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Transitions in care

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https://www.readbyqxmd.com/read/30552863/transitional-care-for-patients-with-surgical-pediatric-hepatobiliary-disease-choledochal-cysts-and-biliary-atresia
#1
REVIEW
Gudrun Aspelund, Elaa M Mahdi, David H Rothstein, Derek S Wakeman
Choledochal cysts (CDCs) and biliary atresia (BA) are rare pediatric hepatobiliary anomalies that require surgical intervention due to increased risk of malignancy and liver failure, respectively. The underlying disease and operative procedures place patients at risk for long-term complications, which may continue to affect them into adulthood. Lack of a transitional care model in the health care system potentiates the challenges they will face following aging out of their pediatric providers' care. We sought to elucidate the long-term complications and challenges patients with CDCs and BA face, review the current literature regarding transitioning care, and propose guidelines aiding adult providers in continued care and surveillance of these patients...
December 15, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30552052/impact-of-a-community-pharmacy-transitions-of-care-program-on-30-day-readmission
#2
Amy Shaver, Melissa Morano, Jill Pogodzinski, Stacy Fredrick, David Essi, Erin Slazak
OBJECTIVES: The primary objective of this study was to evaluate the impact of a transitions-of-care (TOC) program on both all-cause and related 30-day hospital readmission. The secondary objective was to evaluate which patient-specific factors, if any, are predictive of 30-day hospital readmissions. DESIGN, SETTING, AND PARTICIPANTS: A TOC program in an outpatient pharmacy, driven primarily by student pharmacists, provided telephone-based counseling to recently discharged patients...
December 11, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/30551781/cost-effectiveness-analysis-of-total-elbow-arthroplasty-versus-open-reduction-internal-fixation-for-distal-humeral-fractures
#3
Andrew E Federer, Richard C Mather, Matthew L Ramsey, Grant E Garrigues
BACKGROUND: Total elbow arthroplasty (TEA) and open reduction-internal fixation (ORIF) are 2 viable surgical treatment options for acute, intra-articular distal humeral fractures in elderly patients. Whereas recent systematic reviews and randomized trials have suggested that TEA and ORIF result in similar functional outcome scores, no previous study has assessed the comparative cost-effectiveness between TEA and distal humeral ORIF in this specific demographic. METHODS: A Markov model was created with the highest-level data available from the literature depicting transitioning health states based on treatment strategies...
January 2019: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/30551312/peer-counseling-in-depression-care-a-pilot-study-in-a-psychiatric-inpatient-setting
#4
Elisabeth Kohls, Juliane Hug, Marlen Stahl, Pia Driessen, Christel Roemer, Elke Wollschlaeger, Katrin Moldenhauer, Christine Rummel-Kluge
To evaluate in a pilot study whether peer counseling is feasible and accepted for inpatients with depression. A one-to-one peer counseling intervention was implemented in an inpatient psychiatric department. Patients were invited to ask questions concerning their illness. Three trained counselors with a history of depressive episodes supervised peers. The patients evaluated the counseling and their mood. The peer counselors evaluated the counseling; in addition their depression stigma was assessed. Twenty-nine patients (F32 or F33 according to ICD-10, mean age 43 years, 58% female, hospitalized for three weeks minimum) participated...
December 2018: Psychiatry Research
https://www.readbyqxmd.com/read/30550832/a-scoping-review-to-map-empirical-evidence-regarding-key-domains-and-questions-in-the-clinical-pathway-of-delirium-in-palliative-care
#5
Peter G Lawlor, Nicole A Rutkowski, Alistair R MacDonald, Mohammed T Ansari, Lindsey Sikora, Franco Momoli, Salmaan Kanji, David K Wright, Erin Rosenberg, Annmarie Hosie, Jose L Pereira, David Meagher, Jill Rice, John Scott, Shirley H Bush
CONTEXT: Based on the clinical care pathway of delirium in palliative care (PC), a published analytic framework (AF) formulated research questions in key domains and recommended a scoping review to identify evidence gaps. OBJECTIVES: To produce a literature map for key domains of the published AF: screening; prognosis and diagnosis; management and the health-related outcomes. METHODS: A standard scoping review framework was used by an interdisciplinary study team of nurse and physician delirium researchers, an information specialist and review methodologists to conduct the review...
