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https://www.readbyqxmd.com/read/28427925/effect-of-home-and-community-based-physical-activity-interventions-on-physical-function-among-cancer-survivors-a-systematic-review-and-meta-analysis
#1
REVIEW
Maria C Swartz, Zakkoyya H Lewis, Elizabeth J Lyons, Kristofer Jennings, Addie Middleton, Rachel R Deer, Demi Arnold, Kaitlin Dresser, Kenneth J Ottenbacher, James S Goodwin
OBJECTIVE: We reviewed randomized trials to examine the effect of home and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures. DATA SOURCES: Five electronic databases-Medline Ovid, Pubmed, CINAHL, Web of Science, and PsychINFO-were searched from inception to March 2016 for relevant articles. STUDY SELECTION: Search terms included: community-based interventions, physical functioning, and cancer survivors...
April 17, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28426522/patient-safety-culture-survey-in-pediatric-complex-care-settings-a-factor-analysis
#2
Amanda J Hessels, Meghan Murray, Bevin Cohen, Elaine L Larson
OBJECTIVES: Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. METHODS: Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012...
April 19, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28418449/association-of-a-communication-training-program-with-use-of-antipsychotics-in-nursing-homes
#3
Jennifer Tjia, Jacob N Hunnicutt, Laurie Herndon, Carolyn R Blanks, Kate L Lapane, Susan Wehry
Importance: Off-label antipsychotic prescribing in nursing homes (NHs) is common and is associated with increased risk of mortality in older adults. Prior large-scale, controlled trials in the NH setting failed to show meaningful reductions in antipsychotic use. Objective: To quantify the influence of a large-scale communication training program on NH antipsychotic use called OASIS. Design, Setting, and Participants: This investigation was a quasi-experimental longitudinal study of NHs in Massachusetts enrolled in the OASIS intervention...
April 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28413415/effects-of-nursing-home-residency-on-diabetes-care-in-individuals-with-dementia-an-explorative-analysis-based-on-german-claims-data
#4
Larissa Schwarzkopf, Rolf Holle, Michaela Schunk
AIMS: This claims data-based study compares the intensity of diabetes care in community dwellers and nursing home residents with dementia. METHODS: Delivery of diabetes-related medical examinations (DRMEs) was compared via logistic regression in 1,604 community dwellers and 1,010 nursing home residents with dementia. The intra-individual effect of nursing home transfer was evaluated within mixed models. RESULTS: Delivery of DRMEs decreases with increasing care dependency, with more community-living individuals receiving DRMEs...
January 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/28413148/incorporating-site-less-clinical-trials-into-drug-development-a-framework-for-action
#5
Irl B Hirsch, Joe Martinez, E Ray Dorsey, Gerald Finken, Alexander Fleming, Chris Gropp, Philip Home, Daniel I Kaufer, Spyros Papapetropoulos
PURPOSE: Options for leveraging available telemedicine technologies, ranging from simple webcams and telephones to smartphone apps and medical-grade wearable sensors, are evolving faster than the culture of clinical research. Until recently, most clinical trials relied on paper-based processes and technology. This cost- and labor-intensive system, while slowly changing, remains an obstacle to new drug development. Alternatives that use existing tools and processes for collecting real-world data in home settings warrant closer examination...
April 13, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28409703/beyond-screening-a-stepped-care-pathway-for-managing-postpartum-depression-in-pediatric-settings
#6
Su-Chin Serene Olin, Mary McCord, Ruth E K Stein, Bonnie D Kerker, Dara Weiss, Kimberly E Hoagwood, Sarah M Horwitz
The negative consequences of untreated postpartum depression (PD) for both the woman and her infant are well established. The impact of maternal depression has led to recommendations on systematic perinatal depression screening. Unfortunately, large-scale initiatives on PD screening have found no benefit unless systems are in place to facilitate appropriate interventions for women who screen positive. Pediatric primary care has been a focus of efforts to support screening and management of PD because pediatric providers, unlike adult healthcare providers, have the most frequent contact with postpartum women through well-child visits...
