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Population Health Management

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https://www.readbyqxmd.com/read/29785895/complexity-in-pediatric-primary-care
#1
Arwa Nasir, Laeth Nasir, Ariel Tarrell, David Finken, Amy Lacroix, Swetha Pinninti, Sheryl Pitner, Molly McCarthy
BACKGROUND: The management of patients in primary care is often complicated by the presence of multiple chronic conditions and psychosocial issues that increase the complexity of the encounter and have important impacts on care. There is a paucity of literature on this subject in the pediatric population. OBJECTIVES: The aim of this study was to quantify the burden of chronic conditions in pediatric primary care. METHODS: The problem lists of 3995 randomly selected patients from a community pediatric clinic and an academic hospital-based pediatric clinic in the same metropolitan area were analyzed for the presence and number of any chronic condition...
May 22, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29785719/children-s-experiences-and-expectations-of-kidney-transplantation-a-qualitative-interview-study
#2
Rachael C Walker, Derisha Naicker, Tonya Kara, Suetonia C Palmer
RATIONALE AND OBJECTIVE: Kidney transplantation offers improved quality of life and life expectancy compared with dialysis for children. This study aims to understand the experiences and expectations of children during the kidney transplantation process to inform clinical care. STUDY DESIGN: Face-to-face, semi-structured interviews. SETTING AND PARTICIPANTS: We interviewed 13 children and adolescents aged between 7 and 17 years old in New Zealand who had received a kidney transplantation...
May 21, 2018: Nephrology
https://www.readbyqxmd.com/read/29785098/sarcopenia-assessment-of-disease-burden-and-strategies-to-improve-outcomes
#3
REVIEW
Ilaria Liguori, Gennaro Russo, Luisa Aran, Giulia Bulli, Francesco Curcio, David Della-Morte, Gaetano Gargiulo, Gianluca Testa, Francesco Cacciatore, Domenico Bonaduce, Pasquale Abete
Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength - a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors - in particular, nutritional status and degree of physical activity...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29784001/appropriateness-of-malaria-diagnosis-and-treatment-for-fever-episodes-according-to-patient-history-and-anti-malarial-blood-measurement-a-cross-sectional-survey-from-tanzania
#4
Joanna Gallay, Dominic Mosha, Erick Lutahakana, Festo Mazuguni, Martin Zuakulu, Laurent Arthur Decosterd, Blaise Genton, Emilie Pothin
BACKGROUND: Monitoring the impact of case management strategies at large scale is essential to evaluate the public health benefit they confer. The use of methodologies relying on objective and standardized endpoints, such as drug levels in the blood, should be encouraged. Population drug use, diagnosis and treatment appropriateness in case of fever according to patient history and anti-malarials blood concentration was evaluated. METHODS: A cross-sectional survey took place between May and August 2015 in three regions of Tanzania with different levels of malaria endemicity...
May 21, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29783962/predictors-of-weight-stigma-experienced-by-middle-older-aged-general-practice-patients-with-obesity-in-disadvantaged-areas-of-australia-a-cross-sectional-study
#5
Catherine Spooner, Upali W Jayasinghe, Nighat Faruqi, Nigel Stocks, Mark F Harris
BACKGROUND: Rates of obesity have increased globally and weight stigma is commonly experienced by people with obesity. Feeling stigmatised because of one's weight can be a barrier to healthy eating, physical activity and to seeking help for weight management. The aim of this study was to identify predictors of perceived weight among middle-older aged patients with obesity attending general practices in socioeconomically disadvantaged urban areas of Australia. METHODS: As part of a randomised clinical trial in Australia, telephone interviews were conducted with 120 patients from 17 general practices in socioeconomically disadvantaged of Sydney and Adelaide...
