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https://www.readbyqxmd.com/read/28799481/evolving-motivations-patients-and-caregivers-perceptions-about-seeking-myotonic-dystrophy-dm1-and-huntington-s-disease-care
#1
Kori A LaDonna, Christopher J Watling, Susan L Ray, Christine Piechowicz, Shannon L Venance
Patient-centered care provision is challenging under ideal circumstances; myotonic dystrophy (DM1) and Huntington's disease (HD) are examples of chronic, progressive health conditions that may challenge its limits. If we can understand how care unfolds in these conditions, health care providers may be better equipped to address patients' needs. Constructivist grounded theory informed data collection and analysis. Fourteen patients with DM1 or HD, and 10 caregivers participated in semistructured interviews. Constant comparative analysis was used to identify themes...
September 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28751491/pediatric-chronic-critical-illness-reducing-excess-hospitalizations
#2
Renee D Boss, Erin P Williams, Carrie M Henderson, Rebecca R Seltzer, Miriam C Shapiro, Emily Hahn, Nancy Hutton
OBJECTIVES: The past 2 decades have seen an expanding pediatric population that is chronically critically ill: children with repeated and prolonged hospitalizations and ongoing dependence on technologies to sustain vital functions. Although illness complexity prompts many hospitalizations, our goal with this study was to explore modifiable patient, family, and health system contributions to excess hospital days for children with chronic critical illness (CCI). METHODS: Semistructured interviews were conducted with 51 stakeholders known for their CCI expertise...
July 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28744481/visualizing-antimicrobials-in-bacterial-biofilms-three-dimensional-biochemical-imaging-using-tof-sims
#3
Sarah K Davies, Sarah Fearn, Luke P Allsopp, Freya Harrison, Ecaterina Ware, Stephen P Diggle, Alain Filloux, David S McPhail, Jacob G Bundy
Bacterial biofilms are groups of bacteria that exist within a self-produced extracellular matrix, adhering to each other and usually to a surface. They grow on medical equipment and inserts such as catheters and are responsible for many persistent infections throughout the body, as they can have high resistance to many antimicrobials. Pseudomonas aeruginosa is an opportunistic pathogen that can cause both acute and chronic infections and is used as a model for research into biofilms. Direct biochemical methods of imaging of molecules in bacterial biofilms are of high value in gaining a better understanding of the fundamental biology of biofilms and biochemical gradients within them...
July 2017: MSphere
https://www.readbyqxmd.com/read/28727719/intercostal-neuralgia-occurring-as-a-complication-of-splanchnic-nerve-radiofrequency-ablation-in-a-patient-with-chronic-pancreatitis
#4
Saipriya Tewari, Anil Agarwal, Sujeet K Gautam, Rajashree Madabushi
Our intent is to report a case of intercostal neuralgia occuring as a complication of splanchnic radiofreqency ablation (RFA), due to a breach in the integrity of the insulating sheath of the RFA needle.A 48-year-old man presented to our pain clinic with upper abdominal pain due to chronic pancreatitis, recalcitrant to medical management. We decided to perform bilateral splanchnic nerve RFA in this patient. After confirmation of bilateral correct needle placement under fluoroscopic guidance and sensorimotor testing, RFA was performed on the right side uneventfully...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28713094/the-use-of-various-models-of-chronic-immobilization-stress-in-experimental-studies
#5
Mykhailo M Koptev, Nataliia I Vynnyk
INTRODUCTION: Stress is defined as a complex of protective and disturbing responses of the organism, generated in the process of the evolution, which occur as a result of neuroendocrine and metabolic alterations in response to the impact of emergency or pathological factors. Hence, stress is an important link of the adaptive mechanism; however, its adverse course can contribute to pathogenesis of many diseases. The problem of stress, which has been under study for years, is still a relevant topic to be investigated...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28705192/medical-condition-and-care-of-undocumented-migrants-in-ambulatory-clinics-in-tel-aviv-israel-assessing-unmet-needs
#6
Zohar Mor, Yuval Raveh, Ido Lurie, Alex Leventhal, Roni Gamzu, Nadav Davidovitch, Orel Benari, Itamar Grotto
BACKGROUND: Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs and assess gaps between medical needs and available services. METHODS: This cross-sectional study included a random sample of 610 UM aged 18-64 years, who were treated in these community clinics between 2008 and 2011...
