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Frequent attenders

Matthew W McCarthy, Diego Real de Asua, Ezra Gabbay, Paul J Christos, Joseph J Fins
Little is known about the daily ethical conflicts encountered by hospitalists that do not prompt a formal clinical ethics consultation. We describe the frequencies of ethical issues identified during daily rounds on hospitalist teaching services at a metropolitan, tertiary-care, teaching hospital. Data were collected from September 2017 through May 2018 by two attending hospitalists from the ethics committee who were embedded on rounds. A total of 270 patients were evaluated and 113 ethical issues were identified in 77 of those patients...
March 20, 2019: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Edward A S Duncan, Catherine Best, Nadine Dougall, Silje Skar, Josie Evans, Alasdair R Corfield, David Fitzpatrick, Isabella Goldie, Margaret Maxwell, Helen Snooks, Cameron Stark, Chris White, Wojtek Wojcik
BACKGROUND: People experiencing a mental health crisis receive variable and poorer quality care than those experiencing a physical health crisis. Little is known about the epidemiology, subsequent care pathways of mental health and self-harm emergencies attended by ambulance services, and subsequent all-cause mortality, including deaths by suicide. This is the first national epidemiological analysis of the processes and outcomes of people attended by an ambulance due to a mental health or self-harm emergency...
March 20, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Melissa R Marselle, Sara L Warber, Katherine N Irvine
Nature-based activities have been used as therapeutic interventions for those experiencing stress and mental ill health. This study investigates whether group walks could be a nature-based intervention to foster resilience, by buffering the effects of recent stressful life events on mental health. An observational research design with propensity score-matched samples compared the mental health of individuals who did (Nature Group Walkers, n = 1081) or did not (Non-Group Walkers, n = 435) attend nature group walks...
March 19, 2019: International Journal of Environmental Research and Public Health
A Thi Win Shwe, Arthorn Riewpaiboon, Usa Chaikledkaew, Sitaporn Youngkong
Maternal health still remains a major challenge in almost all developing countries. In Myanmar, the country met only 62% of its target for the maternal mortality rate (130 per 100,000 live birth) even though proportion of skilled birth attendant (SBA) and antenatal care (ANC) coverage was 80% in 2015. Despite the estimated large maternal complications, most maternal healthcare program ignored the burden of those morbidity because of limited understanding of the incidence and prevalence of morbidity conditions and cost of those morbidity burdens on society...
2019: PloS One
Fayron Epps, Glenna Brewster, Karah Alexander, Jenny Choe, Virginia Heidbreder, Kenneth Hepburn
African American caregivers for persons living with dementia frequently experience emotional strain, burden, social isolation, and depression. One source of support for them when in distress is their church community. However, many African American churches do not have programs to support families and congregants living with dementia. Dementia often restricts persons living with dementia and their caregivers from attending church. Both become increasingly uncomfortable in church settings due to fear of embarrassment, uncertainty about the behavior of the person living with dementia, and shame...
March 20, 2019: Research in Nursing & Health
Daniel Luiz M Goncalves, Raissa L Romero, Paula L Ferreira, Cláudia G Santi
BACKGROUND: Vulvar complaints are among the most frequent causes for a woman to visit a healthcare provider. The diseases of this area of the body may be a challenge to diagnose. In this study, we assess epidemiologic and clinical data of patients in an outpatient vulvar clinic in the dermatology department of a tertiary hospital. METHODS: We performed an observational retrospective study of patients who attended our consultation service for vulvar diseases at the Dermatology Division at Hospital das Clínicas da Faculdade de Medicina da USP during a 4-year period...
March 20, 2019: International Journal of Dermatology
Kristin K Clemens, Vinusha Kalatharan, Bridget L Ryan, Sonja Reichert
Background: Patients with diabetes and chronic kidney disease (CKD) are at high risk of diabetes-related complications. Diabetes care can support these individuals, but outpatient clinic appointments can be difficult to attend, given their already high burden of multimorbidity. Methods: We systematically searched the medical and grey literature for studies that evaluated the effect of nonconventional diabetes care strategies on diabetes-related outcomes in adults with stages 2-5 CKD or using dialysis (end of search December 30, 2017)...
