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Transitions of care

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https://www.readbyqxmd.com/read/28226652/early-warnings-of-heart-rate-deterioration
#1
Vania G Almeida, Ian T Nabney, Vania G Almeida, Ian T Nabney, Ian T Nabney, Vania G Almeida
Hospitals can experience difficulty in detecting and responding to early signs of patient deterioration leading to late intensive care referrals, excess mortality and morbidity, and increased hospital costs. Our study aims to explore potential indicators of physiological deterioration by the analysis of vital-signs. The dataset used comprises heart rate (HR) measurements from MIMIC II waveform database, taken from six patients admitted to the Intensive Care Unit (ICU) and diagnosed with severe sepsis. Different indicators were considered: 1) generic early warning indicators used in ecosystems analysis (autocorrelation at-1-lag (ACF1), standard deviation (SD), skewness, kurtosis and heteroskedasticity) and 2) entropy analysis (kernel entropy and multi scale entropy)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226421/opening-plenary-speaker-human-genomics-precision-medicine-and-advancing-human-health
#2
Eric D Green
Starting with the launch of the Human Genome Project in 1990, the past quarter-century has brought spectacular achievements in genomics that dramatically empower the study of human biology and disease. The human genomics enterprise is now in the midst of an important transition, as the growing foundation of genomic knowledge is being used by researchers and clinicians to tackle increasingly complex problems in biomedicine. Of particular prominence is the use of revolutionary new DNA sequencing technologies for generating prodigious amounts of DNA sequence data to elucidate the complexities of genome structure, function, and evolution, as well as to unravel the genomic bases of rare and common diseases...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225049/prevalence-and-predictors-of-weight-change-post-discharge-from-hospital-a-study-of-the-canadian-malnutrition-task-force
#3
H Keller, M Laporte, H Payette, J Allard, P Bernier, D Duerksen, L Gramlich, K Jeejeebhoy
BACKGROUND/OBJECTIVES: Little is known about factors associated with weight change post discharge from hospital; yet poor nutritional status in the transition from hospital to community can result in readmission. This exploratory study aimed to determine the factors associated with weight change 30 days post discharge defined as weight gain (WG; 5+ pounds), weight loss (WL; 5+pounds) or weight stable (WS). SUBJECTS/METHODS: A total of 922 medical or surgical patients were recruited from 16 acute care hospitals in 8 Canadian provinces...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28224276/preparedness-and-cancer-related-symptom-management-among-cancer-survivors-in-the-first-year-post-treatment
#4
Corinne R Leach, Alyssa N Troeschel, Dawn Wiatrek, Annette L Stanton, Michael Diefenbach, Kevin D Stein, Katherine Sharpe, Kenneth Portier
BACKGROUND: Many cancer survivors feel unprepared for the physical and psychosocial challenges that accompany the post-treatment care transition (i.e., re-entry phase), including management of cancer-related symptoms. Few studies have investigated personal and contextual factors associated with the extent of preparedness for re-entry or how they are related to cancer-related symptom management. PURPOSE: Data from the American Cancer Society's Cancer Survivor Transition Study examined (1) characteristics of breast, prostate, and colorectal cancer survivors (n = 1188) within the first year of completing treatment who are most and least prepared for re-entry; and (2) how preparedness level and other characteristics are related to cancer-related symptom management...
February 21, 2017: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/28223862/whose-responsibility-is-medication-reconciliation-physicians-pharmacists-or-nurses-a-survey-in-an-academic-tertiary-care-hospital
#5
Amna Al-Hashar, Ibrahim Al-Zakwani, Tommy Eriksson, Mohammed Al Za'abi
Background: Medication errors occur frequently at transitions in care and can result in morbidity and mortality. Medication reconciliation is a recognized hospital accreditation requirement and designed to limit errors in transitions in care. Objectives: To identify beliefs, perceived roles and responsibilities of physicians, pharmacists and nurses prior to the implementation of a standardized medication reconciliation process. Methods: A survey was distributed to the three professions: pharmacists in the pharmacy and physicians and nurses in hospital in-patient units...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28223372/perspectives-of-low-socioeconomic-status-mothers-of-premature-infants
#6
Elizabeth Enlow, Laura J Faherty, Sara Wallace-Keeshen, Ashley E Martin, Judy A Shea, Scott A Lorch
BACKGROUND AND OBJECTIVES: Transitioning premature infants from the NICU to home is a high-risk period with potential for compromised care. Parental stress is high, and families of low socioeconomic status may face additional challenges. Home visiting programs have been used to help this transition, with mixed success. We sought to understand the experiences of at-risk families during this transition to inform interventions. METHODS: Mothers of infants born at <35 weeks' gestation, meeting low socioeconomic status criteria, were interviewed by telephone 30 days after discharge to assess caregiver experiences of discharge and perceptions of home visitors (HVs)...
