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Transition to adult care

Paul C Helm, Sebastian Kempert, Marc-André Körten, Wiebke Lesch, Katharina Specht, Ulrike M M Bauer
BACKGROUND: Children and adolescents with congenital heart disease (CHD) and their families require qualified combined medical and psychosocial information, care, and counseling. This study aimed to analyze CHD patients' and parents' perception of disease-specific knowledge, state of health, and impairments experienced in everyday life, as well as factors influencing these perceptions. MATERIALS AND METHODS: Analyses were based on a survey among patients/parents recruited via the German National Register for Congenital Heart Defects (NRCHD)...
January 25, 2018: Congenital Heart Disease
Marc J Weigensberg, Cheryl Vigen, Paola Sequeira, Donna Spruijt-Metz, Magaly Juarez, Daniella Florindez, Joseph Provisor, Anne Peters, Elizabeth A Pyatak
Background: The transition of young adults with type 1 diabetes (T1D) from pediatric to adult care is challenging and frequently accompanied by worsening of diabetes-related health. To date, there are no reports which prospectively assess the effects of theory-based psycho-behavioral interventions during the transition period neither on glycemic control nor on psychosocial factors that contribute to poor glycemic control. Therefore, the overall aim of this study was to develop and pilot test an integrative group intervention based on the underlying principles of self-determination theory (SDT), in young adults with T1D...
2018: Global Advances in Health and Medicine: Improving Healthcare Outcomes Worldwide
Laurie E Powers, Ann Fullerton, Jessica Schmidt, Sarah Geenen, Molly Oberweiser-Kennedy, JoAnn Dohn, May Nelson, Rosemary Iavanditti, Jennifer Blakeslee
Research clearly documents the serious challenges and poor outcomes experienced by many young people exiting foster care, as well as compounded disparities for the high percentage of youth in care who are identified with disabilities and/or mental health challenges. However, very little research has been conducted to specify or validate effective models for improving the transition trajectories of youth exiting care. Evidence suggests the My Life self-determination enhancement model offers a promising approach for supporting youths' self-determined and positive transition to adulthood...
February 2018: Children and Youth Services Review
Agnes Leu, Corinna Jung, Marianne Frech, Joe Sempik, Urs Moser, Martin Verner, Saul Becker
BACKGROUND: In Switzerland, the issue of young carers and young adult carers - young people under the age of 18 and 24 respectively, who take on significant or substantial caring tasks and levels of responsibility that would usually be associated with an adult - has not been researched before. The number of these younger carers is unknown, as is the extent and kind of their caring activities and the outcomes for their health, well-being, psycho-social development, education, transitions to adulthood, future employability and economic participation...
March 15, 2018: BMC Health Services Research
Albert C Hergenroeder, Douglas S Moodie, Daniel J Penny, Constance M Wiemann, Blanca Sanchez-Fournier, Lauren K Moore, Jane Head
OBJECTIVE: To describe changes in functional status between the last pediatric and first adult congenital heart disease (CHD) clinic visits in patients with moderate to severe CHD after implementing a healthcare transition (HCT) planning program. DESIGN: Quasi-experimental design. Patients were followed prospectively following the implementation of the intervention; Control patients transitioned from the Pediatric CHD Clinic into Adult CHD Clinic before the intervention...
March 15, 2018: Congenital Heart Disease
Lisa Hochstrasser, Alexander Voulgaris, Julian Möller, Tatjana Zimmermann, Regine Steinauer, Stefan Borgwardt, Undine E Lang, Christian G Huber
Background: Implementing an open door policy is a complex intervention comprising changes in therapeutic stance, team processes, and a change from locked to open doors. Recent studies show that it can lead to a reduction of seclusion and forced medication, but the role of the physical change of door status is still unclear. Aims: The aims of this study is to examine the transition from closed to predominantly open doors on a psychiatric intensive care unit (PICU) and its associations with the frequency of seclusion and forced medication...
