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Continuity Care

Li Ping Chung, Mark Hew, Philip Bardin, Vanessa M McDonald, John W Upham
Severe asthma leads to debilitating symptoms for patients and excessive socioeconomic burden for the community. Comprehensive models of care are required to address complex issues, risk factors and comorbidities in patients with severe asthma, and to identify patients most appropriate for specialised treatments. Dedicated severe asthma services improve asthma control, reduce asthma exacerbations and hospital admissions, and improve quality of life. Currently, diverse models of care exist for managing severe asthma across Australia...
December 2018: Internal Medicine Journal
María Fernanda Olarte-Sierra, Roberto Suárez, María Alejandra Rubio
This article explores the sociocultural aspects of a program of pediatric cardiology health brigades that provides care to children from low-income populations in peripheral regions of Colombia. We analyzed the brigades as a humanitarian strategy to close the gaps of inequity in access to health care, and as a particular context of the medical encounter, the experience of heart disease and the definition of care trajectories. Based on ethnographic observation of brigades and interviews with families receiving care and with health personnel, carried out in 2016 in five different cities, we looked at the dynamics that shape the medical encounter and questioned the mechanisms (medical and social) through which it is evaluated and decided which families can access care in Bogota...
July 2018: Salud Colectiva
Laís Machado Freire, Pedro Sérgio Pinto Camponêz, Isadora Virgínia Leopoldino Maciel, Carolina Santiago Vieira, Mariana Bueno, Elysângela Dittz Duarte
OBJECTIVE: To analyze the factors associated with non-adherence to the outpatient follow-up of infants discharged from the Neonatal Intensive Care Unit. METHOD: A cross-sectional study that included 596 children who were discharged between October 1, 2014 and September 30, 2015 and who were referred to outpatient follow-up. The data were collected by evaluating the discharge report and attendance to the consultations. RESULTS: Of the 596 children referred for follow-up, 118 (19...
December 3, 2018: Revista da Escola de Enfermagem da U S P
Claire Humphries, Suganthi Jaganathan, Jeemon Panniyammakal, Sanjeev Singh, Shifalika Goenka, Prabhakaran Dorairaj, Paramjit Gill, Sheila Greenfield, Richard Lilford, Semira Manaseki-Holland
OBJECTIVES: Research concentrating on continuity of care for chronic, non-communicable disease (NCD) patients in resource-constrained settings is currently limited and focusses on inpatients. Outpatient care requires attention as this is where NCD patients often seek treatment and optimal handover of information is essential. We investigated handover, healthcare communication and barriers to continuity of care for chronic NCD outpatients in India. We also explored potential interventions for improving storage and exchange of healthcare information...
2018: PloS One
Nora D Volkow, Emily B Jones, Emily B Einstein, Eric M Wargo
Importance: More than 42 000 Americans died of opioid overdoses in 2016, and the fatalities continue to increase. This review analyzes the factors that triggered the opioid crisis and its further evolution, along with the interventions to manage and prevent opioid use disorder (OUD), which are fundamental for curtailing the opioid crisis. Observations: Opioid drugs are among the most powerful analgesics but also among the most addictive. The current opioid crisis, initially triggered by overprescription of opioid analgesics, which facilitated their diversion and misuse, has now expanded to heroin and illicit synthetic opioids (fentanyl and its analogues), the potency of which further increases their addictiveness and lethality...
December 5, 2018: JAMA Psychiatry
Harun Kundi, Jeffrey J Popma, Kamal R Khabbaz, Louis M Chu, Jordan B Strom, Linda R Valsdottir, Changyu Shen, Robert W Yeh
Importance: Hospital outcomes for transcatheter aortic valve replacement (TAVR) may be dependent on the quality of evaluation, personnel, and procedural and postprocedural care common to patients undergoing cardiac surgery. Objectives: We sought to assess whether those hospitals with better patient outcomes for surgical aortic valve replacement (SAVR) subsequently achieved better TAVR outcomes after launching TAVR programs. Design, Setting, and Participants: This national cohort included US patients 65 years and older...
