MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'acute'. Sat, 03 Sep 2011 01:55:23 +0100 http://www.medworm.com/index.php?rid=5130666&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Ftransforming-community-services-transformational-guides%2F Scan or click to download 'Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services' Title: Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services The Skinny: Guide for use by frontline clinicians, commissioners and providers a based around a framework of ambition, action and achievement: Clearly setting out your ambition Taking action to deliver the ambition using the best available evidence (high impact changes) Demonstrating and measuring achievement (using quality indicators) The guidance also includes six transformational attributes which practitioners and teams need to demonstrate in order to meet the requirements of the high performing practitioner-partner-leader roles. Publisher: DH ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130666 Mon, 15 Aug 2011 08:09:01 +0100 5130666 http://www.medworm.com/index.php?rid=5107523&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-best-thing-a-patient-can-do-following-a-heart-attack%2F2011.08.07 I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good.  And the Italians are out to prove me right.  The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome. In a study of just under 1,300 patients,  Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients.   Researchers also found that resuming smoking increased  death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications.  And I’m sure these ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5107523 Sun, 07 Aug 2011 16:00:00 +0100 5107523 http://www.medworm.com/index.php?rid=5096201&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwilderness-medical-society-publishes-prevention-and-treatment-tips-for-altitude-sickness%2F2011.08.05 Led by Andrew Luks MD and his colleagues, the Wilderness Medical Society has published Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness (Wild Environ Med 2010:21;146-155). These guidelines are intended to provide clinicians about best evidence-based practices, and were derived from the deliberations of an expert panel, of which I was a member. The disorders considered were acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). The guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disorder management. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate the recommend... Better Health blogs http://www.medworm.com/rss/comments.php?id=5096201 Fri, 05 Aug 2011 14:00:00 +0100 5096201 http://www.medworm.com/index.php?rid=5096218&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FUSTuFGYGhvM%2F LITFL puts you to the test, with 10 of the best Questions and Answer from this months EM Critical Care Article on Noninvasive Ventilation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5096218 Tue, 02 Aug 2011 01:52:36 +0100 5096218 http://www.medworm.com/index.php?rid=5086181&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F6lpnY5uHtW0%2F LITFL puts you to the test, with 10 of the best Questions and Answer from this months EM Critical Care Article on Noninvasive Ventilation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5086181 Tue, 02 Aug 2011 01:52:36 +0100 5086181 http://www.medworm.com/index.php?rid=5050581&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fone-of-the-most-common-infections-of-childhood-otitis-media%2F2011.07.20 Ear infections are the bane of childhood and can spoil many outdoor adventures. One of the most common infections of childhood, they provoke long nights of miserable children, sleepless parents, and unhappiness all around. They may be recurrent, and can also progress (rarely) to more serious medical problems, such as meningitis. What Are Ear Infections? Acute otitis (inflammation of the ear) media (“middle”) infection is caused by bacteria or viruses. When it occurs, there is redness and inflammation of the eardrum, frequently with a collection of  blood, serum, or pus behind the drum. To know whether or not this has occurred, and to precisely determine the anatomic diagnosis and severity, one needs to see the eardrum, which is what the healthcare provider does with an otoscope. With ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050581 Wed, 20 Jul 2011 21:00:00 +0100 5050581 http://www.medworm.com/index.php?rid=5008671&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2Fi2yELjH7SyI%2F This is a repost from my blog on PsychCentral: There are changes afoot in the use of opioid agonists for chronic pain treatment. This blog has described the epidemic of opioid dependence that has killed tens of thousands of people across the country over the past few years, and the changes are directed toward reducing the harm caused by this epidemic. A number of interventions have been proposed. Vicodin, the number one-selling medication in the country, contains the opioid hydrocodone combined with acetaminophen, the agent in Tylenol. Hydrocodone and Vicodin are currently ‘Schedule III’ medications, and will likely move to Schedule II, where oxycodone, Oxycontin, and Percocet are currently assigned. The change will have significant impact on the use of Vicodin and hydrocodone, since m... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=5008671 Wed, 06 Jul 2011 01:05:01 +0100 5008671 http://www.medworm.com/index.php?rid=4952846&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-new-world-view-of-coronary-artery-disease%2F2011.06.20 In 2007, when the results were published from the COURAGE trial, all the experts agreed that this study would fundamentally change the way cardiologists managed patients with stable coronary artery disease (CAD).* ____ *”Stable” CAD simply means that a patient with CAD is not suffering from one of the acute coronary syndromes – ACS, an acute heart attack or unstable angina. At any given time, the large majority of patients with CAD are in a stable condition. ____ But a new study tells us that hasn’t happened. The COURAGE trial has barely budged the way cardiologists treat patients with stable CAD. Lots of people want to know why. As usual, DrRich is here to help. The COURAGE trial compared the use of stents vs. drug therapy in patients with stable CAD. Over twenty-two hundred patie... Better Health blogs http://www.medworm.com/rss/comments.php?id=4952846 Mon, 20 Jun 2011 18:00:25 +0100 4952846 http://www.medworm.com/index.php?rid=4952740&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F06%2F17%2Fnursing-times-2011-vol-107-no-22%2F This article describes the findings from a national survey to establish the prevalence of malnutrition in the UK. Data was collected from care homes, hospitals and mental health units. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Acute Hospitals, Care Homes, Hospitals, Malnutrition, Mental Health Units, Nutrition, Nutritional Screening Tools (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4952740 Fri, 17 Jun 2011 15:19:02 +0100 4952740 http://www.medworm.com/index.php?rid=4893927&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F8pitPCKr9a4%2F Ah yes…. another post about my book… Over the past few years, I’ve taken posts from this blog, posts from other sources that I’ve written, some sections of a ‘memoir’ that I have not gotten around to writing… and combined them in a book about addiction. The book does not hold together as well as it should, and it is way too long– so instead of a ‘sit and read’ book it is more like a reference, similar to the blog itself. If you like this blog, you’ll like it; I’ve taken the more important posts and cleaned them up and organized them. I’ve added some new material as well, including a section about my own background. If you have a loved one on Suboxone, or have an interest in the medication yourself, you will know... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=4893927 Fri, 03 Jun 2011 14:07:39 +0100 4893927 http://www.medworm.com/index.php?rid=4872503&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F05%2Frandom-thoughts-of-insomniac-ot.html Can't sleep and it's before six a.m. on a day I have off. Awesome. But here are some of my thoughts on things that have been happening recently.First off, and rather obviously to anyone who has been with me in person, I am under a lot of stress lately. For an OT, I certainly exhibit a lot of poor patterns in dealing with stress when it gets to a high level. I retreat into comfortable things, procrastinate on other tasks (hello blog), and have a thousand questions running through my head all the time. I'm also increasingly more distracted, which feeds back into the procrastination. I've been waking up around 5 for the past several weeks, but for the most part I just stay in bed in a semi-dozing anxiety spree until the alarm actually goes off. Very stressed. Likely to get worse before it get... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4872503 Fri, 27 May 2011 09:49:00 +0100 4872503 http://www.medworm.com/index.php?rid=4642677&cid=t_114792_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F03%2F26%2Fwhen-should-i-come-off-my-antidepressant-6-things-to-consider%2F The question of whether or not you should start taking antidepressants is complex and difficult to answer. But even fuzzier is the question of when or if you should stop. Last May, NPR ran a piece called Coming Off Antidepressants Can Be Tricky Business. Joanne Silberner writes: Several top psychiatrists say there’s just not enough data to say for sure when to try coming off an antidepressant. Drug companies generally test their new products for a few months or up to a year. They don’t spend much time looking into how to taper off their products. The dense informational inserts that come with prescription drugs have a lot of information on how to take the product, but no information on how to stop. According to the Johns Hopkins Depression and Anxiety White Papers, antidepress... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4642677 Sat, 26 Mar 2011 12:58:36 +0100 4642677 http://www.medworm.com/index.php?rid=4626835&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FL1d65XzpRt4%2F Musings on the point of equipoise for investigating and discharging chest pain patients in light of a new paper in the Lancet describing a rapid rule-out protocol for acute coronary syndromes (the ASPECT trial). (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4626835 Wed, 23 Mar 2011 08:55:13 +0100 4626835 http://www.medworm.com/index.php?rid=4622509&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2FJUCM1S6JwUs%2F I recently resumed writing for the expert forum on addiction at MedHelp.Org. One result of writing for MedHelp is that I receive a number of e-mails from people with questions about specific issues related to buprenorphine. The most common questions are from people on buprenorphine undergoing surgery, asking about the safety of anesthesia and about postoperative pain control. There are very significant problems with medical coverage for patients on buprenorphine undergoing surgery. Patients on buprenorphine will occasionally need surgery, and in such cases there are often no doctors willing and/or competent to manage postoperative pain. Psychiatrists, frankly, have little knowledge or experience in this area. Before psychiatry residency, medical school graduates generally complete a medica... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=4622509 Wed, 23 Mar 2011 01:35:08 +0100 4622509 http://www.medworm.com/index.php?rid=4549947&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F03%2Fwho-gets-to-go-home-3-short-case.html One of my biggest responsibilities from a hospital standpoint is providing discharge recommendations. Hospital stays are notoriously short and it is a priority of the case management staff and doctors to determine discharge location, for which they recruit OTs and PTs to assist. But determining discharge readiness and placement is more of an art than a science, no flow chart can be easily developed to guide a novice through the process. So here are 3 case examples of similar patients and situations, whom I saw on the same day, and my rationale for their discharge locations. All three of the individuals were over 80 years old, with moderate dementia. They were all admitted with altered mental status caused by pneumonia and concurrent urinary tract infections. They were all living with famil... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4549947 Fri, 04 Mar 2011 23:58:00 +0100 4549947 http://www.medworm.com/index.php?rid=4525032&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnot-enough-psychiatric-beds%2F2011.02.26 I read today that Eastern Ontario has started a bed registry to keep track of where open psychiatric beds are available. This is something I’ve long advocated. The United States now has less than 10 percent of the beds it used to have 50 years ago. Granted, treatment has improved and community resources are enhanced. But there are still areas that often do not have a sufficient number of hospital beds for folks needing acute inpatient psychiatric care. The Ontario story described in the Ottawa Citizen states that six of the area hospitals have been connected to a computerized “bed board” that provides real-time information on who has an appropriate bed available. This saves time in the ER and gets patients to needed treatment more quickly. Otherwise calls need to be made... Better Health blogs http://www.medworm.com/rss/comments.php?id=4525032 Sat, 26 Feb 2011 19:00:00 +0100 4525032 http://www.medworm.com/index.php?rid=4507282&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fkids-upper-respiratory-viruses-and-ear-infections%2F2011.02.22 According to a new study published this month, more than 20 percent of young children with colds or other upper respiratory viruses will develop middle ear infections. This finding isn’t that surprising. Eear symptoms along with a viral upper respiratory infection (URI) are common, including ear fullness and difficulty popping the ear. Although adults tend to be able to keep their ears clear by swallowing, chewing gum, yawning, or ear popping, most kids don’t know what to do when their ears feel full. Whether in adults or kids, when the ears don’t ventilate or clear properly it can lead to ear problems including fluid buildup and middel ear infection. Why does this occur? With a viral URI the lining of the nose swells, leading to symptoms of runny nose, nasal congest... Better Health blogs http://www.medworm.com/rss/comments.php?id=4507282 Tue, 22 Feb 2011 16:00:00 +0100 4507282 http://www.medworm.com/index.php?rid=4459969&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F4kuUyHw9VaA%2F Review of Peter L Thompson's "Coronary Care Manual (2E)". (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4459969 Thu, 10 Feb 2011 23:20:09 +0100 4459969 http://www.medworm.com/index.php?rid=4450291&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fear-infections-to-treat-or-not-to-treat%2F2011.02.08 Ear infections used to be a devastating problem. In 1932, acute otitis media (AOM) and its suppurative complications accounted for 27 percent of all pediatric admissions to Bellevue Hospital. Since the introduction of antibiotics, it has become a much less serious problem. For decades it was taken for granted that all children with AOM should be given antibiotics, not only to treat the disease itself but to prevent complications like mastoiditis and meningitis. In the 1980s, that consensus began to change. We realized that as many as 80 percent of uncomplicated ear infections resolve without treatment in three days. Many infections are caused by viruses that don’t respond to antibiotics. Overuse of antibiotics leads to the emergence of resistant strains of bacteria. Antibiotics cause ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450291 Tue, 08 Feb 2011 22:00:44 +0100 4450291 http://www.medworm.com/index.php?rid=4411525&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdrug-safety-in-preventing-acute-mountain-sickness%2F2011.01.28 This is a guest post by Dr. Jeremy Windsor. ********** Steroids and Acute Mountain Sickness In recent years, many attempts have been made to identify safe and effective medications to prevent acute mountain sickness (AMS). Acetazolamide (Diamox), currently the “drug of choice” for this purpose, is not perfect and occasionally causes objectionable side effects. Dexamethasone (Decadron), a powerful steroid medication, has become increasingly popular for prevention and treatment in certain circles. While there is ample evidence to suggest that dexamethasone is effective, a recent case report highlights that this drug is not without risk. In the latest issue of the journal Wilderness & Environmental Medicine [WEM 21(4):345-348, 2010] in an article entitled ”Complicat... Better Health blogs http://www.medworm.com/rss/comments.php?id=4411525 Fri, 28 Jan 2011 22:00:00 +0100 4411525 http://www.medworm.com/index.php?rid=4372052&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F06q9U-Q4HJk%2F aka Trauma Tribulation 008 A 26 year-old male was BIBA after falling off his stationary motorbike at a set of traffic lights. C-spine precautions were removed following palpation of his neck and assessment of his sphincter tone. Initially, his only complaint was pain to his right thumb, presumably from a hyperextension injury. However a detailed [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4372052 Wed, 19 Jan 2011 00:00:30 +0100 4372052 http://www.medworm.com/index.php?rid=4360978&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprotect-your-heart-when-shoveling-snow%2F2011.01.18 After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.  