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https://www.readbyqxmd.com/read/28548291/practitioner-review-empirical-evolution-of-youth-psychotherapy-toward-transdiagnostic-approaches
#1
REVIEW
Lauren Krumholz Marchette, John R Weisz
BACKGROUND: Psychotherapy for children and adolescents (herein, 'youths') has grown more precise and focused over the decades, shifting toward empirically supported treatments standardized via therapist manuals. The manuals have increasingly emphasized precise targeting of single disorders or problems, or homogenous clusters. These focal treatments represent a valuable advance, with intervention benefit documented in hundreds of studies. However, relatively few of these treatments are widely used in everyday clinical practice, and their level of benefit may not be ideal, particularly in practice contexts and when compared to usual clinical care...
May 26, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28546780/the-value-of-pragmatic-and-observational-studies-in-health-care-and-public-health
#2
REVIEW
Maxwell S Barnish, Steve Turner
Evidence-based practice is an important component of health care service delivery. However, there is a tendency, embodied in tools such as Grades of Recommendation, Assessment, Development, and Evaluation, to focus principally on the classification of study design, at the expense of a detailed assessment of the strengths and limitations of the individual study. Randomized controlled trials (RCTs), and in particular the classical "explanatory" RCT, have a privileged place in the hierarchy of evidence. However, classical RCTs have substantial limitations, most notably a lack of generalizability, which limit their direct applicability to clinical practice implementation...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28546376/noninvasive-monitoring-of-oxygen-and-ventilation
#3
Craig D Smallwood, Brian K Walsh
Noninvasive monitoring of oxygenation and ventilation is an essential part of pediatric respiratory care. Carbon dioxide, gas exchange monitoring, transcutaneous monitoring, near-infrared spectroscopy, pulse oximetry, and electrical impedance tomography are examined. Although some of these technologies have been utilized for decades, incorporation into mechanical ventilators and recently developed methods may provide important clinical insights in a broader patient range. Less mature technologies (electrical impedance tomography and near-infrared spectroscopy) have been of particular interest, since they offer easy bedside application and potential for improved care of children with respiratory failure and other disorders...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28545370/a-systematic-analysis-of-physicochemical-and-adme-properties-of-all-small-molecule-kinase-inhibitors-approved-by-us-fda-from-january-2001-to-october-2015
#4
Zhihong O'Brien, Mehran F Moghaddam
BACKGROUND: During lead identification and optimization, the advancement criteria may be driven based on scientific principles, prior experiences, and/or by examining the path paved by approved drugs. Accessing the discovery data on physicochemical and ADME properties of the approved kinase inhibitors is a monumental task as these are either scattered in the literature or have not been published. OBJECTIVE: Our goals were, 1) to compile the relevant data on all kinase inhibitors approved prior to 2016 for easy access by the biopharmaceutical community, 2) to provide a retrospective analysis to highlight trends and attributes which may have contributed to the "developability" of these drugs, and 3) to ignite focused debates on what constitutes "actionable", "nice-to-have", and unnecessary data...
May 23, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28545038/assessing-the-facilitators-and-barriers-of-interdisciplinary-team-working-in-primary-care-using-normalisation-process-theory-an-integrative-review
#5
Pauline O'Reilly, Siew Hwa Lee, Madeleine O'Sullivan, Walter Cullen, Catriona Kennedy, Anne MacFarlane
BACKGROUND: Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps...
2017: PloS One
https://www.readbyqxmd.com/read/28544672/providing-end-of-life-care-in-disability-community-living-services-an-organizational-capacity-building-model-using-a-public-health-approach
#6
Andrea Grindrod, Bruce Rumbold
BACKGROUND: There is broad consensus within the disability field that the end-of-life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end-of-life care of people with intellectual disabilities, particularly those in disability community living services. METHODS: A mixed-methods approach was used...
May 24, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28541587/iranian-nurses-challenges-in-caring-for-older-adults-a-content-analysis-study
#7
Haydeh Heidari, Marjan Mardani-Hamooleh
The current study describes Iranian nurses' challenges in caring for older adults. Participants included 22 nurses who were selected by purposeful method and underwent semi-structured, face-to-face interviews. The interviews were reviewed, and three categories and seven subcategories were noted. The category older adults-nurse interaction challenges included: specific characteristics of older adults and inappropriate interaction between nurses and older adults. The category structural problems included: shortage of nurses, inappropriateness of ward environment, and service problems...
May 1, 2017: Research in Gerontological Nursing
https://www.readbyqxmd.com/read/28540115/the-benefits-of-streamlined-hip-fracture-management-in-a-regional-hospital
#8
T C Mow, Jen Lukeis, A G Sutherland
INTRODUCTION: Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. METHODS: Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28539947/development-of-a-diverse-learning-experience-for-diverse-psychiatry-resident-needs-a-four-year-biological-psychiatry-curriculum-incorporating-principles-of-neurobiology-psychopharmacology-and-evidence-based-practice
#9
Andrew J Muzyk, Jane P Gagliardi, Gopalkumar Rakesh, Michael R Jiroutek, Rajiv Radhakrishnan, Chi-Un Pae, Prakash S Masand, Steven T Szabo
OBJECTIVE: A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS: We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program...
