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https://www.readbyqxmd.com/read/28549984/smfm-special-report-the-development-and-implementation-of-checklists-in-obstetrics
#1
Peter S Bernstein, C Andrew Combs, Laurence E Shields, Steven L Clark, Catherine S Eppes
Checklists have been long used as a cognitive aid in various high-stakes environments to improve the reliability and performance of individuals and teams. When designed well, implemented thoughtfully, and monitored closely, they offer the opportunity to improve the performance of health care teams and advance patient safety. There are different types of checklists; examples include task lists, troubleshooting lists, coordination lists, discipline lists, and to-do lists. Each is useful in different situations and requires different implementation strategies...
May 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28549789/systematic-approaches-to-adverse-events-in-obstetrics-part-i-event-identification-and-classification
#2
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
May 23, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28546660/can-we-deliver-better
#3
REVIEW
Ajay Rane, Jay Iyer, Harsha Ananthram, Thomas Currie
Human childbirth has been described as an "obstetrical dilemma". Evolution favours enlargement of the foetal brain, whilst bipedal locomotion demands a reduction in pelvic breadth for improvements in biomechanical efficiency. The result of this conflict is a human pelvis incongruous with the dynamics of childbirth. Acute genital distortion at delivery can inflict lasting damage to female pelvic function. Pelvic organ prolapse, urinary, faecal incontinence and sexual dysfunction are long-term sequelae rarely discussed at antenatal care, impacting upon the expectant mother's ability to make an informed decision...
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28545653/systematic-approaches-to-adverse-events-in-obstetrics-part-ii-event-analysis-and-response
#4
Christian M Pettker
The critical arm of improvement and change comes after events are identified and classified. Getting and making things right when things go wrong defines a successful safety program. This article reviews the important tasks that should be familiar to any team approaching a serious event on an obstetrics unit. Root cause analysis is a critical, but often misunderstood, tool for dissecting the contributing factors leading to an adverse event. Successful root cause analyses have a standardized approach that result in meaningful action plans...
May 22, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28539111/written-versus-verbal-consent-a-qualitative-study-of-stakeholder-views-of-consent-procedures-used-at-the-time-of-recruitment-into-a-peripartum-trial-conducted-in-an-emergency-setting
#5
J Lawton, N Hallowell, C Snowdon, J E Norman, K Carruthers, F C Denison
BACKGROUND: Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women's and staff views about the consent procedures used during the internal pilot of a trial (GOT-IT), where the protocol permitted staff to gain verbal consent at recruitment...
May 24, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28523051/prevalence-of-anemia-and-related-factors-among-women-in-turkey
#6
Birsen Karaca Saydam, Rabia Ekti Genc, Fulden Sarac, Esin Ceber Turfan
OBJECTIVE: To determine the prevalence of anemia and related factors among women in Turkey. METHODS: This descriptive study was conducted at the outpatient clinics of the Department of Internal Medicine, Ege University Medical School. Randomly selected women were given questionnaires regarding their socio-demographic and obstetric characteristics. The data were coded and analyzed using SPSS version 17.0 software. Statistical analyses with 95% confidence intervals were considered to be significant if p<0...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28501236/women-s-health-polycystic-ovarian-syndrome-menopause-and-osteoporosis
#7
REVIEW
Melinda Ring
Surveys consistently show that a significantly higher percentage of women with chronic medical conditions report use of complementary and integrative medicine (CIM) approaches compared with men. A total of 54.5% of women report use of at least one CIM approach specifically for obstetric or gynecologic problems. However, primary care providers remain an underutilized resource by patients for guidance in the safe and appropriate use of integrative therapies. This article provides a practical overview of the most appropriate integrative therapies to consider in the management of commonly seen women's health conditions: polycystic ovarian syndrome, menopause, and osteoporosis...
June 2017: Primary Care
https://www.readbyqxmd.com/read/28501235/women-s-health-pregnancy-and-conception
#8
REVIEW
Judith Cuneo
Preconception is an ideal time to assist women contemplating pregnancy to modify health behaviors. Dietary needs in pregnancy are critical and may require supplementation. The use of mind-body medicine in the antenatal period assists patients in childbirth preparation. Integrative medicine techniques can be safely and effectively used for common third-trimester obstetric complications of pregnancy.