December 11, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/30550788/carm1-and-paraspeckles-regulate-pre-implantation-mouse-embryo-development
#6
Anna Hupalowska, Agnieszka Jedrusik, Meng Zhu, Mark T Bedford, David M Glover, Magdalena Zernicka-Goetz
Nuclear architecture has never been carefully examined during early mammalian development at the stages leading to establishment of the embryonic and extra-embryonic lineages. Heterogeneous activity of the methyltransferase CARM1 during these stages results in differential methylation of histone H3R26 to modulate establishment of these two lineages. Here we show that CARM1 accumulates in nuclear granules at the 2- to 4-cell stage transition in the mouse embryo, with the majority corresponding to paraspeckles...
December 13, 2018: Cell
https://www.readbyqxmd.com/read/30550492/health-optimization-program-for-elders-improving-the-transition-from-hospital-to-skilled-nursing-facility
#7
Michael L Krol, Colette Allen, Loretta Matters, Aubrey Jolly Graham, William English, Heidi K White
BACKGROUND: Individuals discharged from the hospital to skilled nursing facilities (SNFs) experience high rates of unplanned hospital readmission, indicating opportunity for improvement in transitional care. LOCAL PROBLEM: Local physicians providing care in SNFs were not associated with the discharging hospital health care system. As a result, substantive real-time communication between hospital and SNF physicians was not occurring. METHODS: A multidisciplinary team developed and monitored implementation of the Health Optimization Program for Elders (HOPE) to improve patient transitions from acute hospital stay to SNFs...
December 12, 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/30550375/the-impact-of-anti-vascular-endothelial-growth-factor-agents-on-visual-impairment-blindness-prevention-in-patients-with-diabetic-macular-edema-and-on-associated-patient-and-caregiver-burden-in-japan
#8
Shigehiko Kitano, Taiji Sakamoto, Rei Goto, Ayako Fukushima, Anne-Lise Vataire, Yusuke Hikichi
AIMS: To estimate the impact of anti-vascular endothelial growth factor (VEGF) agents on visual impairment and blindness avoided in patients with diabetic macular edema (DME) and on associated patient and caregiver productivity loss in Japan. METHODS: We compared the impact of current care (estimated at 53.8% utilization of anti-VEGF agents using current data) with that of hypothetical care (characterized by a higher utilization of anti-VEGF agents [80.0%], as estimated by an expert panel) of DME patients...
December 14, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/30550372/communicating-risks-of-adjuvant-chemotherapy-for-breast-cancer-getting-beyond-the-laundry-list
#9
Eden R Brauer, Elisa F Long, Joy Melnikow, Peter M Ravdin, Patricia A Ganz
PURPOSE: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists' communication with patients with breast cancer about the long-term and late effects of adjuvant therapy...
December 14, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/30550033/-methodology-for-determining-workforce-in-health-nephrologic-unit-in-italy-update-of-lows
#10
Gianfranco Carnevali, Santina Castellino, Pietro Claudio Giovanni Dattolo, Giovanni Giorgio Battaglia, Giuseppe Quintaliani
Nephrology continues to be in transition. While rates of kidney diseases and injury continue to rise, changes in the general health care system and the delivery of kidney care make it unclear how increases in need will be translated into demand for nephrologists. The changes in the delivery system also raise questions as to the future roles and career paths for nephrologists. There a major interrelated workforce issues to be watched closely : how many nephrologists are needed ? The supply of nephrologists does not reflect the distribution of patients with kidney diseases or the activity and job description related to end stage renal disease (ESRD) patients...