April 14, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28408545/reducing-medical-admissions-into-hospital-through-optimising-medicines-remain-home-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#7
Holly Foot, Christopher Freeman, Karla Hemming, Ian Scott, Ian D Coombes, Ian D Williams, Luke Connelly, Jennifer A Whitty, Nancy Sturman, Sue Kirsa, Caroline Nicholson, Grant Russell, Carl Kirkpatrick, Neil Cottrell
INTRODUCTION: A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients. METHODS AND ANALYSIS: This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up...
April 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28407020/mortality-after-out-of-hospital-cardiac-arrest-in-a-spanish-region
#8
Rosa Requena-Morales, Antonio Palazón-Bru, María Mercedes Rizo-Baeza, José Manuel Adsuar-Quesada, Vicente Francisco Gil-Guillén, Ernesto Cortés-Castell
AIMS: To determine out-of-hospital cardiac arrest mortality in the province of Alicante (Spain) and its associated factors. METHODS: Cross-sectional observational study of all patients who received cardiopulmonary resuscitation (CPR) by the Emergency Medical Services (EMS) (n = 422) in the province of Alicante in 2013. To determine associated factors, a binary logistic regression model was constructed. Primary outcome: death before arriving at the hospital. Predictive variables: gender, age, artificial respiration, prior functional status, asystole, cardiogenic aetiology, bystander CPR, time from the cardiac arrest to the arrival of the EMS and location of cardiac arrest...
2017: PloS One
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#9
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28400222/self-reported-health-and-safety-awareness-improves-prediction-of-level-of-care-needs-in-veterans-discharged-from-a-post-acute-unit
#10
Julija Stelmokas, Linas A Bieliauskas, Katherine A Kitchen Andren, Robert Hogikyan, Neil B Alexander
OBJECTIVES: Evaluate the differential value of a self-reported health and safety awareness measure relative to other medical, psychosocial, and cognitive factors in predicting level of care (LOC) needs following hospital discharge. DESIGN: Retrospective medical record review. SETTING: Community Living Center Post-Acute Care (CLC-PAC) unit at a Veterans Affairs (VA) hospital. PARTICIPANTS: 175 Veterans admitted to the VA hospital or directly to the CLC-PAC from home...
April 8, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28399859/sex-differences-in-healthcare-expenditures-among-adults-with-diabetes-evidence-from-the-medical-expenditure-panel-survey-2002-2011
#11
Joni S Williams, Kinfe Bishu, Clara E Dismuke, Leonard E Egede
BACKGROUND: The evidence assessing differences in medical costs between men and women with diabetes living in the United States is sparse; however, evidence suggests women generally have higher healthcare expenditures compared to men. Since little is known about these differences, the aim of this study was to assess differences in out-of-pocket (OOP) and total healthcare expenditures among adults with diabetes. METHODS: Data were used from 20,442 adults (≥18 years of age) with diabetes from the 2002-2011 Medical Expenditure Panel Survey...
April 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28397131/making-a-medical-home-for-ibd-patients
#12
REVIEW
Lawrence R Kosinski, Joel Brill, Miguel Regueiro
PURPOSE OF REVIEW: The transformation from fee for service to fee for value requires structural changes to the way gastroenterologists manage patients with inflammatory bowel disease (IBD). A team-based approach using technology to engage patients is necessary for success. The Patient-Centered Medical Home (PCMH) represents a unique model that brings together these essential features. This paper describes how the PCMH model has been successfully applied to the management of patients with IBD...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28394204/medication-adherence-staying-within-the-boundaries-of-safety
#13
Robin Sue Mickelson, Richard J Holden
An important domain of patient safety is the management of medications in home and community settings by patients and their caregiving network. This study applied human factors/ergonomics theories and methods to data about medication adherence collected from 61 patients with heart failure accompanied by 31 informal caregivers living in the US. Seventy non-adherence events were identified, described, and analysed for performance shaping factors. Half were classified as errors and half as violations. Performance shaping factors included elements of the person or team (e...
