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https://www.readbyqxmd.com/read/29334495/the-ethics-of-interventional-procedures-for-patients-too-ill-for-surgery
#1
Caroline G Kan, Michael Nurok
PURPOSE OF REVIEW: Minimally invasive interventional procedures are increasingly popular options for patients who are high-risk candidates for open surgical procedures. It is unclear how to proceed in the rare circumstance of a complication during an interventional procedure, where addressing the complication would require exposing the patient to the full risk that was being avoided with the minimally invasive technique. This review provides recommendations on how to approach this paradoxical scenario...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29334350/bespoke-automation-of-medical-workforce-rostering-using-google-s-free-cloud-applications
#2
Peter Benjamin Michael Thomas
BACKGROUND: Providing safe and consistent care requires optimal deployment of medical staff. Ensuring this happens is a significant administrative burden due to complex working patterns. OBJECTIVE: To describe a pilot feasibility study of the automation of medical duty rostering in a busy tertiary Ophthalmology department. METHODS: A cloud based web application was created using Google's free cloud services. Users access the system via a website which hosts live rosters, and use electronic forms to submit requests which are automatically handled by Google App Scripts...
December 11, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29334297/perceptions-of-older-people-s-oral-health-care-among-nurses-working-in-geriatric-home-care
#3
Taru Aro, Marjo Laitala, Anna-Maija Syrjälä, Marja-Liisa Laitala, Jorma I Virtanen
OBJECTIVES: This study investigates nurses' self-reported experiences and perceptions of older people's oral health care using a qualitative method. METHODS: We interviewed 10 nurses working in geriatric home care who regularly visit and take care of older people in their homes. The interviews consisted of semi-structured questions. The interviews were then transcribed and analysed. RESULTS: All nurses were aware of the connection between oral health and general health, but more detailed knowledge about oral health was lacking and confidence in oral health care practices was limited...
January 15, 2018: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/29333500/improving-the-written-medical-handover
#4
Rhys Martin, Melanie Huddart, Cara Garbett, Wendell Storr, Olivia Watts, Sanjeev Gupta
The handover of large numbers of medical patients, during on call periods when staffing levels are reduced, is a challenge for all acute medical services. At the Royal Cornwall Hospital, a large district general hospital, we identified that foundation doctors were reviewing medical inpatients during weekend on call periods with limited written handover information. We chose to address this problem by developing an intervention, a weekend handover sticker, and piloting it. We used the review of documentation to measure improvement and feedback from users to assess the processes involved...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333496/improving-the-wait-time-to-consultation-at-the-emergency-department
#5
Yuzeng Shen, Lin Hui Lee
Prolonged wait times at the emergency department (ED) are associated with increased morbidity and mortality, and decreased patient satisfaction. Reducing wait times at the ED is challenging. The objective of this study is to determine if the implementation of a series of interventions would help decrease the wait time to consultation (WTC) for patients at the ED within 6 months. Interventions include creation of a common board detailing work output, matching manpower to patient arrivals and adopting a team-based model of care...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#6
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333493/a-quality-improvement-project-aimed-at-adapting-primary-care-to-ensure-the-delivery-of-evidence-based-psychotherapy-for-adult-anxiety
#7
Mark D Williams, Craig N Sawchuk, Nathan D Shippee, Kristin J Somers, Summer L Berg, Jay D Mitchell, Angela B Mattson, David J Katzelnick
