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https://www.readbyqxmd.com/read/28638240/perioperative-management-of-neurological-conditions
#1
REVIEW
Manjeet Singh Dhallu, Ahmed Baiomi, Madhavi Biyyam, Sridhar Chilimuri
Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28634428/marketization-in-long-term-care-a-cross-country-comparison-of-large-for-profit-nursing-home-chains
#2
Charlene Harrington, Frode F Jacobsen, Justin Panos, Allyson Pollock, Shailen Sutaria, Marta Szebehely
This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28615955/reply-to-commentary-on-our-paper-palliative-care-and-patient-autonomy
#3
REVIEW
Samuel H LiPuma, Joseph P DeMarco
No abstract text is available yet for this article.
2017: Health Services Insights
https://www.readbyqxmd.com/read/28615954/response-to-lipuma-and-demarco-s-article-on-hastening-death
#4
REVIEW
Julia Zenz
The paper "Palliative care and patient autonomy: moving beyond prohibitions against hastening death" by LiPuma and DeMarco deals with an aspect of end of life care which is the source of considerable disagreement. It is important to emphasize that autonomy is not the unique feature for end of life care. There is always a medical and ethical commitment to care, i.e. beneficence and nonmaleficence. All of these aspects have to be taken into account when treating patients at the very end of life. There is considerable scientific proof indicating that most patients and families can experience a death in dignity when being cared for in palliative care or hospice units...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469459/cardiac-evaluation-and-monitoring-of-patients-undergoing-noncardiac-surgery
#5
REVIEW
Arsalan Rafiq, Eduard Sklyar, Jonathan N Bella
Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Although such events are very small in number, they are associated with a high mortality rate making it essential for physicians to understand the importance of perioperative cardiovascular risk assessment and evaluation. Its involves a detailed process of history taking, patient's medical profile, medications being used, functional status of the patient, and knowledge about the surgical procedure and its inherent risks...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469458/engaging-community-leaders-in-the-development-of-a-cardiovascular-health-behavior-survey-using-focus-group-based-cognitive-interviewing
#6
Gwenyth R Wallen, Johnetta N Saygbe, Alyssa Todaro Brooks, Michael McClurkin, Samantha Thomas, Tiffany M Powell-Wiley
Establishing the validity of health behavior surveys used in community-based participatory research (CBPR) in diverse populations is often overlooked. A novel, group-based cognitive interviewing method was used to obtain qualitative data for tailoring a survey instrument designed to identify barriers to improved cardiovascular health in at-risk populations in Washington, DC. A focus group-based cognitive interview was conducted to assess item comprehension, recall, and interpretation and to establish the initial content validity of the survey...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469457/outcomes-of-surgeries-performed-in-physician-offices-compared-with-ambulatory-surgery-centers-and-hospital-outpatient-departments-in-florida
#7
Robert L Ohsfeldt, Pengxiang Li, John E Schneider, Ivana Stojanovic, Cara M Scheibling
BACKGROUND: The proportion of outpatient surgeries performed in physician offices has been increasing over time, raising concern about the impact on outcomes. OBJECTIVE: To use a private insurance claims database to compare 7-day and 30-day hospitalization rates following relatively complex outpatient surgical procedures across physician offices, freestanding ambulatory surgery centers (ASCs), and hospital outpatient departments (HOPDs). METHODS: A multivariable logistic regression model was used to compare the risk-adjusted probability of hospitalization among patients after any of the 88 study outpatient procedures at physician offices, ASCs, and HOPDs over 2008-2012 in Florida...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469456/mental-health-service-provision-in-low-and-middle-income-countries
#8
REVIEW
Shanaya Rathod, Narsimha Pinninti, Muhammed Irfan, Paul Gorczynski, Pranay Rathod, Lina Gega, Farooq Naeem
This article discusses the provision of mental health services in low- and middle-income countries (LMICs) with a view to understanding the cultural dynamics-how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource allocation and strategic organisation, integrated packages of care underpinned by professional communication and training, and involvement of patients, informal carers, and the wider community in a therapeutic capacity...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469455/perioperative-care-of-patients-with-liver-cirrhosis-a-review
#9
REVIEW
Naeem Abbas, Jasbir Makker, Hafsa Abbas, Bhavna Balar
The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469454/perioperative-management-of-thyroid-dysfunction
#10
REVIEW
Marcia Rashelle Palace
Due to the manifold effects of thyroid hormone across virtually all organ systems, the complications associated with thyroid dysfunction are numerous and diverse. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to be cognizant of the most effective means of optimizing the status of thyrotoxic and hypothyroid patients perioperatively...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28469453/evaluation-and-monitoring-of-patients-with-cardiovascular-implantable-electronic-devices-undergoing-noncardiac-surgery
