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https://www.readbyqxmd.com/read/28632933/patient-characteristics-associated-with-a-successful-response-to-nurse-led-care-programs-targeting-the-oldest-old-a-comparison-of-two-rcts
#1
Nienke Bleijenberg, Lorenz Imhof, Romy Mahrer-Imhof, Margaret I Wallhagen, Niek J de Wit, Marieke J Schuurmans
BACKGROUND: To improve the effectiveness of community-based care programs, especially those targeting the oldest-old population (80+), data are needed that elucidate those factors associated with a successful response to the intervention. Two comparable nurse-led care programs have been evaluated in two large randomized controlled trials (RCTs), one in Switzerland and one in the Netherlands. AIMS: To identify common patient characteristics that are related to a successful response to proactive nurse-led care, we explored if and to what extent, identical factors were present in both study populations...
June 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28632654/an-overview-of-cardiac-computed-tomography-in-adults-with-congenital-heart-disease
#2
Pal Suranyi, Akos Varga-Szemes, Anthony M Hlavacek
Familiarity with congenital heart disease (CHD) and its manifestations in adults is becoming increasingly important for the practicing cardiothoracic imager. The use of computed tomographic angiography is becoming commonplace not only in adults with a history and subsequent interventions for CHD as a child but also in de novo detection of-typically-milder, survivable forms of CHD, which are clinically suspected because of declining cardiac performance, cardiac events, or murmurs. Occasionally, adult CHD (ACHD) is found incidentally on scans performed for other indications (eg, trauma or neoplasm staging) because of improvements in computed tomographic technology and advanced visualization...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28632653/imaging-adults-with-congenital-heart-disease-part-ii-advanced-cmr-techniques
#3
Anurag Sahu, Timothy C Slesnick
Because of great strides in medical care, survival into adulthood has become a common expectation in patients suffering from nearly all forms of congenital heart disease. As this aging population expands, the utilization of cardiac magnetic resonance imaging in their care continues to grow. Magnetic resonance technology has developed exponentially over the last 2 decades, and several advanced techniques for imaging adults with congenital heart disease have moved from the purely research arena into routine clinical care...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28631959/advance-care-planning-for-patients-with-amyotrophic-lateral-sclerosis
#4
Benjamin H Levi, Zachary Simmons, Courtney Hanna, Allyson Brothers, Erik Lehman, Elana Farace, Megan Bain, Renee Stewart, Michael J Green
PURPOSE: To determine whether an advance care planning (ACP) decision-aid could improve communication about end-of-life treatment wishes between patients with amyotrophic lateral sclerosis (ALS) and their clinicians. METHODS: Forty-four patients with ALS (>21, English-speaking, without dementia) engaged in ACP using an interactive computer based decision-aid. Before participants completed the intervention, and again three months later, their clinicians reviewed three clinical vignettes, and made treatment decisions (n = 18) for patients...
March 5, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28630131/-it-s-a-hard-conversation-to-have-healthcare-professionals-views-concerning-advance-care-discussions-with-young-people-affected-by-life-limiting-neuromuscular-diseases-an-interview-study
#5
Andy Hiscock, Stephen Barclay
OBJECTIVE: Life-limiting neuromuscular disease, such as some of the muscular dystrophies, are often diagnosed in early childhood: when death comes, commonly in the second or third decade of life, patients rarely have advance care plans in place or documented end-of-life care preferences. There is very limited literature concerning the discussions about end-of-life plans healthcare professionals have with young people affected by life-limiting neuromuscular diseases. The aim of this study was to investigate the views and experiences of healthcare professionals concerning having discussions about advance care plans and end-of-life care with teenagers and young adult patients affected by life-limiting neuromuscular diseases...
June 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28628782/incorporation-of-a-health-economic-modelling-tool-into-public-health-commissioning-evidence-use-in-a-politicised-context
#6
Tom Sanders, Amy Grove, Sarah Salway, Susan Hampshaw, Elizabeth Goyder
This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency...