May 2017: Psychiatry Investigation
https://www.readbyqxmd.com/read/28539425/perceptual-competition-promotes-suppression-of-reward-salience-in-behavioral-selection-and-neural-representation
#10
Mengyuan Gong, Ke Jia, Sheng Li
Visual attentional selection is influenced by the value of objects. Previous studies have demonstrated that reward-associated items lead to rapid distraction and associated behavioral costs, which are difficult to override with top-down control. However, it has not been determined whether a perceptually competitive environment could render the reward-driven distraction more susceptible to top-down suppression. Here, we trained both genders of human subjects to associate two orientations with high and low magnitudes of reward...
May 24, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28538921/women-s-protection-public-policies-evaluation-of-health-care-for-victims-of-sexual-violence
#11
Lucielma Salmito Soares Pinto, Ingrid Mayra Pereira de Oliveira, Eduardo Salmito Soares Pinto, Camila Botelho Campelo Leite, Auricélia do Nascimento Melo, Maria Castelo Branco Rocha de Deus
Violence against women has increased over the years and is a serious violation of human rights. This study aimed to evaluate public policies, women's rights legislation and health care for victims of sexual violence. This is an exploratory and descriptive study, with interviews to professionals of the Care Center for Women Victims of Violence of Teresina-PI, and collection of medical records data of victims. We analyzed data in the light of legislation and guidelines recommended by the Ministry of Health, according to the established public policies...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28538539/pain-and-analgesia-requirements-with-hip-fracture-surgery
#12
Jamie AʼCourt, Deborah Lees, William Harrison, Thomas Ankers, Mike R Reed
BACKGROUND: Hip hemiarthroplasty and dynamic hip screw (DHS) fixation are common procedures performed in trauma units, but there is little information regarding perioperative pain experience with respect to these treatment modalities. PURPOSE: To evaluate the relationship between pain, analgesia requirements, and type of procedure for hip fracture surgery. METHODS: An analysis was performed on consecutive patients presenting with a hip fracture in 2 hospitals over 2 years...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28537773/a-new-generation-of-comfort-care-order-sets-aligning-protocols-with-current-principles
#13
Melissa A Bender, Caroline Hurd, Nicole Solvang, Kathy Colagrossi, Diane Matsuwaka, J Randall Curtis
BACKGROUND: There are few published comfort care order sets for end-of-life symptom management, contributing to variability in treatment of common symptoms. At our academic medical centers, we have observed that rapid titration of opioid infusions using our original comfort care order set's titration algorithm causes increased discomfort from opioid toxicity. OBJECTIVE: The aim of this study was to describe the process and outcomes of a multiyear revision of a standardized comfort care order set for clinicians to treat end-of-life symptoms in hospitalized patients...
May 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28536095/development-of-a-modular-research-platform-to-create-medical-observational-studies-for-mobile-devices
#14
Martin Zens, Birgit Grotejohann, Adrian Tassoni, Fabian Duttenhoefer, Norbert P Südkamp, Philipp Niemeyer
BACKGROUND: Observational studies have proven to be a valuable resource in medical research, especially when performed on a large scale. Recently, mobile device-based observational studies have been discovered by an increasing number of researchers as a promising new source of information. However, the development and deployment of app-based studies is not trivial and requires profound programming skills. OBJECTIVE: The aim of this project was to develop a modular online research platform that allows researchers to create medical studies for mobile devices without extensive programming skills...
May 23, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28534602/the-management-of-moderate-to-severe-chronic-plaque-psoriasis
#15
Annalisa Tonini, Salvatore Panduri, Angelo M D'Erme, Francesca Papadia, Marco Romanelli, James G Krueger, Andrea Chiricozzi
Recent approval and marketization of novel treatments have widened the range of therapeutic opportunities for moderate-to-severe psoriasis. In the next years, this panorama will be further enlarged as many other agents, both oral small molecules and biologics, have passed phase III and are expected to be approved, and subsequently marketed, shortly. In spite of this array of therapeutic possibilities, there is still an unmet need for an appropriate treatment in a large number of cases. This review was aimed to describe general principles regarding the therapeutic approach to moderate-severe plaque psoriasis, providing an updated overview of the therapeutic armamentarium that is specifically available in Italy, drug prescribility, and some peculiar limitations for reimbursement defined by our National Health Care System...
May 23, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#16
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28533814/teenage-mothers-today-what-we-know-and-how-it-matters
#17
Stefanie Mollborn
Over the past two decades, births to U.S. teenagers have fallen and no longer follow overall fertility patterns. Yet the unique challenges faced by teenage mothers and their families justify continued research. Across disciplines, newer work has furthered our understanding of teenage motherhood today. In this article, I highlight four areas of progress: processes of selection into teenage motherhood, the broader consequences of teenage childbearing beyond the socioeconomic realm, heterogeneity of effects, and the application of life course principles...
March 2017: Child Development Perspectives
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#18
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530258/enhanced-recovery-program-erp-in-major-laryngeal-surgery-building-a-protocol-and-testing-its-feasibility
#19
M Gemma, S Toma, F Lira Luce, L Beretta, M Braga, M Bussi
Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#20
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
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