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Trajectory of illness

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https://www.readbyqxmd.com/read/29045355/complexity-of-chronic-conditions-impact-on-end-of-life-expense-trajectories-of-medicare-decedents
#1
Suzanne S Sullivan, Junxin Li, Yow-Wu Bill Wu, Sharon Hewner
OBJECTIVE: The aim of this study is to determine if the pattern of monthly medical expense can be used to identify individuals at risk of dying, thus supporting providers in proactively engaging in advanced care planning discussions. BACKGROUND: Identifying the right time to discuss end of life can be difficult. Improved predictive capacity has made it possible for nurse leaders to use large data sets to guide clinical decision making. METHODS: We examined the patterns of monthly medical expense of Medicare beneficiaries with life-limiting illness during the last 24 months of life using analysis of variance, t tests, and stepwise hierarchical linear modeling...
October 17, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29044587/weight-suppression-and-bulimic-syndrome-maintenance-preliminary-findings-for-the-mediating-role-of-leptin
#2
Pamela K Keel, Lindsay P Bodell, Alissa A Haedt-Matt, Diana L Williams, Jonathan Appelbaum
OBJECTIVE: Longitudinal studies support a prospective relationship between weight suppression (WS) and bulimic syndrome (BN-S) maintenance. Although biobehavioral mechanisms have been proposed to explain this link, such mechanisms have yet to be identified. Given that weight loss would reduce leptin levels which may influence eating, this study examined whether reduced leptin levels mediate the link between greater WS and longer illness duration. METHOD: Women (N = 53), ages 18-45 years, were recruited from the community if they met criteria for a BN-S, including either DSM-5 bulimia nervosa (BN; n = 33) or purging disorder (PD: n = 20), and fell within a healthy weight range (18...
October 16, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29035422/the-use-of-telemedicine-and-mobile-technology-to-promote-population-health-and-population-management-for-psychiatric-disorders
#3
REVIEW
Carolyn Turvey, John Fortney
PURPOSE OF REVIEW: This article discusses recent applications in telemedicine to promote the goals of population health and population management for people suffering psychiatric disorders. RECENT FINDINGS: The use of telemedicine to promote collaborative care, self-monitoring and chronic disease management, and population screening has demonstrated broad applicability and effectiveness. Collaborative care using videoconferencing to facilitate mental health specialty consults has demonstrated effectiveness in the treatment of depression, PTSD, and also ADHD in pediatric populations...
October 16, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29033602/early-in-hospital-clinical-deterioration-is-not-predicted-by-severity-of-illness-functional-status-or-comorbidity
#4
Janice Wang, Stella S Hahn, Myriam Kline, Rubin I Cohen
BACKGROUND: Prior studies concentrated on unplanned intensive care unit (ICU) transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT) activation within 48 hours of admission as an index of early clinical worsening. METHODS: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#5
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29027619/-even-heroes-get-depressed-sponsorship-and-self-stigma-in-canada-s-mental-illness-awareness-week
#6
Loren Gaudet
In 1992, the Canadian Psychiatric Association launched Canada's first national campaign against mental illness, Mental Illness Awareness Week (MIAW). I stress that pharmaceutical sponsorship of the first five years of MIAW (1992-1997) was integral to shaping the trajectory of the campaign and marks a shift in the way stigma is conceived and resisted in Canada: what was an interpersonal process based on social norms becomes refigured as "self-stigma," or an individualized process in which lack of information, education, and self-assessment contribute to an inability to consider oneself as at-risk for a disease, condition, or disorder...
October 13, 2017: Journal of Medical Humanities
https://www.readbyqxmd.com/read/29022102/as-if-the-disease-was-not-enough-coping-with-the-financial-consequences-of-cancer
#7
Barbara Head, Lesley Harris, Karen Kayser, Amy Martin, Lisa Smith
PURPOSE: The goal of this research was to understand how cancer survivors cope with the financial consequences of their disease. METHODS: Twenty-six cancer survivors who self-identified as having experienced financial hardship related to their disease were interviewed. Transcripts of these interviews were analyzed using constructivist grounded theory approach. An analysis of codes related to coping strategies was conducted, and findings were stratified based on established coping theories (Lazarus and Folkman and Moos and Holahan) previously applied to coping with serious/chronic illnesses...
October 11, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28992537/what-is-not-but-might-be-the-disnarrated-in-parents-stories-of-their-child-s-cancer-treatment
#8
Cecilia Vindrola-Padros, Eugenia Brage
The study of illness narratives is based on the premise that stories are told for a reason and storytellers make narrative decisions on what to include and leave out of a story, the style of narration, the place where the story is told and the audience. Through this narrative work, they situate themselves in particular ways and make sense of the illness and the world around them. In this article, we explore the disnarrated, a style of narration that features events that do not happen, but are nonetheless referred to in the story...
September 29, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28977651/trajectories-of-end-of-life-a-systematic-review
#9
Jiska Cohen-Mansfield, Michal Skornick-Bouchbinder, Shai Brill
Objectives: Because End of life (EOL) is becoming an increasingly long life stage, this paper aims to describe the delineation of EOL by reviewing studies which examine (a) terminal decline (TD), the timing of change in slope of decline in specific abilities; and (b) trajectories of decline in areas such as function, health care expenditures, and well-being according to cause of death. Methods: Studies were identified through Google Scholar, PsycNET, and PubMed...