What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360978 Tue, 18 Jan 2011 18:00:40 +0100 4360978 http://www.medworm.com/index.php?rid=4361322&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F01%2Fadventures-in-serial-casting-part-ii.html This article listed known indicators and contraindications to tx along with the level of evidence for each, however, a confounding variable to this information is that some factors that were exclusion criteria for some studies were inclusion criteria for others. Given the wide variability, comparison of RCTs was unable to be performed in this review. Timing is a decision that has wide variability in each study. Saracco Preissner states (but does not reference) that there is no indication how long after injury casting is effective or when a person is too far removed from injury to benefit. It is stated that "most" advocate casting sooner for increased effectiveness, but again this is unreferenced. Length of time wearing the cast was highly variable as well, with the most relevant results be... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4361322 Tue, 18 Jan 2011 02:41:00 +0100 4361322 http://www.medworm.com/index.php?rid=4322705&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F01%2Flooking-forward-to-2011.html Goodbye 2010. I don't have the energy for a LONG year in review, but...I will touch on a few ups and downs of the year.Firstly, let me thank all readers. I really appreciate the comments (that aren't plugging fake universities or spam in other languages) because I like to see that there has been an effect from my efforts. I don't look at the stats often, but glancing today, I see that since I started tracking in 2008, pageloads have increased by 20,000- more than 300%! WOW! And the cross-posts in the sister blog on OT Connections have brought in an extra 50-350 viewers each time, with one anomaly (thank you 1-minute update). It's really exciting to see how this blog has grown and spread, and gets me thinking about some plans for the future (more on that later). So a BIG THANK YOU to each o... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4322705 Sat, 08 Jan 2011 03:00:00 +0100 4322705 http://www.medworm.com/index.php?rid=4304837&cid=t_114792_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F01%2Facute-chronic-presentation-buddchiari-syndrome%2F Although the “classic” presentation of Budd-Chiari syndrome is an acute venous outflow obstruction of the hepatic veins or inferior vena cava resulting in fulminant liver failure and liver transplantation, the more common occurrence is a more chronic or subacute presentation with the formation of gradually increasing ascites and hepatic dysfunction. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4304837 Sun, 02 Jan 2011 20:46:11 +0100 4304837 http://www.medworm.com/index.php?rid=4285159&cid=t_114792_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F12%2Fpancreatic-pseudocyst%2F pancreatic pseudocyst is large dark egg-shaped mass in upper center (photo courtesy of Wayne State University) Pancreatic pseudocysts form in a percentage of patients with both acute and chronic pancreatitis and are a common cause of abdominal symptoms of pain and satiety, but can also be asymptomatic even when quite large. Related Posts Pathophysiology and Treatment of Pancreatic Pseudocysts (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4285159 Fri, 24 Dec 2010 02:29:11 +0100 4285159 http://www.medworm.com/index.php?rid=4281558&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F12%2Fits-christmas-miracle.html So at rounds today, I was rushing in late and trying to get my computer set up to look things up. They had already started on the first patient (not one of mine) and wanted to know if OT and PT agreed on discharge plans. I asked for a minute to get everything settled, and in that time, the resident looked up the notes and had the answers. I was shocked! I said, "wow, I didn't think you guys ever read our notes!" and got rousing responses from around the table (resident, PA, social work and case management) who stated that they DO read them (even if it's just the summary paragraph at the bottom). It was like a present with a big red bow. (Source: Occupational Therapy Notes) Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4281558 Thu, 23 Dec 2010 00:44:00 +0100 4281558 http://www.medworm.com/index.php?rid=4241727&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F712wumls17c%2F A 6 year-old boy presents with 5 days of vomiting. He is drowsy, lethargic and is now too weak to walk. What's going on? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4241727 Thu, 09 Dec 2010 00:00:17 +0100 4241727 http://www.medworm.com/index.php?rid=4179326&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgROxfIp6PKo%2F Evidence based review of acute severe asthma including clinical recognition and management (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4179326 Thu, 18 Nov 2010 02:00:08 +0100 4179326 http://www.medworm.com/index.php?rid=4172063&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FGAAAvssZU0o%2F Can you spot the subtle ECG abnormality that will help you nail the diagnosis in this patient with chest pain? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4172063 Tue, 16 Nov 2010 12:19:12 +0100 4172063 http://www.medworm.com/index.php?rid=4164529&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FsMX6_NHNJvo%2F Acute Liver Failure in the Emergency Department an EBM Review (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4164529 Sun, 14 Nov 2010 02:00:18 +0100 4164529 http://www.medworm.com/index.php?rid=4133719&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fr4rSIn5CGpo%2F Acute heart failure syndrome (AHFS) spectrum can be divided into 5 groups as regards therapeutic management (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4133719 Thu, 04 Nov 2010 02:00:32 +0100 4133719 http://www.medworm.com/index.php?rid=4118941&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FEFiJIM-kFZw%2F Stroke is the second commonest cause of death (10-12%), consumes >4% total healthcare costs, and is commonest cause of adult disability in western world. 80-85% are ischaemic (thrombotic or embolic) and 15-20% the more lethal haemorrhagic stroke (including 5% SAH), of which over 50% will die by 1 month. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4118941 Sat, 30 Oct 2010 02:00:00 +0100 4118941 http://www.medworm.com/index.php?rid=4118943&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FMzvfm9IcvgU%2F Prof Anthony F T Brown knuckles down and gets to grips with the evidence surrounding assessment and management in acute medicine for the annual FRACP lecture series. Prof Brown aims to contextualize the most pertinent evidence based information pertaining to acute medical emergencies in summative statements. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4118943 Fri, 29 Oct 2010 13:00:42 +0100 4118943 http://www.medworm.com/index.php?rid=4045095&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsex-and-your-defibrillator%2F2010.10.08 Have a defibrillator and feel like getting frisky? For the first time that I can recall, there’s a very helpful article published in Circulation addresses the concerns of implantable cardiac defibrillator (ICD) patients and sexual activity. There’s all kinds of helpful tidbits, like this one: A study of 1,774 patients who had experienced an acute myocardial infarction showed that sexual activity was a likely contributor in fewer than 1 percent of cases. In fact, regular physical exertion, such as that associated with sexual activity, was associated with a decreased risk of cardiac events in patients. Now that’s helpful! Recall that defibrillators are designed to detect rapid, potentially life-threatening arrhythmias. Most of the time, sexual activity does not lead to hea... Better Health blogs http://www.medworm.com/rss/comments.php?id=4045095 Fri, 08 Oct 2010 14:00:00 +0100 4045095 http://www.medworm.com/index.php?rid=4031178&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F10%2F04%2Fnursing-times-2010-vol-106-no-38%2F Fade fave: Liberating the NHS: what the white paper means to community nurses Fade skinny: Proposals to integrate comunity services with acute and mental health trusts could be beneficial if nurses take advantage of the potential opportunities. Contact the Library for a copy of this article Filed under: Current Awareness, Journals, Primary Care Tagged: Acute Services, Community Services, Mental Health, White Paper (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4031178 Mon, 04 Oct 2010 12:54:09 +0100 4031178 http://www.medworm.com/index.php?rid=4001826&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F09%2Fneuro-floor-humor.html Saw this was today's Crankshaft comic and couldn't help cracking a smile. If you come into a hospital with a headache, be prepared for neuro checks Q4!Working on the neuro floor means that I have to suppress my natural propensity to be a worrywart- I start thinking about word finding problems, clumsiness/tripping, and hope that I'm not ignoring signs of a tumor or aneurysm! It's hard to listen to all my patients' stories of symptom onset w/o getting a little paranoid.Just finished a biography of neurosurgeon Keith Black who has very compelling personal narrative and his life story is certainly an object lesson in encouraging the learning interests of your children. He described that his parents got him a dissection kit and chemistry set from a young age and encouraged curiosity in a number... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4001826 Sat, 25 Sep 2010 23:06:00 +0100 4001826 http://www.medworm.com/index.php?rid=3987102&cid=t_114792_109_f&fid=38950&url=http%3A%2F%2Fwww.shockmd.com%2F2010%2F09%2F21%2Fautumn-and-seasonal-affective-disorder-and-acute-coronary-syndrome%2F It’s this time of the year again, autumn. The time for great wines and game and truffle and ….. Also time for some of us to sit behind your lamps every morning for half an hour for two weeks on stretch against seasonal affective disorder. Depressive disorder is not the only disease influenced by seasonality. In a large retrospective study in Bejing the presentation of Acute Coronary Syndrome which usually presents in the late stages of coronary heart disease also has a significantly seasonal and monthly rhythm. The highest seasonal incidence occurred in winter and decreased as the season changed from winter to autumn, the monthly cases reached it’s high in March and it’s lowest in September as can be seen in the graphs above. Beijing is characterized by warm tempe... Dr Shock MD PhD blogs http://www.medworm.com/rss/comments.php?id=3987102 Tue, 21 Sep 2010 06:28:08 +0100 3987102 http://www.medworm.com/index.php?rid=3980792&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F09%2F17%2Fnursing-times-2010-vol-106-no-36%2F This article outlines the development of satellite roles in an infection control team which has resulted in the a reduced in healthcare associated infections, improved clinical practice and patient satisfaction. Contact the Library for a copy of this article Filed under: Current Awareness, Journals Tagged: Acute Services, Infection Control (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3980792 Fri, 17 Sep 2010 11:45:33 +0100 3980792 http://www.medworm.com/index.php?rid=3934618&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2FcmYI8zhgHaw%2F I haven’t gone anywhere in case you’re wondering… but I recently started writing a blog on Psych Central, called ‘an epidemic of addiction.’   Please add it to your reading list!  This is my favorite time of year and the time I am most likely going to be outdoors, so watch for posts to pick up a bit as things get colder outside. I’m probably in the wrong state of mind to be blogging, so consider this more along the line of venting.  I had an encounter with a local physician a couple days ago that left me shaing my head–  I have a solo practice so I have forgotten just how misguided medicine can sometimes be.  I was asked to speak with an orthopedist for a patient who takes buprenorphine, who was having major knee surgery.  The orthopod start... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=3934618 Sat, 04 Sep 2010 17:55:25 +0100 3934618 http://www.medworm.com/index.php?rid=3920782&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F08%2F31%2Fnursing-times-2010-vol-106-no-29%2F This article examines the assessment of acute pain in olde rpeople, as well as different approaches to and challenges in pain management. Contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Acute Pain Management, Older People, Pain, Pain Assessment (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3920782 Tue, 31 Aug 2010 09:57:06 +0100 3920782 http://www.medworm.com/index.php?rid=3907601&cid=t_114792_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-and-their-smartphones%2F2010.08.26 An eye-popping statistic shows that 94 percent of doctors have adopted smartphones, in part to keep up with an information glut. A consulting group released results of 100 in-depth interviews with physicians working in acute and ambulatory care environments in numerous specialties nationwide. The physicians used the phones to communicate, manage personal/business workflows, and access information, including medical reference materials. (In case you’re curious about what your peers are using, 44 percent use an iPhone and 25 percent use a BlackBerry.) This growth in adoption — a 60 percent increase since 2006 — isn’t surprising, since the same survey reported that doctors’ biggest challenges are communicating with colleagues in a timely manner, the volume of... Better Health blogs http://www.medworm.com/rss/comments.php?id=3907601 Thu, 26 Aug 2010 18:00:00 +0100 3907601 http://www.medworm.com/index.php?rid=3868933&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F08%2Ftips.html So this is just a very brief thought I had over dinner tonight. OT is by definition a service profession, we are paid to provide a service to others. Waitstaff who provide good service receive (in theory) increased compensation from their customers, and those who provide subpar service are not as well compensated. However, OT is basically "flat-rate" pay, with some increased compensation for experience, but no financial recognition of competence or above average performance. (at least in my experience- is anyone being compensated for specialty certification or other signs of advanced practice??) The only fiscally-related judgment of competence is whether you continue to be employed. We've had a lot of cuts at our hospital lately, particularly in the employee recognition department, and I t... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3868933 Mon, 16 Aug 2010 01:28:00 +0100 3868933 http://www.medworm.com/index.php?rid=3833587&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F08%2Fadventures-in-serial-casting-part-i.html Image from BBCI recently worked on serial casts for a patient with brain injury to improve PROM and tone of the ankle. Here is the case study which will be followed by an entry of some of my own research into the topic.Pt. is a ~60 y.o. female s/p multiple CVAs who was referred to OT for splinting assessment while in the neuro ICU. Pt. was connected to typical ICU monitors plus arterial line, was breathing comfortably on room air. She presents at a Rancho 3-4 level, depending on the day. Her L foot demonstrates increased tone, plantarflexion, and inversion. I was not able to passively stretch her ankle into neutral position and she demonstrated no AROM. I did not splint her per normal protocols (pre-fabricated multi-podus boot or individualized foot boot constructed from splinting material... