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https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#1
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140836/pyoderma-gangrenosum-a-critical-appraisal
#2
Eran Shavit, Afsaneh Alavi, R Gary Sibbald
GENERAL PURPOSE: To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to: ABSTRACT: Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities...
December 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29139608/current-state-of-screening-high-ace-youth-and-emerging-adults-in-primary-care
#3
Michelle Pardee, Elizabeth Kuzma, Chin Hwa Gina Y Dahlem, Nicole Boucher, Cynthia S Darling-Fisher
BACKGROUND AND PURPOSE: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed...
November 15, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29128195/-what-support-of-young-presenting-a-first-psychotic-episode-when-schooling-is-being-challenged
#4
M-N Vacheron, H Veyrat-Masson, E Wehbe
Psychiatric disorders (more specifically mood disorders and psychosis) represent the 1st cause of disability among young people. Unemployment rate between 75 to 95% for the person with schizophrenia. It is correlated to poor social integration and bad economic status, worse symptomatology loss of autonomy as well as global bad functioning. It is responsible of more than half of the overall cost of psychosis. The onset of most of psychiatric disorders occur between the age of 25 and 35 years old, a critical time in young adult life when they should build their professional as well as social future...
November 8, 2017: L'Encéphale
https://www.readbyqxmd.com/read/29123869/drug-induced-anaphylaxis-in-the-emergency-room
#5
REVIEW
Tomonori Takazawa, Kiyohiro Oshima, Shigeru Saito
Anaphylaxis is a life-threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118855/saudi-lung-cancer-management-guidelines-2017
#6
Abdul Rahman Jazieh, Khaled Al Kattan, Ahmed Bamousa, Ashwaq Al Olayan, Ahmed Abdelwarith, Jawaher Ansari, Abdullah Al Twairqi, Turki Al Fayea, Khalid Al Saleh, Hamed Al Husaini, Nafisa Abdelhafiez, Mervat Mahrous, Medhat Faris, Ameen Al Omair, Adnan Hebshi, Salem Al Shehri, Foad Al Dayel, Hanaa Bamefleh, Walid Khalbuss, Sarah Al Ghanem, Shukri Loutfi, Azzam Khankan, Meshael Al Rujaib, Majed Al Ghamdi, Nagwa Ibrahim, Abdulmonem Swied, Mohammad Al Kayait, Marie Datario
BACKGROUND: Lung cancer management is getting more complex due to the rapid advances in all aspects of diagnostic and therapeutic options. Developing guidelines is critical to help practitioners provide standard of care. METHODS: The Saudi Lung Cancer Guidelines Committee (SLCGC) multidisciplinary members from different specialties and from various regions and healthcare sectors of the country reviewed and updated all lung cancer guidelines with appropriate labeling of level of evidence...
October 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29117892/emergency-department-referral-patterns-of-australian-general-practitioner-registrars-a-cross-sectional-analysis-of-prevalence-nature-and-associations
#7
Nigel Catzikiris, Amanda Tapley, Simon Morgan, Mieke van Driel, Neil Spike, Elizabeth G Holliday, Jean Ball, Kim Henderson, Lawrie McArthur, Parker Magin
Objective Limited international evidence suggests general practice registrars' emergency department (ED) referral rates exceed those of established general practitioners (GPs). The aim of the present study was to fill an evidence gap by establishing the prevalence, nature and associations of Australian GP registrar ED referrals.Methods A cross-sectional analysis was performed of the Registrar Clinical Encounters in Training (ReCEnT) cohort study of GP registrars' consultation experiences, between 2010 and 2015...
