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https://www.readbyqxmd.com/read/29330753/transfer-of-critically-ill-adults-assessing-the-need-for-training
#1
Ruth-Aoibheann O'Leary, Brian Marsh, Paul O'Connor
BACKGROUND: Transfer of critically ill patients within the hospital is commonly associated with adverse incidents, but, despite this, no standardised training exists on how to carry out this task. Very little information is published in the literature on the learning needs of staff undertaking these transfers, and this limits our ability to provide a focused and appropriate educational intervention. AIMS: This study aimed to explore the organisational, environmental and individual issues that increase risk to patients during intrahospital transport (IHT) and to explore the potential educational solutions to these issues as articulated by these practitioners...
January 12, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29289519/contemporary-patterns-of-multidisciplinary-care-in-patients-with-muscle-invasive-bladder-cancer
#2
Lauren C Harshman, Abhishek Tripathi, Matthew Kaag, Jason A Efstathiou, Andrea B Apolo, Jean H Hoffman-Censits, Walter M Stadler, Evan Y Yu, Bernard H Bochner, Eila C Skinner, Tracy Downs, Anne E Kiltie, Dean F Bajorin, Khurshid Guru, William U Shipley, Gary D Steinberg, Noah M Hahn, Srikala S Sridhar
BACKGROUND: Multidisciplinary clinics integrate the expertise of several specialties to provide effective treatment to patients. This exposure is especially relevant in the management of muscle-invasive bladder cancer (MIBC), which requires critical input from urology, radiation oncology, and medical oncology, among other supportive specialties. MATERIALS AND METHODS: In the present study, we sought to catalog the different styles of multidisciplinary care models used in the management of MIBC and to identify barriers to their implementation...
December 6, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29288182/implementation-of-a-lung-cancer-multidisciplinary-team-standardised-template-for-reporting-to-general-practitioners-a-mixed-method-study
#3
Nicole M Rankin, Gemma K Collett, Clare M Brown, Tim J Shaw, Kahren M White, Philip J Beale, Lyndal J Trevena, Cleola Anderiesz, David J Barnes
OBJECTIVES: Few interventions have been designed that provide standardised information to primary care clinicians about the diagnostic and treatment recommendations resulting from cancer multidisciplinary team (MDT) (tumour board) meetings. This study aimed to develop, implement and evaluate a standardised template for lung cancer MDTs to provide clinical information and treatment recommendations to general practitioners (GPs). Specific objectives were to (1) evaluate template feasibility (acceptability, appropriateness and timeliness) with GPs and (2) document processes of preimplementation, implementation and evaluation within the MDT setting...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29285834/evidence-for-increased-use-of-the-society-of-pediatric-anesthesia-critical-events-checklist-in-resource-limited-environments-a-retrospective-observational-study-of-app-data
#4
Vikas N O'Reilly-Shah, Jamie Kitzman, Craig S Jabaley, Grant C Lynde
BACKGROUND: Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. AIMS: We sought to combine demographics with usage information to elucidate important patterns in the rate of use of the Society of Pediatric Anesthesia Critical Events Checklist, as measured by in-app accesses of the checklist via the freely available anesthesia calculator app anesthesiologist...
December 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29280752/medical-graduates-truthful-and-useful-analytics-with-big-data-and-the-art-of-persuasion
#5
Des Gorman, T Michael Kashner
The authors propose that the provision of state-of-the-art, effective, safe, and affordable health care requires medical school graduates not only to be competent practitioners and scientists, but also to be policy makers and professional leaders. To meet this challenge in the era of big data and cloud computing, these graduates must be able to understand and critically interpret analyses of large, observational datasets from electronic health records, third party claims files, surveys, and epidemiologic health datasets...
