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https://www.readbyqxmd.com/read/28334973/analysis-of-dropout-across-the-continuum-of-maternal-health-care-in-tanzania-findings-from-a-cross-sectional-household-survey
#1
Diwakar Mohan, Amnesty E LeFevre, Asha George, Rose Mpembeni, Eva Bazant, Neema Rusibamayila, Japhet Killewo, Peter J Winch, Abdullah H Baqui
The 'continuum of care' is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC).We analyzed data from 1931 women who delivered in the preceding 2-14 months, from a two-stage cluster sampling household survey in four districts of Tanzania's Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program...
March 16, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334653/the-impact-of-transitions-in-insurance-coverage-on-gp-visiting-among-children-in-ireland
#2
Anne Nolan, Richard Layte
The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40 per cent of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use nationally representative data from the Growing up in Ireland (GUI) study to examine the impact of transitions in insurance coverage on GP utilisation among children. GUI surveys two cohorts of nearly 20,000 children (aged 9 months and 9 years at baseline); we use data from the first two waves of each cohort (which covers the period 2007-2012)...
March 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#3
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#4
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#5
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334526/an-unusual-non-emissive-behavior-of-rubrene-j-aggregates-a-rare-violation
#6
Nikhil Aggarwal, Archita Patnaik
Structure - property correlations in Rubrene (RB) colloidal J-aggregates were unravelled by steady state and time resolved spectroscopy in conjunction with excited state density functional calculations. The RB J-aggregate with a slippage angle θ = 30.4(0), estimated from the monomeric transition dipole moment directions, exhibited a broad FWHM of 1073 cm(-1) and a 5 nm red shifted absorption band carrying a transition dipole moment (M ⃗_(λagg )= 1.80 D) almost equivalent to the monomeric dye (M ⃗_(λmon )=1...
March 23, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28334473/history-of-being-in-government-care-associated-with-younger-age-at-injection-initiation-among-a-cohort-of-street-involved-youth
#7
Brittany Barker, Thomas Kerr, Huiru Dong, Evan Wood, Kora DeBeck
INTRODUCTION AND AIMS: Compared to the general population of youth, health-related disparities experienced by youth exposed to the child welfare system are well documented. Amongst these vulnerabilities are elevated rates of substance use, including injection drug use; however, less is known about when these youth transition to this high-risk behaviour. We sought to assess whether having a history of government care is associated with initiating injection drug use before age 18. DESIGN AND METHODS: Between September 2005 and May 2014, data were derived from the At-Risk Youth Study, a cohort of street-involved youth who use illicit drugs in Vancouver, Canada...
March 23, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28333697/medication-reconciliation-during-hospitalization-and-in-hospital-home-interface-an-observational-retrospective-study
#8
Elisabetta Volpi, Alessandro Giannelli, Giulio Toccafondi, Monica Baroni, Sara Tonazzini, Stefania Alduini, Stefania Biagini, Rosa Gini, Tommaso Bellandi, Michele Emdin
OBJECTIVE: Medication errors are one of the leading causes of patient harms. Medication reconciliation is a fundamental process that to be effective, it should be embraced during each single care transition. Our objectives were to investigate current medication reconciliation practices in the 2 Fondazione Toscana Gabriele Monasterio hospitals and comprehensively assess the quality of medication reconciliation practices between inpatient and outpatient care by analyzing the medication patterns 6 months before admission, during hospitalization, and 9 months after discharge for a selected group of patients with cardiovascular diseases...
March 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28333613/collaborative-management-of-neurocognitive-disorders-in-primary-care-explorations-of-an-attempt-at-culture-change
#9
Lewis Mehl-Madrona, Barbara Mainguy
INTRODUCTION: Minor neurocognitive disorder (MiND; previously mild cognitive impairment) is a transitional zone between normal cognitive function and early stages of major neurocognitive disorder (previously called dementia). Of people with MiND, 5% to 10% progress to major neurocognitive disorder. Simple interventions such as memory activities, balance exercises, and anti-inflammatory diets have been shown to improve cognitive ability. Also, education and support in group settings have proved beneficial for patients with MiND...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28332936/ethical-concerns-about-emerging-treatment-paradigms-for-gender-dysphoria
#10
Stephen B Levin
The increasing incidence of request for medical services to support gender transition for children, adolescents and adults has consequences for society, governmental institutions, schools, families, health care professionals, and, of course, patients. The sociological momentum to recognize and accommodate to trans phenomena has posed ethical dilemmas for endocrinologists, mental health professionals and sexual specialists as they experience within themselves the clash between Respect for Patient Autonomy, Beneficence, Nonmalficience, and Informed Consent...
March 23, 2017: Journal of Sex & Marital Therapy
https://www.readbyqxmd.com/read/28332774/changing-hpv-vaccination-rates-in-bisexual-and-lesbian-women
#11
Carolee Polek, Thomas Hardie
BACKGROUND: Human papillomavirus (HPV) vaccination rates continue to be below national targets for women and lower in some sexual minorities. HPV is a primary causal agent in cervical cancer, from which members of the lesbian and bisexual community mistakenly believe they are at low risk. This study characterized rates of HPV vaccination in women based on their sexual orientation. METHODS: Data were obtained from the Centers for Disease Control and Prevention's National Health Interview Survey 2013-2014...