#11
REVIEW
Eduard Sklyar, Jonathan N Bella
In this article, the reader will get some insights into managing patient with implantable cardiac devices while undergoing noncardiac surgery. We will review basic concepts regarding normal function of pacemakers and implantable cardioverter defibrillators, understanding how their function will be influenced during noncardiac surgeries. You will be guided through management steps from preoperative, intraoperative, and postoperative aspects. In an ever-changing world of medicine, it is important to keep up with progress as more and more patients get implantable cardiac devices...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28008269/perioperative-management-of-direct-oral-anticoagulants-doacs-a-systemic-review
#12
REVIEW
Tagore Sunkara, Emmanuel Ofori, Vadim Zarubin, Megan E Caughey, Vinaya Gaduputi, Madhavi Reddy
Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27980420/palliative-care-and-patient-autonomy-moving-beyond-prohibitions-against-hastening-death
#13
Samuel H LiPuma, Joseph P DeMarco
The National Hospice and Palliative Care Organization (NHPCO) upholds policies prohibiting practices that deliberately hasten death. We find these policies overly restrictive and unreasonable. We argue that under specified circumstances it is both reasonable and morally sound to allow for treatments that may deliberately hasten death; these treatments should be part of the NHPCO guidelines. Broadening such policies would be more consistent with the gold standard of bioethical principles, ie, respecting the autonomy of competent adults...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27867301/perioperative-evaluation-of-patients-with-pulmonary-conditions-undergoing-non-cardiothoracic-surgery
#14
REVIEW
Gilda Diaz-Fuentes, Hafiz Rizwan Talib Hashmi, Sindhaghatta Venkatram
This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27812286/development-functioning-and-effectiveness-of-a-preoperative-risk-assessment-clinic
#15
REVIEW
Hassan Tariq, Rafeeq Ahmed, Salil Kulkarni, Sana Hanif, Omesh Toolsie, Hafsa Abbas, Sridhar Chilimuri
Lee first described the concept of preoperative assessment testing (PAT) clinic in 1949. An efficiently run clinic is associated with increased cost-effectiveness by lowering preoperative admission time and thus reducing the length of stay and the associated costs. The setup of the PAT clinic should be based on the needs, culture, and resources of the institution. Various models for the setup of PAT clinic have been described, including the concept of a perioperative surgical home, which is a patient-centered model designed to improve health and the delivery of health care and to reduce the cost of care...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27721654/urban-rural-differences-in-health-care-seeking-pattern-of-residents-of-abia-state-nigeria-and-the-implication-in-the-control-of-ncds
#16
Ugochukwu U Onyeonoro, Okechukwu S Ogah, Andrew U Ukegbu, Innocent I Chukwuonye, Okechukwu O Madukwe, Akhimiem O Moses
BACKGROUND: Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. METHODS: This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27429556/cost-effectiveness-of-shine-a-telephone-translation-of-the-diabetes-prevention-program
#17
Christopher S Hollenbeak, Ruth S Weinstock, Donald Cibula, Linda M Delahanty, Paula M Trief
BACKGROUND: The Support, Health Information, Nutrition, and Exercise (SHINE) trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP) lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC) adaptation was cost effective relative to an individual call (IC) adaptation of the DPP lifestyle intervention in the primary care setting. METHODS: We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27103819/the-need-for-higher-minimum-staffing-standards-in-u-s-nursing-homes
#18
Charlene Harrington, John F Schnelle, Margaret McGregor, Sandra F Simmons
Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27081312/marital-status-and-survival-in-patients-with-carcinoid-tumors
#19
Erin K Greenleaf, Amanda B Cooper, Christopher S Hollenbeak
BACKGROUND: Marital status is a known prognostic factor in overall and disease-specific survival in several types of cancer. The impact of marital status on survival in patients with carcinoid tumors remains unknown. We hypothesized that married patients have higher rates of survival than similar unmarried patients with carcinoid tumors. METHODS: Using the Surveillance, Epidemiology, and End Results database, we identified 23,126 people diagnosed with a carcinoid tumor between 2000 and 2011 and stratified them according to marital status...
2016: Health Services Insights
https://www.readbyqxmd.com/read/26997869/integrating-estimates-of-the-social-and-individual-costs-of-caregiving-into-dementia-treatment-trials
#20
Charles D Phillips
A variety of new treatments for dementia are awaiting or undergoing randomized clinical trails. These trials focus on outcomes such as changes in cognitive function, physical function, or amyloid plaques. What is quite important and is too often missing from these trials are estimates of the impact of these treatments on the social and individual costs of providing care for those facing dementia. Until outcomes such as family caregiver time and caregiver burden are included in trails of dementia treatments, the picture of how well these treatments work will be distressingly incomplete...
2016: Health Services Insights
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