May 21, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29783267/-conceptual-approaches-to-the-investigation-of-a-problem-of-professional-training-of-physical-therapists
#6
Anna V Fastivetz, Pavlo V Khomenko, Inna E Shaparenko
OBJECTIVE: Introduction:The level of people's health and its preservation is a medical problem that requires the optimal solution and the need to improve the management of the system of measures to achieve the goal. According to specialists, the health of Ukrainian people is accompanied by high mortality, significant parameters of disability and morbidity and a decrease in the average life expectancy. Diseases that lead to such negative medical and social and socio-economic consequences are so-called "illnesses of a way of life" or "diseases of civilization"...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783258/-theoretical-grounds-of-a-structural-and-functional-model-for-quality-assurance-of-radiation-diagnostics-under-conditions-of-development-of-the-modern-health-care-system-in-ukraine
#7
Oleg A Korop, Sergiy V Lenskykh
OBJECTIVE: Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783253/planning-of-effective-evaluation-of-the-activities-of-hospital-district-at-the-example-of-poltava-region
#8
Vyacheslav M Zhdan, Valentyn M Dvornyk, Viktor P Lysak, Igor M Skrypnyk, Valeriy I Pokhylko, Iryna A Holovanova, Inna V Bielikova, Maxim V Khorosh, Ludmila M Shylkina, Mariya M Tovstiak
OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783004/-the-thing-that-really-gets-me-is-the-future-symptomatology-in-older-homeless-adults-in-the-hope-home-study
#9
Adam Bazari, Maria Patanwala, Lauren M Kaplan, Colette L Auerswald, Margot B Kushel
CONTEXT: The homeless population is aging. Older homeless adults experience premature development of age-related conditions and an elevated symptom burden. Little is known about symptom experience among older homeless adults. OBJECTIVES: To characterize the experience, understanding, and management of physical, psychological, social (e.g. loneliness), and existential (e.g. regret, loss of dignity) symptoms among older homeless adults. METHODS: We conducted semi-structured interviews from June 2016 through March 2017 with a purposive sample of participants from the HOPE HOME cohort, a longitudinal study of homeless adults ages 50 and older...
May 18, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29781923/going-beyond-clinical-care-to-reduce-health-care-spending-findings-from-the-j-chip-community-based-population-health-management-program-evaluation
#10
Shannon M E Murphy, Douglas E Hough, Martha L Sylvia, Melissa Sherry, Linda J Dunbar, Raymond Zollinger, Regina Richardson, Scott A Berkowitz, Kevin D Frick
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781680/provision-of-antiretroviral-therapy-for-children-in-nelson-mandela-bay-health-care-professionals-challenges
#11
Margaret Williams, Dalena R M Van Rooyen, Esmeralda J Ricks
BACKGROUND:  The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children...
March 12, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29781666/validation-of-the-shortened-perceived-medical-condition-self-management-scale-in-patients-with-chronic-disease
#12
Marcus G Wild, Remo Ostini, Magdalena Harrington, Kerri L Cavanaugh, Kenneth A Wallston
Self-efficacy, or perceived competence, has been identified as an important factor in self-management behaviors and health outcomes in patients with chronic disease. Measures of self-management self-efficacy are currently available for multiple forms of chronic disease. One established measure is the 8-item Perceived Medical Condition Self-Management Scale (PMCSMS). This study investigated the use of the PMCSMS in samples of patients with a chronic disease to develop an abbreviated version of the scale that could be more readily used in clinical contexts or in large population health cohort studies...
May 21, 2018: Psychological Assessment
https://www.readbyqxmd.com/read/29781408/gilles-de-la-tourette-syndrome-as-a-paradigmatic-neuropsychiatric-disorder
#13
Andrea E Cavanna
Gilles de la Tourette syndrome is a chronic and complex tic disorder accompanied by specific behavioral problems in the majority of patients. With its multifaceted interplay between motion and emotion, this condition is a paradigmatic example of the science and art of clinical neuropsychiatry. This review article encompasses the clinical phenomenology of motor and vocal tics and associated sensory experiences (premonitory urges), as well as the behavioral spectrum of the most common comorbidities, including obsessive-compulsive disorder, attention-deficit and hyperactivity disorder, affective symptoms, and impulsivity...
May 21, 2018: CNS Spectrums
https://www.readbyqxmd.com/read/29781353/clinical-trials-with-multiple-endpoints-can-establish-a-correlation-but-not-yet-causality-between-dietary-supplementation-with-omega-3-fatty-acids-and-keratoconjunctivitis-sicca
#14
Roger Lee Mendoza
AIM: We review clinical evidence of therapeutic efficacy and effectiveness of omega-3 fatty acids (omega-3s) in keratoconjunctivitis sicca, colloquially known as dry eye disease. In doing so, we identify relevant literature to address the following questions: 1) What definitive guidance can clinical evidence offer eye physicians and their patients? 2) What aspects of omega-3 supplementation lack definitive evidence, and how might economic assessments help? METHODS: A targeted and systematic search strategy based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was designed in this study for refereed clinical trials of omega-3s in dry eye treatment...
