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https://www.readbyqxmd.com/read/29141183/functional-outcomes-of-acute-inpatient-rehabilitation-in-patients-with-chronic-graft-versus-host-disease
#1
Jason Leung, Sean Smith, Claire Kalpakjian
BACKGROUND: Growing numbers of allogeneic stem cell transplants (HSCT) and improved post-transplant care have led to an increase of individuals with chronic graft versus host disease (cGVHD). Although cGVHD leads to functional impairment for many, there is limited literature regarding the benefits of acute inpatient rehabilitation for cGVHD patients. OBJECTIVE: To assess Functional Independence Measure (FIM) outcomes of cGVHD patients during acute inpatient rehabilitation, and to compare inpatient rehabilitation outcomes to burn patients, a rehabilitation patient population with similar co-morbidities...
November 12, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29140894/incontinence-associated-dermatitis-and-immobility-as-pressure-injury-risk-factors-a-multisite-epidemiologic-analysis
#2
Mikel Gray, Karen K Giuliano
PURPOSE: The purpose of this study was to measure the prevalence of incontinence-associated dermatitis (IAD) among incontinent persons in the acute care setting, characteristics of IAD in this group, and associations among IAD, urinary, fecal, and dual incontinence, immobility, and pressure injury in the sacral area. DESIGN: Descriptive and correlational analysis of data from a large database of IAD, and pressure injuries of sacral area and heels. SUBJECTS AND SETTING: The sample comprised 5342 adult patients in acute care facilities in 36 states representing all regions of the United States...
November 14, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29140890/selecting-an-hiv-test-a-narrative-review-for-clinicians-and-researchers
#3
Christopher B Hurt, Julie A E Nelson, Lisa B Hightow-Weidman, William C Miller
Given the many options available, selecting an HIV test for a particular clinical or research setting can be daunting. Making an informed decision requires an assessment of the likelihood of acute infection in the test population and an understanding of key aspects of the tests themselves. The ability of individual tests to reliably detect HIV infection depends on the target(s) being detected, when they can be expected to be present after infection, and the concentration of stable target in test specimens, all of which are explained by the virologic and serologic events after infection...
December 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29139599/adherence-to-a-multifactorial-fall-prevention-program-following-paramedic-care-predictors-and-impact-on-falls-and-health-service-use-results-from-an-rct-a-priori-subgroup-analysis
#4
A Stefanie Mikolaizak, Stephen R Lord, Anne Tiedemann, Paul Simpson, Gideon Caplan, Jason C Bendall, Kirsten Howard, Jacqueline Close
OBJECTIVE: To identify predictors and impact of adherence to a multifactorial fall-prevention program on falls and health service utilisation. METHODS: Randomised controlled trial with a priori subgroup analysis within intervention group according to adherence. Participants were community dwelling, (≥65 years), not transported to hospital following fall-related paramedic care. The Attitudes to Falls-Related Interventions Scale (AFRIS) was completed at baseline, adherence levels were measured (three-point scale) at six months, and falls and health service utilisation were recorded for 12 months...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29139480/position-paper-the-potential-role-of-optical-biopsy-in-the-study-and-diagnosis-of-environmental-enteric-dysfunction
#5
REVIEW
Alex J Thompson, Michael Hughes, Salzitsa Anastasova, Laurie S Conklin, Tudor Thomas, Cadman Leggett, William A Faubion, Thomas J Miller, Peter Delaney, François Lacombe, Sacha Loiseau, Alexander Meining, Rebecca Richards-Kortum, Guillermo J Tearney, Paul Kelly, Guang-Zhong Yang
Environmental enteric dysfunction (EED) is a disease of the small intestine affecting children and adults in low and middle income countries. Arising as a consequence of repeated infections, gut inflammation results in impaired intestinal absorptive and barrier function, leading to poor nutrient uptake and ultimately to stunting and other developmental limitations. Progress towards new biomarkers and interventions for EED is hampered by the practical and ethical difficulties of cross-validation with the gold standard of biopsy and histology...
