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https://www.readbyqxmd.com/read/28647951/complexities-of-care-in-klinefelter-syndrome-an-aprn-perspective
#1
Sharron Close, Amy Talboy, Ilene Fennoy
47,XXY (Klinefelter Syndrome) is associated with a spectrum of complex clinical needs that are associated with variable physical, neurocognitive and psychosocial aspects. For patients and families affected by this sex chromosome trisomy, navigation of health care services is difficult due to lack of 47,XXY awareness among many health care providers and little evidence to support endocrine and additional treatment plans. While endocrine management of androgen deficiency has been the mainstay of treatment for patients from puberty through adulthood, testosterone replacement, alone, fails to mitigate many symptoms and issues...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647578/regular-source-of-care-for-the-elderly-a-cross-national-comparative-study-of-hong-kong-with-11-developed-countries
#2
Samuel Yeung-Shan Wong, Dan Zou, Roger Y Chung, Regina W Sit, Dexing Zhang, Dicken Chan, Eng Kiong Yeoh, Jean W Woo
OBJECTIVE: This study aimed to give an international perspective of health service gaps for caring for elderly individuals and explore the role of primary care for caring for elderly individuals with chronic conditions in Hong Kong. DESIGN: Cross-sectional, telephone survey. SETTING: Hong Kong. PARTICIPANT: A sample of 1000 Chinese participants in Hong Kong aged 60 or older. MEASUREMENTS: Questionnaire extracted from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults...
June 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28646897/an-exploration-of-facilitators-and-challenges-in-the-scale-up-of-a-national-public-sector-community-health-worker-cadre-in-zambia-a-qualitative-study
#3
Sydney Chauwa Phiri, Margaret Lippitt Prust, Caroline Phiri Chibawe, Ronald Misapa, Jan Willem van den Broek, Nikhil Wilmink
BACKGROUND: In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system...
June 24, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28646858/reasons-for-encounter-by-different-levels-of-urgency-in-out-of-hours-emergency-primary-health-care-in-norway-a-cross-sectional-study
#4
Guttorm Raknes, Steinar Hunskaar
BACKGROUND: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels. METHODS: We analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646242/the-role-of-health-plans-in-supporting-behavioral-health-integration
#5
Maureen T Stewart, Constance M Horgan, Amity E Quinn, Deborah W Garnick, Sharon Reif, Timothy B Creedon, Elizabeth L Merrick
Health plan policies can influence delivery of integrated behavioral health and general medical care. This study provides national estimates for the prevalence of practices used by health plans that may support behavioral health integration. Results indicate that health plans employ financing and other policies likely to support integration. They also directly provide services that facilitate integration. Behavioral health contracting arrangements are associated with use of these policies. Delivery of integrated care requires systemic changes by both providers and payers thus health plans are key players in achieving this goal...
June 23, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#6
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
June 23, 2017: Pediatrics
https://www.readbyqxmd.com/read/28645888/hiv-strategic-information-in-non-european-union-countries-in-the-world-health-organization-european-region-capacity-development-needs
#7
Ivana Bozicevic, Senad Handanagic, Jurja Ivana Cakalo, Annemarie Rinder Stengaard, George Rutherford
BACKGROUND: Capacity building of the national HIV strategic information system is a core component of the response to the HIV epidemic as it enables understanding of the evolving nature of the epidemic, which is critical for program planning and identification of the gaps and deficiencies in HIV programs. OBJECTIVE: The study aims to describe the results of the assessment of the needs for further development of capacities in HIV strategic information systems in the non-European Union (EU) countries in the World Health Organization European Region (EUR)...
June 23, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28645202/effects-of-mobility-and-multimorbidity-on-inpatient-and-post-acute-health-care-utilization
#8
Kristine E Ensrud, Li-Yung Lui, Lisa Langsetmo, Tien N Vo, Brent C Taylor, Peggy M Cawthon, Meredith L Kilgore, Charles E McCulloch, Jane A Cauley, Marcia L Stefanick, Kristine Yaffe, Eric S Orwoll, John T Schousboe
Background: This study examines effects of mobility and multimorbidity on hospitalization and inpatient and post-acute care (PAC) facility days among older men. Methods: Prospective study of 1701 men (mean age 79.3 years) participating in MrOS Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high...
