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https://www.readbyqxmd.com/read/29043947/outpatient-continuing-care-after-residential-substance-use-disorder-treatment-in-the-u-s-veterans-health-administration-facilitators-and-challenges
#1
Anna D Rubinsky, Laura S Ellerbe, Shalini Gupta, Tyler E Phelps, Thomas Bowe, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Veterans Health Administration (VHA), residential treatment programs are an important part of the continuum of care for patients with substance use disorders (SUDs). Outpatient continuing care after residential treatment helps maintain early recovery and treatment gains. Knowing more about the drivers of variation in continuing care practices and performance across residential programs might inform quality improvement efforts. METHODS: We operationalized measures of continuing care and calculated these metrics for each of VHA's 63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs) and 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track in fiscal year 2012...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29042813/rehabilitation-management-of-low-back-pain-it-s-time-to-pull-it-all-together
#2
Yannick Tousignant-Laflamme, Marc Olivier Martel, Anand B Joshi, Chad E Cook
In the past, rehabilitation research initiatives for low back pain (LBP) have targeted outcome enhancement through personalized treatment approaches, namely through classification systems (CS). Although the use of CS has enhanced outcomes, common management practices have not changed, the prevalence of LBP is still high, and only selected patients meet the CS profile, namely those with a nociceptive context. Similarly, although practice guidelines propose some level of organization and occasionally a timeline of care provision, each mainly provides best practice for isolated treatment approaches...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29035007/large-soil-organic-carbon-increase-due-to-improved-agronomic-management-in-the-north-china-plain-from-1980s-to-2010s
#3
Daorui Han, Martin Wiesmeier, Richard T Conant, Anna Kühnel, Zhigang Sun, Ingrid Kögel-Knabner, Ruixing Hou, Peifei Cong, Rubiao Liang, Zhu Ouyang
Agricultural soils are widely recognized to be capable of carbon sequestration that contributes to mitigating CO2 emissions. To better understand soil organic carbon (SOC) stock dynamics and its driving and controlling factors corresponding with a period of rapid agronomic evolution from the 1980s to the 2010s in the North China Plain (NCP), we collected data from two region-wide soil sampling campaigns (in the 1980s and 2010s) and conducted an analysis of the controlling factors using the random forest model...
September 7, 2017: Global Change Biology
https://www.readbyqxmd.com/read/29031542/complications-and-30-day-readmission-rates-after-craniotomy-craniectomy-a-single-institutional-study-of-243-consecutive-patients
#4
Aladine A Elsamadicy, Amanda Sergesketter, Owoicho Adogwa, Michael Ongele, Oren N Gottfried
Early hospital readmission has become a proxy for quality of care and contributes significantly to high health care costs in the United States, with more than $20 billion health care dollars are spent on 30-day readmission annually. Cranial neurosurgical procedures (i.e., craniotomy, craniectomy) are associated with high readmission rates; however, studies examining readmission after cranial procedures are limited and relatively unknown. The aim of this study is to identify the drivers of 30-day unplanned readmission in consecutive patients undergoing craniotomies and craniectomies...
October 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29022422/investigating-cognitive-ability-and-self-reported-driving-performance-of-post-stroke-adults-in-a-driving-simulator
#5
Alison Blane, Torbjörn Falkmer, Hoe C Lee, Tania Dukic Willstrand
Background Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers. Objectives The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls. Methods A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers...
October 12, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28872426/enhancing-quality-practice-for-prevention-and-diagnosis-of-urinary-tract-infection-during-inpatient-spinal-cord-rehabilitation
#6
Seyed Mohammad Alavinia, Maryam Omidvar, Farnoosh Farahani, Mark Bayley, Joana Zee, Beverley Catharine Craven
Objectives To reduce the incidence of Urinary Tract Infection (UTI) in subacute SCI individuals admitted for tertiary inpatient rehabilitation. Design A quality improvement team was assembled to improve UTI prevention/diagnosis. To plan data collection, UTI-related factors were mapped in an Ishikawa (fishbone) driver diagram. Data including patient demographics, presence and frequency of signs and/or symptoms of UTI and antibiotic initiation from August to December 2015 were recorded. Sensitivity, Specificity, Positive and Negative Predictive Values (PPV, NPV), and Likelihood Ratios (LR) were calculated for each sign and symptom...