2018: Frontiers in Psychiatry
Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
K Farrell, R Fernandez, Y Salamonson, R Griffiths, D J Holmes-Walker
AIMS: To identify a) determinants of glycated haemoglobin (HbA1c) at 18 and 30 months following transition in young people with Type 1 diabetes mellitus (T1DM) to a youth-specific diabetes service; and to b) evaluate the impact of the service on acute admissions with diabetic ketoacidosis (DKA) over a 14-year period. METHODS: An audit of records of youth with T1DM referred from paediatric services to the multidisciplinary transition service at Westmead Hospital, from 2001-2012, and followed-up to 2014...
March 10, 2018: Diabetes Research and Clinical Practice
Antoine Rachas, Philippe Tuppin, Laurence Meyer, Bruno Falissard, Albert Faye, Nizar Mahlaoui, Elise de La Rochebrochard, Marie Frank, Pierre Durieux, Josiane Warszawski
INTRODUCTION: The number of adolescents with a severe chronic disease has increased in high-income countries due to improvements in the prognosis of childhood-onset chronic conditions. The transition from childhood to adulthood is a critical period that may be associated with increased mortality and morbidity. We aimed to estimate the prevalence of adolescents with a long-term disease (LTD) in France and assess their mortality and hospitalization risks relative to the general population...
2018: PloS One
Rachel Bennett, Philippa Waterhouse
Understanding the transition to adulthood has important implications for supporting young adults and understanding the roots of diversity in wellbeing later in life. In South Africa, the end of Apartheid means today's youth are experiencing their transition to adulthood in a changed social and political context which offers opportunities compared to the past but also threats. This paper presents the first national level analysis of the patterning of key transitions (completion of education, entry into the labour force, motherhood and marriage or cohabitation), and the association between the different pathways and health amongst young women...
March 2, 2018: Social Science & Medicine
Jason R Falvey, Robert E Burke, Kyle J Ridgeway, Daniel J Malone, Jeri E Forster, Jennifer E Stevens-Lapsley
BACKGROUND AND PURPOSE: Recent evidence has suggested physical therapist involvement in care transitions after hospitalization is associated with reduced rates of hospital readmissions. However, little is known about how physical therapists participate in care transitions for older adults, the content of care communications, and the facilitators and barriers of implementing evidence-based care transition strategies into practice. Thus, the purpose of this article is to evaluate participation in care transition activities known to influence readmission risk among older adults, and understand perceptions of and barriers to participation in these activities...
March 12, 2018: Journal of Geriatric Physical Therapy
Marta Trapero-Bertran, Celia Muñoz, Kathryn Coyle, Doug Coyle, Adam Lester-George, Reiner Leidl, Bertalan Németh, Kei-Long Cheung, Subhash Pokhrel, Ángel Lopez-Nicolás
AIMS: To assess the cost-effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). DESIGN: We used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov-based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self-helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion...
March 13, 2018: Addiction
Stacy Pelekhaty, Jay Menaker
Prader-Willi Syndrome (PWS) is a genetic condition that results in a constellation of symptoms and typically results in hyperphagia and obesity in adulthood. Critically ill adults with PWS present a unique challenge to the nutrition professional, particularly when they require support modalities such as extracorporeal membrane oxygenation (ECMO). The purpose of this case study is to review the nutrition care of a critically ill adult patient with PWS who required venovenous ECMO. The patient was successfully managed with a hypocaloric, high-protein approach, which did not result in the diagnosis of malnutrition during his hospitalization...
March 12, 2018: Nutrition in Clinical Practice
Patrick D Quinn, Kwan Hur, Zheng Chang, Eric L Scott, Erin E Krebs, Matthew J Bair, Martin E Rickert, Robert D Gibbons, Kurt Kroenke, Brian M D'Onofrio
Importance: Adults with mental health conditions are more likely than those without to receive long-term opioid therapy. Less is known about opioid therapy among adolescents, especially those with mental health conditions. Objective: To examine associations between preexisting mental health conditions and treatments and initiation of any opioid and long-term opioid therapy among adolescents. Design, Setting, and Participants: A cohort of 1 224 520 incident opioid recipients without cancer diagnoses aged 14 to 18 years at first receipt was extracted from nationwide commercial health care claims data from January 1, 2003, to December 31, 2014...