June 22, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28644913/supplement-2-for-the-2004-update-of-the-aapm-task-group-no-43-report-joint-recommendations-by-the-aapm-and-gec-estro
#9
Mark J Rivard, Facundo Ballester, Wayne M Butler, Larry A DeWerd, Geoffrey S Ibbott, Ali S Meigooni, Christopher S Melhus, Michael G Mitch, Ravinder Nath, Panagiotis Papagiannis
Since publication of the 2004 update to the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report (TG-43U1) and its 2007 supplement (TG-43U1S1), several new low-energy photon-emitting brachytherapy sources have become available. Many of these sources have satisfied the AAPM prerequisites for routine clinical purposes and are posted on the Brachytherapy Seed Registry managed jointly by the AAPM and the Imaging and Radiation Oncology Core Houston Quality Assurance Center (IROC Houston)...
June 23, 2017: Medical Physics
https://www.readbyqxmd.com/read/28644706/advance-care-planning-and-palliative-care-integration-for-patients-undergoing-hematopoietic-stem-cell-transplantation
#10
Winnie S Wang, Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric J Roeland
PURPOSE: Advance care planning (ACP) in hematopoietic stem-cell transplantation (HSCT) is challenging, given the potential for cure despite increased morbidity and mortality risk.The aim of this study was to evaluate ACP and palliative care (PC) integration for patients who underwent HSCT. METHODS: A retrospective analysis was conducted and data were extracted from electronic medical records of patients who underwent HSCT between January 2011 and December 2015. Patients who received more than one transplant and who were younger than 18 years of age were excluded...
June 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28643812/-conscience-clause-in-end-of-life-care
#11
Ludovica De Panfilis, Daniela Cattaneo, Luisanna Cola, Maddalena Gasparini, Corinna Porteri, Daniela Tarquini, Alessandro Tiezzi, Simone Veronese, Silvia Zullo, Eugenio Pucci
The article proposes a critical reflection on issues that appeal to the conscience clause as part of end of life care can produce and what can guarantee freedom of conscience, self-determination of those involved and respect for the dignity of the sick person. After a philosophical and normative analysis, the article is organized on the basis of two important documents for discussion: a position paper of Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) signed by several scientific societies "Grandi insufficienze d'organo end stage: cure intensive o cure palliative?" and the Design of Law currently being debated "Norme in materia di consenso informato e di disposizioni anticipate di trattamento"...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#12
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28642820/intratumorally-injected-pro-inflammatory-allogeneic-dendritic-cells-as-immune-enhancers-a-first-in-human-study-in-unfavourable-risk-patients-with-metastatic-renal-cell-carcinoma
#13
Anna Laurell, Maria Lönnemark, Einar Brekkan, Anders Magnusson, Anna Tolf, Anna Carin Wallgren, Bengt Andersson, Lars Adamson, Rolf Kiessling, Alex Karlsson-Parra
BACKGROUND: Accumulating pre-clinical data indicate that the efficient induction of antigen-specific cytotoxic CD8+ T cells characterizing viral infections is caused by cross-priming where initially infected DCs produce an unique set of inflammatory factors that recruit and activate non-infected bystander DCs. Our DC-based immunotherapy concept is guided by such bystander view and accordingly, we have developed a cellular adjuvant consisting of pre-activated allogeneic DCs producing high levels of DC-recruiting and DC-activating factors...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28642172/egfr-t790m-ctdna-testing-platforms-and-their-role-as-companion-diagnostics-correlation-with-clinical-outcomes-to-egfr-tkis
#14
Zhiyong Liang, Ying Cheng, Yuan Chen, Yanping Hu, Wei-Ping Liu, You Lu, Jie Wang, Ye Wang, Gang Wu, Jian-Ming Ying, He-Long Zhang, Xu-Chao Zhang, Yi-Long Wu
Somatic mutation in the epidermal growth factor receptor (EGFR) predict clinical response to EGFR tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC) and is a promising target for personalised medicine. EGFR mutations have prognostic value. Initially patients respond well to tyrosine kinase inhibitors but finally they would develop resistance and about 50% of this resistance can be attributed to the emergence of EGFR resistant mutation, T790M. This necessitates the need for genetic testing for clinical management of patients...
