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Complex health assessment

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https://www.readbyqxmd.com/read/28329788/defining-health-trajectories-in-older-adults-with-five-clinical-indicators
#1
Giola Santoni, Alessandra Marengoni, Amaia Calderón-Larrañaga, Sara Angleman, Debora Rizzuto, Anna-Karin Welmer, Francesca Mangialasche, Nicola Orsini, Laura Fratiglioni
Background: People age differently, challenging the identification of those more at risk of rapid health deterioration. This study aimed to explore the heterogeneity in the health of older adults by using five clinical indicators to detect age-related variation and individual health trajectories over time. Methods: Health of 3,363 people aged 60+ from the Swedish National study on Aging and Care-Kungsholmen (SNAC-K) assessed at baseline and at 3- and 6-year follow-ups...
October 19, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329638/developing-a-continuous-quality-improvement-assessment-using-a-patient-centered-approach-in-optimizing-sle-disease-control
#2
Katelyn Updyke, Brittany Urso, James A Solomon
Systemic lupus erythematous is a multi-organ autoimmune disease in which the patient has "lost" self- tolerance and developed immune-complexes containing self-antigen that cause disease through tissue inflammation and multi-organ damage. Patients often have unpredictable flares in symptoms with poorly identified triggers. However, it has been suggested in other literature that exogenous exposures, including ingested beef, cigarette smoke, UV radiation, metal-complexing agents, and infections can contribute to exacerbations and improvements in SLE symptoms...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329414/a-protocol-for-the-development-of-a-critical-thinking-assessment-tool-for-nurses-using-a-delphi-technique
#3
Elisabeth Jacob, Christine Duffield, Darren Jacob
AIM: The aim of this study is to develop an assessment tool to measure the critical thinking ability of nurses. BACKGROUND: As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognising changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28328388/bedside-critical-care-staff-use-of-intensive-care-unit-telemedicine-comparisons-by-intensive-care-unit-complexity
#4
Jonathan T Thomas, Jane Moeckli, Michelle A Mengeling, Cassie Cunningham Goedken, Jacinda Bunch, Peter Cram, Heather Schacht Reisinger
BACKGROUND: Effects of Intensive Care Unit (ICU) telemedicine on patient and staff outcomes are mixed. Variation in utilization is potentially driving these differences. INTRODUCTION: ICU telemedicine utilization is understudied, with existing research focusing on telemedicine staff. We assess ICU telemedicine utilization from the perspective of the end user-ICU staff-to better understand how telemedicine use is conceptualized and practiced at the bedside. MATERIALS AND METHODS: We conducted a thematic content analysis of semistructured interviews with bedside ICU staff...
February 16, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28328314/from-education-to-practice-addressing-opioid-misuse-through-healthcare-provider-training-a-special-issue-of-saj
#5
Adam J Gordon, John Daniel Harding
Opioid misuse may be ignored by providers who are unwilling or not confident in engaging the complex nature of substance use disorders among their patient populations. Addiction is a complex disease and although providers often are comfortable in identifying, assessing, and treating the complex diseases of their patients, basic knowledge and skills of identification, assessment, and treatment expertise involving opioids for pain, addressing opioid misuse, and treatment of opioid use disorder are lacking. Initiatives to improve knowledge of opioid use, misuse, and opioid use disorder among health care providers are emerging...
March 22, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28328011/when-emotional-pain-becomes-physical-adverse-childhood-experiences-pain-and-the-role-of-mood-and-anxiety-disorders
#6
Natalie J Sachs-Ericsson, Julia L Sheffler, Ian H Stanley, Jennifer R Piazza, Kristopher J Preacher
OBJECTIVE: We examined the association between retrospective reports of adverse childhood experiences (ACEs) and painful medical conditions. We also examined the mediating and moderating roles of mood and anxiety disorders in the ACEs-painful medical conditions relationship. METHOD: Ten-year longitudinal data were obtained from the National Comorbidity Surveys (NCS-1, NCS-2; N = 5001). The NCS-1 obtained reports of ACEs, current health conditions, current pain severity, and mood and anxiety disorders...
March 22, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28327415/identifying-families-with-complex-needs-after-an-initial-child-abuse-investigation-a-comparison-of-demographics-and-needs-related-to-domestic-violence-mental-health-and-substance-use
#7
James David Simon, Devon Brooks
Families with complex needs related to domestic violence, mental health, and substance use have some of the worst child protective services (CPS) outcomes. Although many of these families are identified during a CPS investigation and subsequently referred to home-based postinvestigation services (HBPS), many are re-reported to CPS, so it is important to understand the postinvestigation experiences of this vulnerable group. Therefore, this study compared families with and without complex needs to understand their uniquedemographics, needs, and postinvestigation outcomes...