March 12, 2018: JAMA Pediatrics
M Colinart-Thomas, V Noël, G Roques, S Gordes-Grosjean, M Abely, C Pluchart
Sickle cell disease, a hemoglobin disorder with autosomal recessive transmission, is one of the most common genetic diseases screened in France. Thanks to early management, 95% of sickle cell patients reach adulthood and require transition from pediatric care to adult care. Through a retrospective study of records from serious sickle cell patients over 17 years old, followed in the hematology-oncology pediatric unit of Reims University Hospital Center in France, we analyzed transition conditions, compared pediatric and adult management, and proposed a plan for transition care...
March 9, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ali Judd, Mary-Ann Davies
PURPOSE OF REVIEW: To summarize evidence for health outcomes among adolescents and young people living with HIV (AYLHIV) who have transitioned to adult care/adulthood, views of AYLHIV and providers on the transition process, and the effect of adolescent and youth friendly services (AYFS) on outcomes. RECENT FINDINGS: A total of 43 studies were identified [n = 13 high-income countries (HICs), n = 30 low-/middle-income countries (LMICs)]. In HICs, around 75% of patients were retained in care at approximately 4 years posttransition...
March 9, 2018: Current Opinion in HIV and AIDS
F Carbonez, M Al Husni Al Keilani, C Kornreich, V Delvenne
Adolescents and young adults are at particularly at-risk population in mental health. For a large majority of patients suffering from chronic psychiatric condition, the age of onset of psychiatric symptoms is less than 24 years, while the coverage in psychiatric care is the lowest between 16 and 24. Presenting a psychiatric pathology during childhood and adolescence constitutes an independent risk factor for the occurrence of adverse life events in adulthood. Furthermore, that population is at the edge between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS)...
2018: Revue Médicale de Bruxelles
Katherine Schultz, Leanne Carroll, Kristin Mainey, Elsa Dent
BACKGROUND: Transition care programs (TCPs) are designed to optimise functional recovery and independence in older adults post-hospitalisation. These programs are under high demand, and understanding inefficiencies in patient flow are a key step towards service improvement. AIMS: To identify service improvement opportunities in an Australian community TCP service. METHODS: An in-depth retrospective study of 113 community TCP clients. RESULTS: TCP occupancy was high (94%) and client functional level improved across the program...
March 10, 2018: Aging Clinical and Experimental Research
Ann H Tilton
PURPOSE OF THE REVIEW: The goal of the article is to describe a systematic approach through core principles and steps for the transition of the patient with a neurological disorder to the adult model of care, to provide steps and principles to help receiving providers successfully integrate the patient into their practice, and to discuss cultural, systemic, and discipline-based barriers to transition. RECENT FINDING: The literature has expanded rapidly. The recent publications help define the barriers to the process and are currently exploring the best methods to evaluate readiness, needs, barriers, and develop solutions for best practices...
March 10, 2018: Current Neurology and Neuroscience Reports
Wendy N Gray, Bonney Reed-Knight, Pamela J Morgan, Erin Holbrook, Subra Kugathasan, Shehzad A Saeed, Lee A Denson, Kevin A Hommel
PURPOSE: This multi-site study examines patient, parent, and pediatric provider perspectives on what is most important for successful transition. DESIGN AND METHODS: Using the Transition Readiness Assessment Questionnaire, 190 participants recruited from two pediatric IBD centers selected the top five skills they considered "most important for successful transition." Rankings were summarized and compared by group. RESULTS: While patients, parents, and clinicians all identified "calling the doctor about unusual changes in health" and "taking medications correctly and independently" as being important, each stakeholder group qualitatively and statistically differed in terms of transition readiness skills emphasized...
March 2018: Journal of Pediatric Nursing
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