November 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29110572/tracheostomy-as-a-comfort-measure-in-children-with-life-limiting-conditions
#8
Valerie Marshall, Francesca Holt, Suzanne Crowe
Palliative care for children who can expect only a short life has expanded over the last decade. Greater understanding of the measures required to ensure comfort and acceptable quality of life within the critical care environment has grown in tandem. Some more invasive interventions may be considered a "step too far" by some practitioners, including feeding gastrostomy, contracture release, and tracheostomy. Tracheostomy can facilitate a number of measures, which may enhance the brief life of the child and their family...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29074507/systematic-review-of-interventions-for-improving-the-performance-of-community-health-workers-in-low-income-and-middle-income-countries
#9
Madeleine Ballard, Paul Montgomery
OBJECTIVE: To systematically review and critically appraise the evidence for the effects of interventions to improve the performance of community health workers (CHWs) for community-based primary healthcare in low- and middle-income countries. DESIGN: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS: 19 electronic databases were searched with a highly sensitive prespecified strategy and the grey literature examined, completed July 2016...
October 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/29068729/the-consultant-practitioner-an-evolving-role-to-meet-changing-nhs-needs
#10
Elizabeth Rosser, Rachael Grey, Deborah Neal, Julie Reeve, Caroline Smith, Janine Valentine, Kate Brookman
Since the introduction of the consultant practitioner role, with its huge variability in purpose and context, it has had to evolve in response to the changing needs of the NHS to achieve sustainability and transformation of services. AIM: This article reflects on the relevance of the consultant practitioner role and the impact of an action learning set in hastening its evolution in one NHS foundation trust. METHOD: From a process of collective critical reflection on their practice, six consultant practitioners analysed the impact they have had on influencing services and empowerment of their patients...
October 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29067780/after-hours-on-call-experience-during-primary-care-nurse-practitioner-education-utilizing-standard-scenarios-and-simulated-patients
#11
Michelle M Kelly, Elizabeth Blunt, Kelly Nestor
BACKGROUND AND PURPOSE: Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. METHODS: Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter...
October 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29056603/interpreting-diagnostic-tests-with-continuous-results-and-no-gold-standard-a-common-scenario-explained-using-the-tuberculin-skin-test
#12
Claudia C Dobler, M Hassan Murad
Practitioners of evidence-based medicine commonly encounter diagnostic tests with continuous results and no gold standard. In contrast, the traditional critical appraisal teachings assume a binary test (2×2 table) with a gold standard. In this guide, we use the example of the tuberculin skin test to illustrate a simple approach facilitated by using stratum-specific likelihood ratios and odds of developing future patient-important events. This approach can aid practitioners in the interpretation and application of diagnostic tests to patient care...
October 22, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/29053644/dental-approach-for-apert-syndrome-in-children-a-systematic-review
#13
A-S López-Estudillo, M-A Rosales-Bérber, S Ruiz-Rodríguez, A Pozos-Guillén, M-Á Noyola-Frías, A Garrocho-Rangel
BACKGROUND: Apert Syndrome (AS), or type I acrocephalosyndactyly, is a rare, congenital craniosynostosis condition resulting from missense mutations in the gene encoding fibroblast growth factor receptor 2. It is characterized by three specific clinical features: brachycephalic skull; midface hypoplasia, and limb abnormalities (syndactyly of hands and feet). The disorder exhibits variable presentations in bones, brain, skin, internal organs, and in the oral/maxillofacial region. The aim of the present paper was to show the main results from a systematic review of AS...
November 1, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29042387/nature-based-care-opportunities-and-barriers-in-oncology-contexts-a-modified-international-e-delphi-survey
#14
Sarah Blaschke, Clare C O'Callaghan, Penelope Schofield
OBJECTIVE: To develop recommendations regarding opportunities and barriers for nature-based care in oncology contexts using a structured knowledge generation process involving relevant healthcare and design experts. DESIGN: Four-round modified electronic Delphi study. Oncology patients' nature-based recommendations, uncovered in preceding qualitative investigation, were included in the first round for the expert participants' consideration. Key items (opportunities and barriers) were developed using data aggregation and synthesis, followed by item prioritisation and 10-point Likert scale ranking (1=not important, 10=very important)...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29036782/practice-based-research-networks
#15
Marie Pirotta, Meredith Temple-Smith
BACKGROUND: Practice-based research networks (PBRNs) are collaborations between clinical practitioners and academics. PBRNs aim to foster research in general practice through opportunities to learn more about how to undertake and participate in research, and assist in translating new knowledge into practice. Critically, PBRNs also offer clinicians the chance to contribute to research by posing questions of importance to quality clinical care. OBJECTIVE: The objectives of this article are to describe why PRBNs are needed, the current situation regarding PBRNs in Australia, and why Australian general practice and patient outcomes could benefit from further investment in PBRNs...
