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https://www.readbyqxmd.com/read/29352754/providing-ethical-healthcare-in-resource-poor-environments
#1
Kenneth V Iserson
The ethics of providing health care in resource-poor environments is a complex topic. It implies two related questions: What can we do with the resources on hand? Of all the things we can do, which ones should we do? "Resource-poor" (i.e., resource-challenged, resource-constrained) environments are situations in which clinicians, organizations, or healthcare systems have the knowledge and skills, but not the means, to carry out highly effective and beneficial interventions. Determinants of a population's health often rely less on disease and injury management than on recognizing and meeting their basic needs...
January 19, 2018: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/29352706/environmental-conditions-in-health-care-facilities-in-low-and-middle-income-countries-coverage-and-inequalities
#2
Ryan Cronk, Jamie Bartram
Safe environmental conditions and the availability of standard precaution items are important to prevent and treat infection in health care facilities (HCFs) and to achieve Sustainable Development Goal (SDG) targets for health and water, sanitation, and hygiene. Baseline coverage estimates for HCFs have yet to be formed for the SDGs; and there is little evidence describing inequalities in coverage. To address this, we produced the first coverage estimates of environmental conditions and standard precaution items in HCFs in low- and middle-income countries (LMICs); and explored factors associated with low coverage...
January 11, 2018: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/29352682/are-allogeneic-transfusions-decreasing-in-total-knee-arthroplasty-patients-national-inpatient-sample-2009-2013
#3
Jaydev B Mistry, Chukwuweike U Gwam, Qais Naziri, Robert Pivec, Roby Abraham, Michael A Mont, Ronald E Delanois
BACKGROUND: Allogeneic transfusions are commonly used for substantial blood loss in total knee arthroplasty (TKA), but have been associated with adverse effects and increased costs. The purpose of this study is to provide a detailed description of (1) trends of allogeneic blood transfusion; (2) risk factors and adverse events; and (3) discharge disposition, length-of-stay (LOS), and cost/charge analysis for primary TKA patients who received an allogeneic blood transfusion from 2009-2013...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29352674/the-effect-of-vertical-split-flow-patient-management-on-emergency-department-throughput-and-efficiency
#4
John S Garrett, Colyn Berry, Hao Wong, Huanying Qin, Jeffery A Kline
BACKGROUND: To address emergency department overcrowding operational research seeks to identify efficient processes to optimize flow of patients through the emergency department. Vertical flow refers to the concept of utilizing and assigning patients virtual beds rather than to an actual physical space within the emergency department to care of low acuity patients. The aim of this study is to evaluate the impact of vertical flow upon emergency department efficiency and patient satisfaction...
January 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29352620/family-caregivers-facilitation-of-daily-adult-prescription-medication-use
#5
Debra L Roter, Siva Narayanan, Katherine Smith, Ray Bullman, Paula Rausch, Jennifer L Wolff, G Caleb Alexander
OBJECTIVE: To describe ways family members assist adult patients with prescription medications at home, during medical visits and at the pharmacy. METHODS: Online survey of 400 adults (caregivers) who help another adult (care recipient) with prescription medication use. Regression modeled the contribution of caregiver communication during recipients' medical visits, evaluation of physicians' medication communication and discussions with the dispensing pharmacist on caregivers' assistance with home medication management...
December 27, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29352583/description-and-analysis-of-hospital-pharmacies-in-madagascar
#6
H R Ratsimbazafimahefa, F Sadeghipour, P Trouiller, A Pannatier, B Allenet
OBJECTIVE: Madagascar's health care system has operated without formal hospital pharmacies for more than two decades. The gradual integration of pharmacists in public hospitals since 2012 will allow the structuring of this field. This study was conducted to characterize the current situation regarding all aspects relating to the general functioning of hospital pharmacies and the services provided. METHODS: This qualitative research used semi-structured interviews...
January 15, 2018: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29352420/diagnosis-and-management-of-hepatitis-c-infection-in-primary-care-settings
#7
Debra Guss, Jagannath Sherigar, Paul Rosen, Smruti R Mohanty
Hepatitis C virus (HCV) infection is a significant health problem worldwide, and is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation in the United States. The management of HCV has changed significantly over the last 5 years, as treatments have become simpler and more efficacious. Medication efficacy is now greater than 90%, with a high barrier to resistance and few side effects. This review is a collaboration between primary care and hepatology providers to explore all aspects of HCV management: acute versus chronic HCV infection, transmission and testing, and diagnosis and treatment...