April 10, 2017: Ergonomics
https://www.readbyqxmd.com/read/28389998/psychotropic-drug-related-fall-incidents-in-nursing-home-residents-living-in-the-eastern-part-of-the-netherlands
#14
Sarah I M Janus, Gezinus H Reinders, Jeannette G van Manen, Sytse U Zuidema, Maarten J IJzerman
BACKGROUND: Older people are more susceptible to falls than younger people. Therefore, as the Dutch population ages, the total number of falls and costs associated with them will rise. The use of psychotropic drugs is associated with an increased risk of falling. To create tailored fall-prevention programmes, information on the magnitude of the association between fall incidents and specific psychotropic drugs or drug classes is needed. OBJECTIVE: The goal of this study was to delineate the associations between fall incidents and specific psychotropic drugs or drug classes...
April 8, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28387598/patient-experiences-with-care-differ-with-chronic-care-management-in-a-federally-qualified-community-health-center
#15
Claude M Setodji, Denise D Quigley, Marc N Elliott, Q Burkhart, Michael E Hochman, Alex Y Chen, Ron D Hays
This study compares patient experience among practices that vary in adoption of the chronic care management (CCM) dimension of the patient-centered medical home (PCMH) model that focuses on care coordination and management of chronic diseases. Study participants were 2903 adult patients (ages 18 years or older) at 14 primary care centers in California. Seven of the sites were classified as high (more CCM) and the other 7 low on a CCM index. Hypotheses were tested using ordinary least squares regression models...
April 7, 2017: Population Health Management
https://www.readbyqxmd.com/read/28385481/rehabilitation-services-use-and-patient-reported-outcomes-among-older-adults-in-the-united-states
#16
Nancy M Gell, Tracy M Mroz, Kushang V Patel
OBJECTIVES: To characterize rehabilitation service use among community-dwelling older adults in the United States by identifying predictors of rehabilitation utilization, patient-reported functional improvement and rehabilitation goal attainment. DESIGN: Cross-sectional analysis of the 2015 National Health and Aging Trends Study, which used an age-stratified, multistage sampling design and oversampled non-Hispanic Blacks and the oldest old (≥85 years). SETTING: Standardized, in-person home interviews and physical performance testing...
April 3, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28381394/using-smartphones-and-health-apps-to-change-and-manage-health-behaviors-a-population-based-survey
#17
Clemens Ernsting, Stephan U Dombrowski, Monika Oedekoven, Julie L O Sullivan, Melanie Kanzler, Adelheid Kuhlmey, Paul Gellert
BACKGROUND: Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions. OBJECTIVE: The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors...
April 5, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28380701/falls-risks-and-prevention-behaviors-among-community-dwelling-homebound-and-non-homebound-older-adults
#18
Carri Casteel, Jennifer Jones, Paula Gildner, James M Bowling, Susan J Blalock
The objectives were to examine falls risk factors to determine how the magnitude of risk may differ between homebound and non-homebound older adults, and to describe falls prevention behaviors and participation in falls prevention education. A cross-sectional survey was conducted with convenience samples of community-dwelling older adults recruited through Meals on Wheels programs (homebound, n = 80) and senior centers (non-homebound, n = 84) in North Carolina. Data were collected during home visits and included an interview and medication inventory...
October 1, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28372885/the-cost-differential-between-warfarin-versus-aspirin-treatment-after-a-fontan-procedure
#19
Chris Schilling, Kim Dalziel, Ajay J Iyengar, Yves d'Udekem
BACKGROUND: The use of aspirin versus warfarin for treatment of patients after a Fontan procedure remains contentious. Current preference-based models of treatment across Australia and New Zealand show variation in care that is unlikely to reflect patient differences and/or clinical risk. METHODS: We combine data from the Australian and New Zealand Fontan Registry and a home INR (International Normalised Ratio) monitoring program (HINRMP) from the Royal Children's Hospital (RCH) Melbourne, to estimate the cost difference for Fontan recipients receiving aspirin versus warfarin for 2015...
March 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28368550/home-or-foster-home-care-versus-institutional-long-term-care-for-functionally-dependent-older-people
#20
REVIEW
Camilla Young, Amanda M Hall, Daniela C Gonçalves-Bradley, Terry J Quinn, Lotty Hooft, Barbara C van Munster, David J Stott
BACKGROUND: Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. OBJECTIVES: To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people...
April 3, 2017: Cochrane Database of Systematic Reviews
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