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https://www.readbyqxmd.com/read/29332428/the-effectiveness-of-preoperative-preparation-for-improving-perioperative-outcomes-in-children-and-caregivers
#1
Chia-Jung Lin, Hsin-Ping Liu, Pei-Ya Wang, Mei-Hua Yu, Mei-Chun Lu, Ling-Yu Hsieh, Tzu-Chia Lin
Most children experience significant anxiety during the preoperative period. Greater preoperative anxiety may be related to a higher incidence of negative behaviors. This study aimed to develop a family-centered preoperative preparation program and to evaluate the effects of this program on children's preoperative emotional behaviors, postoperative behavior, and posthospital behavior, and on caregiver anxiety. A prospective, randomized controlled study was conducted. The population consisted of children who underwent minor surgery and their caregivers...
January 1, 2018: Behavior Modification
https://www.readbyqxmd.com/read/29325943/neurosurgical-care-availability-and-access-in-low-and-middle-income-countries
#2
Maria Punchak, Swagoto Mukhopadhyay, Sonal Sachdev, Ya-Ching Hung, Sophie Peeters, Abbas Rattani, Michael Dewan, Walter D Johnson, Kee B Park
BACKGROUND: An estimated 5 billion people worldwide lack access to basic surgical care. In particular, the vast majority of low- and middle-income countries (LMICs) currently struggle to provide adequate neurosurgical services. Significant barriers exist, including limited access to trained medical, nursing and allied health staff, lack of equipment, and availability of services at reasonable distance and at reasonable cost to patients. An accurate assessment of current neurosurgical capacity in LIMCs is an essential first step in tackling this deficit...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29314556/barriers-and-reinforcing-factors-to-self-management-behaviour-in-rheumatoid-arthritis-patients-a-qualitative-study
#3
M Chaleshgar-Kordasiabi, B Enjezab, M Akhlaghi, I Sabzmakan
OBJECTIVE: The aim of the present study was to explore the view of rheumatoid arthritis (RA) patients about the barriers and reinforcing factors in practising self-management behaviour (SMB). METHODS: This was a qualitative study based on directed content analysis of in-depth semi-structured interviews with 30 patients. The participants were selected using a purposeful sampling approach. The interviews continued until data saturation was reached. The study was conducted over 6 months in 2014-2015 at the Rheumatology Clinic of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran...
January 5, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29286434/mri-guided-focused-ultrasound-thalamotomy-for-patients-with-medically-refractory-essential-tremor
#4
Ying Meng, Yuexi Huang, Benjamin Solomon, Kullervo Hynynen, Nadia Scantlebury, Michael L Schwartz, Nir Lipsman
Essential tremor (ET) is the most common type of tremor in adults. While ET does not result in decreased life expectancy, the disabilities associated with ET can have a significant impact on quality of life, mood, functional activities, and socialization. Patients suffering from ET not sufficiently treated with first line medications may be eligible for alternative strategies such as deep brain stimulation, radiofrequency ablation, and MRI guided focused ultrasound (MRgFUS). High-intensity MRgFUS is an emerging modality to treat ET, its attraction for patients being that it is noninvasive and associated with short recovery time, as patients are home the day after treatment...
December 13, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29241143/perceptions-about-supervised-injection-facilities-among-people-who-inject-drugs-in-philadelphia
#5
Robert E Harris, Jessica Richardson, Rosemary Frasso, Evan D Anderson
BACKGROUND: People who inject drugs (PWID) are at high risk for infectious diseases, skin and soft tissue infections, and overdose. However, these harms are all avoidable when sterile injection equipment, hygienic places to inject, and medical care are accessible. Unfortunately, many PWID in the U.S lack these resources. The most vulnerable are forced to inject in public spaces, where individual risks are high and communal harms are sometimes many. Supervised Injection Facilities (SIFs) are an established intervention for reducing these harms...
December 10, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29228939/the-ethics-of-caring-for-hospital-dependent-patients
#6
Calvin Sung, Jennifer L Herbst
BACKGROUND: Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis...
December 11, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29226458/communicating-risk-in-dementia-care-survey-of-health-and-social-care-professionals
#7
Brian J Taylor, Mabel Stevenson, Michelle McDowell
Supporting people to live at home in line with community care policies requires increasing attention to assessing, communicating and managing risks. There is a challenge in supporting client choices that include risk-taking while demonstrating professional accountability. Risk communication becomes increasingly important with the need to engage clients and families in meaningful shared decision-making. This presents particular challenges in dementia services. This survey of risk communication in dementia care was administered to all health and social care professionals in community dementia services in Northern Ireland: June-September 2016...