December 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/30549394/transition-to-suicide-attempt-from-recent-suicide-ideation-in-u-s-army-soldiers-results-from-the-army-study-to-assess-risk-and-resilience-in-servicemembers-army-starrs
#11
James A Naifeh, Robert J Ursano, Ronald C Kessler, Alan M Zaslavsky, Matthew K Nock, Catherine L Dempsey, Danielle Bartolanzo, Tsz Hin Hinz Ng, Pablo A Aliaga, Kelly L Zuromski, Hieu M Dinh, Carol S Fullerton, Tzu-Cheg Kao, Holly B Herberman Mash, Nancy A Sampson, Gary H Wynn, Murray B Stein
BACKGROUND: Most people with suicide ideation (SI) do not attempt suicide (SA). Understanding the transition from current/recent SI to SA is important for mental health care. Our objective was to identify characteristics that differentiate SA from 30-day SI among representative U.S. Army soldiers. METHODS: Using a unique case-control design, soldiers recently hospitalized for SA (n = 132) and representative soldiers from the same four communities (n = 10,193) were administered the same questionnaire...
December 14, 2018: Depression and Anxiety
https://www.readbyqxmd.com/read/30548480/cost-effectiveness-of-a-patient-navigation-intervention-to-increase-colonoscopy-screening-among-low-income-adults-in-new-hampshire
#12
Ketra Rice, Krishna Sharma, Chunyu Li, Lynn Butterly, Joanne Gersten, Amy DeGroff
BACKGROUND: Colonoscopy is the most widely used colorectal cancer (CRC) screening test in the United States. Through the detection and removal of potentially precancerous polyps, it can prevent CRC. However, CRC screening remains low among adults who are recommended for screening. The New Hampshire Colorectal Cancer Screening Program implemented a patient navigation (PN) intervention to increase colonoscopy screening among low-income patients in health centers in New Hampshire. In the current study, the authors examined the cost-effectiveness of this intervention...
December 12, 2018: Cancer
https://www.readbyqxmd.com/read/30548454/young-adults-with-chronic-kidney-disease-an-exploration-of-their-relationships-and-support-networks
#13
Emma Coyne, Heather Langham, Matthew Tomlin, Wendy Hope, Catherine Johnson, Catherine Byrne, Charlotte Bebb, Heather Buchanan
BACKGROUND: Young people with chronic kidney disease (CKD) have a number of key issues and life changes to manage while also possibly transitioning into adult care. During this time, the nature of their support networks including, social, romantic, family and health care relationships, is changing. OBJECTIVE: To explore these young people's experience and perceptions of their past, current and future relationships and support networks. DESIGN: Qualitative study...
December 12, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/30547963/impact-of-survivorship-care-on-young-adult-survivors-of-childhood-cancer-with-post-traumatic-stress-symptoms
#14
Wilhelmenia L Ross, Hannah-Rose Mitchell, Neel S Iyer, Sheila J Santacroce, Nina S Kadan-Lottick
OBJECTIVES: To assess post-traumatic stress symptoms (PTSSs) in young adult survivors of childhood cancer not receiving survivorship care and to determine whether attending a survivorship-focused healthcare visit was associated with changes in PTSSs. SAMPLE & SETTING: 44 young adult survivors from the Yale Cancer Center in Connecticut without prior survivorship clinic attendance. METHODS & VARIABLES: As part of a larger trial, participants were randomized to a model of survivorship-focused health care...
January 13, 2019: Oncology Nursing Forum
https://www.readbyqxmd.com/read/30547664/-comprehensive-approach-for-malnourished-patients-aiming-for-continuity-in-nutritional-support
#15
Francisco Botella Romero
days of hospitalization, a greater number of complementary tests, the need for artificial nutritional support and / or drugs to treat complications, which is a very important economic burden. Most patients who are malnourished, or at risk, can benefit from oral nutritional support, which includes dietary modifications (fortification, extra snacks, etc.), prescription of a personalized diet by a registered dietitian and the use of oral nutritional supplements (ONS). The use of ONS has shown benefits, in several meta-analysis, in weight recovery, reduction in the number of complications or hospital readmissions and functional improvement, without a reduction in the usual food intake...