December 5, 2018: JAMA Cardiology
Joseph S Kass, Ariane Lewis, Michael A Rubin
Management of patients with terminal brain disorders can be medically, socially, and ethically complex. Although a growing number of feasible treatment options may exist, there are times when further treatment can no longer meaningfully improve either quality or length of life. Clinicians and patients should discuss goals of care while patients are capable of making their own decisions. However, because such discussions can be challenging, they are often postponed. These discussions are then conducted with patients' health care proxies after patients lose the capacity to make their own decisions...
December 2018: Continuum: Lifelong Learning in Neurology
Bruno L Ferreyro, Laveena Munshi
PURPOSE OF REVIEW: A wide spectrum of heterogeneous conditions can render a patient immunocompromised. Recent years have seen an increase in the number of immunocompromised patients given the earlier detection of conditions that require immunosuppressive therapies, changes in immunosuppressive regimens leading to increased survival or novel therapeutic advancements in oncologic care. Acute respiratory failure (ARF) is the leading cause of critical illness and mortality in this population...
December 3, 2018: Current Opinion in Critical Care
Carl J Palad, Siddharth Yarlagadda, Fatima Cody Stanford
PURPOSE OF REVIEW: This review aims to evaluate current research findings relevant to weight stigmatization, to acknowledge the deleterious impact it has on the health of the paediatric population and to provide insight to optimize future guidelines for the treatment of individuals with overweight and obesity. RECENT FINDINGS: Obesity prevalence continues to rise in the USA with estimates in children from ages 2-19 years of 18.5%, an all-time high. With the increase in obesity, there has been a concomitant increase in weight stigma, which affects both youth and general population across varied levels of socioeconomic status and body sizes...
December 3, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
Racheal L Wood, Laurie A Migliore, Sandra J Nasshan, Sara R Mirghani, Annette C Contasti
BACKGROUND: Heart failure (HF) is considered a condition in which a portion of hospital admissions are preventable if timely and appropriate outpatient care management occurs. Facility readmission rates for HF are reportable and subject to penalty. Both military and civilian healthcare systems have fiscal responsibility and are accountable for successful disease management. Therefore, best practices and evidence-based strategies to reduce readmissions are in critical demand. However, translating best evidence into practice can be challenging due to the complexities of the healthcare system...
December 5, 2018: Worldviews on Evidence-based Nursing
Frank Holloway
SummaryIn this issue, MacDonald et al have used data from the South London and Maudsley NHS Foundation Trust electronic patient record to investigate the relationship between service change, routine outcome data and 'continuity of care'. The period they have looked at was one of huge change in the configuration of services and the background to this is explored here.Declaration of interestF.H. was a clinical director of South London and Maudsley NHS Foundation Trust and its predecessor organisations from 1991 to 2010...
December 5, 2018: British Journal of Psychiatry: the Journal of Mental Science
Pia Liljamo, Ulla-Mari Kinnunen, Kaija Saranto
Patient-care data from the electronic health record systems are increasingly in demand for re-use in administration and resource planning. Nursing documentation with coded concepts is expected to produce more reliable data, fulfilling better requirements for re-use. The aim was to ascertain what kind of relation exist between coded nursing diagnoses, nursing interventions, and nursing intensity and to discuss the possibilities for re-using nursing data for workload design. We analysed the retrospective nursing records of 794 patients documented by the Finnish Care Classification and nursing intensity data assessed by the Oulu Patient Classification over a 15-day period in nine inpatient units at a university hospital...
December 5, 2018: Health Informatics Journal
Sarah Ziegler, Margareta Schmid, Matthias Bopp, Georg Bosshard, Milo Alan Puhan
BACKGROUND: In the last decade, the use of sedative substances to keep a patient in deep sedation until death increased fourfold in German-speaking Switzerland, where every third patient admitted to hospital, palliative care unit or hospice died continuously deeply sedated. AIM: To investigate sedation practices across healthcare settings and to identify their associations with conventional symptom control. DESIGN: National mortality follow-back study in Switzerland between 2013 and 2014...
