedness-among-adolescents-living-with-hiv-in-cambodia
#2
Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Pheak Chhoun, Gitau Mburu, Sok Chamreun Choub, Kolab Chhim, Penhsun Ly
BACKGROUND: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia. METHODS: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15-17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire...
July 17, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28716047/protocol-adherence-for-continuously-titrated-interventions-in-randomized-trials-an-overview-of-the-current-methodology-and-case-study
#3
F Lauzier, N K Adhikari, A Seely, K K Y Koo, E P Belley-Côté, K E A Burns, D J Cook, F D'Aragon, B Rochwerg, M E Kho, S J W Oczkowksi, E H Duan, M O Meade, A G Day, F Lamontagne
BACKGROUND: The standard definition for protocol adherence is the proportion of all scheduled doses that are delivered. In clinical research, this definition has several limitations when evaluating protocol adherence in trials that study interventions requiring continuous titration. DISCUSSION: Building upon a specific case study, we analyzed a recent trial of a continuously titrated intervention to assess the impact of different definitions of protocol deviations on the interpretation of protocol adherence...
July 17, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#4
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28711339/imaging-department-organization-in-a-stroke-center-and-workflow-processes-in-acute-stroke
#5
REVIEW
Zarina Abdul Assis, Bijoy K Menon, Mayank Goyal
The imaging department is an integral part of the stroke management task force and plays a critical role. Accurate and timely interpretation of images obtained in the emergency department and involvement in decision-making has contributed immensely in stroke care. In fact, the treatment paradigm has changed considerably after the recent positive endovascular clinical trials; and so is the hospital workflow and treatment site. As a result, the imaging department has become the site of maximum activity during an acute stroke protocol...
June 20, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28711122/the-establishment-and-management-of-an-observation-unit
#6
REVIEW
Jared Conley, J Stephen Bohan, Christopher W Baugh
The current health care landscape and evidence support the establishment of observation units (OUs) for safe and efficient care for observation patients. Careful attention is required in the design of OU process, location, and layout to enable optimal care and finances. Developing and maintaining protocols to guide patient selection and clinical care are critical. OU management requires a strong, collaborative leadership model, appropriate staffing, and a robust monitoring system for quality, safety, and finances...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28710219/comparison-of-propofol-and-dexmedetomidine-infused-overnight-to-treat-hyperactive-and-mixed-icu-delirium-a-protocol-for-the-basel-prodex-clinical-trial
#7
Alexa Hollinger, Katrin Ledergerber, Stefanie von Felten, Raoul Sutter, Stephan Rüegg, Lukas Gantner, Sibylle Zimmermann, Andrea Blum, Luzius A Steiner, Stephan Marsch, Martin Siegemund
BACKGROUND/OBJECTIVES: Delirium is a neurobehavioural disturbance that frequently develops particularly in the intensive care unit (ICU) population. It was first described more than half a century ago, where it was already discovered as a state that might come along with serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality. However, in most cases, there is still lack of proof for causal relationship. Its presence frequently remains unrecognised due to suggested predominance of the hypoactive form...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710215/a-study-protocol-for-an-observational-cohort-investigating-cognitive-outcomes-and-wellness-in-survivors-of-critical-illness-the-cogwell-study
#8
M Elizabeth Wilcox, Andrew S Lim, Mary P McAndrews, Richard A Wennberg, Ruxandra L Pinto, Sandra E Black, Karolina D Walczak, Jan O Friedrich, Michael S Taglione, Gordon D Rubenfeld
INTRODUCTION: Up to 9 out of 10 intensive care unit (ICU) survivors will suffer some degree of cognitive impairment at hospital discharge and approximately half will have decrements that persist for years. The mechanisms for this newly acquired brain injury are poorly understood. The purpose of this study is to describe the prevalence of sleep abnormalities and their association with cognitive impairment, examine a well-known genetic risk factor for dementia (Apolipoprotein E ε4) that may allow for genetic risk stratification of ICU survivors at greatest risk of cognitive impairment and determine if electroencephalography (EEG) is an independent predictor of long-term cognitive impairment and possibly a candidate intermediate end point for future clinical trials...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706103/vitamin-d-levels-in-critically-ill-patients-with-acute-kidney-injury-a-protocol-for-a-prospective-cohort-study-vid-aki
#9
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28702940/heart-rate-variability-in-critical-care-medicine-a-systematic-review
#10
Shamir N Karmali, Alberto Sciusco, Shaun M May, Gareth L Ackland
BACKGROUND: Heart rate variability (HRV) has been used to assess cardiac autonomic activity in critically ill patients, driven by translational and biomarker research agendas. Several clinical and technical factors can interfere with the measurement and/or interpretation of HRV. We systematically evaluated how HRV parameters are acquired/processed in critical care medicine. METHODS: PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (1996-2016) were searched for cohort or case-control clinical studies of adult (>18 years) critically ill patients using heart variability analysis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28693596/prioritising-responses-of-nurses-to-deteriorating-patient-observations-pronto-protocol-testing-the-effectiveness-of-a-facilitation-intervention-in-a-pragmatic-cluster-randomised-trial-with-an-embedded-process-evaluation-and-cost-analysis
#11
Tracey K Bucknall, Gill Harvey, Julie Considine, Imogen Mitchell, Jo Rycroft-Malone, Ian D Graham, Mohammadreza Mohebbi, Jennifer Watts, Alison M Hutchinson
BACKGROUND: Vital signs are the primary indicator of physiological status and for determining the need for urgent clinical treatment. Yet, if physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, unplanned intensive care admissions, cardiac arrest and death may ensue. Although evidence demonstrates the benefit of early recognition and management of deteriorating patients, failure to escalate care and manage deteriorating patients remains a relatively frequent occurrence in hospitals...
