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https://www.readbyqxmd.com/read/29031156/hiv-misdiagnosis-a-root-cause-analysis-leading-to-improvements-in-hiv-diagnosis-and-patient-care
#1
Raynell Lang, Carmen Charlton, Brenda Beckthold, Kiana Kadivar, Stephanie Lavoie, Doug Caswell, Paul Levett, Greg Horsman, John Kim, M John Gill
BACKGROUND: Standard diagnostic testing for HIV infection has traditionally relied on a high sensitivity HIV antibody screening test using an enzyme-linked immunosorbent assay (ELISA) followed by a high specificity antibody confirmatory test such as a Western Blot. Recently several of the screening assays have been enhanced with an ability to identify p24 antigen thereby narrowing the diagnostic window. OBJECTIVES: To explore the implications of enhanced HIV screening methods that may be leading to HIV misdiagnoses...
October 9, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29031135/shared-agenda-making-for-quality-improvement-towards-more-synergy-in-maternity-care
#2
Carola J M Groenen, Noortje T L van Duijnhoven, Jan A M Kremer, Marisja Scheerhagen, Frank P H A Vandenbussche, Marjan J Faber
OBJECTIVES: Professionals in maternity care have started working in a network approach. To further enhance the efficacy of this multidisciplinary maternity network, the identification of priorities for improvement is warranted. The aim of this study was to create key recommendations for the improvement agenda, in co-production with patients and professionals. STUDY DESIGN: We conducted a Delphi study to inventory (round 1), prioritize (round 2) and eventually approve (round 3) the improvement agenda for the maternity network...
October 7, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29029357/a-pilot-retrospective-study-to-evaluate-two-multi-layer-foam-dressings-for-the-management-of-moderately-exudative-pressure-injuries
#3
Kevin Woo, Jennifer Kasaboski
Prevention and treatment of pressure injuries (PI) is a standard benchmark for quality of care, performance, risk reduction, and patient safety. Foam dressings are designed to wick away a large volume of exudate with minimal lateral movement to prevent periwound skin maceration; this renders foam dressings a popular choice for the treatment of chronic wounds with high to moderate amounts of exudate. In addition, multi-layer foam dressings may have added benefits to alleviate pressure and minimize shear as the dressing materials slide against each other...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29029195/helpfulness-trust-and-safety-of-neighborhoods-social-capital-household-income-and-self-reported-health-of-older-adults
#4
Cindy L Cain, Steven Wallace, Ninez Ponce
Background and Objectives: Growing literature documents that where you live has an impact on your health, due in part to social capital. Building on social capital literature, we assess how subjective appraisals of neighborhood quality are associated with self-reported health (SRH) for older adults. Research Design and Methods: Cross-sectional analysis of the 2014 California Health Interview Survey, a representative survey of diverse, noninstitutionalized California residents...
September 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/29029076/neoliberal-long-term-care-from-community-to-corporate-control
#5
Larry Polivka, Baozhen Luo
Publicly (mainly Medicaid) funded long-term care (LTC) services have evolved from a nursing home dominated system of service to a much more balanced system including home- and community-based services (HCBS) programs over the last 30 years. The HCBS programs have been largely administered by the state and local level nonprofit aging networks (ANs) consisting of Area Agencies on Aging and thousands of service providers. Over the last decade, however, for-profit HMOs administered primarily by large insurance companies have begun to displace AN organizations...
September 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/29028964/the-cost-effectiveness-of-hiv-testing-and-treatment-engagement-initiatives-in-british-columbia-canada-2011-2013
#6
B Nosyk, J E Min, E Krebs, X Zang, M Compton, R Gustafson, R Barrios, J S G Montaner
Background: Recognition of the secondary preventive benefits of antiretroviral therapy (ART) has mobilized global efforts to 'seek, test, treat and retain' people living with HIV/AIDS (PLHIV) in HIV care. We aimed to determine the cost-effectiveness of a set of HIV testing and treatment engagement interventions initiated in British Columbia (BC), Canada in 2011-2013. Methods: Using a previously-validated dynamic, compartmental HIV transmission model, linked individual-level health administrative data for PLHIV and aggregate-level HIV testing data, we estimated the cost-effectiveness of primary care testing (hospital, emergency department, outpatient), ART initiation and ART retention initiatives, versus a counterfactual scenario approximating the status quo...
September 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29028930/use-of-a-hand-held-digital-cognitive-aid-in-simulated-crises-the-max-randomized-controlled-trial
#7
R Lelaidier, B Balança, S Boet, A Faure, M Lilot, F Lecomte, J-J Lehot, T Rimmelé, J-C Cejka
Background: Cognitive aids improve the technical performance of individuals and teams dealing with high-stakes crises. Hand-held electronic cognitive aids have rarely been investigated. A randomized controlled trial was conducted to investigate the effects of a smartphone application, named MAX (for Medical Assistance eXpert), on the technical and non-technical performance of anaesthesia residents dealing with simulated crises. Methods: This single-centre randomized, controlled, unblinded trial was conducted in the simulation centre at Lyon, France...
