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https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#1
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28646217/why-do-physicians-lack-engagement-with-smoking-cessation-treatment-in-their-copd-patients-a-multinational-qualitative-study
#2
Eva Anne Marije van Eerd, Mette Bech Risør, Mark Spigt, Maciek Godycki-Cwirko, Elena Andreeva, Nick Francis, Anja Wollny, Hasse Melbye, Onno van Schayck, Daniel Kotz
Smoking cessation is the only effective intervention to slow down the accelerated decline in lung function in smokers with chronic obstructive pulmonary disease. Nevertheless, physicians often do not routinely provide evidence-based smoking cessation treatment to their patients. To understand underlying reasons, we explored how physicians engage in smoking cessation treatment in their chronic obstructive pulmonary disease patients. In total, 21 focus group discussions were held with general practitioners and pulmonologists in seven different countries in Europe and Asia...
June 23, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28645535/data-security-and-privacy-in-apps-for-dementia-an-analysis-of-existing-privacy-policies
#3
Lisa Rosenfeld, John Torous, Ipsit V Vahia
INTRODUCTION: Despite tremendous growth in the number of health applications (apps), little is known about how well these apps protect their users' health-related data. This gap in knowledge is of particular concern for apps targeting people with dementia, whose cognitive impairment puts them at increased risk of privacy breaches. In this article, we determine how many dementia apps have privacy policies and how well they protect user data. METHODS: Our analysis included all iPhone apps that matched the search terms "medical + dementia" or "health & fitness + dementia" and collected user-generated content...
June 1, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28644183/more-dose-dependent-side-effects-with-mercaptopurine-over-azathioprine-in-ibd-treatment-due-to-relatively-higher-dosing
#4
Mark M T J Broekman, Marieke J H Coenen, Corine J van Marrewijk, Geert J A Wanten, Dennis R Wong, Andre L M Verbeek, Olaf H Klungel, Piet M Hooymans, Henk-Jan Guchelaar, Hans Scheffer, Luc J J Derijks, Dirk J de Jong
BACKGROUND: There are substantial global differences in the preference for mercaptopurine (MP) or its prodrug azathioprine (AZA) as first-choice thiopurine to treat inflammatory bowel diseases. Studies comparing both agents are scarce. Our aim was to compare AZA and MP in thiopurine-naive patients with inflammatory bowel disease for the frequency of side effects and efficacy. METHODS: Post hoc analysis of the "Thiopurine response Optimization by Pharmacogenetic testing in Inflammatory bowel disease Clinics" (TOPIC) trial, in which thiopurine-naive patients with inflammatory bowel disease with an indication for a thiopurine were randomized for a genotype-based dose versus standard of care...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28643054/a-structured-extended-training-program-to-facilitate-adoption-of-new-techniques-for-practicing-surgeons
#5
Jacob A Greenberg, Sally Jolles, Sarah Sullivan, Sudha Pavuluri Quamme, Luke M Funk, Anne O Lidor, Caprice Greenberg, Carla M Pugh
INTRODUCTION: Laparoscopic inguinal hernia repair has been shown to have significant benefits when compared to open inguinal hernia repair, yet remains underutilized in the United States. The traditional model of short, hands-on, cognitive courses to enhance the adoption of new techniques fails to lead to significant levels of practice implementation for most surgeons. We hypothesized that a comprehensive program would facilitate the adoption of laparoscopic inguinal hernia repair (TEP) for practicing surgeons...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642213/development-of-a-web-based-intervention-for-addressing-distress-in-caregivers-of-patients-receiving-stem-cell-transplants-formative-evaluation-with-stakeholder-interviews-and-focus-groups
#6
Nicole Amoyal Pensak, Tanisha Joshi, Teresa Simoneau, Kristin Kilbourn, Alaina Carr, Jean Kutner, Mark L Laudenslager
BACKGROUND: Caregivers of cancer patients experience significant burden and distress including depression and anxiety. We previously demonstrated the efficacy of an eight session, in-person, one-on-one stress management intervention to reduce distress in caregivers of patients receiving allogeneic hematopoietic stem cell transplants (allo-HSCT). OBJECTIVE: The objective of this study was to adapt and enhance the in-person caregiver stress management intervention to a mobilized website (eg, tablet, smartphone, or computer-based) for self-delivery in order to enhance dissemination to caregiver populations most in need...
