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Plan of care

Eva Kovacs, Anna-Janina Stephan, Amanda Phillips, Jörg Schelling, Ralf Strobl, Eva Grill
OBJECTIVES: Vertigo and dizziness are highly prevalent symptoms in primary care, frequently misdiagnosed. Based on a thorough need assessment, INDICORE (INform, DIagnose, COmmunicate, REfer), an evidence-based complex intervention has been developed to transfer knowledge of specialized tertiary clinics to primary care providers (PCPs), improve the referral process and, ultimately, improve functioning and quality of life of patients with vertigo/dizziness. The main objective of the PRIMA-Vertigo pilot study is to examine whether the INDICORE intervention is feasible and sufficiently promising to warrant a larger trial...
March 22, 2018: Current Medical Research and Opinion
Bruno Santos Assis, Jairza Maria Barreto-Medeiros Jairza, Jamile Almeida Lopes, Ana Karla Carneiro Roriz, Adriana Lima Melo, Agatha Previdell, Rita De Cássia Aquino, Lilian Barbosa Ramos
OBJECTIVE: The aim of this study was to evaluate the ingestion of micronutrients in elderly living in nursing homes. METHODS: This is a cross-sectional study, conducted with 216 individuals of both sexes, age equal or greater than 60 years, living in nursing homes for elderly in Salvador, Bahia, Brazil. Direct weighing of the food was used to get food intake, and prevalence of inadequacy was obtained using the software Multiple Source Method (MSM) and evaluated by estimated average requirement (EAR)...
February 13, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
(no author information available yet)
In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with a global overview of the role of PRM in healthcare systems in Europe. Several documents and reports by WHO and the UN call for the worldwide strengthening of rehabilitation as a key health strategy of the 21st century. Therefore, further implementation of PRM in healthcare systems is crucial. Many aspects need to be considered when implementing PRM in a health system. Since PRM should be provided along the whole continuum of care, a specific phase model has been developed...
April 2018: European Journal of Physical and Rehabilitation Medicine
(no author information available yet)
In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper describes the background to the context of PRM services and comprises the following: - Epidemiological Aspects of Functioning and Disability - Ethical Aspects and Human Rights - Rehabilitation and Health Systems - Economic Burden of Disability - Effects of Lack of Rehabilitation Health care service planning accounts for the burden of disability among society and the chapter describes the justification for specialist rehabilitation, the background of PRM and why making a functional diagnosis and a management plan based on function is its core competence...
April 2018: European Journal of Physical and Rehabilitation Medicine
Barbora Szonowská
Despite the advances in dialysis technology over the past decades, patients with advanced chronic kidney disease (CKD) have a high symptom burden, shortened survival and substantial physical, emotional and spiritual suffering. Number of frailty patients with advanced chronic kidney disease is growing and for many of them the beginning or continuation of dialysis is associated with a high risk of short-term mortality or worsening of functional status. Identifying these fragile patients and integrating palliative care into standard nephrological care improves patients quality of life and has the potential to prolong their lives without demanding dialysis treatment...
2018: Casopís Lékar̆ů C̆eských
Martin Gřiva, Jiří Šťastný, Marie Lazárová, Helena Krejčíková
Chronic heart failure is a progressive disease with an increasing prevalence. In spite of all medical progress (or thanks to it), it is finally one of the most common causes of death. Palliative care is an approach aimed to improve the quality of life of patients and their families in cases of life-threatening illness. Therefore, the use of palliative care in cardiology is entirely relevant. Estimating the course and prognosis of a patient with chronic heart failure is difficult despite many prognostic tools...
2018: Casopís Lékar̆ů C̆eských
Shwu-Feng Tsay, Shih-Chung Chen, Shu-Jen Lu, Li-Ting Liu
Taiwan is projected to become an aged society in 2018. In addition to establishing a comprehensive, long-term care system that is able to deal with the expected impacts of population aging, it is imperative that the government focus on improving the prevention of aging-related conditions. This article introduces the innovative preventive care policy promoted by Taiwan's Ministry of Health and Welfare and its preliminary results. Furthermore, the foundational ideas behind this policy and how it is being executed are explained...
