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https://www.readbyqxmd.com/read/28734561/avoiding-adult-in-hospital-cardiac-arrest-a-retrospective-cohort-study-to-determine-preventability
#1
Gordon Bingham, Irma Bilgrami, Mandy Sandford, Sarah Larwill, Judit Orosz, Carl Luckhoff, Tony Kambourakis
INTRODUCTION: This study had three main aims. Develop a methodology for reviewing in-hospital cardiac arrests (IHCA). Assess appropriateness and potential preventability of IHCAs. Identify areas for improvement within the rapid response system (RRS). DESIGN: A retrospective cohort study of IHCA identified from an existing organisational electronic database of medical emergency (MET) and Code Blue team activation. Potential preventability of IHCA and Code Blue team activation were established by an expert panel based on a standardised case review process with descriptive and content analyses for each IHCA event...
July 19, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28731509/keeping-safe-continuous-glucose-monitoring-cgm-in-persons-with-type-1-diabetes-and-impaired-awareness-of-hypoglycaemia-a-qualitative-study
#2
A F Vloemans, C A J van Beers, M de Wit, W Cleijne, S M Rondags, P H Geelhoed-Duijvestijn, M H H Kramer, E H Serné, F J Snoek
AIM: To further our understanding of individual use and experience of continuous glucose monitoring (CGM) in adults with Type 1 diabetes and impaired awareness of hypoglycaemia, we conducted a qualitative study supplementary to a randomized controlled trial, using semi-structured interviews. METHODS: Twenty-three participants of the IN CONTROL trial were interviewed within 4 weeks after the last study visit. The interview centred around experiences of CGM, taking into account the person's expectations prior to the trial...
July 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28726159/diagnosis-and-treatment-delays-among-elderly-breast-cancer-patients-with-pre-existing-mental-illness
#3
Kristy Iglay, Melissa L Santorelli, Kim M Hirshfield, Jill M Williams, George G Rhoads, Yong Lin, Kitaw Demissie
PURPOSE: This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. METHODS: A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis...
July 19, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28724373/changing-nutrition-care-practices-in-hospital-a-thematic-analysis-of-hospital-staff-perspectives
#4
Celia Laur, Renata Valaitis, Jack Bell, Heather Keller
BACKGROUND: Many patients are admitted to hospital and are already malnourished. Gaps in practice have identified that care processes for these patients can be improved. Hospital staff, including management, needs to work towards optimizing nutrition care in hospitals to improve the prevention, detection and treatment of malnutrition. The objective of this study was to understand how staff members perceived and described the necessary ingredients to support change efforts required to improve nutrition care in their hospital...
July 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28723252/across-the-continuum-how-inpatient-palliative-care-consultations-are-reported-in-hospital-discharge-summaries
#5
Nikki Miller, John Shuler, Deon Hayley, Jianghua He, Karin Porter-Williamson, Jessica Kalender-Rich
BACKGROUND: Inpatient Palliative Care (PC) consultations help develop a patient-centered and quality-of-life-focused plan of care for patients with serious illness. Discharge summaries (DSs) are an essential tool to maintain continuity of these care plans across multiple locations and providers. METHODS: We conducted a retrospective chart review of selected DSs of patients who received inpatient PC consultations at the University of Kansas Hospital from July 2011 to May 2015...
July 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28720751/exploring-the-perspectives-of-clinical-professionals-and-support-staff-on-implementing-supported-self-management-for-asthma-in-uk-general-practice-an-imp-2-art-qualitative-study
#6
Susan Morrow, Luke Daines, Sharon Wiener-Ogilvie, Liz Steed, Lorna McKee, Ann-Louise Caress, Stephanie J C Taylor, Hilary Pinnock
Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices...
July 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28720090/-we-and-the-nurses-are-now-working-with-one-voice-how-community-leaders-and-health-committee-members-describe-their-role-in-sierra-leone-s-ebola-response
#7
Shannon A McMahon, Lara S Ho, Kerry Scott, Hannah Brown, Laura Miller, Ruwan Ratnayake, Rashid Ansumana
BACKGROUND: Across low-income settings, community volunteers and health committee members support the formal health system - both routinely and amid emergencies - by engaging in health services such as referrals and health education. During the 2014-2015 Ebola epidemic, emerging reports suggest that community engagement was instrumental in interrupting transmission. Nevertheless, literature regarding community volunteers' roles during emergencies generally, and Ebola specifically, is scarce...
