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https://www.readbyqxmd.com/read/28636200/functional-impairment-an-unmeasured-marker-of-medicare-costs-for-postacute-care-of-older-adults
#1
S Ryan Greysen, Irena Stijacic Cenzer, W John Boscardin, Kenneth E Covinsky
OBJECTIVES: To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. DESIGN: Longitudinal cohort study. SETTING: Health and Retirement Study (HRS). PARTICIPANTS: Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. MEASUREMENTS: The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28636070/development-of-a-population-based-microsimulation-model-of-body-mass-index
#2
Deirdre Hennessy, Rochelle Garner, William M Flanagan Ron Wall And Claude Nadeau M Flanagan, Ron Wall, Claude Nadeau
BACKGROUND: The increasing prevalence of overweight and obesity has necessitated the development of body mass index (BMI) projection models such as the POpulation HEalth Model (POHEM). This study describes the POHEM-BMI model, a microsimulation tool that can be used to support evidence-based health policy making for obesity reduction. DATA AND METHODS: The National Population Health Survey, the Canadian Community Health Survey (CCHS), and the Canadian Health Measures Survey (CHMS) were used to develop and validate a predictive model of BMI for adults and childhood BMI history...
June 21, 2017: Health Reports
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#3
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28635440/adding-an-accredited-exercise-physiologist-role-to-a-new-model-of-care-at-a-secure-extended-care-mental-health-service-a-qualitative-study
#4
Trentham Furness, Jude Hewavasam, Jakqui Barnfield, Brian McKenna, Corey Joseph
BACKGROUND: Accredited exercise physiologists (AEPs) are emerging as essential members of allied health in the management of non-communicable chronic diseases. People diagnosed with severe mental illness (SMI) are at greater risk of cardiovascular diseases. Secure extended care units (SECUs) provide treatment, supervision and support for people with SMI whose needs cannot be met adequately in the community. However, the role of AEPs in SECUs has not been described. AIM: Describe the processes and outcomes of adding an AEP to a new model of care at a SECU...
March 1, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28635437/assessment-of-diagnostic-information-and-quality-of-working-alliance-with-clients-diagnosed-with-personality-disorders-during-the-mental-health-intake
#5
Ora Nakash, Maayan Nagar
BACKGROUND: A primary purpose of diagnostic systems is to improve care, yet, little is known about how providers use it routine clinical care. AIMS: We investigated specific DSM-IV personality disorders (PDs) diagnostic information therapists collected during intake visits and the association between a therapist PD diagnosis and clients' and therapists' reports of the quality of working alliance during the intake. METHOD: A total of 122 intakes (n = 34, 27...
March 1, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28635417/suicide-attempts-among-individuals-with-specific-learning-disorders-an-underrecognized-issue
#6
Esme Fuller-Thomson, Samara Z Carroll, Wook Yang
Several studies have linked specific learning disorders (SLDs) with suicidal ideation, but less is known about the disorders' association with suicide attempts. This gap in the literature is addressed via the 2012 nationally representative Canadian Community Health Survey ( n = 21,744). The prevalence of lifetime suicide attempts among those with an SLD was much higher than those without (11.1% vs. 2.7%, p < .001). In comparison with their peers without SLDs, adults with SLDs had 46% higher odds of having ever attempted suicide, even after adjusting for most known risk factors (e...
June 1, 2017: Journal of Learning Disabilities
https://www.readbyqxmd.com/read/28635383/rendering-lgbtq-visible-in-nursing-embodying-the-philosophy-of-caring-science
#7
Lisa Goldberg, Neal Rosenburg, Jean Watson
Although health care institutions continue to address the importance of diversity initiatives, the standard(s) for treatment remain historically and institutionally grounded in a sociocultural privileging of heterosexuality. As a result, lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities in health care remain largely invisible. This marked invisibility serves as a call to action, a renaissance of thinking within redefined boundaries and limitations. We must therefore refocus our habits of attention on the wholeness of persons and the diversity of their storied experiences as embodied through contemporary society...
June 1, 2017: Journal of Holistic Nursing: Official Journal of the American Holistic Nurses' Association
https://www.readbyqxmd.com/read/28634634/pain-and-fracture-related-limitations-persist-6%C3%A2-months-after-a-fragility-fracture
#8
Joanna E M Sale, Lucy Frankel, Stephen Thielke, Larry Funnell
Our objective was to examine the experience of pain after a fracture beyond the conventional healing duration of 6 months. We conducted a phenomenological study in participants who were deemed high risk for future fracture and recruited through an urban fracture clinic in Toronto, Canada. In-depth interviews were conducted with questions addressing the experience of pain, the status of recovery from the fracture, ways in which the fracture affected one's daily activities, and interactions with health care providers...
