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https://www.readbyqxmd.com/read/28196828/systematic-review-of-the-effectiveness-barriers-and-facilitators-to-general-practitioner-engagement-with-specialist-secondary-services-in-integrated-palliative-care
#1
REVIEW
Sue-Ann Carmont, Geoffrey Mitchell, Hugh Senior, Michele Foster
: The general practitioner (GP) has a critical role in an integrated model of palliative care as they often know the patient and carer well, are experts in generalist care and have knowledge of health and social services in the community. Specialist palliative services have insufficient capacity to meet demand and those with non-cancer terminal conditions and those from rural and remote areas are underserved. Research has focused on improving access to palliative care by engaging the GP with specialist secondary services in integrated palliative care...
February 14, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28190626/interrupting-pathways-to-sepsis-effectiveness-of-an-intervention-to-reduce-delays-in-timely-care-for-sick-children-in-rural-bangladesh
#2
Frances E Aboud, Ehsanur Rahman, Rosemin Kassam, Jasmin Khan, Nabeel Ashraf Ali, Fahmida Taleb
RATIONALE: The time it takes for a child with suspected sepsis to receive care is critical. OBJECTIVE: We evaluated care-seeking practices for sick children under 5 years in rural Bangladesh, following interpersonal communication to inform households of newly introduced supports for quality care. Based on the Delays Framework, we assessed length and source of care-seeking delays, use of formal providers, and autonomous decision-making among mothers. METHOD: Using two cross-sectional rounds before and after the 3-year intervention (August 2012 and August 2015), we surveyed 400 mothers of recently sick children in 26 randomly sampled villages from 2 intervention and 2 control subdistricts, using structured questions about delays...
February 1, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28178063/detecting-pulmonary-edema-in-obstetric-patients-through-point-of-care-lung-ultrasonography
#3
Sarah Pachtman, Seth Koenig, Natalie Meirowitz
BACKGROUND: Point-of-care lung ultrasonography is used in critical care settings for evaluating respiratory symptoms. Lung ultrasonography is sensitive and specific for the diagnosis of pulmonary edema in nonpregnant patients but is not well-studied in pregnancy. TECHNIQUE: Lung ultrasonography was performed using a portable ultrasound machine with a 2- to 5-MHz curvilinear probe that is available on many labor and delivery units. EXPERIENCE: Lung ultrasonography guided management decisions in a case of shortness of breath after induction of labor for preeclampsia and a case of hemolysis, elevated liver enzymes, and low platelet count syndrome complicated by pulmonary edema...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28177273/-you-feel-like-your-whole-world-is-caving-in-a-qualitative-study-of-primary-care-patients-conceptualisations-of-emotional-distress
#4
Adam Wa Geraghty, Miriam Santer, Samantha Williams, Jennifer Mc Sharry, Paul Little, Ricardo F Muñoz, Tony Kendrick, Michael Moore
General practitioners are tasked with determining the nature of patients' emotional distress and providing appropriate care. For patients whose symptoms appear to fall near the 'boundaries' of psychiatric disorder, this can be difficult with important implications for treatment. There is a lack of qualitative research among patients with symptoms severe enough to warrant consultation, but where general practitioners have refrained from diagnosis. We aimed to explore how patients in this potentially large group conceptualise their symptoms and consequently investigate lay understandings of complex distinctions between emotional distress and psychiatric disorder...
October 1, 2016: Health (London)
https://www.readbyqxmd.com/read/28174662/psychological-rumination-and-recovery-from-work-in-intensive-care-professionals-associations-with-stress-burnout-depression-and-health
#5
Tushna Vandevala, Louisa Pavey, Olga Chelidoni, Nai-Feng Chang, Ben Creagh-Brown, Anna Cox
BACKGROUND: The work demands of critical care can be a major cause of stress in intensive care unit (ICU) professionals and lead to poor health outcomes. In the process of recovery from work, psychological rumination is considered to be an important mediating variable in the relationship between work demands and health outcomes. This study aimed to extend our knowledge of the process by which ICU stressors and differing rumination styles are associated with burnout, depression and risk of psychiatric morbidity among ICU professionals...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28173796/identification-of-factors-that-support-successful-implementation-of-care-bundles-in-the-acute-medical-setting-a-qualitative-study
#6
Stuart A Green, Derek Bell, Nicholas Mays
BACKGROUND: Clinical guidelines offer an accessible synthesis of the best evidence of effectiveness of interventions, providing recommendations and standards for clinical practice. Many guidelines are relevant to the diagnosis and management of the acutely unwell patient during the first 24-48 h of admission. Care bundles are comprised of a small number of evidence-based interventions that when implemented together aim to achieve better outcomes than when implemented individually. Care bundles that are explicitly developed from guidelines to provide a set of related evidence-based actions have been shown to improve the care of many conditions in emergency, acute and critical care settings...
