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https://www.readbyqxmd.com/read/29679434/key-issues-to-consider-and-innovative-ideas-on-fall-prevention-in-the-geriatric-department-of-a-teaching-hospital
#1
Daniel Ky Chan, Cathie Sherrington, Vasi Naganathan, Ying Hua Xu, Jack Chen, Anita Ko, Ian Kneebone, Robert Cumming
Falls in hospital are common and up to 70% result in injury, leading to increased length of stay and accounting for 10% of patient safety-related deaths. Yet, high-quality evidence guiding best practice is lacking. Fall prevention strategies have worked in some trials but not in others. Differences in study setting (acute, subacute, rehabilitation) and sampling of patients (cognitively intact or impaired) may explain the difference in results. This article discusses these important issues and describes the strategies to prevent falls in the acute hospital setting we have studied, which engage the cognitively impaired who are more likely to fall...
April 20, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29679047/a-quality-improvement-initiative-to-reduce-necrotizing-enterocolitis-across-hospital-systems
#2
Amy T Nathan, Laura Ward, Kurt Schibler, Laurel Moyer, Andrew South, Heather C Kaplan
OBJECTIVE: Necrotizing enterocolitis (NEC) is a devastating intestinal disease in premature infants. Local rates of NEC were unacceptably high. We hypothesized that utilizing quality improvement methodology to standardize care and apply evidence-based practices would reduce our rate of NEC. STUDY DESIGN: A multidisciplinary team used the model for improvement to prioritize interventions. Three neonatal intensive care units (NICUs) developed a standardized feeding protocol for very low birth weight (VLBW) infants, and employed strategies to increase the use of human milk, maximize intestinal perfusion, and promote a healthy microbiome...
April 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29678379/desquamative-gingivitis-diagnosis-and-treatment
#3
REVIEW
Andrea D Maderal, Paul Lee Salisbury, Joseph L Jorizzo
Desquamative gingivitis is a clinical finding with several potential etiologies, and therefore histologic examination should be performed to confirm the diagnosis before the implementation of systemic therapy. The best methods for obtaining a mucosal biopsy specimen are discussed to aid the dermatologist in approaching these patients, and indications for additional testing, such as immunofluorescence studies, are reviewed. Desquamative gingivitis is uncommon, and there are no systematic guidelines to assist the physician in treatment, producing a practice gap in management...
May 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29677006/evidence-basis-for-integrated-management-of-mineral-metabolism-in-patients-with-end-stage-renal-disease
#4
Julia J Scialla
PURPOSE OF REVIEW: Treatment of mineral metabolism is a mainstay of dialysis care including some of its most widely used and costly pharmaceuticals. Although many mineral metabolites are associated with increased risk of mortality, cardiovascular disease, and other morbidities, few clinical trials are available to guide therapy and most focus on single drug approaches. In practice, providers manage many aspects of mineral metabolism simultaneously in integrated treatment approaches that incorporate multiple agents and changes in the dialysis prescription...
April 6, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29674755/characterizing-metal-binding-sites-in-proteins-with-x-ray-crystallography
#5
Katarzyna B Handing, Ewa Niedzialkowska, Ivan G Shabalin, Misty L Kuhn, Heping Zheng, Wladek Minor
Metals have crucial roles in many physiological, pathological, toxicological, pharmaceutical, and diagnostic processes. Proper handling of metal-containing macromolecule samples for structural studies is not trivial, and failure to handle them properly is often a source of irreproducibility caused by issues such as pH changes, incorporation of unexpected metals, or oxidization/reduction of the metal. This protocol outlines the guidelines and best practices for characterizing metal-binding sites in protein structures and alerts experimenters to potential pitfalls during the preparation and handling of metal-containing protein samples for X-ray crystallography studies...
May 2018: Nature Protocols
https://www.readbyqxmd.com/read/29672475/suicidal-ideation-and-attempts-among-students-in-grades-8-10-and-12-utah-2015
#6
Marissa L Zwald, Francis B Annor, Amanda Wilkinson, Mike Friedrichs, Anna Fondario, Angela C Dunn, Allyn Nakashima, Leah K Gilbert, Asha Ivey-Stephenson
Suicidal thoughts and behaviors among youths are important public health concerns in Utah, where the suicide rate among youths consistently exceeds the national rate and has been increasing for nearly a decade (1). In March 2017, CDC was invited to assist the Utah Department of Health (UDOH) with an investigation to characterize the epidemiology of fatal and nonfatal suicidal behaviors and identify risk and protective factors associated with these behaviors, among youths aged 10-17 years. This report presents findings related to nonfatal suicidal behaviors among Utah youths...
