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https://www.readbyqxmd.com/read/28093421/gp-views-on-strategies-to-cope-with-increasing-workload-a-qualitative-interview-study
#1
Rebecca Fr Fisher, Caroline Hd Croxson, Helen F Ashdown, Fd Richard Hobbs
BACKGROUND: The existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative. AIM: To explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each. DESIGN AND SETTING: Semi-structured, qualitative interviews with GPs working within NHS England...
January 16, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28065200/testing-the-start-triage-protocol-can-it-improve-the-ability-of-nonmedical-personnel-to-better-triage-patients-during-disasters-and-mass-casualties-incidents
#2
Stefano Badiali, Aimone Giugni, Lucia Marcis
OBJECTIVE: START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. METHODS: In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group)...
January 9, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28059233/cytopathological-image-analysis-using-deep-learning-networks-in-microfluidic-microscopy
#3
G Gopakumar, K Hari Babu, Deepak Mishra, Sai Siva Gorthi, Gorthi R K Sai Subrahmanyam
Cytopathologic testing is one of the most critical steps in the diagnosis of diseases, including cancer. However, the task is laborious and demands skill. Associated high cost and low throughput drew considerable interest in automating the testing process. Several neural network architectures were designed to provide human expertise to machines. In this paper, we explore and propose the feasibility of using deep-learning networks for cytopathologic analysis by performing the classification of three important unlabeled, unstained leukemia cell lines (K562, MOLT, and HL60)...
January 1, 2017: Journal of the Optical Society of America. A, Optics, Image Science, and Vision
https://www.readbyqxmd.com/read/28057029/the-norwegian-guidelines-for-the-prehospital-management-of-adult-trauma-patients-with-potential-spinal-injury
#4
REVIEW
Daniel K Kornhall, Jørgen Joakim Jørgensen, Tor Brommeland, Per Kristian Hyldmo, Helge Asbjørnsen, Thomas Dolven, Thomas Hansen, Elisabeth Jeppesen
The traditional prehospital management of trauma victims with potential spinal injury has become increasingly questioned as authors and clinicians have raised concerns about over-triage and harm. In order to address these concerns, the Norwegian National Competence Service for Traumatology commissioned a faculty to provide a national guideline for pre-hospital spinal stabilisation. This work is based on a systematic review of available literature and a standardised consensus process. The faculty recommends a selective approach to spinal stabilisation as well as the implementation of triaging tools based on clinical findings...
January 5, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28045625/ki67-proliferation-index-as-a-tool-for-chemotherapy-decisions-during-and-after-neoadjuvant-aromatase-inhibitor-treatment-of-breast-cancer-results-from-the-american-college-of-surgeons-oncology-group-z1031-trial-alliance
#5
Matthew J Ellis, Vera J Suman, Jeremy Hoog, Rodrigo Goncalves, Souzan Sanati, Chad J Creighton, Katherine DeSchryver, Erika Crouch, Amy Brink, Mark Watson, Jingqin Luo, Yu Tao, Michael Barnes, Mitchell Dowsett, G Thomas Budd, Eric Winer, Paula Silverman, Laura Esserman, Lisa Carey, Cynthia X Ma, Gary Unzeitig, Timothy Pluard, Pat Whitworth, Gildy Babiera, J Michael Guenther, Zoneddy Dayao, David Ota, Marilyn Leitch, John A Olson, D Craig Allred, Kelly Hunt
Purpose To determine the pathologic complete response (pCR) rate in estrogen receptor (ER) -positive primary breast cancer triaged to chemotherapy when the protein encoded by the MKI67 gene (Ki67) level was > 10% after 2 to 4 weeks of neoadjuvant aromatase inhibitor (AI) therapy. A second objective was to examine risk of relapse using the Ki67-based Preoperative Endocrine Prognostic Index (PEPI). Methods The American College of Surgeons Oncology Group (ACOSOG) Z1031A trial enrolled postmenopausal women with stage II or III ER-positive (Allred score, 6 to 8) breast cancer whose treatment was randomly assigned to neoadjuvant AI therapy with anastrozole, exemestane, or letrozole...
