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Advanced care plans

Maureen E Lyon, Patricia A Garvie, Lawrence J D'Angelo, Ronald H Dallas, Linda Briggs, Patricia M Flynn, Ana Garcia, Yao I Cheng, Jichuan Wang
OBJECTIVES: To determine the effect of family-centered pediatric advance care planning (FACE pACP) on HIV-specific symptoms. METHODS: In this single-blinded, randomized controlled trial conducted at 6 US hospital-based HIV clinics, 105 adolescent-family dyads, randomly assigned from July 2011 to June 2014, received 3 weekly sessions in either the FACE pACP arm ([1] pediatric advance care planning survey, [2] Respecting Choices interview, and [3] 5 Wishes directive) or the control arm ([1] developmental history, [2] safety tips, and [3] nutrition and exercise tips)...
October 19, 2018: Pediatrics
Adeel A Siddiqui, Muhammad Jamil, Ghulam M Kaimkhani, Malik Wasim, Muhammad Soughat Katto, Uzair Yaqoob, Mariyam Adeel
Objective Burnout is exceptionally pervasive among medical professionals, especially surgeons, and is considered the main indicator of surgeons' fulfillment with career choice. Our objectives are to discover the extent of orthopedic specialist burnout in Pakistan and to explore the clinical impact of burnout. The efficacy of surgeons may be enhanced by implementing burnout prevention and treatment plans. Data collection This observational study was conducted from April 2018 to May 2018 in various tertiary care hospitals in Pakistan and includes post-graduate trainees and consultants...
August 4, 2018: Curēus
Yasuko Igai
Aim: The aim of this study was to examine the reported characteristics of extant studies on palliative care for patients with idiopathic pulmonary fibrosis. Design: Narrative review. Methods: A comprehensive search of the following electronic databases in English and Japanese commenced from 2002 - December 2017. Eligibility criteria was determined by the inclusion and exclusion criteria. Results: Nineteen articles were eligible...
October 2018: Nursing Open
María José Merino-Plaza, Vicenta Rodrigo-Bartual, Milagros Boza-Cervilla, Ana García-Llopis, Fernando Gomez-Pajares, Francisco Javier Carrera-Hueso, Narjis Fikri-Benbrahim
OBJECTIVE: Nosocomial infection is a frequent adverse event in health care. Hand hygiene (HH) reduces cross-transmission, but staff adherence is not always adequate. The objectives of this work were evaluating the effectiveness of the HH technique applied in the workplace and monitoring the adherence of the healthcare staff of a Hospital of Medium-Long Stay to the HH protocol. METHODS: Two cross sectional studies were carried out (2010-2012), to determine the prevalence of colonization of the hands of the staff by pathogenic microorganisms, a cross-sectional study (2015), to evaluate their knowledge of the HH technique and two cross-sectional studies (2015-2016), to evaluate the compliance of the protocol in the healthcare practice...
October 19, 2018: Revista Española de Salud Pública
D H Blackwood, C Vindrola-Padros, M G Mythen, D Walker
Whilst the risk of dying after an operation in the UK is very small, the volume of surgery means that there are 20 000-25 000 deaths each year. For these patients and others who suffer major complications, critical illness often leads to a loss of capacity. If wishes are not discussed in advance, the patients may be excluded from meaningful involvement in decisions affecting their care. The preoperative period has been postulated as one where advance care planning could begin by engaging in voluntary conversations about an individual's wishes, priorities, and values should he/she loses capacity...
November 2018: British Journal of Anaesthesia
Rachel W Linnemann, Deborah Friedman, Lily L Altstein, Suhayla Islam, Kieu-Tram Bach, Anna M Georgiopoulos, Samuel M Moskowitz, Lael M Yonker
BACKGROUND: Advance care planning (ACP) is recommended for people with cystic fibrosis (CF), yet guidance for optimal implementation is lacking. OBJECTIVE: To assess ACP-related thoughts, comfort level, and preferences among people with CF to guide evidence-based routine implementation of ACP in the CF clinic. DESIGN: A cross-sectional survey assessed ACP-related experiences and preferences. SUBJECTS: Thirty-eight adolescents and adults with CF from an urban CF center...
October 18, 2018: Journal of Palliative Medicine
Briana L Rigau, Elizabeth A Scully, Jodi K Dooling-Litfin, Natalie J Murphy, Beth M McManus, Mary A Khetani
Background: Electronic data capture is essential to advancing family-centered coordinated care in early intervention (EI). The purpose of this paper is to report on EI service coordinator response to piloting an electronic parent-reported outcome (e-PRO) assessment as part of their routine workflow, including lessons learned that may inform future phases of e-PRO implementation. Methods: This second pilot study involved families enrolled in a large EI program (n=1040 families) in concert with their implementation of a statewide quality improvement initiative for care plan development and outcomes reporting...
