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https://www.readbyqxmd.com/read/28749775/implementing-a-quality-improvement-collaborative-to-improve-hypertension-control-and-advance-million-hearts-among-low-income-californians-2014-2015
#1
Desiree R Backman, Neal D Kohatsu, Zhiwei Yu, Rachel E Abbott, Kenneth W Kizer
From January through December 2015, the California Department of Health Care Services, which administers Medi-Cal, the nation's largest Medicaid program, conducted a quality improvement collaborative (QIC) with 9 Medi-Cal managed care plans (MCPs) aimed at improving hypertension control consistent with the Million Hearts initiative. The QIC included quarterly webinars and links to local, state, and national resources that consisted of materials and consultations with subject matter experts. Participating MCPs demonstrated an average increase of 5...
July 27, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28749165/impact-of-robotic-ultrasound-image-guidance-on-plan-quality-in-sbrt-of-the-prostate
#2
Stefan Gerlach, Ivo Kuhlemann, Floris Ernst, Christoph Fürweger, Alexander Schlaefer
OBJECTIVES: Ultrasound provides good image quality, fast volumetric imaging, and is established for abdominal image guidance. Robotic transducer placement may facilitate intra-fractional motion compensation in radiation therapy. We consider integration with the CyberKnife and study whether the kinematic redundancy of a seven-degrees-of-freedom robot allows for acceptable plan quality for prostate treatments. METHODS: Reference treatment plans were generated for ten prostate cancer cases previously treated with the CyberKnife...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28749065/concise-review-the-high-cost-of-high-tech-medicine-planning-ahead-for-market-access
#3
REVIEW
Dawn Driscoll, Stephanie Farnia, Panos Kefalas, Richard T Maziarz
Cellular therapies and other regenerative medicines are emerging as potentially transformative additions to modern medicine, but likely at a staggering financial cost. Public health care systems' budgets are already strained by growing and aging populations, and many private insurer's budgets are equally stretched. The current systems that most payers employ to manage their cash flow are not structured to absorb a sudden onslaught of very expensive prescriptions for a large portion of their covered population...
August 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28748743/community-based-game-intervention-to-improve-south-asian-indian-americans-engagement-with-advanced-care-planning
#4
Kavita Radhakrishnan, Lauren Jodi Van Scoy, Regina Jillapalli, Shubhada Saxena, Miyong T Kim
OBJECTIVE: Advance care planning (ACP) allows individuals to express their preferences for medical treatment in the event that they become incapable of making their own decisions. This study assessed the efficacy of a conversation game intervention for increasing South Asian Indian Americans' (SAIAs') engagement in ACP behaviors as well as the game's acceptability and cultural appropriateness among SAIAs. DESIGN: Eligible community-dwelling SAIAs were recruited at SAIA cultural events held in central Texas during the summer of 2016...
July 27, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28747535/palliative-care-in-end-stage-valvular-heart-disease
#5
REVIEW
Jill M Steiner, Stephanie Cooper, James N Kirkpatrick
Valvular heart disease (VHD), particularly aortic valve disease, is prevalent with increasing incidence. When surgery is not possible, or when risks outweigh benefits, percutaneous treatment options may offer effective alternatives. However, procedures may not always go as planned, and frail patients or those whose symptoms are caused by other comorbidities may not benefit from valve intervention at all. Significant effort should be made to assess frailty, comorbidities and patient goals prior to intervention...
August 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28745851/maxillofacial-trauma-managing-potentially-dangerous-and-disfiguring-complex-injuries-digest
#6
Devjani Das, Lea Salazar, Milana Zaurova
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face...
April 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28743662/community-game-day-using-an-end-of-life-conversation-game-to-encourage-advance-care-planning
#7
Lauren J Van Scoy, Jean M Reading, Margaret Hopkins, Brandi Smith, Judy Dillon, Michael J Green, Benjamin H Levi
CONTEXT: Advance care planning (ACP) is an important process that involves discussing and documenting one's values and preferences for medical care, particularly end-of-life treatments. OBJECTIVES: This convergent, mixed methods study assessed whether an end-of-life conversation card game is an acceptable and effective means for performing ACP for patients with chronic illness and/or their caregivers when deployed in a community setting. METHODS: 22 games (n=93 participants) were held in community settings surrounding XXX, PA in 2016...