January 3, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28039232/the-role-of-reduced-heart-rate-volatility-in-predicting-disposition-from-the-emergency-department
#6
Ya-El Mandel-Portnoy, George T Loo, Diana Gregoriou, Sameer Bansilal, Lynne D Richardson
OBJECTIVE: Heart rate volatility (HRVO) is a physiological parameter that is believed to reflect the sympathetic activity of the autonomic nervous system. We explored the utility of HRVO as a predictive tool for declining physiological states, hypothesising that patients admitted from the resuscitation area of the ED to a high-dependency unit (HDU) experience low HRVO compared with patients who did not. METHODS: We retrospectively reviewed HR data recordings, medical charts and disposition decisions from the ED of patients who were admitted to the five resuscitation beds in our adult ED between 29 April 2014 and 30 May 2015...
December 30, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28030608/predicting-hospitalised-paediatric-pneumonia-mortality-risk-an-external-validation-of-risc-and-mrisc-and-local-tool-development-risc-malawi-from-malawi
#7
Shubhada Hooli, Tim Colbourn, Norman Lufesi, Anthony Costello, Bejoy Nambiar, Satid Thammasitboon, Charles Makwenda, Charles Mwansambo, Eric D McCollum, Carina King
BACKGROUND: Pneumonia is the leading infectious cause of under-5 mortality in sub-Saharan Africa. Clinical prediction tools may aide case classification, triage, and allocation of hospital resources. We performed an external validation of two published prediction tools and compared this to a locally developed tool to identify children admitted with pneumonia at increased risk for in-hospital mortality in Malawi. METHODS: We retrospectively analyzed the performance of the Respiratory Index of Severity in Children (RISC) and modified RISC (mRISC) scores in a child pneumonia dataset prospectively collected during routine care at seven hospitals in Malawi between 2011-2014...
2016: PloS One
https://www.readbyqxmd.com/read/28028788/factors-associated-with-the-need-for-intensive-care-unit-admission-following-supratentorial-intracerebral-hemorrhage-the-triage-ich-model
#8
James P Klaas, Sherri Braksick, Jay Mandrekar, Petra Sedova, M Fernanda Bellolio, Alejandro A Rabinstein, Robert D Brown
BACKGROUND: Providing the correct level of care for patients with intracerebral hemorrhage (ICH) is crucial, but the level of care needed at initial presentation may not be clear. This study evaluated factors associated with admission to intensive care unit (ICU) level of care. METHODS: This is an observational study of all adult patients admitted to our institution with non-traumatic supratentorial ICH presenting within 72 h of symptom onset between 2009-2012 (derivation cohort) and 2005-2008 (validation cohort)...
December 27, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28026705/a-screening-mechanism-to-recognize-and-support-at-risk-aboriginal-children
#9
Nancy L Young, Diane Jacko, Mary Jo Wabano, Lauren Hawthorne, Sarah Seabrook, Sheri Wabanosse, Koyo Usuba
OBJECTIVES: The Aboriginal Children's Health and Well-Being Measure© (ACHWM) was developed to assess health from the perspectives of Aboriginal children. The purpose of this paper is to document the screening process, embedded within the ACHWM, and assess its effectiveness. METHODS: The ACHWM was implemented in 2014/2015 with children 8 to 18 years of age living on the Wiikwemkoong Unceded Territory. Survey responses were screened to identify potential risk, using an automated algorithm run on computer tablets...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28019647/a-novel-surrogate-to-identify-anatomical-changes-during-radiotherapy-of-head-and-neck-cancer-patients
#10
Sébastien A A Gros, William Xu, John C Roeske, Mehe Choi, Bahman Emami, Murat Surucu
To develop a novel method to monitor external anatomical changes in head and neck cancer patients in order to triage possible adaptive radiotherapy needs METHODS: The presented approach aims to provide information on internal anatomical changes based on variations observed in external anatomy. Setup Cone Beam Computed Tomography (CBCT) images are processed to produce an accurate external contour of the patient's skin. After registering the CBCTs to the reference planning CT, the external contours from each CBCT are transferred to the initial- first week - CBCT...