November 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#6
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Nicholaas C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND : Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS : This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29138129/patient-portal-utilization-among-ethnically-diverse-low-income-older-adults-observational-study
#7
Thomas A Arcury, Sara A Quandt, Joanne C Sandberg, David P Miller, Celine Latulipe, Xiaoyan Leng, Jenifer W Talton, Kathryn P Melius, Alden Smith, Alain G Bertoni
BACKGROUND: Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization. OBJECTIVE: The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities...
November 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29137903/implementation-of-alere-i-influenza-a-b-point-of-care-test-for-the-diagnosis-of-influenza-in-an-emergency-department
#8
E Trabattoni, V Le, B Pilmis, G Pean de Ponfilly, C Caisso, C Couzigou, B Vidal, A Mizrahi, O Ganansia, A Le Monnier, B Lina, J C Nguyen Van
STUDY OBJECTIVE: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. METHODS: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N=301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137723/the-promise-and-problems-of-non-physician-practitioners-in-general-surgery-education-results-of-a-multi-center-mixed-methods-study-of-faculty
#9
James E Coverdill, Jeff Scott Shelton, Adnan Alseidi, David C Borgstrom, Daniel L Dent, Russell Dumire, Jonathan Fryer, Thomas H Hartranft, Steven B Holsten, M Timothy Nelson, Mohsen M Shabahang, Stanley R Sherman, Paula M Termuhlen, Randy J Woods, John D Mellinger
BACKGROUND: Nurse Practitioners and Physician Assistants - called non-physician practitioners or NPPs - are common, but little is known about their educational promise and problems. METHODS: General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns...
November 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29137645/distribution-of-essential-medicines-to-primary-care-institutions-in-hubei-of-china-effects-of-centralized-procurement-arrangements
#10
Lianping Yang, Cunrui Huang, Chaojie Liu
BACKGROUND: Poor distribution of essential medicines to primary care institutions has attracted criticism since China adopted provincial centralized regional tendering and procurement systems. This study evaluated the impact of new procurement arrangements that limit the number of distributors at the county level in Hubei province, China. METHODS: Procurement ordering and distribution data were collected from four counties that pioneered a new distribution arrangement (commencing September 2012) compared with six counties that continued the existing arrangement over the period from August 2011 to September 2013...
November 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29137017/prognostic-value-of-glucose-metabolism-for-non-st-segment-elevation-infarction-patients-with-diabetes-mellitus-and-single-concomitant-chronic-total-occlusion-following-primary-percutaneous-coronary-intervention
#11
Zhi Xing, Lei Zhang, Zhiqiang Liu, Pengyi He, Yuchun Yang, Muhuyati Wulasihan
Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutaneous transluminal coronary intervention (pPCI)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#12
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29136589/nucleic-acid-aptamer-based-methods-for-diagnosis-of-infections
#13
REVIEW
Ki Soo Park
Infectious diseases are a serious global problem, which not only take an enormous human toll but also incur tremendous economic losses. In combating infectious diseases, rapid and accurate diagnostic tests are required for pathogen identification at the point of care (POC). In this review, investigations of diagnostic strategies for infectious diseases that are based on aptamers, especially nucleic acid aptamers, oligonucleotides that have high affinities and specificities toward their targets, are described...
November 8, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29136461/enzyme-free-nucleic-acid-amplification-assay-using-a-cellphone-based-well-plate-fluorescence-reader
#14
Donghyuk Kim, Qingshan Wei, Dong Hyeok Kim, Derek Tseng, Jingzi Zhang, Eric Pan, Omai Brandt Garner, Aydogan Ozcan, Dino Di Carlo
Nucleic acids, DNA and RNA, provide important fingerprint information for various pathogens and have significant diag-nostic value; however, improved approaches are urgently needed to enable rapid detection of nucleic acids in simple point-of-care formats with high sensitivity and specificity. Here, we present a system that utilizes a series of toehold-triggered hy-bridization/displacement reactions that are designed to convert a given amount of RNA molecules (i.e., the analyte) into an amplified amount of signaling molecules without any washing steps or thermocycling...
November 14, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29136049/-a-phd-completed-oral-health-care-and-oral-health-related-quality-of-life-of-frail-and-care-dependent-older-people
#15
D Niesten
When older people become frail, they often give up making dental visits, while their oral health care and oral health deteriorate. Open interviews and questionnaires were used to explore why frail older people change their oral health care behaviour and which (frailty-related) factors contribute to this change. These are mainly motivation-related factors. There seems to be a turning point where frail older people discontinue their oral health care routines and stop caring whether or not they loose teeth, because the perceived efforts no longer outweigh the perceived benefits of making dental visits and upkeep of oral hygiene...