February 2018: Journal of Clinical and Translational Science
Stacy M Fischer, Danielle M Kline, Sung-Joon Min, Sonia Okuyama-Sasaki, Regina M Fink
Importance: Strategies to increase access to palliative care, particularly for racial/ethnic minorities, must maximize primary palliative care and community-based models to meet the ever-growing need in a culturally sensitive and congruent manner. Objective: To investigate if a culturally tailored patient navigator intervention can improve palliative care outcomes for Latino adults with advanced cancer. Design, Setting, and Participants: The Apoyo con Cariño (Support With Caring) randomized clinical trial was conducted from July 2012 to March 2016...
September 20, 2018: JAMA Oncology
Liisa Ecola, Steven W Popper, Richard Silberglitt, Laura Fraade-Blanar
Imagine that, in 2050, not a single person in the United States dies in a traffic crash. This is the scenario described in this article, in which RAND researchers set forth a vision and strategy for achieving zero roadway deaths by 2050. The authors propose that a combination of three approaches can realize this scenario. The first is doubling down on programs and policies that have already been shown to be effective, including laws and enforcement, changes to roadway infrastructure designed to reduce traffic conflicts, reductions in speeds where crashes are likely, improvements to emergency response and trauma care, and more safety education and outreach...
October 2018: Rand Health Quarterly
Susan S Vos Chair, Meagan M Brown, Elizabeth A Cardello, Matthew R Dintzner, George E MacKinnon, Eric M Maroyka, Peter Mbi, Sharon K Park, Krystalyn K Weaver, Jacqueline M Zeeman, Lynette R Bradley-Baker, Cecilia M Plaza
The 2017-2018 AACP Professional Affairs Committee addressed the charges of (1) developing a self-reflection/self-assessment tool for pharmacy faculty and preceptors to allow them to assess their capability and confidence with Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes, the Pharmacists' Patient Care Process (PPCP), and the Entrustable Professional Activities (EPAs) for New Pharmacy Graduates and (2) creation of a plan for AACP to utilize in the development of preceptor continuing education and training programs...
September 2018: American Journal of Pharmaceutical Education
Natasha Smallwood, David Currow, Sara Booth, Anna Spathis, Louis Irving, Jennifer Philip
BACKGROUND: Chronic obstructive pulmonary disease (COPD) guidelines recommend early access to palliative care together with optimal, disease-directed therapy for people with advanced disease, however, this occurs infrequently. This study explored the approaches of respiratory and palliative medicine specialists to palliative care and advance care planning (ACP) in advanced COPD. METHODS: An online survey was emailed to all specialists and trainees in respiratory medicine in Australia and New Zealand (ANZ), and to all palliative medicine specialists and trainees in ANZ and the United Kingdom...
October 15, 2018: BMC Palliative Care
Priscilla K Gazarian, Julie Cronin, Jodi L Dalto, Kayla M Baker, Barbara J Friel, Winona Bruce-Baiden, Lesley Y Rodriguez
BACKGROUND: Advance care planning (ACP) conversations help individuals exercise autonomy and make informed decisions about their care. There are many ACP resources available to support the process of advance care planning, yet available resources not universally accepted and under-utilized in clinical practice. OBJECTIVE: This study aims to systematically evaluate commonly available general ACP patient educational resources using a comprehensive approach to assess elements ranging from resource inclusion to health literacy...
October 11, 2018: Geriatric Nursing
Rachel Koch, Lina Roa, Jordan Pyda, Monica Kerrigan, Ernest Barthélemy, John G Meara
BACKGROUND: The Bill and Melinda Gates Foundation has made unparalleled contributions to global health and human development by bringing together generous funding, strategic partnerships, and innovative leadership. For the last twenty years, the Gates Foundation has supported the expansion of programs that directly address the fundamental barriers to the advancement of marginalized communities around the globe, with a transformative focus on innovations to combat communicable diseases and to ensure maternal and child health...
