keyword
MENU ▼
Read by QxMD icon Read
search

Escalation of care

keyword
https://www.readbyqxmd.com/read/29453384/longitudinal-impact-of-ibs-type-symptoms-on-disease-activity-healthcare-utilization-psychological-health-and-quality-of-life-in-inflammatory-bowel-disease
#1
David J Gracie, P John Hamlin, Alexander C Ford
OBJECTIVES: The impact of irritable bowel syndrome (IBS)-type symptoms on the natural history of inflammatory bowel disease (IBD) is uncertain. We aimed to address this in a longitudinal study of secondary care patients. METHODS: Longitudinal disease activity was defined by disease flare, escalation of medical therapy, hospitalization, or intestinal resection. The number of investigations performed and clinics attended determined healthcare utilization. Psychological well-being and quality of life were assessed using validated questionnaires...
February 16, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29449119/violence-against-health-care-providers-a-mixed-methods-study-from-karachi-pakistan
#2
Lubna Ansari Baig, Shiraz Shaikh, Maciej Polkowski, Syeda Kausar Ali, Seemin Jamali, Lubna Mazharullah, Marium Soomro, Bhavita Kumari, Sobia Memon, Greesh Maheshwari, Saleema Arif
BACKGROUND: Violence against health care providers (HCPs) remains a significant public health problem in developing countries, affecting their performance and motivation. OBJECTIVES: To report the quantity and perceived causes of violence committed upon HCPs and identify strategies intended to prevent and de-escalate it. METHODS: This was a mixed-methods concurrent study design (QUAN-QUAL). A structured questionnaire was filled in on-site by trained data collectors for quantitative study...
February 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29447585/service-seeking-experiences-of-college-aged-sexual-and-intimate-partner-violence-victims-with-a-mental-health-and-or-behavioral-disability
#3
Emily M Nichols, Amy Bonomi, Rebecca Kammes, Elizabeth Miller
OBJECTIVE: To examine mental health service experiences following sexual violence (SV) and intimate partner violence (IPV) victimization among college women with a disability. PARTICIPANTS: College women (n = 27, ages 19 to 24) with a disability who experienced at least one SV/IPV occurrence; interviewed July/August 2016. METHODS: Qualitative study using in-depth interviews, with thematic analysis. RESULTS: Women tended to wait several months (or did not seek care at all) following SV/IPV, because they downplayed their experience (e...
February 15, 2018: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/29444195/decrease-in-inpatient-telemetry-utilization-through-a-system-wide-electronic-health-record-change-and-a-multifaceted-hospitalist-intervention
#4
Karli Edholm, Polina Kukhareva, Claire Ciarkowski, Jason Carr, David Gill, Austin Rupp, Jack Morshedzadeh, Nathan Wanner, Kensaku Kawamoto
BACKGROUND: Unnecessary telemetry monitoring contributes to healthcare waste. OBJECTIVE: To evaluate the impact of 2 interventions to reduce telemetry utilization. DESIGN, SETTING, PATIENTS: A 2-group retrospective, observational pre- to postintervention study of 35,871 nonintensive care unit (ICU) patients admitted to 1 academic medical center. INTERVENTION: On the hospitalist service, we implemented a telemetry reduction intervention including education, process change, routine feedback, and a financial incentive between January 2015 and June 2015...
February 8, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29441815/the-secret-drama-at-the-patient-s-bedside-refusal-of-treatment-because-of-the-practitioner-s-ethnic-identity-the-medical-staff-s-point-of-view
#5
Ariela Popper-Giveon, Yael Keshet
Patients' refusal of treatment based on the practitioner's ethnic identity reveals a clash of values: neutrality in medicine versus patient-centered care. Taking the Israeli-Palestinian conflict into account, this article aims at examining Israeli health care professionals' points of view concerning patients' refusal of treatment because of a practitioner's ethnic identity. Fifty in-depth interviews were conducted with 10 managers and 40 health care professionals, Jewish and Arab, employed at 11 public hospitals...
February 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29438467/prophylactic-antimicrobial-therapy-for-acute-aspiration-pneumonitis
#6
Vlad Dragan, Lex Wei, Marion Elligsen, Alex Kiss, Sandra A N Walker, Jerome A Leis
Background: Prophylactic antimicrobial therapy is frequently prescribed for acute aspiration pneumonitis following macro-aspiration with the intent of preventing the development of aspiration pneumonia; however, few clinical studies have examined the benefits and harms of this practice. Methods: A retrospective cohort study design was used to assess outcomes of patients receiving antimicrobial prophylaxis with those receiving supportive care only during the initial two days following an acute aspiration pneumonitis episode...