June 2017: Primary Care
https://www.readbyqxmd.com/read/28498004/a-sequential-implementation-model-for-workforce-development-a-case-study-of-medical-residency-training-for-substance-use-concerns
#9
Patricia S O'Sullivan, Patrick Yuan, Derek D Satre, Maria Wamsley, Jason Satterfield
PROBLEM: In graduate medical education, residency programs are often educationally isolated from each other, with varying needs and patient populations, so strategies are needed when attempting to implement training in evidence-based practices across multiple residencies. INTERVENTION: Using implementation science as a guide, we adapted a community development model to sequentially implement an evidence-based intervention, Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and drug use problems, across internal medicine, pediatrics, emergency medicine, psychiatry, and obstetrics and gynecology residency programs...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28491133/the-way-forward
#10
Sandra A Lowe
Improving maternal health and reducing maternal morbidity and mortality into the future will require a range of health-related and non-health-related strategies. The latter include education for women, better communication, access to transport and technology and cultural change. The role of obstetric medicine practice, research and education in achieving these objectives is discussed in this article. We need to recognise that it will require improvements in health provision and access to achieve our goal of safer childbirth for women and babies throughout the world...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28491132/obstetric-medical-care-and-training-in-the-united-kingdom
#11
Adam D Jakes, Ingrid Watt-Coote, Matthew Coleman, Catherine Nelson-Piercy
The UK confidential enquiry into maternal deaths identified poor management of medical problems in pregnancy to be a contributory factor to a large proportion of indirect maternal deaths. Maternal (obstetric) medicine is an exciting subspecialty that encompasses caring for both women with pre-existing medical conditions who become pregnant, as well as those who develop medical conditions in pregnancy. Obstetrics and gynaecology trainees have some exposure to maternal medicine through their core curriculum and can then complete an advanced training skills module, subspecialise in maternal-fetal medicine or take time out to complete the Royal College of Physicians membership examination...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#12
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28483503/gaps-in-knowledge-among-physicians-regarding-diagnostic-criteria-and-management-of-polycystic-ovary-syndrome
#13
Anuja Dokras, Shailly Saini, Melanie Gibson-Helm, Jay Schulkin, Laura Cooney, Helena Teede
OBJECTIVE: To identify gaps in polycystic ovary syndrome (PCOS) knowledge and practice patterns among physicians in North America in response to significant dissatisfaction identified among women with PCOS regarding their diagnosis and treatment experience. DESIGN: Online survey conducted via American College of Obstetrics and Gynecology of gynecologists (ObGyn) and American Society of Reproductive Medicine of reproductive endocrinologists (REI-ObGyn) in 2015-16...
May 5, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28479890/prevalence-and-risk-factors-of-pre-hypertension-in-congolese-pre-and-post-menopausal-women
#14
Mjs Muchanga, F B Lepira, R Tozin, E P Mbelambela, N R Ngatu, E K Sumaili, J R Makulo, N Suganuma
OBJECTIVES: We aimed to assess the prevalence of prehypertension and its associated factors in a population of Congolese pre and postmenopausal women. METHODS: We had consecutively recruited 200 women (100 premenopausal and 100 postmenopausal) aged 40 - 60 years at the department of Gynecology and Obstetrics, University of Kinshasa Hospital, and AKRAM Medical Center in Kinshasa, DRC. An interview was carried out using a questionnaire that comprised questions related to lifestyle, menses characteristics, medical history of diabetes, CVD, hypertension, current antihypertensive medication and use of traditional medicine...
December 2016: African Health Sciences
https://www.readbyqxmd.com/read/28477295/do-tort-reforms-impact-the-incidence-of-birth-by-cesarean-section-a-reassessment
#15
Javier Cano-Urbina, Daniel Montanera
Investigations into the existence and impact of defensive medicine in obstetrics have produced mixed and often conflicting implications. The most widely-cited and accepted results in this literature find that less severe malpractice environments cause an increase in the use of cesarean section. This has been interpreted as "offensive medicine"; taking advantage of lenient malpractice environments by providing unnecessary services in order to raise revenue. In this article we show that an assumption concerning births with an unknown method of delivery, which is not explicitly stated in the literature, is pivotal in obtaining these results...