September 27, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028854/clinical-insights-and-emerging-strategies-in-managing-cutaneous-t-cell-lymphoma
#8
Christina C Patrone, Larisa J Geskin
<p>Mycosis Fungoides and Sézary Syndrome, the two most common types of Cutaneous T-Cell Lymphoma (CTCL), present many management challenges for dermatologists. Here, we provide a comprehensive review of up-to-date literature, guidelines, and expert clinical insights. We highlight the updates in the World Health Organization Classification of Cutaneous Lymphomas; we summarize the epidemiology, including a recently observed stabilization of increasing incidence of CTCL in the past decade and increased incidence in males, blacks, and veterans; we also provide the most recent updates on prognostic factors for CTCL...
May 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29028759/which-domains-of-the-odi-best-predict-change-in-physical-function-in-patients-after-surgery-for-degenerative-lumbar-spondylolisthesis
#9
Hamadi A Murphy, Eugene Warnick, Richard McGintee, Kristen Nicholson, Douglas A Hollern, Christie Stawicki, Daniel Tarazona, Gregory D Schroeder, Barrett I Woods, Mark F Kurd, Jeffrey A Rihn, Greg D Anderson, Christopher K Kepler, Alan S Hilibrand, Alexander R Vaccaro, Kris E Radcliff
STUDY DESIGN: Retrospective Review OBJECTIVE.: The purpose of this study is to determine the differential improvement of the various individual items of the ODI and to determine their relationship to other measures of HRQOL. SUMMARY OF BACKGROUND DATA: The oswestry disability index (ODI) is an easily scored, common, ten-item questionnaire about symptoms relevant to lumbar spine pathology. It is not clear if all of the items can be reliably applied to spine surgery...
October 12, 2017: Spine
https://www.readbyqxmd.com/read/29028651/endoscopic-conduit-harvest-in-coronary-artery-bypass-grafting-surgery-an-ismics-systematic-review-and-consensus-conference-statements
#10
Francis D Ferdinand, John K MacDonald, Husam H Balkhy, Gianluigi Bisleri, Ho Young Hwang, Patricia Northrup, Richard H J Trimlett, Lai Wei, Bob B Kiaii
OBJECTIVE: The purpose of this consensus conference was to develop and update evidence-informed consensus statements and recommendations on harvesting saphenous vein and radial artery via an open as compared with endoscopic technique by systematically reviewing and performing a meta-analysis of randomized and nonrandomized clinical trials. METHODS: All randomized controlled trials and nonrandomized controlled trials included in the first the International Society for Minimally Invasive Cardiothoracic Surgery Consensus Conference and Statements, in 2005 up to November 30, 2015, were included in a systematic review and meta-analysis...
October 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29028634/establishing-a-successful-transition-care-plan-for-the-adolescent-with-congenital-heart-disease
#11
Christopher Talluto
PURPOSE OF REVIEW: In this review we explore the aspects needed to develop a successful transition program for adolescents with congenital heart disease and the barriers that exist to the development of such a program. RECENT FINDINGS: We review the literature including more recent publications which support the development of a transition program in order to facilitate transfer from the pediatric to the adult healthcare system. SUMMARY: With the development of a successful transition program patients will hopefully receive high-quality, continuous life-long care in the appropriate setting...
October 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29028421/medical-student-reflections-on-geriatrics-moral-distress-empathy-ethics-and-end-of-life
#12
Mary E Camp, Haekyung Jeon-Slaughter, Anne E Johnson, John Z Sadler
INTRODUCTION: Medical students' early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd year medical students on required clinical rotations. METHODS: Using content analysis, the authors analyzed the essays' thematic content. The authors then used chi-square analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. RESULTS: 120 out of 802 essays described a geriatric patient...
October 13, 2017: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/29028375/health-disparities-in-patients-with-pulmonary-arterial-hypertension-a-blueprint-for-action-an-official-american-thoracic-society-statement
#13
Arunabh Talwar, Joe G N Garcia, Halley Tsai, Matthew Moreno, Tim Lahm, Roham T Zamanian, Roberto Machado, Steven M Kawut, Mona Selej, Stephen Mathai, Laura Hoyt D'Anna, Sonu Sahni, Erik J Rodriquez, Richard Channick, Karen Fagan, Michael Gray, Jessica Armstrong, Josanna Rodriguez Lopez, Vinicio de Jesus Perez
BACKGROUND: Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. OBJECTIVES: The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research...