March 16, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28327137/does-indigenous-health-research-have-impact-a-systematic-review-of-reviews
#8
REVIEW
Irina Kinchin, Janya Mccalman, Roxanne Bainbridge, Komla Tsey, Felecia Watkin Lui
BACKGROUND: Aboriginal and Torres Strait Islander Australians (hereafter respectfully Indigenous Australians) claim that they have been over-researched without corresponding research benefit. This claim raises two questions. The first, which has been covered to some extent in the literature, is about what type(s) of research are likely to achieve benefits for Indigenous people. The second is how researchers report the impact of their research for Indigenous people. This systematic review of Indigenous health reviews addresses the second enquiry...
March 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28326694/tales-from-the-acfi-dementia-in-residential-aged-care
#9
Jenni Joenperä
OBJECTIVE: Provide an overview of how care needs in permanent residential aged care differ by dementia status. METHODS: On entry into permanent residential aged care, people's care needs are assessed on the Aged Care Funding Instrument (ACFI). ACFI also captures health conditions that are considered to affect the cost of people's care, such as dementia. Data were compared between 2009 and 2015. RESULTS: Assessed care needs have increased regardless of dementia status...
March 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#10
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28325207/using-a-systematic-framework-of-interventions-to-improve-early-discharges
#11
Hemali Patel, Sasha Morduchowicz, Michelle Mourad
BACKGROUND: Late-afternoon hospital discharges can lead to admission bottlenecks and negatively affect the flow of patients needing hospital admission. Delays in discharge are a prevalent health care problem and have been linked to increased length of stay, lower patient satisfaction scores, and adverse outcomes. As a result, hospitals are placing a renewed emphasis on early discharge as a way to reduce admission delays and achieve optimal patient flow. This study shows that the Model for Improvement (MFI) is an effective approach for complex improvement efforts...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28324673/a-framework-to-guide-the-assessment-of-human-machine-systems
#12
Kimberly Stowers, James Oglesby, Shirley Sonesh, Kevin Leyva, Chelsea Iwig, Eduardo Salas
OBJECTIVE: We have developed a framework for guiding measurement in human-machine systems. BACKGROUND: The assessment of safety and performance in human-machine systems often relies on direct measurement, such as tracking reaction time and accidents. However, safety and performance emerge from the combination of several variables. The assessment of precursors to safety and performance are thus an important part of predicting and improving outcomes in human-machine systems...
March 2017: Human Factors
https://www.readbyqxmd.com/read/28323768/use-of-cardiovascular-age-for-assessing-risks-and-benefits-of-menopausal-hormone-therapy
#13
Richard J Santen
The Women's Health Initiative studies and others have suggested that menopausal hormone therapy may enhance the risk of new cardiovascular (CV) events in older women and diminish the development of coronary atherosclerosis in younger women. The underlying mechanisms to explain these findings are encapsulated in the term "Timing Hypothesis." Extensive pathophysiologic studies have provided mechanistic evidence for the dichotomous effects of estrogen on coronary artery vasculature. Early in the atherosclerotic disease process, estrogen exerts protective effects on the endothelium and retards plaque formation...
March 20, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28323114/physician-activity-during-outpatient-visits-and-subjective-workload
#14
Alan Calvitti, Harry Hochheiser, Shazia Ashfaq, Kristin Bell, Yunan Chen, Robert El Kareh, Mark T Gabuzda, Lin Liu, Sara Mortensen, Braj Pandey, Steven Rick, Richard L Street, Nadir Weibel, Charlene Weir, Zia Agha
We describe methods for capturing and analyzing EHR use and clinical workflow of physicians during outpatient encounters and relating activity to physicians' self-reported workload. We collected temporally-resolved activity data including audio, video, EHR activity, and eye-gaze along with post-visit assessments of workload. These data are then analyzed through a combination of manual content analysis and computational techniques to temporally align streams, providing a range of process measures of EHR usage, clinical workflow, and physician-patient communication...
March 17, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28321685/the-role-of-culture-and-acculturation-in-researchers-perceptions-of-rules-in-science
#15
Alison L Antes, Tammy English, Kari A Baldwin, James M DuBois
Successfully navigating the norms of a society is a complex task that involves recognizing diverse kinds of rules as well as the relative weight attached to them. In the United States (U.S.), different kinds of rules-federal statutes and regulations, scientific norms, and professional ideals-guide the work of researchers. Penalties for violating these different kinds of rules and norms can range from the displeasure of peers to criminal sanctions. We proposed that it would be more difficult for researchers working in the U...
