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Home visits

Björn Westerlind, Carl Johan Östgren, Sigvard Mölstad, Patrik Midlöv, Staffan Hägg
BACKGROUND: Falls and related injuries are common among older people, and several drug classes are considered to increase fall risk. AIMS: This study aimed to investigate the association between the use of certain drug classes and falls in older nursing home residents in Sweden, and relate these to different age groups. METHODS: Information on falls that occurred in the previous year and regular use of possible fall risk drugs including non-benzodiazepine hypnotics (zopiclone and zolpidem) was collected from 331 nursing home residents during 2008-2011...
October 19, 2018: Aging Clinical and Experimental Research
Olveen Carrasquillo, BreAnne Young, Stuti Dang, Orieta Fontan, Natalie Ferras, Jose G Romano, Chuanhui Dong, Sonjia Kenya
BACKGROUND: Hispanic-Latino populations face a disproportionate stroke burden and are less likely to have sufficient control over stroke risk factors in comparison with other ethnic populations. A promising approach to improving chronic health outcomes has been the use of community health workers (CHWs). OBJECTIVE: The objective of this randomized controlled trial is to evaluate the effectiveness of a CHW intervention among Latino patients at risk of recurrent stroke...
October 19, 2018: JMIR Research Protocols
Elaine O'Connell Francischetto, Sarah Damery, James Ferguson, Gill Combes
BACKGROUND: Video clinics, where patients can have a hospital appointment with their clinician from home, are emerging in practice, but their effectiveness is unclear. This study will evaluate whether a video clinic implemented at the University Hospitals Birmingham (UHB) NHS Foundation Trust improves patient satisfaction compared to standard face-to-face appointments for liver transplant patients. METHODS: This will be a parallel, two-arm, statistician-blinded, randomised evaluation...
October 19, 2018: Trials
Petra Mäkelä, Mary Godfrey, Andrea Cradduck-Bamford, Graham Ellis, Sasha Shepperd
BACKGROUND: Attempts to design services to support the delivery of healthcare closer to home have taken various forms as countries respond to an increase in hospital admission rates for older people, who are at risk of hospital-acquired morbidity, prolonged lengths of stay and readmission. Evidence to support the development of these services is limited. We are conducting a process evaluation, alongside a UK multi-site randomised trial, to understand the contexts and practices of implementing geriatrician-led admission avoidance hospital at home services and to explore ways that the intervention might be effective, under what conditions, for whom, and how it differs from inpatient care...
October 19, 2018: Trials
Aaron Legler, Megan Price, Megha Parikh, Jonathan R Nebeker, Merry C Ward, Linda Wedemeyer, Steven D Pizer
PURPOSE: To examine associations between patient perceptions that their provider was knowledgeable of their medical history and clinicians' early adoption of an application that presents providers with an integrated longitudinal view of a patient's electronic health records (EHR) from multiple healthcare systems. METHOD: This retrospective analysis utilizes provider audit logs from the Veterans Health Administration Joint Legacy Viewer (JLV) and patient responses to the Survey of Patient Healthcare Experiences Patient-Centered Medical Home (SHEP/PCMH) patient satisfaction survey (FY2016) to assess the relationship between the primary care provider being an early adopter of JLV and patient perception of the provider's knowledge of their medical history...
October 18, 2018: Journal of General Internal Medicine
Stephanie Lovinsky-Desir, Luis M Acosta, Andrew G Rundle, Rachel L Miller, Inge F Goldstein, Judith S Jacobson, Steven N Chillrud, Matthew S Perzanowski
BACKGROUND: Social and environmental stressors may modify associations between environmental pollutants and asthma symptoms. We examined if neighborhood asthma prevalence (higher: HAPN vs. lower: LAPN), a surrogate for underlying risk factors for asthma, modified the relationship between pollutants and urgent asthma visits. METHODS: Through zip code, home addresses were linked to New York City Community Air Survey's land use regression model for street-level, annual average nitrogen dioxide (NO2 ), particulate matter (PM2...