April 3, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/30547425/transition-of-children-with-perinatally-acquired-hiv-infection-into-adulthood-social-outcome-and-quality-of-life
#16
G N Sanjeeva, M Sahana, H B Pavithra, V H T Swamy, B R Srirama, D R Sunil Kumar, Lalitha Hande, S N Mothi
OBJECTIVES: In India, access to free anti-retroviral therapy has improved the survival of perinatally human immunodeficiency virus (HIV) infected children resulting in the transition of many such children to adulthood. This study aims to understand the social-outcomes and quality of life (QOL) among these adults. METHODS: This cross-sectional study was conducted in two tertiary HIV care centers in south India. Perinatally HIV-infected adults aged >18 y were enrolled after obtaining consent...
December 13, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/30545234/-comprehensive-approach-for-malnourished-patients-aiming-for-continuity-in-nutritional-support
#17
Francisco Botella Romero
days of hospitalization, a greater number of complementary tests, the need for artificial nutritional support and / or drugs to treat complications, which is a very important economic burden. Most patients who are malnourished, or at risk, can benefit from oral nutritional support, which includes dietary modifications (fortification, extra snacks, etc.), prescription of a personalized diet by a registered dietitian and the use of oral nutritional supplements (ONS). The use of ONS has shown benefits, in several meta-analysis, in weight recovery, reduction in the number of complications or hospital readmissions and functional improvement, without a reduction in the usual food intake...
April 3, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/30544267/einschr%C3%A3-nkungen-in-der-gehf%C3%A3-higkeit-und-der-sprunggelenksdorsalflexion-bei-kindern-nach-intensiver-krebsbehandlung
#18
Vanessa Oschwald, Aram Prokop, Jonas Boehme, Nadja Gressler, Felicitas Harscheidt, Volker Maas, Wilhelm Bloch, Freerk T Baumann, Julia Daeggelmann
BACKGROUND: With improved survival rates in pediatric oncology, the detection of adverse side- and late-effects is gaining increased interest. This cross-sectional study investigated walking abilities and ankle dorsiflexion function in children with cancer. PATIENTS: Study participants included 16 children with various cancers (4-20 years, patient group) after completion of the intense treatment and 16 age- and gender-matched healthy peers (comparison group). METHOD: Walking speed (10-meter-walking-test, treadmill test assessing preferred transition speed), walking capacity (2-minute-walk-test), walking balance (Timed-Up-And-Go-Test), active/passive ankle dorsiflexion range of motion (ROM) (goniometer) and ankle dorsiflexion strength (hand-held dynamometer) were comprehensively assessed...
December 13, 2018: Klinische Pädiatrie
https://www.readbyqxmd.com/read/30544026/assisting-bsn-students-in-moving-from-novice-to-advanced-beginner-through-student-led-simulations
#19
Katherine Menard, Nancy Maas
Faculty in a baccalaureate nursing (BSN) program recognized that fundamentals students often expressed a lack of confidence regarding translating knowledge and skills from long-term care environments into acute medical-surgical environments. This study used Benner's novice to expert framework as the basis for designing and implementing a peer-coached student led simulation with the aim of easing student transition from novice to advanced beginner. A mixed-methods descriptive design was used to gather and analyze qualitative data from peer-coach and learner focus groups...
December 1, 2018: Nurse Education in Practice
https://www.readbyqxmd.com/read/30543667/hospitalization-and-post-discharge-care-in-south-africa-a-critical-event-in-the-continuum-of-care
#20
Cody Cichowitz, Rachael Pellegrino, Katlego Motlhaoleng, Neil A Martinson, Ebrahim Variava, Christopher J Hoffmann
OBJECTIVES: The purpose of this prospective cohort study is to characterize the event of acute hospitalization for people living with and without HIV and describe its impact on the care continuum. This study describes care-seeking behavior prior to an index hospitalization, inpatient HIV testing and diagnosis, discharge instructions, and follow-up care for patients for patients being discharged from a single hospital in South Africa. METHODS: A convenience sample of adult patients was recruited from the medical wards of a tertiary care facility...
2018: PloS One
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