March 23, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28332090/disparities-in-the-clinical-evolution-of-anal-neoplasia-in-an-hiv-infected-cohort
#12
Edward R Cachay, Wollelaw Agmas, Wm Christopher Mathews
BACKGROUND: A recent meta-analysis suggested that anal intraepithelial neoplasia and invasive anal cancer are more prevalent among black men having sex with men (MSM). METHODS: We conducted a retrospective cohort of HIV-infected adult patients under care between 2001 and 2012. Disparities in clinical evolution of anal intraepithelial neoplasia to high-grade squamous intraepithelial lesion (HSIL) and invasive anal cancer were evaluated in a three-state Markov model adjusted for cytology misclassification...
March 23, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28331636/patient-experiences-of-decentralized-hiv-treatment-and-care-in-plateau-state-north-central-nigeria-a-qualitative-study
#13
Grace O Kolawole, Hannah N Gilbert, Nancin Y Dadem, Becky L Genberg, Patricia A Agaba, Prosper Okonkwo, Oche O Agbaji, Norma C Ware
Background. Decentralization of care and treatment for HIV infection in Africa makes services available in local health facilities. Decentralization has been associated with improved retention and comparable or superior treatment outcomes, but patient experiences are not well understood. Methods. We conducted a qualitative study of patient experiences in decentralized HIV care in Plateau State, north central Nigeria. Five decentralized care sites in the Plateau State Decentralization Initiative were purposefully selected...
2017: AIDS Research and Treatment
https://www.readbyqxmd.com/read/28331102/clinical-features-of-women-with-turner-syndrome-experiencing-transition-period-in-japan
#14
Satsuki Nishigaki, Takashi Hamazaki, Akitoshi Tsuruhara, Toshiko Yoshida, Takuji Imamura, Hiroshi Inada, Keinosuke Fujita, Haruo Shintaku
Turner syndrome results from the entire or partial loss of the second X chromosome, and is associated with a number of medical problems. Affected women require long-term medical follow-up. This study investigated the status of medical follow-up focusing on the transition for young adult women with Turner syndrome (TS). The clinical profiles of 63 women with TS over the age of 16 were retrospectively examined. Thirty-three women are continuously followed by pediatric endocrinologists at our pediatric division...
March 22, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28329583/dermatologic-care-of-the-transgender-patient
#15
Timothy Hermosura Almazan, Filamer D Kabigting
Literature is limited regarding the medical and cosmetic dermatologic issues pertinent to transgender patients and the reasons why 19 transgender individuals seek care from dermatologists. Clinical management of this population has historically been limited to 20 mental health providers, endocrinologists, and select surgeons with expertise in sex reassignment surgery. The impact of hormonal 21 therapy on transgender skin has been well documented in endocrinology journals, but is underrepresented in dermatology 22 literature...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329433/understanding-maternal-postpartum-needs-a-descriptive-survey-of-current-maternal-health-services
#16
Mona Ma Almalik
OBJECTIVE: To assess mothers' learning needs and concerns after giving birth and to examine whether these needs were met at 6-8 weeks postpartum. BACKGROUND: Women experience many physiologic and psychological changes during postpartum period which is considered a vital transitional time. Exploring and meeting women's needs help woman to pass this period with little complications and enhance health care provider's ability to provide appropriate care following childbirth...
March 22, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#17
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28329212/clinical-status-of-adolescents-with-perinatal-hiv-at-transfer-to-adult-care-in-the-uk-ireland
#18
Intira Jeannie Collins, Caroline Foster, Anna Tostevin, Pat Tookey, Andrew Riordan, David Dunn, D M Gibb, Ali Judd
Background.: Increasing numbers of children infected perinatally with human immunodeficiency virus (HIV) are surviving to adolescence and transitioning to adult care, yet there are scarce data on their clinical status at transfer. Methods.: We analyzed prospective cohort data from the UK/Ireland national Collaborative HIV Pediatric Study (CHIPS). Clinical status at last pediatric clinic visit prior to transfer was described. Factors associated with higher CD4 cell count and viral load (VL) suppression<400 c/mL among patients on antiretroviral therapy (ART) at transfer were assessed using linear and logistic regression, respectively...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28327147/medical-student-changes-in-self-regulated-learning-during-the-transition-to-the-clinical-environment
#19
Kenneth K Cho, Brahm Marjadi, Vicki Langendyk, Wendy Hu
BACKGROUND: Self-regulated learning (SRL), which is learners' ability to proactively select and use different strategies to reach learning goals, is associated with academic and clinical success and life-long learning. SRL does not develop automatically in the clinical environment and its development during the preclinical to clinical learning transition has not been quantitatively studied. Our study aims to fill this gap by measuring SRL in medical students during the transitional period and examining its contributing factors...
March 21, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#20
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
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