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Continuity of Care Document

Sukanya Srinivasan, Lisa Schlar, Stephanie E Rosener, Daniel J Frayne, Scott G Hartman, Michael A Horst, Jessica L Brubach, Stephen Ratcliffe
BACKGROUND: Preterm birth, birth defects, and unintended pregnancy are major sources of infant and maternal morbidity, mortality, and associated resource use in American health care. Interconception Care (ICC) is recommended as a strategy to improve birth outcomes by modifying maternal risks between pregnancies, but no established model currently exists. The Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network developed and implemented a unique approach to ICC by assessing mothers during their baby's well-child visits (WCVs) up to 24 months...
March 2018: Journal of the American Board of Family Medicine: JABFM
Benjamin James Tarrant, Anne Holland, Caitlin Le Maitre, Rebecca Robinson, Monique Corbett, Janet Bondarenko, Brenda Button, Bruce Thompson, Greg Snell
BACKGROUND AND PURPOSE: Physiotherapy "standard care" for the acute post lung transplant recipient has not yet been documented. We aimed to analyse how soon patients commence exercise and how much time is dedicated to this during physiotherapy sessions acutely post lung transplantation. METHODS: Prospective observational study of bilateral sequential and single lung transplant recipients for any indication, ≥18 years. Participants were observed during 6 physiotherapy sessions: 3 initial and 3 prior to acute inpatient discharge...
March 12, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Ray W Squires, Adam M Shultz, Joerg Herrmann
PURPOSE OF REVIEW: Cancer patients nearly universally experience a decline in quality of life, with fatigue and reduced exercise tolerance as cardinal reflections. A routine exercise program can improve these signs and symptoms as well as overall outcomes. The review provides an updated overview of the field and its translation to clinical practice. RECENT FINDINGS: A wealth of clinical studies have documented the safety and benefits of exercise after and during cancer therapy, and pilot and larger-scale studies are currently ongoing to integrate exercise into the treatment program for cancer patients undergoing active therapy (EXACT pilot, OptiTrain, and TITAN study)...
March 10, 2018: Current Oncology Reports
Meg Osler, Katherine Hilderbrand, Eric Goemaere, Nathan Ford, Mariette Smith, Graeme Meintjes, James Kruger, Nelesh P Govender, Andrew Boulle
Background: Antiretroviral treatment (ART) has been massively scaled up to decrease human immunodeficiency virus (HIV)-related morbidity, mortality, and HIV transmission. However, despite documented increases in ART coverage, morbidity and mortality have remained substantial. This study describes trends in the numbers and characteristics of patients with very advanced HIV disease in the Western Cape, South Africa. Methods: Annual cross-sectional snapshots of CD4 distributions were described over 10 years, derived from a province-wide cohort of all HIV patients receiving CD4 cell count testing in the public sector...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Bridgette Kram, Kylie M Weigel, Michelle Kuhrt, Daniel L Gilstrap
OBJECTIVE: To evaluate the proportion of patients receiving a hospital discharge prescription for a scheduled enteral opioid following initiation as a weaning strategy from a continuous opioid infusion in the Intensive Care Unit (ICU). DESIGN: Retrospective, observational study. SETTING: Five adult ICUs at a large, quaternary care academic medical center. PATIENTS: Endotracheally intubated, opioid-naive adults receiving a continuous opioid infusion with a concomitant scheduled enteral opioid initiated...
January 2018: Journal of Opioid Management
Allan Best, Alex Berland, Trisha Greenhalgh, Ivy L Bourgeault, Jessie E Saul, Brittany Barker
Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders...
March 19, 2018: Journal of Health Organization and Management
Anthony Pham, Becky Lee, Eric L Chang
Brain metastases are the most common intracranial tumors in the adult population and have been historically treated with whole brain radiation therapy (WBRT). However, as medical advances improve life expectancy, stereotactic radiosurgery (SRS) has replaced WBRT as the standard of care for limited (one to three) brain metastases due to the relative sparing of neurocognitive function (NCF) and therefore quality of life (QoL). The use of SRS has been less documented in the case of multiple (four or more) brain metastases, with literature limited to non-randomized studies showing comparable survival and local control...