February 21, 2017: Pediatrics
https://www.readbyqxmd.com/read/28222271/pathways-to-lung-cancer-diagnosis-a-qualitative-study-of-patients-and-general-practitioners-about-diagnostic-and-pre-treatment-intervals
#7
Nicole M Rankin, Sarah York, Emily Stone, David Barnes, Deborah McGregor, Michelle Lai, Tim Shaw, Phyllis N Butow
RATIONALE: Pathways to lung cancer diagnosis and treatment are complex. International evidence shows significant variations in pathways. Qualitative research investigating pathways to lung cancer diagnosis rarely considers both patient and general practitioner views simultaneously. OBJECTIVES: To describe the lung cancer diagnostic pathway, focusing on the perspective of patients and general practitioners about diagnostic and pre-treatment intervals. METHODS: This qualitative study of lung cancer patients and general practitioners in Australia used qualitative interviews or a focus group in which participants responded to a semistructured questionnaire designed to explore experiences of the diagnostic pathway...
February 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28220340/preventing-youth-from-falling-through-the-cracks-between-child-adolescent-and-adult-mental-health-services-a-systematic-review-of-models-of-care
#8
Tram Nguyen, Mark G Embrett, Neil G Barr, Gillian M Mulvale, Diana K Vania, Glen E Randall, Briano DiRezze
Optimizing the transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) is a priority for healthcare systems. The purpose of this systematic review is to: (1) identify and compare models of care that may be used to facilitate the transition from CAMHS to AMHS; and (2) discuss trends and implications to inform future research and practice. Results identified three models of care which move beyond healthcare services and incorporate a broader range of services that better meet the dynamic needs of transition-aged youth...
February 20, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28219846/changing-caregiving-relationships-for-older-home-based-chinese-people-in-a-transitional-stage-trends-factors-and-policy-implications
#9
Lijuan Gu, Mark W Rosenberg, Juxin Zeng
BACKGROUND: In the transitional stage of socioeconomic development, the traditional practice of home-based care in China is being tested. The evolution and factors of home-based care utilization are the prerequisites for the formulation of a support policy. However, no extant research has studied home-based elder care on a national scale. AIM: This paper aims to examine changing caregiving relationships nationwide for home-based elderly individuals and investigate the changing factors of care utilization in a ten-year period, with special attention to the effects of "location" on care patterns...
February 11, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28219776/deactivation-in-the-posterior-mid-cingulate-cortex-reflects-perceptual-transitions-during-binocular-rivalry-evidence-from-simultaneous-eeg-fmri
#10
Abhrajeet Roy, Keith Jamison, Sheng He, Steve Engel, Bin He
Binocular rivalry is a phenomenon in which perception spontaneously shifts between two different images that are dichoptically presented to the viewer. By elucidating the cortical networks responsible for these stochastic fluctuations in perception, we can potentially learn much about the neural correlates of visual awareness. We obtained concurrent EEG-fMRI data for a group of 20 healthy human subjects during the continuous presentation of dichoptic visual stimuli. The two eyes' images were tagged with different temporal frequencies so that eye specific steady-state visual evoked potential (SSVEP) signals could be extracted from the EEG data for direct comparison with changes in fMRI BOLD activity associated with binocular rivalry...
February 17, 2017: NeuroImage
https://www.readbyqxmd.com/read/28219383/the-alice-springs-hospital-readmission-prevention-project-ashrapp-a-randomised-control-trial
#11
Gabrielle Diplock, James Ward, Simon Stewart, Paul Scuffham, Penny Stewart, Carole Reeve, Lea Davidson, Graeme Maguire
BACKGROUND: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28214431/simulation-in-undergraduate-paediatric-nursing-curriculum-evaluation-of-a-complex-ward-for-a-day-education-program
#12
Andree S Gamble
Simulation in health education has been shown to increase confidence, psychomotor and professional skills, and thus positively impact on student preparedness for clinical placement. It is recognised as a valuable tool to expose and engage students in realistic patient care encounters without the potential to cause patient harm. Although inherent challenges exist in the development and implementation of simulation, variability in clinical placement time, availability and quality dictates the need to provide students with learning opportunities they may otherwise not experience...
February 4, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28214043/-i-just-want-to-be-normal-a-qualitative-study-of-pregnant-women-s-blogs-who-present-themselves-as-overweight-or-obese
#13
Lovisa Lingetun, Madicken Fungbrant, Ing-Marie Claesson, Christina Baggens
OBJECTIVE: to describe what pregnant women who present themselves as overweight or obese write about their pregnancy in their blogs. SETTING: Swedish private blogs. DESIGN: a qualitative study, using 13 Internet blogs as the source of data. Google was used to find the blogs. The blog content was analysed using thematic analysis. FINDINGS: three main themes were identified: Pregnancy as an excuse, Perspectives on the pregnant body and Becoming a mother...