January 2019: Journal of comorbidity
Laura Papetti, Irene Salfa, Barbara Battan, Romina Moavero, Cristiano Termine, Beatrice Bartoli, Francesca Di Nunzio, Samuela Tarantino, Pierfrancesco Alaimo Di Loro, Federico Vigevano, Massimiliano Valeriani
Introduction: Chronic headaches are not a rare condition in children and adolescents with negative effects on their quality of life. Our aims were to investigate the clinical features of chronic headache and usefulness of the International Classification of Headache Disorders 3rd edition (ICHD 3) criteria for the diagnosis in a cohort of pediatric patients. Methods: We retrospectively reviewed the charts of patients attending the Headache Center of Bambino Gesù Children and Insubria University Hospital during the 2010-2016 time interval...
2019: Frontiers in Neurology
Frédéric Chagué, Marjolaine Georges, Aurélie Gudjoncik, Thierry Hermerel, Gilles Garet, Jean Israël, Jean-Philippe Hager, Patrick Aviat, Yves Laurent, Vincent Gremeaux, Yves Cottin, Marianne Zeller
BACKGROUND AND AIM: We aimed to investigate cardiovascular risk factors and health behaviours prospectively in a large population of French amateur rugby players. METHODS: An anonymous questionnaire was displayed to rugby players aged over 12 years enrolled in the 2014-2015 French amateur rugby championship from the Burgundy region ( n = 5140). Questions addressed awareness on: (a) cardiovascular prevention; (b) tobacco, alcohol and highly caffeinated beverages consumption; and (c) adherence to prevention guidelines (ECG checks, training in basic life support, avoidance of sports practice during fever/infectious episodes)...
March 19, 2019: European Journal of Preventive Cardiology
Mei Li M Kwong, Jeffrey Pelton
Hepatic artery variations occur in about one-fourth of the population, are frequent questions on standardized surgery exams, and are often discussed on teaching rounds with an attending surgeon. Intraoperatively, it is important to be aware of possible vascular anomalies in order to prevent ligation or injury of an essential vessel. This case report describes an extremely rare vascular anomaly encountered during a pancreaticoduodenectomy (Whipple operation). Our patient was a middle-aged woman who was incidentally diagnosed with a cystic pancreatic lesion...
2019: Case Reports in Surgery
Boressa Adugna Horsa, Yewondwossen Tadesse, Ephrem Engidawork
OBJECTIVE: This study was conducted to assess hypertension control and factors associated with it among hypertensive patients on treatment at Zewditu Memorial Hospital. RESULTS: A total of 225 patients were included in the study, of which 55.6% of patients were females. The mean age of the patients was 55.2 years and half of them had a family history of hypertension. About 29% of patients had comorbidities. Angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs) and beta-blockers (BBs) were the most frequently prescribed medications...
March 18, 2019: BMC Research Notes
Silje Haukenes Stavestrand, Kristine Sirevåg, Inger Hilde Nordhus, Trond Sjøbø, Trygve Bruun Endal, Hans M Nordahl, Karsten Specht, Åsa Hammar, Anne Halmøy, Egil W Martinsen, Eva Andersson, Helene Hjelmervik, Jan Mohlman, Julian F Thayer, Anders Hovland
BACKGROUND: Generalised anxiety disorder (GAD) is a frequent and severe anxiety disorder among older adults. GAD increases the risk of developing other disorders such as depression and coronary heart disease. Older adults with GAD exhibit a poorer response to cognitive behaviour therapy (CBT) compared to younger patients with GAD. The normal age-related cognitive decline can be a contributor to reduced treatment efficacy. One strategy for improving treatment efficacy is to combine CBT with adjunctive interventions targeted at improving cognitive functions...
March 18, 2019: Trials
Vera Nieswand, Matthias Richter, Reinhard Berner, Maja von der Hagen, Anna Klimova, Ingo Roeder, Thea Koch, Rainer Sabatowski, Gudrun Gossrau
BACKGROUND/OBJECTIVE: Headache in pupils is underestimated and has a negative impact on learning and life. The aim of this study was to investigate headache prevalence and its collateral effects, in pupils of different ages and school types in a German city. METHODS: Anonymized questionnaires were distributed to 5419 pupils attending primary and secondary schools. Demographics, headache frequency, analgesic use, school absence and, for secondary school children, data on lifestyle were collected...