February 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28163343/old-er-care-home-residents-and-sexual-intimate-citizenship
#7
Paul Simpson, Maria Horne, Laura J E Brown, Christine Brown Wilson, Tommy Dickinson, Kate Torkington
Sexuality and intimacy in care homes for older people are overshadowed by concern with prolonging physical and/or psychological autonomy. When sexuality and intimacy have been addressed in scholarship, this can reflect a sexological focus concerned with how to continue sexual activity with reduced capacity. We review the (Anglophone) academic and practitioner literatures bearing on sexuality and intimacy in relation to older care home residents (though much of this applies to older people generally). We highlight how ageism (or ageist erotophobia), which defines older people as post-sexual, restricts opportunities for the expression of sexuality and intimacy...
February 2017: Ageing and Society
https://www.readbyqxmd.com/read/28157808/improved-clinical-performance-and-teamwork-of-pediatric-interprofessional-resuscitation-teams-with-a-simulation-based-educational-intervention
#8
Elaine Gilfoyle, Deanna A Koot, John C Annear, Farhan Bhanji, Adam Cheng, Jonathan P Duff, Vincent J Grant, Cecilia E St George-Hyslop, Nicole J Delaloye, Afrothite Kotsakis, Carolyn D McCoy, Christa E Ramsay, Matthew J Weiss, Ronald D Gottesman
OBJECTIVES: To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. DESIGN: Multicenter prospective interventional study. SETTING: Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. SUBJECTS: Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams)...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28147213/improving-the-ascertainment-of-refugee-background-people-in-health-datasets-and-health-services
#9
Jane Yelland, Elisha Riggs, Josef Szwarc, Dannielle Vanpraag, Wendy Dawson, Stephanie Brown
Ascertainment of vulnerable populations in health datasets is critical to monitoring disparities in health outcomes, enables service planning and guides the delivery of health care. There is emerging evidence that people of refugee backgrounds in Australia experience poor health outcomes and barriers to accessing services, yet a clear picture of these disparities is limited by what is routinely collected in health datasets. There are challenges to improving the accuracy of ascertainment of refugee background, with sensitivities for both consumers and providers about the way questions are asked...
February 2, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28141611/an-exemplar-interprofessional-academic-emergency-nurse-practitioner-program-a-blueprint-for-success
#10
Dian Dowling Evans, Meredith Pollock Ashooh, Laura P Kimble, Katherine L Heilpern
Emergency department census rates and manpower gaps have continued to rise over the past decade, creating a demand for well-prepared emergency nurse practitioners (ENPs). The implementation of the consensus model for advanced practice nurses has brought acknowledgment by leading health care, physician, and nursing organizations of the ENP specialty as critical to building a high-quality emergency care workforce. Recognition of the ENP's unique skill set, and therefore need of specialty certification, has led to a growing interest in the expansion of nurse practitioner curricula in emergency care...
January 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28110561/delivering-high-quality-hip-fracture-rehabilitation-the-perspective-of-occupational-and-physical-therapy-practitioners
#11
Natalie E Leland, Michael Lepore, Carin Wong, Sun Hwa Chang, Lynn Freeman, Karen Crum, Heather Gillies, Paul Nash
AIM: The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. METHODS: Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California...