October 2017: Australian Family Physician
https://www.readbyqxmd.com/read/29036629/nanotechnology-a-promising-new-paradigm-for-the-control-of-pain
#16
Krishnan V Chakravarthy, Frank J Boehm, Paul J Christo
Objective: The objective of this article is to critically review both preclinical and clinical studies that focus on the use of nanotechnology for both acute and chronic pain management, surveying both diagnostic and therapeutic applications. The article also provides information on nanotechnology for pain practitioners, so that they may better understand how this technology works and how it may be applied to their day-to-day clinical practice. Study Design: Narrative review...
June 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29032792/centralisation-of-oesophagectomy-in-australia-is-only-caseload-critical
#17
Richard Hummel, Ngoc Hoang Ha, Andrew Lord, Markus I Trochsler, Guy Maddern, Harsh Kanhere
Objective High caseload is considered one of the most important factors for good outcomes after high-risk surgeries such as oesophagectomy. However, many Australian centres perform low volumes of oesophagectomies due to demographics. The aim of the present study was to audit outcome after oesophagectomy in an Australian low-volume centre over a period of 13 years and to discuss potential contributors to outcome other than just case volume.Methods Perioperative and long-term outcomes of all oesophagectomies over a 13-year period in a low-volume Australian tertiary care centre were analysed retrospectively...
October 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29031424/the-experience-and-influence-of-social-support-and-social-dynamics-on-cardiovascular-disease-prevention-in-migrant-pakistani-communities-a-qualitative-synthesis
#18
REVIEW
Farina Kokab, Sheila Greenfield, Antje Lindenmeyer, Manbinder Sidhu, Lynda Tait, Paramjit Gill
OBJECTIVE: The objective of this research was to synthesise qualitative literature about the perceived influence and experience of social support, in relation to cardiovascular disease (CVD) prevention in migrant Pakistani communities. METHODS: Articles were systematically reviewed, critically appraised, and analysed using an adapted meta-ethnography approach. RESULTS: Sixteen qualitative studies on health behaviours related to CVD prevention were included...
October 4, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29023584/intravenous-fluid-prescribing-errors-in-children-mixed-methods-analysis-of-critical-incidents
#19
Richard L Conn, Steven McVea, Angela Carrington, Tim Dornan
INTRODUCTION: Recent National Institute for Health and Care Excellence (NICE) guidelines aim to improve intravenous (IV) fluid prescribing for children, but existing evidence about how and why fluid prescribing errors occur is limited. Studying this can lead to more effective implementation, through education and systems design. AIMS: Identify types of IV fluid prescribing errors reported in practiceAnalyse factors that contribute to errorsProvide guidance to educators and those responsible for designing systems...
2017: PloS One
https://www.readbyqxmd.com/read/29017890/faulty-brca1-brca2-genes-how-poor-is-the-prognosis
#20
REVIEW
John O'Quigley
We take a critical look at the meaning behind the number 87% given to 25-year-old Sophie, a BRCA1 and BRCA2 carrier. Sophie has been told she has an 87% chance of getting breast cancer. She is contemplating a preventive double mastectomy after genetic counseling and her physician's advice. Some 92% of British general practitioners are in favor of prophylactic mastectomy as a treatment option for women similar to Sophie. The treatment decision results, to a very large extent, from the size of the number (87%) alone...
October 2017: Annals of Epidemiology
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