April 2018: Hu Li za Zhi the Journal of Nursing
Jing-Jy Wang, Yueh-Ying Yang, Mei-Yin Liu
Advancing medical technology continues to extend the average human life span, resulting in population aging globally as well as in Taiwan. The challenges posed by aging society increase not only medical and care costs but also the burden on pension funds and the social welfare system. In addition, there is currently a desperate need for many well-trained health providers as well as a friendly and comprehensive long-term care system. However, attention should not simply focus on medical payments and long-term care, as this may prolong the length of unhealthy living years for the aged and further strain national finances...
April 2018: Hu Li za Zhi the Journal of Nursing
Friederike Schaub, Werner Adler, Philip Enders, Meike C Koenig, Konrad R Koch, Claus Cursiefen, Bernd Kirchhof, Ludwig M Heindl
PURPOSE: The purpose of the present study was to evaluate whether preexisting epiretinal membrane (ERM) is a significant risk factor for developing pseudophakic cystoid macular edema (PCME). METHODS: Two hundred four consecutive eyes and 153 consecutive eyes without preexisting epiretinal membranes were retrospectively compared regarding PCME development following phacoemulsification with posterior chamber lens implantation. Patients with vascular retinal diseases, uveitis, trauma, neovascular macular degeneration, chronic inflammatory conditions, diabetic retinopathy, endophthalmitis, eventful cataract surgery, and combination of cataract surgery and vitrectomy during the observation period were excluded...
March 21, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Elisabeth Paul, Lucien Albert, Badibanga N'Sambuka Bisala, Oriane Bodson, Emmanuel Bonnet, Paul Bossyns, Sandro Colombo, Vincent De Brouwere, Alexandre Dumont, Dieudonné Sèdjro Eclou, Karel Gyselinck, Fatoumata Hane, Bruno Marchal, Remo Meloni, Mathieu Noirhomme, Jean-Pierre Noterman, Gorik Ooms, Oumar Mallé Samb, Freddie Ssengooba, Laurence Touré, Anne-Marie Turcotte-Tremblay, Sara Van Belle, Philippe Vinard, Valéry Ridde
This paper questions the view that performance-based financing (PBF) in the health sector is an effective, efficient and equitable approach to improving the performance of health systems in low-income and middle-income countries (LMICs). PBF was conceived as an open approach adapted to specific country needs, having the potential to foster system-wide reforms. However, as with many strategies and tools, there is a gap between what was planned and what is actually implemented. This paper argues that PBF as it is currently implemented in many contexts does not satisfy the promises...
2018: BMJ Global Health
Murad Megjhani, Kalijah Terilli, Hans-Peter Frey, Angela G Velazquez, Kevin William Doyle, Edward Sander Connolly, David Jinou Roh, Sachin Agarwal, Jan Claassen, Noemie Elhadad, Soojin Park
Purpose: Accurate prediction of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone. Methods: 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included...
2018: Frontiers in Neurology
Subramanian Vaidyanathan, Bakulesh M Soni, Peter L Hughes, Tun Oo
Introduction: Over-distension of urinary bladder in a high spinal cord injury patient is a triggering factor for autonomic dysreflexia. Removing triggering factors is vital to prevent autonomic dysreflexia. Case presentation: A 36-year-old tetraplegic patient, who was managed by intermittent catheterizations performed by caregivers, developed recurrent autonomic dysreflexia during a week due to: 1) carers not performing intermittent catheterizations every night; 2) infrequent catheterizations during the day, leading to distension of urinary bladder...
2018: International Medical Case Reports Journal
Holly Dieu, Gregory D Kearney, Hui Bian, Katherine Jones, Arjun Mohan
BACKGROUND The purpose of this study was to compare asthma-related emergency department (ED) visit rates across North Carolina. Results from this study can inform health planning while helping public health and health care professionals in identifying geographical areas and targeting age groups to reduce the asthma burden in North Carolina. METHODS This was a retrospective data analysis between 2010 and 2014 among North Carolina patients presenting to an ED with a first or second listed diagnosis code related to asthma (ICD-9-CM, 493...
