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Model of care

Susanne Lohmann, Elke Mattern, Gertrud M Ayerle
OBJECTIVE: To explore how midwives perceive patient preferences related to midwifery care in Germany. DESIGN: This qualitative study, which was part of a larger study, used a hermeneutic-interpretive approach and involved focus group interviews with midwives. Data collection and analysis were done in a conjoined fashion between April 2015 and September 2016. SETTING: Four focus group interviews were conducted in four different federal states of Germany...
February 10, 2018: Midwifery
Ángel Herráiz-Adillo, Iván Cavero-Redondo, Celia Álvarez-Bueno, Johana Bidner, Vicente Martínez-Vizcaíno, Blanca Notario-Pacheco
BACKGROUND AND AIMS: The diagnostic performance of the oscillometric ankle brachial index (ABI) to detect peripheral arterial disease (PAD) varies among populations, suggesting a spectrum effect. When this heterogeneity modifies post-test probabilities, a spectrum bias arises. This study evaluates the presence and influence of spectrum effect and spectrum bias on test performance and clinical decisions. METHODS: Oscillometric and Doppler ABI were compared in two settings: Primary-Care (333 legs) and Vascular-Service (41 legs)...
March 2, 2018: Atherosclerosis
Dan Norbäck, Chan Lu, Juan Wang, Yinping Zhang, Baizhan Li, Zhuohui Zhao, Chen Huang, Xin Zhang, Hua Qian, Yuexia Sun, Jan Sundell, Qihong Deng
BACKGROUND: Few data exist on asthma and rhinitis across China in relation to indoor and outdoor air pollution, climate and socioeconomic factors. The main aim was to study associations between asthma, rhinitis and current respiratory symptoms among pre-school children across China and selected indoor and outdoor exposure and indicators of socio-economic status (SES) in mutually adjusted models. METHODS: Chinese children (3-6 yr.) (n = 39,782) were recruited from randomly selected day care centres in seven cities in China...
March 9, 2018: Environment International
Mathilde Bourdon, Pietro Santulli, Fleur Kefelian, Laurine Vienet-Legue, Chloé Maignien, Khaled Pocate-Cheriet, Jacques de Mouzon, Louis Marcellin, Charles Chapron
STUDY QUESTION: How does the duration of estrogen (E2) treatment prior to frozen-blastocyst transfers affect the live birth rate (LBR)? SUMMARY ANSWER: Prolonged E2 exposure as part of artificial endometrial preparation (AEP) significantly decreases the LBR after autologous frozen-thawed blastocyst transfer. WHAT IS KNOWN ALREADY: One effective method for endometrial preparation prior to frozen embryo transfer is AEP, a sequential regimen with E2 and progesterone, which aims to mimic the endocrine exposure of the endometrium in a normal cycle...
February 26, 2018: Human Reproduction
Matthew R Sydes, Melissa R Spears, Malcolm D Mason, Noel W Clarke, David P Dearnaley, Johann S de Bono, Gert Attard, Simon Chowdhury, Bill Cross, Silke Gillessen, Zaf Malik, Rob Jones, Chris Parker, Alastair W S Ritchie, J Martin Russell, Robin Millman, David Matheson, Claire Amos, Clare Gilson, Alison Birtle, Susannah Brock, Lisa Capaldi, Prabir Chakraborti, Ananya Choudhury, Linda Evans, Daniel Ford, Joanna Gale, Stephanie Gibbs, Duncan Gilbert, Robert Hughes, Duncan McLaren, Jason Lester, Ashok Nikapota, Joe O'Sullivan, Omi Parikh, Clive Peedell, Andrew Protheroe, Sarah M Rudman, Richard Shaffer, Denise Sheehan, Matthew Simms, Narayanan Srihari, Räto Strebel, Santhanam Sundar, Shaun Tolan, David Tsang, Mohini Varughese, John Wagstaff, Mahesh K B Parmar, Nicholas D James
Background: Adding abiraterone acetate with prednisolone (AAP) or docetaxel with prednisolone (DocP) to standard-of-care (SOC) each improved survival in STAMPEDE: a multi-arm multi-stage platform randomised controlled protocol recruiting patients with high-risk locally advanced or metastatic PCa starting long-term androgen deprivation therapy (ADT). The protocol provides the only direct, randomised comparative data of SOC+AAP vs SOC+DocP. Method: Recruitment to SOC+DocP and SOC+AAP overlapped Nov-2011─Mar-2013...
