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https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#1
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28102874/cardiorespiratory-hospitalisation-and-mortality-reductions-after-smoking-bans-in-switzerland
#2
Ana M Vicedo-Cabrera, Martin Röösli, Dragana Radovanovic, Leticia Grize, Fabienne Witassek, Christian Schindler, Laura Perez
INTRODUCTION: Smoking bans are considered one of the most effective policies to reduce population exposure to tobacco smoke and prevent adverse health outcomes. However, evidence on the effect of contextual variables on the effectiveness of smoking bans is still lacking. AIMS: The patchwork of cantonal smoke-free laws in Switzerland was used as a quasi-experimental setting to assess changes after their introduction in: hospitalisations and mortality due to cardiorespiratory diseases in adults; total hospitalisations and hospitalisations due to respiratory disorders in children; and the modifying effects of contextual factors and the effectiveness of the laws...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28097328/diabetes-outpatient-care-and-acute-complications-before-and-after-high-deductible-insurance-enrollment-a-natural-experiment-for-translation-in-diabetes-next-d-study
#3
J Frank Wharam, Fang Zhang, Emma M Eggleston, Christine Y Lu, Stephen Soumerai, Dennis Ross-Degnan
Importance: High-deductible health plans (HDHPs) have expanded under the Affordable Care Act and are expected to play a major role in the future of US health policy. The effects of modern HDHPs on chronically ill patients and adverse outcomes are unknown. Objective: To determine the association of HDHP with high-priority diabetes outpatient care and preventable acute complications. Design, Setting, and Participants: Controlled interrupted-time-series study using a large national health insurer database from January 1, 2003, to December 31, 2012...
January 9, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28088214/determinants-and-materno-fetal-outcomes-related-to-cesarean-section-delivery-in-private-and-public-hospitals-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis-protocol
#4
Idrissa Beogo, Bomar Mendez Rojas, Marie-Pierre Gagnon
BACKGROUND: Despite the well-established morbidity, mortality, long-term effects, and unnecessary extra-cost burden associated with cesarean section delivery (CSD) worldwide, its rate has grown exponentially. This has become a great topical challenge for the international healthcare community and individual countries. Estimated at three times the acceptable rate as defined by the World Health Organization in 1985, the continued upward trend has been fuelled by higher income countries...
January 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28087295/postconditioning-induced-neuroprotection-mechanisms-and-applications-in-cerebral-ischemia
#5
REVIEW
Yan-Ying Fan, Wei-Wei Hu, Fang Nan, Zhong Chen
Ischemic postconditioning (PostC) is defined as a series of rapid intermittent interruptions of blood flow at the phase of reperfusion, which produces neuroprotection against cerebral ischemia/reperfusion injury via mobilizing the brain's own endogenous adaptive mechanisms. Now the concept of conventional ischemic PostC has been extended to limb remote ischemic PostC and chemical PostC with hypoxia, volatile anesthetic, CO2, etc. According to the different temporal profile of PostC, it is divided into rapid and delayed PostC...
January 10, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28077223/an-exploratory-randomized-controlled-trial-of-personalized-lifestyle-advice-and-tandem-skydives-as-a-means-to-reduce-anhedonia
#6
Eeske Van Roekel, Charlotte Vrijen, Vera E Heininga, Maurits Masselink, Elisabeth H Bos, Albertine J Oldehinkel
Anhedonia is a major public health concern and has proven particularly difficult to counteract. It has been hypothesized that anhedonia can be deterred by engagement in rewarding social and physical events. The aims of the present study were to examine (1) the effects of personalized lifestyle advice based on observed individual patterns of lifestyle factors and experienced pleasure in anhedonic young adults; and (2) whether a tandem skydive can enhance the motivation to carry out the recommended lifestyle changes...
