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Quality Of Death

Paola Di Giulio, Silvia Finetti, Fabrizio Giunco, Ines Basso, Debora Rosa, Francesca Pettenati, Alessandro Bussotti, Daniele Villani, Simona Gentile, Lorenzo Boncinelli, Massimo Monti, Sandro Spinsanti, Massimo Piazza, Lorena Charrier, Franco Toscani
CONTEXT: End-of-life care in nursing homes (NH) needs improvement. We carried out a study in 29 NHs in the Lombardy Region (Italy). OBJECTIVES: To compare End-of-Life care in NH residents with advanced dementia before and after an educational intervention aimed to improving palliative care. METHODS: The intervention consisted of a 7-hour lecture, followed by two 3-hour meetings consisting of case discussions. The intervention was held in each NH and well attended by NH staff...
October 10, 2018: Journal of Pain and Symptom Management
Matthew Murray, Alexander Stone, Virginia Pearson, Glenn Treisman
The current opiate epidemic has caused tens of thousands of deaths annually and hundreds of billions in economic losses. From 1979 to 2015, accidental opiate-related deaths increased by 4250%. Despite its magnitude, the driving forces remain poorly understood. A narrow understanding by physicians, administrators, and policy makers has resulted in a clinical approach to chronic pain treatment misguided by expediency, shortsighted cost reduction, pharmaceutical profit, and patient satisfaction. Until the broken elements are well understood, effective policy solutions will remain elusive...
October 10, 2018: Preventive Medicine
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
Xue-Qing Yu, Meng-Hua Chen, Jie Dong, Hong Liu, Zhang-Suo Liu, Qiang Yao, James A Sloand, Mark Marshall
BACKGROUND: The aim of this study was to determine if there were centers in China with unusually high levels of risk-adjusted mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: We analyzed an inception cohort commencing CAPD between 1 January 2005 and 13 August 2015, followed until death, dropout defined as discontinuation of Baxter products, loss to follow-up, or 13 November 2015, whichever occurred first. We calculated standardized mortality ratios (SMRs) from Cox proportional hazards models, adjusting for age, gender, employment status, insurance status, primary renal disease, size of peritoneal dialysis (PD) program, and year of dialysis inception...
October 12, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Ting Hway Wong, Yu Jie Wong, Zheng Yi Lau, Nivedita Nadkarni, Gek Hsiang Lim, Dennis Chuen Chai Seow, Marcus Eng Hock Ong, Kelvin Bryan Tan, Hai V Nguyen, Chek Hooi Wong
OBJECTIVES: Readmission after acute care is a significant contributor to health care costs, and has been proposed as a quality indicator. Our earlier studies showed that patients aged ≥55 years who are injured by falls from heights of ≤0.5 m were at increased risk for long-term mortality, compared to patients by high-velocity blunt trauma (higher fall heights, road injuries, and other blunt trauma). We hypothesized that these patients are also at higher risk of readmission, compared to patients injured by high-velocity mechanisms...
October 9, 2018: Journal of the American Medical Directors Association
Juneyoung L Yi, Christina A Porucznik, Lisa H Gren, Jian Guan, Evan Joyce, Darrel S Brodke, Andrew T Dailey, Mark A Mahan, Robert S Hood, Brandon D Lawrence, William R Spiker, Nicholas T Spina, Erica F Bisson
BACKGROUND: Prescription opioid medications negatively affect postoperative outcomes after lumbar spine surgery. Furthermore, opioid-related overdose death rates in the U.S. increased by 200% between 2000 and 2014. Thus, alternatives are imperative. Mindfulness-based stress reduction (MBSR), a mind-body therapy, has been associated with improved activity and mood in opioid-using chronic pain patients. This study assessed whether preoperative MBSR is an effective adjunct to standard postoperative care in adult patients undergoing lumbar spine surgery for degenerative disease...
October 9, 2018: World Neurosurgery
E V Plokhova, D P Dundua
Thrombosis traditionally considered as a complication of cardiovascular disease, however, this problem until recently was rarely taken into account in the presence of cancer. Although the association between cancer and thrombosis has been known almost 150 years ago, awareness of the impact of thrombotic complications have increased only now. Cancer is an independent major risk factor for venous thromboembolism (VTE), which is the leading cause of death of cancer patient. The incidence of VTE is steadily increasing in these patients...