July 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28719228/successful-use-of-noninvasive-ventilation-in-chronic-obstructive-pulmonary-disease-how-do-high-performing-hospitals-do-it
#8
Kimberly A Fisher, Kathleen M Mazor, Sarah Goff, Mihaela S Stefan, Penelope S Pekow, Lauren A Williams, Vida Rastegar, Michael B Rothberg, Nicholas S Hill, Peter K Lindenauer
RATIONALE: Noninvasive ventilation (NIV) is a cornerstone of treatment for patients with severe exacerbations of chronic obstructive pulmonary disease (COPD) where it has been shown to reduce the need for intubation, hospital length of stay, and mortality. Despite high quality evidence and strong recommendations in clinical guidelines, use of NIV varies widely across hospitals. OBJECTIVE: To identify approaches used by hospitals which have been successful in implementing NIV to treat patients with severe exacerbations of COPD...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28716771/an-intervention-using-gamification-to-increase-human-immunodeficiency-virus-and-sexually-transmitted-infection-screening-among-young-men-who-have-sex-with-men-in-california-rationale-and-design-of-stick-to-it
#9
Christopher M Mejia, Daniel Acland, Raluca Buzdugan, Reva Grimball, Lauren Natoli, Mark R McGrath, Jeffrey D Klausner, Sandra I McCoy
BACKGROUND: In the United States, young men who have sex with men (YMSM) remain disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Although routine HIV/STI screening is pivotal to the timely diagnosis of HIV and STIs, initiation of appropriate treatment, and reduced onward disease transmission, repeat screening is underused. Novel interventions that incorporate elements of games, an approach known as gamification, have the potential to increase routinization of HIV/STI screening among YMSM...
July 17, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#10
Elizabeth D Rosenman, Aurora J Dixon, Jessica M Webb, Sarah Brolliar, Simon J Golden, Kerin A Jones, Sachita Shah, James A Grand, Steve W J Kozlowski, Georgia T Chao, Rosemarie Fernandez
OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision-making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA; but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement...
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28710219/comparison-of-propofol-and-dexmedetomidine-infused-overnight-to-treat-hyperactive-and-mixed-icu-delirium-a-protocol-for-the-basel-prodex-clinical-trial
#11
Alexa Hollinger, Katrin Ledergerber, Stefanie von Felten, Raoul Sutter, Stephan Rüegg, Lukas Gantner, Sibylle Zimmermann, Andrea Blum, Luzius A Steiner, Stephan Marsch, Martin Siegemund
BACKGROUND/OBJECTIVES: Delirium is a neurobehavioural disturbance that frequently develops particularly in the intensive care unit (ICU) population. It was first described more than half a century ago, where it was already discovered as a state that might come along with serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality. However, in most cases, there is still lack of proof for causal relationship. Its presence frequently remains unrecognised due to suggested predominance of the hypoactive form...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710055/what-patients-value-about-reading-visit-notes-a-qualitative-inquiry-of-patient-experiences-with-their-health-information
#12
Macda Gerard, Alan Fossa, Patricia H Folcarelli, Jan Walker, Sigall K Bell
BACKGROUND: Patients are increasingly asking for their health data. Yet, little is known about what motivates patients to engage with the electronic health record (EHR). Furthermore, quality-focused mechanisms for patients to comment about their records are lacking. OBJECTIVE: We aimed to learn more about patient experiences with reading and providing feedback on their visit notes. METHODS: We developed a patient feedback tool linked to OpenNotes as part of a pilot quality improvement initiative focused on patient engagement...
July 14, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28707924/suppression-of-alfv%C3%A3-n-modes-on-the-national-spherical-torus-experiment-upgrade-with-outboard-beam-injection
#13
E D Fredrickson, E V Belova, D J Battaglia, R E Bell, N A Crocker, D S Darrow, A Diallo, S P Gerhardt, N N Gorelenkov, B P LeBlanc, M Podestà, Nstx-U Team
In this Letter we present data from experiments on the National Spherical Torus Experiment Upgrade, where it is shown for the first time that small amounts of high pitch-angle beam ions can strongly suppress the counterpropagating global Alfvén eigenmodes (GAE). GAE have been implicated in the redistribution of fast ions and modification of the electron power balance in previous experiments on NSTX. The ability to predict the stability of Alfvén modes, and developing methods to control them, is important for fusion reactors like the International Tokamak Experimental Reactor, which are heated by a large population of nonthermal, super-Alfvénic ions consisting of fusion generated α's and beam ions injected for current profile control...