November 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/29136001/a-combination-intervention-strategy-to-improve-linkage-to-and-retention-in-hiv-care-following-diagnosis-in-mozambique-a-cluster-randomized-study
#16
Batya Elul, Matthew R Lamb, Maria Lahuerta, Fatima Abacassamo, Laurence Ahoua, Stephanie A Kujawski, Maria Tomo, Ilesh Jani
BACKGROUND: Concerning gaps in the HIV care continuum compromise individual and population health. We evaluated a combination intervention strategy (CIS) targeting prevalent barriers to timely linkage and sustained retention in HIV care in Mozambique. METHODS AND FINDINGS: In this cluster-randomized trial, 10 primary health facilities in the city of Maputo and Inhambane Province were randomly assigned to provide the CIS or the standard of care (SOC). The CIS included point-of-care CD4 testing at the time of diagnosis, accelerated ART initiation, and short message service (SMS) health messages and appointment reminders...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29135779/impact-of-cross-level-measurement-noninvariance-on-hospital-rankings-based-on-patient-experiences-with-care-in-7-european-countries
#17
Benedict O Orindi, Emmanuel Lesaffre, Walter Sermeus, Luk Bruyneel
BACKGROUND: Hospital-level findings on patient experiences with care are increasingly reported publicly. A critical aspect left unexamined is the commonality of composite measures of patient experiences across different groups of patients, nursing units, hospitals, and countries. Absence of commonality is termed measurement noninvariance and is hypothesized to have a strong impact on performance assessment. AIM: The aim of this study is to examine measurement invariance across groups and levels under study (patients, nursing units, hospitals, and countries) and illustrate the degree to which this method of analysis impacts hospital rankings...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135769/medicaid-coverage-of-methadone-maintenance-and-the-use-of-opioid-agonist-therapy-among-pregnant-women-in-specialty-treatment
#18
Marcus A Bachhuber, Pooja K Mehta, Laura J Faherty, Brendan Saloner
BACKGROUND: Opioid agonist therapy (OAT) is the standard of care for pregnant women with opioid use disorder (OUD). Medicaid coverage policies may strongly influence OAT use in this group. OBJECTIVE: To examine the association between Medicaid coverage of methadone maintenance and planned use of OAT in the publicly funded treatment system. RESEARCH DESIGN: Retrospective cross-sectional analysis of treatment admissions in 30 states extracted from the Treatment Episode Data Set (2013 and 2014)...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135752/experiences-and-shared-meaning-of-teamwork-and-interprofessional-collaboration-among-health-care-professionals-in-primary-health-care-settings-a-systematic-review
#19
Carine Sangaleti, Mariana Cabral Schveitzer, Marina Peduzzi, Elma Lourdes Campos Pavone Zoboli, Cassia Baldini Soares
BACKGROUND: During the last decade, teamwork has been addressed under the rationale of interprofessional practice or collaboration, highlighted by the attributes of this practice such as: interdependence of professional actions, focus on user needs, negotiation between professionals, shared decision making, mutual respect and trust among professionals, and acknowledgment of the role and work of the different professional groups. Teamwork and interprofessional collaboration have been pointed out as astrategy for effective organization of health care services as the complexity of healthcare requires integration of knowledge and practices from differente professional groups...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29135451/software-design-and-implementation-concepts-for-an-interoperable-medical-communication-framework
#20
Andreas Besting, Sebastian Bürger, Martin Kasparick, Benjamin Strathen, Frank Portheine
The new IEEE 11073 service-oriented device connectivity (SDC) standard proposals for networked point-of-care and surgical devices constitutes the basis for improved interoperability due to its independence of vendors. To accelerate the distribution of the standard a reference implementation is indispensable. However, the implementation of such a framework has to overcome several non-trivial challenges. First, the high level of complexity of the underlying standard must be reflected in the software design. An efficient implementation has to consider the limited resources of the underlying hardware...
November 14, 2017: Biomedizinische Technik. Biomedical Engineering
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