April 20, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29669522/home-based-bimanual-training-based-on-motor-learning-principles-in-children-with-unilateral-cerebral-palsy-and-their-parents-the-coad-study-rationale-and-protocols
#7
Marlous Schnackers, Laura Beckers, Yvonne Janssen-Potten, Pauline Aarts, Eugène Rameckers, Jan van der Burg, Imelda de Groot, Rob Smeets, Sander Geurts, Bert Steenbergen
BACKGROUND: Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge...
April 18, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#8
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
April 17, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29669216/is-use-of-homeopathy-associated-with-poor-prescribing-in-english-primary-care-a-cross-sectional-study
#9
Alex J Walker, Richard Croker, Seb Bacon, Edzard Ernst, Helen J Curtis, Ben Goldacre
Objectives Prescribing of homeopathy still occurs in a small minority of English general practices. We hypothesised that practices that prescribe any homeopathic preparations might differ in their prescribing of other drugs. Design Cross-sectional analysis. Setting English primary care. Participants English general practices. Main outcome measures We identified practices that made any homeopathy prescriptions over six months of data. We measured associations with four prescribing and two practice quality indicators using multivariable logistic regression...
January 1, 2018: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/29668895/evidence-to-improve-physical-activity-among-medically-underserved-older-adults-a-scoping-review
#10
Yi-Ling Hu, Kristin Junge, An Nguyen, Kelsey Hiegel, Emily Somerville, Marian Keglovits, Susan Stark
Background and Objectives: Participation in leisure physical activity (PA) and engagement in PA interventions among older adults is influenced by socioeconomic status (SES), race/ethnicity, and environment. However, studies of PA for medically underserved older adults have not yet been systematically evaluated. The objective of this study is to map the nature and extent of research conducted on PA participation, interventions, and components of effective leisure PA programs for medically underserved older adults...
April 16, 2018: Gerontologist
https://www.readbyqxmd.com/read/29667703/diagnosis-and-management-practices-for-gestational-diabetes-mellitus-in-australia-cross-sectional-survey-of-the-multidisciplinary-team
#11
Nina Meloncelli, Adrian Barnett, Fiona Pelly, Susan de Jersey
BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common pregnancy disorders; however, if well managed, women with GDM experience similar pregnancy outcomes to those without. Currently, there is limited evidence on actual management practices across Australia or how multidisciplinary teams interact to optimise care. AIMS: To examine the current screening, diagnostic, task and role perceptions and management practices, as reported by members of the GDM multidisciplinary team...
April 18, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29667256/procalcitonin-and-c-reactive-protein-as-biomarkers-for-neonatal-bacterial-infection
#12
Ashfaque F Quadir, Philip N Britton
AIM: Neonates are predisposed to bacterial infection which are an important cause of early childhood morbidity and mortality globally. It has been proposed that procalcitonin has significant utility as a diagnostic marker for bacterial infection in febrile neonates when compared to C-reactive protein (CRP). The aim of this study is to conduct a literature search to find the best available evidence to answer the clinical question of the utility of procalcitonin when compared to CRP as a predictor of bacterial infection in febrile neonates...
April 17, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29666813/ground-glass-opacities-management-in-the-lung-cancer-screening-era
#13
REVIEW
Marcello Migliore, Mariaconcetta Fornito, Manuela Palazzolo, Alessandra Criscione, Mariapia Gangemi, Francesco Borrata, Paolo Vigneri, Marco Nardini, Joel Dunning
Pulmonary ground glass opacity (GGO) is becoming an important clinical dilemma in oncology as its diagnosis in clinical practice is increasing due to the introduction of low dose computed tomography (CT) scan and screening. The incidence of cancer in GGO has been reported as high as 63%. The purpose of this manuscript is to review best available evidence papers on management of GGO in lung cancer to address the following questions: (I) how to correlate CT findings with malignancy; (II) when and who operate? (III) how to perform intraoperative detection of intrapulmonary GGO? (IV) wedge, segmentectomy or lobectomy? Taking a cue from a clinical scenario, a review on PubMed was conducted...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29665405/adherence-to-2016-european-society-of-cardiology-guidelines-predicts-outcome-in-a-large-real-world-population-of-heart-failure-patients-requiring-cardiac-resynchronization-therapy-adherence-to-guidelines-predicts-crt-outcome
#14
Giuseppe Stabile, Patrizia Pepi, Pietro Palmisano, Antonio D'Onofrio, Antonio De Simone, Salvatore Ivan Caico, Domenico Pecora, Antonio Rapacciuolo, Giuseppe Arena, Massimiliano Marini, Paolo Pieragnoli, Sandra Badolati, Gianluca Savarese, Gianpiero Maglia, Assunta Iuliano, Giovanni Luca Botto, Maurizio Malacrida, Emanuele Bertaglia
BACKGROUND: Professional guidelines are based on the best available evidence. However, patients treated in clinical practice may differ from those included in reference trials. OBJECTIVE: The aim of this study was to evaluate the effects of cardiac resynchronization therapy (CRT) in a large population of patients implanted with a CRT device, stratified in accordance with the 2016 European heart failure (HF) guidelines. METHODS: We collected data on 930 consecutive patients from the CRT-MORE registry...