December 26, 2016: Medical Physics
https://www.readbyqxmd.com/read/28012828/can-patient-variables-measured-on-arrival-to-the-emergency-department-predict-disposition-in-medium-acuity-patients
#11
John P Riordan, Wayne L Dell, James T Patrie
BACKGROUND: Emergency department crowding has led to innovative "front end" care models to safely and efficiently care for medium and lower acuity patients. In the United States, most treatment algorithms rely on the emergency severity index (ESI) triage tool to sort patients. However, there are no objective criteria used to differentiate ESI 3 patients. OBJECTIVE: We seek to derive and validate a model capable of predicting patient discharge disposition (DD) using variables present on arrival to the emergency department for ESI 3 patients...
December 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28012507/the-utility-of-a-handheld-metal-detector-in-detection-and-localization-of-pediatric-metallic-foreign-body-ingestion
#12
Javan Nation, Wen Jiang
OBJECTIVE: To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. METHODS: Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. RESULTS: Thirty-seven of the 38 ingested foreign bodies were MFBs...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27981617/utility-of-the-hemangioma-severity-scale-as-a-triage-tool-and-predictor-of-need-for-treatment
#13
Jamie L Mull, Sarah L Chamlin, Jin-Shei Lai, Jennifer L Beaumont, David Cella, Elizabeth A Rancour, Eulalia Baselga, Anita N Haggstrom
BACKGROUND/OBJECTIVES: Infantile hemangiomas (IHs) are commonly encountered in primary care and most often remain asymptomatic, resolving without sequelae. Certain characteristics are associated with a greater risk of complications, associated anomalies, and disfigurement. The heterogeneous presentation poses a clinical challenge for physicians in determining the need for treatment and subspecialty referral. This study aims to evaluate the utility of the previously published Hemangioma Severity Scale (HSS) to predict the need for treatment...
December 16, 2016: Pediatric Dermatology
https://www.readbyqxmd.com/read/27981272/ultrasonography-as-an-integrated-tool-in-clinical-decision-making-in-the-emergency-department
#14
Adela C Golea, Eugenia Gp Mureșan, Sorin S Lăcan, Mihaela Gh Pasc, Sorana D Bolboacă
AIM: The aim of this retrospective study was to identify the role of ultrasonography as a decision-making and screening tool in emergency patients with pathological changes. MATERIAL AND METHOD: The study was carried out for 28 months in the Emergency Department of the County Emergency University Hospital, Cluj-Napoca. An ultrasound examination was performed as part of the clinical algorithm within the first hour of treating non-critical patients after they had been triaged...
December 5, 2016: Medical Ultrasonography
https://www.readbyqxmd.com/read/27974505/metabolomic-screening-using-esi-ft-ms-identifies-potential-radiation-responsive-molecules-in-mouse-urine
#15
Daisuke Iizuka, Susumu Yoshioka, Hidehiko Kawai, Shunsuke Izumi, Fumio Suzuki, Kenji Kamiya
The demand for establishment of high-throughput biodosimetric methods is increasing. Our aim in this study was to identify low-molecular-weight urinary radiation-responsive molecules using electrospray ionization Fourier transform mass spectrometry (ESI-FT MS), and our final goal was to develop a sensitive biodosimetry technique that can be applied in the early triage of a radiation emergency medical system. We identified nine metabolites by statistical comparison of mouse urine before and 8 h after irradiation...