September 5, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28845700/investigating-the-driving-performance-of-drivers-with-and-without-autism-spectrum-disorders-under-complex-driving-conditions
#7
Derserri Yan Ting Chee, Hoe Chung Yeung Lee, Ann-Helen Patomella, Torbjörn Falkmer
PURPOSE: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions. METHOD: Seventeen drivers with autism spectrum disorders and 18 typically developed drivers participated in a driving simulator trial. Prior to the assessment, participants completed the Driving Behaviour Questionnaire and measurements of cognitive and visual-motor ability. The driving simulation involved driving in an urban area with dense traffic and unpredictable events...
August 28, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28832865/drivers-of-payment-variation-in-90-day-coronary-artery-bypass-grafting-episodes
#8
Vinay Guduguntla, John D Syrjamaki, Chad Ellimoottil, David C Miller, Richard L Prager, Edward C Norton, Patricia Theurer, Donald S Likosky, James M Dupree
Importance: Coronary artery bypass grafting (CABG) is scheduled to become a mandatory Medicare bundled payment program in January 2018. A contemporary understanding of 90-day CABG episode payments and their drivers is necessary to inform health policy, hospital strategy, and clinical quality improvement activities. Furthermore, insight into current CABG payments and their variation is important for understanding the potential effects of bundled payment models in cardiac care. Objective: To examine CABG payment variation and its drivers...
August 23, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28758543/inconsistencies-with-screening-for-traumatic-brain-injury-in-spinal-cord-injury-across-the-continuum-of-care
#9
Seema Sikka, Angela Vrooman, Librada Callender, David Salisbury, Monica Bennett, Rita Hamilton, Simon Driver
OBJECTIVE: Explore how traumatic brain injury (TBI) is screened among spinal cord injury (SCI) patients across the continuum of care. DESIGN: Retrospective chart review Setting: Emergency department, trauma, inpatient rehabilitation Participants: 325 patients with SCI from inpatient rehabilitation facility (IRF) between March 1, 2011 and December 31, 2014 were screened. 49 eligible subjects had traumatic SCI and received care in adjoining acute care (AC) hospital...
July 31, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28752408/the-nlrp3-inflammasome-an-important-driver-of-neuroinflammation-in-hemorrhagic-stroke
#10
REVIEW
Shao-Jun Yang, Gao-Feng Shao, Jiang-Li Chen, Jie Gong
Hemorrhagic stroke is a devastating clinical event with no effective medical treatment. Neuroinflammation, which follows a hemorrhagic stroke, is an important element that involves both acute brain injury and subsequent brain rehabilitation. Therefore, delineating the key inflammatory mediators and deciphering their pathophysiological roles in hemorrhagic strokes is of great importance in the development of novel therapeutic targets for this disease. The NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome is a multi-protein complex that is localized within the cytoplasm...
July 27, 2017: Cellular and Molecular Neurobiology
https://www.readbyqxmd.com/read/28648313/cost-of-osteoporotic-fractures-in-singapore
#11
Charmaine Shuyu Ng, Tang Ching Lau, Yu Ko
OBJECTIVES: To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital's and patient's perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. METHODS: Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28624885/cardiac-rehabilitation-following-acute-coronary-syndrome-in-women
#12
REVIEW
Amanda L Bennett, Carl J Lavie, Sherry L Grace
Acute coronary syndrome (ACS) is among the leading burdens of disease among women. It is a significant driver of morbidity and chronically undermines their quality of life. Cardiac rehabilitation (CR) is indicated for ACS patients in clinical practice guidelines, including those specifically for women. CR is a multi-component model of care, proven to reduce mortality and morbidity, including in women. However, women are significantly less likely to be referred to CR by providers, and if they are referred, to enroll and adhere to programs...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28479794/factors-influencing-utilization-of-physiotherapy-service-among-children-with-cerebral-palsy-in-jalandhar-district-of-punjab
#13
Akhoury Gourang Sinha, Raju Sharma
BACKGROUND: Physiotherapy plays a central role in the management of children with cerebral palsy (CP); however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. AIMS AND OBJECTIVES: To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punjab...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28454124/influence-of-the-rehabilitation-outcome-on-returning-to-drive-after-neurological-impairment
#14
Urša Š Čižman, Gaj Vidmar, Petra Drnovšek
In traumatic brain injury (TBI) and stroke rehabilitation, the question of reintegration of the driver into traffic is faced very often. Driving is an important domain and for some patients, return to driving represents a crucial event for community inclusion. The aim of our study was to examine the utility of Glasgow Coma Scale within the first 24 h of injury and the Functional Independence Measure (FIM) at rehabilitation admission for predicting the return to driving. We included 72 patients after TBI or stroke...
