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Hospital capacity

Siyang Zeng, Andrea Tham, Bruce Bos, Joan Jin, Mehrdad Arjomandi
BACKGROUND: Abnormal lung volumes that represent air trapping are common in chronic obstructive pulmonary disease (COPD). However, their clinical significance in those without spirometrically defined COPD (normal forced expiratory volume in 1 s [FEV1 ] to forced vital capacity [FVC] ratio) is unclear. METHODS: Using the Veterans Administration Informatics and Computing Infrastructure (VINCI) database, we identified 7,479 patients at risk for COPD (smokers > 40 years of age without restrictive lung disease) who had preserved spirometry (FEV1 /FVC and FEV1  ≥ lower limit of normal) and also had concomitant lung volume measurements by plethysmography across 37 Veterans Affairs Medical Centers in the United States between 1985 and 2017, and examined their subsequent health records for clinical diagnoses of COPD, respiratory exacerbations, healthcare utilization, spirometry, and mortality...
December 2018: Annals of the American Thoracic Society
Seema K Singh, Ashutossh Naaraayan, Prakash Acharya, Balakrishnan Menon, Vishal Bansal, Stephen Jesmajian
Setting Our study was conducted at a tertiary care center for respiratory illnesses (Viswanathan Chest Hospital, Vallabhbhai Patel Chest Institute (VPCI), University of Delhi, Delhi, India). Patients were enrolled in the study from the outpatient clinic. Objective To assess the effects of pulmonary rehabilitation (PR) in patients with chronic lung impairment from previously treated tuberculosis (CLIPTB), on exercise capacity (six-minute walk distance), pulmonary function tests, quality of life and markers of systemic inflammation...
November 30, 2018: Curēus
Chloé Maignien, Pietro Santulli, Sandrine Chouzenoux, Iñaki Gonzalez-Foruria, Louis Marcellin, Ludivine Doridot, Mohammed Jeljeli, Philippe Grange, Fernando M Reis, Charles Chapron, Frédéric Batteux
STUDY QUESTION: Is endometriosis associated with aberrant sialylation patterns and what is the potential impact of such anomalies on cell migratory properties? SUMMARY ANSWER: The reduced α-2,6 sialylation patterns in the peritoneal fluid of endometriosis-affected women and in stromal and epithelial cells from endometriotic lesions could be associated with enhanced cell migration. WHAT IS KNOWN ALREADY: Endometriosis is considered to be a benign disease although, like cancer, it has the characteristic of being an invasive disease with cells that have an enhanced capacity to migrate...
February 12, 2019: Human Reproduction
Richard Griffith
Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the legal options available to a nurse who believes their patient should be moved from home to hospital for treatment when the person lacks decision-making capacity to consent to the move.
February 14, 2019: British Journal of Nursing: BJN
Ali Al-Zuhairy, Søren H Sindrup, Henning Andersen, Johannes Jakobsen
OBJECTIVE: To evaluate the long-term outcome in Danish patients treated for multifocal motor neuropathy (MMN). METHODS: A population-based, cross-sectional study of patients referred to the Danish hospital system between 1985 and 2006. RESULTS: Thirty-four MMN patients were identified, three had died of unrelated diseases, 10 were excluded, one did not reply to study request and 20 were included. The median disease duration was 24 years (IQR: 18...
February 12, 2019: Journal of the Peripheral Nervous System: JPNS
Kim M Nielsen, Ann-Dorthe Zwisler, Rod S Taylor, Jesper H Svendsen, Jane Lindschou, Lindsey Anderson, Janus C Jakobsen, Selina K Berg
BACKGROUND: An effective way of preventing sudden cardiac death is the use of an implantable cardioverter defibrillator (ICD). In spite of the potential mortality benefits of receiving an ICD device, psychological problems experienced by patients after receiving an ICD may negatively impact their health-related quality of life, and lead to increased readmission to hospital and healthcare needs, loss of productivity and employment earnings, and increased morbidity and mortality. Evidence from other heart conditions suggests that cardiac rehabilitation should consist of both exercise training and psychoeducational interventions; such rehabilitation may benefit patients with an ICD...
