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integrated care pathways

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https://www.readbyqxmd.com/read/28927389/follow-up-care-after-treatment-for-prostate-cancer-protocol-for-an-evaluation-of-a-nurse-led-supported-self-management-and-remote-surveillance-programme
#1
Jane Frankland, Hazel Brodie, Deborah Cooke, Claire Foster, Rebecca Foster, Heather Gage, Jake Jordan, Ines Mesa-Eguiagaray, Ruth Pickering, Alison Richardson
BACKGROUND: As more men survive a diagnosis of prostate cancer, alternative models of follow-up care that address men's enduring unmet needs and are economical to deliver are needed. This paper describes the protocol for an ongoing evaluation of a nurse-led supported self-management and remote surveillance programme implemented within the secondary care setting. METHODS/DESIGN: The evaluation is taking place within a real clinical setting, comparing the outcomes of men enrolled in the Programme with the outcomes of a pre-service change cohort of men, using a repeated measures design...
September 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28924245/understanding-the-factors-affecting-self-management-of-copd-from-the-perspectives-of-healthcare-practitioners-a-qualitative-study
#2
Oladapo J Ogunbayo, Sian Russell, James J Newham, Karen Heslop-Marshall, Paul Netts, Barbara Hanratty, Eileen Kaner
Self-management is recognised as an essential criteria for the provision of high quality care for chronic obstructive pulmonary disease (COPD). The management of COPD is usually delivered by a wide range of healthcare practitioners. This study aimed to understand the factors affecting self-management of COPD from the perspectives of the different multidisciplinary healthcare teams involved in COPD care. Semi-structured interviews were conducted with participants from primary care, specialist respiratory and pulmonary rehabilitation (PR) teams...
September 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28913831/asymmetry-between-on-and-off-alpha-ganglion-cells-of-mouse-retina-integration-of-signal-and-noise-from-synaptic-inputs
#3
Michael A Freed
ON and OFF pathways in the retina include functional pairs of neurons that, at first glance, appear to have symmetrically similar responses to brightening and darkening, respectively. Upon careful examination, however, functional pairs exhibit asymmetries in receptive field size and response kinetics. Until now, descriptions of how light-adapted retinal circuitry maintains a preponderance of signal over the noise have not distinguished between ON and OFF pathways. Here I present evidence of marked asymmetries between members of a functional pair of sustained alpha ganglion cells in the mouse retina...
September 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28903969/healing-journey-a-qualitative-analysis-of-the-healing-experiences-of-americans-suffering-from-trauma-and-illness
#4
John Glenn Scott, Sara L Warber, Paul Dieppe, David Jones, Kurt C Stange
OBJECTIVES: To elucidate pathways to healing for people having suffered injury to the integrity of their function as a human being. METHODS: A team of physician-analysts conducted thematic analyses of in-depth interviews of 23 patients who experienced healing, as identified by six primary care physicians purposefully selected as exemplary healers. RESULTS: People in the sample experienced healing journeys that spanned a spectrum from overcoming unspeakable trauma and then becoming healers themselves to everyday heroes functioning well despite ongoing serious health challenges...
September 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28903542/reviewing-the-evidence-for-biosimilars-key-insights-lessons-learned-and-future-horizons
#5
Till Uhlig, Guro L Goll
Biologic therapies have become central to the long-term management of many chronic diseases, including inflammatory rheumatic diseases. Over recent years, the development and licensing pathways for biosimilars have become more standardized, and several biosimilars have been made available for patients with inflammatory rheumatic diseases, such as RA. Pre-licensing requirements for biosimilars mandate the demonstration of comparability with reference products in terms of clinical activity, safety and immunogenicity, whereas post-marketing surveillance and risk minimization requirements are set in place to ensure that long-term, real-world safety data are collected to assess biosimilars in clinical practice...
August 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#6
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895233/validation-of-the-opportunity-for-treatment-in-oncology-option-questionnaire-measuring-continuity-of-care
#7
Paola Rucci, Silvia Foglino, Francesca Bravi, Rossella D'Avenia, Mattia Altini, Tiziano Carradori, Angela Angelastro, Maria Pia Fantini
Increasing efforts are ongoing to deliver effective cancer care through integrated networks of services. Measuring patients' experience of care is essential to identify problematic areas that require organisational adjustments. The aim of the present study was to examine the validity of OPTION questionnaire, designed to measure patient's perceived continuity of care across different phases of their care pathway. The study was carried at the Institute for Cancer Treatment and Research, Meldola and the oncology departments of the Local Health Authority of Romagna, Italy...