October 10, 2018: Surgery
Ellen M Denzen, Jaime M Preussler, Elizabeth A Murphy, K Scott Baker, Linda J Burns, Jackie Foster, Lensa Idossa, Heather K Moore, Tammy J Payton, Darlene Haven, Balkrishna Jahagirdar, Naynesh Kamani, J Douglas Rizzo, Lizette Salazar, Barry A Schatz, Karen L Syrjala, John R Wingard, Navneet S Majhail
PURPOSE: This study aimed to develop a survivorship care plan (SCP) that could be individualized to facilitate long-term follow-up care of hematopoietic cell transplantation (HCT) survivors. METHODS: A sample SCP was developed that included two documents- a treatment summary and preventive care recommendations that combined data on treatment exposures routinely submitted by HCT centers to the Center for International Blood and Marrow Transplant Research (CIBMTR) with long-term follow-up guidelines...
October 10, 2018: Biology of Blood and Marrow Transplantation
Anne F Peery, Seth D Crockett, Caitlin C Murphy, Jennifer L Lund, Evan S Dellon, J Lucas Williams, Elizabeth T Jensen, Nicholas J Shaheen, Alfred S Barritt, Sarah R Lieber, Bharati Kochar, Edward L Barnes, Y Claire Fan, Virginia Pate, Joseph Galanko, Todd H Baron, Robert S Sandler
BACKGROUND & AIMS: Estimates of disease burden can inform national health priorities for research, clinical care, and policy. We aimed to estimate health care use and spending among gastrointestinal (GI) (including luminal, liver, and pancreatic) diseases in the United States. METHODS: We estimated health care use and spending based on the most currently available administrative claims from commercial and Medicare Supplemental plans, data from the GI Quality Improvement Consortium Registry, and national databases...
October 10, 2018: Gastroenterology
Ruchi Shah, Ravi P Jagani
Endometriosis is characterized as the ectopic presence of endometrium in various locations within the abdominal cavity, such as the fallopian tube, the pouch of Douglas, the ovaries, outside the ovaries, and more. The inner lining of the uterus, endometrium, is a dynamic tissue that undergoes morphological and functional changes cyclically. The proliferation of endometrial cells during menstruation is influenced by increasing circulating estrogen levels. Adult progenitor stem cells are likely responsible for this remarkable regenerative capacity and hence, enhanced capacity to generate endometriosis...
2018: Critical Reviews in Biomedical Engineering
Takahiro Nakajima, Ichiro Yoshino
Recent advance in bronchology and interventional pulmonology contributes to improve the quality of patient care in thoracic surgery. Narrow band imaging (NBI) combined with high definition bronchoscopy clearly visualize the aberrant tumor vessels on the mucosa of endobronchial malignancy. It helps the preoperative surgical planning for the clear bronchial margin during the surgery. The index of hemoglobin (IHb) show the approximate amount of hemoglobin within the mucosal surface and we use the IHb for the evaluation of local circulation of bronchial anastomosis after bronchoplasty...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Rebecca Luckett, Kitenge Kalenga, Fong Liu, Katharine Esselen, Chris Awtrey, Mompati Mmalane, Thabo Moloi, Hope Ricciotti, Surbhi Grover
OBJECTIVES: Gynecologic malignancies are the leading cause of cancer death among women in Botswana. Twenty-five percent of cervical cancers present at a stage that could be surgically cured; however, there are no gynecologic oncologists to provide radical surgeries. A sustainable model for delivery of advanced surgery is essential to advance treatment for gynecologic malignancies. METHODS/MATERIALS: A model was developed to provide gynecologic oncology surgery in Botswana, delivered by US-based gynecologic oncologists in four 2-week blocks per year...
October 10, 2018: International Journal of Gynecological Cancer
Christina Higa, Jessica Okamura, Sean Okamoto, Norman Okamura
Small island developing states (SIDS) have much to gain from the use of Health Information Technology (HIT) and telehealth to improve care, improve population health, increase access to care, and lessen costs. At the same time, planning, implementing, and operationalizing HIT is costly and requires significant technical, human, financial and planning resource infrastructure to support implementation and operations. This paper provides a broad overview of how HIT and telehealth has evolved in the U.S. Affiliated Pacific Islands (USAPI) SIDS, the progress that has been achieved, the role of political affiliations and international assistance, and the many challenges that remain...
2018: Studies in Health Technology and Informatics
Elizabeth Anderson, Annette Aldous, Dale Lupu
Advance care planning for persons with chronic kidney disease is under-utilized despite evidence it can improve care at the end of life. Motivational interviewing and Stages of Change Theory can help healthcare professionals elicit behavior change. This article outlines an approach to advance care planning using motivational interviewing with a healthcare coach to assist patients in expressing their unique values and wishes regarding care at the end of life. This Make Your Wishes About You (MY WAY) approach to advance care planning for patients with chronic kidney disease includes patient education material and a coach training curriculum freely available from the Coalition for Supportive Care of Kidney Patients...
September 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
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