June 12, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28627303/the-surprise-question-in-paediatric-palliative-care-a-prospective-cohort-study
#7
Kimberley Burke, Lucy Helen Coombes, Antoinette Menezes, Anna-Karenia Anderson
BACKGROUND: The question 'would you be surprised if this patient died in the next 12-months' is widely used for identifying adult patients in the last year of life. However, this has not yet been studied in children. AIM: To assess the prognostic accuracy of the surprise question when used by a multidisciplinary team to predict survival outcomes of children with life-limiting conditions over a 3 and 12 month period. DESIGN: A prospective cohort study...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28627287/utilizing-the-electronic-health-record-to-improve-advance-care-planning-a-systematic-review
#8
Michael Todd Huber, Janelle Deneen Highland, Venkatesan Ram Krishnamoorthi, Joyce Wing-Yi Tang
PURPOSE: Advance care planning may ensure care that is concordant with patient wishes. However, advance care plans are frequently absent when needed due to failure to engage patients in planning, inability to access prior documentation, or poor documentation quality. Interventions utilizing tools within the electronic health record (EHR) may address these barriers at the point of care. We aimed to identify EHR interventions previously utilized to improve advance care plans. METHODS: We systematically searched 7 databases for observational and experimental studies of EHR interventions associated with advance care plans...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28627221/management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#9
Kara Harrington, Claire T Boyle, Kellee M Miller, Marisa E Hilliard, Barbara J Anderson, Michelle Van Name, Linda A DiMeglio, Lori M Laffel
BACKGROUND: This study investigated unique burdens experienced by parents of young children with type 1 diabetes in the context of contemporary diabetes management. METHODS: Self-report surveys and medical record information from the T1D Exchange clinic registry were used. Parental burden and family impact scores were tabulated across demographic and clinical characteristics, overall and according to age group (<4, 4-<6, and 6-<7 years). RESULTS: The mean age of the 549 children was 5...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28624484/progression-to-stage-d-heart-failure-among-outpatients-with-stage-c-heart-failure-and-reduced-ejection-fraction
#10
Andreas P Kalogeropoulos, Ayman Samman-Tahhan, Jeffrey S Hedley, Andrew A McCue, Jonathan B Bjork, David W Markham, Kunal N Bhatt, Vasiliki V Georgiopoulou, Andrew L Smith, Javed Butler
OBJECTIVES: This study sought to estimate the rate of progression to Stage D heart failure (HF) among outpatients with Stage C HF and to identify risk factors for progression. BACKGROUND: The pool of patients who may be candidates for advanced HF therapies is growing. METHODS: We estimated 3-year progression to clinically determined Stage D HF and competing mortality among 964 outpatients with Stage C heart failure with reduced ejection fraction (HFrEF), where ejection fraction is ≤40%...
June 14, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28623155/care-toward-the-end-of-life-in-older-populations-and-its-implementation-facilitators-and-barriers-a-scoping-review
#11
REVIEW
Diane Erin Threapleton, Roger Y Chung, Samuel Y S Wong, Eliza L Y Wong, Nicole Kiang, Patsy Y K Chau, Jean Woo, Vincent C H Chung, Eng Kiong Yeoh
PURPOSE: To inform health system improvements for care of elderly populations approaching the end of life (EOL) by identifying important elements of care and implementation barriers and facilitators. DESIGN: A scoping review was carried out to identify key themes in EOL care. Articles were identified from MEDLINE, the Cochrane Library, organizational websites, and internet searches. Eligible publications included reviews, reports, and policy documents published between 2005 and 2016...