June 30, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28706009/perceptions-of-cancer-care-and-clinical-trials-in-the-black-community-implications-for-care-coordination-between-oncology-and-primary-care-teams
#14
Linda Sprague Martinez, Elmer R Freeman, Karen M Winkfield
BACKGROUND: Despite efforts to ameliorate disparities in cancer care and clinical trials, barriers persist. As part of a multiphase community-engaged assessment, an exploratory community-engaged research partnership, forged between an academic hospital and a community-based organization, set out to explore perceptions of cancer care and cancer clinical trials by black Bostonians. MATERIALS AND METHODS: Key informant interviews with health care providers and patient advocates in community health centers (CHCs), organizers from grassroots coalitions focused on cancer, informed the development of a focus group protocol...
July 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28704594/critical-diagnoses-in-cytopathology-experience-at-a-large-medical-center
#15
Juan Xing, Lindsey Seigh, Sara E Monaco, N Paul Ohori, Samuel A Yousem, Rajnikant Amin, Liron Pantanowitz
BACKGROUND: Critical values have been well established and accepted in laboratory medicine, but to the authors' knowledge are less well accepted in anatomic pathology. Herein, the authors used a reporting process whereby reports with critical diagnoses were coded to ensure that the patient's clinical team was promptly notified electronically of this finding. The aim of the current study was to determine whether this coding mechanism was used appropriately for critical cytopathology diagnoses in the study health care system...
July 13, 2017: Cancer
https://www.readbyqxmd.com/read/28699937/techniques-and-behaviors-associated-with-exemplary-inpatient-general-medicine-teaching-an-exploratory-qualitative-study
#16
Nathan Houchens, Molly Harrod, Stephanie Moody, Karen Fowler, Sanjay Saint
BACKGROUND: Clinician educators face numerous obstacles to their joint mission of facilitating high-quality learning while also delivering patient-centered care. Such challenges necessitate increased attention to the work of exemplary clinician educators, their respective teaching approaches, and the experiences of their learners. OBJECTIVE: To describe techniques and behaviors utilized by clinician educators to facilitate excellent teaching during inpatient general medicine rounds...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28698034/exploring-physicians-verbal-and-nonverbal-responses-to-cues-concerns-learning-from-incongruent-communication
#17
R Gorawara-Bhat, L Hafskjold, P Gulbrandsen, H Eide
OBJECTIVES: Explore physicians' verbal and nonverbal responses to cues/concerns in consultations with older-patients. METHODS: Two teams independently coded a sample of Norwegian consultations (n=24) on verbal and nonverbal dimensions of communication using VR-CoDES and NDEPT instruments. Consultations exploring older-patients' verbal emotional expressions were labeled 'Acknowledging of patients' emotional expressions', and 'Distancing from patients' emotional expressions...
June 27, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28696334/recent-advances-in-heart-sound-analysis
#18
Gari D Clifford, Chengyu Liu, Benjamin E Moody, José Millet Roig, Samuel E Schmidt, Qiao Li, Ikaro Silva, Roger G Mark
Heart sounds have been widely studied and have been demonstrated to have value for detecting pathologies in clinical applications. Over the last few decades, the use of heart sound signals has become increasingly uncommon and its practice in modern medicine somewhat diminished, although research into automated analysis has continued. Unfortunately, a comparative analyses of algorithms in the literature have been hindered by the lack of high-quality, rigorously validated, and standardized open databases of heart sound recordings...
July 11, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28692191/capture-and-coding-of-industry-and-occupation-measures-findings-from-eight-national-program-of-cancer-registries-states
#19
MaryBeth B Freeman, Lori A Pollack, Judy R Rees, Christopher J Johnson, Randi K Rycroft, David L Rousseau, Mei-Chin Hsieh
BACKGROUND: Although data on industry and occupation (I&O) are important for understanding cancer risks, obtaining standardized data is challenging. This study describes the capture of specific I&O text and the ability of a web-based tool to translate text into standardized codes. METHODS: Data on 62 525 cancers cases received from eight National Program of Cancer Registries (NPCR) states were submitted to a web-based coding tool developed by the National Institute for Occupational Safety and Health for translation into standardized I&O codes...
August 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28691173/successes-and-challenges-in-school-meal-reform-qualitative-insights-from-food-service-directors
#20
Yuka Asada, Margaret Ziemann, Lara Zatz, Jamie Chriqui
BACKGROUND: The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) directed the US Department of Agriculture (USDA) to revise school meal standards to increase healthy food offerings. A critical stakeholder in the implementation of standards is Food Service Directors (FSDs). We sought to examine FSDs' perspectives on revised school meal standards to gain insight into successful implementation strategies. METHODS: Semistructured interviews were conducted with FSDs (N = 9) from high schools that had achieved HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) status...
August 2017: Journal of School Health
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