March 2017: International Journal of Health Economics and Management
https://www.readbyqxmd.com/read/28472976/the-effect-of-dehydroepiandrosterone-supplementation-on-ovarian-response-is-associated-with-androgen-receptor-in-diminished-ovarian-reserve-women
#16
Qiaofei Hu, Liming Hong, Mingyue Nie, Qin Wang, Ying Fang, Yinmei Dai, Yanhong Zhai, Shuyu Wang, Chenghong Yin, Xiaokui Yang
BACKGROUND: Diminished ovarian reserve(DOR) is associated with female infertility and poor response to ovarian stimulation. Our objective was to assess the effect of dehydroepiandrosterone(DHEA) on DOR women and to explore whether the improvement of ovarian response after DHEA supplementation was dependent on the expression levels of androgen receptor(AR). METHODS: A prospective cohort study was performed in the Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital during August 2014 to August 2016...
May 4, 2017: Journal of Ovarian Research
https://www.readbyqxmd.com/read/28455087/assessing-the-potential-impact-of-extending-antenatal-steroids-to-the-late-preterm-period
#17
Vivienne Souter, Ellen Kauffman, Ms Alice J Marshall, Jodie G Katon
BACKGROUND: In 2016 guidance statements were issued by the Society for Maternal Fetal Medicine and by the American College of Obstetricians and Gynecologists about extending antenatal steroid use to selected late preterm singleton pregnancies. OBJECTIVE: To review antenatal steroid use prior to the 2016 guidance statements and assess the potential impact of these. STUDY DESIGN: This cohort study used chart-abstracted data from singleton deliveries from January 1, 2012 to March 31, 2016 at 12 centers participating in the Obstetrics Clinical Outcomes Assessment Program, a quality initiative in Washington State...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28450412/the-art-of-medicine-arts-based-training-in-observation-and-mindfulness-for-fostering-the-empathic-response-in-medical-residents
#18
Joyce Zazulak, May Sanaee, Andrea Frolic, Nicole Knibb, Eve Tesluk, Edward Hughes, Lawrence E M Grierson
Empathy is an essential attribute for medical professionals. Yet, evidence indicates that medical learners' empathy levels decline dramatically during medical school. Training in evidence-based observation and mindfulness has the potential to bolster the acquisition and demonstration of empathic behaviours for medical learners. In this prospective cohort study, we explore the impact of a course in arts-based visual literacy and mindfulness practice (Art of Seeing) on the empathic response of medical residents engaged in obstetrics and gynaecology and family medicine training...
April 27, 2017: Medical Humanities
https://www.readbyqxmd.com/read/28441842/-analysis-of-funding-of-projects-on-obstetrics-and-gynecology-supported-by-national-natural-science-foundation-of-china-from-2007-to-2016
#19
S H Qin, Q S Huang, S Z Yao
Objective: To summarize the funding of scientific research projects on obstetrics and gynecology by National Natural Science Foundation of China (NSFC) from 2007 to 2016 and to display the hotspots of scientific research on obstetrics and gynecology. Methods: A systemic search was performed for the information of projects supported by NSFC from 2007 to 2016. The indicators for analysis included the number of projects, total investment, project categories, research units and research field. The research direction of each project was decided based on title, summary and key words provided by the profile of each project...
April 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28434089/pregnancy-and-kidney-disease-from-medicine-based-on-exceptions-to-exceptional-medicine
#20
EDITORIAL
Giorgina Barbara Piccoli, Gianfranca Cabiddu
The Webster dictionary defines exception as an anomaly, a person or thing that does not follow a rule, while the adjective exceptional has a different nuance, and means "above average". These two words may describe how obstetric nephrology has shifted from the description of very rare cases, to the development of a complex new and fascinating branch of medicine, that counterbalances obstetricians' usually optimistic outlook by focusing on subtle challenges posed by chronic diseases, and mitigate the frequently grim approach of nephrologists, with a message of hope: women with kidney disease can have the same basic life goals as healthy women their age...
April 22, 2017: Journal of Nephrology
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