May 21, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29781096/weight-loss-interventions-for-adults-with-overweight-obesity-and-chronic-musculoskeletal-pain-a-mixed-methods-systematic-review
#15
REVIEW
L Cooper, C G Ryan, L J Ells, S Hamilton, G Atkinson, K Cooper, M I Johnson, J P Kirwan, D Martin
Worldwide prevalence of adult overweight and obesity is a growing public health issue. Adults with overweight/obesity often have chronic musculoskeletal pain. Using a mixed-methods review, we aimed to quantify the effectiveness and explore the appropriateness of weight loss interventions for this population. Electronic databases were searched for studies published between 01/01/90 and 01/07/16. The review included 14 randomized controlled trials that reported weight and pain outcomes and three qualitative studies that explored perceptions of adults with co-existing overweight/obesity and chronic musculoskeletal pain...
May 20, 2018: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29780822/epidemiology-characteristics-and-outcomes-of-icu-managed-homeless-patients-a-population-based-study
#16
Lavi Oud
Background: The population-level demand for critical care services among the homeless (H) remains unknown, with only sparse data on the characteristics and outcomes of those managed in the ICU. Methods: The Texas Inpatient Public Use Data File and annual federal reports were used to identify H hospitalizations and annual estimates of the H population between 2007 and 2014. The incidence of ICU admissions in the H population, the characteristics of ICU-managed H, and factors associated with their short-term mortality were examined...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780812/characteristics-of-mobile-phone-access-and-usage-in-rural-and-urban-guatemala-assessing-feasibility-of-text-message-reminders-to-increase-childhood-immunizations
#17
Gretchen J Domek, Ingrid L Contreras-Roldan, Edwin J Asturias, Michael Bronsert, Guillermo Antonio Bolaños Ventura, Sean T O'Leary, Allison Kempe, Sheana Bull
Background: Despite efforts to promote vaccination in low- and middle-income countries (LMICs), over 20 million infants remain under-immunized and at risk for unnecessary morbidity and mortality. Mobile health technologies, such as Short Message Service (SMS) texts, have tremendous and untapped potential for disease management. Patient reminder systems are an important mechanism for improving childhood vaccination coverage and can be easily adapted to SMS platforms. However, current research lacks an understanding of the barriers and facilitators to mHealth program design, implementation, and scale in LMICs...
2018: MHealth
https://www.readbyqxmd.com/read/29779710/comorbidity-network-for-chronic-disease-a-novel-approach-to-understand-type-2-diabetes-progression
#18
Arif Khan, Shahadat Uddin, Uma Srinivasan
BACKGROUND: Chronic diseases management outside expensive hospital settings has become a major target for governments, funders and healthcare service providers. It is well known that chronic diseases such as Type 2 Diabetes (T2D) do not occur in isolation, and has a shared aetiology common to many other diseases and disorders. Diabetes Australia reports that it is associated with a myriad of complications, which affect the feet, eyes, kidneys, and cardiovascular health. For instance, nerve damage in the lower limbs affects around 13% of Australians with diabetes, diabetic retinopathy occurs in over 15% of Australians with diabetes, and diabetes is now the leading cause of end-stage kidney disease...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29779548/utilization-and-economic-contribution-of-psychiatric-mental-health-nurse-practitioners-in-public-behavioral-health-services
#19
Susan A Chapman, Bethany J Phoenix, Talia E Hahn, Deborah C Strod
INTRODUCTION: Expanded insurance coverage through the Affordable Care Act and parity in behavioral health coverage have increased demand for services. Yet there is a persistent shortage in the behavioral health workforce. Psychiatric Mental Health Nurse Practitioners (PMHNPs) may be part of the solution to shortages but are not yet fully utilized. The purpose of this study was to describe how PMHNPs are utilized, identify barriers to full utilization, and assess PMHNPs' economic contribution in public behavioral health systems...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779008/intervention-planning-for-the-reduce-maintenance-intervention-a-digital-intervention-to-reduce-reulceration-risk-among-patients-with-a-history-of-diabetic-foot-ulcers
#20
Kate Greenwell, Katy Sivyer, Kavita Vedhara, Lucy Yardley, Frances Game, Trudie Chalder, Gayle Richards, Nikki Drake, Katie Gray, John Weinman, Katherine Bradbury
OBJECTIVES: To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk. METHODS: Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20)...
May 18, 2018: BMJ Open
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