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https://www.readbyqxmd.com/read/29317418/home-polygraphic-recording-with-telemedicine-monitoring-for-diagnosis-and-treatment-of-sleep-apnoea-in-stroke-hopes-study-study-protocol-for-a-single-blind-randomised-controlled-trial
#1
Stefan Thomas Kotzian, Angela Schwarzinger, Sandra Haider, Bernd Saletu, Josef Spatt, Michael Timothy Saletu
INTRODUCTION: Meta-analyses report that more than 50% of patients who had a stroke suffer from moderate to severe sleep apnoea (SA), with adherence rates to positive airway pressure (PAP) therapy of only 30%. The primary objective of this study is to determine whether PAP adherence in patients who had a stroke with obstructive sleep apnoea (OSA) can be improved by a PAP training strategy during inhospital rehabilitation combined with a telemedicine monitoring system after discharge. Further objectives are (1) to compare the validity of a non-attended level-III polygraphy with that of a level-II polysomnography (PSG) in the diagnosis of SA, (2) to compare the validity of an apnoea-hypopnoea index (AHI) yielded by the PAP device with that obtained during PSG, (3) to determine changes in nocturnal systolic blood pressure (BP) due to PAP therapy with the pulse transit time (PTT) method and (4) to assess the impact of telemonitored PAP therapy on neurorehabilitation outcome parameters...
January 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#2
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29314328/nurse-to-nurse-shift-handoffs-on-medical-surgical-units-a-process-within-the-flow-of-nursing-care
#3
Katherine M Ernst, Sara A McComb, Cathaleen Ley
AIMS AND OBJECTIVES: The aim of this research was to qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. BACKGROUND: The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilizing nurse perceptions as the primary measure of quality...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29313293/management-of-care-transition-and-hospital-discharge
#4
Amedeo Zurlo, Giovanni Zuliani
Current demographic and epidemiological trends highlight a growing task in surgical departments by elderly patients, characterized by high prevalence of comorbidity, complexity, and functional disability. Of consequence, discharge of an elderly patient must be considered in a new cultural perspective and should be imagined as a well-structured process starting from admission to surgical department and finishing with the patient discharge in a setting able to support her/him in the best possible way. The lack of a suitable discharge planning and of a proper transition program in the elderly subjects increases the risk of quick re-admission and may negatively affect the functional and the status quality of life of patients and caregivers...
January 8, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29313286/once-daily-triple-therapy-in-patients-with-copd-patient-reported-symptoms-and-quality-of-life
#5
Maggie Tabberer, David A Lomas, Ruby Birk, Noushin Brealey, Chang-Qing Zhu, Steve Pascoe, Nicholas Locantore, David A Lipson
INTRODUCTION: Directly recorded patient experience of symptoms and health-related quality of life (HRQoL) can complement lung function and exacerbation rate data in chronic obstructive pulmonary disease (COPD) clinical studies. The FULFIL study recorded daily symptoms and activity limitation together with additional patient-reported outcomes of dyspnea and HRQoL, as part of the prespecified analyses. FULFIL co-primary endpoint data have been previously reported. METHODS: FULFIL was a phase III, 24-week, randomized, double-blind, double-dummy, multicenter study comparing once-daily single inhaler triple therapy [fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI)] 100 µg/62...
January 8, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29304857/a-qualitative-exploration-of-the-discharge-process-and-factors-predisposing-to-readmissions-to-the-intensive-care-unit
#6
Uchenna R Ofoma, Yue Dong, Ognjen Gajic, Brian W Pickering
BACKGROUND: Quantitative studies have demonstrated several factors predictive of readmissions to intensive care. Clinical decision tools, derived from these factors have failed to reduce readmission rates. The purpose of this study was to qualitatively explore the experiences and perceptions of physicians and nurses to gain more insight into intensive care readmissions. METHODS: Semi-structured interviews of intensive care unit (ICU) and general medicine care providers explored work routines, understanding and perceptions of the discharge process, and readmissions to intensive care...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29299613/the-effectiveness-of-critical-time-intervention-for-abused-women-leaving-women-s-shelters-a-randomized-controlled-trial
#7
Danielle A M Lako, Mariëlle D Beijersbergen, Irene E Jonker, Renée de Vet, Daniel B Herman, Albert M van Hemert, Judith R L M Wolf
OBJECTIVES: To examine the effectiveness of critical time intervention (CTI)-an evidence-based intervention-for abused women transitioning from women's shelters to community living. METHODS: A randomized controlled trial was conducted in nine women's shelters across the Netherlands. 136 women were assigned to CTI (n = 70) or care-as-usual (n = 66). Data were analyzed using intention-to-treat three-level mixed-effects models. RESULTS: Women in the CTI group had significant fewer symptoms of post-traumatic stress (secondary outcome) (adjusted mean difference - 7...