February 26, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Julie C Fitzgerald, Yimei Li, Brian T Fisher, Yuan-Shung Huang, Tamara P Miller, Rochelle Bagatell, Alix E Seif, Richard Aplenc, Neal J Thomas
OBJECTIVES: To evaluate hospital-level variability in resource utilization and mortality in children with new leukemia who require ICU support, and identify factors associated with variation. DESIGN: Retrospective cohort study. SETTING: Children's hospitals contributing to the Pediatric Health Information Systems administrative database from 1999 to 2011. PATIENTS: Inpatients less than 25 years old with newly diagnosed acute lymphocytic leukemia or acute myeloid leukemia requiring ICU support (n = 1,754)...
March 9, 2018: Pediatric Critical Care Medicine
Troels Munch, Christian Fynbo Christiansen, Lars Pedersen, Henrik Toft Sørensen
OBJECTIVES: Compare all-cause mortality following nonsurgical ICU admission for opioid users with nonusers. DESIGN: Nationwide register-based cohort study. SETTING: All 43 ICUs in Denmark (7,028,668 citizens cumulatively during the study period). The Danish National Health Service provides universal healthcare, guaranteeing equal access to healthcare along with partial reimbursement for prescribed drugs. PATIENTS: All 118,388 nonsurgical patients admitted to an ICU from 2005 to 2014...
March 9, 2018: Critical Care Medicine
Jenna Dran
In 2015, Zika virus rapidly emerged as a concern for obstetric patients and health care providers as the disease spread geographically and it was discovered that Zika virus infection had the potential to cause devastating birth defects. Essentially overnight, obstetric care providers were faced with an influx of rapidly evolving information and an increased workload. New systems, workflows, and personnel were needed to effectively address the new patient care needs fueled by the burgeoning Zika virus epidemic...
March 8, 2018: Obstetrics and Gynecology
Heather C Kaplan, Eileen King, Beth E White, Susan E Ford, Sandra Fuller, Michael A Krew, Michael P Marcotte, Jay D Iams, Jennifer L Bailit, Jo M Bouchard, Kelly Friar, Carole M Lannon
OBJECTIVE: To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. METHODS: Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching...
March 8, 2018: Obstetrics and Gynecology
John Noel M Viaña, Frederic Gilbert
Memory dysfunction and cognitive impairments due to Alzheimer's disease can affect the selfhood and identity of afflicted individuals, causing distress to both people with Alzheimer's disease and their caregivers. Recently, a number of case studies and clinical trials have been conducted to determine the potential of deep brain stimulation as a therapeutic modality for people with Alzheimer's disease. Some of these studies have shown that deep brain stimulation could induce flashbacks and stabilize or even improve memory...
January 1, 2018: Dementia
Kazuho Hisamura, Eisuke Matsushima, Syouichi Tsukayama, Shinya Murakami, Yoshiharu Motoo
OBJECTIVE: Little is known about the social problems experienced by cancer patients in non-Western countries. The aims of this study were: 1) to explore the characteristics and frequencies of social problems in cancer outpatients, as well as their associations with the need for help, and 2) to take the initial steps to develop an instrument for the assessment of cancer-related social problems in Japan. METHODS: A cross-sectional group of 109 patients completed the Social Problem Checklist (SPC) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30)...
March 12, 2018: Psycho-oncology
Jessica A Rowland, Emily Nicholson, Nicholas J Murray, David A Keith, Rebecca E Lester, Lucie M Bland
Ongoing ecosystem degradation and transformation are key threats to biodiversity. Measuring ecosystem change towards collapse relies on monitoring indicators that quantify key ecological processes. Yet little guidance is available on selecting and implementing indicators for ecosystem risk assessment. Here, we reviewed indicator use in ecological studies of decline towards collapse in marine pelagic and temperate forest ecosystems. We evaluated the use of indicator selection methods, indicator types (geographic distribution, abiotic, biotic), methods of assessing multiple indicators, and temporal quality of time series...
March 12, 2018: Conservation Biology: the Journal of the Society for Conservation Biology
Joshua I Rosenbloom, Methodius G Tuuli, Molly J Stout, Omar M Young, Candice L Woolfolk, Julia D López, George A Macones, Alison G Cahill
OBJECTIVE:  To determine the factors associated with severe maternal morbidity in a modern cohort of women laboring at term and to create a prediction model. STUDY DESIGN:  This is a retrospective cohort study of all term, laboring patients with live births at a single tertiary care center from 2004 to 2014. The primary outcome was composite maternal morbidity including organ failure, amniotic fluid embolism, anesthesia complications, sepsis, shock, thrombotic events, transfusion, or hysterectomy...