December 11, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/29190695/high-accuracy-detection-of-early-parkinson-s-disease-using-multiple-characteristics-of-finger-movement-while-typing
#8
Warwick R Adams
Parkinson's Disease (PD) is a progressive neurodegenerative movement disease affecting over 6 million people worldwide. Loss of dopamine-producing neurons results in a range of both motor and non-motor symptoms, however there is currently no definitive test for PD by non-specialist clinicians, especially in the early disease stages where the symptoms may be subtle and poorly characterised. This results in a high misdiagnosis rate (up to 25% by non-specialists) and people can have the disease for many years before diagnosis...
2017: PloS One
https://www.readbyqxmd.com/read/29137878/integration-of-medicare-and-medicaid-for-dually-eligible-beneficiaries-a-focus-group-study-examining-beneficiaries-early-experiences-in-california-s-dual-financial-alignment-demonstration
#9
Carrie L Graham, Holly C Stewart, Elaine Kurtovich, Pi-Ju Liu
BACKGROUND: In 2014 California implemented a federal dual alignment demonstration that used a capitated managed care health plans called Cal MediConnect (CMC) to integrate medical care and long term services and supports (LTSS) for beneficiaries with both Medicare and Medicaid. These beneficiaries often have complex care needs, including multiple chronic conditions and disabilities. By 2016, 120,000 eligible beneficiaries were enrolled in the program. OBJECTIVES: Focus groups with enrolled beneficiaries were conducted to gather rich data about their early experiences with quality of care, access to care, and coordination of care in CMC plans and to identify recommendations for program improvement...
July 21, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/29037222/the-efficacy-and-stability-of-an-information-and-communication-technology-based-centralized-monitoring-system-of-adherence-to-immunosuppressive-medication-in-kidney-transplant-recipients-study-protocol-for-a-randomized-controlled-trial
#10
Hee-Yeon Jung, Sook Jin Seong, Ji-Young Choi, Jang-Hee Cho, Sun-Hee Park, Chan-Duck Kim, Young-Ran Yoon, Hyung-Kee Kim, Seung Huh, Se-Hee Yoon, Jong Soo Lee, Yong-Lim Kim
BACKGROUND: Immunosuppression non-adherence in kidney transplant recipients (KTRs) not only increases the risk of medical intervention due to acute rejection and graft loss but burdens the socioeconomic system in the form of increased healthcare costs. An aggressive preemptive effort by healthcare professionals, geared to ensure adherence to immunosuppressants in KTRs, is significant and imperative. METHODS/DESIGN: This study was designed as a prospective, open-label, multicenter, randomized controlled study aimed at evaluating the efficacy and stability of an information and communication technology (ICT)-based centralized monitoring system in boosting medication adherence in KTRs...
October 16, 2017: Trials
https://www.readbyqxmd.com/read/29024613/remote-monitoring-of-automated-peritoneal-dialysis-patients-assessing-clinical-and-economic-value
#11
Dilip Makhija, Mark Dominik Alscher, Stefan Becker, Silvia D'Alonzo, Raj Mehrotra, Leslie Wong, Kim McLeod, Judy Danek, Mary Gellens, Todd Kudelka, James A Sloand, Suzanne Laplante
BACKGROUND: For chronic kidney disease patients who progress to end-stage renal disease, survival is dependent on renal replacement therapy in the form of kidney transplantation or chronic dialysis. Peritoneal dialysis (PD), which can be performed at home, is both more convenient and less costly than hemodialysis that requires three 4-h visits per week to the dialysis facility and complicated equipment. Remote therapy management (RTM), technologies that collect medical information and transmit it to healthcare providers for patient management, has the potential to improve the outcomes of patients receiving automated peritoneal dialysis (APD) at home...
