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Transition, quality, outcomes

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https://www.readbyqxmd.com/read/29139209/protocol-for-a-new-concept-of-no-prep-ultrathin-ceramic-veneers
#1
Camillo D'Arcangelo, Mirco Vadini, Maurizio D'Amario, Zaccheo Chiavaroli, Francesco De Angelis
OBJECTIVES: No-prep veneers, although ideally considered the best option because of tooth structure maximum preservation, have been frequently criticized for some potential limitations including esthetic outcomes and periodontal complications. CLINICAL CONSIDERATIONS: A new protocol to optimize no-prep veneers restorations is presented. A key point of the proposed technique is to identify optimal margins' positions: margin is positioned in the point of maximum convexity of teeth, avoiding the over contouring of traditional no-prep veneers...
November 15, 2017: Journal of Esthetic and Restorative Dentistry
https://www.readbyqxmd.com/read/29135717/traditional-versus-hybrid-outpatient-cardiac-rehabilitation-a-comparison-of-patient-outcomes
#2
Jacqueline Gabelhouse, Neil Eves, Sherry L Grace, R Colin Reid, Cristina M Caperchione
PURPOSE: Due to the suboptimal uptake of cardiac rehabilitation (CR), alternative models have been proposed. This study compared the effectiveness of a traditional supervised program in a medical setting versus a hybrid CR model, where patients transition to unsupervised programming. METHODS: This was a prospective, 2-arm, nonrandomized study. Health-related quality of life (HRQoL), functional capacity, physical activity, diet, smoking, blood pressure, lipids, blood glucose, anthropometrics, and depressive symptoms were assessed before and after the 8-week program models...
November 9, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#3
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29123661/the-psychology-of-chronic-post-surgical-pain-new-frontiers-in-risk-factor-identification-prevention-and-management
#4
Aliza Z Weinrib, Muhammad A Azam, Kathryn A Birnie, Lindsay C Burns, Hance Clarke, Joel Katz
In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29120010/innovative-transition-interventions-to-better-align-healthcare-needs-in-hospitalised-medical-patients
#5
Alexander Kutz, Fahim Ebrahimi, Tristan Struja, Jeffrey Greenwald, Philipp Schuetz, Beat Mueller
Understanding how best to manage the complex healthcare needs of hospitalised, mostly multimorbid medical patients is an international priority. Healthcare should be effective, safe and provide high quality at a reasonable cost. However, basic logistic and organisational issues of medical ward-based care have received less attention than the medical treatment of specific pathologies. Consequently, we still use old-fashioned care and transition procedures for medical inpatients. This contrasts with dynamic developments in other, non-healthcare industries, where process optimisation is a major part of innovation...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29119815/improving-transition-to-adult-healthcare-for-young-people-with-cystic-fibrosis-a-systematic-review
#6
Imelda Coyne, Aisling M Sheehan, Emily Heery, Alison E While
As survival increases worldwide, large numbers of young people will need to transition from child to adult cystic fibrosis (CF) services. Little is known about the best method for transitioning patients with CF and which transition programmes yield better outcomes. This paper provides a systematic review of the empirical literature on the outcomes and experiences of transition for young people with CF. Outcomes data were subject to a narrative synthesis and a thematic synthesis of experiences data. Structured transition programmes were associated with increased satisfaction, discussions about transition, self-care and self-advocacy skills, more independence, lower anxiety, and increased self-management and parent management of physiotherapy and nutritional supplementation...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29111810/new-outcome-measures-in-perioperative-care
#7
Tom Salih, Hoon Ying Lau, S Ramani Moonesinghe
Improvements in outcome measurement are needed to produce quality improvement in perioperative care. However, problems with the collection and use of outcome data persist in research and clinical practice. This is being addressed by several national programmes and initiatives to standardize and integrate outcome measurement. The use of different outcome measures is changing and there has been a transition towards patient-focused measures. Traditional measures of quality in perioperative care include mortality, morbidity and resource utilization measures...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29111690/aerosol-health-effects-from-molecular-to-global-scales
#8
Manabu Shiraiwa, Kayo Ueda, Andrea Pozzer, Gerhard Lammel, Christopher J Kampf, Akihiro Fushimi, Shinichi Enami, Andrea M Arangio, Janine Fröhlich-Nowoisky, Yuji Fujitani, Akiko Furuyama, Pascale Sylvie Jeanne Lakey, Jos Lelieveld, Kurt Lucas, Yu Morino, Ulrich Pöschl, Satoshi Takahama, Akinori Takami, Haijie Tong, Bettina Weber, Ayako Yoshino, Kei Sato
Poor air quality is the globally largest environmental health risk. Epidemiological studies have uncovered clear relationships of gaseous pollutants and particulate matter (PM) with adverse health outcomes, including mortality by cardiovascular and respiratory diseases. Studies of health impacts by aerosols are highly multidisciplinary with a broad range of scales in space and time. We assess recent advances and future challenges regarding aerosol effects on health from molecular to global scales, through epidemiological studies, field measurements, health-related properties of PM, and multiphase interactions of oxidants and PM upon respiratory deposition...