December 26, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29262441/imaging-in-neurocritical-care-practice
#6
Craig Williamson, Larry Morgan, Joshua P Klein
The use of neuroimaging in conjunction with serial neurological examinations is a core component of modern neurocritical care practice. Although there is a growing role for other neuromonitoring techniques, the ability to quickly and accurately interpret images in the context of a patient's clinical status arguably remains the indispensable skill for neurocritical care practitioners. Due to its rapid acquisition time and excellent ability to detect intracerebral hemorrhage (ICH), cerebral edema, and signs of elevated intracranial pressure, computed tomography (CT) remains the most useful neuroimaging technique for intensive care unit (ICU) patients...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#7
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29233755/postoperative-fasting-after-general-anaesthesia-a-survey-of-french-anaesthesiology-practices
#8
Sylvain Le Pape, Matthieu Boisson, Thibault Loupec, FabienVigneau, Bertrand Debaene, Denis Frasca
BACKGROUND: Preoperative fasting is well-codified worldwide. In contrast, the literature on the postoperative fasting (POF) is scarce leading to potentially wide discrepancies among anaesthesiology practices. This survey assessed French POF practices. METHODS: From March 2013 to January 2014, a survey was conducted among anaesthesiologists, members of the French Society of Anaesthesiology and Critical Care. The POF durations of either fluid or solid food intake was assessed according to airway management procedures (endotracheal intubation [EI] or laryngeal mask [LMA]) and age of the patients (adult or paediatric)...
December 9, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29227955/developing-and-validating-a-perinatal-depression-screening-tool-in-kenya-blending-western-criteria-with-local-idioms-a-mixed-methods-study
#9
Eric P Green, Hawa Tuli, Edith Kwobah, D Menya, Irene Chesire, Christina Schmidt
BACKGROUND: Routine screening for perinatal depression is not common in most primary health care settings. The U.S. Preventive Services Task Force only recently updated their recommendation on depression screening to specifically recommend screening during the pre- and postpartum periods. While practitioners in high-income countries can respond to this new recommendation by implementing one of several existing depression screening tools developed in Western contexts, such as the Edinburgh Postnatal Depression Scale (EPDS) or the Patient Health Questionnaire-9 (PHQ-9), these tools lack strong evidence of cross-cultural equivalence, validity for case finding, and precision in measuring response to treatment in developing countries...
December 2, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29227776/the-specialty-and-naughty-nice-tendency-audit-santa-which-medical-specialists-can-be-trusted-to-follow-recipes
#10
Shian Miller, Tamara C Johnson
OBJECTIVE: To evaluate the influence of medical specialty on the likelihood of doctors making the Naughty or Nice lists this Christmas. DESIGN, SETTING, AND PARTICIPANTS: A quantitative observational study. Doctors in a medical parent Facebook group were asked about their specialty and their tendency to follow recipes. MAIN OUTCOME MEASURES: Self-reported tendency to follow the recipe (always, sometimes, never) as an indicator of rule-breaking behaviour, extrapolated as indicating Naughty (unlikely to follow a recipe) or Nice (always follow recipes) tendencies, and consequently the likelihood of being included in the Nice list this Christmas...
December 11, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29221475/a-critical-realist-evaluation-of-a-music-therapy-intervention-in-palliative-care
#11
Sam Porter, Tracey McConnell, Mike Clarke, Jenny Kirkwood, Naomi Hughes, Lisa Graham-Wisener, Joan Regan, Miriam McKeown, Kerry McGrillen, Joanne Reid
BACKGROUND: Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK). METHODS: Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches...