2018: Kardiologiia
Christabel C Enweronu-Laryea, Hilary D Andoh, Audrey Frimpong-Barfi, Francis M Asenso-Boadi
The major causes of newborn deaths in sub-Saharan Africa are well-known and countries are gradually implementing evidence-based interventions and strategies to reduce these deaths. Facility-based care provides the best outcome for sick and or small babies; however, little is known about the cost and burden of hospital-based neonatal services on parents in West Africa, the sub-region with the highest global neonatal death burden. To estimate the actual costs borne by parents of newborns hospitalised with birth-associated brain injury (perinatal asphyxia) and preterm/low birth weight, this study examined economic costs using micro-costing bottom-up approach in two referral hospitals operating under the nationwide social health insurance scheme in an urban setting in Ghana...
2018: PloS One
S Jane Henley, Shayne Gallaway, Simple D Singh, Mary Elizabeth O'Neil, Natasha Buchanan Lunsford, Behnoosh Momin, Thomas B Richards
November marks Lung Cancer Awareness Month, and reminds us that lung cancer is the leading cause of cancer death among women in the United States. In this brief report, we highlight CDC resources that can be used to examine the most recent data on lung cancer incidence, survival, prevalence, and mortality among women. Using the U.S. Cancer Statistics Data Visualizations tool, we report that in 2015, 104,992 new cases of lung cancer and 70,073 lung cancer deaths were reported among women in the United States...
October 12, 2018: Journal of Women's Health
Maja Holm, Anette Alvariza, Carl-Johan Fürst, Joakim Öhlen, Kristofer Årestedt
The Texas Revised Inventory of Grief (TRIG) was developed to measure the intensity of grief after the death of a close person. It consists of two scales: TRIG I (past behaviors) and TRIG II (present feelings). Because of inconsistencies in previous validations, the instrument needs to be further validated, hence the aim of this study was to evaluate the psychometric properties of the TRIG in a sample of bereaved family caregivers in Sweden. The TRIG was translated to Swedish according to standard principles, and 129 bereaved family caregivers completed the questionnaire...
October 12, 2018: Research in Nursing & Health
Andrea S Melani
Inhaled bronchodilators are the key-stone of chronic obstructive pulmonary disease (COPD) management. Olodaterol 5 µg, a long-acting β2-adrenoceptor agonist (LABA) is one such bronchodilator indicated as a once-daily maintenance therapy. Areas covered: This article reviews the several trials that have assessed olodaterol as a COPD therapy. It covers safety and tolerability data and provides the reader with an expert opinion on its use as a treatment for COPD. Expert opinion: Olodaterol improves lung function for 24 h and reduces rescue medication use...
October 12, 2018: Expert Opinion on Pharmacotherapy
Sarah Finocchario-Kessler, Brad Gautney, AnLin Cheng, Catherine Wexler, May Maloba, Niaman Nazir, Samoel Khamadi, Raphael Lwembe, Melinda Brown, Thomas A Odeny, Jacinda K Dariotis, Matthew Sandbulte, Natabhona Mabachi, Kathy Goggin
BACKGROUND: The HIV Infant Tracking System (HITSystem) is a web-based intervention linking providers of early infant diagnosis, laboratory technicians, and mothers and infants to improve outcomes for HIV-exposed infants. We aimed to evaluate the efficacy of the HITSystem on key outcomes of early infant diagnosis. METHODS: We did a cluster-randomised trial at six hospitals in Kenya, which were matched on geographic region, resource level, and volume of patients (high, medium, and low)...
October 8, 2018: Lancet HIV
Jiahui Yuan, Min Chen, Shangzhong Chen, Caibao Hu, Guolong Cai, Jing Yan
OBJECTIVE: To systematically evaluate the effects of left ventricular global longitudinal strain (GLS) determined by two dimensional speckle tracking imaging technology (2D-STI) and left ventricular ejection fraction (LVEF) on the prognosis of patients with sepsis/septic shock. METHODS: Databases such as the National Library of Medicine PubMed database, Dutch medical abstracts Embase, Cochrane Library, Netherlands Elsevier, Springer and China biomedical literature database (CBMdisc), China National Knowledge Internet (CNKI), Wanfang database, China science and technology journal full-text database, Vip Chinese biomedical journal database were searched from the establishment of literature database to April 2018 to study GLS, LVEF and their relationships with mortality of septic/septic shock patients...
