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Complex health assessment

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https://www.readbyqxmd.com/read/28214992/data-mining-in-hiv-aids-surveillance-system-application-to-portuguese-data
#1
Alexandra Oliveira, Brígida Mónica Faria, A Rita Gaio, Luís Paulo Reis
The Human Immunodeficiency Virus (HIV) is an infectious agent that attacks the immune system cells. Without a strong immune system, the body becomes very susceptible to serious life threatening opportunistic diseases. In spite of the great progresses on medication and prevention over the last years, HIV infection continues to be a major global public health issue, having claimed more than 36 million lives over the last 35 years since the recognition of the disease. Monitoring, through registries, of HIV-AIDS cases is vital to assess general health care needs and to support long-term health-policy control planning...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#2
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214168/medication-adherence-a-practical-measurement-selection-guide-using-case-studies
#3
Leah L Zullig, Phil Mendys, Hayden B Bosworth
OBJECTIVES: Medication adherence is a complex problem and can be evaluated using a variety of methods. There is no single or perfect strategy to assess adherence. The "best" measure depends on contextual factors. Our objective is to provide a practical, illustrative guide for selecting the most appropriate measure of medication adherence in common contexts. METHODS: We present three case studies - from the perspectives of an academic researcher, health care payer, and clinical care provider - to describe common problems and processes for measuring medication adherence, as well as proposing possible solutions...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28212968/-what-goes-around-comes-around-lessons-learned-from-economic-evaluations-of-personalized-medicine-applied-to-digital-medicine
#4
Kathryn A Phillips, Michael P Douglas, Julia R Trosman, Deborah A Marshall
BACKGROUND: The growth of "big data" and the emphasis on patient-centered health care have led to the increasing use of two key technologies: personalized medicine and digital medicine. For these technologies to move into mainstream health care and be reimbursed by insurers, it will be essential to have evidence that their benefits provide reasonable value relative to their costs. These technologies, however, have complex characteristics that present challenges to the assessment of their economic value...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212967/decision-making-on-medical-innovations-in-a-changing-health-care-environment-insights-from-accountable-care-organizations-and-payers-on-personalized-medicine-and-other-technologies
#5
Julia R Trosman, Christine B Weldon, Michael P Douglas, Patricia A Deverka, John B Watkins, Kathryn A Phillips
BACKGROUND: New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. OBJECTIVES: To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212966/estimating-preferences-for-complex-health-technologies-lessons-learned-and-implications-for-personalized-medicine
#6
Deborah A Marshall, Juan Marcos Gonzalez, Karen V MacDonald, F Reed Johnson
We examine key study design challenges of using stated-preference methods to estimate the value of whole-genome sequencing (WGS) as a specific example of genomic testing. Assessing the value of WGS is complex because WGS provides multiple findings, some of which can be incidental in nature and unrelated to the specific health concerns that motivated the test. In addition, WGS results can include actionable findings (variants considered to be clinically useful and can be acted on), findings for which evidence for best clinical action is not available (variants considered clinically valid but do not meet as high of a standard for clinical usefulness), and findings of unknown significance...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212606/the-implementation-of-health-promotion-in-primary-and-community-care-a-qualitative-analysis-of-the-prescribe-vida-saludable-strategy
#7
Catalina Martinez, Gonzalo Bacigalupe, Josep M Cortada, Gonzalo Grandes, Alvaro Sanchez, Haizea Pombo, Paola Bully
BACKGROUND: The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. METHODS: We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28211026/social-networks-and-health-status-in-the-elderly-the-anziani-in-rete-population-based-study
#8
Luca Bianchetti, Flaminio Squazzoni, Niccolò Casnici, Devis Bianchini, Emirena Garrafa, Claudia Archetti, Valentina Romano, Luca Rozzini, Michele Melchiori, Chiara Fiorentini, Daniela Uberti, Stefano Calza, Alessandra Marengoni
BACKGROUND: Certain features of the social environment could maintain and even improve not only psychological well-being, but also health and cognition of the elderly. AIMS: We tested the association between social network characteristics and the number of chronic diseases in the elderly. METHODS: A randomized sample of the elderly population of Brescia, Italy, was evaluated (N = 200, age ≥65 years). We performed a comprehensive geriatric assessment, including information on socio-demographic variables (family, friendships, and acquaintance contacts)...