February 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29437908/a-quality-improvement-initiative-to-reduce-nicu-transfers-for-neonates-at-risk-for-hypoglycemia
#7
Sherry LeBlanc, Jamie Haushalter, Carl Seashore, Karen S Wood, Michael J Steiner, Ashley G Sutton
BACKGROUND AND OBJECTIVE: Neonatal hypoglycemia is a common problem, often requiring management in the NICU. Nonpharmacologic interventions, including early breastfeeding and skin-to-skin care (SSC), may prevent hypoglycemia and the need to escalate care. Our objective was to maintain mother-infant dyads in the mother-infant unit by decreasing hypoglycemia resulting in NICU transfer. METHODS: Inborn infants ≥35 weeks' gestation with at least 1 risk factor for hypoglycemia were included...
February 8, 2018: Pediatrics
https://www.readbyqxmd.com/read/29432074/an-opioid-overdose-curriculum-for-medical-residents-impact-on-naloxone-prescribing-knowledge-and-attitudes
#8
Jessica Lee Taylor, Alison B Rapoport, Christopher F Rowley, Kenneth J Mukamal, Wendy Stead
BACKGROUND: Despite escalating opioid overdose death rates, addiction medicine is underrepresented in residency curricula. Providing naloxone to at-risk patients, relatives, and first responders reduces overdose deaths, but rates of naloxone prescribing remain low. The goal of this study is to examine the impact of a brief curricular intervention for internal medicine residents on naloxone prescribing rates, knowledge, and attitudes. METHODS: Internal medicine residents (n = 160) at an urban, tertiary care medical center received two one-hour didactic sessions addressing overdose prevention, including intranasal naloxone...
February 12, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29430981/the-diabetic-foot-attack-tis-too-late-to-retreat
#9
Prashanth R J Vas, Michael Edmonds, Venu Kavarthapu, Hisham Rashid, Raju Ahluwalia, Christian Pankhurst, Nikolaos Papanas
The "diabetic foot attack" is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival...
February 1, 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29428432/supporting-doctors-as-healthcare-quality-and-safety-advocates-recommendations-from-the-associations-of-surgeons-in-training-asit
#10
C A Fleming, G Humm, J R Wild, H M Mohan, S T Hornby, R L Harries, J E F Fitzgerald, A J Beamish
BACKGROUND: As front-line healthcare staff, doctors in surgical training occupy a unique organisational space rotating through hospitals and services in which they witness first hand both good and bad practice. This puts trainees in a clear position to identify and raise patient safety issues, and to contribute to discussions regarding quality and safety improvement. However, there are a number of real and perceived barriers to trainees doing so. These include concerns about the impact on training assessments and career progression, and uncertainty about the appropriate route...
February 8, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29423279/physiotherapy-for-people-with-mental-health-problems-in-sub-saharan-african-countries-a-systematic-review
#11
REVIEW
Davy Vancampfort, Brendon Stubbs, Michel Probst, James Mugisha
Background: There is a need for psychosocial interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Physiotherapists could have a central role in reducing the burden and facilitating recovery within the multidisciplinary care of people with mental health problems. The aim of this systematic review was to explore the role of physiotherapists within the current mental health policies of SSA countries and to explore the current research evidence for physiotherapy to improve functional outcomes in people with mental health problems in SSA...
2018: Archives of Physiotherapy
https://www.readbyqxmd.com/read/29420246/ards-complicating-pustular-psoriasis-treatment-with-low-dose-corticosteroids-vitamin-c-and-thiamine
#12
Paul Ellis Marik, Ashleigh Long
We report the case of a 45-year-old Caucasian woman with a history of psoriasis, admitted to our Medical intensive care unit following the acute onset of diffuse rash and progressive dyspnoea and hypoxaemia requiring escalating respiratory support (continuous positive airway pressure of 10 cm H2O). Her chest X-ray was consistent with findings of non-cardiogenic pulmonary oedema. Echocardiogram was normal. Dermatology considered her skin lesions to be consistent with psoriasis vulgaris with pustular flare. In the absence of an identifiable cause for her respiratory failure, she was diagnosed with acute respiratory distress syndrome due to her psoriatic flare...
February 2, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29406846/six-values-never-to-silence-jewish-perspectives-on-nazi-medical-professionalism
#13
REVIEW
Jacob M Kolman, Susan M Miller
An ideological case study based on medical profession norms during the Third Reich will be used to exemplify the importance of diversity in the manifestations of professional ethics. The German professional medical community banned their Jewish colleagues from treating German citizens. This included legally mandated employment discrimination and outright censure which led to a professional ethic devoid of diverse voices. While the escalation to the T-4 program and medicalized genocide was influenced by many causes, the intentional, ethnocentric-based exclusion of voices was an important contributing element to the chronicled degradation of societal mores...