Primary care patients frequently present with anxiety with prevalence ratios up to 30%. Brief cognitive-behavioural therapy (CBT) has been shown in meta-analytic studies to have a strong effect size in the treatment of anxiety. However, in surveys of anxious primary care patients, nearly 80% indicated that they had not received CBT. In 2010, a model of CBT (Coordinated Anxiety Learning and Management (CALM)) adapted to primary care for adult anxiety was published based on results of a randomised controlled trial...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333408/is-long-term-storage-of-cryopreserved-stem-cells-for-hematopoietic-stem-cell-transplantation-a-worthwhile-exercise-in-developing-countries
#8
Santhosh Kumar Devadas, Minal Khairnar, Sumathi S Hiregoudar, Shashank Ojha, Sachin Punatar, Alok Gupta, Anant Gokarn, Pallavi Bhole, Sadhana Kannan, Navin Khattry
Background: Stem cell units (SCUs) that are cryopreserved prior to both autologous and allogeneic hematopoietic stem cell transplants (for donor lymphocyte infusion) remain unused or partially used several times, and become an increased burden to blood banks/SCU repositories. Because of the scarcity of data regarding the duration for which the storage is useful, there is no general consensus regarding disposal of SCUs. Methods: We conducted a retrospective audit of SCU utilization in 435 patients who planned to undergo either autologous stem cell transplantation (auto-SCT) (N=239) or allogeneic stem cell transplantation (allo-SCT) (N=196) at a tertiary cancer care center between November 2007 to January 2015...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29333106/which-point-of-care-tests-would-be-most-beneficial-to-add-to-clinical-practice-findings-from-a-survey-of-3-family-medicine-clinics-in-the-united-states
#9
Victoria Hardy, William Alto, Gina A Keppel, Laura-Mae Baldwin, Matthew Thompson
Background: Point-of-care tests (POCTs) are increasingly used in family medicine to facilitate screening, diagnosis, monitoring, treatment, and referral decisions for a variety of conditions. Point-of-care tests that clinicians believe might be beneficial to add to clinical practice and the conditions for which they would be most useful in family medicine remain poorly understood in the United States. Methods: Forty-two clinicians at 3 family medicine residency clinics completed a brief survey asking which POCTs they believed would be beneficial to add to their clinical practice and the conditions POCTs would be most useful for...
December 2017: Point of Care
https://www.readbyqxmd.com/read/29332636/implementation-of-an-electronic-routine-outcome-monitoring-at-an-inpatient-unit-for-psychosomatic-medicine
#10
Jonas Egeter, Katharina Hüfner, Monika Sztankay, Bernhard Holzner, Barbara Sperner-Unterweger
BACKGROUND: Patient-reported outcomes (PROs) can be part of an electronic routine outcome monitoring (eROM). eROM can improve patient involvement, treatment outcomes and simplify scientific data assessment. Available studies on eROM focus on its evaluation only and lack a detailed description of the prior implementation procedure. OBJECTIVE: The aim was to implement an eROM assessment at a division of Psychosomatic Medicine and provide a detailed description of the implementation procedure...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29332236/child-desire-among-men-and-women-living-with-hiv-aids-in-the-traditional-culture-of-vietnam
#11
Bach Xuan Tran, Ha Dai Duong, Anh Quynh Nguyen, Linh Dieu Pham, Tung Thanh Tran, Carl A Latkin
In various settings, heterogeneity in fertility rates among HIV-affected couples highlights the importance of understanding contextual factors to inform program planning and implementation. We interviewed 1016 patients with HIV/AIDS at seven clinics in Vietnam to assess their desire to have a(nother) child and willingness to pay (WTP) for prevention of mother to child transmission (PMTCT) services. One-fifth of participants reported their desire for a(another) child and this was slightly higher among men than women...
January 13, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29332213/survivorship-care-plan-outcomes-for-primary-care-physicians-cancer-survivors-and-systems-a-scoping-review
#12
REVIEW
Weston LaGrandeur, Julie Armin, Carol L Howe, Leila Ali-Akbarian
PURPOSE: With the focus on survivorship care-coordination between oncology and primary care providers (PCPs), there is a need to assess the research regarding the use of survivorship care plans (SCPs) and determine emerging research areas. We sought to find out how primary care physicians have been involved in the use of SCPs and determine SCP's effectiveness in improving care for cancer survivors. In this scoping review, we aimed to identify gaps in the current research and reveal opportunities for further research...