September 11, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28892731/a-new-integrated-care-pathway-for-ambulance-attended-severe-hypoglycaemia-in-the-east-of-england-the-eastern-academic-health-science-network-eahsn-model
#8
Michael Sampson, Marcus Bailey, John Clark, Mark L Evans, Rebekah Fong, Helen Hall, Clare Hambling, Martin Hadley-Brown, Nick Morrish, Helen Murphy, Gerry A Rayman, Karunakaran Vithian, Peter Winocour, Amanda Harries
AIMS: We developed a new clinical integrated pathway linking a regional Ambulance Trust with a severe hypoglycaemia (SH) prevention team. We present clinical data from the first 2000 emergency calls taken through this new clinical pathway in the East of England. METHODS: SH patients attended by Ambulance crew receive written information on SH avoidance, and are contacted for further education through a new regional SH prevention team. All patients are contacted unless they actively decline...
September 1, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28881752/integrated-expression-profiles-analysis-reveals-novel-predictive-biomarker-in-pancreatic-ductal-adenocarcinoma
#9
Hongzhe Li, Xinjing Wang, Yuan Fang, Zhen Huo, Xiongxiong Lu, Xi Zhan, Xiaxin Deng, Chenghong Peng, Baiyong Shen
Pancreatic ductal adenocarcinoma (PDAC) is the most lethal human malignant tumor, with a dismal 5-year survival rate of less than 5%. The lack of specific symptoms at early tumor stages and the paucity of biomarkers contribute to the poor diagnosis of pancreatic ductal adenocarcinoma. To improve prognosis, a screening biomarker for early diagnosis of pancreatic cancer is in urgent need. We searched the databases of expression profiling by array on GEO, aiming at comparing gene expression profile of matched pairs of pancreatic tumor and adjacent non-tumor tissues, and we screen out 4 suitable series of gene expression microarray data ("GSE15471", "GSE18670", "GSE28735" and "GSE58561")...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28880393/the-feasibility-and-acceptability-of-nurse-led-chronic-disease-management-interventions-in-primary-care-an-integrative-review
#10
REVIEW
Catherine Stephen, Susan Mcinnes, Elizabeth Halcomb
AIMS: To explore the feasibility and acceptability of nurse-led chronic disease management and lifestyle risk factor reduction interventions in primary care (general practice / family practice). BACKGROUND: Growing international evidence suggests that interventions delivered by primary care nurses can assist in modifying lifestyle risk factors and managing chronic disease. To date, there has been limited exploration of the feasibility and acceptability of such interventions...
September 7, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28874177/improving-diets-and-nutrition-through-an-integrated-poultry-value-chain-and-nutrition-intervention-selever-in-burkina-faso-study-protocol-for-a-randomized-trial
#11
Aulo Gelli, Elodie Becquey, Rasmane Ganaba, Derek Headey, Melissa Hidrobo, Lieven Huybregts, Hans Verhoef, Romain Kenfack, Sita Zongouri, Hannah Guedenet
BACKGROUND: The SELEVER study is designed to evaluate the impact of an integrated agriculture-nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design. METHODS: The impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso...
September 6, 2017: Trials
https://www.readbyqxmd.com/read/28871541/procedures-of-mitochondria-purification-and-gene-expression-to-study-alternative-respiratory-and-uncoupling-pathways-in-fruits
#12
Jurandi Gonçalves de Oliveira, Luis Miguel Mazorra Morales, Gláucia Michelle Cosme Silva, Kátia Daniella da Cruz Saraiva, Diederson Bortolino Santana, Clesivan Pereira Dos Santos, Marcos Goes Oliveira, José Hélio Costa
We describe detailed procedures to get intact and well-coupled mitochondria from a variety of fruit species such as papaya (Carica papaya), guava (Psidium guajava), tomato (Solanum lycopersicum), and strawberry (Fragaria x ananassa) as well as the protocols to assess the capacities of AOX and UCP pathways in intact fruit mitochondria. The procedures presented here were tested for the species mentioned above; their use with other types of fruits must be tested for yield of intact and active mitochondria. This is possible from individual adjustments...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28867544/standardization-of-radiation-therapy-dose-for-locally-advanced-non-small-cell-lung-cancer-through-changes-to-a-lung-cancer-clinical-pathway-in-a-large-integrated-comprehensive-cancer-center-network
#13
Pooja Karukonda, Brian J Gebhardt, Zachary D Horne, Dwight E Heron, Sushil Beriwal
PURPOSE: The results of Radiation Therapy Oncology Group (RTOG) 0617, which randomized patients with stages IIIA/IIIB non-small cell lung cancer (NSCLC) to definitive chemoradiation therapy to 60 Gy versus 74 Gy, demonstrated a detrimental survival impact with high-dose radiation therapy. We evaluated the impact of changes to a provider-driven clinical pathway (CP) guiding management of NSCLC on practice throughout our cancer center network. METHODS AND MATERIALS: In 2001, we implemented a CP for management of stage IIIA/IIIB NSCLC with definitive chemoradiation therapy...