January 29, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29404175/characterization-of-chronic-obstructive-pulmonary-disease-patients-with-a-long-length-of-stay-a-retrospective-observational-cohort-study
#14
Yasser Madani, Anita Saigal, Juno Sunny, Leila Morris, Robin H Johns
OBJECTIVES: Chronic obstructive pulmonary disease (COPD) exacerbation is one of the most common reasons for hospital admission. Patients with COPD with a long length of stay (LoS) occupy a disproportionately high fraction of hospital bed-days. The objective of this study was to identify associations of long LoS in patients admitted with COPD exacerbation. MATERIAL AND METHODS: From December 2012 until June 2013, 499 patients were admitted to Queens Hospital, Romford, UK, with COPD exacerbation...
October 2017: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29402339/knowledge-attitudes-and-practices-regarding-antimicrobial-use-and-stewardship-among-prescribers-at-acute-care-hospitals
#15
Elizabeth Salsgiver, Daniel Bernstein, Matthew S Simon, Daniel P Eiras, William Greendyke, Christine J Kubin, Monica Mehta, Brian Nelson, Angela Loo, Liz G Ramos, Haomiao Jia, Lisa Saiman, E Yoko Furuya, David P Calfee
OBJECTIVE To assess antimicrobial prescriber knowledge, attitudes, and practices (KAP) regarding antimicrobial stewardship (AS) and associated barriers to optimal prescribing. DESIGN Cross-sectional survey. SETTING Online survey. PARTICIPANTS A convenience sample of 2,900 US antimicrobial prescribers at 5 acute-care hospitals within a hospital network. INTERVENTION The following characteristics were assessed with an anonymous, online survey in February 2015: attitudes and practices related to antimicrobial resistance, AS programs, and institutional AS resources; antimicrobial prescribing and AS knowledge; and practices and confidence related to antimicrobial prescribing...
February 6, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29399952/the-last-taboo-the-experience-of-violence-in-first-episode-psychosis-caregiving-relationships
#16
Juliana Onwumere, Grace Parkyn, Stephanie Learmonth, Elizabeth Kuipers
OBJECTIVES: Informal caregiving relationships play an important role in facilitating recovery outcomes in psychosis. The relationship can serve as a source of positive experiences that co-exist alongside common challenges typically associated with mental health problems. People with psychosis, when compared to the general population, are more likely to perpetrate acts of violence, a relationship that is particularly evident during the first psychosis episode. Although victims of service user violence are typically people already known to them, such as informal carers, there remains a lack of understanding about their caring experiences and needs...
February 5, 2018: Psychology and Psychotherapy
https://www.readbyqxmd.com/read/29395692/approach-to-the-agitated-emergency-department-patient
#17
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Acute agitation is a common occurrence in the emergency department (ED) that requires rapid assessment and management. OBJECTIVE: This review provides an evidence-based summary of the current ED evaluation and management of acute agitation. DISCUSSION: Acute agitation is an increasingly common presentation to the ED and has a broad differential diagnosis including metabolic, neurologic, infectious, toxicologic, and psychiatric etiologies...
January 29, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29393806/the-incompatibility-of-healthcare-services-and-end-of-life-needs-in-advanced-liver-disease-a-qualitative-interview-study-of-patients-and-bereaved-carers
#18
Benjamin Hudson, Victoria Hunt, Andrea Waylen, Catherine Anne McCune, Julia Verne, Karen Forbes
BACKGROUND: Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. AIM: To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29393044/early-warning-score-challenges-and-opportunities-in-the-care-of-deteriorating-patients%C3%A2
#19
John Asger Petersen
Clinical deterioration of patients hospitalized on general wards is often preceded by worsening vital signs. If identified early and acted upon quickly, it is conjectured that further deterioration can be prevented. To this means the early warning score (EWS) was implemented in all hospitals in the Capital Region of Denmark in 2013. EWS consists of an aggregated weighted track-and-trigger system (TTS), to identify at-risk patients early, and a treatment protocol to escalate care appropriately and determine the level of competency of the provider...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29392450/a-phase-i-study-of-intravenous-artesunate-in-patients-with-advanced-solid-tumor-malignancies
#20
John F Deeken, Hongkun Wang, Marion Hartley, Amrita K Cheema, Brandon Smaglo, Jimmy J Hwang, Aiwu Ruth He, Louis M Weiner, John L Marshall, Giuseppe Giaccone, Stephen Liu, Jim Luecht, Jay Y Spiegel, Michael J Pishvaian
PURPOSE: The artemisinin class of anti-malarial drugs has shown significant anti-cancer activity in pre-clinical models. Proposed anti-cancer mechanisms include DNA damage, inhibition of angiogenesis, TRAIL-mediated apoptosis, and inhibition of signaling pathways. We performed a phase I study to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of intravenous artesunate (IV AS). METHODS: Patients were enrolled in an accelerated titration dose escalation study with planned dose levels of 8, 12, 18, 25, 34 and 45 mg/kg given on days 1 and 8 of a 21-day cycle...
February 1, 2018: Cancer Chemotherapy and Pharmacology
keyword
keyword
83948
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"