July 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28743661/chronic-pain-patient-physician-engagement-and-family-communication-associated-with-drug-using-hiv-patients-discussing-advanced-care-planning-with-their-physicians
#8
Eric D Hansen, Mary M Mitchell, Tom Smith, Nancy Hutton, Jeanne Keruly, Amy R Knowlton
CONTEXT: In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV into a serious chronic illness, warranting patient-provider discussion about advanced care planning (ACP). Evidence is needed to inform physicians on how to approach ACP for these patients. Chronic pain is common in PLWHA, particularly in those who have substance use disorders; although it is known this population is at risk for poorer patient-physician engagement, the effects on ACP are unknown...
July 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28739159/lung-stereotactic-body-radiation-therapy-sbrt-for-early-stage-non-small-cell-lung-cancer-in-the-very-elderly-%C3%A2-80years-old-extremely-safe-and-effective
#9
Paul Kreinbrink, Philip Blumenfeld, George Tolekidis, Neilayan Sen, David Sher, Gaurav Marwaha
OBJECTIVE: Stereotactic body radiotherapy (SBRT) for early-stage non-small-cell lung cancer (NSCLC) is the standard of care in medically inoperable patients. In very elderly patients, previous studies have shown SBRT to offer excellent local control, though with higher toxicities than in younger populations. We report our institutional experience using SBRT in the definitive management of NSCLC in patients ≥80years old. MATERIALS AND METHODS: Using an IRB-approved registry of 158 patients treated with definitive-intent lung SBRT for early-stage NSCLC at our institution between 2010 and 2016, 31 consecutively treated patients ≥80years of age were identified...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28738968/exploration-of-an-allied-health-workforce-redesign-model-quantifying-the-work-of-allied-health-assistants-in-a-community-workforce
#10
Lisa Somerville, Annette Davis, Sarah Milne, Desiree Terrill, Kathleen Philip
The Victorian Assistant Workforce Model (VAWM) enables a systematic approach for the identification and quantification of work that can be delegated from allied health professionals (AHPs) to allied health assistants (AHAs). The aim of the present study was to explore the effect of implementation of VAWM in the community and ambulatory health care setting. Data captured using mixed methods from allied health professionals working across the participating health services enabled the measurement of opportunity for workforce redesign in the community and ambulatory allied health workforce...
July 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28738055/pd-1-inhibitor-therapy-consensus-statement-from-the-faculty-of-the-melanoma-nursing-initiative-on-managing-adverse-events%C3%A2
#11
Suzanne McGettigan, Krista M Rubin
BACKGROUND: Programmed cell death protein 1 (PD-1) inhibitor therapies are now a standard treatment for advanced melanoma and other tumor types. The immune-related adverse events (irAEs) associated with PD-1 inhibitor therapy are drastically different from the AEs associated with chemotherapy. Because these irAEs reflect immune system activation rather than side effects of therapy, nurses should be cognizant of the range of organ systems potentially affected as well as likely clinical presentations...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28735269/patient-family-agreement-on-values-and-preferences-for-life-sustaining-treatment-results-of-a-multicentre-observational-study
#12
Amane Abdul-Razzak, Daren K Heyland, Jessica Simon, Sunita Ghosh, Andrew G Day, John J You
OBJECTIVES: To quantify agreement between patients and their family members on their own values and preferences for use or non-use of life-sustaining treatments for the patient. METHODS: Hospitalised patients aged 55 years or older with advanced pulmonary, cardiac, liver disease or metastatic cancer or aged 80 years or older from medical wards at 16 Canadian hospitals and their family members completed a questionnaire including eight items about values related to life-sustaining treatment and a question about preferences for life-sustaining treatments...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28733697/perspectives-of-newly-diagnosed-advanced-cancer-patients-receiving-dignity-therapy-during-cancer-treatment
#13
Ann Marie Dose, Lori M Rhudy
PURPOSE: Dignity therapy is a psychosocial intervention that has been used primarily at the end of life to improve quality of life and other patient outcomes, but many individuals are unable to complete it due to health decline and death. The purpose of this study was to identify what individuals with advanced pancreatic or lung cancer with limited life expectancy, undergoing active cancer treatment describe during the dignity therapy intervention as important to them when not immediately facing end of life...