July 11, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28686124/influence-of-an-intratumoral-cyst-on-drug-distribution-by-convection-enhanced-delivery-case-report
#12
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/28683729/crrtnet-a-prospective-multi-national-observational-study-of-continuous-renal-replacement-therapy-practices
#13
Michael Heung, Sean M Bagshaw, Andrew A House, Luis A Juncos, Robin Piazza, Stuart L Goldstein
BACKGROUND: Continuous renal replacement therapy (CRRT) is the recommended modality of dialysis for critically ill patients with hemodynamic instability. Yet there remains significant variability in how CRRT is prescribed and delivered, and limited evidence-basis to guide practice. METHODS: This is a prospective, multi-center observational study of patients undergoing CRRT. Initial enrollment phase will occur at 4 academic medical centers in North America over 5 years, with a target enrollment of 2000 patients...
July 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28680956/patient-reported-outcomes-pros-as-part-of-value-based-care-can-shape-therapy-guidelines-impact-on-emerging-targeted-agents-and-immunotherapy-protocols-in-resource-limited-regions
#14
EDITORIAL
Frank E Mott
Patient reported outcomes (PROs) are commonly integrated into clinical trials for new cancer therapies or treatment modalities; however, beyond a cursory review during the registration process for a new drug, these important measures of patient satisfaction and cost-effectiveness are often under-used in daily practice. We cite literature under-scoring the value of PROs not only in clinical trials, but in practical decision making and how such metrics can help guide the oncologist and the patient in choosing the best and most cost-effective therapy for their cancer...
2017: Oncology and Therapy
https://www.readbyqxmd.com/read/28679430/practical-issues-regarding-implementing-a-randomized-clinical-trial-in-a-homeless-population-strategies-and-lessons-learned
#15
Olamide Ojo-Fati, Anne M Joseph, Jed Ig-Izevbekhai, Janet L Thomas, Susan A Everson-Rose, Rebekah Pratt, Nancy Raymond, Ned L Cooney, Xianghua Luo, Kolawole S Okuyemi
There is a critical need for objective data to guide effective health promotion and care for homeless populations. However, many investigators exclude homeless populations from clinical trials due to practical concerns about conducting research with this population. This report is based on our experience and lessons learned while conducting two large NIH-funded randomized controlled trials targeting smoking cessation among persons who are homeless. The current report also addresses challenges when conducting clinical trials among homeless populations and offers potential solutions...
July 5, 2017: Trials
https://www.readbyqxmd.com/read/28670201/-teamwork-in-hospitals-a-quasi-experimental-study-protocol-applying-a-human-factors-approach
#16
Randi Ballangrud, Sissel Eikeland Husebø, Karina Aase, Oddveig Reiersdal Aaberg, Anne Vifladt, Geir Vegard Berg, Marie Louise Hall-Lord
BACKGROUND: Effective teamwork and sufficient communication are critical components essential to patient safety in today's specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals, however the scientific rigor of studies must be strengthen and more research is required to compare studies across samples, settings and countries. The aims of the study are to translate and validate teamwork questionnaires and investigate healthcare personnel's perception of teamwork in hospitals (Part 1)...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28667221/effectiveness-of-behavioural-change-techniques-in-physiotherapy-interventions-to-promote-physical-activity-adherence-in-patients-with-hip-and-knee-osteoarthritis-a-systematic-review-protocol
#17
Matthew Willett, Joan Duda, Charlotte Gautrey, Sally Fenton, Carolyn Greig, Alison Rushton
INTRODUCTION: Osteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28666342/achieving-accountability-through-maternal-death-reviews-in-nigeria-a-process-analysis
#18
Bregje de Kok, M Imamura, L Kanguru, O Owolabi, F Okonofua, J Hussein
Maternal death reviews (MDRs) are part of the drive to increase accountability for maternal deaths and reduce their occurrence by identifying barriers to effective, quality care. However, conducting MDRs well is difficult; staff commitment and establishing a blame free environment are key challenges. By examining the communication strategies used in MDRs this study sought to understand how MDR members implement policy imperatives (e.g. 'no blame, no name') and manage the inevitable sensitivities of discussing a client's death in a multidisciplinary team...
June 28, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28659166/familiar-ethical-issues-amplified-how-members-of-research-ethics-committees-describe-ethical-distinctions-between-disaster-and-non-disaster-research
#19
Catherine M Tansey, James Anderson, Renaud F Boulanger, Lisa Eckenwiler, John Pringle, Lisa Schwartz, Matthew Hunt
BACKGROUND: The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. METHODS: We aim to answer the following questions: 1) what do research ethics committee (REC) members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries (LMICs) perceive as the key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members...
June 28, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28659159/searching-for-management-approaches-to-reduce-hai-transmission-smart-a-study-protocol
#20
Ann Scheck McAlearney, Jennifer L Hefner, Cynthia J Sieck, Daniel M Walker, Alison M Aldrich, Lindsey N Sova, Alice A Gaughan, Caitlin M Slevin, Courtney Hebert, Erinn Hade, Jacalyn Buck, Michele Grove, Timothy R Huerta
BACKGROUND: Healthcare-associated infections (HAIs) impact patients' lives through prolonged hospitalization, morbidity, and death, resulting in significant costs to both health systems and society. Central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) are two of the most preventable HAIs. As a result, these HAIs have been the focus of significant efforts to identify evidence-based clinical strategies to reduce infection rates...
June 28, 2017: Implementation Science: IS
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