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https://www.readbyqxmd.com/read/28817392/minimum-operational-standards-for-24-7-available-emergency-departments-in-the-netherlands-a-first-step-taken-by-emergency-physicians-using-an-e-delphi-approach
#1
Menno I Gaakeer, Rebekka Veugelers, Peter Patka, Robbert Huijsman
OBJECTIVE: The objective of this study was to effectuate a consensus of emergency physicians on minimum requirements for facility, diagnostic, and medical specialist availability as a first step toward minimum operational standards for 24/7 available emergency departments (EDs) in the Netherlands. PATIENTS AND METHODS: A two-part e-Delphi through online survey was performed between January 2015 and May 2016, using a panel of 20 experts in emergency medicine. The aim of part I was to reach an agreement on a list of possible ED elements and their definitions...
August 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28813502/addressing-the-challenge-of-high-priced-prescription-drugs-in-the-era-of-precision-medicine-a-systematic-review-of-drug-life-cycles-therapeutic-drug-markets-and-regulatory-frameworks
#2
Toon van der Gronde, Carin A Uyl-de Groot, Toine Pieters
CONTEXT: Recent public outcry has highlighted the rising cost of prescription drugs worldwide, which in several disease areas outpaces other health care expenditures and results in a suboptimal global availability of essential medicines. METHOD: A systematic review of Pubmed, the Financial Times, the New York Times, the Wall Street Journal and the Guardian was performed to identify articles related to the pricing of medicines. FINDINGS: Changes in drug life cycles have dramatically affected patent medicine markets, which have long been considered a self-evident and self-sustainable source of income for highly profitable drug companies...
2017: PloS One
https://www.readbyqxmd.com/read/28811039/twenty-years-of-staffing-practice-environment-and-outcomes-research-in-military-nursing
#3
Patricia A Patrician, Lori A Loan, Mary S McCarthy, Pauline Swiger, Sara Breckenridge-Sproat, Laura Ruse Brosch, Bonnie Mowinski Jennings
BACKGROUND: Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. PURPOSE: This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. METHOD: This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research...
July 10, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28768134/saving-or-creating-which-are-we-doing-when-we-resuscitate-extremely-preterm-infants
#4
Travis N Rieder
Neonatal intensive care units represent simultaneously one of the great success stories of modern medicine, and one of its most controversial developments. One particularly controversial issue is the resuscitation of extremely preterm infants. Physicians in the United States generally accept that they are required to resuscitate infants born as early as 25 weeks and that it is permissible to resuscitate as early as 22 weeks. In this article, I question the moral pressure to resuscitate by criticizing the idea that resuscitation in this context "saves" a human life...
August 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#5
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28737775/fertility-preservation-issues-in-pediatric-hematopoietic-stem-cell-transplantation-practical-approaches-from-the-consensus-of-the-pediatric-diseases-working-party-of-the-ebmt-and-the-international-bfm-study-group
#6
A Balduzzi, J-H Dalle, K Jahnukainen, M von Wolff, G Lucchini, M Ifversen, K T Macklon, C Poirot, T Diesch, A Jarisch, D Bresters, I Yaniv, B Gibson, A M Willasch, R Fadini, L Ferrari, A Lawitschka, A Ahler, N Sänger, S Corbacioglu, M Ansari, R Moffat, A Dalissier, E Beohou, P Sedlacek, A Lankester, C D De Heredia Rubio, K Vettenranta, J Wachowiak, A Yesilipek, E Trigoso, T Klingebiel, C Peters, P Bader
Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guidelines. Patients and families should be informed of possible gender- and age-specific cryopreservation strategies that should be tailored according to the underlying disease, clinical condition and previous exposure to chemotherapy...