February 16, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28207962/validating-an-electronic-health-literacy-scale-in-an-older-hispanic-population
#9
Judith Aponte, Kathleen M Nokes
AIM: Examine the validity of the Spanish version of an instrument used to measure electronic health literacy (eHEALS) with an older Hispanic population from a number of Spanish-language countries living in New York City in the United States (US). BACKGROUND: Although the internet is available globally, complex skills are needed in order to use this source of valuable health-related information effectively. Electronic health literacy is a multifactorial concept that includes health literacy but also requires technology skills...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28207783/patient-experience-with-outpatient-encounters-at-public-hospitals-in-shanghai-examining-different-aspects-of-physician-services-and-implications-of-overcrowding
#10
Yuhua Bao, Guanrong Fan, Dongdong Zou, Tong Wang, Di Xue
BACKGROUND: Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care. OBJECTIVE: To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments. RESEARCH DESIGN: Retrospective analysis of a large survey of outpatient experience in Shanghai, China...
2017: PloS One
https://www.readbyqxmd.com/read/28207502/impact-of-the-dietary-fatty-acid-intake-on-c-reactive-protein-levels-in-us-adults
#11
Mohsen Mazidi, Hong-Kai Gao, Hassan Vatanparast, Andre Pascal Kengne
Growing evidence suggests that the effects of diet on cardiovascular disease (CVD) occur through mechanisms involving subclinical inflammation. We assessed whether reported dietary fatty acid intake correlates with a serum high-sensitivity C-reactive protein (hs-CRP) concentration in a population-based sample of US men and women.In this cross-sectional analysis, participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and restricted to those with available data on dietary intake, biochemical and anthropometric measurements from 2001 to 2010...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28202783/evaluation-of-a-complex-healthcare-intervention-to-increase-smoking-cessation-in-pregnant-women-interrupted-time-series-analysis-with-economic-evaluation
#12
Ruth Bell, Svetlana V Glinianaia, Zelda van der Waal, Andrew Close, Eoin Moloney, Susan Jones, Vera Araújo-Soares, Sharon Hamilton, Eugene Mg Milne, Janet Shucksmith, Luke Vale, Martyn Willmore, Martin White, Steven Rushton
OBJECTIVES: To evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking. DESIGN: Interrupted time series analysis of routine data before and after introducing the intervention, within-study economic evaluation. SETTING: Eight acute NHS hospital trusts and 12 local authority areas in North East England...
February 15, 2017: Tobacco Control
https://www.readbyqxmd.com/read/28202407/epilepsy-monitoring-the-patients-views-a-qualitative-study-based-on-kolcaba-s-comfort-theory
#13
Andrea Egger-Rainer, Eugen Trinka, Julia Höfler, Anna Maria Dieplinger
PURPOSE: The aim of this qualitative study was to determine which perception of personal comfort patients name in the context of their hospitalization in an Austrian Epilepsy Monitoring Unit (EMU). METHODS: Problem-centred interviews with twelve inpatients were conducted. Data analyses were done according to Mayring's qualitative content analyses following the technique of structuring-deductive category assignment. RESULTS: Patients experienced different kinds of comfort along with their hospitalization in the EMU...
February 12, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28202135/discovering-pockets-of-complexity-socioeconomic-status-stress-exposure-and-the-nuances-of-the-health-gradient
#14
Scott Schieman, Jonathan Koltai
One of the most pervasive statements about stratification and health identifies the strong inverse relationship-or gradient-between socioeconomic status (SES) and poor health. We elaborate on the ways that the SES-based gradient in stress exposure contributes to nuances in the SES-health association. In analyses of the 2008 National Study of the Changing Workforce, we find some evidence that the inverse association between SES and health outcomes is finely graded-but several 'pockets of complexity' emerge. First, education and income have different associations with health and well-being...