March 20, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28321132/the-outcomes-of-health-promoting-communities-being-active-eating-well-initiative-a-community-based-obesity-prevention-intervention-in-victoria-australia
#16
K A Bolton, P Kremer, L Gibbs, E Waters, B Swinburn, A de Silva
OBJECTIVE: To evaluate the impact of the Health Promoting Communities: Being Active Eating Well (HPC:BAEW, 2007-2010) initiative which comprised of community-based multi-component interventions adapted to community context in five separate communities. The intervention aimed to promote healthy eating, physical activity and stronger, healthier communities. METHODS: A mixed method and multi-level quasi-experimental evaluation of the HPC:BAEW initiative captured process, impact and outcome data...
March 21, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28320688/implementation-of-a-home-monitoring-system-for-heart-failure-patients-a-feasibility-study
#17
Martin Steven Kohn, Jeffrey Haggard, Jack Kreindler, Kade Birkeland, Ilan Kedan, Raymond Zimmer, Raj Khandwalla
BACKGROUND: Improving the management of patients with complex chronic disease is a substantial undertaking with the simultaneous goals of improving patient outcomes and controlling costs. Reducing avoidable hospitalization for such patients is a step toward both objectives. Some of the deterioration experienced in chronic disease patients occurs outside the view of their clinicians, and before the patient becomes overtly symptomatic. Home monitoring has been used for more than 20 years to detect deterioration earlier so that the patients could be treated before they became ill enough to require hospitalization...
March 20, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28320406/the-acceptability-and-feasibility-of-a-brief-psychosocial-intervention-to-reduce-blood-borne-virus-risk-behaviours-among-people-who-inject-drugs-a-randomised-control-feasibility-trial-of-a-psychosocial-intervention-the-protect-study-versus-treatment-as-usual
#18
Gail Gilchrist, Davina Swan, April Shaw, Ada Keding, Sarah Towers, Noel Craine, Alison Munro, Elizabeth Hughes, Steve Parrott, John Strang, Avril Taylor, Judith Watson
BACKGROUND: While opiate substitution therapy and injecting equipment provision (IEP) have reduced blood-borne viruses (BBV) among people who inject drugs (PWID), some PWID continue to share injecting equipment and acquire BBV. Psychosocial interventions that address risk behaviours could reduce BBV transmission among PWID. METHODS: A pragmatic, two-armed randomised controlled, open feasibility study of PWID attending drug treatment or IEP in four UK regions. Ninety-nine PWID were randomly allocated to receive a three-session manualised psychosocial group intervention and BBV transmission information booklet plus treatment as usual (TAU) (n = 52) or information booklet plus TAU (n = 47)...
March 21, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28320348/methods-for-conceptualising-visual-ability-as-a-measurable-construct-in-children-with-cerebral-palsy
#19
Belinda Deramore Denver, Margareta Adolfsson, Elspeth Froude, Peter Rosenbaum, Christine Imms
BACKGROUND: Vision influences functioning and disability of children with cerebral palsy, so there is a growing need for psychometrically robust tools to advance assessment of children's vision abilities in clinical practice and research. Vision is a complex construct, and in the absence of clarity about this construct it is challenging to know whether valid, reliable measures exist. This study reports a method for conceptualising 'visual ability' as a measurable construct. METHODS: Using the items from 19 assessment tools previously identified in a systematic review, this study used a two-phase process: first, deductive content analysis linked items to the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY), and second, vision-specific 'Activity'-level items were explored using inductive thematic analysis...
March 21, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28320325/-was-that-a-success-or-not-a-success-a-qualitative-study-of-health-professionals-perspectives-on-support-for-people-with-long-term-conditions
#20
John Owens, Vikki A Entwistle, Alan Cribb, Zoë C Skea, Simon Christmas, Heather Morgan, Ian S Watt
BACKGROUND: Support for self-management (SSM) is a prominent strand of health policy internationally, particularly for primary care. It is often discussed and evaluated in terms of patients' knowledge, skills and confidence, health-related behaviours, disease control or risk reduction, and service use and costs. However, these goals are limited, both as guides to professional practice and as indicators of its quality. In order to better understand what it means to support self-management well, we examined health professionals' views of success in their work with people with long-term conditions...
March 20, 2017: BMC Family Practice
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