November 7, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/29097058/the-quality-of-discharge-care-planning-in-acute-stroke-care-influencing-factors-and-association-with-postdischarge-outcomes
#9
Nadine E Andrew, Doreen Busingye, Natasha A Lannin, Monique F Kilkenny, Dominique A Cadilhac
BACKGROUND: Comprehensive discharge planning is important for successful transitions from hospital to home after stroke. The aim of this study was to describe the quality of discharge planning received by patients discharged home from acute care, identify factors associated with a positive discharge experience, and assess the influence of discharge quality on outcomes. METHOD: Patients discharged to the community and registered in the Australian Stroke Clinical Registry in 2014 were invited to participate...
October 30, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29095705/transitioning-to-a-high-value-health-care-model-academic-accountability
#10
Pamela T Johnson, Matthew D Alvin, Roy C Ziegelstein
Health care spending in the United States has increased to unprecedented levels, and these costs have broken medical providers' promise to do no harm. Medical debt is the leading contributor to U.S. personal bankruptcy, more than 50% of household foreclosures are secondary to medical debt and illness, and patients are choosing to avoid necessary care because of its cost. Evidence that the health care delivery model is contributing to patient hardship is a call for action to the profession to transition to a high value model, one that delivers the highest health care quality and safety at the lowest personal and financial cost to patients...
November 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29089795/effects-of-the-community-based-wellspring-cancer-exercise-program-on-functional-and-psychosocial-outcomes-in-cancer-survivors
#11
D Santa Mina, D Au, J Brunet, J Jones, G Tomlinson, N Taback, D Field, A Berlingeri, H Bradley, D Howell
PURPOSE: In this study, we examined the effects of a 30-week community-based exercise program on cancer-related fatigue, quality of life, and other health-related outcomes in a sample of adults with mixed cancer diagnoses. METHODS: This prospective cohort study looked at outcomes for participants involved in the Wellspring Cancer Exercise Program in southern Ontario. The program consisted of an initial phase of two supervised sessions weekly for 10 weeks and a transition phase of one supervised session weekly for the subsequent 20 weeks...
October 2017: Current Oncology
https://www.readbyqxmd.com/read/29082488/guidelines-for-microplate-selection-in-high-content-imaging
#12
Oscar J Trask
Since the inception of commercialized automated high content screening (HCS) imaging devices in the mid to late 1990s, the adoption of media vessels typically used to house and contain biological specimens for interrogation has transitioned from microscope slides and petri dishes into multi-well microtiter plates called microplates. The early 96- and 384-well microplates commonly used in other high-throughput screening (HTS) technology applications were often not designed for optical imaging. Since then, modifications and the use of next-generation materials with improved optical clarity have enhanced the quality of captured images, reduced autofocusing failures, and empowered the use of higher power magnification objectives to resolve fine detailed measurements at the subcellular pixel level...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29082460/implementation-of-an-it-guided-checklist-to-improve-the-quality-of-medication-history-records-at-hospital-admission
#13
Tanja Huber, Franziska Brinkmann, Silke Lim, Christoph Schröder, Daniel Johannes Stekhoven, Walter Richard Marti, Richard Robert Egger
Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital...
October 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29081667/cost-effectiveness-of-vedolizumab-compared-with-conventional-therapy-for-ulcerative-colitis-patients-in-the-uk
#14
Michele R Wilson, Ismail Azzabi Zouraq, Helene Chevrou-Severac, Ross Selby, Matthew C Kerrigan
OBJECTIVE: To examine the clinical and economic impact of vedolizumab compared with conventional therapy in the treatment of moderately-to-severely active ulcerative colitis (UC) in the UK based on results of the GEMINI I trial. METHODS: A decision-analytic model in Microsoft Excel was used to compare vedolizumab with conventional therapy (aminosalicylates, corticosteroids, immunomodulators) for the treatment of patients with UC in the UK. We considered the following three populations: the overall intent-to-treat population from the GEMINI I trial, patients naïve to anti-TNF therapy, and those who had failed anti-TNF-therapy...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29079605/cost-effectiveness-of-the-faecal-immunochemical-test-at-a-range-of-positivity-thresholds-compared-with-the-guaiac-faecal-occult-blood-test-in-the-nhs-bowel-cancer-screening-programme-in-england
#15
Jacqueline Murphy, Stephen Halloran, Alastair Gray
OBJECTIVES: Through the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP), men and women in England aged between 60 and 74 years are invited for colorectal cancer (CRC) screening every 2 years using the guaiac faecal occult blood test (gFOBT). The aim of this analysis was to estimate the cost-utility of the faecal immunochemical test for haemoglobin (FIT) compared with gFOBT for a cohort beginning screening aged 60 years at a range of FIT positivity thresholds. DESIGN: We constructed a cohort-based Markov state transition model of CRC disease progression and screening...
