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https://www.readbyqxmd.com/read/28101983/working-to-define-professionalism-in-pediatric-anesthesiology-a-qualitative-study-of-domains-of-the-expert-pediatric-anesthesiologist-as-valued-by-interdisciplinary-stakeholders
#1
Justin L Lockman, Alan Jay Schwartz, Peter F Cronholm
BACKGROUND: Unprofessional behavior is a significant problem throughout graduate medical education programs and medical centers. Some authors have suggested that professionalism curricula should be focused toward faculty, not trainees, to interrupt the modeling of unprofessionalism. Developing such curricula requires a needs assessment and is challenging given data indicating that the definition of professionalism varies based on medical specialty. Thus, a specialty-specific definition of professionalism is needed as a first step in any curriculum development...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28101479/excessive-daytime-sleepiness-and-sleep-disorders-in-a-population-of-patients-with-epilepsy-a-case-control-study
#2
Matilde Gammino, Leila Zummo, Anna Lo Bue, Lidia Urso, Valeria Terruso, Oreste Marrone, Brigida Fierro, Ornella Daniele
BACKGROUND AND PURPOSE: There are several primary causes for excessive daytime sleepiness (EDS) and sleep disorders in patients with epilepsy. Up to now, studies in the literature report conflicting data in terms of both prevalence and aetiology. The aim of our study was therefore to evaluate the prevalence of EDS and some sleep disorders in a population of patients with epilepsy treated with no more than two antiepileptic drugs (AEDs). We also investigated the role of the depression of mood as a variable that can negatively affect EDS...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28101263/team-based-learning-in-a-pipeline-course-in-medical-microbiology-for-under-represented-student-populations-in-medicine-improves-learning-of-microbiology-concepts
#3
K C Behling, M M Murphy, J Mitchell-Williams, H Rogers-McQuade, O J Lopez
As part of an undergraduate pipeline program at our institution for students from underrepresented minorities in medicine backgrounds, we created an intensive four-week medical microbiology course. Team-based learning (TBL) was implemented in this course to enhance student learning of course content. Three different student cohorts participated in the study, and there were no significant differences in their prior academic achievement based on their undergraduate grade point average (GPA) and pre-course examination scores...
December 2016: Journal of Microbiology & Biology Education: JMBE
https://www.readbyqxmd.com/read/28101127/mental-health-and-trauma-in-asylum-seekers-landing-in-sicily-in-2015-a-descriptive-study-of-neglected-invisible-wounds
#4
Anna Crepet, Francesco Rita, Anthony Reid, Wilma Van den Boogaard, Pina Deiana, Gaia Quaranta, Aurelia Barbieri, Francesco Bongiorno, Stefano Di Carlo
BACKGROUND: In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28100689/effectiveness-and-duration-of-protection-of-one-dose-of-a-meningococcal-conjugate-vaccine
#5
Amanda C Cohn, Jessica R MacNeil, Lee H Harrison, Ruth Lynfield, Arthur Reingold, William Schaffner, Elizabeth R Zell, Brian Plikaytis, Xin Wang, Nancy E Messonnier
BACKGROUND: Meningococcal conjugate vaccines were licensed beginning in 2005 on the basis of serologic end points and recommended for use in adolescents. A single dose at age 11 to 12 years was expected to provide protection through late adolescence. We conducted a case-control evaluation of vaccine effectiveness (VE) and duration of protection of a meningococcal (groups A, C, W, and Y) polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D). METHODS: Cases of culture- or polymerase chain reaction-confirmed serogroup A, C, W, and Y meningococcal disease among adolescents were identified through meningococcal disease surveillance sites in the United States from January 1, 2006, through August 31, 2013...