October 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28992158/avoidable-emergency-department-visits-a-starting-point
#12
Renee Y Hsia, Matthew Niedzwiecki
Objective: To better characterize and understand the nature of a very conservative definition of 'avoidable' emergency department (ED) visits in the United States to provide policymakers insight into what interventions can target non-urgent ED visits. Design/setting: We performed a retrospective analysis of a very conservative definition of 'avoidable' ED visits using data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011. Participants: We examined a total of 115 081 records, representing 424 million ED visits made by patients aged 18-64 years who were seen in the ED and discharged home...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28981766/overview-methods-and-results-of-multi-country-community-based-maternal-and-newborn-care-economic-analysis
#13
Emmanuelle Daviaud, Helen Owen, Catherine Pitt, Kate Kerber, Fiorella Bianchi Jassir, Diana Barger, Fatuma Manzi, Elizabeth Ekipara-Kiracho, Giulia Greco, Peter Waiswa, Joy E Lawn
Home visits for pregnancy and postnatal care were endorsed by the WHO and partners as a complementary strategy to facility-based care to reduce newborn and maternal mortality. This article aims to synthesise findings and implications from the economic analyses of community-based maternal and newborn care (CBMNC) evaluations in seven countries. The evaluations included five cluster randomized trials (Ethiopia, Ghana, South Africa, Tanzania, Uganda) and programmatic before/after assessments (Bolivia, Malawi)...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28964193/design-implementation-and-application-of-150-degree-commutation-vsi-to-improve-speed-range-of-sensored-bldc-motor
#14
Mehmet Cihat Ozgenel
Permanent magnet brushless dc (BLDC) motors are very convenient for many applications such as industrial, medical, robotic, aerospace, small electric vehicles, and home applications because of their inherent satisfying dynamic characteristics. There are numerous studies about these motors and their control schemes such as sensorless control and different speed and torque control schemes. All electric motors need commutation in order to produce speed and torque. Commutation in brushed DC motors is performed by means of a brush and collector...
September 2017: Review of Scientific Instruments
https://www.readbyqxmd.com/read/28958032/fall-risk-supports-and-services-and-falls-following-a-nursing-home-discharge
#15
Marwa Noureldin, Zachary Hass, Kathleen Abrahamson, Greg Arling
Background and Objectives: Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Research Design and Methods: Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample...
September 4, 2017: Gerontologist
https://www.readbyqxmd.com/read/28935129/environmental-design-for-end-of-life-care-an-integrative-review-on-improving-quality-of-life-and-managing-symptoms-for-patients-in-institutional-settings
#16
REVIEW
Rana Sagha Zadeh, Paul Eshelman, Judith Setla, Laura Kennedy, Emily Hon, Aleksa Basara
CONTEXT: The environment in which end-of-life care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers. OBJECTIVES: This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in end-of-life care and to clarify directions for future research. METHOD: This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28914227/a-system-analysis-of-delay-in-outpatient-respiratory-equipment-delivery
#17
Sheila Kun, Gregory Placencia, Sally Davidson Ward, Thomas Keens
OBJECTIVES: To systematically assess barriers delaying home respiratory equipment requisition and to evaluate for temporal correlation between delays and emergency room or hospitalization episodes. BACKGROUND: Initiation of home respiratory treatments is delayed because of delays in delivery of durable medical equipment (DME). This study assesses root causes of such delays from a system perspective. We also describe clinical consequences by measuring emergency room visits and hospitalization days for temporal correlations...
December 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28751491/pediatric-chronic-critical-illness-reducing-excess-hospitalizations
#18
Renee D Boss, Erin P Williams, Carrie M Henderson, Rebecca R Seltzer, Miriam C Shapiro, Emily Hahn, Nancy Hutton
OBJECTIVES: The past 2 decades have seen an expanding pediatric population that is chronically critically ill: children with repeated and prolonged hospitalizations and ongoing dependence on technologies to sustain vital functions. Although illness complexity prompts many hospitalizations, our goal with this study was to explore modifiable patient, family, and health system contributions to excess hospital days for children with chronic critical illness (CCI). METHODS: Semistructured interviews were conducted with 51 stakeholders known for their CCI expertise...
July 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28698249/pd-vs-hd-in-post-economic-crisis-greece-differences-in-patient-characteristics-and-estimation-of-therapy-cost
#19
Marilena G Koukou, Vassilios E Smyrniotis, Nikolaos F Arkadopoulos, Eirini I Grapsa
OBJECTIVE: The aim of this study was to investigate patient characteristics and make an estimation of the cost of peritoneal dialysis (PD) and hemodialysis (HD) to Greek society during the economic crisis. METHODS: We recorded the characteristics and the total cost of dialysis treatment in 100 patients on PD and 100 on HD. Total costs included dialysis procedure, consumables, drugs, laboratory tests, food, and transportation fees (only HD), covered by patients' insurance...
September 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28648313/cost-of-osteoporotic-fractures-in-singapore
#20
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
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