January 31, 2017: Midwifery
https://www.readbyqxmd.com/read/28213305/risk-of-suicide-according-to-the-level-of-psychiatric-contact-in-the-older-people-analysis-of-national-health-insurance-databases-in-taiwan
#14
Shin-Ting Yeh, Yee-Yung Ng, Shiao-Chi Wu
PURPOSE: Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. METHODS: A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence...
February 1, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28212967/decision-making-on-medical-innovations-in-a-changing-health-care-environment-insights-from-accountable-care-organizations-and-payers-on-personalized-medicine-and-other-technologies
#15
Julia R Trosman, Christine B Weldon, Michael P Douglas, Patricia A Deverka, John B Watkins, Kathryn A Phillips
BACKGROUND: New payment and care organization approaches, such as those of accountable care organizations (ACOs), are reshaping accountability and shifting risk, as well as decision making, from payers to providers, within the Triple Aim context of health reform. The Triple Aim calls for improving experience of care, improving health of populations, and reducing health care costs. OBJECTIVES: To understand how the transition to the ACO model impacts decision making on adoption and use of innovative technologies in the era of accelerating scientific advancement of personalized medicine and other innovations...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212167/the-varying-roles-of-nurses-during-interfacility-care-transitions
#16
Lianne Jeffs, Marianne Saragosa, Madelyn Law, Kerry Kuluski, Sherry Espin, Heidi Parker, Kristen Collins
This study explored health care professionals' perceptions and experiences associated with the role of point-of-care nurses during care transitions from an acute care hospital to a rehabilitation setting to being discharged home. We used a qualitative exploratory design and semistructured interviews. Content analysis revealed 3 themes that point to the ambiguity related to the roles that nurses enact with older patients during care transitions. We suggest ways to better support nurses to engage in quality care transitions...
February 15, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28209746/a-phase-ii-randomized-trial-go27827-of-first-line-folfox-plus-bevacizumab-with-or-without-the-met-inhibitor-onartuzumab-in-patients-with-metastatic-colorectal-cancer
#17
Johanna C Bendell, Howard Hochster, Lowell L Hart, Irfan Firdaus, Joseph R Mace, Joshua J McFarlane, Mark Kozloff, Daniel Catenacci, Jessie J Hsu, Stephen P Hack, David S Shames, See-Chun Phan, Hartmut Koeppen, Allen L Cohn
BACKGROUND: Dysregulated hepatocyte growth factor/mesenchymal-epithelial transition (MET) signaling is associated with poor prognosis and resistance to vascular endothelial growth factor inhibition in metastatic colorectal cancer (mCRC). We report outcomes from a double-blind, multicenter phase II trial of the MET inhibitor onartuzumab in combination with mFOLFOX-6 and bevacizumab for mCRC (GO27827; NCT01418222). MATERIALS AND METHODS: Patients were randomized 1:1 to receive onartuzumab (10 mg/kg intravenously [IV]) or placebo plus mFOLFOX-6 and bevacizumab (5 mg/kg IV)...
February 16, 2017: Oncologist
https://www.readbyqxmd.com/read/28209071/collaboration-between-primary-care-physicians-and-radiation-oncologists
#18
Elizabeth A Barnes, Edward Chow, Cyril Danjoux, May Tsao
Communication between physicians is required to ensure important patient information is relayed during the workup, treatment, follow-up and subsequent transition of care back to the primary care physician (PCP). In this review we discuss how survivorship care is being increasingly recognized as an important component of the patient's cancer journey, and one often provided by the PCP. Palliative care and symptom control for patients with non-curable malignancy is often provided by the PCP during and after cancer treatment...
January 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28208610/non-emergency-medical-transportation-needs-of-middle-aged-and-older-adults-a-rural-urban-comparison-in-delaware-usa
#19
Matthew Lee Smith, Thomas R Prohaska, Kara E MacLeod, Marcia G Ory, Amy R Eisenstein, David R Ragland, Cheryl Irmiter, Samuel D Towne, William A Satariano
Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30...
February 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28207601/advanced-monitoring-in-traumatic-brain-injury-microdialysis
#20
Keri L H Carpenter, Adam M H Young, Peter J Hutchinson
PURPOSE OF REVIEW: Here, we review the present state-of-the-art of microdialysis for monitoring patients with severe traumatic brain injury, highlighting the newest developments. Microdialysis has evolved in neurocritical care to become an established bedside monitoring modality that can reveal unique information on brain chemistry. RECENT FINDINGS: A major advance is recent consensus guidelines for microdialysis use and interpretation. Other advances include insight obtained from microdialysis into the complex, interlinked traumatic brain injury disorders of electrophysiological changes, white matter injury, inflammation and metabolism...
February 14, 2017: Current Opinion in Critical Care
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