December 28, 2017: Curēus
Carlo Castellani, Alistair J A Duff, Scott C Bell, Harry G M Heijerman, Anne Munck, Felix Ratjen, Isabelle Sermet-Gaudelus, Kevin W Southern, Jurg Barben, Patrick A Flume, Pavla Hodková, Nataliya Kashirskaya, Maya N Kirszenbaum, Sue Madge, Helen Oxley, Barry Plant, Sarah Jane Schwarzenberg, Alan R Smyth, Giovanni Taccetti, Thomas O F Wagner, Susan P Wolfe, Pavel Drevinek
Developments in managing CF continue to drive dramatic improvements in survival. As newborn screening rolls-out across Europe, CF centres are increasingly caring for cohorts of patients who have minimal lung disease on diagnosis. With the introduction of mutation-specific therapies and the prospect of truly personalised medicine, patients have the potential to enjoy good quality of life in adulthood with ever-increasing life expectancy. The landmark Standards of Care published in 2005 set out what high quality CF care is and how it can be delivered throughout Europe...
March 2, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Patricia Louie, Rima Wilkes
Although a large literature has documented racial inequities in health care delivery, there continues to be debate about the potential sources of these inequities. Preliminary research suggests that racial inequities are embedded in the curricular edification of physicians and patients. We investigate this hypothesis by considering whether the race and skin tone depicted in images in textbooks assigned at top medical schools reflects the diversity of the U.S. POPULATION: We analyzed 4146 images from Atlas of Human Anatomy, Bates' Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray's Anatomy for Students by coding race (White, Black, and Person of Color) and skin tone (light, medium, and dark) at the textbook, chapter, and topic level...
February 23, 2018: Social Science & Medicine
Tsegahun Manyazewal, Mokgadi C Matlakala
Background: Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. Methods: A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia...
June 2018: Journal of Global Health
L Deravin, K Francis, J Anderson
AIM: This paper will review progress towards the identified targets within the Australian government policy document commonly known as 'Closing the Gap' and examine the role of nurses in supporting its implementation. BACKGROUND: Australia is not alone in seeking to address the health inequity between Indigenous and non-Indigenous people. Globally such health inequities are similar and require interventions supported by governments in conjunction with health and education systems to affect desired change...
March 1, 2018: International Nursing Review
Adam M H Young, Joseph Donnelly, Xiuyun Liu, Mathew R Guilfoyle, Melvin Carew, Manuel Cabeleira, Danilo Cardim, Matthew R Garnett, Helen M Fernandes, Christina Haubrich, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
OBJECTIVE:  Although secondary insults such as raised intracranial pressure (ICP) or cardiovascular compromise strongly contribute to morbidity, a growing interest can be noticed in how the pre-hospital management can affect outcomes after traumatic brain injury (TBI). The objective of this study was to determine whether pre-hospital co-morbidity has influence on patterns of continuously measured waveforms of intracranial physiology after paediatric TBI. MATERIALS AND METHODS: Thirty-nine patients (mean age, 10 years; range, 0...
2018: Acta Neurochirurgica. Supplement
M Margariti, M Hadjulis, M Lazaridou, G F Angelidis, V Fotopoulos, L Markaki, F Koulouri
The initiative for the development of national treatment guidelines, dates back to the '90s. In Greece, however, National Clinical Guidelines for the management of schizophrenia were first formulated in 2014 when a Working Group was set up for this purpose by the Greek Ministry of Health. The objective of this Working Group was to provide evidence-based recommendations covering the pharmacological and psychosocial treatment of schizophrenia as well as the development of appropriate treatment services. The Working Group utilized the NICE Guideline (National Institute of Clinical Excellence, 2010, 2014) for the management of Psychosis & Schizophrenia as the main guide to develop the Greek National Guidelines , and in addition the American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Schizophrenia (APA 2004), the Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders (Royal Australian and New Zealand College of Psychiatrists 2005) , as well as other relevant sources...