March 18, 2019: Cephalalgia: An International Journal of Headache
Sindi Diko, Maryam Guiahi, Amy Nacht, Kathleen A Connell, Shane Reeves, Beth A Bailey, K Joseph Hurt
INTRODUCTION AND HYPOTHESIS: There are no data on midwives' knowledge and management of obstetric anal sphincter injuries (OASIs) in the USA. We performed a cross-sectional national survey characterizing OASI practice by certified nurse midwives (CNMs), hypothesizing that few midwives personally repair OASIs and that there are gaps in CNM OASI training/education. METHODS: We emailed a REDCap internet-based survey to 6909 American College of Nurse Midwives members (ACNM)...
March 15, 2019: International Urogynecology Journal
Alice Pallier, Anna Karimova, Adrien Boillot, Pierre Colon, Damien Ringuenet, Philippe Bouchard, Hélène Rangé
OBJECTIVES: This study evaluates dental and periodontal health in anorexia nervosa and bulimia nervosa patients. METHODS: Seventy females with eating disorders (36 anorexia nervosa) attending a public hospital Psychiatry and Addiction unit were compared with age-matched controls (n = 70). Full-mouth examination and oral hygiene behaviours were recorded for all participants. RESULTS: More frequent dental attendance and toothbrushing were observed in patients with eating disorders than in controls (p < 0...
March 12, 2019: Journal of Dentistry
Laura Farrell, Gisele Bourgeois-Law, Sarah Buydens, Glenn Regher
Phenomenon: Despite a long-standing recognition of the importance of learning goals in feedback, there has been relatively little research on how to address mismatches between learner goals and preceptor goals in medical education. Our study addresses this gap by reporting on challenges and strategies around goal coconstruction as identified by clinical educators who were learning and attempting to implement a goal-oriented feedback approach in their own teaching contexts. Approach: We employed a qualitative, design-based research methodology to study how 5 clinician educators incorporated goal-oriented feedback into their teaching practice...
March 15, 2019: Teaching and Learning in Medicine
Matthew G Hiller, Michael S Caffery, Rodolfo E Bégué
A 21-question survey was conducted among parents attending 4 pediatric outpatient practices to assess their knowledge, perceptions, and attitudes about fever. One hundred and ninety-seven surveys were included. Most commonly the participating parent was the mother. Parents used mainly axillary thermometers to measure child's temperature and mentioned integers for their definition of fever, 100°F being the most frequent answer. Most parents would treat all fevers and would use alternating antipyretics. Parents had a generally negative perception of fever: only one third thought fever may have some benefit, and more than half thought there must be some risk...
March 15, 2019: Clinical Pediatrics
Julie A Adsett, Norman R Morris, Alison M Mudge
PURPOSE: For individuals with heart failure (HF), frequent attendance at exercise training programs and meeting physical activity (PA) guidelines are significantly associated with improvements in 6-min walk distance. Despite the evidence, adherence to exercise interventions remains poor. The aim of this study was to identify predictors of these 2 variables in patients recently hospitalized with HF. METHODS: In this substudy of the Exercise Joins Education: Combined Therapy to Improve Outcomes in Newly-discharged Heart Failure (EJECTION-HF) trial, all participants were enrolled in a HF disease management program, including weekly review of a home exercise program for 12 wk...
March 11, 2019: Journal of Cardiopulmonary Rehabilitation and Prevention
Brian A Anderson, Mark K Britton
Attention is biased toward stimuli that have been associated with aversive outcomes in the past. This bias has previously been interpreted as reflecting automatic orienting toward threat signals. However, in many prior studies, either the threatening stimulus provided valuable predictive information, signaling the possibility of an otherwise unavoidable punishment and thereby allowing participants to brace themselves, or the aversive event could be avoided with fast and accurate task performance. Under these conditions, monitoring for threat could be viewed as an adaptive strategy...
March 14, 2019: Emotion
Pedro Clarós, Iwona Porebska, Astrid Clarós-Pujol, Carmen Pujol, Andrés Clarós, Francisco López-Muñoz, Konrad Kaczmarek
Importance: Pediatric vocal fold pathology is important because having a healthy voice free from disorders is crucial in a child's emotional and educational development. Objective: To determine whether there is an association between singing in a children's choir and the development of voice disorders. Design, Setting, and Participants: Prospective cohort study of children (aged 8 to 14 years) singers selected from local children's choirs and nonsingers selected from local schools evaluated at Clarós Otorhinolaryngology Clinic in Barcelona, Spain, from October 2016 through April 2018...
March 14, 2019: JAMA Otolaryngology—Head & Neck Surgery
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