July 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28647945/the-emerging-adult-with-diabetes-transitioning-from-pediatric-to-adult-care
#7
Jodi Krall, Ingrid Libman, Linda Siminerio
Transfer from pediatric to adult health care is a significant life event for youth with chronic medical conditions. Unfortunately, youth may not be well prepared to navigate the shift in health care services, increasing their risk for loss to follow up and poor health outcomes. This review explores transition in care through the lens of type 1 diabetes, highlighting current practices and guidelines and offering recommendations for future consideration. Limited evidence suggests that transition programs that focus on strategies to prepare youth developmentally and equip the health care system appropriately have positive impact on the hand off of care, and health outcomes...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28644422/immersive-virtual-reality-for-pediatric-pain
#8
REVIEW
Andrea Stevenson Won, Jakki Bailey, Jeremy Bailenson, Christine Tataru, Isabel A Yoon, Brenda Golianu
Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain...
June 23, 2017: Children
https://www.readbyqxmd.com/read/28593001/teaching-echoscopy-for-the-early-diagnosis-of-ascites-in-cirrhosis-assessment-of-an-objective-structured-clinical-examination-osce
#9
Salmi Andrea, Lanzani Giovanna, Campagnola Pietro, Frulloni Luca
INTRODUCTION: We assessed the efficacy of a brief, 8-h teaching program, using an objective structured clinical examination (OSCE) for the use of a pocket ultrasound device (echoscope) focused on bed side diagnosis of subclinical ascites in chronic liver disease. PATIENTS AND METHODS: Ten cirrhotic patients, five with subclinical ascites and five without, were selected during ultrasound examination performed with a high performance equipment for screening of hepatocellular carcinoma...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28543624/areas-for-quality-improvements-in-heart-failure-care-quality-of-care-from-the-family-members-perspective
#10
Karin Hellström Ängerud, Kurt Boman, Margareta Brännström
BACKGROUND: The complex needs of people with chronic heart failure (HF) place great demands on their family members, and it is important to ask family members about their perspectives on the quality of HF care. OBJECTIVE: To describe family members' perceptions of quality of HF care in an outpatient setting. METHODS: A cross-sectional study using a short form of the Quality from Patients' Perspective (QPP) questionnaire for data collection...
May 24, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#11
REVIEW
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28487872/incidence-and-severity-of-nausea-and-vomiting-in-a-group-of-maintenance-hemodialysis-patients
#12
Mohammad Reza Asgari, Fatemeh Asghari, Ali Asghar Ghods, Raheb Ghorbani, Nahid Hoshmand Motlagh, Fatemeh Rahaei
Introduction: Chronic kidney disease (CKD) is a rising problem across the world, including Iran. Most of the patients will require hemodialysis for survival. Despite the great progress has been made in the hemodialysis equipment, but it is still associated with complications. Nausea and vomiting are common complication of during hemodialysis, which leads to unpleasant feeling in patients. Objectives: This study aimed to determine incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28422296/keeping-out-and-getting-in-reframing-emergency-department-gatekeeping-as-structural-competence
#13
Mara Buchbinder
Sociologists have tended to frame medical gatekeeping as an exclusionary social practice, delineating how practitioners and clerical staff police the moral boundaries of medicine by keeping out patients who are categorised as 'bad', 'deviant', or otherwise problematic. Yet medical gatekeeping, understood more broadly, can include not only keeping patients out of particular clinical settings, but also redirecting them to alternative sources of care. In this article, I draw on qualitative analysis of audio-recorded patient-provider interactions in a United States emergency department (ED) to illustrate medical gatekeeping as a two-step process of, first, categorising certain patient complaints as unsuitable for treatment within a particular setting, and second, diverting patients to alternative sites for care...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28342694/nursing-led-home-visits-post-hospitalization-for-children-with-medical-complexity
#14
Sarah Wells, Margaret O'Neill, Jayne Rogers, Kevin Blaine, Amy Hoffman, Sarah McBride, Meghan M Tschudy, Igor Shumskiy, Sangeeta Mauskar, Jay G Berry
PURPOSE: Hospital discharge for children with medical complexity (CMC) can be challenging for families. Home visits could potentially benefit CMC and their families after leaving the hospital. We assessed the utility of post-discharge home visits to identify and address health problems for recently hospitalized CMC. DESIGN AND METHODS: A prospective study of 36 CMC admitted to a children's hospital from 4/15/2015 to 4/14/2016 identified with a possible high risk of hospital readmission and offered a post-discharge home visit within 72h of discharge...