June 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28641582/a-multicentre-randomised-controlled-trial-of-levetiracetam-versus-phenytoin-for-convulsive-status-epilepticus-in-children-protocol-convulsive-status-epilepticus-paediatric-trial-consept-a-predict-study
#7
Stuart R Dalziel, Jeremy Furyk, Megan Bonisch, Ed Oakley, Meredith Borland, Jocelyn Neutze, Susan Donath, Cynthia Sharpe, Simon Harvey, Andrew Davidson, Simon Craig, Natalie Phillips, Shane George, Arjun Rao, Nicholas Cheng, Michael Zhang, Kam Sinn, Amit Kochar, Christine Brabyn, Franz E Babl
BACKGROUND: Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile...
June 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28640723/intravitreal-injections-service-a-patient-experience-evaluation
#8
Hani Hasan, Sarah Flockhart, Waseem Qureshi, Selina Khan, Shahina Ahmed, Nimish Shah
INTRODUCTION: This survey has been conducted following the introduction of nurse-led intravitreal injections clinics at the Great Western Hospital. A team of 5 nurses regularly carry out an average of 90 injections per week. METHODS: A series of 169 consecutive injection patients have been offered the study questionnaire between 28 January 2016 and 28 February 2016; patients with no previous experience with a nurse injector were excluded. RESULTS: 76...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28640330/-incorporation-of-information-and-communication-technologies-and-quality-of-primary-healthcare-in-brazil
#9
Alaneir de Fátima Dos Santos, Délcio Fonseca, Lucas Lobato Araujo, Cristiane da Silva Diniz Procópio, Érica Araújo Silva Lopes, Angela Maria de Lourdes Dayrell de Lima, Clarice Magalhães Rodrigues Dos Reis, Daisy Maria Xavier de Abreu, Alzira Oliveira Jorge, Antonio Thomaz Matta-Machado
Information and Communication Technologies (ICTs) are means to handle information, streamline communication, and contribute to patient care. This article describes the incorporation of Information and Communication Technologies in primary care and its association with quality, based on the Brazilian National Program for the Improvement of Access and Quality in Primary Care (PMAQ in portuguese). This was a cross-sectional study with 17,053 teams. An Index of Incorporation of ICTs was created, which included: information infrastructure, systems, and utilization...
June 5, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28639262/interprofessional-collaboration-to-improve-professional-practice-and-healthcare-outcomes
#10
REVIEW
Scott Reeves, Ferruccio Pelone, Reema Harrison, Joanne Goldman, Merrick Zwarenstein
BACKGROUND: Poor interprofessional collaboration (IPC) can adversely affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. OBJECTIVES: To assess the impact of practice-based interventions designed to improve interprofessional collaboration (IPC) amongst health and social care professionals, compared to usual care or to an alternative intervention, on at least one of the following primary outcomes: patient health outcomes, clinical process or efficiency outcomes or secondary outcomes (collaborative behaviour)...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639253/ultrasonography-in-trauma-a-nation-wide-cross-sectional-investigation
#11
Jesper Weile, Klaus Nielsen, Stine C Primdahl, Christian A Frederiksen, Christian B Laursen, Erik Sloth, Hans Kirkegaard
BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28638566/necessity-is-the-mother-of-invention-an-innovative-hospitalist-resident-initiative-for-improving-quality-and-reducing-readmissions-from-skilled-nursing-facilities
#12
Sunny Petigara, Mahesh Krishnamurthy, David Livert
Background: Hospital readmissions have been a major challenge to the US health system. Medicare data shows that approximately 25% of Medicare skilled nursing facility (SNF) residents are readmitted back to the hospital within 30 days. Some of the major reasons for high readmission rates include fragmented information exchange during transitions of care and limited access to physicians round-the-clock in SNFs. These represent safety, quality, and health outcome concerns. Aim: The goal of the project was to reduce hospital readmission rates from SNFs by improving transition of care and increasing physician availability in SNFs (five to seven days a week physical presence with 24/7 accessibility by phone)...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28637449/task-shifting-interpersonal-counseling-for-depression-a-pragmatic-randomized-controlled-trial-in-primary-care
#13
Camila T Matsuzaka, Milton Wainberg, Andrea Norcini Pala, Elis V Hoffmann, Bruno M Coimbra, Rosaly F Braga, Annika C Sweetland, Marcelo F Mello
BACKGROUND: Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low- and middle-income countries. This study aims to examine the a new model for depression care in a low-resource environment compared to enhanced treatment at usual (E-TAU). METHODS: We trained non-specialist community health workers (local lay employees of the public health system) to provide Interpersonal Counseling (IPC) to treat depressive symptoms in the Brazilian, São Paulo city, family health strategy (FHS)...