July 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28725641/mechanisms-mediating-pediatric-severe-asthma-and-potential-novel-therapies
#7
REVIEW
Aldara Martin Alonso, Sejal Saglani
Although a rare disease, severe therapy-resistant asthma in children is a cause of significant morbidity and results in utilization of approximately 50% of health-care resources for asthma. Improving control for children with severe asthma is, therefore, an urgent unmet clinical need. As a group, children with severe asthma have severe and multiple allergies, steroid resistant airway eosinophilia, and significant structural changes of the airway wall (airway remodeling). Omalizumab is currently the only add-on therapy that is licensed for use in children with severe asthma...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28719767/capacity-of-commune-health-stations-in-chi-linh-district-hai-duong-province-for-prevention-and-control-of-noncommunicable-diseases
#8
Nguyen Thi Thuy Nga, Bui Thi My Anh, Nguyen Nguyen Ngoc, Dang Minh Diem, Vu Duy Kien, Tran Bich Phuong, Tran Quynh Anh, Hoang Van Minh
The primary health care system in Vietnam has been playing an important role in prevention and control of diseases. This study aimed to describe the capacity of commune health stations in Chi Linh district, Hai Duong province for prevention and control of noncommunicable diseases (NCDs). A mixed-methods (quantitative and qualitative approaches) approach was applied to collect data in 20 commune health stations. The participants, including health workers, stakeholders, and patients with NCDs, were selected for the study...
July 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28712122/clinical-features-and-treatment-response-of-cutaneous-leishmaniasis-in-north-west-ethiopia
#9
Helina Fikre, Rezika Mohammed, Saba Atinafu, Johan van Griensven, Ermias Diro
OBJECTIVE: Cutaneous leishmaniasis (CL) receives far less attention than visceral leishmaniasis. Nevertheless, CL is predominantly caused by a unique species in Ethiopia (L aethiopica), which is known to cause severe forms such as diffuse (DCL) and mucocutaneous leishmaniasis (MCL). We report on the number and type of CL cases diagnosed, the clinical features, the treatments and treatment outcomes in North-West Ethiopia. METHODS: This is a retrospective chart record analysis of CL patients treated at the Leishmania Research and Treatment Center (LRTC) of the University of Gondar, Ethiopia...
July 16, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28703072/-it-s-up-to-nurses-to-tell-politicians-how-it-is
#10
Layla Haidrani
What is your job? I am a practising advanced nurse practitioner in urgent first contact care and visiting professor of prescribing and medicines at Birmingham City University. I also have roles with the Resuscitation Council UK and the British National Formulary. As an independent consultant, I work with organisations to investigate errors, as well as chairing and presenting conferences.
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28699941/hospital-based-clinicians-use-of-technology-for-patient-care-related-communication-a-national-survey
#11
Kevin O'Leary, David Liebovitz, Robert Wu, Ksheeraja Ravi, Claire Knoten, Mengxin Sun, Ashley Walker, Madhu Reddy
OBJECTIVE: To characterize current use of communication technologies, including standard text messaging and secure mobile messaging applications, for patient care-related (PCR) communication. METHODS: We used a Society of Hospital Medicine database to conduct a national cross-sectional survey of hospital-based clinicians. RESULTS: We analyzed data from 620 survey respondents (adjusted response rate, 11.0%). Pagers were provided by hospitals to 495 (79...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28697736/end-of-life-perceptions-among-physicians-in-intensive-care-units-managed-by-anesthesiologists-in-germany-a-survey-about-structure-current-implementation-and-deficits
#12
Manfred Weiss, Andrej Michalsen, Anke Toenjes, Franz Porzsolt, Thomas Bein, Marc Theisen, Alexander Brinkmann, Heinrich Groesdonk, Christian Putensen, Friedhelm Bach, Dietrich Henzler
BACKGROUND: Structural aspects and current practice about end-of-life (EOL) decisions in German intensive care units (ICUs) managed by anesthesiologists are unknown. A survey among intensive care anesthesiologists has been conducted to explore current practice, barriers and opinions on EOL decisions in ICU. METHODS: In November 2015, all members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthesiologists (BDA) were asked to participate in an online survey to rate the presence or absence and the importance of 50 items...