April 14, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29664739/ce-original-research-exploring-clinicians-perceptions-about-sustaining-an-evidence-based-fall-prevention-program
#15
Rebecca B Porter, Laura Cullen, Michele Farrington, Grace Matthews, Sharon Tucker
Findings from this qualitative study may help improve sustainability. ABSTRACT: Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidencebased fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. DESIGN: A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. METHODS: Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014...
April 16, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29661117/sexual-victimization-and-mental-illness-prevalence-rates-among-incarcerated-women-a-literature-review
#16
Marie E Karlsson, Melissa J Zielinski
Incarcerated women evidence high rates of both interpersonal trauma and mental illness. In particular, the rates of sexual violence victimization are so high that some researchers have suggested that sexual abuse may be a pathway to prison for women, likely through the development of mental illness, including substance abuse. This review article summarizes the literature on sexual victimization ( n = 32 articles; 28 independent studies) and mental illness ( n = 11 articles; 8 independent studies) prevalence among samples of incarcerated women ( Ns ≥ 100) in context of methodological choices within included articles...
January 1, 2018: Trauma, Violence & Abuse
https://www.readbyqxmd.com/read/29658851/an-eye-on-vision-five-questions-about-vision-screening-and-eye-health
#17
P Kay Nottingham Chaplin, Kira Baldonado, Geoffrey E Bradford, Susan Cotter, Bruce Moore
Current evidence-based and best-practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the past 3 years and advances in research during the past 18 years. In providing answers to the five questions in this article, the National Center for Children's Vision and Eye Health at Prevent Blindness used published, peer-reviewed research; vision screening and eye health national guidelines; and consensus-based best practices from eye care professionals and public health experts...
May 2018: NASN School Nurse
https://www.readbyqxmd.com/read/29657855/developing-sustainable-research-careers-for-kl2-scholars-the-importance-of-an-inclusive-environment-and-mentorship
#18
Carrie L Byington, Erin Rothwell, Trent Matheson, Rebecca Childs, Erin Wachs, Ruben Rocha, Maureen Murtaugh, David Turok, Anthea Letsou, Julie Shakib, Rachel Hess, Willard Dere
Introduction: The National Clinical and Translational Science Award (CTSA) Consortium 2.0 has developed common metrics as a collaborative project for all participating sites. Metrics address several important aspects and functions of the consortium, including workforce development. The first workforce development metrics to be proposed for all CTSA hubs include the proportion of CTSA-supported trainees and scholars with sustainable careers in translational research and the diversity and inclusiveness of programs...
August 2017: Journal of Clinical and Translational Science
https://www.readbyqxmd.com/read/29657014/resistance-delaying-strategies-on-uk-sheep-farms-a-cost-benefit-analysis
#19
Jane Learmount, Mike J Glover, Mike A Taylor
UK guidelines for the sustainable control of parasites in sheep (SCOPS) were formulated with the primary aim of delaying development of anthelmintic resistance (AR) on UK sheep farms. Promoting their use requires the engagement and commitment of stakeholders. An important driver for behavioural change in sheep farmers is evidence of economic benefits. A recent evaluation of SCOPS guidance in practice demonstrated a significant reduction in anthelmintic use, suggesting economic benefits through a direct reduction in product and labour costs...
April 30, 2018: Veterinary Parasitology
https://www.readbyqxmd.com/read/29656722/toward-a-contingency-model-for-hospital-based-health-technology-assessment-evidence-from-adhophta-project
#20
Americo Cicchetti, Valentina Iacopino, Silvia Coretti, Alessandra Fiore, Marco Marchetti, Laura Sampietro-Colom, Kristian Kidholm, Jean-Blaise Wasserfallen, Rabia Kahveci, Esa Halmesmäki, Magdalene Rosenmöller, Claudia Wild, Raul-Allan Kivet
OBJECTIVES: Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several similarities. The aims of this study were to explore, describe, interpret, and explain seven cases of the application of HB-HTA logic and to propose a classification for HB-HTA organizational models which may be beneficial for policy makers and HTA professionals...
April 16, 2018: International Journal of Technology Assessment in Health Care
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