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https://www.readbyqxmd.com/read/28445441/mining-productive-associated-periodic-frequent-patterns-in-body-sensor-data-for-smart-home-care
#1
Walaa N Ismail, Mohammad Mehedi Hassan
The understanding of various health-oriented vital sign data generated from body sensor networks (BSNs) and discovery of the associations between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where occupants' health status is continuously monitored remotely, it is essential to provide the required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach for mining the periodic patterns obtained from BSN data...
April 26, 2017: Sensors
https://www.readbyqxmd.com/read/28445217/why-health-insurance-matters-and-why-research-evidence-should-too
#2
Benjamin D Sommers
In the current debate over the future of the Affordable Care Act (ACA), research evidence on the impact of the law and the effects of health insurance coverage in general is critical. Studies of health insurance expansion over the past decade have demonstrated that coverage expansions can produce significant reductions in mortality-particularly among minorities, those living in poorer areas, and those with chronic conditions potentially treatable with timely medical care. More recent studies of the ACA in particular demonstrate that the law has produced historically large reductions in the uninsured rate, with resulting improvements in access to care, perceived quality of care, and self-reported health...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28444071/reducing-pressure-ulcers-in-patients-with-prolonged-acute-mechanical-ventilation-a-quasi-experimental-study
#3
Cecilia Inés Loudet, María Cecilia Marchena, María Roxana Maradeo, Silvia Laura Fernández, María Victoria Romero, Graciela Esther Valenzuela, Isabel Eustaquia Herrera, Martha Teresa Ramírez, Silvia Rojas Palomino, Mariana Virginia Teberobsky, Leandro Ismael Tumino, Ana Laura González, Rosa Reina, Elisa Estenssoro
Objective: To determine the effectiveness of a quality management program in reducing the incidence and severity of pressure ulcers in critical care patients. Methods: This was a quasi-experimental, before-and-after study that was conducted in a medical-surgical intensive care unit. Consecutive patients who had received mechanical ventilation for ≥ 96 hours were included. A "Process Improvement" team designed a multifaceted interventional process that consisted of an educational session, a pressure ulcer checklist, a smartphone application for lesion monitoring and decision-making, and a "family prevention bundle"...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443389/neuroscience-intermediate-level-care-units-staffed-by-intensivists-clinical-outcomes-and-cost-analysis
#4
Kwadwo Kyeremanteng, Ariel Hendin, Kalpana Bhardwaj, Kednapa Thavorn, Dave Neilipovitz, Dalibour Kubelik, Gianni D'Egidio, Grant Stotts, Erin Rosenberg
INTRODUCTION: With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28441255/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#5
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28439711/-intensive-care-medicine-in-old-age-the-individual-status-is-the-determining-factor
#6
A Valentin
The increasing aging of the population in highly developed countries poses a profound impact on intensive care services. This is illustrated by a finding from a large Austrian database showing that 20% of all intensive care patients are aged ≥80 years. Age per se is not an exclusion criteria for admission to the intensive care unit, but older patients are frequently affected by multiple comorbidities and experience a decreased physiologic reserve. Due to the very heterogeneous population of aged patients and since no generally accepted criteria for admission and treatment of these patients exist, any treatment decision must be made taking into consideration the individual situation...
April 24, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#7
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#8
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#9
Aziz S Alali, Victroia McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
February 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28437209/conversations-about-goals-and-values-are-feasible-and-acceptable-in-long-term-acute-care-hospitals-a-pilot-study
#10
Daniela J Lamas, Robert L Owens, R Nicholas Nace, Anthony F Massaro, Nathan J Pertsch, Susan T Moore, Rachelle E Bernacki, Susan D Block
RATIONALE: The chronically critically ill have survived acute critical illness but require prolonged mechanical ventilation. These patients are frequently transferred from acute care to long-term acute care hospitals (LTACHs) for prolonged recovery, yet many suffer setbacks requiring readmission to acute care. The patient's relatively improved condition while at the LTACH might be an opportunity for communication regarding care goals; however, there have been no prior studies of the feasibility of such conversations in the LTACH...
February 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436244/a-systematic-review-and-meta-synthesis-of-the-qualitative-literature-exploring-the-experiences-and-quality-of-life-of-survivors-of-a-cardiac-arrest
#11
Gunilla Haydon, Pamela van der Riet, Kerry Inder
BACKGROUND: Survival following cardiac arrest and subsequent cardiopulmonary resuscitation (CPR) is increasing worldwide, mainly due to greater awareness of the symptoms of cardiac events and an increased attention to CPR training. Although patient outcomes remain unpredictable and quantitative studies suggest that the overall quality of life (QOL) is acceptable, it is valuable to synthesise qualitative studies exploring these phenomena in depth, providing a deeper knowledge of survivors' experiences and QOL...