January 19, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29352419/a-systematic-review-of-interventions-to-follow-up-test-results-pending-at-discharge
#8
Patrick J Darragh, T Bodley, A Orchanian-Cheff, K G Shojania, J L Kwan, P Cram
BACKGROUND: Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management...
January 19, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29352416/point-of-care-ultrasound-in-pediatric-anesthesiology-and-critical-care-medicine
#9
REVIEW
Erik Su, Nicholas Dalesio, Aliaksei Pustavoitau
Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population...
January 19, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29352401/does-giving-parents-their-choice-of-interventions-for-child-behavior-problems-improve-child-outcomes
#10
Abigail H Gewirtz, Susanne S Lee, Gerald J August, Yaliu He
Empowering consumers to be active decision-makers in their own care is a core tenet of personalized, or precision medicine. Nonetheless, there is a dearth of research on intervention preferences in families seeking interventions for a child with behavior problems. Specifically, the evidence is inconclusive as to whether providing parents with choice of intervention improves child/youth outcomes (i.e., reduces externalizing problems). In this study, 129 families presenting to community mental health clinics for child conduct problems were enrolled in a doubly randomized preference study and initially randomized to choice or no-choice conditions...
January 20, 2018: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/29352368/endocrine-therapy-and-related-issues-in-hormone-receptor-positive-early-breast-cancer-a-roundtable-discussion-by-the-breast-cancer-therapy-expert-group-bcteg
#11
REVIEW
Jame Abraham, Humberto Caldera, Robert Coleman, Anthony Elias, Matthew P Goetz, Muaiad Kittaneh, Elyse Lower, Reshma Mahtani, E Terry Mamounas, Mark Pegram, Hope Rugo, Lee Schwartzberg, Tiffany Traina, Chuck Vogel
PURPOSE: Management of breast cancer is a rapidly evolving field, and, although evidence-based guidelines are available for clinicians to provide direction on critical issues in patient care, clinicians often left to address these issues in the context of community practice situations with their patients. These include the patient's comorbid conditions, actual versus perceived benefit of treatments, patient's compliance as well as financial/reimbursement issues, and long-term tolerability of therapy...
January 19, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29351898/young-people-s-parents-and-professionals-views-on-required-components-of-mobile-apps-to-support-self-management-of-juvenile-arthritis-qualitative-study
#12
Jennifer M Waite-Jones, Rabiya Majeed-Ariss, Joanna Smith, Simon R Stones, Vanessa Van Rooyen, Veronica Swallow
BACKGROUND: There is growing evidence that supporting self-management of Juvenile Arthritis can benefit both patients and professionals. Young people with Juvenile Arthritis and their healthy peers increasingly use mobile technologies to access information and support in day-to-day life. Therefore, a user-led, rigorously developed and evaluated mobile app could be valuable for facilitating young people's self-management of Juvenile Arthritis. OBJECTIVE: The objective of this study was to seek the views of young people with Juvenile Arthritis, their parents or carers, and health care professionals (HCPs) as to what should be included in a mobile app to facilitate young people's self-management of chronic Juvenile Arthritis...
January 19, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29351797/evaluating-the-impact-of-a-quality-management-intervention-on-post-abortion-contraceptive-uptake-in-private-sector-clinics-in-western-kenya-a-pre-and-post-intervention-study
#13
Susy Wendot, Rachel H Scott, Inviolata Nafula, Isaac Theuri, Edward Ikiugu, Katharine Footman
BACKGROUND: Integration of family planning counselling and method provision into safe abortion services is a key component of quality abortion care. Numerous barriers to post-abortion family planning (PAFP) uptake exist. This study aimed to evaluate the effect of a quality management intervention for providers on PAFP uptake. METHODS: We conducted a pre- and post-intervention study between November 2015 and July 2016 in nine private clinics in Western Kenya. We collected baseline and post-intervention data using in-person interviews on the day of procedure, and follow-up telephone interviews to measure contraceptive uptake in the 2 weeks following abortion...
January 19, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29351792/successful-recruitment-to-trials-findings-from-the-scimitar-trial
#14
Emily Peckham, Catherine Arundel, Della Bailey, Tracy Callen, Christina Cusack, Suzanne Crosland, Penny Foster, Hannah Herlihy, James Hope, Suzy Ker, Tayla McCloud, Crystal-Bella Romain-Hooper, Alison Stribling, Peter Phiri, Ellen Tait, Simon Gilbody
BACKGROUND: Randomised controlled trials (RCT) can struggle to recruit to target on time. This is especially the case with hard to reach populations such as those with severe mental ill health. The SCIMITAR+ trial, a trial of a bespoke smoking cessation intervention for people with severe mental ill health achieved their recruitment ahead of time and target. This article reports strategies that helped us to achieve this with the aim of aiding others recruiting from similar populations...