January 2017: Behavior Therapy
https://www.readbyqxmd.com/read/28068924/de-implementation-strategy-to-reduce-the-inappropriate-use-of-urinary-and-intravenous-catheters-study-protocol-for-the-ricat-study
#7
Bart J Laan, Ingrid J B Spijkerman, Mieke H Godfried, Berend C Pasmooij, Jolanda M Maaskant, Marjon J Borgert, Brent C Opmeer, Margreet C Vos, Suzanne E Geerlings
BACKGROUND: Urinary and (peripheral and central) intravenous catheters are widely used in hospitalized patients. However, up to 56% of the catheters do not have an appropriate indication and some serious complications with the use of these catheters can occur. The main objective of our quality improvement project is to reduce the use of catheters without an appropriate indication by 25-50%, and to evaluate the affecting factors of our de-implementation strategy. METHODS: In a multicenter, prospective interrupted time series analysis, several interventions to avoid inappropriate use of catheters will be conducted in seven hospitals in the Netherlands...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28052316/training-interventions-for-improving-telephone-consultation-skills-in-clinicians
#8
REVIEW
Alberto Vaona, Yannis Pappas, Rumant S Grewal, Mubasshir Ajaz, Azeem Majeed, Josip Car
BACKGROUND: Since 1879, the year of the first documented medical telephone consultation, the ability to consult by telephone has become an integral part of modern patient-centred healthcare systems. Nowadays, upwards of a quarter of all care consultations are conducted by telephone. Studies have quantified the impact of medical telephone consultation on clinicians' workload and detected the need for quality improvement. While doctors routinely receive training in communication and consultation skills, this does not necessarily include the specificities of telephone communication and consultation...
January 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28048266/th-cd-207a-11-sensitivity-analysis-of-action-limits-for-real-time-epid-based-delivery-verification-system-using-artificial-clinical-relevant-error-simulations
#9
T Fuangrod, J Simpson, R Middleton, P Greer
PURPOSE: A real-time patient treatment delivery verification system using EPID (Watchdog) has been developed as an advanced patient safety tool. In a pilot study data was acquired for 119 prostate and head and neck (HN) IMRT patient deliveries to generate body-site specific action limits using statistical process control. The purpose of this study is to determine the sensitivity of Watchdog to detect clinically significant errors during treatment delivery. METHODS: Watchdog utilizes a physics-based model to generate a series of predicted transit cine EPID images as a reference data set, and compares these in real-time to measured transit cine-EPID images acquired during treatment using chi comparison (4%, 4mm criteria) after the initial 2s of treatment to allow for dose ramp-up...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031607/effectiveness-of-flipped-classroom-with-poll-everywhere-as-a-teaching-learning-method-for-pharmacy-students
#10
Kumar Shiva Gubbiyappa, Ankur Barua, Biswadeep Das, C R Vasudeva Murthy, Hasnain Zafar Baloch
OBJECTIVES: Flipped classroom (FC) is a pedagogical model to engage students in learning process by replacing the didactic lectures. Using technology, lectures are moved out of the classroom and delivered online as means to provide interaction and collaboration. Poll Everywhere is an audience response system (ARS) which can be used in an FC to make the activities more interesting, engaging, and interactive. This study aims to study the perception of undergraduate pharmacy students on FC activity using Poll Everywhere ARS and to study the effectiveness of FC activity as a teaching-learning tool for delivering complementary medicine module in the undergraduate pharmacy program...
October 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28029417/paying-for-volume-british-columbia-s-experiment-with-funding-hospitals-based-on-activity
#11
Jason M Sutherland, Guiping Liu, R Trafford Crump, Michael Law
INTRODUCTION: For decades, Canadian hospitals have been funded using global budgets, a lump sum for providing care irrespective of the volume or mix of patients. In 2010, British Columbia (BC) introduced a controversial, but limited, form of activity-based funding (ABF) for hospitals. This study uses a quasi-experimental design to evaluate the impact of the introduction of ABF funding in the province. METHODS: Our analysis used the population of patient-level acute hospitalization and day surgery discharge summaries from BC's acute hospitals from April 1, 2008 to March 31, 2013...
September 24, 2016: Health Policy
https://www.readbyqxmd.com/read/28027367/association-between-hospital-penalty-status-under-the-hospital-readmission-reduction-program-and-readmission-rates-for-target-and-nontarget-conditions
#12
Nihar R Desai, Joseph S Ross, Ji Young Kwon, Jeph Herrin, Kumar Dharmarajan, Susannah M Bernheim, Harlan M Krumholz, Leora I Horwitz
Importance: Readmission rates declined after announcement of the Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for excess readmissions for acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Objective: To compare trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status. Design, Setting, and Participants: Retrospective cohort study of Medicare fee-for-service beneficiaries older than 64 years discharged between January 1, 2008, and June 30, 2015, from 2214 penalty hospitals and 1283 nonpenalty hospitals...