July 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28733461/should-heart-failure-be-regarded-as-a-terminal-illness-requiring-palliative-care-a-study-of-heart-failure-patients-carers-and-clinicians-understanding-of-heart-failure-prognosis-and-its-management
#14
Rachel Stocker, Helen Close, Helen Hancock, A Pali S Hungin
OBJECTIVES: Communication and planning for heart failure (HF) care near the end of life is known to be complex. Little is known about how the patient experience of palliative assessment and communication needs change over time, and how this might inform management. Our aim was to explore experiences of giving or receiving a prognosis and advanced palliative care planning (ACP) for those with HF. METHODS: We carried out a longitudinal grounded theory study, employing in-depth interviews with 14 clinicians (primary and secondary care) and observations of clinic and home appointments, followed by a series of interviews with 13 patients with HF and 9 carers...
July 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28731881/implementation-of-a-nurse-driven-educational-program-improves-management-of-sorafenib-s-toxicities-in-hepatocellular-carcinoma
#15
Angélique Brunot, Florence Le Roy, Samuel Le Sourd, Amel MʼSadek, Marielle Duval, Laurence Crouzet, Anne Guillygomarcʼh, Eveline Boucher, Brigitte Laguerre, Julien Edeline
BACKGROUND: Sorafenib is the standard treatment of advanced hepatocellular carcinoma. Because of its unique toxicities, improving patients' tolerance merits close follow-up. Nurses can play a crucial role by leading a patient educational program (EP). OBJECTIVES: The aim of this study was to assess whether adding EP to usual care (UC) improves patient's care. METHODS: Since 2011, oncologists referred patients treated by sorafenib to the EP led by clinical nurses...
July 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28731821/trust-in-physicians-continuity-and-coordination-of-care-and-quality-of-death-in-patients-with-advanced-cancer
#16
Jun Hamano, Tatsuya Morita, Sakiko Fukui, Yoshiyuki Kizawa, Satoru Tunetou, Yasuo Shima, Makoto Kobayakawa, Maho Aoyama, Mitsunori Miyashita
BACKGROUND: Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. OBJECTIVE: To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home...
July 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28731291/critical-questions-advancing-the-health-of-female-veterans
#17
Lisa Muirhead, Priscilla Hall, Cedrella Jones-Taylor, Gari D Clifford, Tasha Felton-Williams, Kathy Williams
PURPOSE: Women are the fastest growing Veteran population in the United States and many receive all or part of their health care outside of the Department of Veterans Affairs (VA). The purpose of this article is to review the healthcare issues of women Veterans and discuss implications for care. DATA SOURCES: Review of selected literature, VA resources and guidelines, and expert opinion. CONCLUSIONS: Few providers are aware of the impact military service has on the health of women and fail to ask the all-important question, "Have you served in the military?" Recognizing women's military service can reveal important information that can answer perplexing clinical questions, aid in designing comprehensive plans of care, and enable women to receive the assistance needed to address complex physical and psychosocial issues to improve the quality of their lives...
July 21, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28728918/financing-transformative-health-systems-towards-achievement-of-the-health-sustainable-development-goals-a-model-for-projected-resource-needs-in-67-low-income-and-middle-income-countries
#18
Karin Stenberg, Odd Hanssen, Tessa Tan-Torres Edejer, Melanie Bertram, Callum Brindley, Andreia Meshreky, James E Rosen, John Stover, Paul Verboom, Rachel Sanders, Agnès Soucat
BACKGROUND: The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published. METHODS: We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time...
July 14, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28727486/association-of-physician-orders-for-life-sustaining-treatment-form-use-with-end-of-life-care-quality-metrics-in-patients-with-cancer
#19
Sandra L Pedraza, Stacey Culp, Mark Knestrick, Evan Falkenstine, Alvin H Moss
PURPOSE: Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs). METHODS: We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28726791/implementation-of-a-multidisciplinary-guideline-improves-preterm-infant-admission-temperatures
#20
M W Harer, B Vergales, T Cady, A Early, C Chisholm, J R Swanson
BACKGROUND: Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. METHODS: To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team...
July 20, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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