October 2017: Psychiatrikē, Psychiatriki
Corinne M Hohl, Serena S Small, David Peddie, Katherin Badke, Chantelle Bailey, Ellen Balka
BACKGROUND: Adverse drug events are unintended and harmful events related to medications. Adverse drug events are important for patient care, quality improvement, drug safety research, and postmarketing surveillance, but they are vastly underreported. OBJECTIVE: Our objectives were to identify barriers to adverse drug event documentation and factors contributing to underreporting. METHODS: This qualitative study was conducted in 1 ambulatory center, and the emergency departments and inpatient wards of 3 acute care hospitals in British Columbia between March 2014 and December 2016...
February 27, 2018: JMIR Public Health and Surveillance
Satya Surbhi, Ilana Graetz, Jim Y Wan, Justin Gatwood, James E Bailey
BACKGROUND: Nonadherence to essential chronic medications has been identified as a potential driver of high health care costs in superutilizers of inpatient services. Few studies, however, have documented the levels of nonadherence and factors associated with nonadherence in this high-cost, vulnerable population. OBJECTIVE: To examine the factors associated with nonadherence to essential chronic medications, with special emphasis on mental illness and use of opioid medications...
March 2018: Journal of Managed Care & Specialty Pharmacy
Florentia Dimitriou, Anna L Frauchiger, Mirjana Urosevic-Maiwald, Mirjam C Naegeli, Simone M Goldinger, Marjam Barysch, Daniel Franzen, Jivko Kamarachev, Ralph Braun, Reinhard Dummer, Joanna Mangana
The development of cancer immunotherapy and targeted therapy has reached an important inflection point in the history of melanoma. Immune checkpoint inhibitors and kinase inhibitors are today's standard of care treatments in advanced melanoma patients. Treatment-related toxicities can be very intriguing and quite challenging. Sarcoidosis is a multisystemic granulomatous disease characterized by an aberrant immune response to unknown antigens, whereas sarcoid-like reactions (SLRs) refer to localized clinical features...
February 26, 2018: Melanoma Research
Eugène J F M Custers, Olle Ten Cate
In this article, the authors present a historic overview of the development of medical education in the United States and Europe (in particular the Netherlands), as it relates to the issues of time (duration of the course) and proficiency (performance requirements and examinations). This overview is necessarily limited and based largely on post hoc interpretation, as historic data on time frames are not well documented and the issue of competence has only recently been addressed.During times when there were few, if any, formal regulations, physicians were primarily "learned gentlemen" in command of few effective practical skills, and the duration of education and the competencies acquired by the end of a course simply did not appear to be issues of any interest to universities or state authorities...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Laura C Seeff, Tricia McGinnis, Hilary Heishman
CONTEXT: As the US health care system continues to undergo dynamic change, the increased alignment between health care quality and payment has provided new opportunities for public health and health care sectors to work together. PROGRAM: The Centers for Disease Control and Prevention's 6|18 Initiative accelerates cross-sector collaboration between public health and health care purchasers, payers, and providers and highlights 6 high-burden conditions and 18 associated interventions with evidence of cost reduction/neutrality and improved health outcomes...
February 22, 2018: Journal of Public Health Management and Practice: JPHMP
Alok Thakar, Madan P Gupta, Achal Srivastava, Deepak Agrawal, Atin Kumar
Importance: Current recommendations envisage early surgical exploration for complete facial nerve paralysis associated with temporal bone fracture and unfavorable electrophysiologic features (response to electroneuronography, <5%). However, the evidence base for such a practice is weak, with the potential for spontaneous improvement being unknown, and the expected results from alternative nonsurgical treatment also undefined. Objective: To document the results of nonsurgical treatment for posttraumatic complete facial paralysis with undisplaced temporal bone fracture and unfavorable electrophysiologic features...
February 22, 2018: JAMA Otolaryngology—Head & Neck Surgery
Abraham Lwidiko, Stephen Matthew Kibusi, Azan Nyundo, Bonaventura C T Mpondo
BACKGROUND: Children and adolescents continue to have HIV/AIDS in southern Saharan Africa. Scaling up of HIV services has significantly improved access to ARV and consequently improved on morbidity and mortality related to HIV/AIDS including opportunistic infection. Despite the above efforts, non-communicable conditions including mental disorders such as depression have been observed to contribute to the burden of disabilities about which little is documented. This study, therefore, aimed to determine the magnitude of depressive symptoms and the associated factors among HIV-infected children and adolescents...
2018: PloS One
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