March 23, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28330486/relationships-between-structure-process-and-outcome-to-assess-quality-of-integrated-chronic-disease-management-in-a-rural-south-african-setting-applying-a-structural-equation-model
#15
Soter Ameh, Francesc Xavier Gómez-Olivé, Kathleen Kahn, Stephen M Tollman, Kerstin Klipstein-Grobusch
BACKGROUND: South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28299542/understanding-and-improving-knowledge-of-cancer-survivorship-care-among-college-providers
#16
Alexandra M Psihogios, Helen Pauly-Hubbard, Lisa Schwartz, Jill P Ginsberg, Wendy Hobbie, Dava Szalda
This study aimed to assess college providers' basic knowledge of the health risks of young adult cancer survivors (YAS) and related care guidelines and to determine whether an educational in-service is an effective platform for increasing college health providers' knowledge about survivorship care at a large university health center. During phase 1, staff from college health centers and office of disabilities in the Philadelphia area (n = 40 staff members from 24 colleges/universities) completed a needs assessment on their experiences with YAS and preferences for education and care coordination...
March 15, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28283007/-mortality-related-factors-in-patients-requiring-hospitalization-for-influenza-like-illness
#17
Lale Özışık, Mine Durusu Tanrıöver, Meral Çıblak Akçay, Kübra Yuntçu, Serhat Ünal, Selim Badur, Banu Çakır
The knowledge about the viral etiologies causing respiratory disease in adults is limited. Viral respiratory diseases may lead deterioration in certain patient populations. The aim of this study was to determine the viral etiologies of influenza-like illness among patients requiring hospitalization and to document the risk factors for mortality. This prospective study was performed in one of the 7 centers in Turkey in the context of influenza surveillance by the Global Influenza Hospital Surveillance Network...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28248782/occupational-exposures-of-home-healthcare-workers
#18
Noma Agbonifo, Beverly Hittle, Rassull Suarez, Kermit Davis
Population demographics in the United States are rapidly changing with increased dependence on home healthcare (HHC) by an aging population, patients suffering from chronic diseases, and inability to perform activities of daily living. Despite the occupational injury rates for HHC workers (HHCW) being higher than the national average, an understanding of the occupational safety and health experiences and exposures of HHCW is limited. The purpose of this study was to understand the health and safety risk factors for HHCW...
March 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#19
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
https://www.readbyqxmd.com/read/28186390/pain-management-in-the-ehlers-danlos-syndromes
#20
REVIEW
Pradeep Chopra, Brad Tinkle, Claude Hamonet, Isabelle Brock, Anne Gompel, Antonio Bulbena, Clair Francomano
Chronic pain in the Ehlers-Danlos syndromes (EDS) is common and may be severe. According to one study, nearly 90% of patients report some form of chronic pain. Pain, which is often one of the first symptoms to occur, may be widespread or localized to one region such as an arm or a leg. Studies on treatment modalities are few and insufficient to guide management. The following is a discussion of the evidence regarding the underlying mechanisms of pain in EDS. The causes of pain in this condition are multifactorial and include joint subluxations and dislocations, previous surgery, muscle weakness, proprioceptive disorders, and vertebral instability...
March 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
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