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https://www.readbyqxmd.com/read/29332316/how-do-i-implement-a-whole-blood-program-for-massively-bleeding-patients
#1
Mark H Yazer, Andrew P Cap, Philip C Spinella, Louis Alarcon, Darrell J Triulzi
Building on the successful military experience, interest has been rekindled in transfusing whole blood (WB) early in the resuscitation of traumatically injured civilians, often before their ABO group is known. WB efficiently provides treatment for shock and coagulopathy, as well as platelet hemostatic function, to patients losing large volumes of blood. Unlike group O uncrossmatched red blood cells (RBCs), group O WB contains a substantial amount of plasma, which is incompatible with the RBCs of all non-group O recipients...
January 14, 2018: Transfusion
https://www.readbyqxmd.com/read/29332213/survivorship-care-plan-outcomes-for-primary-care-physicians-cancer-survivors-and-systems-a-scoping-review
#2
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/29331475/end-of-life-care-for-patients-with-advanced-kidney-disease-in-the-us-veterans-affairs-health-care-system-2000-2011
#3
Susan P Y Wong, Margaret K Yu, Pamela K Green, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare
BACKGROUND: Little is known about patterns of end-of-life care for patients with advanced kidney disease not treated with maintenance dialysis. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: A sample of 14,071 patients with sustained estimated glomerular filtration rates < 15mL/min/1.73m2 treated in the US Veterans Affairs health care system who died during 2000 to 2011. Before death, 12,756 of these patients had been treated with dialysis, 503 had been discussing and/or preparing for dialysis therapy, and for 812, there had been a decision not to pursue dialysis therapy...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29330695/glucosuria-and-all-cause-mortality-among-general-screening-participants
#4
Kunitoshi Iseki, Tsuneo Konta, Koichi Asahi, Kunihiro Yamagata, Shouichi Fujimoto, Kazuhiko Tsuruya, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Toshiki Moriyama, Masahide Kondo, Chiho Iseki, Tsuyoshi Watanabe
BACKGROUND: Dipstick urine tests are used for general health screening in Japan, but how the test results (e.g., glucosuria) relate to mortality is unknown. METHODS: Subjects participated in a nationwide screening in 2008 in six districts in Japan. We identified those who might have died using the national database of death certificates from 2008 to 2012 (total registered ~ 6 million) and verified candidates with the regional National Health Insurance Agency and public health nurses...
January 12, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29330643/antihypertensive-medication-and-dementia-risk-in-older-adult-african-americans-with-hypertension-a-prospective-cohort-study
#5
Michael D Murray, Hugh C Hendrie, Kathleen A Lane, Mengjie Zheng, Roberta Ambuehl, Shanshan Li, Frederick W Unverzagt, Christopher M Callahan, Sujuan Gao
BACKGROUND: African Americans are especially at risk of hypertension and dementia. Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia. OBJECTIVE: To assess the longitudinal effects of antihypertensive medications and blood pressure on the onset of incident dementia in a cohort of African Americans. DESIGN: Prospective cohort. PARTICIPANTS: 1236 community-dwelling patients from an inner-city public health care system, aged 65 years and older, with a history of hypertension but no history of dementia, and who had at least three primary care visits and a prescription filled for any medication...
January 12, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29329921/assessment-of-test-methods-for-evaluating-effectiveness-of-cleaning-flexible-endoscopes
#6
Rebecca E Washburn, Jennifer J Pietsch
BACKGROUND: Strict adherence to each step of reprocessing is imperative to removing potentially infectious agents. Multiple methods for verifying proper reprocessing exist; however, each presents challenges and limitations, and best practice within the industry has not been established. Our goal was to evaluate endoscope cleaning verification tests with particular interest in the evaluation of the manual cleaning step. The results of the cleaning verification tests were compared with microbial culturing to see if a positive cleaning verification test would be predictive of microbial growth...
January 9, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29329310/medication-discrepancies-across-multiple-care-transitions-a-retrospective-longitudinal-cohort-study-in-italy
#7
Marco Bonaudo, Maria Martorana, Valerio Dimonte, Alessandra D'Alfonso, Giulio Fornero, Gianfranco Politano, Maria Michela Gianino
PURPOSE: Medication discrepancies are defined as unexplained differences among regimens across different sites of care. The problem of medication discrepancies that occur during the entire care pathway from hospital admission to a local care setting discharge (namely all types of settings dedicated to formal care other than hospitals) has received little attention in the medical literature. The present study aims to (1) determine the prevalence of medication discrepancies that occur during the entire care pathway from hospital admission to local care setting discharge, (2) describe the discrepancy and medication type, and (3) identify potential risk factors for experiencing medication discrepancies in patient care transitions...