June 20, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28634579/precision-in-setting-cancer-prevention-priorities-synthesis-of-data-literature-and-expert-opinion
#9
Jennifer Girschik, Laura Jean Miller, Tony Addiscott, Mike Daube, Paul Katris, David Ransom, Terry Slevin, Tim Threlfall, Tarun Stephen Weeramanthri
Cancer will continue to be a leading cause of ill health and death unless we can capitalize on the potential for 30-40% of these cancers to be prevented. In this light, cancer prevention represents an enormous opportunity for public health, potentially saving much of the pain, anguish, and cost associated with treating cancer. However, there is a challenge for governments, and the wider community, in prioritizing cancer prevention activities, especially given increasing financial constraints. This paper describes a method for identifying cancer prevention priorities...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28634574/reducing-viability-bias-in-analysis-of-gut-microbiota-in-preterm-infants-at-risk-of-nec-and-sepsis
#10
Gregory R Young, Darren L Smith, Nicholas D Embleton, Janet E Berrington, Edward C Schwalbe, Stephen P Cummings, Christopher J van der Gast, Clare Lanyon
Necrotising enterocolitis (NEC) and sepsis are serious diseases of preterm infants that can result in feeding intolerance, the need for bowel resection, impaired physiological and neurological development, and high mortality rates. Neonatal healthcare improvements have allowed greater survival rates in preterm infants leading to increased numbers at risk of developing NEC and sepsis. Gut bacteria play a role in protection from or propensity to these conditions and have therefore, been studied extensively using targeted 16S rRNA gene sequencing methods...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28634520/effect-of-heartfulness-meditation-on-burnout-emotional-wellness-and-telomere-length-in-health-care-professionals
#11
Jayaram Thimmapuram, Robert Pargament, Kedesha Sibliss, Rodney Grim, Rosana Risques, Erik Toorens
Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals. Objective: We assessed the effects of a 12-week 'Heartfulness Meditation' program on burnout, emotional wellness, and telomere length in residents, faculty members, and nurses at a large community teaching hospital during the 2015-16 academic year...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634517/introduction-of-a-quality-improvement-curriculum-in-the-department-of-internal-medicine-lincoln-medical-center
#12
Usha Venugopal, Moiz Kasubhai, Vikram Paruchuri
Community hospitals with limited resources struggle to engage physicians in Quality improvement initiatives. We introduced Quality Improvement (QI) curriculum for residents in response to ACGME requirements and surveyed the residents understanding of QI and their involvement in QI projects before and after the introduction of the curriculum. The current article describes our experiences with the process, the challenges and possible solutions to have a successful resident led QI initiative in a community hospital...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634475/cesarean-or-vaginal-birth-does-not-impact-the-longitudinal-development-of-the-gut-microbiome-in-a-cohort-of-exclusively-preterm-infants
#13
Christopher J Stewart, Nicholas D Embleton, Elizabeth Clements, Pamela N Luna, Daniel P Smith, Tatiana Y Fofanova, Andrew Nelson, Gillian Taylor, Caroline H Orr, Joseph F Petrosino, Janet E Berrington, Stephen P Cummings
The short and long-term impact of birth mode on the developing gut microbiome in neonates has potential implications for the health of infants. In term infants, the microbiome immediately following birth across multiple body sites corresponds to birth mode, with increased Bacteroides in vaginally delivered infants. We aimed to determine the impact of birth mode of the preterm gut microbiome over the first 100 days of life and following neonatal intensive care unit (NICU) discharge. In total, 867 stool samples from 46 preterm infants (21 cesarean and 25 vaginal), median gestational age 27 weeks, were sequenced (V4 region 16S rRNA gene, Illumina MiSeq)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28634021/mycoplasma-pneumoniae-and-health-outcomes-in-children-with-asthma
#14
Pamela R Wood, Jordan C Kampschmidt, Peter H Dube, Marianna P Cagle, Paola Chaparro, Norma S Ketchum, Thirumalai R Kannan, Harjinder Singh, Jay I Peters, Joel B Baseman, Edward G Brooks
BACKGROUND: Acute infections with Mycoplasma pneumoniae (Mp) have been associated with worsening asthma in children. Mp can be present in the respiratory tract for extended periods; it is unknown whether the long-term persistence of Mp in the respiratory tract affects long-term asthma control. OBJECTIVE: To determine the effect of Mp on asthma control. METHODS: We enrolled 31 pediatric subjects 3 to 10 years of age with persistent asthma who completed up to 8 visits over a 24-month period...
