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critical care practitioner

Pablo Blanco, Giovanni Volpicelli
BACKGROUND: Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. While having an impressive diagnostic accuracy in the hands of highly skilled operators, inexperienced practitioners must be aware of some common misinterpretations that may lead to wrong decisions at the bedside. OBJECTIVES: This article provides a revision list of common POCUS misdiagnoses usually found in practice and offers useful tips to recognize and avoid them...
December 2016: Critical Ultrasound Journal
Lisa I Iezzoni, Amy J Wint, Suzanne C Smeltzer, Jeffrey L Ecker
BACKGROUND: Although growing numbers of women with mobility disability are becoming pregnant and desiring motherhood, relatively little is known about their pregnancy experiences or what they might recommend to other women with mobility disability contemplating pregnancy. METHODS: Using a semistructured, open-ended interview protocol, we conducted 2-hour telephone interviews with 22 women who had a significant mobility disability before becoming pregnant and had delivered babies within the prior 10 years...
October 20, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Herman Veenker, Wolter Paans
BACKGROUND: Research within the framework of Self-Determination Theory (SDT) indicates that patients' autonomy is to be considered a critical health care outcome in its own right since it promotes improved mental and physical health. This paper presents an analysis of studies addressing communication and interaction interventions in health literacy curricula for medical and health care practitioners, focusing on patient-oriented skills in "making sense" and "to adapt and self-manage"...
October 21, 2016: BMC Medical Education
A C Shortall, R B Price, L MacKenzie, F J T Burke
Light curing is a critical step in the restorative process when using light-activated resin-based composites, but it is frequently not given the attention it deserves. The selection of a reliable light curing unit (LCU) that meets the practitioner's needs is an important equipment purchase. Using an inappropriate LCU may seriously compromise the quality of care without the practitioner realising their mistake until years later. The importance of the subject is reflected by the rapidly increasing use of light-cured composites and the decline in the use of amalgam...
October 21, 2016: British Dental Journal
Emma K Hooper, Tracy Collins
Dementia caregiving is thought to have a negative impact on health and wellbeing. This critical review of qualitative literature explored the lived experience of familial dementia caregivers from an occupational therapy perspective. The method was informed by systematic review and qualitative research methodologies and was structured within the occupational dimensions framework of doing-being-becoming-belonging. A comprehensive search of major databases was undertaken which identified 484 studies on the topic; 14 met the inclusion criteria and were included in the review...
October 6, 2016: Dementia
Ernesto Schiffrin
Clinical practice guidelines, which are systematically developed statements aimed at helping people make clinical, policy-related and system-related decisions, frequently vary widely in quality. A strategy is needed to differentiate among guidelines and ensure that those of the highest quality are implemented. Hypertension Canada provides annually updated standardized recommendations and clinical practice guidelines to detect, treat and control hypertension. The annual, evidence-based recommendations are developed through intense discussion of the clinical implications via a systematic review of the literature followed by critical appraisals of all the new clinical research, taking into account the assessment criteria in the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument that evaluates the process of practice guideline development and the quality of reporting...
September 2016: Journal of Hypertension
Dagmar Schmitz
Since cell-free DNA (cfDNA) fragments of placental origin can be isolated and analyzed from the blood of pregnant women. Applications of this finding have been developed and implemented in clinical care pathways worldwide at an unprecedented pace and manner. Implementation patterns, however, exhibit considerable insufficiencies. Different "motors" of implementation processes, like the market or various regulatory institutions, can be identified at a national level. Each "motor" entails characteristic ethical challenges which are exemplified impressively by a rising number of case reports...
2016: Advances in Experimental Medicine and Biology
Rory Spiegel
No abstract text is available yet for this article.
March 2016: Clin Exp Emerg Med
Barbara Stetson, Karl E Minges, Caroline R Richardson
Accelerating diabetes rates have resulted in a global public health epidemic. Lifestyle change is a cornerstone of care, yet regimen demands may result in adherence difficulties. Distress, depression, and other psychosocial concerns are higher in those with diabetes. While interventions, such as the Diabetes Prevention Program appear to be effective, further research is needed to support the translation of interventions to prevent diabetes. Studies assessing optimal approaches to promoting effective decision making, coping and adherence are needed...
October 14, 2016: Journal of Behavioral Medicine
Caroline Se Homer
There has been substantial reform in the past decade in the provision of maternal and child health services, and specifically regarding models of maternity care. Increasingly, midwives are working together in small groups to provide midwife-led continuity of care. This article reviews the current evidence for models of maternity care that provide midwifery continuity of care, in terms of their impact on clinical outcomes, the views of midwives and childbearing women, and health service costs. A systematic review of midwife-led continuity of care models identified benefits for women and babies, with no adverse effects...
October 17, 2016: Medical Journal of Australia
Nicole A Sitkin, John E Pachankis
PURPOSE: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. METHODS: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty...