December 14, 2016: Journal of Radiation Research
https://www.readbyqxmd.com/read/27941328/upper-extremity-function-predicts-adverse-health-outcomes-among-older-adults-hospitalized-for-ground-level-falls
#16
Bellal Joseph, Nima Toosizadeh, Tahereh Orouji Jokar, Michelle R Heusser, Jane Mohler, Bijan Najafi
BACKGROUND: Despite National Surgical Quality Improvement guidelines to integrate frailty into surgical elder assessments, a quick, accurate, and simple frailty assessment tool suitable for busy clinical settings is still not available. Recently, we have demonstrated that a simple upper-extremity function (UEF) test based on wearable sensors could identify frailty with high agreement with conventional assessments by testing 20-s repetitive elbow flexion and extension. OBJECTIVE: We examined whether UEF parameters are sensitive for predicting adverse health outcomes in bedbound older adults admitted to hospital due to ground-level fall injuries...
December 10, 2016: Gerontology
https://www.readbyqxmd.com/read/27939464/remote-monitoring-of-blood-pressure-to-reduce-the-risk-of-preeclampsia-related-complications-with-an-innovative-use-of-mobile-technology
#17
R Ganapathy, A Grewal, J S Castleman
OBJECTIVE: Assess suitability of remote self-monitoring of blood pressure with an innovative use of technology in detecting raised blood pressure in pregnancy. STUDY DESIGN: Assess ease of use and safety of the newly developed kit which included a Bluetooth enabled blood pressure machine and an android based mobile phone. The phone was modified to have only one application in it which showed the blood pressure readings with a traffic light system. The study was a proof of concept for wider use of the kit...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27930596/systemic-inflammatory-response-syndrome-is-more-associated-with-bacteremia-in-elderly-patients-with-suspected-sepsis-in-emergency-departments
#18
Hsien-Ling Chou, Shih-Tsung Han, Chun-Fu Yeh, I-Shaing Tzeng, Tsung-Han Hsieh, Chin-Chieh Wu, Jen-Tse Kuan, Kuan-Fu Chen
Early diagnosis of bacteremia for patients with suspected sepsis is 1 way to improve prognosis of sepsis. Systemic inflammatory response syndrome (SIRS) has long been utilized as a screening tool to detect bacteremia by front-line healthcare providers. The value of SIRS to predict bacteremia in elderly patients (≥65 years) with suspected sepsis has not yet been examined in emergency departments (EDs).We aimed to evaluate the performance of SIRS components in predicting bacteremia among elderly patients in EDs...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27928973/development-of-a-mass-gathering-triage-tool-an-australian-perspective
#19
Matt Cannon, Rebecca Roitman, Jamie Ranse, Julia Morphet
Many health service organizations deploy first responders and health care professionals to mass gatherings to assess and manage injuries and illnesses. Patient presentation rates (PPRs) to on-site health services at a mass gathering range from 0.48-170 per 10,000 participants. Transport to hospital rates (TTHRs) range from 0.035-15 per 10,000 participants. The aim of this report was to outline the current literature pertaining to mass-gathering triage and to describe the development of a mass-gathering triage tool for use in the Australian context by first responders...
December 8, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27928085/development-of-a-prediction-model-for-ebola-virus-disease-a-retrospective-study-in-nz%C3%A3-r%C3%A3-kor%C3%A3-ebola-treatment-center-guinea
#20
Paul Loubet, Romain Palich, Richard Kojan, Olivier Peyrouset, Christine Danel, Sarala Nicholas, Mamoudou Conde, Klaudia Porten, Augustin Augier, Yazdan Yazdanpanah
The 2014 Ebola epidemic has shown the importance of accurate and rapid triage tools for patients with suspected Ebola virus disease (EVD). Our objective was to create a predictive score for EVD. We retrospectively reviewed all suspected cases admitted to the Ebola treatment center (ETC) in Nzérékoré, Guinea, between December 2, 2014, and February 23, 2015. We used a multivariate logistic regression model to identify clinical and epidemiological factors associated with EVD, which were used to create a predictive score...
December 7, 2016: American Journal of Tropical Medicine and Hygiene
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