June 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28636455/the-role-of-the-healthcare-chaplain-a-literature-review
#14
Fiona Timmins, Sílvia Caldeira, Maryanne Murphy, Nicolas Pujol, Greg Sheaf, Elizabeth Weathers, Jacqueline Whelan, Bernadette Flanagan
Healthcare chaplains operate in many healthcare sites internationally and yet their contribution is not always clearly understood by medical and healthcare staff. This review aims to explore the chaplains' role in healthcare, with a view to informing best practice in future healthcare chaplaincy. Overall the extent of the provision and staffing of chaplaincy service internationally is unclear. From this review, several key spiritual and pastoral roles in healthcare emerge including a potential contribution to ethical decision making at the end of life...
June 21, 2017: Journal of Health Care Chaplaincy
https://www.readbyqxmd.com/read/28636449/zika-virus-in-ontario-evaluating-a-rapid-risk-assessment-tool-for-emerging-infectious-disease-threats
#15
Ryan Van Meer, Karin Hohenadel, Alanna Fitzgerald-Husek, Bryna Warshawsky, Doug Sider, Brian Schwartz, Mark P Nelder
To determine the Ontario-specific risk of local and travel-related Zika virus transmission in the context of a public health emergency of international concern, Public Health Ontario (PHO) completed a rapid risk assessment (RRA) on January 29, 2016, using a newly developed RRA guidance tool. The RRA concluded that risk of local mosquito-borne transmission was low, with a high risk of imported cases through travel. The RRA was updated 3 times based on predetermined triggers. An independent evaluation assessed both the application of the RRA guidance tool (process evaluation) and the usefulness of the RRA (outcome evaluation)...
May 2017: Health Security
https://www.readbyqxmd.com/read/28636076/prevalence-and-impact-of-obesity-in-people-with-haemophilia-review-of-literature-and-expert-discussion-around-implementing-weight-management-guidelines
#16
REVIEW
S Kahan, A Cuker, R F Kushner, J Maahs, M Recht, T Wadden, T Willis, S Majumdar, D Ungar, D Cooper
Obesity affects more than 35% of Americans, increasing the risk of more than 200 comorbid conditions, impaired quality of life and premature mortality. This review aimed to summarize literature published over the past 15 years regarding the prevalence and impact of obesity in people with haemophilia (PWH) and to discuss implementing general guidelines for weight management in the context of the haemophilia comprehensive care team. Although few studies have assessed the effects of obesity on haemophilia-specific outcomes, existing evidence indicates an important impact of weight status on lower extremity joint range of motion and functional disability, with potentially important effects on overall quality of life...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28634619/implementation-of-li-rads-into-a-radiological-practice
#17
REVIEW
Stefan T Siedlikowski, Ania Z Kielar, Eleanor L Ormsby, Bijan Bijan, Christopher Kagay
Since its introduction in 2011, Liver Imaging Reporting and Data System (LI-RADS) has become an increasingly utilized method for radiologists to categorize lesions for hepatocellular carcinoma (HCC) in patients at risk (American College of Radiology, www.acr.org/quality-safety/resources/lirads 2016). This overview article presents insight into methods of incorporating LI-RADS into an existing clinical practice, highlighting concrete ways to establish this system as a mainstay in any radiologist's evidence-based armamentarium...
June 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28634565/home-based-telepsychiatry-in-us-urban-area
#18
Alireza Amirsadri, Jaclynne Burns, Albert Pizzuti, Cynthia L Arfken
Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted in detecting unrecognized depression and complex trauma...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28633761/the-opinion-of-health-professionals-regarding-the-presence-of-relatives-during-cardiopulmonary-resucitation
#19
J M Asencio-Gutiérrez, I Reguera-Burgos
BACKGROUND: The latest recommendations from the American Heart Association and the European Resuscitation Council invite allowance for the presence of relatives (PR) during cardiopulmonary resuscitation (CPR) as an extra measure of family care. OBJECTIVE: To discover the opinion of health professionals on the PR during CPR. METHOD: Cross-sectional observational study through an online survey in Spain, based on a non-probability sample (n=315)...
June 17, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28632597/leadership-communication-and-negotiation-across-a-diverse-workforce-an-aoa-critical-issues-symposium
#20
Denis R Clohisy, Michael J Yaszemski, Joanne Lipman
The current workforce in the United States is rapidly changing and is increasingly inclusive of individuals from a broad range of ages, ethnicities, and cultural backgrounds. Engaging and leading a diverse workforce creates great opportunities for innovation and adaptation in our evolving medical economic and clinical care delivery environment. For optimal engagement of employees and partners, orthopaedic surgeons must develop the necessary skills for executing change inside complex organizations and across teams composed of a variety of providers and skilled workers...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
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