June 17, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28633681/copewell-a-conceptual-framework-and-system-dynamics-model-for-predicting-community-functioning-and-resilience-after-disasters
#15
Jonathan M Links, Brian S Schwartz, Sen Lin, Norma Kanarek, Judith Mitrani-Reiser, Tara Kirk Sell, Crystal R Watson, Doug Ward, Cathy Slemp, Robert Burhans, Kimberly Gill, Tak Igusa, Xilei Zhao, Benigno Aguirre, Joseph Trainor, Joanne Nigg, Thomas Inglesby, Eric Carbone, James M Kendra
OBJECTIVE: Policy-makers and practitioners have a need to assess community resilience in disasters. Prior efforts conflated resilience with community functioning, combined resistance and recovery (the components of resilience), and relied on a static model for what is inherently a dynamic process. We sought to develop linked conceptual and computational models of community functioning and resilience after a disaster. METHODS: We developed a system dynamics computational model that predicts community functioning after a disaster...
June 21, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#16
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28633661/prevalence-of-arthritis-according-to-age-sex-and-socioeconomic-status-in-six-low-and-middle-income-countries-analysis-of-data-from-the-world-health-organization-study-on-global-ageing-and-adult-health-sage-wave-1
#17
Sharon L Brennan-Olsen, S Cook, M T Leech, S J Bowe, P Kowal, N Naidoo, I N Ackerman, R S Page, S M Hosking, J A Pasco, M Mohebbi
BACKGROUND: In higher income countries, social disadvantage is associated with higher arthritis prevalence; however, less is known about arthritis prevalence or determinants in low to middle income countries (LMICs). We assessed arthritis prevalence by age and sex, and marital status and occupation, as two key parameters of socioeconomic position (SEP), using data from the World Health Organization Study on global AGEing and adult health (SAGE). METHODS: SAGE Wave 1 (2007-10) includes nationally-representative samples of older adults (≥50 yrs), plus smaller samples of adults aged 18-49 yrs...
June 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28633634/the-development-and-appraisal-of-a-tool-designed-to-find-patients-harmed-by-falsely-labelled-falsified-counterfeit-medicines
#18
Marija Anđelković, Einar Björnsson, Virgilio De Bono, Nenad Dikić, Katleen Devue, Daniel Ferlin, Miroslav Hanževački, Freyja Jónsdóttir, Mkrtich Shakaryan, Sabine Walser
BACKGROUND: Falsely labelled, falsified (counterfeit) medicines (FFCm's) are produced or distributed illegally and can harm patients. Although the occurrence of FFCm's is increasing in Europe, harm is rarely reported. The European Directorate for the Quality of Medicines & Health-Care (EDQM) has therefore coordinated the development and validation of a screening tool. METHODS: The tool consists of a questionnaire referring to a watch-list of FFCm's identified in Europe, including symptoms of their use and individual risk factors, and a scoring form...
June 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28633543/staffs-documentation-of-participation-for-adults-with-profound-intellectual-disability-or-profound-intellectual-and-multiple-disabilities
#19
Lena Talman, Christine Gustafsson, Jonas Stier, Jenny Wilder
PURPOSE: This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation. METHODS: A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool. RESULTS: One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors...
June 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28633502/promoting-seniors-health-with-home-care-aides-a-pilot
#20
Naoko Muramatsu, Lijuan Yin, Michael L Berbaum, David X Marquez, Donald A Jurivich, Joseph P Zanoni, Katya Y Cruz Madrid, Surrey M Walton
Purpose: Regular physical activity (PA) benefits older adults. However, frail older adults lack opportunities to be physically active. This pilot study aimed to test and enhance the feasibility of a PA program delivered by home care aides (HCAs) for community-dwelling older adults in a Medicaid-funded home care setting and to generate preliminary efficacy and cost data. Design and Methods: HCAs were trained to deliver a brief motivational enhancement and three chair-bound movements to motivate their older clients to do PA daily and to help maintain their independence in the community...
June 17, 2017: Gerontologist
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