July 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28670119/improved-lfias-for-highly-sensitive-detection-of-bnp-at-point-of-care
#13
Yan Gong, Jie Hu, Jane Ru Choi, Minli You, Yamin Zheng, Bo Xu, Ting Wen, Feng Xu
Heart failure (HF) has become a major cause of morbidity and mortality with a significant global economic burden. Although well-established clinical tests could provide early diagnosis, access to these tests is limited in developing countries, where a relatively higher incidence of HF is present. This has prompted an urgent need for developing a cost-effective, rapid and robust diagnostic tool for point-of-care (POC) detection of HF. Lateral flow immunoassay (LFIA) has found widespread applications in POC diagnostics...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28666445/challenges-for-gatekeeping-a-qualitative-systems-analysis-of-a-pilot-in-rural-china
#14
Jin Xu, Anne Mills
BACKGROUND: Gatekeeping involves a generalist doctor who controls patients' access to specialist care, and has been discussed as an important policy option to rebalance the primary care and hospital sectors in low- and middle-income countries, despite thin evidence. A gatekeeping pilot in a Chinese rural setting launched in 2013 has offered an opportunity to study the functioning of gatekeeping under such conditions. METHODS: In this qualitative study within a mixed-method evaluation of the gatekeeping pilot, we developed an innovative systems analysis method, combining the World Health Organisation categorisation of health system building blocks, the "Framework" approach of policy analysis and causal loop analysis...
July 1, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28653190/therapeutics-against-filovirus-infection
#15
John Connor, Gary Kobinger, Gene Olinger
Therapies for filovirus infections are urgently needed. The paradoxical issue facing therapies is the need for rigorous safety and efficacy testing, adhering to the principle tenant of medicine to do no harm, while responding to the extreme for a treatment option during an outbreak. Supportive care remains a primary goal for infected patients. Years of research into filoviruses has provided possible medical interventions ranging from direct antivirals, host-factor supportive approaches, and passive immunity...
June 27, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28641321/identifying-and-acting-on-potentially-inappropriate-care-inadequacy-of-current-hospital-coding-for-this-task
#16
P David Cooper, David R Smart
INTRODUCTION: Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28634908/an-entrustable-professional-activity-epa-based-framework-to-prepare-fourth-year-medical-students-for-internal-medicine-careers
#17
D Michael Elnicki, Meenakshy K Aiyer, Maria L Cannarozzi, Alexander Carbo, Paul R Chelminski, Shobhina G Chheda, Saumil M Chudgar, Heather E Harrell, L Chad Hood, Michelle Horn, Karnjit Johl, Gregory C Kane, Diana B McNeill, Marty D Muntz, Anne G Pereira, Emily Stewart, Heather Tarantino, T Robert Vu
The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#18
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28597121/current-research-priorities-in-perioperative-intensive-care-medicine
#19
REVIEW
Michael A Gillies, Michael Sander, Andrew Shaw, Duminda N Wijeysundera, John Myburgh, Cesar Aldecoa, Ib Jammer, Suzana M Lobo, Naomi Pritchard, Michael P W Grocott, Marcus J Schultz, Rupert M Pearse
INTRODUCTION: Surgical treatments are offered to more patients than ever before, and increasingly to older patients with chronic disease. High-risk patients frequently require critical care either in the immediate postoperative period or after developing complications. The purpose of this review was to identify and prioritise themes for future research in perioperative intensive care medicine. METHODS: We undertook a priority setting process (PSP). A panel was convened, drawn from experts representing a wide geographical area, plus a patient representative...
June 8, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28586939/-urgent-visits-to-nursing-homes-a-general-practitioner-s-perspective
#20
Markus Bleckwenn, David Ashrafnia, Rieke Schnakenberg, Klaus Weckbecker
Aim of the study Due to demographic changes, home visits to nursing care facilities are increasing. Urgent home visits represent a challenge for general practitioners. There are no recommendations for the implementation of urgent home visits. Therefore, in this study, we investigated how GP practices deal with urgent home visits and what improvements can be made to the medical emergency care. Methods A total of 15 teaching doctors of the Department of Family Medicine at the University of Bonn were interviewed using semi-structured interviews on the subject...
June 6, 2017: Das Gesundheitswesen
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