June 19, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28642008/concurrent-once-daily-versus-twice-daily-chemoradiotherapy-in-patients-with-limited-stage-small-cell-lung-cancer-convert-an-open-label-phase-3-randomised-superiority-trial
#15
Corinne Faivre-Finn, Michael Snee, Linda Ashcroft, Wiebke Appel, Fabrice Barlesi, Adityanarayan Bhatnagar, Andrea Bezjak, Felipe Cardenal, Pierre Fournel, Susan Harden, Cecile Le Pechoux, Rhona McMenemin, Nazia Mohammed, Mary O'Brien, Jason Pantarotto, Veerle Surmont, Jan P Van Meerbeeck, Penella J Woll, Paul Lorigan, Fiona Blackhall
BACKGROUND: Concurrent chemoradiotherapy is the standard of care in limited-stage small-cell lung cancer, but the optimal radiotherapy schedule and dose remains controversial. The aim of this study was to establish a standard chemoradiotherapy treatment regimen in limited-stage small-cell lung cancer. METHODS: The CONVERT trial was an open-label, phase 3, randomised superiority trial. We enrolled adult patients (aged ≥18 years) who had cytologically or histologically confirmed limited-stage small-cell lung cancer, Eastern Cooperative Oncology Group performance status of 0-2, and adequate pulmonary function...
June 19, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28641750/predicting-outcomes-in-congenital-diaphragmatic-hernia
#16
Oluwatomilayo Daodu, Mary E Brindle
Identification of CDH infant populations at high risk for mortality postnatally may help to develop targeted care strategies, guide discussions surrounding palliation and contribute to standardizing reporting and benchmarking, so that care strategies at different centers can be compared. Clinical prediction rules are evidence-based tools that combine multiple predictors to estimate the probability that a particular outcome in an individual patient will occur. In CDH, a suitable clinical prediction rule can stratify high- and low-risk populations and provide the ability to tailor management strategies based on severity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#17
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28641356/-tracheal-surgery
#18
Jan Volmerig, Erich Hecker
Surgery of the trachea is a specialised field in which many disciplines work jointly due to the variety of indications and the extended topography. Not only because of its particular functional importance, but also because of its complex morphology, anatomy and physiology, this organ represents a special therapeutic challenge. A variety of diseases require surgical procedures of the trachea; the therapeutic strategy is influenced both by the disease itself as well as patient-dependent parameters. Regardless of the nature of the underlying disorder, good results require a high level of expertise in airway management, a careful diagnosis and interventional planning as well as an experienced surgical team that masters extended operative techniques...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641166/care-coordination-at-a-pediatric-accountable-care-organization-aco-a-qualitative-analysis
#19
Baria Hafeez, Sophia Miller, Anup D Patel, Zachary M Grinspan
OBJECTIVE: Care coordinators may help manage care for children with chronic illness. Their role in pediatric epilepsy care is understudied. We aimed to qualitatively describe the content of a care coordination intervention for children with epilepsy. METHODS: We conducted nine semi-structured interviews and one focus group with care coordinators at a pediatric accountable care organization (ACO) in Ohio. The care coordinators used a modified version of a published care coordination checklist for children with epilepsy (Patel AD, 2014)...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28641123/the-practice-environment-scale-of-the-nursing-work-index-an-updated-review-and-recommendations-for-use
#20
REVIEW
Pauline A Swiger, Patricia A Patrician, Rebecca S Susie Miltner, Dheeraj Raju, Sara Breckenridge-Sproat, Lori A Loan
OBJECTIVES: The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument...
June 12, 2017: International Journal of Nursing Studies
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