April 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28435234/strengthening-care-teams-to-improve-adherence-in-cystic-fibrosis-a-qualitative-practice-assessment-and-quality-improvement-initiative
#12
Allison J Gardner, Alice L Gray, Staci Self, Jeffrey S Wagener
BACKGROUND: Treatment regimens for patients with cystic fibrosis (CF) are complex, time consuming, and burdensome, and adherence to CF treatment is suboptimal. CF care teams play a critical role in supporting patients' chronic self-management skills, but there is no uniform method for assessing patients' adherence to treatment or standard interventions to help patients improve when necessary. METHODS: Between May 2015 and March 2016, care team members from 10 CF centers in the USA participated in a practice assessment and quality improvement (QI) initiative...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28433678/montreal-accord-on-patient-reported-outcomes-use-series-paper-4-patient-reported-outcomes-pro-can-inform-clinical-decision-making-in-chronic-care
#13
Clifton O Bingham, Vanessa Noonan, Claudine Auger, Debbie Feldman, Sara Ahmed, Susan J Bartlett
BACKGROUND: Providing patient-centered healthcare requires that patient needs, preferences, and valued outcomes are more fully integrated into all decisions. Patient reported outcome measures (PROs) provide unique information from the patient perspective on overall health, symptoms, burden, and treatment response. OBJECTIVE: We sought to describe applications of PROs in clinical settings and considerations for implementation from the perspectives of PRO researchers, clinicians, administrators, policy makers, and patients attending a multidisciplinary meeting...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28432967/friendliness-functionality-and-freedom-design-characteristics-that-support-midwifery-practice-in-the-hospital-setting
#14
Athena Hammond, Caroline S E Homer, Maralyn Foureur
OBJECTIVE: to identify and describe the design characteristics of hospital birth rooms that support midwives and their practice. DESIGN: this study used a qualitative exploratory descriptive methodology underpinned by the theoretical approach of critical realism. Data was collected through 21 in-depth, face-to-face photo-elicitation interviews and a thematic analysis guided by study objectives and the aims of exploratory research was undertaken. SETTING: the study was set at a recently renovated tertiary hospital in a large Australian city...
April 4, 2017: Midwifery
https://www.readbyqxmd.com/read/28432920/health-family-strains-dependency-and-life-satisfaction-of-older-adults
#15
Srinivasan Chokkanathan, Jayashree Mohanty
Using stress process theory and structural equation modelling, this study investigated the complex relationship between health status, family strain, dependency, and the life satisfaction of rural older adults with reported functional impairments in India. Data were extracted from a large-scale study of 903 randomly selected adults aged 61 years and older from 30 rural clusters of India. The sample for this study was confined to 653 older adults who reported functional impairments. Structural equation modelling showed that poor health status indirectly lowered the life satisfaction of older adults through family strains...
April 10, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28432843/vitamin-b1-in-critically-ill-patients-needs-and-challenges
#16
REVIEW
Jake T B Collie, Ronda F Greaves, Oliver A H Jones, Que Lam, Glenn M Eastwood, Rinaldo Bellomo
BACKGROUND: Thiamine has a crucial role in energy production, and consequently thiamine deficiency (TD) has been associated with cardiac failure, neurological disorders, oxidative stress (lactic acidosis and sepsis) and refeeding syndrome (RFS). This review aims to explore analytical methodologies of thiamine compound quantification and highlight similarities, variances and limitations of current techniques and how they may be relevant to patients. CONTENT: An electronic search of Medline, PubMed and Embase databases for original articles published in peer-reviewed journals was conducted...
April 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28432547/health-related-quality-of-life-and-diabetes-self-care-activity-in-elderly-patients-with-diabetes-in-korea
#17
Hacksun Kim, Kisook Kim
A critical goal in the management of elderly patients with diabetes is to improve their health-related quality of life (HRQOL). This study aimed to identify the factors affecting HRQOL in elderly Korean patients with diabetes. Participants were 365 elderly patients with diabetes who were treated in a general hospital in Korea. The data were analysed using independent t-tests, Pearson correlations, and stepwise multiple regression. The mean total HRQOL score was 74.77, and HRQOL showed positive correlations with activities of daily living (ADL), instrumental activities of daily living (IADL), and the Summary of Diabetes Self-care Activities (SDSA)...
April 21, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28431333/regeneration-and-health-a-structured-rapid-literature-review
#18
REVIEW
G McCartney, W Hearty, M Taulbut, R Mitchell, R Dryden, C Collins
OBJECTIVE: To identify and synthesise what is known about the impacts of regeneration on health, health inequalities and their socio-economic determinants. STUDY DESIGN: Rapid, structured literature review. METHODS: A rapid, structured approach was undertaken to identifying relevant studies involving a search of peer-reviewed literature databases, an Internet search to identify relevant grey literature, and a review of articles citing two key systematic reviews...
April 17, 2017: Public Health
https://www.readbyqxmd.com/read/28430978/culture-matters-indigenizing-patient-safety-in-bhutan
#19
Rinchen Pelzang, Megan-Jane Johnstone, Alison M Hutchinson
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan's traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan's traditional cultural values on staff attitudes towards patient safety and quality care...
April 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28430833/on-the-need-for-quantitative-bias-analysis-in-the-peer-review-process
#20
Matthew P Fox, Timothy L Lash
Peer review is central to the process through which epidemiologists generate evidence to inform public health and medical interventions. Reviewers thereby act as critical gatekeepers to high-quality research. They are asked to carefully consider the validity of the proposed work or research findings by paying careful attention to the methodology and critiquing the importance of the insight gained. However, although many have noted problems with the peer-review system for both manuscripts and grant submissions, few solutions have been proposed to improve the process...
April 18, 2017: American Journal of Epidemiology
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