Education Program Regarding Labor Epidurals Increases Utilization by Hispanic Medicaid Beneficiaries A Randomized Controlled Trial

Editor ’s PerspectiveWhat We Already Know about This TopicHispanic women choose epidural labor analgesia less commonly than non-Hispanic women. The causes of the healthcare disparity are unknown, and effective interventions are to be established.What This Article Tells Us That Is NewA language-concordant, educational program regarding labor epidurals during the first stage of labor, in addition to the routine prenatal education, is feasible and does not cause any negative effect.Such an intervention increases epidural use among Hispanic but not non-Hispanic women.It also reduces misconceptions regarding epidural analgesia in both Hispanic and non-Hispanic women.Background Hispanic women choose epidural labor analgesia less commonly than non-Hispanic women. This may represent a healthcare disparity related to a language barrier and inadequate opportunities for labor analgesia education. It was hypothesized that a language-concordant, educational program regarding labor epidurals would improve epidural utilization in two independent cohorts of Hispanic and non-Hispanic women.Methods A randomized controlled trial, blinded to anesthesia, nursing, and obstetric providers, was completed at an academic hospital (February 2015 to February 2017). Two cohorts of Medicaid beneficiaries of Hispanic (English- and/or Spanish-speaking) and non-Hispanic ethnicity were enrolled concurrently. The patients were randomized to routine care alone or routine care and an additional educational...
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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CONCLUSIONS: OVD applied to the ocular surface during cataract surgery had a protective effect on the ocular surface one week after surgery. PMID: 31612658 [PubMed - in process]
Source: Korean Journal of Ophthalmology : KJO - Category: Opthalmology Tags: Korean J Ophthalmol Source Type: research
CONCLUSIONS: This survey provided a comprehensive update of the present cataract surgery practices in the Republic of Korea. The results emphasized the increasing use of premium intraocular lenses, optical biometry, and topical anesthesia. PMID: 31612656 [PubMed - in process]
Source: Korean Journal of Ophthalmology : KJO - Category: Opthalmology Tags: Korean J Ophthalmol Source Type: research
I see a lot of depressing threads from 2006/2009/2012 etc. about Gas or Anesthesiology losing jobs and being paid less, but the statistics seem to say otherwise. Its 2019 and: Automation doesn't look like it happening any time soon [https://www.washingtonpost.com/news/the-switch/wp/2016/03/28/its-game-over-for-the-robot-intended-to-replace-anesthesiologists/] Job outlook is high... Considering CNRA's came to be in 1956 and so far MD/DO Gas docs are making more and have stable employment, where did the negativity come from?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Medical Students - MD Source Type: forums
I’ve heard from the PD at my school that significantly more students are applying to anesthesia than in previous years, and that they’re a lot more 250s/AOA caliber students applying as well. It seems like no matter how many rights midlevels get, or how many times people here try to warn students not to go into anesthesia, more and more people are gunning for it.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums
Authors: Song B, Yang Y, Teng X, Li Y, Bai W, Zhu J Abstract A randomized double-blinded controlled trial was performed to explore the association between pre-operative anxiety and intra-operative butorphanol requirement to evaluate the precise sedative requirement and to confirm the sedative effect of butorphanol in patients receiving lower-limb orthopedic surgery. The Amsterdam pre-operative anxiety and information scale and the Ramsay sedation score (RSS) were used to assess the patients' pre-operative anxiety score and sedation state during surgery. Patients were divided into two groups according to their pre-o...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
This article outlines the basic physics of electricity, in particular the principles behind diathermy, the hazards posed by it and by other devices and the various measures available to reduce the risk of these.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 15 October 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Kevin Wu, Fin O'SullivanAbstractPoisoning with chemical agents was once thought to be confined to the battlefield. However, over the past decade there has been an increase in the use of chemical weapon agents and toxic industrial chemicals as weapons of terror. As well as use during conflict, these poisons have been used in other attacks with deadly effects. These agents require particular treatments that fall out with standard medical practice to reduce harm and prevent contamination of medical treatment facilities...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
This article will provide an update on the most recent evidence base on clinical practice, including the use of acute severe respiratory failure bundles and extracorporeal techniques to support lung protective ventilation.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 15 October 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Emma L. Hartley, Stuart GillonAbstractIn the last 20 years there have been significant advances in extracorporeal support of the respiratory system. What once was a highly complex intervention, undertaken as a salvage procedure in a handful of patients, has become more wide spread, both in terms of availability and underlying indications. We review the principles of equipment; physiological control of oxygenation and decarboxylation; associated complications; and role in clinical practice. The evidence for extracorp...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
ConclusionsVery low- to moderate-quality evidence suggests intraosseous injection using 2% lidocaine with 1:100,000 epinephrine or 4% articaine with 1:100,000 epinephrine or buccal and lingual infiltrations of 4% articaine with 1:100,000 epinephrine are superior strategies to achieve pulpal anesthesia during endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. Preoperative NSAIDs or opioids with or without acetaminophen may increase the efficacy of these injections.
Source: Dental Technology Blog - Category: Dentistry Source Type: news
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