October 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29028282/characteristics-of-quality-improvement-champions-in-nursing-homes-a-systematic-review-with-implications-for-evidence-based-practice
#14
Kyungmi Woo, Gvira Milworm, Dawn Dowding
BACKGROUND: Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality. AIMS: To identify the role, use and preparation of champions in a nursing home setting as a way of informing future QI strategies in nursing homes...
October 13, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29028227/a-strong-tb-programme-embedded-in-a-developing-primary-healthcare-system-is-a-lose-lose-situation-insights-from-patient-and-community-perspectives-in-cambodia
#15
Neisha Sundaram, Richard James, Um Sreynimol, Pen Linda, Joanne Yoong, Saint Saly, Pichenda Koeut, Mao Tan Eang, Richard Coker, Mishal S Khan
As exemplified by the situation in Cambodia, disease specific (vertical) health programmes are often favoured when the health system is fragile. The potential of such an approach to impede strengthening of primary healthcare services has been studied from a health systems perspective in terms of access and quality of care. In this bottom-up, qualitative study we investigate patient and community member experiences of health services when a strong tuberculosis (TB) programme is embedded into a relatively underutilized primary healthcare system...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29028226/large-funding-inflows-limited-local-capacity-and-emerging-disease-control-priorities-a-situational-assessment-of-tuberculosis-control-in-myanmar
#16
Mishal S Khan, Sara Schwanke-Khilji, Joanne Yoong, Zaw Myo Tun, Samantha Watson, Richard James Coker
There are numerous challenges in planning and implementing effective disease control programmes in Myanmar, which is undergoing internal political and economic transformations whilst experiencing massive inflows of external funding. The objective of our study-involving key informant discussions, participant observations and linked literature reviews-was to analyse how tuberculosis (TB) control strategies in Myanmar are influenced by the broader political, economic, epidemiological and health systems context using the Systemic Rapid Assessment conceptual and analytical framework...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29028223/are-scientific-research-outputs-aligned-with-national-policy-makers-priorities-a-case-study-of-tuberculosis-in-cambodia
#17
Lydia Boudarene, Richard James, Richard Coker, Mishal S Khan
With funding for tuberculosis (TB) research decreasing, and the high global disease burden persisting, there are calls for increased investment in TB research. However, justification of such investments is questionable, when translation of research outputs into policy and health care improvements remains a challenge for TB and other diseases. Using TB in Cambodia as a case study, we investigate how evidence needs of national policy makers are addressed by topics covered in research publications. We first conducted a systematic review to compile all studies on TB in Cambodia published since 2000...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29028221/quality-of-life-and-patient-reported-outcomes-following-proton-radiation-therapy-a-systematic-review
#18
Vivek Verma, Charles B Simone, Mark V Mishra
Background: As costs of cancer care rise, the importance of documenting value in oncology increases. Proton beam radiotherapy (PBT) has the potential to reduce toxicities in cancer patients, but is relatively expensive and unproven. Evaluating quality of life (QOL) and patient-reported outcomes (PROs) is essential to establishing PBT's "value" in oncologic therapy. The goal of this systematic review was to assess QOL and PROs in patients treated with PBT. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic searches were conducted...
April 1, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29028151/delirium-care-real-world-solutions-to-real-world-problems
#19
Eamonn Eeles, Judy McCrow, Andrew Teodorczuk, Gideon A Caplan
OBJECTIVES: Implementation research into delirium care is lacking. Exploiting known practice barriers to understand what management strategies work best in delirium is a means of prioritising care interventions. A consensus approach to determining priority interventions in delirium was derived and related to reference standards in health-care practice. METHODS: A workshop of 20 experts was held at the Australasian Delirium Association conference 2016. Structured small group work, iterative ranking and a 21-member check were undertaken to (i) explore research barriers in delirium care; (ii) explore how barriers related to individual items of multicomponent interventions; and (iii) rank multicomponent interventions in relation to each statement within the newly released Australian Commission on Safety and Quality in Health Care delirium standard...
October 13, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29028072/vitamin-d-in-human-reproduction-the-more-the-better-an-evidence-based-critical-appraisal
#20
A S Laganà, S G Vitale, H Ban Frangež, E Vrtačnik-Bokal, R D'Anna
OBJECTIVE: Vitamin D is a fat-soluble secosteroid hormone that regulates calcium, magnesium, and phosphate homeostasis and plays a pivotal role as antiproliferative and immunomodulatory mediator. Considering the different sources of synthesis and dietary intake as well as the pleiotropic actions in extremely diverse (micro)environments of the body, the supplementation of this Vitamin should be carefully evaluated taking into account the several pathways that it regulates. In the current brief review, we aimed to summarize the available evidence about the topic, in order to suggest the best evidence-based supplementation strategy for human reproduction, avoiding the unuseful (and sometimes hazardous) empiric supplementation...
September 2017: European Review for Medical and Pharmacological Sciences
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