June 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28421268/using-a-population-model-to-inform-the-management-of-river-flows-and-invasive-carp-cyprinus-carpio
#15
John D Koehn, Charles R Todd, Brenton P Zampatti, Ivor G Stuart, Anthony Conallin, Leigh Thwaites, Qifeng Ye
Carp are a highly successful invasive fish species, now widespread, abundant and considered a pest in south-eastern Australia. To date, most management effort has been directed at reducing abundances of adult fish, with little consideration of population growth through reproduction. Environmental water allocations are now an important option for the rehabilitation of aquatic ecosystems, particularly in the Murray-Darling Basin. As carp respond to flows, there is concern that environmental watering may cause floodplain inundation and provide access to spawning habitats subsequently causing unwanted population increase...
April 18, 2017: Environmental Management
https://www.readbyqxmd.com/read/28372579/va-residential-substance-use-disorder-treatment-program-providers-perceptions-of-facilitators-and-barriers-to-performance-on-pre-admission-processes
#16
Laura S Ellerbe, Luisa Manfredi, Shalini Gupta, Tyler E Phelps, Thomas R Bowe, Anna D Rubinsky, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics...
April 4, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28320346/process-for-developing-rehabilitation-practice-recommendations-for-individuals-with-traumatic-brain-injury
#17
Librada Callender, Rachel Brown, Simon Driver, Marie Dahdah, Ashley Collinsworth, Shahid Shafi
BACKGROUND: Attempts at measuring quality of rehabilitation care are hampered by a gap in knowledge translation of evidence-based approaches and lack of consensus on best practices. However, adoption of evidence-based best practices is needed to minimize variations and improve quality of care. Therefore, the objective of this project was to describe a process for assessing the quality of evidence of clinical practices in traumatic brain injury (TBI) rehabilitative care. METHODS: A multidisciplinary team of clinicians developed discipline-specific clinical questions using the Population, Intervention, Control, Outcome process...
March 20, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28319713/observational-evidence-on-the-effects-of-mega-fires-on-the-frequency-of-hydrogeomorphic-hazards-the-case-of-the-peloponnese-fires-of-2007-in-greece
#18
M Diakakis, E I Nikolopoulos, S Mavroulis, E Vassilakis, E Korakaki
Even though rare, mega-fires raging during very dry and windy conditions, record catastrophic impacts on infrastructure, the environment and human life, as well as extremely high suppression and rehabilitation costs. Apart from the direct consequences, mega-fires induce long-term effects in the geomorphological and hydrological processes, influencing environmental factors that in turn can affect the occurrence of other natural hazards, such as floods and mass movement phenomena. This work focuses on the forest fire of 2007 in Peloponnese, Greece that to date corresponds to the largest fire in the country's record that burnt 1773km(2), causing 78 fatalities and very significant damages in property and infrastructure...
March 16, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28299152/ebola-viral-disease-in-west-africa-a-threat-to-global-health-economy-and-political-stability
#19
Semeeh Akinwale Omoleke, Ibrahim Mohammed, Yauba Saidu
The West African sub-continent is currently experiencing its first, and ironically, the largest and longest Ebola viral diseases (EVD) outbreak ever documented in modern medical history. The current outbreak is significant in several ways, including longevity, magnitude of morbidity and mortality, occurrence outside the traditional niches, rapid spread and potential of becoming a global health tragedy. The authors provided explicit insights into the current and historical background, drivers of the epidemic, societal impacts, status of vaccines and drugs development and proffered recommendations to halt and prevent future occurrences...
August 17, 2016: Journal of Public Health in Africa
https://www.readbyqxmd.com/read/28295670/high-resource-utilization-in-liver-transplantation-how-strongly-differ-costs-between-the-care-sectors-and-what-are-the-main-cost-drivers
#20
Lena Harries, Harald Schrem, Jona T Stahmeyer, Christian Krauth, Volker Eric Amelung
To control treatment pathways of transplant patients across health care sectors a profound knowledge of the underlying cost structure is necessary. The aim of this study was to analyze the resource utilization of patients undergoing liver transplantation. Data on resource utilization for 182 liver transplanted patients was investigated retrospectively. The observational period started with the entry on the waiting list and ended up to 3 years after transplantation. Median treatment cost was 144,424€. During waiting time median costs amounted to 9,466€; 72% of costs were attributed to inpatient care, 3% to outpatient care and 26% to pharmaceuticals...
March 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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