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3833587 Sat, 07 Aug 2010 13:21:00 +0100 3833587 http://www.medworm.com/index.php?rid=3808858&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F08%2Fbye-bye-july.html So July should probably just be labeled the month that got out of control.I had an additional 5 days off on top of regular weekends, (I did work a holiday) and had lots of days switched from normal schedule. It makes for an interesting new rotation when life is all topsy-turvy. I'm not sure that my coworkers would say the same, but don't worry buds I'll be back with a vengeance in August.So I switched to neuro coming off my vacation, had some personal issues come up mid-month and then capped off by entertaining friends last week. In addition to trying to make some changes in my personal life and reading extra novels, that has made less time to update on here. (sidenote- I read The Eyre Affair by Jasper Fforde and am completely hooked on the Thursday Next novels) But there's been plenty of ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3808858 Mon, 02 Aug 2010 01:20:00 +0100 3808858 http://www.medworm.com/index.php?rid=3764205&cid=t_114792_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FVbM6zOBGUnM%2F           I remember as a child, a friend of mine had a disorder called idiopathic thrombocytopenic purpura.  It sounded so awful and I thought she was really sick.  However, she had the acute form that disappeared and she was fine.  The blood disorder, referred to most commonly as ITP, is characterized by an abnormal decrease in the number of platelets in the blood.  Platelets are cells in the blood that help stop bleeding.  So, an individual with the disorder can have easy bruising, bleeding gums and internal bleeding.  Idiopathic actually means the cause is unknown.  Thrombocytopenia simply means a decreased number of platelets in the blood and purpura is the purple discoloring of the skin, as with a bruise.  Normal platelet count is in the range of 150,000 to 450,000. ... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3764205 Sun, 18 Jul 2010 15:50:00 +0100 3764205 http://www.medworm.com/index.php?rid=3746675&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F12%2Fequity-and-excellence-liberating-the-nhs%2F Title: Equity and excellence: liberating the NHS Skinny: White paper that sets out the Government’s long-term vision for the future of the NHS. The vision builds on the core values and principles of the NHS – a comprehensive service, available to all, free at the point of use, based on need, not ability to pay. Publisher: DH Size of Publication: 61p. Published: 12/07/2010 Filed under: Grey Literature, Primary Care, Quality Tagged: Acute Services, Commissioning, Financial Management, Grey Literature, NHS, Organisational Design, Primary Care, Quality, Social Policy, White Papers (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3746675 Mon, 12 Jul 2010 16:03:39 +0100 3746675 http://www.medworm.com/index.php?rid=3714272&cid=t_114792_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FGXVkVfXULRU%2F           Disseminated intravascular coagulation (DIC) is a disorder characterized by massive systemic activation of coagulation with consumption of platelets and coagulation proteins.  Normally, when you are injured, certain proteins in the blood become activated and travel to the injury site to help stop bleeding.  However, in persons with DIC, these proteins become abnormally active.  The disorder presents in a very ill patient as bleeding into the skin (purpura) and other tissues.  It arises as a complication of different serious and life-threatening diseases.  It covers the continuum of events that occur in the coagulation pathway.  Initially there is uncontrolled activation of clotting factors in the blood vessels, causing clotting of blood throughout the whole body. �... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3714272 Wed, 30 Jun 2010 12:42:50 +0100 3714272 http://www.medworm.com/index.php?rid=3687359&cid=t_114792_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FQ8SscvbYqOI%2F The decision to withdraw Mylotarg, a drug used to treat acute myeloid leukemia, or AML, is more significant for the FDA than for Pfizer, which garnered about $100 million in worldwide sales from the medicine. That’s because the drug was approved in 2000 as part of the accelerated approval process. As the FDA explained when announcing the withdrawal: “This program allows the agency to approve a drug to treat serious diseases with an unmet medical need based on a surrogate endpoint – a laboratory measurement or a physical sign used as a substitute for a clinically meaningful endpoint that directly measures how a patient feels, functions, or survives.” The program was an outgrowth of criticism that the agency wasn’t moving fast enough to approve new drugs, especially... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3687359 Tue, 22 Jun 2010 12:03:13 +0100 3687359 http://www.medworm.com/index.php?rid=3671621&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F06%2F17%2Fjournal-of-the-american-medical-association-2010-vol-303-no-22%2F This article examines national trends in the United States of using long term acute care for patients recovering from severe acute illness aged 65 years or older. An NHS Athens password is required to access this article online, alternatively contact the Library for a copy of this article. Filed under: Current Awareness, Journals Tagged: Acute Hospitals, Critical Care, Long Term Care, United States (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3671621 Thu, 17 Jun 2010 15:47:06 +0100 3671621 http://www.medworm.com/index.php?rid=3644885&cid=t_114792_127_f&fid=38263&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdeepesthealth%2FBMCc%2F%7E3%2FBI9oTIC2MlQ%2F This week I’d like to introduce a vital concept from the world of Classical Chinese military strategy, namely that of timing and momentum.  In the Chinese military classic The Art of War, Sun Zi states: “When a falcon strike breaks the body of its prey, it is because of timing. When torrential water tosses boulders, it is because of momentum.” In everything we do, whether using acupuncture, herbs, tui na, or even speaking with a patient, following this concept is what allows us to accomplish great things on behalf of our patients, while not following it will lead to frustration and lack of results. Let’s break this into two subjects and cover them individually. Timing In the current culture of TCM, the evidence-based protocol is king. A hypothetical example: &#822... Deepest Health: Exploring Classical Chinese Medicine blogs http://www.medworm.com/rss/comments.php?id=3644885 Wed, 09 Jun 2010 15:55:57 +0100 3644885 http://www.medworm.com/index.php?rid=3621976&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F06%2Fyikes.html Holy cow... it's been almost a month since conference. Where has the time gone? I would say that I want to go back... but the time since the conference has been pretty rough as evidenced by the scarce/nonexistent updates. And at such a terrible time, after handing out those nice business cards haha. So, some brief updates. - I took no time off after the conference, and that was not smart. Next year, I take a day to recuperate and absorb info. I still need to print out handouts- both for sessions that I attended and others that looked interesting- and then compile my notes. - I went to some great sessions and met more "famous" OTs than ever before. I think that the quality of presentations was very high this year. - I hope to get a submission in so that I might present next year in Phila... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3621976 Wed, 02 Jun 2010 01:14:00 +0100 3621976 http://www.medworm.com/index.php?rid=3581558&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F20%2Fnhs-emergency-planning-guidance-planning-for-the-development-and-deployment-of-medical-emergency-response-incident-teams-in-the-provision-of-advanced-medical-care-at-the-scene-of-an-incident%2F Title: NHS emergency planning guidance: planning for the development and deployment of Medical Emergency Response Incident Teams in the provision of advanced medical care at the scene of an incident Skinny: Best practice guidance to National Health Service (NHS) organisations in developing and deploying Medical Emergency Response Incident Teams (MERITs). It builds on the guidance given in the underpinning section of the NHS Emergency Planning Guidance: immediate medical care at the scene. The purpose of a MERIT response is to provide advanced medical care on scene at a range of emergency incidents, up to and including major and mass casualty incidents. Publisher: DH Size of Publication: 12p. Published: 23/03/2010 Filed under: Acute Services, Ambulance Services, Emergency Planning, Grey Li... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3581558 Thu, 20 May 2010 03:52:41 +0100 3581558 http://www.medworm.com/index.php?rid=3552305&cid=t_114792_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F10%2Fwhen-violence-strikes-on-a-psychiatric-ward%2F Milwaukee County’s Mental Health Complex features a short-term inpatient psychiatric facility that seeks to help those with serious mental health issues — including survivors of trauma and sexual abuse — get better. Patients stay an average of 11.5 days while at the facility and more than 90 percent of them are discharged back to their own care or home. By far, most people who are admitted to the facility carry a diagnosis within the “psychoses” category of diagnoses — which usually means schizophrenia or a related disorder. Over one-third of their patients are under 19 years old — teens and children. About half the patients they treat are men, the other half women. More than half the people who seek out treatment at a facility like this will have ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3552305 Mon, 10 May 2010 19:36:00 +0100 3552305 http://www.medworm.com/index.php?rid=3542905&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F05%2Freflection-of-week.html A few reflections from the past week, which has been very hard.First off, I would just like to say that the AOTA conference was great, but I was very foolish to stay for the entire time and then head right back to work the next day. Because as fun as it is, it is also exhausting, and I didn't get any time to process the new information before heading right back into my crazy daily life. I was looking forward to today, my day off, to do some of that. However, I neglected to remember that we're traveling AGAIN this weekend. So that has added to the stress, and I won't really get a "me day" to process stuff until next Saturday. Very difficult on a personal level, and also because I would like to do some recaps about the cool sessions I attended and to give a glimpse of conference awesomeness ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3542905 Fri, 07 May 2010 14:52:00 +0100 3542905 http://www.medworm.com/index.php?rid=3533774&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F05%2Fthe-nhs-constitution-for-england-2010-edition%2F Title: The NHS Constitution for England, 2010 edition Skinny: Revised NHS Constitution detailing: patients’ rights and pledges responsibilities of patients and the public and staff staff rights and NHS pledges to its staff. It also provides the legal source for both the patient and staff rights in the NHS Constitution. Publisher: DH Size of Publication: 12p. Published: 08/03/2010 Filed under: Acute Services, Grey Literature, Hospitals, NHS, Primary Care, Quality, Waiting Times Tagged: Cancer, Commissioning, Consultations, Grey Literature, NHS, NHS Constitution, Non-Urgent Waiting, Quality, Referral, Responsibilities, Rights, Waiting Times (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3533774 Wed, 05 May 2010 07:13:42 +0100 3533774 http://www.medworm.com/index.php?rid=3533775&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F05%2Fthe-handbook-to-the-nhs-constitution%2F Title: The Handbook to the NHS Constitution Skinny: Revised handbook to give NHS staff and patients all the information they need about the NHS Constitution for England. It outlines the roles we all have to play in protecting and developing the NHS and will help you understand our rights, pledges, values and responsibilities. Publisher: DH Size of Publication: 148p. Published: 08/03/2010 Filed under: Acute Services, Hospitals, NHS, Primary Care, Quality, Waiting Times Tagged: Cancer, Commissioning, Consultations, Grey Literature, NHS, NHS Constitution, Non-Urgent Waiting, Quality, Referral, Responsibilities, Rights, Waiting Times (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3533775 Wed, 05 May 2010 07:09:47 +0100 3533775 http://www.medworm.com/index.php?rid=3533776&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F05%2Fchanges-to-the-nhs-constitution-government-response-to-the-consultation-on-new-patient-rights%2F Title: The NHS Constitution: Government response to consultation on new patient rights Skinny: Response from the government on the consultation on changes to the NHS Constitution that have led to the new rights to start non-urgent treatment within 18 weeks, and to see a specialist where cancer is suspected within 2 weeks of referral and for the NHS to take all reasonable steps to offer a range of alternative providers where this is not possible. Publisher: DH Size of Publication: 27p. Published: 08/03/2010 Filed under: Acute Services, Commissioning, Grey Literature, Hospitals, NHS, Primary Care, Quality, Waiting Times Tagged: Cancer, Commissioning, Consultations, Grey Literature, NHS, NHS Constitution, Non-Urgent Waiting, Referral, Responsibilities, Rights, Waiting Times (Source: Fade Libr... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3533776 Wed, 05 May 2010 07:05:23 +0100 3533776 http://www.medworm.com/index.php?rid=3533778&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F05%2Fnhs-appraisal-toolkit-website-restored-after-security-checks-satisfied%2F Title: Cancer Awareness and Early Diagnosis Programme funding Skinny: Dear Collegue letter announcing reinstatement of the NHS appraisal toolkit following security checks on Thursday 4 March 2010. Publisher: DH Size of Publication: 3p. Published: 05/03/2010 Filed under: Acute Services, Hospitals, NHS, Primary Care, Quality Tagged: Dear Colleague Letters, Information Technology, NHS, Quality, Security Management (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3533778 Wed, 05 May 2010 06:53:38 +0100 3533778 http://www.medworm.com/index.php?rid=3524467&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F05%2Falmost-over.html Our conference time is almost at an end...Saturday was a long day, but still had some highlights. I got some good videos and pictures, which will all be uploaded to the OT Connections Conference Gallery either at the airport or Monday after I get home. So if you're not already on OT Connections... get there! I have been talking especially to acute care practitioners at conference trying to get them involved w/ OTC because I feel that we are very isolated in our practice and need to connect so we can determine what is best practice and what is just "facility tradition." It's hard after conference to maintain the same energy and excitement, and I feel that using OTC can help keep that feeling alive longer in the face of everyday work.Time to go to my last workshop... these Sunday sessions ar... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3524467 Sun, 02 May 2010 11:12:00 +0100 3524467 http://www.medworm.com/index.php?rid=3486625&cid=t_114792_139_f&fid=38879&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FVirologyBlog%2F%7E3%2FeYY8hlOy30U%2F Download: .wmv (322 MB) | .mp4 (91 MB) Visit the virology W3310 home page for a complete list of course resources. (Source: virology blog) virology blog blogs http://www.medworm.com/rss/comments.php?id=3486625 Tue, 20 Apr 2010 14:20:43 +0100 3486625 http://www.medworm.com/index.php?rid=3456900&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F04%2Fwelcome-to-first-ever-otnotes-podcast.html Welcome to the First-Ever OTNotes podcast! Featuring Kelly Casey, Occupational Therapist from The Johns Hopkins Hospital in Baltimore, who is presenting multiple topics at the AOTA Conference. (Get it? That's why we're using the special "speakers-only" badge for this entry) The audio is 22 minutes, please forgive the technical quality and instead focus on the awesome discussion points offered. Here are some links to helpful information in case you're not taking notes: Kelly's Topics: Thu, Apr 29, 9:00 - 10:30 AM Short Course 105 Culture Change In Acute Care: An Interdisciplinary Approach to Creating Respect For Therapies Thu, Apr 29, 1:00 - 3:00 PM Poster 207 Movement Towards The Centennial Vision: Steps Of Post-professional And Entry Level OTDs Fri, Apr 30, 2:00 - 3:... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3456900 Fri, 09 Apr 2010 18:30:00 +0100 3456900 http://www.medworm.com/index.php?rid=3416389&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F03%2Fcrazy-life.html Been going through some crazy busy times lately.So, work kinda blew up recently (2 weeks ago? I don't know it's getting hard to keep up), going from a manageable, reasonable, daily activity to a "what the heck happened here" type experience. Earliest I left all week was 1 hour overtime. YIKES. Here's a little recap. Got my first Level 1 student, and I think we had a pretty good week. Tried to arrange for some interesting stuff everyday (hard to do when we started the week with 5/5 pts having severe dementia). Most amusing moment may have been the kitchen assessment with the man who required step by step instructions and multiple interventions for safety. He wanted to make oatmeal by pouring milk into the oats canister, then tried to fill the pot with water while the pot still had a lid on ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3416389 Sun, 28 Mar 2010 23:46:00 +0100 3416389 http://www.medworm.com/index.php?rid=3420567&cid=t_114792_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2Fs9HhSbVBGp0%2F           Leukemia is a rather complex form of cancer.  The term refers to cancers of the white blood cells, which are also called leukocytes or WBCs.  The disorder actually starts in the tissue that forms the blood.  To understand the cancer disease more thoroughly, it helps to know that normal blood cells develop from cells in the bone marrow called stem cells.  Bone marrow is the soft material located in the center of most bones.  Stem cells mature into different kinds of blood cells, and each one has a specific purpose.  White blood cells help fight infection in our bodies.  Red blood cells carry oxygen to tissues throughout the body.  Platelets help form blood clots that control bleeding.           Leukemia develops when the marrow produces far too many white... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3420567 Mon, 22 Mar 2010 10:30:57 +0100 3420567 http://www.medworm.com/index.php?rid=3366144&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F15%2Faccess-to-health-services-for-military-veterans-priority-treatment%2F Title: Access to health services for military veterans priority treatment Skinny: Dear Collegue letter advising of the guidance in place to ensure that military veterans receive priority access to NHS secondary care, for any conditions which are likely to be related to their service subject to the clinical needs of all patients. Publisher: DH Size of Publication: 2p. Published: 09/02/2010 Filed under: Acute Services, Grey Literature, Hospitals, NHS Tagged: Armed Forces, Dear Colleague Letters, Grey Literature, Priorities (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3366144 Mon, 15 Mar 2010 02:30:00 +0100 3366144 http://www.medworm.com/index.php?rid=3366145&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F15%2Fdelivering-same-sex-accommodation-self-declaration%2F Title: Delivering same-sex accommodation: self declaration Skinny: Dear Colleague letter introducing the declaration process for all providers of NHS funded care.  Monitor will be introducing similar reporting requirements for NHS Foundation Trusts. The accompanying information has been developed to help provider organisations to determine their position. Publisher: DH Size of Publication: 3p. Published: 08/02/2010 Filed under: Acute Services, Grey Literature, Hospitals, NHS Tagged: Dear Colleague Letters, Digity, Grey Literature, Hospitals, Organisational Design, Privacy (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3366145 Mon, 15 Mar 2010 02:00:48 +0100 3366145 http://www.medworm.com/index.php?rid=3354246&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F11%2Fquality-accounts-2-reviewing-nhs-foundation-trusts%25e2%2580%2599-2009-experiences-and-plans%2F This report re-visits the concept of the circle of quality improvement and identifies how this process has been applied. Key findings are: A wide range of priorities and performance indicators are being used nationally under Darzi headings of Safety, Effectiveness and Patient Experience. Stakeholder Engagement is in its infancy, first year priorities have been set by boards and clinicians, the second round of quality accounts will see the implementation of stakeholder engagement. A large range of processes is being emplyed to embed quality throughout organisations e.g. Quality Baords, Subcommittees, Quality Review Panels, Monthly Monitoring of the Accounts, Ward to Board Reporting, Workforce development and Reward Schemes. Mental Health Trusts lead the way in stakeholder engagement and de... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3354246 Thu, 11 Mar 2010 06:56:32 +0100 3354246 http://www.medworm.com/index.php?rid=3354601&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F03%2Fpre-ci-jitters.html I'm getting my first Level 1 student and trying to beat a case of the pre-CI jitters.I'm growing out of the "new practitioner" label. I'm on my second job, practiced in multiple settings (sometimes daily) and I'm pretty sure that I pay "big girl" OT prices for AOTA membership now. But of course there are still "firsts," and I am now, finally, getting my first real OT student. I've played hostess to several job-shadow candidates before, but those were usually just for a couple hours. Most of those also came from the local high school and had to rotate through multiple healthcare jobs and were not particularly interested in OT. I missed out on students at my last job because state law required that you have 1 year experience before being a supervisor (or Clinical Instructor... same dif) and ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3354601 Thu, 11 Mar 2010 01:55:00 +0100 3354601 http://www.medworm.com/index.php?rid=3311961&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F02%2Facute-care-courses-at-aota-conference.html I feel that it's difficult to find OT courses on acute care topics. It's also hard to apply evidence from those courses to the everyday fast paced world. Here are some parts of the AOTA conference especially for Acute Care OTs (places where you're almost guaranteed to find me!)Links go to full course description on the Create Itinerary page for conference. PosterPO 623. The Role of Occupational Therapy With Pediatric Oncologic Patients Who Undergo Complex Orthopedic Procedures in the Acute Care SettingSat, May 1, 12:30 - 2:30 PM PosterPO 408. An Interdisciplinary Approach to Acute Care Using Standardized Patients and Human Patient SimulatorsFri, Apr 30, 3:00 - 5:00 PM PosterPO 226. Mind-Body Interventions for the Inpatient Acute Care Oncology PopulationThu,... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3311961 Fri, 26 Feb 2010 13:09:00 +0100 3311961 http://www.medworm.com/index.php?rid=3294833&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F02%2Fwhat-week.html What a long strange week it's been...It was a busy, and sometimes downright lousy week. I had 2 people that I was asked to see, cleared for home with family supervision, and then neither family would take them home. It is really sad to see someone who could be in an assisted living or adult day care go to a facility due to the lack of help at home. I hate being put in the middle of these family power plays where the caregiver child just doesn't want to do it anymore but won't say anything until the person is hospitalized. In a strangeness typical of this topsy-turvy week, I also had a lot of people insisting that they would take their parent home when they were very debilitated and largely dependent. The only bright spot for me was getting time to do some follow ups on Friday and changing ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3294833 Mon, 22 Feb 2010 01:35:00 +0100 3294833 http://www.medworm.com/index.php?rid=3259301&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F02%2Fpatterns.html "What we call chaos is just patterns we haven't recognized. What we call random is just patterns we cant decipher. What we can't understand we call nonsense. What we can't read we call gibberish. There is no free will. There are no variables. There is only the inevitable."Chuck Palahniuk (That guy wrote Fight Club. Thank you Google.)I am a person who appreciates patterns. I often find myself examining tile floors to analyze the pattern or lack of. Routines, a valuable part of life, are just patterns of actions and behaviors. While my appreciation of patterns may just be deep enough to cross (slightly?) into the spectrum, it has also proved interesting at work.I've only been working since 2007, so I don't have scores of case examples yet, but I have been interested to see the patterns in ho... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3259301 Wed, 10 Feb 2010 02:08:00 +0100 3259301 http://www.medworm.com/index.php?rid=3254498&cid=t_114792_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F02%2F09%2F7-office-depression-busters-tips-for-work-depression%2F In his classic, “The Prophet,” Kahlil Gibran writes: Always you have been told that work is a curse … But I say to you that when you work you fulfill a part of earth’s furthest dream, assigned to you when that dream was born. Unfortunately Kahlil’s words don’t jibe with a new Australian study that found almost one in six cases of depression among working people caused by job stress, that nearly one in five (17 percent) working women suffering depression attribute their condition to job stress and more than one in eight (13 percent) working men. In the last decade, the number of American workers that say job stress is a major problem in their lives has doubled. In fact, the US Department of Health reported that 70 percent of physical and mental complaints... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3254498 Tue, 09 Feb 2010 12:25:28 +0100 3254498 http://www.medworm.com/index.php?rid=3243741&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F02%2F05%2Fmajor-trauma-care-in-england%2F Title: Major trauma care in England (Executive Summary) Skinny: National Audit Office report that finds unacceptable variation in major trauma care in England.  Care for patients who have suffered major trauma, for example following a road accident or a fall, has not significantly improved in the last 20 years despite numerous reports identifying poor practice, and services are not being delivered efficiently or effectively. Survival rates vary significantly with a range from five unexpected survivors to eight unexpected deaths per 100 trauma patients, reflecting the variable quality of care. The NAO estimates that 450 to 600 lives could be saved each year in England if major trauma care was managed more effectively. Best outcomes are delivered by services led by consultants experienced i... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3243741 Fri, 05 Feb 2010 11:53:51 +0100 3243741 http://www.medworm.com/index.php?rid=3216528&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F28%2Fhealth-service-journal-2010-21st-january%2F Fade Fade: Rise in acute admissions will be ‘unsustainable’ for PCTs Fade Skinny: Just 10 per cent of primary care trusts have successfully reduced emergency admissions to their local acute trusts. (Print subscription held at Fade Library) Posted in Current Awareness, Journals Tagged: Acute Services, Current Awareness, Emergency Admissions, Journals, Primary Care Trusts (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3216528 Thu, 28 Jan 2010 12:07:35 +0100 3216528 http://www.medworm.com/index.php?rid=3201927&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F01%2Faimless-thoughts.html Took a bit of an OT break with a vacay to Las Vegas and reading some novels instead of OT stuff pretty much since Thanksgiving. Now I'm back and ready to play! Been working on a few entries off and on, but this is mostly unstructured. My NBCOT was due to be renewed this year, which caused a minor panic attack the other day. Not that I've been slacking on licensure or anything, I've been going to conferences, but there was a wrinkle I didn't anticipate. I graduated in May '07, but didn't test until Aug '07. My original state license did not require first year graduates to submit continuing ed to be recertified. And unlike the first 2 years of my OT schooling, I didn't pick up any CEUs in my final year due to silly things like fieldwork, graduation, getting married, etc. Somewhere in the ba... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3201927 Sun, 24 Jan 2010 03:05:00 +0100 3201927 http://www.medworm.com/index.php?rid=3185278&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F19%2Fthe-standard-nhs-contracts-for-acute-hospital-mental-health-community-and-ambulance-services-and-supporting-guidance%2F Title: NHS Standard Contract Acute Services 2010-2011 multilateral (NHS Standard Contract – Activity Plan 2010-11) Skinny: NHS standard contracts for Mental Health and Learning Disability and Ambulance Services.  The contracts support the  NHS Operating Framework for 2010-2011: The contracts should be read in conjunction with the  Principles and Rules for Co-operation and Competition and the PCT Procurement Guide.  The NHS standard contracts cover agreements between PCTs and all types of provider delivering  NHS funded services.  The contract will apply to agreements from 2009-10 for: NHS trusts NHS Foundation Trusts New agreements between PCTs and independent sector providers New agreements between PCTs and third sector providers Publisher: DH Size of Publication: 26p. Pub... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3185278 Tue, 19 Jan 2010 13:13:59 +0100 3185278 http://www.medworm.com/index.php?rid=3171844&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F14%2Fimproving-dementia-services-in-england-an-interim-report%2F Title: Improving dementia services in England – an interim report (Executive Summary) Skinny: Interim report from the National Audit Office that identifies that while the Department of Health has developed an ambitious and comprehensive strategy for dementia. There has not yet been a robust approach to implementation and t has not been given the levers or urgency normally expected for such a priority and there is a risk that value for money will remain poor unless these weaknesses are addressed urgently. Dementia was not included in the Department’s tier 1 Vital Signs indicators for the NHS, through which it monitors performance. Other levers built into the NHS’ devolved management arrangements, such as joined-up commissioning and comprehensive performance information, are not ye... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3171844 Thu, 14 Jan 2010 08:06:27 +0100 3171844 http://www.medworm.com/index.php?rid=3146227&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F01%2Fstarting-new-year.html New Year, but Same Old? Starting a new year in January really cramps my style. Like Caulfield in Frazz, I usually can't make resolutions at that time, and like most all people who actually set resolutions, I usually don't keep them either. Would I like to exercise more? Yes... but not in 20* weather. Would I like to eat better? Yes... but not when there's delicious comfort food leftovers in the fridge. Would I like to set detailed achievable goals for myself? No way! I get paid for that! I thought this was a cute little goal tracker, thought of some ways to use this personally/professionally, but I know myself. I'd start getting little red x's and it would be the last time I ever went to the site.I am a little apathetic about this current new year business. I am back on the medicine floor ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3146227 Wed, 06 Jan 2010 01:52:00 +0100 3146227 http://www.medworm.com/index.php?rid=3142485&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F04%2Fconservatives-draft-manifesto-2010-chapter-one-our-reform-plan-for-the-nhs%2F Title: Conservatives Draft Manifesto 2010 Chapter One Our Reform Plan for the NHS The Skinny: First shot in the general election campaign as the Conservative Party issue Chapter 1 of their draft manifesto which details proposed NHS Policy.  Widely presaged in the mass media over the weekend.  If elected they plan to: Scrap process targets Ensure innovation by ensuring NHS Providers become autonomous NHS Foundation Trusts Make NHS data on performance freely available to all Focus on key areas such as cancer/stroke survival and infection control Enable patient rating of the quality of services Ensure patients have choice of providers meeting NHS standards Putting patients in charge of their own records and which providers they wish to share them with Open up the NHS to private and third ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3142485 Mon, 04 Jan 2010 21:48:24 +0100 3142485 http://www.medworm.com/index.php?rid=3138998&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F04%2Ftoo-much-of-the-hard-stuff-what-alcohol-costs-the-nhs%2F Title: New Horizons: the next stage of mental health policy The Skinny: Briefing  from both the NHS Confederation and Royal College of Physicians in advance of the Health Select Committee Report on alchol due for publication on Friday.  It notes an 19% increase in alcohol consumption in the UK over the last three decades resulting  in consumption that is higher than in any other European country.  