January 18, 2017: Pediatrics
https://www.readbyqxmd.com/read/28100576/perioperative-management-of-a-large-late-presenting-phaeochromocytoma
#6
Duncan Macrosson, Andrew Love
A 77-year-old man presenting to the emergency department with an acute coronary syndrome was later found to have a phaeochromocytoma. The lateness of this presentation was likely due to the protective α blocking effects of long-term terazosin therapy for his prostatism. α blockers such as terazosin are a well-recognised medical therapy in the perioperative optimisation of phaeochromocytoma because they treat the adrenergic effects of catecholamine release from the tumour such as hypertension. This patient was diagnosed with an ST elevation myocardial infarction (STEMI)...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100204/acceptance-and-attitudes-of-healthcare-staff-towards-the-introduction-of-clinical-pharmacy-service-a-descriptive-cross-sectional-study-from-a-tertiary-care-hospital-in-sri-lanka
#7
Lelwala Guruge Thushani Shanika, Chandrani Nirmala Wijekoon, Shaluka Jayamanne, Judith Coombes, Ian Coombes, Nilani Mamunuwa, Andrew Hamilton Dawson, Hithanadura Asita De Silva
BACKGROUND: Multidisciplinary patient management including a clinical pharmacist shows an improvement in patient quality use of medicine. Implementation of a clinical pharmacy service represents a significant novel change in practice in Sri Lanka. Although attitudes of doctors and nurses are an important determinant of successful implementation, there is no Sri Lankan data about staff attitudes to such changes in clinical practice. This study determines the level of acceptance and attitudes of doctors and nurses towards the introduction of a ward-based clinical pharmacy service in Sri Lanka...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28099977/a-step-by-step-clinical-approach-for-the-management-of-neuroendocrine-tumours
#8
A Yordanova, H Ahmadzadehfar, M Gonzalez-Carmona, C Strassburg, K Mayer, G Feldmann, I Schmidt-Wolf, R Lingohr, S Fischer, G Kristiansen, M Essler
Neuroendocrine tumours (NET) are rare neoplasms, but the incidence is permanently increasing. Most of the NETs are slow proliferating and clinically silent, and for that reason, they are often diagnosed at a stage with advanced disease. The complexity and diversity of the NET-biology require the treatment of patients in specialised centres to guarantee a qualified, multidisciplinary treatment planning. At our institution, we developed an interdisciplinary model for the assessment and treatment of NET. The aim was to adapt the guidelines to the clinical practice, exchange of current knowledge, and a tailored approach to the individual patient...
January 18, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28099639/failure-to-activate-the-in-hospital-emergency-team-causes-and-outcomes
#9
Vera Barbosa, Ernestina Gomes, Senio Vaz, Gustavo Azevedo, Gonçalo Fernandes, Amélia Ferreira, Rui Araujo
Objective: To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure. Methods: A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099287/anesthetic-outcomes-of-children-with-arthrogryposis-syndromes-no-evidence-of-hyperthermia
#10
Stephen J Gleich, Michael Tien, Darrell R Schroeder, Andrew C Hanson, Randall Flick, Michael E Nemergut
BACKGROUND: Arthrogryposis syndromes are a heterogeneous group of disorders characterized by congenital joint contractures often requiring multiple surgeries during childhood to address skeletal and visceral abnormalities. Previous reports suggest that these children have increased perioperative risk, including hypermetabolic events discrete from malignant hyperthermia, difficult airway management, isolated hyperthermia, and difficult IV line placement. We sought to compare children with arthrogryposis multiplex congenita (AMC) versus the less severe, distal arthrogryposis syndromes (DAS) and to evaluate possible intraoperative hyperthermia of patients with AMC...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099065/exploring-variation-in-transformation-of-primary-care-practices-to-patient-centered-medical-homes-a-mixed-methods-approach
#11
Robert D Lieberthal, Tom Karagiannis, Evan Bilheimer, Manisha Verma, Colleen Payton, Mona Sarfaty, George Valko
The objective was to quantify the activities required for patient-centered medical home (PCMH) transformation in a sample of small to medium-sized National Committee for Quality Assurance (NCQA) recognized practices, and explore barriers and facilitators to transformation. Eleven small to medium-sized PCMH practices in Southeastern Pennsylvania completed a survey, which was adapted from the 2011 NCQA standards. Semistructured follow-up interviews were conducted, descriptive statistics were computed for the quantitative analysis, and a process of thematic coding was deployed for the qualitative analysis...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28099053/palliative-care-involvement-is-associated-with-less-intensive-end-of-life-care-in-adolescent-and-young-adult-oncology-patients
#12
Jennifer M Snaman, Erica C Kaye, Jessie J Lu, April Sykes, Justin N Baker
BACKGROUND: Adolescent and young adult oncology (AYAO) patients often receive intensive medical care and experience significant symptoms at the end of life (EOL). OBJECTIVE: This study aimed to describe the characteristics of AYAO patients aged 15-26 years who died as inpatients in a hospital and to compare the illness and EOL experiences of AYAO patients who did and did not receive palliative care (PC). DESIGN AND SETTING: A standardized data extraction tool was used to collect information about demographics, treatment, terminal characteristics, and symptoms during the last month of life (LMOL) for 69 AYAO patients who died while hospitalized between 2008 and 2014...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28098743/analysis-of-incident-and-accident-reports-and-risk-management-in-spine-surgery
#13
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Masayoshi Morozumi, Yoshihiro Nishida, Yoshimasa Nagao, Naoki Ishiguro
STUDY DESIGN: A review of accident and incident reports. OBJECTIVE: To analyze prevalence, characteristics, and details of perioperative incidents and accidents in patients receiving spine surgery. SUMMARY OF BACKGROUND DATA: In our institution, a clinical error that potentially results in an adverse event is usually submitted as an incident or accident report through a web database, to ensure anonymous and blame-free reporting. All reports are analyzed by a medical safety management group...