February 12, 2019: Cochrane Database of Systematic Reviews
Erin Pfeiffer, Medge Owen, Christie Pettitt-Schieber, Romeck Van Zeijl, Emmanuel Srofenyoh, Adeyemi Olufolabi, Rohit Ramaswamy
BACKGROUND: Frontline healthcare workers are critical to meeting the maternal, newborn and child health Sustainable Development Goals in low- and middle-income countries. The World Health Organization has identified leadership development as integral to achieving successful health outcomes, but few programs exist for frontline healthcare workers in low-resource settings. METHODS: An 18-month pilot leadership development program was designed and implemented at Greater Accra Regional Hospital, a tertiary care facility in Ghana...
February 11, 2019: BMC Medical Education
Marike Lijkendijk, Peter B Licht, Kirsten Neckelmann
BACKGROUND: Management of chest drains following thoracic surgery remains an area with little consensus. To optimize our chest drainage algorithms with electronic chest drainage systems we conducted a randomized controlled trial comparing low variable suction (-5 cm H2 O) versus high variable suction (-20 cm H2 O). METHODS: We did a prospective open label randomized trial in patients undergoing lobectomy. Sample size was calculated from a clinical relevant difference in chest drain duration as one full day...
February 8, 2019: Annals of Thoracic Surgery
Sang Guen Cho, Youngsoo Kim, Youngeun Choi, Wankyo Chung
OBJECTIVES: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. METHODS: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source...
January 2019: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
Leontien C C Toussaint-Duyster, Monique H M van der Cammen-van Zijp, Johan C de Jongste, Dick Tibboel, Rene M H Wijnen, Saskia J Gischler, Joost van Rosmalen, Hanneke IJsselstijn
OBJECTIVE: Children with congenital diaphragmatic hernia (CDH) suffer from long-term pulmonary morbidity. Longitudinal data of exercise capacity in these children are lacking. We hypothesized that exercise capacity would be impaired in children with CDH and deteriorates over time. We evaluated exercise capacity and its determinants in CDH patients longitudinally until 12 years of age. DESIGN: Prospective longitudinal follow-up study in tertiary university hospital...
February 11, 2019: Pediatric Pulmonology
Carolyn J Peddle-McIntyre, Favil Singh, Rajesh Thomas, Robert U Newton, Daniel A Galvão, Vinicius Cavalheri
BACKGROUND: Patients with advanced lung cancer have a high symptom burden, which is often complicated by coexisting conditions. These issues, combined with the indirect effects of cancer treatment, can cumulatively lead patients to continued deconditioning and low exercise capacity. This is a concern as exercise capacity is considered a measure of whole body health, and is critical in a patient's ability to participate in life activities and tolerate difficult treatments. There is evidence that exercise training improves exercise capacity and other outcomes, such as muscle force and health-related quality of life (HRQoL), in cancer survivors...
February 11, 2019: Cochrane Database of Systematic Reviews
Darren Hudson, Gurmeet Singh
Hospital capacity strain is ubiquitous, and a significant stressor in critical care. Avoidable days (AD) are frequently used as a metric of capacity. Using a Markov chain model, we studied the relationship between AD and surgical cancellations in a cardiovascular ICU. The model varied the probability of discharging a patient to study this effect over a pool of 108 simulated patients with length of stay data reflecting the actual population. The model behaved as expected with decreasing AD with increasing probability of patient discharge...
2019: Studies in Health Technology and Informatics
John N Morris, Katherine Berg, Elizabeth P Howard, Palmi V Jonsson, Meredith Craig
OBJECTIVE: To identify home care clients with substantial functional deficits who had capacity to improve and, thus, for whom recovery goals should be articulated. DESIGN: Retrospective longitudinal analysis of an international home care database. SETTING AND PARTICIPANTS: 523,907 persons receiving home care, having 2 assessments, on average, 8 months apart. MEASURES: Recovery algorithm variables included counts of dependencies of activities of daily living (ADL) and instrumental ADL (IADL) tasks, hospitalization in the last 30 days, functional decline in the last 90 days, and self-belief in one's capacity to improve...
February 6, 2019: Journal of the American Medical Directors Association
Maria J Robinson, Jodi Taylor, Stephen J Brett, Jerry P Nolan, Matthew Thomas, Barnaby C Reeves, Chris A Rogers, Sarah Voss, Madeleine Clout, Jonathan R Benger
BACKGROUND: The research study titled "Cluster randomised trial of the clinical and cost effectiveness of the i-gel supraglottic airway device versus tracheal intubation in the initial airway management of out-of-hospital cardiac arrest (AIRWAYS-2)" is a large-scale study being run in the English emergency medical (ambulance) services (EMS). It compares two airway management strategies (tracheal intubation and the i-gel) in out-of-hospital cardiac arrest. We describe the methods used to minimise bias and the challenges associated with the set-up, enrolment, and follow-up that were addressed...