Alcohol is the third leading cause of disease burden in developed countries and, as a result, the cost of providing alcohol-related services is escalating. The burden on the NHS will be unsustainable if this continues.  This briefing outlines the extent of the problem and gives examples of where the NHS is managing problem drinkers effectively and efficiently.  Key points are: Over a quart... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3138998 Mon, 04 Jan 2010 10:54:19 +0100 3138998 http://www.medworm.com/index.php?rid=3136615&cid=t_114792_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F32upWk8QQ40%2F It’s January again – funny how that comes around every 12 months, isn’t it? And with January and a new year, we’re back to Glaucoma Awareness Month. It seems that one month isn’t enough to help raise awareness for such a devastating disease. Glaucoma, which is really a group of diseases, hits what people seem to fear most – losing their eyesight. Glaucoma is a silent disease, it has no symptoms in its early stages, nothing that can warn you that it’s going to happen to you. This is why awareness is so important, particularly if you fall into a high risk category. What is Glaucoma? Glaucoma is the leading cause of preventable blindness around the world. While it’s more common among seniors, even babies can develop it. According to Glaucoma.or... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=3136615 Fri, 01 Jan 2010 22:40:38 +0100 3136615 http://www.medworm.com/index.php?rid=3123416&cid=t_114792_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2FbDAn9q7HkQY%2F It’s easy to remember the most recent stories or advances in health and medicine – but what about what else has happened since the hysteria of Y2K? Whether it’s Terri Shiavo in 2005 or the H1N1 virus in 2009, it’s impossible to list a “top 10″ list with everyone in agreement. However, the idea of the top 10 lists is to help us remember, to think about what’s happened, and maybe to continue making a difference. Here is a list of top 10 health stories that did get a lot of press: 2000: The Human Genome Project. Scientists had been working on mapping out the genes of humans and finally, in June 2000, they were able to present their draft of the human genome. 2001: Anthrax scare. According to CNN.com news people, the anthrax scare made it to the top 10... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=3123416 Sat, 26 Dec 2009 16:57:44 +0100 3123416 http://www.medworm.com/index.php?rid=3119075&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Fsuboxonetalkzone.com%2Fmedinteractions.pdf A note of follow up:  According to TMZ, a variety of medications were found in Brittany Murphy’s apartment under her name and under the name of her husband and mother.  Of course it is possible that the medications actually belonged to her husband and to her mother– but as you read in my last post, I am not surprised that opiates were included on the list.  THe medication list:   Was her death related to dangerous medication combinations? 1.  Topamax.  Topamax is an anticonvulsant that is also used to treat migraine headaches, and sometimes prescribed as a mild ‘mood stabilizer’–  say for someone who has symptoms of bipolar disorder but who instead has borderline personality or just ‘mood swings’ that don’t quite qualify as full blow... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=3119075 Thu, 24 Dec 2009 01:30:05 +0100 3119075 http://www.medworm.com/index.php?rid=3111369&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F22%2Fusing-the-cquin-payment-framework-an-addendum-to-the-policy-guidance-for-201011%2F Title: Using the CQUIN payment framework – an addendum to the policy guidance for 2010/11 Skinny: The Commissioning for Quality and Innovation (CQUIN) payment framework makes a proportion of providers’ income conditional on quality and innovation.   This is an addendum to the Using the Commissioning for Quality and Innovation (CQUIN) payment framework – 2008 guidance that should be read in the context of the NHS operating framework for England for 2010/11 and the national standard contracts for acute, ambulance, community, mental health and learning disability services. These contracts require commissioners to make 1.5% of contract value available for providers to earn if they achieve locally agreed quality improvement and innovation goals and, for acute providers, two nati... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3111369 Tue, 22 Dec 2009 06:51:40 +0100 3111369 http://www.medworm.com/index.php?rid=3108563&cid=t_114792_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F12%2F21%2Fgetting-through-it%2F This study is a qualitative study of women’s experiences after cardiac surgery – some points to note right off.  Firstly, more women than men complain of post-operative pain than men – curious but not unexpected.  More women than men complain of pain at all ages from puberty until menopause.  Secondly, pain experiences depended on what women’s expectations of pain after cardiac surgery were.   Thirdly, early discharge requires increased patient participation in pain management.  It’s that one that I think could be much more emphasised! The findings indicated that women described four aspects of the pain experience – location, quality, consequences and cognitive aspects – the latter dealing with ‘expected pain’, ‘unexpected pain&... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3108563 Mon, 21 Dec 2009 01:01:10 +0100 3108563 http://www.medworm.com/index.php?rid=3101084&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F12%2Fadditional-clock-drawings.html Sometimes I think these clock drawings are revealing, sometimes just plain confusing.This one is from a man with dementia. I don't remember much else about the case since it was awhile ago. I do remember leaving him tucked in bed, call bell in hand, last words out of mouth "call the nurse, don't get up on your own" and before I could wash my hands he was already up on his feet on the way to the bathroom. I don't remember what time I asked for, but I have to assume that it was 7:40 and we get the numbers instead of hands.This was my first experience with the Montreal Cognitive Assessment, which is becoming my preferred pencil/paper tool. However, it does start off with alternating trailmaking and has a 5 words after 5 minutes recall section, both of which are rather difficult for many peopl... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3101084 Fri, 18 Dec 2009 02:37:00 +0100 3101084 http://www.medworm.com/index.php?rid=3096796&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F17%2Fnhs-operating-framework-for-201011-letter-to-social-partnership-forum-and-national-stakeholder-forum%2F Title: NHS operating framework for 2010/11 (letter to Social Partnership Forum and National Stakeholder Forum) Skinny: Letter introducing the NHS operating framework 2010/11 to the Social Partnership Forum and National Stakeholder Forum Publisher: DH Size of Publication: 3p. Published: 16/12/2009 Posted in Acute Services, Ambulance Services, Decision Making, Demand, Equity, Financial Management, Governance, Grey Literature, Health Economics, Hospitals, Inequalities in Health, Management, NHS, Poverty, Primary Care, Quality, Social Exclusion, Social Inclusion Tagged: Access, Deprivation, Equity, Grey Literature, H1N1, Hospitals, Inequalities, Infection Control, Influenza, NHS, Pandemic, Patient Experience, Poverty, Primary Care, Priorities, Quality, Staff Satisfaction, Stakeholder Engagemen... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3096796 Thu, 17 Dec 2009 08:30:38 +0100 3096796 http://www.medworm.com/index.php?rid=3096797&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F17%2Fthe-operating-framework-for-201011-for-the-nhs-in-england%2F Title: The operating framework for 2010/11 for the NHS in England Skinny: Letter introducing the NHS operating framework 2010/11 to Chief Executives in the NHS. Publisher: DH Size of Publication: 3p. Published: 16/12/2009 Posted in Acute Services, Decision Making, Financial Management, Governance, Grey Literature, Management, NHS, Primary Care, Quality Tagged: Access, Deprivation, Equity, Grey Literature, H1N1, Hospitals, Inequalities, Infection Control, Influenza, NHS, Pandemic, Patient Experience, Poverty, Primary Care, Priorities, Quality, Staff Satisfaction, Stakeholder Engagement, Waiting Times (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3096797 Thu, 17 Dec 2009 08:00:21 +0100 3096797 http://www.medworm.com/index.php?rid=3092643&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F16%2Fthe-nhs-operating-framework-for-england-for-201011%2F Title: The NHS operating framework for England for 2010/11 Skinny: Establishes the priorities for the NHS for the year ahead to enable them to begin their planning. For the third year in a row, the national priorities in the operating framework remain the same, providing important stability. The five priorities continue to be: improving cleanliness and reducing healthcare associated infections; improving access through achievement of the 18-week referral to treatment pledge and improving access (including at evenings and weekends) to GP services; keeping adults and children well, improving their health and reducing health inequalities; improving patient experience, staff satisfaction, and engagement; and preparing to respond in a state of emergency such as an outbreak of pandemic flu, lea... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3092643 Wed, 16 Dec 2009 15:39:24 +0100 3092643 http://www.medworm.com/index.php?rid=3084560&cid=t_114792_139_f&fid=38879&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FVirologyBlog%2F%7E3%2FHQxnyAUW-lY%2F There is some evidence that viruses are involved in colony collapse disorder, a phenomenon in which worker bees disappear. This condition is receiving a great deal of attention ranging from basic scientific research (summarized on TWiV 46) to a PBS episode to a documentary entitled Colony which says that “The unexplainable phenomenon known as Colony Collapse Disorder has left landscapes of empty beehives all across America, threatening not only the beekeeping industry but our food supply.” From my view as a virologist, there is no compelling evidence for a single viral etiology in colony collapse disorder. I asked Tom, a honeybee breeder in California, whether he thinks that there is a pandemic that will wipe out the world’s honeybees. Here is his answer: “I can on... virology blog blogs http://www.medworm.com/rss/comments.php?id=3084560 Mon, 14 Dec 2009 14:56:39 +0100 3084560 http://www.medworm.com/index.php?rid=3056916&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F12%2Ffighting-frustration-and-fatigue.html This has been a hard 2 weeks.It is my impression that the hospital staff was stressed and unpleasant last week due to the impending holiday and just wanting to leave work and go eat copious amounts of gravy laden food. However, they seemed to bring their bad moods BACK with them after Thanksgiving, which is just not fair. Get a grip people- it's holiday season for everyone, not just you. I'm working Christmas day, so that leaves 16 more working days before I can really rest. I'm already so tired... spent this a.m. in a fog since I fell asleep on the bus, and then was ok until I walked through my apt door where I have now crumpled into a semi-lifeless blob. My eyes and brain are fatigued... I can't even begin to think about learning more about Google Wave even though I have OT buddies on th... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3056916 Fri, 04 Dec 2009 00:57:00 +0100 3056916 http://www.medworm.com/index.php?rid=2993946&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F11%2Fsome-sad-times.html My time at work has been sad lately.My current rotation has been a mighty mishmash of cardiopulmonary pts on intensive and progressive care units, orthopedic pts, and frequent floating back to the neuro floor and ICU. In short, my pts have been much more acutely ill than on my other rotations.It's very depressing seeing pts on multiple admissions for severe COPD or CHF exacerbations. People who are far past where cardiopulmonary rehab can be beneficial. I've had several pts travel back and forth from the regular floor to the ICU, but I have a couple that I'm concerned aren't likely to come out. I've had to get much more diligent about checking with nurses even for follow up sessions since my pts fluctuate considerably from day to day. Got as close as I care to get to a pt coding... me thro... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2993946 Sat, 14 Nov 2009 22:00:00 +0100 2993946 http://www.medworm.com/index.php?rid=2984987&cid=t_114792_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F11%2F11%2Fucla-researchers-significantly-inhibit-growth-of-ovarian-cancer-cell-lines-with-fda-approved-leukemia-drug-dasatinib-sprycel%25c2%25ae%2F The drug dasatinib (Sprycel®), approved for use by the U.S. Food and Drug Administration in patients with specific types of leukemia, significantly inhibited the growth and invasiveness of ovarian cancer cells and also promoted their death, say UCLA researchers in the November 10th issue of the British Journal of Cancer. The drug, when paired with [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2984987 Thu, 12 Nov 2009 00:45:53 +0100 2984987 http://www.medworm.com/index.php?rid=2934623&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F27%2Fhealthy-child-programme-from-5-to-19-years-old%2F Title: Healthy Child Programme from 5 to 19 years old Skinny: Sets out the recommended framework of universal and progressive services for children and young people to promote optimal health and wellbeing. It outlines suggested roles and responsibilities for commissioners, health, education, local authority and other partners to encourage the development of high-quality services. Publisher: DH Size of Publication: 97p Published: 27/10/2009 Posted in Acute Services, Children, Grey Literature, Interagency Relations, Local Authorities, NHS, Primary Care, Public Sector, Young People Tagged: Children, Commissioning, Grey Literature, Interagency Relations, Local Authorities, NHS, Primary Care, Quality, Young People (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2934623 Tue, 27 Oct 2009 18:01:49 +0100 2934623 http://www.medworm.com/index.php?rid=2930908&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F27%2Fmanaging-patients%25e2%2580%2599-medicines-after-discharge-from-hospital%2F Title: Managing patients’ medicines after discharge from hospital Skinny: Report that raises concerns that : GPs and hospitals do not always exchange enough information about medicines, and don’t share it on time. In a minority of GP practices (17%), administrative staff rather than clinical staff update records, and they don’t have the clinical skills to check whether medications are right. There’s not enough being done to talk to patients themselves about their medications, either when they’re discharged from hospital or in the longer term. Monitoring and learning from serious incidents is patchy. Publisher: Care Quality Commission Size of Publication: 56p Published: 27/10/2009 Tool: Managing patients’ medicine after discharge – self-assessment tool North West Report: Stu... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2930908 Tue, 27 Oct 2009 13:00:00 +0100 2930908 http://www.medworm.com/index.php?rid=2905059&cid=t_114792_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2009%2F10%2Fblood-hounds.html I dry my hands carefully so I can put a fresh plaster on my finger, post washing up and then nip upstairs to bed down the smalls. I whip up the ladder to start with the smallest one on the top bunk.“Night, night luvvy.”“Agh!”“What’s the matter dear?” “Dat is dah worstest.”“What is?”“Dat smell?”“Hmm sorry about that. I was a bit heavy handed with the garlic tonight.”“Not food smell.”“Which smell?”“Yur finger stinks.”“My finger?”“Dah one wiv dah band aid.”“Can’t, I’ve only just washed them. Is it the soap? Doesn’t smell much too me.”“No dah blood.”“You can smell the blood?”“Yes it is being still wet.”“So if it was dry you wouldn’t be able to smell it?”“Duh!”“!”“Scabs smell differenter.”“Do they indeed... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=2905059 Mon, 19 Oct 2009 06:55:00 +0100 2905059 http://www.medworm.com/index.php?rid=2886369&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F13%2Fthe-crc-energy-efficiency-scheme-and-the-nhs%2F Title: The CRC energy efficiency scheme and the NHS The Skinny: The Carbon Reduction Commitment Energy Efficiency Scheme, which will begin in April 2010 with an introductory three-year phase, is a mandatory energy efficiency scheme that will affect both the public and the private sector. Key points: Trusts should work out if they qualify for the scheme and start preparing. It supports the NHS’s pledge to reduce carbon emissions as outlined in the NHS Sustainable Development Unit’s Carbon Reduction Strategy. It will affect an estimated 180 NHS organisations. Participating trusts will need to report their carbon emissions to the Environment Agency and will have to buy carbon allowances. Trusts should nominate a responsible director and may also want to nominate a lead for managi... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2886369 Tue, 13 Oct 2009 12:55:32 +0100 2886369 http://www.medworm.com/index.php?rid=2862761&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F10%2Ftis-season-for-changing.html 3 months has gone by, neuro rotation is over.This month, I begin on a new floor, the last "new" floor possible (NICU/peds does not count into the rotation). So I will now be working with cardiopulmonary pts, some in ICUs, and orthos. I don't find any of these superbly interesting but hope to find some fun stuff to do. Little worried from a productivity standpoint since I suspect we'll be taking a lot of rest breaks, lots of breaks to check vitals, and probably a lot of advance planning to separate OT/PT sessions into morning/afternoon. I haven't ventured fully into the ICUs yet... we are starting an effort for early mobility and decreased sedation (similar to this) so that will be interesting but it is also stressful to make sure that I know enough about what is going on and protecting my ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2862761 Sun, 04 Oct 2009 22:17:00 +0100 2862761 http://www.medworm.com/index.php?rid=2846312&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F30%2Fthe-delayed-discharges-continuing-care-directions-2009%2F Title: The Delayed Discharges (Continuing Care) Directions 2009 The Skinny: Amendment to current regulations relating to delayed discharges. Publisher: DH Size of Publication: 4p Published: 29/09/2009 Posted in Acute Services, Hospitals, Legislation, Local Authorities, NHS, Social Services Tagged: Legislation, Patient Discharge, Reglulations (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2846312 Wed, 30 Sep 2009 16:21:23 +0100 2846312 http://www.medworm.com/index.php?rid=2803840&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F17%2Faction-to-deliver-same-sex-accommodation-root-cause-analysis%2F Title: Action to deliver same-sex accommodation The Skinny: Toolkit to enable trusts to identify, understand and address issues relating to mixed sex accommodation occurrences. The purpose is to facilitate local learning and improvement and to make this sustainable. The Root Cause Analysis Toolkit feedback form provides the opportunity for people to comment on the toolkit in terms of format and user friendliness. Publisher: DH Size of Publication: 35p Published: 17/09/2009 Posted in Acute Services, Grey Literature, Hospitals, NHS, NHS Estates, Quality, Toolkits Tagged: Grey Literature, Hospitals, NHS Estates, Organisational Design, Same Sex Accomodation (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2803840 Thu, 17 Sep 2009 14:59:01 +0100 2803840 http://www.medworm.com/index.php?rid=2782337&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F09%2Fmy-first-wiihab.html So our hospital has a Wii (actually 2, one lives solely in the burn unit) which I have thought was interesting since I didn't know how well it could be used in acute care. I missed the inservice but figured I could go ahead with my session since I have a Wii at home and am somewhat familiar with the games.The way I see it, for the Wii to be used in acute care, you have to have a client who is sticking around for a few days, has the required cognitive capabilities to understand the system, and has deficits that can be addressed using the system. We currently have 3 games- the basic sports game, Wii Play, and Wii Fit. The first client that I had who would have been appropriate (since the program starting) was a cute little lady who was extrememly active prior to her stroke- walking 3 miles a... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2782337 Thu, 10 Sep 2009 18:06:00 +0100 2782337 http://www.medworm.com/index.php?rid=2781973&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F10%2Fpandemic-influenza-paediatric-clinical-pathways-information-for-health-care-professionals-working-in-primary-care-and-the-community%2F Title: Pandemic influenza paediatric clinical pathways: information for health care professionals working in primary care and the community The Skinny: Forms part of the Swine Flu Clinical Package and should be used with the adult modules and provides additional paediatric information suitable for clinical staff in locations where acute medical care may be provided to children. This information should be used in combination with local training by paediatric specialist staff as available to you. Publisher: DH Size of Publication: 21p Published: 09/09/2009 Posted in Children, Grey Literature, Infants, Influenza, Neonates, NHS, Pandemic, Young People Tagged: Acute Services, Adults, Ambulance Services, Assessment, Care Pathways, Children, Grey Literature, H1N1, Influenza, NHS, Pandemic, Prim... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2781973 Thu, 10 Sep 2009 13:07:35 +0100 2781973 http://www.medworm.com/index.php?rid=2785998&cid=t_114792_109_f&fid=38950&url=http%3A%2F%2Fwww.shockmd.com%2F2009%2F09%2F04%2Fchocolate-lowers-cardiac-mortality-after-first-acute-myocardial-infarction%2F Chocolate consumption was associated with lower cardiac mortality in a dose dependent manner in patients free of diabetes surviving their first Acute Myocardial Infarction. In contrast, intake of other sweets was not associated with cardiac or total mortality. Now be aware that Dr Shock is extremely biased when it comes to chocolate but this conclusion is based on a study done in Sweden and recently published in the Journal of Internal Medicine. This was an observational study, in need of confirmation by more scientifically superior designs such as a study with a large scale, long-term, controlled randomized trials. Having said all this what they did was following 1169 patients without diabetes who were hospitalized for a confirmed nonfatal first acute myocardial infarction (”heart ... Dr Shock MD PhD blogs http://www.medworm.com/rss/comments.php?id=2785998 Fri, 04 Sep 2009 07:09:41 +0100 2785998 http://www.medworm.com/index.php?rid=2762156&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F_8WoDtll8Rw%2F Today I received a call from a patient who has been taking Suboxone for about six months, asking for help with a pain issue.  Before getting into the specific details I’ll mention something that I have mentioned many times before; some people do very well on Suboxone maintenance for opiate dependence, and others do less well.  Some people take their daily morning dose of Suboxone and then live life almost as non-addicts, rarely even thinking about opiates as they go about the business of life.  But others will remain in an addictive relationship with opiates.  The Suboxone bails them out of jams, or even prevents the jams from happening in the first place.  They don’t spend all of their money on oxycodone or heroin, and in most cases they will manage to avoid taking opiate agonist... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2762156 Thu, 03 Sep 2009 04:34:08 +0100 2762156 http://www.medworm.com/index.php?rid=2730024&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F25%2Fthe-point-of-care-measures-of-patients-experience-in-hospital-purpose-methods-and-uses%2F Title: The Point of Care: Measures of patients’ experience in hospital: purpose, methods and uses The Skinny: Provides a brief guide to these to help trust boards and other interested parties decide which measurement and feedback tools are appropriate for their requirements. Publisher: The King’s Fund Size of Publication: 32p Published: 03/08/2009 Posted in Acute Services, Grey Literature, Hospitals, NHS, Quality, Standards Tagged: Grey Literature, Hospitals, Management, NHS, Patient Experience, Quality (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2730024 Tue, 25 Aug 2009 09:22:57 +0100 2730024 http://www.medworm.com/index.php?rid=2726965&cid=t_114792_139_f&fid=38879&url=http%3A%2F%2Fmedia.rawvoice.com%2Fpmn_twiv%2Fwww.twiv.tv%2FTWiV046.mp3 Hosts: Vincent Racaniello and Dick Despommier In episode #46 of the podcast “This Week in Virology”, Vincent and Dick continue virology 101 with a discussion of virus entry into cells, then answer reader email on colony collapse disorder and viruses that confer a benefit to their host. Download TWiV #46 (35 MB .mp3, 50 minutes) Subscribe to TWiV in iTunes, by the RSS feed, or by email Links for this episode: Illustrations of virus entry into cells Nice reference for biological items (thanks Jim!) Colony collapse disorder: PBS program,  descriptive study, metagenomic study, genetic analysis (thanks Swiss compass!) Potato virus Y and Alzheimer’s disease (thanks Jennifer!) A virus in a fungus in a plant (thanks Jennifer!) Weekly Science Picks Vincent PLoS Pearls ... virology blog blogs http://www.medworm.com/rss/comments.php?id=2726965 Sun, 23 Aug 2009 15:12:34 +0100 2726965 http://www.medworm.com/index.php?rid=2709073&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F18%2Fguide-to-good-practice-in-clinical-perfusion%2F Title: Guide to good practice in clinical perfusion The Skinny: New guide to good practice in clinical perfusion has been developed in response to a critical incident in 2005 which led to the publication of the Gritten report. It provides a Quality Management System and a Framework for the Administration of Named Medicines to form the basis of patient-specific directions which are recorded in the patient’s notes and clinical perfusion record. This guidance and the recommended frameworks should assist in the assurance of safe and high quality clinical perfusion services provided by the NHS. Publisher: DH Size of Publication: 52p. Published: 22/07/2009 Posted in Acute Services, Cardiovascular Diseases, Circulatory Diseases, Clinical Guidelines, Grey Literature, Health and Safety, Heart Dis... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2709073 Tue, 18 Aug 2009 11:14:26 +0100 2709073 http://www.medworm.com/index.php?rid=2709097&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F17%2Fpayment-by-results-update-august-2009%2F Title: Payment by Results update – August 2009 The Skinny: NHS Confederation details the latest PbR developments  in acute care, mental health and out-of-hospital care, with a specific foundation trust perspective. Publisher: NHS Confederation Size of Publication: 4p Published: 14/08/2009 Posted in Acute Services, Community Services, Financial Management, Grey Literature, Health Economics, NHS, Payment by Results, Primary Care Tagged: Financial Management, Foundation Trusts, Grey Literature, Health Economics, Mental Health, Payment by Results, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2709097 Mon, 17 Aug 2009 14:29:22 +0100 2709097 http://www.medworm.com/index.php?rid=2705357&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F08%2Ftrying-for-better-week.html Goals this week are a little morbid.So I had multiple pt deaths last week, 2 expected, but 1 not. None due to receiving OT services or lack thereof but still not a pleasant thing. I did get one lady up to the chair about 5 hours before she coded, didn't do much else since her O2 sats were not stellar. So I've been a little depressed and I would just like for people to stay alive this week.Saw a cute-as-a-button 89 y.o. lady on Friday who had a pontine CVA (blessedly mild) but told me "I've never been sick all my life, so if I die it's ok" and I am just thinking NOOOOOOOOOO!!!!!!!!! The COTA saw her yesterday and she met all her OT goals, but after that she transfered into intermediate care for continually BAD blood pressures (222/101 etc) which is not good. Went in and talked to her today.... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2705357 Mon, 17 Aug 2009 00:33:00 +0100 2705357 http://www.medworm.com/index.php?rid=2688607&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F10%2Fnursing-times-2009-vol-105-no-30%2F Posted in Current Awareness, Journals Tagged: Acute Services, Dementia, Nurse Education, Nursing (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2688607 Mon, 10 Aug 2009 14:52:26 +0100 2688607 http://www.medworm.com/index.php?rid=2667758&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F08%2Fhow-to-prioritize-full-day-and-other.html 9 hours today, and it was JAM packed. So much so that it will span into tomorrow morning. Mondays are always difficult for me since every name and face is fresh. To top it off, we were shorthanded today which adds the task of prioritization into the mix. There are many methods for this, some of which are mutually exclusive, and some of which aren't applicable when you need them to bed. Regardless of what I choose, it is hard to pick and know that a certain amount will not get done.Here are a few of the ways that you can prioritize evals-- Pathway patients first- this is an overriding rule in my facility. Gastric bypass, new stroke, spinal surgery, and joint replacement patients are on a "pathway" and need to be seen on day 1.- Highest priority first- this is common sense, but we have a box... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2667758 Tue, 04 Aug 2009 01:52:00 +0100 2667758 http://www.medworm.com/index.php?rid=2663909&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F03%2Fnursing-times-2009-vol-105-no-29%2F Fade Fave: Exploring how to measure patients’ experience of care in hospital to improve services. Fade Skinny: The King’s Fund’ Point of Care programme held a workshop to examine various approaches to measuring patients’ experience and to help staff deliver the quality of care they would want for themselves and their own families. A print copy of this article is available from Fade Library. Posted in Accidents, Current Awareness, Journals Tagged: Acute Services, Patient Experience, Patient Satisfaction, Quality, Service Improvement (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2663909 Mon, 03 Aug 2009 10:47:04 +0100 2663909 http://www.medworm.com/index.php?rid=2621736&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F20%2Fcoercion-and-consent-monitoring-the-mental-health-act-2007%25e2%2580%25932009-the-mental-health-act-commission-thirteenth-biennial-report-2007%25e2%2580%25932009%2F Title: Coercion and consent monitoring the Mental Health Act 2007–2009: The Mental Health Act Commission Thirteenth Biennial Report 2007–2009 The Skinny: Provides an overview of the care provided to people detained under the Act. MHAC found examples of people receiving good care during their visits to services and meetings with patients. But the report also indicates that there is variation across services. Publisher: TSO Published: 19/07/2009 Size of Document: 250p Posted in Mental Health Tagged: Acute Services, Adolescent Psychiatry, Child Psychiatry, Children, Communication, Community Care, Consumer Participation, Ethnic Groups, Gender, Grey Literature, Information Technology, Internet, Learning Disabilities, Legislation, Mental Capacity, Mental Health, Mobile Telephony, Patient Con... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2621736 Mon, 20 Jul 2009 15:39:44 +0100 2621736 http://www.medworm.com/index.php?rid=2605914&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F16%2Fthe-vision-how-we-are-doing-one-year-on%2F This report clearly shows that the passion, determination and commitment is there amongst NHS staff to transform services. Identifies ‘Tools for Change’ that are being developed, good practice and case-studies from our primary care trusts; and identifies the need to boost activity to achieve our long-term vision. Publisher: NHS North West Published: 15/07/2009 Size of Publication: 79p Posted in Acute Services, Ambulance Services, Grey Literature, NHS, Primary Care, Quality Tagged: Darzi Report, Darzi Review, Good Practice, Grey Literature, NHS, North West England, Quality (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2605914 Thu, 16 Jul 2009 09:23:18 +0100 2605914 http://www.medworm.com/index.php?rid=2591408&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F10%2Fevidence-for-transforming-community-services%2F Documents: Overview Review: acute services in the community Review: services for children and families Review: services for long term conditions Review: rehabilitation services Review: wellbeing and health inequalities Review: services for end of life care The Skinny: Independent research by , The Health Services Management Centre (HSMC) at the University of Birmingham to examine the evidence for a range of community services, commissioned by DH to underpin the guidance within the 6 transformational guides: Publisher: DH Size of Document: 10p (25p,  18p, 27p, 21p,  24p and 15p) Posted in Grey Literature, NHS, Primary Care Tagged: Acute Services, Chronic Diseases, Closer to Home, Equity, Evidence Based Practice, Grey Literature, NHS, Organisational Design, Paediatrics, Palliative Care, ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2591408 Fri, 10 Jul 2009 14:41:29 +0100 2591408 http://www.medworm.com/index.php?rid=2576509&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F07%2Fscience-and-technology-committee-2nd-report-of-session-2008%25e2%2580%259309-genomic-medicine-volume-i-report%2F Title: Science and Technology Committee: 2nd Report of Session 2008–09: Genomic Medicine: Volume I: Report (Volume II) The Skinny: Makes recommendations in the following areas: The framework for translational research in the UK Funding and translational research Making the conduct of clinical trials less burdensome Promoting collaborative translational research Research to demonstrate the clinical utility and validity of genomic tests within the NHS Evaluation of the clinical utility and validity of genomic tests for use within the NHS Evaluation and regulation of genetic and genomic tests developed outside of the NHS Incentives to develop stratified uses of medicines Intellectual property rights Co-development and evaluation of stratified uses of medicines and genetic tests Encouraging... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2576509 Tue, 07 Jul 2009 10:52:54 +0100 2576509 http://www.medworm.com/index.php?rid=2576905&cid=t_114792_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2009%2F07%2Ffirst-day-back.html First day back... first day on the surgery floor.It's hard returning from vacay anyway, but trying to get a feel for a brand new floor at the same time is double hard. Added into that is a factor I had not previously considered- July 1 marked the transition from classroom medical students to residents. So not only do I not know the ropes, but the people who are writing the orders don't know the ropes either. I didn't realize when I accepted a job at a teaching hospital that part of my job would be teaching doctors. But we are all teachers, and we are all students... I had a sad realization today when I realized that a PT student who was present before I left must have completed her rotation. Already in just three months there have been 3 different OT/PT students in the office that have com... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=2576905 Tue, 07 Jul 2009 02:00:00 +0100 2576905 http://www.medworm.com/index.php?rid=2576516&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F06%2Fform-following-function-getting-the-structure-right-for-foundation-trust-business-models%2F Title: Form following function: getting the structure right for foundation trust business models The Skinny: Guide to help trusts understand some of the differences between different business models, ask themselves fundamental questions concerned with business formation, and provide an overview of the key benefits, risks and considerations to take into account prior to setting up a new business model.  This is of increasing importance in an environment of plurality, competition and choice. Publisher: NHS Confederation (Requires Releant Membership of the NHS Confederation) Posted in Acute Services, Grey Literature, Hospitals, NHS Tagged: Business Models, Foundation Trusts, Grey Literature, Organisational Design (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2576516 Mon, 06 Jul 2009 15:27:49 +0100 2576516 http://www.medworm.com/index.php?rid=2570339&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F03%2Fpatient-safety-sixth-report-of-session-2008%25e2%2580%259309-volume-i-report-together-with-formal-minutes%2F Title: Patient Safety: Sixth Report of Session 2008–09: Volume I: Report, together with formal minutes The Skinny: Identifies the need for improved patient safety systems in the NHS and emphasises that this should be the first consideration of NHS organisations. Recommends: Measurement and evaluation using samples of patients’ case notes at periodic intervals to calculate rates of harm. (Trusts, NPSA) NHS organisations must recognise it is key that harmed patients and their families or carers are seen to be entitled to receive information, anexplanation, an apology and an undertaking that the harm will not be repeated.  PALS should be utilised as an independent service. The NHS Redress Scheme should be implemented to reduce litigation. (DH, Tusts) Develop an an open, reporting and le... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2570339 Fri, 03 Jul 2009 10:42:50 +0100 2570339 http://www.medworm.com/index.php?rid=2570689&cid=t_114792_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FzIeL9Z2BXzA%2F I was reading through a short article entitled “CCHIT TASK FORCE TO FOCUS ON STIMULUS PACKAGE REQUIREMENTS” which is actually a bit misplaced since the article really seems to talk about the CCHIT Task Force for Long Term and Post Acute Care, but I digress. The thing that drew my attention was just reading through the process by which CCHIT puts together their criteria using task forces. I believe a number of people on my twitter feed are on or lead some of these CCHIT EHR task forces. I’d be interested to have a nice writeup from some of them on what it’s like to be on a CCHIT task force. How does it work? What’s the dynamic? If you’re willing to share, I’d love to hear more in the comments or drop me a note on my contact page. I also was trying t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2570689 Thu, 02 Jul 2009 17:28:35 +0100 2570689 http://www.medworm.com/index.php?rid=2561183&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F30%2Fhigh-quality-care-for-all-our-journey-so-far%2F Title: High Quality Care for All: Our journey so far The Skinny: Examines the progress that has been made since High Quality Care for All was published a year ago.  Major improvements highlighted in the report include the opening of 50 new GP led Health Centres, the introduction of personal care plan for 9.3 million patients with long term conditions and the growth in keyhole surgery. The focus on quality has moved up the agenda for staff and organisations, supported by the promotion of innovation through the introduction of tools and funds such as NHS Evidence, the Innovation Fund and the Challenge Prizes.  Also outlines plans to drive up the quality agenda even further and free up clinicians time to do this by: Refining targets based on evidence Clinician budget ownership Peer review ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2561183 Tue, 30 Jun 2009 10:52:22 +0100 2561183 http://www.medworm.com/index.php?rid=2528172&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2FqMa0hQ26IYo%2F You’ll notice a link to a company that makes medical ID jewelry in the sidebar and below–  not a bad idea to wear one if you are taking Suboxone.  I think that a year ago it was less important, only because many EMT’s didn’t know what the heck Suboxone was!  But realize that if you have been in an accident and are in pain, it will take significantly higher doses of narcotic (usually morphine in an ambulance or ER) to get any pain reduction– sometimes as much as 10-fold higher doses!  Even if you are able to speak, a bracelet or necklace with the name of the drug will likely be taken more seriously than whatever words you are able to put together in the confusion of an accident scene.  I think an imprint of either ‘Suboxone’ or ‘buprenorp... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2528172 Sat, 27 Jun 2009 01:41:01 +0100 2528172 http://www.medworm.com/index.php?rid=2515164&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F25%2Ftransforming-community-services-ambition-action-achievement%2F Title: Transforming community services: ambition, action, achievement The Skinny: best practice guides to support delivery of the intentions for High Quality Care for All: the Next Stage Review. They set out ambitions, taking action and measurement of the achievement and link with, should be read in conjunction with the quality framework/quality indicators. The Guides: Transforming services for health, wellbeing and reducing inequalities Transforming services for children, young people and families Transforming services for acute care closer to home Transforming services for people with long term conditions Transforming rehabilitation services Transforming end of life care Publisher: DH Published: 24/06/2009 Posted in Acute Services, Children, Equity, Grey Literature, NHS, Palliative ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2515164 Thu, 25 Jun 2009 10:33:23 +0100 2515164 http://www.medworm.com/index.php?rid=2477497&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F15%2F3881%2F Title: Same-sex accommodation: your privacy, our responsibility The Skinny: Provides a background to the Department of Health’s Same-sex accommodation: your privacy, our responsibility initiative, launched in January 2009, to provide clearer guidance and support for hospitals. It sets out the practical issues that boards must address to ensure their patients’ privacy and modesty is protected at all times. key points: The NHS Constitution states that all patients should feel that their privacy and dignity are respected during their time in hospital. Same-sex accommodation is “a visible affirmation” of this commitment. 99% of trusts report that they have same-sex sleeping accommodation, and 97% have same-sex toilets and bathrooms. Yet around a quarter of patients report sharing a mi... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2477497 Mon, 15 Jun 2009 15:07:20 +0100 2477497 http://www.medworm.com/index.php?rid=2463309&cid=t_114792_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F06%2F08%2Fmore-pain-sites-over-time-greater-risk-of-work-disability%2F It struck me today, as I spent a little time with two people who have been returned to Pain Management Centre for a review of their progress, that something we don’t do very well is help people distinguish between an acute or new problem and what might be a flare-up of the old chronic problem. And by ‘we’ I mean all health providers. Ok, so that the problem is there is not really so surprising – after all, helping clinicians work out that chronic pain doesn’t respond to acute pain management is quite a change of focus (from short-term cure to long-term management), but I guess I hadn’t really thought through how to help people deal with new pain problems as they arise. Let me illustrate what I mean. Gary (not his real name, and other details are also dis... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2463309 Mon, 08 Jun 2009 04:42:58 +0100 2463309 http://www.medworm.com/index.php?rid=2452329&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F03%2Fhealthy-mind-healthy-body%2F Title: Healthy mind, healthy body The Skinny: NHS Confederation briefing that looks at opportunities to improve quality and efficiency in acute services by focusing on the needs of the significant number of patients who also have mental health problems complicating their care and discharge. Key points: One quarter of acute inpatients have mental health problems. Identifying and treating the mental health needs of acute inpatients early has a direct impact on the recovery of their physical health. Liaison services can improve care and bring costs savings as patients can be discharged earlier if their mental health needs are addressed. Services can also bring savings for primary care trusts (PCTs) by reducing re-attendances. Publisher: NHS Confederation Size of Document: 6p. Published: 07... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2452329 Wed, 03 Jun 2009 19:00:21 +0100 2452329 http://www.medworm.com/index.php?rid=2423997&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F05%2F20%2Fdeed-of-variation-for-2008-nhs-standard-acute-contract%2F A suite of documents is for those commissioners and providers who entered into the acute services contract that was published in December 2007, who are now working to a document that does not reflect changes brought about by the operating framework for 2009-1010. The Standard deed of variation is designed to vary those existing acute services contracts by incorporating the significant elements of the 2009/2010 standard NHS contract for acute services brought about by the operating framework. Guidance on the use of the deed of variation is also provided. Posted in Acute Services, Commissioning, Grey Literature, Hospitals, NHS, Primary Care Tagged: Acute Services, Commissioning, Contracts, Grey Literature, Operating Framework, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2423997 Wed, 20 May 2009 10:17:13 +0100 2423997 http://www.medworm.com/index.php?rid=2353998&cid=t_114792_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FuasOYsIqjDo%2F It may be unconventional to post a promo trailer on a genetics site, but I’ve been waiting for this film since I first heard of it. “My Sister’s Keeper” is the story of two young sisters whose lives would be intertwined beyond their control. Kate is the older sister – beautiful, graceful and living with a rare genetic disease called acute promyelocytic leukemia. Anna is three years younger – genetically engineered and conceived to be a genetic match for Kate. Whatever Kate’s body needs – cord blood, blood, bone marrow, kidney – Anna is the donor. How many times can you save your sister’s life? Cameron Diaz, Abigail Breslin and Sofia Vassilieva star in “My Sister’s Keeper”. Image: Bauer Griffin “Genetically engineered to be a donor” sounds so unethical and f... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=2353998 Tue, 21 Apr 2009 06:33:42 +0100 2353998 http://www.medworm.com/index.php?rid=2367352&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F04%2F15%2Fcore-interventions-in-the-treatment-and-management-of-schizophrenia-in-primary-and-secondary-care-update%2F Title: Core interventions in the treatment and management of schizophrenia in primary and secondary care (update) Source: NICE The Skinny: Updates and replaces: Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care. NICE clinical guideline 1 (2002) Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia. NICE technology appraisal guidance 43 (2002) Documents For healthcare professionals: CG82 Schizophrenia (update): NICE guideline (41p, 256.26 Kb) CG82 Schizophrenia (update): NICE guideline (MS Word format) (41p, 605 Kb) CG82 Schizophrenia (update): full guideline (399p, 3.16 Mb) CG82 Schizophrenia (update): full guideline - clinical evidence summary tables (194p, 2.54 Mb) CG82 Schizophren... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2367352 Wed, 15 Apr 2009 09:38:28 +0100 2367352 http://www.medworm.com/index.php?rid=2341900&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F3vHWFoXQFnE%2F Thanks, all of you who wrote comments to my last post.  I remind everyone once again to consider taking your comments here and after writing them, also taking them to SuboxForum.com.  I am going to put up a new category to discuss topics that were initiated here;  it would be great to get a spirited, respectful ‘give and take’ on some of these topics.  As I have mentioned before, the only thing that I will block on that site would be debating whether people on Suboxone are ‘in Recovery’– just because there are plenty of other sites for that, and I want the forum to be for people who have made their decision– and don’t want to be harassed over it.  I will be upgrading that site shortly and changing the hosting account;  hopefully I will pull i... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2341900 Mon, 13 Apr 2009 04:27:30 +0100 2341900 http://www.medworm.com/index.php?rid=2287230&cid=t_114792_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F03%2F23%2Ffda-approves-symbyax-for-treatment-resistant-depression%2F Today, the U.S. Food and Drug Administration (FDA) approved Symbyax for the acute treatment of treatment-resistant depression (TRD). It is the first drug approved for this indication. Symbyax is a combination pill that combines olanzapine (Zyprexa) and fluoxetine HCl (a long-acting form of Prozac) in a single capsule. Symbyax is manufactured by Eli Lilly and Company. According to the company’s press release: The new Symbyax TRD indication is for acute treatment of adult patients with major depressive disorder who have not responded to two separate trials of different antidepressants of adequate dose and duration in their current episode. Zyprexa, in combination with fluoxetine, is now approved for the acute treatment of TRD in adults. Symbyax was the first drug approved by the FD... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2287230 Mon, 23 Mar 2009 21:02:51 +0100 2287230 http://www.medworm.com/index.php?rid=2200394&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F02%2F20%2Ftransactions-manual%2F The Transactions Manual is a system management tool introduced in the 2008/9 Operating Framework aimed at SHAs, PCTs, NHS Trusts, NHS Foundation Trusts and independent sector organisations where they are involved or considering involvement in a transaction and where one of the parties to the transaction is an NHS Trust or PCT. Covered in the Manual are acquisitions divestments or disposals demergers joint ventures franchises and statutory mergers It guides parties through a best practice approach via guidance  to the transaction process and provides technical detail to the various areas of law, policy and practice that may be needed to complete the transaction successfully. The Manual also incorporates mandatory practice required by law or by policy that may change from time to tim... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2200394 Fri, 20 Feb 2009 10:25:10 +0100 2200394 http://www.medworm.com/index.php?rid=2190438&cid=t_114792_86_f&fid=34461&url=http%3A%2F%2Fdigicmb.blogspot.com%2F2009%2F02%2Fzorg-20-first-congress-for-and-by.html "The Acute Care Region East and the University Medical Centre UNC St Radboud are organising the first Care 2.0 Congress. It is to be a gathering with an interactive programme about the possibilities the Internet can hold for the care sector for and by healthcare professionals" They do a great job at the Acute Care Region East. It seems they willingly decided to take this path of Web 2.0 integration in all Health Care aspects and this event is focussing on it. Some info in English The Zorg 2.0 Congress will be held on March 24, 2009. More info & registration: www.azo.nl/zorg20.htm (in Dutch) More background information about the acute care region Acute Zorgregio Oost at www.azo.nl Related articles by ZemantaNational Dialogue on Health IT Publishes Final Report (Uses Scribd in True ... DigiCMB blogs http://www.medworm.com/rss/comments.php?id=2190438 Mon, 16 Feb 2009 10:27:00 +0100 2190438 http://www.medworm.com/index.php?rid=2131685&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2FEvzJOH4NYc8%2F A question about Suboxone and Surgery: Hi-this is in reply to your message back to me. I am the girl who is soon to have surgery. You said that 3 days would be good to be off the suboxone, but you said the worst withdrawal takes about 3 days to hit, so it’s a bit of a compromise. But, won’t the withdrawal be halted once the pain medication gets into my body? Are you just saying that I will have to deal with some detox discomfort during the 3 day period? I, unlike many people, know quite a bit about suboxone (it is so surprising how many people are clueless), but the one thing I am not clear on is how long it would take to “feel” opiates after stopping suboxone (thank God I am ignorrant in this area!). On one of your blogs you said that opiates would work as short as... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2131685 Sun, 25 Jan 2009 05:21:00 +0100 2131685 http://www.medworm.com/index.php?rid=2122105&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F516238041%2F I answered a post today that is similar to many prior posts– a patient with significant pain is no longer getting good pain relief from the pain pills he has taken for the past three years, and he asked whether it was a good idea to change from one narcotic– let’s say oxycodone– to another narcotic– let’s say Duragesic, the fentanyl skin patch. I often come across this question in one form or another.  For a person in pain, opiate pain medications are wonderful– at least initially.  The problem is that the medications lose their potency over time through a process called ‘tolerance’.  In order to continue to get relief, the person with pain has to keep increasing the dose of the medication.  This leads to problems; often the doctor... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2122105 Mon, 19 Jan 2009 03:32:07 +0100 2122105 http://www.medworm.com/index.php?rid=2101604&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F510460709%2F A question from a reader about taking Suboxone for chronic pain, and about physical dependence vs. addiction: Thanks for the web page. It gave me a lot of information that I had been searching for. Most of your blog deals with addiction. Will Suboxone work for dependence? I have been on Oxycontin for 7 years due to nerve damage in my back and Fibromyalgia. I have been able to get down to 30 mg per day with the help of RF ablations but unfortunately there aren’t any pain doctors in my area that will take medicare anymore. RFA’s don’t last forever and I’m being forced to increase the Oxycontin again to manage the back pain. The severe cold with snow has made this a very miserable winter which is why I’m looking for a different answer. From what I’ve read, ... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2101604 Tue, 13 Jan 2009 04:13:34 +0100 2101604 http://www.medworm.com/index.php?rid=2083921&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F01%2F06%2Fusing-mobile-phones-in-nhs-hospitals-january-2009%2F , replaces all previous guidance issued by the Department. It aims to reflect the rapidly developing principles of patient choice in the matter of mobile phone usage.  The prevailing working presumption should be that patients will be allowed the widest possible use of mobile phones in hospitals where the NHS trust’s local risk assessment indicates that such use would not represent a threat to: patients’ own safety or that of others, the operation of electrically sensitive medical devices in critical care situations, the levels of privacy and dignity that must be the hallmark of all NHS care. Posted in Acute Services, Grey Literature, Health and Safety, Hospitals, Information Technology, NHS, Risk Evaluation   Tagged: Grey Literature, Hospitals, Mobile Telephony, Risk... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2083921 Tue, 06 Jan 2009 16:17:10 +0100 2083921 http://www.medworm.com/index.php?rid=2078894&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F503100328%2F The questions: I am having surgery and my doc was unaware of some things and I thought that you could confirm them for him?  Could you advise him to take me off the Suboxone 10-14 days prior to surgery?  I have been researching this religously and I have come to the conclusion that it would take 2 weeks to get the Bupenepherine 100% out of my system so that there is no blockage, unless you think otherwise?  Also could you tell him about the oxycodone to keep me out of withdrawal and to help me cope with the pain? Note: I had also received a note from the doctor, saying that he was going to change the patient from Suboxone to Subutex before the surgery, and then back again at a later point.  This is fine, but not enough– the naloxone isn’t the problem– the buprenorphi... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2078894 Mon, 05 Jan 2009 05:36:44 +0100 2078894 http://www.medworm.com/index.php?rid=2067994&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F496111412%2F I write for a couple of medical sites– not the ones I have mentioned here, but sites where they actually allow doctors to identify themselves so that the person asking the question knows the credentials of the person providing the reply.  Oh, what the heck– I think it is OK to name them…  I answer questions ‘formally’ for MedHelp.com and for DoctorsLounge.com.  Go ahead and check them out if you like– if you do, be sure to give me good feedback!!  They are unpaid positions–  as I have whined about many times, I cannot find a way to make money as a doctor on the internet!  But I do them for the publicity– although what the publicity does for me, I’m not really sure… Here is something I wrote recently about chronic pain;  I f... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2067994 Sat, 27 Dec 2008 06:07:39 +0100 2067994 http://www.medworm.com/index.php?rid=2011731&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F473247309%2F I’m in a bad mood tonight– squabbling with my 13-y-o daughter will do that to me– so I’m going to cheat and copy an e-mail that I recently sent to a reader.  She takes Suboxone and will be having surgery;  she did everything correctly, tapering her dose and then stopping the Suboxone for a few days before surgery.  Ideally her addiction doc or her surgeon would prescribe her a large dose of oxycodone to treat the post-op pain, but instead she was told that she is already treated for pain from being on the Suboxone, so she doesn’t need anything more.  After her appropriate objection, he told her that he would recommend that the surgeon prescribe– of all things– fentanyl patches.  Never mind that fentanyl patches have a ‘Black Box Warning&... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2011731 Wed, 03 Dec 2008 05:16:03 +0100 2011731 http://www.medworm.com/index.php?rid=2006602&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F470991446%2F An entirely logical question: Soboxdoc, I am taking 16mg of Suboxone a day - 8mg in the morning and 8mg at night. You state above that Suboxone has a ceiling effect of about 4mg. Does that mean I could take a half of an 8mg tab once a day and it would have the same effect as the 16mg that I am currently taking? Even after the three day half-life? Or should I still cut it down by 2mg a week until I get to 4mg? That would be great if I could do it right away with the same benefit! Either way I am still left speechless on how much this medication has changed life for me. Thanks again for all the wonderful info. My Best Guess: Thanks for writing! The 4 mg level for the ‘ceiling’ is an average for patients overall, and assumes that you are taking the Suboxone in an effective way. My... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=2006602 Mon, 01 Dec 2008 06:28:01 +0100 2006602 http://www.medworm.com/index.php?rid=1999433&cid=t_114792_151_f&fid=36896&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2F468629807%2F The topic of post-op pain control on buprenorphine is important enough to get top billing Many thanks to Dr. J Walsh in Seattle for the following post: I am a physician in Seattle.  In two c-section cases we have found that high affinity opiates (fentanyl or hydromorphone) delivered by PCA can provide adequate anesthesia even while sublingual buprenorphine is continued. To clarify, patients taking Suboxone, Subutex, or any other form of buprenorphine face a problem when they need pain control, particularly if the need is acute– after injury or surgery.  Buprenorphine is a ‘partial agonist’ at the mu opiate receptor;  it has a ‘ceiling’ to its effects, so that increases in dose of buprenorphine will not provide increased analgesia.  This is great for addic... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=1999433 Fri, 28 Nov 2008 19:22:16 +0100 1999433 http://www.medworm.com/index.php?rid=1993575&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2008%2F11%2Faftb-lecture-notes-acute-coronary-syndromes-part-iii%2F RISK STRATIFICATION OF PATIENTS WITH SUSPECTED AMI Less than 30% patients currently admitted to CCU have final diagnosis AMI. Conversely 2-5% AMI patients are inadvertently sent home, accounting for 25% of all emergency care malpractice dollars awarded in litigation. Twenty-five percent AMI patients have atypical symptoms and signs, 50% an initial non-diagnostic ECG. EDs +/- chest pain [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=1993575 Wed, 26 Nov 2008 07:00:48 +0100 1993575 http://www.medworm.com/index.php?rid=1985774&cid=t_114792_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2008%2F11%2Faftb-lecture-notes-acute-coronary-syndrome-part-i%2F MYOCARDIAL INFARCTION / ACUTE CORONARY SYNDROMES (ACS) - Part I EPIDEMIOLOGY Over 32,000 deaths per year in Australia: largest single cause. 50% reduction age-adjusted mortality (by risk-factor modification) since 1960, still falling now, but those with chronic CAD are increasing commensurately. Still 60-70% die prehospital (this proportion unchanged) - thus overall 28-day mortality has improved little, compared with reduced [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=1985774 Tue, 25 Nov 2008 07:00:43 +0100 1985774 http://www.medworm.com/index.php?rid=1984678&cid=t_114792_115_f&fid=34670&url=http%3A%2F%2Fsumerdoc.blogspot.com%2F2008%2F11%2Fsub-acute-combined-degeneration-mri.html Sub-acute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication due to vitamin B12 deficiency. This is a case of SCD of the spinal cord in a 40-year-old man. Magnetic resonance imaging (MRI) of the spine showed intramedullary hyperintensity seen on T2-weighted images in the posterior column of the cervico-dorsal spinal cord, and lateral columns. A diagnosis of SCD of the spinal cord was considered and confirmed by a low serum cobalamin. Detection of lateral tracts involvement by the MRI is uncommon.Dr.Sumer K Sethi, MDSr Consultant Radiologist ,VIMHANS and CEO-Teleradiology ProvidersEditor-in-chief, The Internet Journal of Radiology Director, DAMS (Delhi Academy of Medical Sciences) From Sumer's ... Sumer's Radiology Site blogs http://www.medworm.com/rss/comments.php?id=1984678 Mon, 24 Nov 2008 10:09:00 +0100 1984678 http://www.medworm.com/index.php?rid=1977374&cid=t_114792_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F11%2F21%2Fwork-conditioning-work-hardening-and-functional-restoration-for-workers-with-back-and-neck-pain%2F In New Zealand most people who have been off work with chronic pain, and receive compensation from ACC, will have been a participant in some sort of fitness programme.  It’s almost a rite of passage for people to have a programme of functional restoration before or during an attempted return to work once the person has been off work for around 3 - 6 months. There are a lot of different types of programme available: two of the Prof Mick Sullivan’Goal attainment’ programmes for sub-acute pain, Functional restoration programme - for sub-acute pain, involving activity with some ‘education’ Pain management psychological services - for psychological strategies for pain management Activity focus programme - for chronic pain, involving activity and cognitive behavio... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1977374 Thu, 20 Nov 2008 19:11:35 +0100 1977374 http://www.medworm.com/index.php?rid=1889366&cid=t_114792_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F10%2F20%2Fscreening-for-the-risk-of-chronic-disability%2F In this study, again the total score was found to be most predictive of future sick leave ‘The prediction of future sick leave with the OMPSQ is based on the total score. As in earlier studies the results showed that the total score of the screening questionnaire was related to future sick leave and functional ability; the higher the score, the higher the risk for long term sick leave and developing of chronic problems.’ The higher functional limitation scores the greater disability in the long term, which is slightly different from previous studies which have suggested psychosocial distress and avoidance were more predictive. Again, this study shows that using this screening tool early in the course of an episode of low back pain (whether the first episode or subsequent episo... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1889366 Sun, 19 Oct 2008 18:23:40 +0100 1889366 http://www.medworm.com/index.php?rid=1886299&cid=t_114792_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2008%2F10%2F17%2Ffoundation-trusts-and-monitor%2F : Sixth Report of Session 2007–08: Volume I Report, together with formal minutes from the House of Commons Health Select Committee, finds that while FTs have some proven strengths in terms of financial management and routine NHS process quality measures, much remains unknown. There is a lack of clarity whether high-performance results from their changed status, or is a continuation of long term trends, since the best trusts have become FTs.   A key aim of Foundation Trusts was the promotion of innovation and greater public involvement. The Committee found examples of good practice in both of these areas, but a lack of objective evidence. Fears about FTs’ impact on local health economies have not been borne out; however, they have made little contribution towards the Government’s ai... Fade Library blogs http://www.medworm.com/rss/comments.php?id=1886299 Fri, 17 Oct 2008 14:40:57 +0100 1886299 http://www.medworm.com/index.php?rid=1852800&cid=t_114792_105_f&fid=36987&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FIvorKovicMd%2F%7E3%2F411496995%2F British Heart Foundation maintains a website to warn people about heart attack symptoms and the importance to promptly seek professional help if you start experiencing them. A two minute film which enables you to experience what it’s like to have a heart attack first hand plays a central role in their campaign to save lives. Be sure to watch this incredible film and share it with others. You might have recognized Stephen Berkoff, a famous English actor playing a lead role in this film. Isn’t he just brilliant? Like some old mobster. (Source: Ivor Kovic, M.D.) Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=1852800 Sun, 05 Oct 2008 00:32:11 +0100 1852800