September 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Monika A Roy, Jean M Arnaud, Paul M Jasmin, Steve Hamner, Nur A Hasan, Rita R Colwell, Timothy E Ford
The cholera epidemic that occurred in Haiti post-earthquake in 2010 has resulted in over 9000 deaths during the past eight years. Currently, morbidity and mortality rates for cholera have declined, but cholera cases still occur on a daily basis. One continuing issue is an inability to accurately predict and identify when cholera outbreaks might occur. To explore this surveillance gap, a metagenomic approach employing environmental samples was taken. In this study, surface water samples were collected at two time points from several sites near the original epicenter of the cholera outbreak in the Central Plateau of Haiti...
October 10, 2018: International Journal of Environmental Research and Public Health
Sara Marchetti, Eleonora Longhin, Rossella Bengalli, Pasquale Avino, Luca Stabile, Giorgio Buonanno, Anita Colombo, Marina Camatini, Paride Mantecca
Biomass combustion significantly contributes to indoor and outdoor air pollution and to the adverse health effects observed in the exposed populations. Besides, the contribution to toxicity of the particles derived from combustion of different biomass sources (pellet, wood, charcoal), as well as their biological mode of action, are still poorly understood. In the present study, we investigate the toxicological properties of PM10 particles emitted indoor from a stove fueled with different biomasses. PM10 was sampled by gravimetric methods and particles were chemically analyzed for Polycyclic Aromatic Hydrocarbons (PAHs) and elemental content...
February 1, 2019: Science of the Total Environment
Rachel E Menzies, Matteo Zuccala, Louise Sharpe, Ilan Dar-Nimrod
Death anxiety has been proposed as a transdiagnostic construct, underlying numerous mental disorders. Although it has been argued that treatments, which reduce death anxiety, are needed, research investigating the impact of interventions on death fears has produced mixed results. As such, the current meta-analysis aimed to examine the effect of psychosocial interventions on death anxiety. Overall, results from 15 randomised controlled trials suggested that psychosocial treatments produced significant reductions in death anxiety, with a small to medium effect size (g = ...
October 3, 2018: Journal of Anxiety Disorders
Benjamin A Kamala, Hege L Ersdal, Ingvild Dalen, Muzdalifat S Abeid, Matilda M Ngarina, Jeffrey M Perlman, Hussein L Kidanto
BACKGROUND: Intrapartum Fetal Heart Rate (FHR) monitoring is crucial for the early detection of abnormal FHR, facilitating timely obstetric interventions and thus the potential reduction of adverse perinatal outcomes. We explored midwifery practices of intrapartum FHR monitoring pre and post implementation of a novel continuous automatic Doppler device (the Moyo). METHODOLOGY: A pre/post observational study among low-risk pregnancies at a tertiary hospital was conducted from March to December 2016...
2018: PloS One
Jillian L Peters, Daniel K Cho, Adam R Aluisio, Stephen B Kennedy, Moses B F Massaquoi, Fodey Sahr, Shiromi M Perera, Adam C Levine
OBJECTIVE: Fluid loss during Ebola virus disease (EVD) infections from gastrointestinal dysfunction leads to volume depletion. It is possible that high environmental temperatures may exacerbate volume depletion or interfere with the provision of medical care by providers in full personal protective equipment. We investigated the effect of environmental temperature on case fatality. METHODS: The International Medical Corps (IMC) operated 5 Ebola Treatment Units (ETUs) in Liberia and Sierra Leone during the 2014-16 epidemic...
October 11, 2018: Tropical Medicine & International Health: TM & IH
S K Kunutsor, D Gillatt, A W Blom
BACKGROUND: Osseointegration, an approach for direct skeletal attachment of a prosthesis to an amputated limb, may address many of the problems associated with socket prostheses. The safety of osseointegration remains uncertain. The aim of this study was to summarize evidence on functional and clinical outcomes, as well as adverse effects of osseointegration for patients with a limb amputation. METHODS: MEDLINE, Embase, Web of Science and the Cochrane Library were searched to April 2018...
October 11, 2018: British Journal of Surgery
Yang Zhang, Ling Wang, Lei Meng, Guang-Ke Cao, Yu-Liang Zhao, Yu Wu
Background: Sepsis is one of the common death factors in intensive care unit, which refers to the systemic inflammatory response syndrome caused by infection. It has many complications such as acute renal injury, shock, multiple organ dysfunction, and failure. The mortality of acute renal injury is the highest among the complications, which is a serious threat to the safety of patients and affects the quality of life. This study aimed to observe the changes in autophagy-related protein expressions in patients with acute kidney injury (AKI) after continuous renal replacement therapy (CRRT) and their impacts on prognosis...
2018: Immunity & Ageing: I & A
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