February 8, 2018: American Journal of Perinatology
Fawaz Al-Mufti, Kalina Anna Misiolek, David Roh, Aws Alawi, Andrew Bauerschmidt, Soojin Park, Sachin Agarwal, Philip M Meyers, E Sander Connolly, Jan Claassen, J Michael Schmidt
BACKGROUND: Immune dysregulation has long been implicated in the development of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To determine the relationship of inflammatory cell biomarkers with DCI. METHODS: We evaluated 849 aSAH patients who were enrolled into a prospective observational cohort study and had a white blood cell (WBC) differential obtained within 72 h of bleed onset. RESULTS: WBC count > 12...
March 8, 2018: Neurosurgery
Jennifer L Cerully, Joie D Acosta, Jennifer Sloan
Introduction: Many service members experiencing symptoms of mental health conditions do not receive mental health care for these symptoms. The stigma associated with having a mental health condition or seeking treatment is often cited as a specific barrier to mental health care. However, study results bearing on the question of whether and how stigma may reduce treatment-seeking have been inconsistent. Methods: We searched 10 databases for sources published between 2004 and 2014 that prospectively linked stigma to treatment-related outcomes (such as treatment seeking, retention, and reports of symptoms) using longitudinal data and predictive models...
March 8, 2018: Military Medicine
Robin Newhouse, Ha Do Byon, Emily Storkman Wolf, Meg Johantgen
PROBLEM: High-quality smoking cessation counseling guidelines for people who use tobacco are not fully integrated in acute-care services presenting missed opportunities to improve health outcomes. The role of the practice environment on enhancing or inhibiting guideline use is unknown. OBJECTIVE: To examine the relationship between the nurse practice environment and nurses' use of smoking cessation counseling practices, and to evaluate the effect of the individual nurse and organization characteristics on nurse smoking cessation counseling practices...
March 12, 2018: Worldviews on Evidence-based Nursing
Marzieh Akbarzadeh, Sima Kiani Rad, Marzieh Moattari, Najaf Zare
Postpartum blues is a major risk factor for the incidence of postpartum depression and disruption of breastfeeding. This semi-experimental study investigated the effect of breastfeeding training based on the BASNEF model on severity of postpartum blues in 2012. Four educational sessions based on the BASNEF model were held separately for pregnant women and their mothers, mothers-in-law and spouses. The control group received routine care at the clinic. After delivery, women's knowledge of and attitude towards postpartum blues were evaluated using the Zung Self- Rating Depression Scale...
March 5, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Jinsong Zhang, Anastasia Miller, Yongxia Li, Qinqin Lan, Ning Zhang, Yanling Chai, Bing Hai
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations...
March 7, 2018: Tuberculosis and Respiratory Diseases
Fernando Bril, Laura Millán, Srilaxmi Kalavalpalli, Michael J McPhaul, Michael P Caulfield, Ibon Martinez-Arranz, Cristina Alonso, Pablo Ortiz Betes, José M Mato, Kenneth Cusi
AIMS: While several non-invasive clinical/metabolic scores have been designed to predict the presence of nonalcoholic steatohepatitis (NASH), none was specifically validated in patients with T2DM. We aimed to assess the utility of existing metabolomics scores to classify liver disease in patients with T2DM. MATERIALS AND METHODS: A total of 220 patients with T2DM were recruited. Patients underwent routine lab tests, a liver proton magnetic resonance spectroscopy (1 H-MRS), a 75-gram OGTT, and a liver biopsy if they had NAFLD by1 H-MRS...
March 12, 2018: Diabetes, Obesity & Metabolism
Daniel Lin, Heather T Gold, David Schreiber, Lawrence P Leichman, Scott E Sherman, Daniel J Becker
BACKGROUND: Although outcomes for patients with squamous cell carcinoma of the anus (SCCA) have improved, the gains in benefit may not be shared uniformly among patients of disparate socioeconomic status. In the current study, the authors investigated whether area-based median household income (MHI) is predictive of survival among patients with SCCA. METHODS: Patients diagnosed with SCCA from 2004 through 2013 in the Surveillance, Epidemiology, and End Results registry were included...
March 12, 2018: Cancer
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