December 5, 2018: Palliative Medicine
Justine Fletcher, Bridget Hamilton, Stuart Kinner, Georgina Sutherland, Kylie King, Juan Jose Tellez, Carol Harvey, Lisa Brophy
There has been a shift towards provision of mental health care in community-based settings in Australia. However, hospitals continue to care for people in acute mental health wards. An increasing proportion of the people in wards are admitted involuntarily, subject to restrictions of movement to minimize risk of harm to self and others. In response to concerns about the safety of people absconding from care, Queensland Health introduced a policy requiring all acute mental health wards in the State to be locked...
December 5, 2018: International Journal of Mental Health Nursing
Vincent Lorant, Adeline Grard, Chantal Van Audenhove, Mark Leys, Pablo Nicaise
Mental health and social care services networks aim to provide patients with continuity of care and support their recovery. There is, however, no conclusive evidence of their effectiveness. Since 2011, Belgium has been implementing a nation-wide reform of mental health care by commissioning service networks. Using a case-control design, we assessed the reform's effectiveness for continuity of care, social integration, quality of life, and re-hospitalization for 1407 patients from 23 networks. Greater reform exposure was associated with a slight improvement in continuity of care, but not with other outcomes...
December 4, 2018: Administration and Policy in Mental Health
Michael A Bohl, Michael A Mooney, John Sheehy, Clinton D Morgan, Michael J Donovan, Andrew Little, Peter Nakaji
Medical innovation is the application of scientific knowledge and problem solving for the betterment of the human condition. Every great advancement in the field of neurosurgery can be traced back to a novel surgical procedure or technology that challenged existing standards of care. Considering the critical importance of innovation to the advancement of neurosurgery, and a surprising lack of formal training in innovation among residency programs, we sought to create a residency training program in neurosurgical innovation...
February 2, 2018: Curēus
Karishma Ramsubeik, Laurie Ann Ramrattan, Gurjit S Kaeley, Jasvinder A Singh
Background: We aimed to systematically review the effectiveness of healthcare behavioral and education interventions for gout patients on clinical outcomes. Methods: We searched multiple databases to identify trials or observational studies of educational or behavioral interventions in gout. Risk of bias was assessed with the Cochrane tool for randomized control trials (RCTs) and the Newcastle-Ottawa Scale for observational studies. We estimated odds ratios (ORs) for categorical and standardized mean difference (SMD) for continuous measures using a random-effects model...
December 2018: Therapeutic Advances in Musculoskeletal Disease
Tanya Halsall, Ian Manion, Joanna Henderson
Integrated youth service (IYS) is a collaborative approach that brings practitioners together from across disciplines to provide comprehensive services including mental health care for youth and their families. IYS models serve as an advancement in practice as they go beyond the capacity of individual programs and services to reduce the fragmentation of care. Yet, there continue to be opportunities to expand on this perspective and promote health beyond the scope of formalized services. The bioecological model is a theoretical model that examines individual development within multiple systems of influence as well as through interactional processes between the individual and their environment...
November 30, 2018: International Journal of Integrated Care
Jennifer Wallis
In the 1880 s and 1890 s the operations of the St James's Home for Female Inebriates in Kennington, London, attracted the attention of both the Charity Organisation Society and the popular press when the proprietors of the Home were accused of mistreating women in their care. Such mistreatment, it was suggested, had been allowed to continue for many years due to the cloak of secrecy that surrounded the Home. Both medical and popular conceptions of the inebriate had functioned to legitimise institutionalisation as necessary for cure and-by implying a degree of moral culpability that aligned inebriate women with 'fallen women' more generally-to sanction the secrecy of such treatment...
November 2018: Social History of Medicine: the Journal of the Society for the Social History of Medicine
Victoria A Grunberg, Pamela A Geller, Alexa Bonacquisti, Chavis A Patterson
Many infants (7-15%) spend time in the neonatal intensive care unit (NICU) and continue to experience medical issues after discharge. Family psychological responses range widely depending on burden of care, access to resources, and parental characteristics. The current systematic review examined how infant health severity is assessed and related to family psychological (e.g., mental health) and social (e.g., parent-infant attachment) outcomes. Seventy articles were deemed relevant. Infant health was operationalized in several ways including validated assessments, indices of infant health (e...
December 4, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
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