January 13, 2018: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29332181/management-of-rotator-cuff-injuries-in-the-elite-athlete
#13
REVIEW
Leigh J Weiss, Dean Wang, Michael Hendel, Philip Buzzerio, Scott A Rodeo
PURPOSE OF REVIEW: Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries. RECENT FINDINGS: Conservative management of rotator cuff injuries continues to be the "gold standard" in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29331972/cohort-profile-the-comparative-outcomes-and-service-utilization-trends-coast-study-among-people-living-with-and-without-hiv-in-british-columbia-canada
#14
Oghenowede Eyawo, Mark W Hull, Kate Salters, Hasina Samji, Angela Cescon, Paul Sereda, Viviane D Lima, Bohdan Nosyk, David G T Whitehurst, Scott A Lear, Julio S G Montaner, Robert S Hogg
PURPOSE: The Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study also assesses how age-associated comorbidities and health care use among PLHIV may differ from those observed in the general population. PARTICIPANTS: COAST was established through a data linkage between two provincial data sources: The BC Centre for Excellence in HIV/AIDS Drug Treatment Program, which centrally manages cART dispensation across BC and contains prospectively collected data on demographic, immunological, virological, cART use and other clinical information for all known PLHIV in BC; and Population Data BC, a provincial data repository that holds individual event-level, longitudinal data for all 4...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29330992/client-satisfaction-and-decision-making-amongst-females-visiting-family-planning-clinics-in-hyderabad-pakistan
#15
Arbia Memon, Saima Hamid, Ramesh Kumar
BACKGROUND: Family Planning is the basic right of the human being. It involves decision regarding the number of children and desired space between children by the couple themselves. Quality services involving multiple dimensions build the confidence of the clients and lack of quality is one of the constraints behind incomplete coverage of family planning. Objectives of the current study were to determine the client satisfaction, decision-making process and various influences on clients in adopting family planning methods...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#16
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330753/transfer-of-critically-ill-adults-assessing-the-need-for-training
#17
Ruth-Aoibheann O'Leary, Brian Marsh, Paul O'Connor
BACKGROUND: Transfer of critically ill patients within the hospital is commonly associated with adverse incidents, but, despite this, no standardised training exists on how to carry out this task. Very little information is published in the literature on the learning needs of staff undertaking these transfers, and this limits our ability to provide a focused and appropriate educational intervention. AIMS: This study aimed to explore the organisational, environmental and individual issues that increase risk to patients during intrahospital transport (IHT) and to explore the potential educational solutions to these issues as articulated by these practitioners...
January 12, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29330707/effects-of-periodontal-treatment-on-carotid-intima-media-thickness-in-patients-with-lifestyle-related-diseases-japanese-prospective-multicentre-observational-study
#18
Chieko Kudo, Wee Soo Shin, Nobuhiro Sasaki, Kazuo Harai, Kai Kato, Hiroaki Seino, Eiji Goke, Takemasa Fujino, Nobuichi Kuribayashi, Youko Onuki Pearce, Masato Taira, Ryoji Matsushima, Masato Minabe, Shogo Takashiba
Atherosclerosis, a chronic inflammatory disease in arterial blood vessels, is one of the major causes of death in worldwide. Meanwhile, periodontal disease is a chronic inflammatory disease caused by infection with periodontal pathogens such as P. gingivalis (Porphyromonas gingivalis). Several studies have reported association between periodontal infection and atherosclerosis, but direct investigation about the effects of periodontal treatment on atherosclerosis has not been reported. We have planned Japanese local clinics to determine the relationship between periodontal disease and atherosclerosis under collaborative with medical and dental care...
January 12, 2018: Odontology
https://www.readbyqxmd.com/read/29330634/corrective-osteotomies-using-patient-specific-3d-printed-guides-a-critical-appraisal
#19
Wouter Rosseels, Michiel Herteleer, An Sermon, Stefaan Nijs, Harm Hoekstra
INTRODUCTION: Over the last decade, the technique of 3D planning has found its way into trauma surgery. The use of this technique in corrective osteotomies for treatment of malunions provides the trauma surgeon with a powerful tool. However, this technique is not entirely straightforward. We aimed to define potential pitfalls of this technique and possible solutions to overcome these shortcomings. MATERIALS AND METHODS: Ten patients with either a uni-, bi- or triplanar malunion of the long bones were included in this study...
January 12, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29330247/frequency-and-criticality-of-diagnoses-in-family-medicine-practices-from-the-national-ambulatory-medical-care-survey-namcs
#20
Michael R Peabody, Thomas R O'Neill, Keith L Stelter, James C Puffer
BACKGROUND: Family medicine is a specialty of breadth, providing comprehensive health care for the individual and the family that integrates the broad scope of clinical, social, and behavioral sciences. As such, the scope of practice (SOP) for family medicine is extensive; however, over time many family physicians narrow their SOP. We sought to provide a nationally representative description of the most common and the most critical diagnoses that family physicians see in their practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
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