March 2017: Social Science Research
https://www.readbyqxmd.com/read/28202032/cost-effectiveness-analysis-for-a-tele-based-health-coaching-program-for-chronic-disease-in-primary-care
#15
Erja Oksman, Miika Linna, Iiris Hörhammer, Johanna Lammintakanen, Martti Talja
BACKGROUND: The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF)...
February 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28202031/making-sense-of-complexity-in-context-and-implementation-the-context-and-implementation-of-complex-interventions-cici-framework
#16
Lisa M Pfadenhauer, Ansgar Gerhardus, Kati Mozygemba, Kristin Bakke Lysdahl, Andrew Booth, Bjørn Hofmann, Philip Wahlster, Stephanie Polus, Jacob Burns, Louise Brereton, Eva Rehfuess
BACKGROUND: The effectiveness of complex interventions, as well as their success in reaching relevant populations, is critically influenced by their implementation in a given context. Current conceptual frameworks often fail to address context and implementation in an integrated way and, where addressed, they tend to focus on organisational context and are mostly concerned with specific health fields. Our objective was to develop a framework to facilitate the structured and comprehensive conceptualisation and assessment of context and implementation of complex interventions...
February 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28199923/assistance-at-mealtimes-in-hospital-settings-and-rehabilitation-units-for-patients-65years-from-the-perspective-of-patients-families-and-healthcare-professionals-a-mixed-methods-systematic-review
#17
REVIEW
Deborah Edwards, Judith Carrier, Jane Hopkinson
BACKGROUND: Malnutrition is one of the key issues affecting the health of older people (>65years). With an aging population the problem is expected to increase further since the prevalence of malnutrition increases with age. Studies worldwide have identified that some older patients with good appetites do not receive sufficient nourishment because of inadequate feeding assistance. Mealtime assistance can enhance nutritional intake, clinical outcomes and patient experience. OBJECTIVES/AIM: To determine the effectiveness of meal time assistance initiatives for improving nutritional intake and nutritional status for older adult patients (>65years) in hospital settings and rehabilitation units...
January 30, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28197810/a-wrist-sensor-and-algorithm-to-determine-instantaneous-walking-cadence-and-speed-in-daily-life-walking
#18
Benedikt Fasel, Cyntia Duc, Farzin Dadashi, Flavien Bardyn, Martin Savary, Pierre-André Farine, Kamiar Aminian
In daily life, a person's gait-an important marker for his/her health status-is usually assessed using inertial sensors fixed to lower limbs or trunk. Such sensor locations are not well suited for continuous and long duration measurements. A better location would be the wrist but with the drawback of the presence of perturbative movements independent of walking. The aim of this study was to devise and validate an algorithm able to accurately estimate walking cadence and speed for daily life walking in various environments based on acceleration measured at the wrist...
February 14, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28197620/measuring-practicing-clinicians-information-literacy-an-exploratory-analysis-in-the-context-of-panel-management
#19
Brian E Dixon, Katherine Barboza, Ashley E Jensen, Katelyn J Bennett, Scott E Sherman, Mark D Schwartz
BACKGROUND: As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES: This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans' Affairs (VA) medical center. METHODS: Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28196831/child-and-adolescent-mental-health-repeat-visits-to-the-emergency-department-a-systematic-review
#20
REVIEW
Stephanie L Leon, Paula Cloutier, Christine Polihronis, Roger Zemek, Amanda S Newton, Clare Gray, Mario Cappelli
OBJECTIVES: Repeat visits represent up to 45% of mental health (MH) presentations to emergency departments (EDs) and are associated with higher health care costs. We aimed to synthesize available literature on predictors of pediatric MH repeat ED visits and differences between repeat visitors and nonrepeat visitors. METHODS: A systematic review was performed using PsycINFO, PubMed, and CINAHL databases. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist...
February 14, 2017: Hospital Pediatrics
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