January 3, 2018: International Journal of Public Health
https://www.readbyqxmd.com/read/29288620/assessing-emergency-department-utilization-in-the-era-of-population-health
#8
EDITORIAL
Jesse D Schold, Jayme E Locke
Population health has been broadly defined as "health outcomes of a group of individuals, including the distribution of such outcomes within the group." (1) Increasingly, population health has gained prominence and impact with emergence of Accountable Care Organizations that serve populations across transitions of care and different providers (often extended to communities). Population health has also been a focus of healthcare reform and development of policies and interventions aimed at simultaneously improving quality and reducing costs...
December 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29276115/the-cost-effectiveness-of-total-hip-arthroplasty-in-patients-80-years-of-age-and-older
#9
Samuel T Kunkel, Matthew J Sabatino, Ravinder Kang, David S Jevsevar, Wayne E Moschetti
BACKGROUND: This study investigates the cost-effectiveness of total hip arthroplasty (THA) in patients 80 years old. METHODS: A Markov, state-transition model projecting lifetime costs and quality-adjusted life years (QALYs) was constructed to determine cost-effectiveness from a societal perspective. Costs (in 2016 US dollars), health state utilities, and state transition probabilities were obtained from published literature. Primary outcome was incremental cost-effectiveness ratio, with a willingness-to-pay threshold of $100,000/QALY...
December 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29274725/geographic-region-and-profit-status-drive-variation-in-hospital-readmission-outcomes-among-inpatient-rehabilitation-facilities-in-the-united-states
#10
Laura Coots Daras, Melvin J Ingber, Anne Deutsch, Jennifer Gaudet Hefele, Jennifer Perloff
OBJECTIVE: To examine whether there are differences in inpatient rehabilitation facilities (IRFs') all-cause, 30-day post-discharge hospital readmission rates by organizational characteristics and geographic regions. DESIGN: Observational study. SETTING AND PARTICIPANTS: We analyzed Medicare claims and administrative data sources for Medicare fee-for-service beneficiaries discharged from all IRFs nationally (N=1,166) in 2013 and 2014. MAIN OUTCOME MEASURE: We applied specifications for an existing quality measure adopted by CMS for public reporting that assesses all-cause unplanned hospital readmissions for 30 days post-discharge from inpatient rehabilitation...
December 21, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29273573/medication-adherence-and-technology-based-interventions-for-adolescents-with-chronic-health-conditions-a-few-key-considerations
#11
Sherif M Badawy, Alexis A Thompson, Lisa M Kuhns
The number of children and adolescents with chronic health conditions (CHCs) has doubled over the past two decades. Medication adherence is a key component of disease management within these groups. Low adherence to prescribed medications is a known problem in adolescents with CHCs and is related to health outcomes, including quality of life, disease complications, and mortality. Adolescence is a critical time to create routines and health behaviors that optimize disease self-management and transition to adult care...
December 22, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29246224/optimizing-clinical-and-organizational-practice-in-cancer-survivor-transitions-between-specialized-oncology-and-primary-care-teams-a-realist-evaluation-of-multiple-case-studies
#12
Dominique Tremblay, Catherine Prady, Karine Bilodeau, Nassera Touati, Maud-Christine Chouinard, Martin Fortin, Isabelle Gaboury, Jean Rodrigue, Marie-France L'Italien
BACKGROUND: Cancer is now viewed as a chronic disease, presenting challenges to follow-up and survivorship care. Models to shift from haphazard, suboptimal and fragmented episodes of care to an integrated cancer care continuum must be developed, tested and implemented. Numerous studies demonstrate improved care when follow-up is assured by both oncology and primary care providers rather than either group alone. However, there is little data on the roles assumed by specialized oncology teams and primary care providers and the extent to which they work together...
December 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29243559/multiplicity-and-mutuality-in-the-transition-of-patient-and-therapist-s-self-states-comparison-of-good-vs-poor-outcome-groups
#13
Nehama Hacohen, Dana Atzil-Slonim, Rivka Tuval-Mashiach, Eran Bar-Kalifa, Hadar Fisher
OBJECTIVE: According to the Assimilation Model, the self is consisted of multiple internal voices which are sometimes conflicted, or even dissociated, from one another. Thus, a key therapeutic goal is to create awareness and dialogue between a patient's various internal voices, in order to facilitate positive change. A recent development of this theoretical line suggests that clinically addressing both the patients' and therapists' internal voices, and their mutual influences, contributes significantly to the treatment outcome...
December 15, 2017: Psychotherapy Research: Journal of the Society for Psychotherapy Research
https://www.readbyqxmd.com/read/29243347/cost-effectiveness-of-increasing-the-reach-of-smoking-cessation-interventions-in-germany-results-from-the-equiptmod
#14
Manuel B Huber, Maximilian Präger, Kathryn Coyle, Doug Coyle, Adam Lester-George, Marta Trapero-Bertran, Bertalan Nemeth, Kei Long Cheung, Renee Stark, Matthias Vogl, Subhash Pokhrel, Reiner Leidl
AIMS: To evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany. DESIGN: A Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates...