June 13, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28618896/managing-risk-during-care-transitions-when-approaching-end-of-life-a-qualitative-study-of-patients-and-health-care-professionals-decision-making
#12
Maureen A Coombs, Roses Parker, Kay de Vries
BACKGROUND: Increasing importance is being placed on the coordination of services at the end of life. AIM: To describe decision-making processes that influence transitions in care when approaching the end of life. DESIGN: Qualitative study using field observations and longitudinal semi-structured interviews. SETTING/PARTICIPANTS: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28618112/older-patients-with-late-stage-copd-their-illness-experiences-and-involvement-in-decision-making-regarding-mechanical-ventilation-and-noninvasive-ventilation
#13
Heidi Jerpseth, Vegard Dahl, Per Nortvedt, Kristin Halvorsen
Older patients with late-stage COPD: their illness experiences and involvement in decision-making regarding mechanical ventilation and noninvasive ventilation AIMS AND OBJECTIVES: The aim of this study was twofold: first, to explore the illness experiences of older patients' with late-stage chronic obstructive pulmonary disease; and second, to develop knowledge about how patients perceive their preferences to be taken into account in decision-making processes concerning mechanical ventilation and /or non-invasive ventilation...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28617421/a-targeted-noise-reduction-observational-study-for-reducing-noise-in-a-neonatal-intensive-unit
#14
S Chawla, P Barach, M Dwaihy, D Kamat, S Shankaran, B Panaitescu, B Wang, G Natarajan
BACKGROUND: Excessive noise in neonatal intensive care units (NICUs) can interfere with infants' growth, development and healing.Local problem:Sound levels in our NICUs exceeded the recommended levels by the World Health Organization. METHODS: We implemented a noise reduction strategy in an urban, tertiary academic medical center NICU that included baseline noise measurements. We conducted a survey involving staff and visitors regarding their opinions and perceptions of noise levels in the NICU...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28615932/expanding-the-inspired-copd-outreach-program%C3%A2-to-the-emergency-department-a-feasibility-assessment
#15
Darcy Gillis, Jillian Demmons, Graeme Rocker
BACKGROUND: The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%-80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28614465/implementation-strategy-for-advanced-practice-nursing-in-primary-health-care-in-latin-america-and-the-caribbean
#16
David Oldenburger, Silvia Helena De Bortoli Cassiani, Denise Bryant-Lukosius, Ruta Kristina Valaitis, Andrea Baumann, Joyce Pulcini, Ruth Martin-Misener
SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice...
June 8, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28614076/knowing-about-others-on-the-role-of-relational-knowing-in-advance-care-planning
#17
Jamie Lindemann Nelson
Kate Robins-Browne and her colleagues have written a conceptually daring, empirically grounded article that is rich in scholarship and just conceivably might have a salutary effect on the theory and practice of advance care planning. It is, alas, just as easy to believe that its appreciation will be restricted to like-minded theorists. Writing from a posture of great admiration for this article's agenda and achievements, I will consider why non-relationally-based understanding of deciding for others are so enduring, and what might be done about that...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28614075/the-role-of-relational-knowing-in-advance-care-planning
#18
Kate Robins-Browne, Kelsey Hegarty, Marilys Guillmen, Paul Komesaroff, Victoria Palmer
Medical decision making when a patient cannot participate is complicated by the question of whose voice should be heard. The most common answer to this question is that "autonomy" is paramount, and therefore it is the voice of the unwell person that should be given priority. Advance care planning processes and practices seek to capture this sentiment and to allow treatment preferences to be documented and decision makers to be nominated. Despite good intentions, advance care planning is often deficient because it is unable to facilitate a relational approach to decision making in cases when the patient's competence is reduced...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28613119/relatives-level-of-satisfaction-with-advanced-cancer-care-in-greenland-a-mixed-methods-study
#19
Mikaela Augustussen, Lise Hounsgaard, Michael Lynge Pedersen, Per Sjøgren, Helle Timm
Palliative cancer care in Greenland is provided by health professionals at local level, the national Queen Ingrid's Hospital and at Rigshospitalet in Denmark. To improve and develop care for relatives of patients with advanced cancer, we conducted a mixed method study examining relatives' level of satisfaction with care and treatment and their current main concerns. The aim was to investigate relatives' level of satisfaction with advanced cancer care and bring to light their current main concerns. The FAMCARE-20 questionnaire was translated to Greenlandic and pilot tested...
2017: International Journal of Circumpolar Health
https://www.readbyqxmd.com/read/28611367/the-hippocampus-sparing-volume-modulated-arc-therapy-does-not-influence-plan-quality-on-locally-advanced-nasopharyngeal-carcinoma-patients
#20
Wendong Gu, Qilin Li, Dan Xi, Ye Tian, Juncong Mo, Honglei Pei
Irradiation on hippocampus would lead to neuro-cognitive dysfunction in locally advanced nasopharyneal carcinoma (LA-NPC) patients accepting radiotherapy. Our study here aimed to investigate if undergoing hippocampus sparing (HS) volume modulated arc therapy (VMAT) would influence the plan quality in LA NPC patients. We designed three kinds of radiotherapeutic plans for 11 LA NPC patients: conventional VMAT (C-VMAT), HS-VMAT and HS intensity modulated radiation therapy with dynamic multileaf collimator (HS-dMLC)...
June 13, 2017: Scientific Reports
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