February 8, 2019: Trials
Katrina Lynn Piggott, Ameen Patel, Arthur Wong, Leslie Martin, Alexandra Patel, Matthew Patel, Yudong Liu, Sukhbinder Dhesy-Thind, John J You
BACKGROUND: Cancer is the leading cause of death in the developed world, and yet healthcare practitioners infrequently discuss goals of care (GoC) with hospitalized cancer patients. We sought to identify barriers to GoC discussions from the perspectives of staff oncologists, oncology residents, and oncology nurses. METHODS: This was a single center survey of staff oncologists, oncology residents, and inpatient oncology nurses. Barriers to GoC discussions were assessed on a 7-point Likert scale (1 = extremely unimportant; 7 = extremely important)...
February 8, 2019: BMC Cancer
Xueyuan Wu, Chi-Kin Law, Paul Siu Fai Yip
To assess the impact of ageing on hospitalisation in a rapidly ageing society. A study using retrospective and prospective data was conducted using hospitalisation data with age-specific admission rates in the period from 2001⁻2010 and demographic data from the period of 2001⁻2066 by the United Nations. The Hong Kong Special Administrative Region (SAR) with a 7 million population experiences extreme low fertility (1.1 children per woman) and long life expectancy (84 years old). Days of hospitalisation: For the period 2010⁻2066, the length of stay (LOS) in the age group 85+ is projected to increase by 555...
February 6, 2019: International Journal of Environmental Research and Public Health
G Taskiran, U Baykal
AIM: This descriptive correlational study aimed to identify nurses' perceptions of their own disaster preparedness and core competencies. BACKGROUND: As disasters have increased in number and severity in recent years, it is crucial that nurses should be appropriately prepared. There is still limited research on this issue in Turkey. INTRODUCTION: With changes in disaster policies in the last decade, the need to improve the disaster core competencies of nurses has also increased...
February 7, 2019: International Nursing Review
M Mella Laborde, M T Gea Velázquez, G M Ramos Forner, A F Compañ Rosique, M Morales Calderón, J M Aranaz Andrés
OBJECTIVE: Creation and validation of a new in-house synthetic scale to measure patient safety culture. MATERIAL AND METHOD: Cross-sectional and descriptive study in which the results of the assessment of the level of safety culture in health and non-health professionals of a university hospital are collected using a new in-house synthetic scale as a measurement tool. It is called 'Questionnaire on patient safety culture in a Spanish speaking environment'. The construction process was carried out in six phases: Bibliographic search; Validation of the structure and content of the questionnaire by a group of experts in patient safety using a nominal group technique; Assumptions verification and exploratory factor analysis; Pilot test to ensure its compression by a convenience sample of expert professionals; Modification of version 1...
February 4, 2019: Journal of healthcare quality research
Kelsey Berg, Patrick McLane, Nicole Eshkakogan, Jennifer Mantha, Tracy Lee, Chelsea Crowshoe, Ann Phillips
BACKGROUND: Emergency departments are primary health care entry points for Indigenous persons in Canada. They are also among the settings where Indigenous patients report access barriers and discriminatory treatment. Cultural competency and cultural safety have been proposed as approaches to improving emergency care. AIM: To identify and elaborate upon barriers and facilitators of cultural competency and safety in Canadian Emergency Departments. METHODS: We conducted a scoping review to search published and grey literature to identify and extract data on definitions, measures, facilitators and barriers of cultural competency and safety...
February 4, 2019: International Emergency Nursing
Caroline J Coats, Menelaos Pavlou, Oliver T Watkinson, Alexandros Protonotarios, Linda Moss, Rebecca Hyland, Khadija Rantell, Antonis A Pantazis, Maite Tome, William J McKenna, Michael P Frenneaux, Rumana Omar, Perry M Elliott
Importance: Hypertrophic cardiomyopathy causes limiting symptoms in patients, mediated partly through inefficient myocardial energy use. There is conflicting evidence for therapy with inhibitors of myocardial fatty acid metabolism in patients with nonobstructive hypertrophic cardiomyopathy. Objective: To determine the effect of oral therapy with trimetazidine, a direct inhibitor of fatty acid β-oxidation, on exercise capacity in patients with symptomatic nonobstructive hypertrophic cardiomyopathy...
February 6, 2019: JAMA Cardiology
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