December 15, 2017: Addiction
https://www.readbyqxmd.com/read/29227175/effects-of-28-day-bifidobacterium-animalis-subsp-lactis-hn019-supplementation-on-colonic-transit-time-and-gastrointestinal-symptoms-in-adults-with-functional-constipation-a-double-blind-randomized-placebo-controlled-and-dose-ranging-trial
#15
Alvin Ibarra, Mathilde Latreille-Barbier, Yves Donazzolo, Xavier Pelletier, Arthur C Ouwehand
Bifidobacterium animalis subsp. lactis HN019 (HN019) ameliorates chronic idiopathic constipation. Our aim was to determine the efficacy and safety of 28-day supplementation with 1 × 109 or 1 × 1010 CFU of HN019/day for constipation. A total of 228 adults who were diagnosed with functional constipation according to the Rome III criteria were randomized in a double-blind and placebo-controlled trial. Colonic transit time (CTT), the primary outcome, and secondary outcomes that were measured using inventories-patient assessment of constipation symptoms (PAC-SYM) and quality of life (PAC-QoL), bowel function index (BFI), bowel movement frequency (BMF), stool consistency, degree of straining, bowel emptying, bloating, and pain severity-were assessed...
December 11, 2017: Gut Microbes
https://www.readbyqxmd.com/read/29223006/the-temple-star-transitional-model-of-care-for-epilepsy-the-outcome-of-a-quality-improvement-project
#16
Suzanne L Crowley, Susan Byrne, Sandra McNulty, Kim Keating, Therese Nestor, Yvonne Owen, Declan O'Rourke, Bryan Lynch, Amre Shahwan, Mary D King
OBJECTIVE: The aim and objective of this study was to assess the knowledge and views of parents on transitional and adolescent care in young adults with epilepsy, and to develop a transitional and adolescent program for epilepsy. METHODS: Data were collected from questionnaires completed by parents during focus groups exploring transitional care and inherent issues for young adults, aged 12-18years, with epilepsy. The questionnaire assessed the current knowledge and views of parents of children with epilepsy on transitional care, and following a presentation on "Transition in Epilepsy" (including themes such as self-advocacy, independent healthcare behavior, sexual health, psychosocial support, educational and vocational planning, health and lifestyle issues) assessed feedback on the proposed model of care in transitional and adolescent care...
December 6, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29222670/venetoclax-for-treating-chronic-lymphocytic-leukaemia-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#17
REVIEW
Hema Mistry, Chidozie Nduka, Martin Connock, Jill Colquitt, Theodoros Mantopoulos, Emma Loveman, Renata Walewska, James Mason
Venetoclax is licensed to treat relapsed or refractory (R/R) chronic lymphocytic leukaemia (CLL). As part of the Single Technology Appraisal (STA) ID944, the National Institute for Health and Care Excellence (NICE) invited AbbVie, the manufacturer, to submit evidence on the use of venetoclax, within its licensed indication. The Evidence Review Group (ERG), Warwick Evidence, was asked to provide an independent and critical review of the submitted evidence. Evidence came from three single-arm trials in CLL patients with or without 17p deletion [del(17p])/TP53 chromosomal abnormalities...
December 8, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29210031/adjuvant-statin-therapy-for-esophageal-adenocarcinoma-a-cost-utility-analysis
#18
Rebekah Fong Soe Khioe, Chris Skedgel, Andrew Hart, Michael Philip Nelson Lewis, Leo Alexandre
BACKGROUND: Emerging preclinical evidence indicates statins, medications commonly used in the prevention of cardiovascular disease (CVD), inhibit proliferation, promote apoptosis and limit invasiveness of esophageal adenocarcinoma (EAC). Population-based observational data demonstrate statin treatment after diagnosis of EAC is associated with significant reductions in all-cause and cancer-specific mortality. A feasibility study of adjuvant statin therapy following potentially curative resection for EAC has been completed, with planned progression to a full phase III, randomized controlled trial...
December 5, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29209274/optimizing-patient-management-and-adherence-for-children-receiving-growth-hormone
#19
Carlo L Acerini, Katarzyna Wac, Peter Bang, Dagmar Lehwalder
Poor adherence with growth hormone (GH) therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The "360° GH in Europe" meeting, held in Lisbon, Portugal, in June 2016 and funded by Merck KGaA (Germany), examined many aspects of GH diseases. The three sessions, entitled "Short Stature Diagnosis and Referral," "Optimizing Patient Management," and "Managing Transition," each benefited from three guest speaker presentations, followed by an open discussion and are reported as a manuscript, authored by the speakers...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29208447/impact-of-advanced-practice-registered-nurses-on-quality-measures-the-missouri-quality-initiative-experience
#20
Marilyn J Rantz, Lori Popejoy, Amy Vogelsmeier, Colleen Galambos, Greg Alexander, Marcia Flesner, Cathy Murray, Charles Crecelius, Bin Ge, Gregory Petroski
PURPOSE: The purpose of this article is to review the impact of advanced practice registered nurses (APRNs) on the quality measure (QM) scores of the 16 participating nursing homes of the Missouri Quality Initiative (MOQI) intervention. The MOQI was one of 7 program sites in the US, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services Innovations Center. While the goals of the MOQI for long-stay nursing home residents did not specifically include improvement of the QM scores, it was anticipated that improvement most likely would occur...
December 2, 2017: Journal of the American Medical Directors Association
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