October 18, 2018: Pediatric Research
Jason R Falvey, Michael J Bade, Jeri E Forster, Robert E Burke, Jason M Jennings, Eugene Nuccio, Jennifer E Stevens-Lapsley
BACKGROUND: Home-health-care utilization after total knee arthroplasty (TKA) is increasing. Recent publications have suggested that supervised rehabilitation is not needed to optimize functional recovery after TKA; however, few studies have evaluated patients in home-health-care settings. The objectives of this study were to (1) determine whether physical therapy (PT) utilization is associated with functional improvements for patients in home-health-care settings after TKA and (2) determine which factors are related to utilization of PT...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Caroline Whidden, Kassoum Kayentao, Jenny X Liu, Scott Lee, Youssouf Keita, Djoumé Diakité, Alexander Keita, Samba Diarra, Jacqueline Edwards, Amanda Yembrick, Isaac Holeman, Salif Samaké, Boureima Plea, Mama Coumaré, Ari D Johnson
Background: Countries across sub-Saharan Africa are scaling up Community Health Worker (CHW) programmes, yet there remains little high-quality research assessing strategies for CHW supervision and performance improvement. This randomised controlled trial aimed to determine the effect of a personalised performance dashboard used as a supervision tool on the quantity, speed, and quality of CHW care. Methods: We conducted a randomised controlled trial in a large health catchment area in peri-urban Mali...
December 2018: Journal of Global Health
Hanneke J A Smaling, Karlijn J Joling, Peter M van de Ven, Judith E Bosmans, Joyce Simard, Ladislav Volicer, Wilco P Achterberg, Anneke L Francke, Jenny T van der Steen
INTRODUCTION: Quality of life of people with advanced dementia living in nursing homes is often suboptimal. Family caregivers can feel frustrated with limited contact with their relatives, which results in visits that are perceived as stressful and not very meaningful. Few psychosocial interventions are specifically developed for people with advanced dementia, and actively involve family caregivers or volunteers. Also, interventions usually stop when it becomes difficult for people to participate...
October 15, 2018: BMJ Open
R González-Peredo, M D Prieto-Salceda, L Campos-Caubet, F Fernández-Díaz, Á García-Lago-Sierra, I M Incera-Alvear
OBJECTIVE: To present an assessment of the different profiles of patients that visit the emergency department, including a description of the illness leading to such visits, as well to describe the profiles of individuals who visit with high frequency. METHOD: The study was carried out during 2013. Users were classified as infrequent if they made 1 to 3 visits per year, frequent if they made 4 to 9, and hyper-frequent if they visited at least 10 times. RESULTS: There were 86,673 visits in 2013...
October 13, 2018: Semergen
Patricia Moscibrodzki, Molly Dobelle, Jessie Stone, Charles Kalumuna, Yueh-Hsiu Mathilda Chiu, Nils Hennig
BACKGROUND: While the distribution of mosquito bed nets is a widely adopted approach for malaria prevention, studies exploring how the usage of a net may be influenced by its source and other factors remain sparse. METHODS: A standardized questionnaire and home-visit observations were used to collect data from 9 villages in Budondo sub-county, Uganda in 2016. Household- and individual-level data were collected, such as bed net ownership (at least one net versus none), acquirement source (free versus purchased), demographics, as well as knowledge of malaria and preventative measures...
October 16, 2018: Malaria Journal
Mary Matthews, Peter Richman, Scott Krall, Kimberly Leeson, K Tom Xu, Albert L Gest, Osbert Blow
BACKGROUND: Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. METHODS: This was a retrospective cohort study conducted at an academic ED...
October 16, 2018: BMC Emergency Medicine
Ciara O'Toole, Alice S-Y Lee, Fiona E Gibbon, Anne K van Bysterveldt, Nicola J Hart
BACKGROUND: Communication and language development are areas of particular weakness for young children with Down syndrome. Caregivers' interaction with children influences language development, so many early interventions involve training parents how best to respond to their children and provide appropriate language stimulation. Thus, these interventions are mediated through parents, who in turn are trained and coached in the implementation of interventions by clinicians. As the interventions involve a considerable commitment from clinicians and families, we undertook this review to synthesise the evidence of their effectiveness...
October 15, 2018: Cochrane Database of Systematic Reviews
Peter B White, Alberto V Carli, Morteza Meftah, Narges Ghazi, Michael M Alexiades, Russell E Windsor, Amar S Ranawat
The purpose of this study was to determine if there is a difference in the number of diagnostic tests and interventions, pain and function scores, or satisfaction of patients discharged to inpatient rehabilitation facilities vs to home. From February to May 2015, 171 consecutive patients were prospectively recruited following primary total knee arthroplasty. Six weeks postoperatively, based on the patients' recollections, the number and types of diagnostic imaging tests, number of blood transfusions, and overall satisfaction whether discharged to inpatient rehabilitation facilities (n=85) or to home (n=86) were assessed...