October 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/29079603/combination-of-obstructive-sleep-apnoea-and-insomnia-treated-by-continuous-positive-airway-pressure-with-the-sensawake-pressure-relief-technology-to-assist-sleep-a-randomised-cross-over-trial-protocol
#16
Jean Louis Pepin, Frédéric Gagnadoux, Alison Foote, Rachel Vicars, Bhavi Ogra, Véronique Viot-Blanc, Meriem Benmerad, Marie-Pia D'Ortho, Renaud Tamisier
INTRODUCTION: Obstructive sleep apnoea (OSA) is a common sleep breathing disorder affecting up to 17% of the middle-aged population. Continuous positive airway pressure (CPAP) is the primary treatment for patients with OSA, but acceptance and adherence to therapy is suboptimal in specific subgroups particularly those with insomnia or poor sleep quality (40%-80% of patients with OSA). Pressure intolerance, particularly during periods of wakefulness, inhibiting sleep onset or return to sleep, is one reason for poor CPAP adherence...
October 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/29078618/transition-from-video-assisted-thoracic-surgery-to-robotic-pulmonary-surgery
#17
REVIEW
Takashi Suda
The "da Vinci Surgical System" is a robotic surgical system that utilizes multi-jointed robotic arms and a high-resolution three-dimensional video-monitoring system. We report on the state of transition from video-assisted thoracoscopic surgery (VATS) to robotic pulmonary surgery, the surgical outcomes of robotic surgery compared to VATS, and the future of robotic surgery. Surgery utilizing the da Vinci Surgical System requires a console surgeon and assistant who have been certified by Intuitive Surgical, Inc...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29069110/vortioxetine-for-major-depressive-disorder-vasomotor-and-cognitive-symptoms-associated-with-the-menopausal-transition
#18
Marlene P Freeman, Laura J Cheng, Danna Moustafa, Abigail Davies, Alexandra Z Sosinsky, Betty Wang, Laura F Petrillo, Charlotte Hogan, Lee S Cohen
BACKGROUND: In a preliminary trial, we assessed the efficacy of vortioxetine for major depressive disorder (MDD) during the menopausal transition. Secondary outcomes included hot flashes (HFs), anxiety, and cognitive complaints. METHODS: Perimenopausal and early postmenopausal women with MDD (N = 27) received 8 weeks of open-label, flexible-dose treatment with vortioxetine. The Montgomery-Åsberg Depression Rating Scale (MADRS) was the primary outcome measure. Secondary measures included: HF frequency, the Greene Climacteric Scale (GCS), Menopause-Specific Quality of Life Questionnaire (MEN-QOL), Beck Anxiety Inventory (BAI), Cognitive and Physical Functioning Questionnaire (CPFQ), Digit Symbol Substitution Test (DSST), and Cogstate testing...
November 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/29068784/predictors-of-posthospital-transitions-of-care-in-patients-with-advanced-cancer
#19
Daniel E Lage, Ryan D Nipp, Sara M D'Arpino, Samantha M Moran, P Connor Johnson, Risa L Wong, William F Pirl, Ephraim P Hochberg, Lara N Traeger, Vicki A Jackson, Barbara J Cashavelly, Holly S Martinson, Joseph A Greer, David P Ryan, Jennifer S Temel, Areej El-Jawahri
Purpose Patients with advanced cancer experience potentially burdensome transitions of care after hospitalizations. We examined predictors of discharge location and assessed the relationship between discharge location and survival in this population. Methods We conducted a prospective study of 932 patients with advanced cancer who experienced an unplanned hospitalization between September 2014 and March 2016. Upon admission, we assessed patients' physical symptoms (Edmonton Symptom Assessment System) and psychological distress (Patient Health Questionnaire-4)...
October 25, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29062749/transcatheter-aortic-valve-implantation-in-nonagenarians-selectively-feasible-or-extravagantly-futile
#20
Antonis S Manolis, Antonis A Manolis
A growing number of nonagenarians is recorded as life expectancy increases. Unfortunately, this extreme-aged group is plagued by increased prevalence of aortic stenosis amidst a higher occurrence of comorbidities that pose dilemmas to cardiologists and cardiac surgeons when having to choose a conservative or interventional treatment modality, and a surgical or transcatheter aortic valve implantation (TAVI) approach. TAVI is an expensive procedure, which also confers a higher mortality and morbidity risk in nonagenarians, compared to younger patients...
September 2017: Annals of Cardiothoracic Surgery
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