27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28026710/trends-in-unintentional-injury-mortality-in-canadian-children-1950-2009-and-association-with-selected-population-level-interventions
#13
Sarah A Richmond, Jennifer D'Cruz, Armend Lokku, Alison Macpherson, Andrew Howard, Colin Macarthur
OBJECTIVES: To examine unintentional injury mortality rates in children (0-19 years) in Canada from 1950 to 2009 against national population-level injury prevention interventions. METHODS: Injury mortality rates were age and sex adjusted. Changes in trend and level of mortality rates were assessed at pre-specified intervention periods using segmented linear regression analyses for interrupted time series. Maximum likelihood estimation was used with a second order autoregressive error process...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28012659/heavy-rainfall-and-risk-of-infectious-intestinal-diseases-in-the-most-populous-city-in-vietnam
#14
Dung Phung, Cordia Chu, Shannon Rutherford, Huong Lien Thi Nguyen, Mai Anh Luong, Cuong Manh Do, Cunrui Huang
The association between heavy rainfall and infectious intestinal diseases (IID) has not been well described and little research has been conducted in developing countries. This study examines the association between heavy rainfall and hospital admissions for IID in Ho Chi Minh City, the most populous city in Vietnam. An interrupted time-series method was used to examine the effect of each individual heavy rainfall event (HRE) on IID. The percentage changes in post-HRE level and trends of IID were estimated for 30days following each HRE...
December 21, 2016: Science of the Total Environment
https://www.readbyqxmd.com/read/28004389/withdrawn-community-based-population-level-interventions-for-promoting-child-oral-health
#15
REVIEW
Andrea M de Silva, Shalika Hegde, Bridget Akudo Nwagbara, Hanny Calache, Mark G Gussy, Mona Nasser, Hannah R Morrice, Elisha Riggs, Pamela M Leong, Lisa K Meyenn, Reza Yousefi-Nooraie
BACKGROUND: Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES: Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27999058/systematic-review-of-public-targeted-communication-interventions-to-improve-antibiotic-use
#16
Elizabeth Louise Anne Cross, Robert Tolfree, Ruth Kipping
BACKGROUND: Excessive use of antibiotics accelerates the acquisition/spread of antimicrobial resistance. A systematic review was conducted to identify the components of successful communication interventions targeted at the general public to improve antibiotic use. METHODS: The databases MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library were searched. Search terms were related to the population (public, community), intervention (campaign, mass media) and outcomes (antibiotic, antimicrobial resistance)...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27999034/sustained-impact-of-a-computer-assisted-antimicrobial-stewardship-intervention-on-antimicrobial-use-and-length-of-stay
#17
Vincent Nault, Jacques Pepin, Mathieu Beaudoin, Julie Perron, Jean-Marie Moutquin, Louis Valiquette
OBJECTIVES: Prospective audit and feedback interventions are the core components of an antimicrobial stewardship programme. Herein, we describe the sustained impact of an antimicrobial stewardship programme, based on a novel clinical decision-support system (Antimicrobial Prescription Surveillance System; APSS), on antimicrobial use and costs, hospital length of stay (LOS) in days and the proportion of inappropriate antimicrobial prescriptions. METHODS: A quasi-experimental, retrospective study was conducted using interrupted time series between 2008 and 2013...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27992930/insurance-expansion-and-hospital-emergency-department-access-evidence-from-the-affordable-care-act
#18
Craig Garthwaite, Tal Gross, Matthew Notowidigdo, John A Graves
Background: Little is known about whether insurance expansion affects the location and type of emergency department (ED) use. Understanding these changes can inform state-level decisions about the Medicaid expansion under the Patient Protection and Affordable Care Act (ACA). Objective: To investigate the effect of the 2014 ACA Medicaid expansion on the location, insurance status, and type of ED visits. Design: Quasi-experimental observational study from 2012 to 2014...
December 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27969028/safe-and-effective-nursing-shift-handover-with-nursepass-an-interrupted-time-series
#19
Marian Smeulers, Christine D Dolman, Danielle Atema, Susan van Dieren, Jolanda M Maaskant, Hester Vermeulen
AIM: Implementation of a locally developed evidence based nursing shift handover blueprint with a bedside-safety-check to determine the effect size on quality of handover. METHODS: A mixed methods design with: (1) an interrupted time series analysis to determine the effect on handover quality in six domains; (2) descriptive statistics to analyze the intercepted discrepancies by the bedside-safety-check; (3) evaluation sessions to gather experiences with the new handover process...
November 2016: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/27960229/automated-telephone-communication-systems-for-preventive-healthcare-and-management-of-long-term-conditions
#20
REVIEW
Pawel Posadzki, Nikolaos Mastellos, Rebecca Ryan, Laura H Gunn, Lambert M Felix, Yannis Pappas, Marie-Pierre Gagnon, Steven A Julious, Liming Xiang, Brian Oldenburg, Josip Car
BACKGROUND: Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention...
14, 2016: Cochrane Database of Systematic Reviews
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