January 16, 2017: Spine
https://www.readbyqxmd.com/read/28098631/after-the-fall-the-tapestry-of-disturbance-and-recovery
#14
Nalini M Nadkarni
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her 10 days in the ICU...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098505/facilitating-and-hindering-factors-for-coping-with-the-experience-of-having-a-child-with-cancer-a-lebanese-perspective
#15
Myrna A A Doumit, May Naifeh Khoury
BACKGROUND: Families with a child with cancer face significant emotional and psychosocial stressors. The frequency of childhood cancer is increasing in Lebanon with more than 282 children diagnosed each year. This condition is reported to evoke a range of challenging emotions for parents, yet no studies have been conducted on the facilitating and hindering factors that affect Lebanese parents coping with a child with cancer. OBJECTIVES: The purpose of the study was to gain an in-depth understanding of factors facilitating and hindering coping methods of Lebanese parents with a child with cancer...
January 18, 2017: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/28098492/insomnia-management-in-the-australian-primary-care-setting
#16
Fatema-Tun-Naher Sake, Keith Wong, Delwyn J Bartlett, Bandana Saini
BACKGROUND AND OBJECTIVE: Insomnia is one of the most prevalent and costly sleep disorders presenting in general practice, and when left untreated, has major health consequences. However, studies are limited on how general practitioners respond to this health issue, especially since the reconceptualization of insomnia in DSM 5. Therefore, the aim of this study was to explore how insomnia is diagnosed and treated in Australian general practices. PARTICIPANTS: Twenty-four (54% male) general practitioners were recruited throughout the greater Sydney metropolitan area in New South Wales using the professional network of research team members and snowballing technique...
January 18, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28097438/attitudes-towards-fever-amongst-uk-paediatric-intensive-care-staff
#17
Thomas Brick, Rachel S Agbeko, Patrick Davies, Peter J Davis, Akash Deep, Peter-Marc Fortune, David P Inwald, Amy Jones, Richard Levin, Kevin P Morris, John Pappachan, Samiran Ray, Shane M Tibby, Lyvonne N Tume, Mark J Peters
: The role played by fever in the outcome of critical illness in children is unclear. This survey of medical and nursing staff in 35 paediatric intensive care units and transport teams in the United Kingdom and Ireland established attitudes towards the management of children with fever. Four hundred sixty-two medical and nursing staff responded to a web-based survey request. Respondents answered eight questions regarding thresholds for temperature control in usual clinical practice, indications for paracetamol use, and readiness to participate in a clinical trial of permissive temperature control...
January 18, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28097370/osseointegrated-prosthesis-for-patients-with-an-amputation-multidisciplinary-team-approach-in-the-netherlands
#18
J P M Frölke, R A Leijendekkers, H van de Meent
This article reviews the development of multidisciplinary osseointegration treatment in the Netherlands since its start in 2009. People experiencing limitations due to their socket prosthesis after a leg amputation present to the Radboud University Nijmegen Medical Centre for an osseointegration implant or "bone-anchored" prosthesis. In this article we share our experience with the first 100 patients regarding referral pattern, selection criteria, available osseointegration systems, preoperative planning, surgical treatment, the rehabilitation protocol, outcome measurement, revision surgery, and future developments...
January 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28096281/de-freezing-frozen-patient-management
#19
Ayala Kobo-Greenhut, Amin Shnifi, Eran Tal-Or, Racheli Magnezi, Amos Notea, Meir Ruach, Erez Onn, Ayala Cohen, Etti Doveh, Izhar Ben Shlomo
OBJECTIVE: To compare the effectiveness of two methods in encouraging the consideration of a leap from one patient management routine to another: (i) real-time review of the facts by an external medical team (ii) implementation of the 're-thinking-protocol' ('de-Freezing') by both treating and external medical teams. DESIGN: Students accompanied doctors, nurses and patients as non-interrupting observers. When an obvious gap between the expected and actual findings occurred, it was discussed four times: by two teams (treating team, external medical team) in two discussion modes (real-time review, de-Freezing-questionnaire)...
January 16, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28096208/improving-door-to-needle-times-for-acute-ischemic-stroke-effect-of-rapid-patient-registration-moving-directly-to-computed-tomography-and-giving-alteplase-at-the-computed-tomography-scanner
#20
Noreen Kamal, Jessalyn K Holodinsky, Caroline Stephenson, Devika Kashayp, Andrew M Demchuk, Michael D Hill, Renee L Vilneff, Erin Bugbee, Charlotte Zerna, Nancy Newcommon, Eddy Lang, Darren Knox, Eric E Smith
BACKGROUND: The effectiveness of specific systems changes to reduce DTN (door-to-needle) time has not been fully evaluated. We analyzed the impact of 4 specific DTN time reduction strategies implemented prospectively in a staggered fashion. METHODS AND RESULTS: The HASTE (Hurry Acute Stroke Treatment and Evaluation) project was implemented in 3 phases at a single academic medical center. In HASTE I (June 6, 2012 to June 5, 2013), baseline performance was analyzed...
January 2017: Circulation. Cardiovascular Quality and Outcomes
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