January 19, 2018: Trials
https://www.readbyqxmd.com/read/29351772/effect-of-an-interactive-e-learning-tool-for-delirium-on-patient-and-nursing-outcomes-in-a-geriatric-hospital-setting-findings-of-a-before-after-study
#15
Elke Detroyer, Fabienne Dobbels, Andrew Teodorczuk, Mieke Deschodt, Yves Depaifve, Etienne Joosten, Koen Milisen
BACKGROUND: Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium...
January 19, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29351672/high-treatment-success-rate-among-multidrug-resistant-tuberculosis-patients-in-myanmar-2012-2014-a-retrospective-cohort-study
#16
Myat K Thu, Ajay M V Kumar, Kyaw T Soe, Saw Saw, Saw Thein, Zaw Mynit, Htet M W Maung, Si T Aung
Background: Since 2011, Myanmar has adopted domiciliary care for multidrug-resistant tuberculosis (MDR-TB) patients and implemented several patient-support measures such as community-based directly observed treatment, nutritional support and financial incentives for patients and providers. We assessed treatment outcomes among MDR-TB patients registered for treatment in the Yangon and Mandalay Regions of Myanmar during 2012-2014 and factors associated with unfavourable treatment outcomes...
January 17, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29351295/effects-of-a-population-based-person-centred-and-integrated-care-service-on-health-wellbeing-and-self-management-of-community-living-older-adults-a-randomised-controlled-trial-on-embrace
#17
Sophie L W Spoorenberg, Klaske Wynia, Ronald J Uittenbroek, Hubertus P H Kremer, Sijmen A Reijneveld
OBJECTIVE: To evaluate the effects of the population-based, person-centred and integrated care service 'Embrace' at twelve months on three domains comprising health, wellbeing and self-management among community-living older people. METHODS: Embrace supports older adults to age in place. A multidisciplinary team provides care and support, with intensity depending on the older adults' risk profile. A randomised controlled trial was conducted in fifteen general practices in the Netherlands...
2018: PloS One
https://www.readbyqxmd.com/read/29351233/postpartum-women-s-perspectives-of-engaging-with-a-dietitian-and-exercise-physiologist-via-video-consultations-for-weight-management-a-qualitative-evaluation
#18
Lisa Vincze, Megan E Rollo, Melinda J Hutchesson, Robin Callister, Debbe I Thompson, Clare E Collins
Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women's perspectives of engaging with a dietitian and exercise physiologist through video consultations for tailored nutrition and exercise care. A qualitative study using individual telephone interviews (13-36 min) was undertaken. 21 women (body mass index (BMI): 28.1 ± 3...
January 19, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29351183/the-effect-of-impactful-papers-on-clinical-practice-in-the-us-corticosteroid-injection-for-patients-with-lateral-epicondylitis
#19
Yuki Fujihara, Helen E Huetteman, Ting-Ting Chung, Melissa J Shauver, Kevin C Chung
BACKGROUND: Following the publication of high level evidence demonstrating that corticosteroid inject is not an effective treatment for lateral epicondylitis, a reduction in the rate of corticosteroid injection would be expected. We aimed to clarify the current clinical practice pattern for lateral epicondylitis and to identify which factors hinder or encourage the introduction of evidence into clinical practice. METHODS: In this administrative claims analysis, we used the 2009 to 2015 Truven MarketScan databases...
January 12, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29350698/identification-and-management-sinusoidal-obstruction-syndrome-veno-occlusive-disease-eelated-to-hematopoietic-stem-cell-transplantation%C3%A2
#20
Mairéad Ní Chonghaile, Karen Wolownik
BACKGROUND: Sinusoidal obstruction syndrome (SOS), also called hepatic veno-occlusive disease (VOD), is a potentially life-threatening complication of hematopoietic stem cell transplantation (HSCT) that affects about 1 in 7 patients undergoing this procedure. SOS/VOD is caused by the conditioning regimens administered prior to HSCT; in some cases, SOS/VOD results from chemotherapy alone. SOS/VOD usually develops within three weeks following HSCT; however, it can have later onset. 
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February 1, 2018: Clinical Journal of Oncology Nursing
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