March 2018: North Carolina Medical Journal
Jose Duncan, Pranit Chotai, Anna Slagle, Ajay Talati, Eunice Huang, Mauro Schenone
PURPOSE: We aim to compare the mode of delivery in pregnancies with gastroschisis delivered in nonacademic institutions with those delivered in an academic center. MATERIAL AND METHODS: Chart review from 2008 to 2015 was performed. Cesarean delivery rate (CDR), attempted vaginal delivery rate (AVR), planned cesarean rate (PCR) and adverse neonatal outcomes were compared among pregnancies with gastroschisis delivered in nonacademic hospitals with those delivered in an academic institution...
March 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
Marcia Polansky, Hardeep Singh, Yang Gao, Erika Aaron
OBJECTIVE: This study assessed associations of sociodemographic factors and pregnancy intent and wantedness with pregnancy happiness and prenatal depressive symptoms and the relationship between prenatal depressive symptoms and pregnancy happiness. BACKGROUND: Depression is the leading cause of disability world-wide and more so for women. Women are most likely to experience depression in their child bearing years, including during pregnancy. Untreated prenatal depression, associated with unwanted pregnancies endangers the health and wellbeing of the mother and her child...
March 21, 2018: Journal of Reproductive and Infant Psychology
Frances R Nedjat-Haiem, Iraida V Carrion, Krystyna Gonzalez, Elizabeth D Bennett, Kathleen Ell, Mary O'Connell, Beti Thompson, Shiraz I Mishra
Advance care planning (ACP) does not readily occur in medical settings and often gets missed. Older Latinos need ACP information to encourage advance directive (AD) completion indicating preferences for end-of-life (EOL) care. OBJECTIVE: To explore the experiences with counseling using motivational interviewing (MI) techniques and social workers to encourage ACP communication among older Latinos with advance chronic diseases. This study describes stages of readiness to plan for EOL care...
January 1, 2018: American Journal of Hospice & Palliative Care
Simon Pini, Emma Ingleson, Molly Megson, Linda Clare, Penny Wright, Jan R Oyebode
Background and Objectives: Approximately half the care for people with dementia is provided by families. It is therefore imperative that research informs ways of maintaining such care. In this study, we propose that a needs-led approach can provide a useful, novel means of conceptualizing the impact of caring on the lives of family carers. Our aim was to develop and present a needs-led framework for understanding how providing care impacts on carers' fulfilment of needs. Design and Methods: In this qualitative study, we conducted 42 semistructured interviews with a purposively diverse sample of family carers to generate nuanced contextualized accounts of how caring impacted on carers' lives...
March 19, 2018: Gerontologist
Olivier Moranne, Coraline Fafin, Sophie Roche, Maud Francois, Vincent Allot, Jerome Potier, Daniela Babici, Thierry Lobbedez, Marie Matignon, Christophe Mariat, Cecile Vigneau, Cecile Couchoud
Background: Elderly patients with advanced chronic kidney disease require accurate outcome descriptions to make treatment decisions. Methods: The PSPA [Parcours de soins des personnes âgées (Treatment pathways for elderly patients)] prospective multicentre cohort study included 573 such patients with a median age of 82 [interquartile range (IQR) 79-86] years and a median estimated glomerular filtration rate of 14 (IQR 11-17) mL/min/1.73 m2 and studied their 5-year outcomes according to the dialysis component of their treatment plans...
March 19, 2018: Nephrology, Dialysis, Transplantation
Claudia Cooper, Louise Marston, Julie Barber, Deborah Livingston, Penny Rapaport, Paul Higgs, Gill Livingston
BACKGROUND: There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. METHODS: 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. OUTCOMES: Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent...
2018: PloS One
Kanchan Thapa, Sulochana Manandhar, Manisha Bista, Jivan Shakya, Govind Sah, Maheshwar Dhakal, Netra Sharma, Bronwyn Llewellyn, Claudia Wultsch, Lisette P Waits, Marcella J Kelly, Jean-Marc Hero, Jane Hughes, Dibesh Karmacharya
With fewer than 200 tigers (Panthera tigris tigris) left in Nepal, that are generally confined to five protected areas across the Terai Arc Landscape, genetic studies are needed to provide crucial information on diversity and connectivity for devising an effective country-wide tiger conservation strategy. As part of the Nepal Tiger Genome Project, we studied landscape change, genetic variation, population structure, and gene flow of tigers across the Terai Arc Landscape by conducting Nepal's first comprehensive and systematic scat-based, non-invasive genetic survey...
2018: PloS One
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