October 15, 2018: Orthopedics
Jessica E Manousakis, Anna J Scovelle, Shantha M W Rajaratnam, Sharon L Naismith, Clare Anderson
BACKGROUND: Increased sleep fragmentation and advanced circadian timing are hallmark phenotypes associated with increased age-related cognitive decline. Subjective cognitive decline (SCD) is considered a prodromal stage of neurodegeneration and dementia; however, little is known about how sleep and circadian timing impact on memory complaints in SCD. OBJECTIVE: To determine how sleep and circadian timing impact on memory complaint subtypes in older adults with SCD...
October 6, 2018: Journal of Alzheimer's Disease: JAD
Steven P Dehmer, Michael V Maciosek, Nicole K Trower, Stephen E Asche, Anna R Bergdall, Rachel A Nyboer, Patrick J O'Connor, Pamela A Pawloski, JoAnn M Sperl-Hillen, Beverly B Green, Karen L Margolis
Background: Pharmacist-managed (team-based) care for hypertension with home blood pressure monitoring support interventions have been widely studied and shown to be effective in improving rates of hypertension control and lowering blood pressure; however, few studies have evaluated the economic considerations related to bringing these programs into usual practice. Objective: To analyze the economic outcomes of the Blood Pressure Telemonitoring and Pharmacist Management on Blood Pressure (Hyperlink) study, a cluster randomized controlled trial which used home blood pressure telemonitoring and pharmacist case management to achieve better blood pressure control in patients with uncontrolled hypertension...
October 2018: Journal of the American College of Clinical Pharmacy: JAACP
Priti S Flanagan, Andrea Barns
The scope of clinical pharmacy services available in outpatient settings, including home care, continues to expand. This review sought to identify the evidence to support pharmacist provision of clinical pharmacy services in a home care setting. Seventy-five reports were identified in the literature that provided evaluation and description of clinical pharmacy home visit services available around the world. Based on results from randomized controlled trials, pharmacist home visit interventions can improve patient medication adherence and knowledge, but have little impact on health care resource utilization...
2018: Integrated Pharmacy Research and Practice
Ashley J Malin, Julia Riddell, Hugh McCague, Christine Till
BACKGROUND: Fluoride exposure has the potential to disrupt thyroid functioning, though adequate iodine intake may mitigate this effect. This is the first population-based study to examine the impact of chronic low-level fluoride exposure on thyroid function, while considering iodine status. The objective of this study was to determine whether urinary iodine status modifies the effect of fluoride exposure on thyroid stimulating hormone (TSH) levels. METHODS: This cross-sectional study utilized weighted population-based data from Cycle 3 (2012-2013) of the Canadian Health Measures Survey (CHMS)...
October 10, 2018: Environment International
Ajay Pillarisetti, Manpreet Gill, Tracy Allen, Sathish Madhavan, Arun Dhongade, Makarand Ghorpade, Sudipto Roy, Kalpana Balakrishnan, Sanjay Juvekar, Kirk R Smith
Conditional cash transfers (CCTs)-cash payments provided to households or specific household members who meet defined conditions or fulfill certain behaviors-have been extensively used in India to encourage antenatal care, institutional delivery, and vaccination. This paper describes the social design and technical development of a low-cost, meal-counting stove use monitor (the Pink Key) that enables a CCT based on liquefied petroleum gas (LPG) usage and presents pilot data from its testing and the initial deployment...
October 12, 2018: EcoHealth
Alfa J Muhihi, David P Urassa, Rose N M Mpembeni, Germana H Leyna, Bruno F Sunguya, Deodatus Kakoko, Anna Tengia Kessy, Marina A Njelekela
BACKGROUND: Cardiovascular diseases (CVDs) increasingly contribute to morbidity and mortality in Tanzania. Public knowledge about CVD risk factors is important for the primary prevention of CVDs and can be improved through community-based interventions delivered by community health workers (CHWs). However, evidence of the utility of CHWs in improving knowledge and CVD risk factors profile is lacking in Tanzania. This study aims at assessing the effect of training CHWs and their CVD-specific interventions for reduction of hypertension and other CVD risk factors among adults in Morogoro, Tanzania...
October 11, 2018: Trials
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