Since the widespread implementation of implantable cardioverter-defibrillators (ICDs), their effectiveness in various situations has become well-established. However, despite many advances in both the technology and its utilization, inappropriate therapy remains a risk. Here, we review ICD shocks, their effect on outcomes, and current methods to reduce inappropriate therapy, finding overall that inappropriate ICD shocks are common and associated with adverse outcomes. However, strategies do exist to minimize inappropriate shock rates including device selection and programming, medication, catheter ablation, and remote monitoring. Overall, ICDs are useful in reducing the risk of sudden cardiac death, but many patients with an ICD will receive an inappropriate shock. Understanding strategies to prevent inappropriate shocks is crucial to improving the care of patients with ICDs.
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http://dx.doi.org/10.19102/icrm.2019.100403 | DOI Listing |
J Gen Intern Med
January 2025
Center for Health Optimization and Implementation Research, VA Boston Healthcare System and VA Bedford Healthcare System, Boston and Bedford, MA, USA.
Background: Deprescribing, intentional medication discontinuation or dose reduction, can reduce potentially inappropriate medication use and medication-related harms. Engaging patients in deprescribing discussions may increase likelihood of deprescribing and promote shared decision-making.
Objective: To examine the impact of patient-directed educational brochures on patient engagement and deprescribing discussions with primary care providers (PCPs).
BMJ Open
January 2025
Centre for Behavioural and Implementation Science Interventions, National University of Singapore Yong Loo Lin School of Medicine, Singapore.
Introduction: Inhalers are critical in asthma treatment, and inappropriate inhaler use leads to poor asthma outcomes. In adults and adolescents, dry powder inhalers (DPIs) are safe and effective alternatives to mainstay pressurised metered dose inhalers and could bridge the asthma care gap while also reducing the environmental burden of asthma care. Despite being licensed for use in ages 5 years old and older, the evidence for clinical effectiveness is less clear for patients between ages 5 and 12 years.
View Article and Find Full Text PDFNurs Outlook
January 2025
School of Nursing, University of Pennsylvania, Philadelphia, PA.
Background: Microaggressions are pervasive in clinical and academic environments, often unnoticed by those unaware of the privileges and power dynamics tied to socially constructed hierarchies. These subtle manifestations of bias and prejudice are typically directed toward historically marginalized individuals and groups (HMIGs), contributing to a toxic culture that undermines interprofessional communication, collaboration, and healthcare delivery.
Purpose: This article aims to explore the concept of microaggressions and their impact on healthcare environments.
Integr Environ Assess Manag
January 2025
Industrieverband Agrar e. V. (IVA), Wissenschaft und Innovation, Frankfurt am Main, Germany.
Current publications that are shaping public perception repeatedly claim that residues of plant protection products (PPP) in the environment demonstrate gaps in assessing the exposure and effects of PPP, allegedly revealing the inability of the European regulatory system to prevent environmental contamination and damage such as biodiversity decline. The hypothesis is that environmental risk assessments rely on inappropriate predictive models that underestimate exposure and do not explicitly account for the impact of combinations of environmental stressors and physiological differences in stress responses. This article puts this criticism into context to allow for a more balanced evaluation of the European regulatory system for PPP.
View Article and Find Full Text PDFCochrane Database Syst Rev
January 2025
Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Chuo-ku, Japan.
Background: Antimicrobial resistance (AMR) is a major global health concern. One of the most important causes of AMR is the excessive and inappropriate use of antimicrobial drugs in healthcare and community settings. Most countries have policies that require antimicrobial drugs to be obtained from a pharmacy by prescription.
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