2018: PloS One
https://www.readbyqxmd.com/read/29327405/from-non-encounters-to-autonomic-agency-conceptions-of-patients-with-low-back-pain-about-their-encounters-in-the-health-care-system
#8
Riikka Holopainen, Arja Piirainen, Ari Heinonen, Jaro Karppinen, Peter O'Sullivan
Low back pain is a considerable health problem which affects people around the world, causing major healthcare costs. The use of qualitative research methods enables us to describe and understand patients' experience of, and attitudes to, healthcare. The aim of the present phenomenographic study was to identify and describe the contextual nature of the conceptions of patients with low back pain of their encounters in the HCS. Seventeen patients with chronic or episodic low back pain classified as "high risk" were interviewed in open recall interviews, using videos of patients' initial physiotherapy sessions that had been recorded previously...
January 12, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29325815/intersectionality-and-the-lgbt-cancer-patient
#9
REVIEW
Penny Damaskos, Beau Amaya, RuthAnn Gordon, Chasity Burrows Walters
OBJECTIVES: To present the ways in which race, ethnicity, class, gender, and sexual orientation interact in the context of cancer risk, access to care, and treatment by health care providers. Cancer risk factors, access to care, and treatment for lesbian, gay, bisexual, and transgender (LGBT) patients are discussed within the context of intersectionality and cultural humility. DATA SOURCES: Peer reviewed articles, cancer organizations, and clinical practice. CONCLUSION: LGBT patients have multiple identities that intersect to create unique experiences...
January 8, 2018: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29325440/case-mix-adjustment-of-the-bereaved-family-survey
#10
Ann Kutney-Lee, Joan Carpenter, Dawn Smith, Joshua Thorpe, Alina Tudose, Mary Ersek
Surveys of bereaved family members are increasingly being used to evaluate end-of-life (EOL) care and to measure organizational performance in EOL care quality. The Bereaved Family Survey (BFS) is used to monitor EOL care quality and benchmark performance in the Veterans Affairs (VA) health-care system. The objective of this study was to develop a case-mix adjustment model for the BFS and to examine changes in facility-level scores following adjustment, in order to provide fair comparisons across facilities...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29325000/alcohol-tobacco-and-health-care-costs-a-population-wide-cohort-study-n-606-947-patients-of-current-drinkers-based-on-medical-and-administrative-health-records-from-catalonia
#11
Laia Miquel, Jürgen Rehm, Kevin D Shield, Emili Vela, Montserrat Bustins, Lidia Segura, Joan Colom, Peter Anderson, Antoni Gual
Background: Most cost of illness studies are based on models where information on exposure is combined with risk information from meta-analyses, and the resulting attributable fractions are applied to the number of cases. Methods: This study presents data on alcohol and tobacco use for 2011 and 2012 obtained from a routine medical practice in Catalonia of 606 947 patients, 18 years of age and older, as compared with health care costs for 2013 (all costs from the public health care system: primary health care visits, hospital admissions, laboratory and medical tests, outpatient visits to specialists, emergency department visits and pharmacy expenses)...