October 11, 2016: LGBT Health
Mark Tambe Keboa, Natalie Hiles, Mary Ellen Macdonald
INTRODUCTION: Improving the oral health of refugees and asylum seekers is a global priority, yet little is known about the overall burden of oral diseases and their causes for this population. OBJECTIVE: To synthesize available evidence on the oral health of, and access to oral health care by this population. METHODS: Using a scoping review methodology, we retrieved 3321 records from eight databases and grey literature; 44 publications met the following inclusion criteria: empirical research focused on refugees and/or asylum seekers' oral health, published between 1990 and 2014 in English, French, Italian, Portuguese, or Spanish...
October 7, 2016: Globalization and Health
Sue Hignett, Alexandra Lang, Laura Pickup, Christine Ives, Mike Fray, Celine McKeown, Sarah Tapley, Matthew Woodward, Paul Bowie
What prevents the delivery of effective, high quality, and safe healthcare in the National Health Service (NHS) in England? This paper presents 760 challenges which 330 NHS staff reported as preventing the delivery of effective, high quality and safe care. Some problems have been known for over 25 years (staff shortages, finance and patient complexity) but other challenges raise questions about the commitment of the NHS to patient and staff safety. For example Organisational Culture leading to 'stifling bureaucracy', 'odds stacked against smooth […] working' and Workload resulting in 'firefighting daily' and 'perpetual crisis mode'...
October 7, 2016: Ergonomics
Christine Dennis, Pamela Baxter, Jenny Ploeg, Susan Blatz
AIMS: A discussion of partnership in the context of family centered care in the acute paediatric setting, through a critical analysis of partnership models. BACKGROUND: Paediatric healthcare practitioners understand the importance of family centered care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family centered care, yet less is known about strategies to fully engage or support parents in these partnerships...
October 5, 2016: Journal of Advanced Nursing
Alexis Descatha, Alice Huynh Tuong, Pierre Coninx, Michel Baer, Thomas Loeb, Thomas Despréaux
In massive catastrophic events, occupational health practitioners are more and more frequently involved in the management of such situations. We aim to describe the multiple aspects of the role that occupational health practitioners might play, by focusing on the recent example of the Paris terrorist attack of November 2015. During and after the Paris attack, occupational practitioners, in collaboration with emergency and security professionals, were involved in psychological care, assembling information, follow-up, return-to-work, and improving in-company safety plans...
2016: Frontiers in Public Health
Charlotte Şahin, Olaf Iseringhausen, Kira Hower, Constanze Liebe, Anja Rethmeier-Hanke, Bernd Wedmann
BACKGROUND: Regional planning of healthcare requires special consideration for the complex needs of elderly, multimorbid people living in a domestic environment. In the District of Lippe, a hospital (Klinikum Lippe) and network of ambulatory care physicians (Ärztenetz Lippe) developed and tested a geriatric care network based on case management for geriatric patients living in a domestic environment. MATERIAL AND METHODS: The establishment of the geriatric care network (e...
September 30, 2016: Zeitschrift Für Gerontologie und Geriatrie
Jennifer L Marino, Lucy N Lewis, Deborah Bateson, Martha Hickey, S Rachel Skinner
BACKGROUND: Australia's teenage birth rate has fallen to historic lows, but teenage motherhood still occurs and can be challenging for mother and baby. OBJECTIVE: The aim of this article is to review current evidence on the epidemiology and clinical care of teenage pregnancy and parenting, and provide recommendations around management of these young people in Australia. DISCUSSION: Teenage mothers may have experienced family, sexual, and partner violence, family disruption, and socioeconomic disadvantage...
October 2016: Australian Family Physician
Robert C Sibley, Stephen P Reis, Jarrod J MacFarlane, Mark A Reddick, Sanjeeva P Kalva, Patrick D Sutphin
Noninvasive physiologic vascular studies play an important role in the diagnosis and characterization in peripheral arterial disease (PAD) of the lower extremity. These studies evaluate the physiologic parameters of blood flow through segmental arterial pressures, Doppler waveforms, and pulse volume recordings. Collectively, they comprise a powerful toolset for defining the functionality of the arterial system, localizing the site of disease, and providing prognostic data. This technology has been widely adopted by diverse medical specialty practitioners, including radiologists, surgeons, cardiologists, and primary care providers...
September 30, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Joanne Westwood, Louise M Howard, Nicky Stanley, Cathy Zimmerman, Clare Gerada, Siân Oram
BACKGROUND: Physical and psychological morbidity is high in trafficked people but little is known about their experiences of accessing and using healthcare services while, or after, being trafficked. AIM: To explore trafficked people's access to, and use of, health care during and after trafficking. DESIGN AND SETTING: A mixed-methods study - a cross-sectional survey comprising a structured interview schedule and open-ended questions - was undertaken in trafficked people's accommodation or support service offices across England...
September 26, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Alice Travers, Vanessa Taylor
INTRODUCTION: Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. METHOD: Six electronic databases were searched for potentially relevant records published between 2008 and 2015...
September 2, 2016: International Journal of Palliative Nursing
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