January 23, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28109279/a-comparative-analysis-of-centralized-waiting-lists-for-patients-without-a-primary-care-provider-implemented-in-six-canadian-provinces-study-protocol
#12
Mylaine Breton, Michael Green, Sara Kreindler, Jason Sutherland, Jalila Jbilou, Sabrina T Wong, Jay Shaw, Valorie A Crooks, Damien Contandriopoulos, Mélanie Ann Smithman, Astrid Brousselle
BACKGROUND: Having a regular primary care provider (i.e., family physician or nurse practitioner) is widely considered to be a prerequisite for obtaining healthcare that is timely, accessible, continuous, comprehensive, and well-coordinated with other parts of the healthcare system. Yet, 4.6 million Canadians, approximately 15% of Canada's population, are unattached; that is, they do not have a regular primary care provider. To address the critical need for attachment, especially for more vulnerable patients, six Canadian provinces have implemented centralized waiting lists for unattached patients...
January 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28107158/human-trafficking-in-areas-of-conflict-health-care-professionals-duty-to-act
#13
Christina Bloem, Rikki E Morris, Makini Chisolm-Straker
Given the significant global burden of human trafficking, the ability of clinicians to identify and provide treatment for trafficked persons is critical. Particularly in conflict settings, health care facilities often serve as the first and sometimes only point of contact for trafficked persons. As such, medical practitioners have a unique opportunity and an ethical imperative to intervene, even in nonclinical roles. With proper training, medical practitioners can assist trafficked persons by documenting human trafficking cases, thereby placing pressure on key stakeholders to enforce legal protections, and by providing adequate services to those trafficked...
January 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#14
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#15
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28094081/emerging-human-fetuin-a-assays-for-biomedical-diagnostics
#16
REVIEW
Sandeep Kumar Vashist, E Marion Schneider, A G Venkatesh, John H T Luong
Human fetuin A (HFA) plays a prominent pathophysiological role in numerous diseases and pathophysiological conditions with considerable biomedical significance; one example is the formation of calciprotein particles in osteoporosis and impaired calcium metabolisms. With impressive advances in in vitro diagnostic assays during the last decade, ELISAs have become a workhorse in routine clinical diagnostics. Recent diagnostic formats involve high-sensitivity immunoassay procedures, surface plasmon resonance, rapid immunoassay chemistries, signal enhancement, and smartphone detection...
January 13, 2017: Trends in Biotechnology
https://www.readbyqxmd.com/read/28090365/nurse-communication-about-goals-of-care
#17
REVIEW
Elaine Wittenberg, Betty Ferrell, Joy Goldsmith, Haley Buller, Tammy Neiman
Conversations about goals of care with the patient and family are a critical component of advanced practice in oncology. However, there are often inadequate team structures, training, or resources available to assist advanced practitioners in initiating these conversations. We conducted a study to assess nurses' perceived role and communication tasks in such conversations about goals of care. In a cross-sectional survey of 109 nurses attending a comprehensive 2-day end-of-life nursing education course, nurses were asked to describe how they would participate in a "goals of care" meeting in three different scenarios...
March 2016: Journal of the Advanced Practitioner in Oncology
https://www.readbyqxmd.com/read/28090336/medical-feminism-working-mothers-and-the-limits-of-home-finding-a-balance-between-self-care-and-other-care-in-cross-cultural-debates-about-health-and-lifestyle-1952-1956
#18
Frederick Cooper
Post-war medical debates about the psychiatric consequences of married women's economic behaviour witnessed far more divergence and collision between perspectives than has often been acknowledged. Practitioners who approached women primarily as facilitators of family health-as wives and mothers-were mistrustful of the competing demands presented by paid employment. They were faced by a growing spectrum of opinion, however, which represented women as atrophying in the confines of domestic life, and which positioned work as a therapeutic act...
July 12, 2016: Palgrave Communications
https://www.readbyqxmd.com/read/28072938/welfare-of-anaesthesia-trainees-survey
#19
G B Downey, J M McDonald, R G Downey
This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28056149/hearing-impairment-and-undiagnosed-disease-the-potential-role-of-clinical-recommendations
#20
Nicole M Marlow, John Malaty, Ara Jo, Rebecca J Tanner, Valery M Beau de Rochars, Peter J Carek, Arch G Mainous
Purpose: The objective of this study was to use cross-sectional, nationally representative data to examine the relationship between self-reported hearing impairment and undetected diabetes, hypertension, hypercholesterolemia, and chronic kidney disease. Method: We analyzed the National Health and Nutrition Examination Survey for the years 2007-2012 for individuals 40 years of age and older without previously diagnosed cardiovascular disease. Analyses were conducted examining hearing impairment and undiagnosed disease...
January 1, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
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