December 8, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29212638/reversal-strategies-for-newer-oral-anticoagulants
#12
Adam J Singer, Susan Wilson
Nonvitamin K antagonist oral anticoagulants have advantages compared with warfarin, but both types of anticoagulants come with uncertainty about how best to manage life-threatening bleeding events, urgent surgeries, and invasive procedures. Nurse practitioners and physician assistants may need to manage such emergency situations in the critical care setting. Achieving hemostasis quickly is key, and efforts to do so have relied mainly on blood products. Targeted reversal agents are in clinical development and one, idarucizumab, which reverses dabigatran anticoagulation, has been approved...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29210768/safety-and-security-concerns-of-nurses-working-in-the-intensive-care-unit-a-qualitative-study
#13
Yolanda Keys, Jaynelle F Stichler
Intensive care units (ICUs) exist to serve as a safe place for critically ill patients to receive care from skilled practitioners. In this qualitative study, ICU nurses shared their perspectives on elements that promote safety and security on their units. After obtaining institutional review board approval, participants participated in telephone interviews with a nurse researcher who has experience as a bedside ICU nurse. Five categories and 14 themes were identified and then confirmed using member checking...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29206729/extracorporeal-cardiopulmonary-resuscitation-in-the-pediatric-cardiac-population-in-search-of-a-standard-of-care
#14
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29205781/the-graduating-european-dentist-domain-iii-patient-centred-care
#15
J C Field, A Kavadella, S Szep, J R Davies, E DeLap, M C Manzanares Cespedes
This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to patient-centred care. This approach is becoming increasingly prominent within the literature and within policy documents. Whilst working to an evidence base is critical, dentists must also be aware of the scientific basis that underpins the treatment they provide. The evaluation process, which supports treatment planning, also requires dentists to be able to listen, collate, and record pertinent information effectively...
December 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/29198507/british-society-for-sexual-medicine-guidelines-on-adult-testosterone-deficiency-with-statements-for-uk-practice
#16
REVIEW
Geoff Hackett, Michael Kirby, David Edwards, Thomas Hugh Jones, Kevan Wylie, Nick Ossei-Gerning, Janine David, Asif Muneer
BACKGROUND: Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging. AIM: To review the available literature on TD and provide evidence-based statements for UK clinical practice. METHODS: Evidence was derived from Medline, EMBASE, and Cochrane searches on hypogonadism, testosterone (T) therapy, and cardiovascular safety from May 2005 to May 2015...
December 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29198261/inter-hospital-transport-of-the-child-with-critical-cardiac-disease
#17
Padmanabhan Ramnarayan, Zafurallah Intikhab, Neil Spenceley, Ilias Iliopoulos, Alana Duff, Johnny Millar
Centralisation of services such as cardiology, cardiac surgery, and intensive care in many parts of the world has resulted in the need to safely transport children with critical cardiac disease from local hospitals to specialist centres for diagnostic, surgical, and/or critical care intervention. The transport of this cohort of children, whether locally or internationally, can present specific clinical and logistical challenges. An international group of clinicians with expertise in cardiac care and critical care transport worked together to summarise current clinical practice relating to key areas of transport...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29196488/antimicrobial-prescribing-behaviour-in-dogs-and-cats-by-belgian-veterinarians
#18
Alexia Van Cleven, Steven Sarrazin, Hilde de Rooster, Dominique Paepe, Sofie Van der Meeren, Jeroen Dewulf
The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps...
December 1, 2017: Veterinary Record
https://www.readbyqxmd.com/read/29192471/biologic-agents-perception-in-patients-attending-for-the-first-time-to-psoriasis-centers-a-multicenter-italian-survey
#19
Maria Luca, Maria L Musumeci, Federico Bardazzi, Concetta Potenza, Nicoletta Bernardini, Francesca Ferrara, Alessandra Pavone, Giuseppe Micali
BACKGROUND: Inadequate treatment and delayed access to care represent critical issues regarding psoriasis. In Italy, patients treated with biologics are scanty and patients' misinformation could interfere with both biologics prescription and access to care. Literature provide data on disease awareness and perception about biologics in already-treated patients, but there is a lack of information concerning patients never treated with such drugs. METHODS: We conducted a national survey including three academic-based psoriasis care centers at Bologna, Rome and Catania...
November 30, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29190443/corrigendum-to-it-s-more-than-money-policy-options-to-secure-medical-specialist-workforce-for-regional-centres
#20
Jennifer May, Judi Walker, Mathew McGrail, Fran Rolley
Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery.Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making...
December 2017: Australian Health Review: a Publication of the Australian Hospital Association
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