January 8, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29324605/estimating-the-hospital-delivery-costs-associated-with-severe-maternal-morbidity-in-new-york-city-2008-2012
#12
Renata E Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Tsu-Yu Tsao
OBJECTIVE: To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. METHODS: We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324529/inappropriately-timed-pediatric-orthopaedic-referrals-from-the-emergency-department-result-in-unnecessary-appointments-and-financial-burden-for-patients
#13
Taylor J Jackson, Todd J Blumberg, Apurva S Shah, Wudbhav N Sankar
BACKGROUND: Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29323833/wheels-for-all-addressing-social-determinants-of-health-one-bicycle-at-a-time
#14
Lucas Zellmer, Nathan Fleming
BACKGROUND: Wheels For All provides bicycles to individuals in La Crosse, Wisconsin to address the transportation barrier that often inhibits low-income individuals' ability to access community resources. METHODS: Recipients are referred by social service, health care, or other community agencies based on their need for transportation or exercise. Donated bicycles are matched to a recipient, repaired, and delivered personally by volunteers. RESULTS: Through collaboration with social service agencies, health care systems, and the community at-large, Wheels For All received referrals from 21 different sources and provided 101 recipients with bicycles from April 2015 to July 2017...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322291/personality-pathology-in-primary-care-ongoing-needs-for-detection-and-intervention
#15
Steven K Huprich
Recent studies demonstrate that personality disorders are prevalent within outpatient psychiatry clinics, though they also are quite common in primary care settings. Studies across multiple health care settings demonstrate that those with a known PD have higher incidences of health problems, higher utilization of the health care system, and have a life expectancy 17.7 years less than that of the population in general. Despite these data, little attention has been directed toward detecting, managing, and treating patients with personality pathology in primary care settings...
January 10, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29322199/the-impact-of-socioeconomic-status-on-the-association-between-biomedical-and-psychosocial-well-being-and-all-cause-mortality-in-older-spanish-adults
#16
Joan Doménech-Abella, Jordi Mundó, Maria Victoria Moneta, Jaime Perales, José Luis Ayuso-Mateos, Marta Miret, Josep Maria Haro, Beatriz Olaya
PURPOSE: The aim of this paper was to analyze the effect of biomedical and psychosocial well-being, based on distinct successful aging models (SA), on time to mortality, and determine whether this effect was modified by socioeconomic status (SES) in a nationally representative sample of older Spanish adults. METHODS: Data were taken from a 3-year follow-up study with 2783 participants aged 50 or over. Vital status was ascertained using national registers or asking participants' relatives...
January 10, 2018: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/29321068/psychosocial-issues-discovered-through-reflective-group-dialogue-between-medical-students
#17
Shao-Yin Chu, Chi-Wei Lin, Meei-Ju Lin, Chin-Chen Wen
BACKGROUND: The biopsychosocial model is a comprehensive approach emphasizing holistic medical care. However, medical curricula that incorporate narrative reflective writing and group dynamic discussion of psychosocial issues among patients and their family members in reflective dialogue groups are currently underutilized. The aim of this study was to determine psychosocial issues among patients and their family members through medical students' reflective dialogue groups. METHODS: This study was completed as part of a pediatric clerkship...
January 10, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29320947/from-global-to-local-rural-mental-health-in-south-africa
#18
Richard Vergunst
In this paper, the current situation regarding rural mental health in South Africa is explored. The current status is presented, followed by an attempt to provide approaches and ideas to improve the situation in order to make it more context appropriate and relevant. Issues of staffing, task shifting or sharing, and formal vs informal health care systems are considered and discussed as possible future approaches to improve rural mental health care in South Africa.
2018: Global Health Action
https://www.readbyqxmd.com/read/29320901/if-we-keep-doing-what-we-re-doing-we-ll-keep-getting-what-we-re-getting-a-need-to-rethink-academic-medicine
#19
Michael Wilkes, Christine Cassel, Marc Klau
PURPOSE: For generations there have been warnings of the need to reform medical education at all levels. Today the voices pushing reform are louder, the need is greater, and there is an urgency not seen before. Approaches that have worked in the past to train physicians are no longer as relevant today as demographics, disease patterns, human resources, practice behaviors, technology, and attention to costs demand new collaborative approaches to clinical practice. To prepare for this practice tomorrow's doctors will need a different type of educational model, a different type of learning, in different environments, often taught by different faculty...
January 10, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29318691/trends-in-alcohol-related-mortality-in-east-and-west-germany-1980-to-2014-age-period-and-cohort-variations
#20
Daniela Piontek, Ludwig Kraus
BACKGROUND AND AIMS: Several indicators suggest that the extent and trends of alcohol-related mortality differ between East and West Germany. Regional drinking patterns and differences in health care systems are assumed to affect the risk of dying from an alcohol-induced disease. The study addresses two questions: (1) What are the unbiased and independent age, period, and cohort effects on alcohol-related mortality trends in Germany? (2) Do these trends differ between East and West Germany? METHODS: Data on alcohol-related mortality for East and West Germany came from the national causes of deaths register for the years 1980 to 2014...
January 10, 2018: Addiction
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