July 8, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28864455/genetic-ancestry-is-not-associated-with-breast-cancer-recurrence-or-survival-in-u-s-latina-women-enrolled-in-the-kaiser-permanente-pathways-study
#14
Natalie J Engmann, Isaac J Ergas, Song Yao, Marilyn L Kwan, Janise M Roh, Christine B Ambrosone, Lawrence H Kushi, Laura Fejerman
Background: The U.S. Hispanic/Latino population is heterogeneous both socioculturally and by the proportion of European, Indigenous American, and African ancestry of the regions from which individuals originate. A previous study reported that genetic ancestry was associated with breast cancer survival among Latinas, independent of sociodemographic and tumor characteristics, suggesting that a genetic factor associated with ancestry may affect breast cancer survival.Methods: We evaluated the association of genetic ancestry with breast cancer outcomes among 506 Latina women with invasive breast cancer in the Pathways Study, a cohort study within Kaiser Permanente, an integrated health care delivery system...
September 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28855231/inequalities-in-the-dental-health-needs-and-access-to-dental-services-among-looked-after-children-in-scotland-a-population-data-linkage-study
#15
Alex D McMahon, Lawrie Elliott, Lorna Md Macpherson, Katharine H Sharpe, Graham Connelly, Ian Milligan, Philip Wilson, David Clark, Albert King, Rachael Wood, David I Conway
BACKGROUND: There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population. METHODS: Population data linkage study utilising national datasets of social work referrals for 'looked after' placements, the Scottish census of children in local authority schools, and national health service's dental health and service datasets...
August 30, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#16
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28851413/a-large-cluster-randomized-trial-of-outcome-based-pathways-to-improve-home-based-wound-care
#17
Merrick Zwarenstein, Salimah Shariff, Nicole Mittmann, Anita Stern, Katie N Dainty
BACKGROUND: Although not always recognized as a pressing health care problem, wounds are a common, complex and costly condition. The burden of treating wounds is growing rapidly due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The Integrated Client Care (ICC) Project was a multi-year initiative to develop and test a new, integrated model of wound care within the home care sector in Ontario, Canada to improve health outcomes for patients and decrease system costs...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28845724/adding-insult-to-brain-injury-young-adults-experiences-of-residing-in-nursing-homes-following-acquired-brain-injury
#18
Aoife Dwyer, Caroline Heary, Marcia Ward, Pádraig MacNeela
PURPOSE: There is general consensus that adults under age 65 with acquired brain injury residing in nursing homes is inappropriate, however there is a limited evidence base on the issue. Previous research has relied heavily on third-party informants and qualitative studies have been of questionable methodological quality, with no known study adopting a phenomenological approach. This study explored the lived experiences of young adults with brain injury residing in aged care facilities...
August 28, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28838647/from-nonclinical-research-to-clinical-trials-and-patient-registries-challenges-and-opportunities-in-biomedical-research
#19
José M de la Torre Hernández, Elazer R Edelman
The most important challenge faced by human beings is health. The only way to provide better solutions for health care is innovation, true innovation. The only source of true innovation is research, good research indeed. The pathway from a basic science study to a randomized clinical trial is long and not free of bumps and even landmines. These are all the obstacles and barriers that limit the availability of resources, entangle administrative-regulatory processes, and restrain investigators' initiatives. There is increasing demand for evidence to guide clinical practice but, paradoxically, biomedical research has become increasingly complex, expensive, and difficult to integrate into clinical care with increased barriers to performing the practical aspects of investigation...
August 21, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28832432/elevating-oral-health-interprofessional-practice-among-pediatricians-through-a-statewide-quality-improvement-learning-collaborative
#20
Joni D Nelson, Sharon M Spencer, Christine E Blake, Justin B Moore, Amy B Martin
CONTEXT: Because of persistent effects of early childhood caries and impacts of dental health professional shortages areas, the integration of oral health in primary care settings is a public health priority. In this study, we explored oral health interprofessional practice (OHIP) as an integrative pathway to reduce oral health disparities. OHIP can include performing oral health risk assessments, describing the importance of fluoride in the drinking water, implementing fluoride varnish application, and referring patients to a dental home...
August 21, 2017: Journal of Public Health Management and Practice: JPHMP
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