July 8, 2017: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
https://www.readbyqxmd.com/read/28975426/early-integration-of-palliative-cancer-care-patients-and-caregivers-challenges-treatment-preferences-and-knowledge-of-illness-and-treatment-throughout-the-cancer-trajectory
#10
Martina Preisler, Silke Heuse, Manuel Riemer, Friederike Kendel, Anne Letsch
PURPOSE: Early integration of palliative care (EIPC) into oncology is beneficial for cancer patients and their caregivers. Best practice models of EIPC throughout the course of cancer treatment aim to support patients and caregivers in meeting their individual needs. So far, we know little about whether EIPC offers should be phase-specific or patient-centered. This study investigated patients' and caregivers' needs considering individual challenges, treatment preferences, and knowledge over the cancer trajectory...
October 4, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28974405/structural-anomalies-of-the-peripheral-olfactory-system-in-psychosis-high-risk-subjects
#11
Bruce I Turetsky, Paul J Moberg, Megan Quarmley, Erich Dress, Monica E Calkins, Kosha Ruparel, Karthik Prabhakaran, Raquel E Gur, David R Roalf
BACKGROUND: Olfactory impairments are prominent in both schizophrenia and the preceding at-risk state. Their presence prior to illness predicts poor functional outcome. In schizophrenia, these impairments reflect peripheral olfactory structural abnormalities, which are hypothesized to arise during early embryonic development. If this is correct, then similar structural anomalies should be apparent among clinical high-risk subjects. METHODS: Thirty-nine clinical high-risk (CR) subjects (24M/15F) were compared to 36 low-risk (LR) subjects (19M/17F)...
September 30, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28974404/influence-of-venus-and-mars-in-the-cognitive-sky-of-schizophrenia-results-from-the-first-step-national-face-sz-cohort
#12
G Fond, L Boyer, M Leboyer, O Godin, P M Llorca, M Andrianarisoa, F Berna, L Brunel, B Aouizerate, D Capdevielle, I Chereau, T D'Amato, C Dubertret, J Dubreucq, C Faget, F Gabayet, J Mallet, D Misdrahi, R Rey, C Lancon, C Passerieux, P Roux, P Vidailhet, H Yazbek, F Schürhoff, E Bulzacka
OBJECTIVES: Sex differences can yield important clues regarding illness pathophysiology and its treatment. Schizophrenia (SZ) has a lower incidence rate, and a better prognosis, in women versus men. The present study investigated the cognitive profiles of both sexes in a large multi-centre sample of community-dwelling SZ patients. METHOD: 544 community-dwelling stable SZ subjects (141 women and 403 men; mean age 34.5±12.1 and 31.6±8.7years, respectively) were tested with a comprehensive battery of neuropsychological tests...
September 30, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28973934/projections-of-white-and-black-older-adults-without-living-kin-in-the-united-states-2015-to-2060
#13
Ashton M Verdery, Rachel Margolis
Close kin provide many important functions as adults age, affecting health, financial well-being, and happiness. Those without kin report higher rates of loneliness and experience elevated risks of chronic illness and nursing facility placement. Historical racial differences and recent shifts in core demographic rates suggest that white and black older adults in the United States may have unequal availability of close kin and that this gap in availability will widen in the coming decades. Whereas prior work explores the changing composition and size of the childless population or those without spouses, here we consider the kinless population of older adults with no living close family members and how this burden is changing for different race and sex groups...
October 2, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28969611/truenth-sexual-recovery-study-protocol-a-multi-institutional-collaborative-approach-to-developing-and-testing-a-web-based-intervention-for-couples-coping-with-the-side-effects-of-prostate-cancer-treatment-in-a-randomized-controlled-trial
#14
D Wittmann, A Mehta, L Northouse, R Dunn, T Braun, A Duby, L An, L Arab, R Bangs, S Bober, J Brandon, M Coward, M Dunn, M Galbraith, M Garcia, J Giblin, M Glode, B Koontz, A Lowe, S Mitchell, J Mulhall, C Nelson, K Paich, C Saigal, T Skolarus, J Stanford, T Walsh, C E Pollack
BACKGROUND: Over half of men who receive treatment for prostate suffer from a range of sexual problems that affect negatively their sexual health, sexual intimacy with their partners and their quality of life. In clinical practice, however, care for the sexual side effects of treatment is often suboptimal or unavailable. The goal of the current study is to test a web-based intervention to support the recovery of sexual intimacy of prostate cancer survivors and their partners after treatment...
October 2, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28962566/-i-stayed-with-my-illness-a-grounded-theory-study-of-health-seeking-behaviour-and-treatment-pathways-of-patients-with-obstetric-fistula-in-kenya
#15
Anne M Khisa, Grace M Omoni, Isaac K Nyamongo, Rachel F Spitzer
BACKGROUND: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women's health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? METHODS: We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya...
September 29, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28959452/predicting-early-transition-from-sub-syndromal-presentations-to-major-mental-disorders
#16
Shane P M Cross, Jan Scott, Ian B Hickie
BACKGROUND: Transition from at-risk state to full syndromal mental disorders is underexplored for unipolar and bipolar disorders compared with psychosis. AIMS: Prospective, trans-diagnostic study of rates and predictors of early transition from sub-threshold to full syndromal mental disorder. METHOD: One-year outcome of 243 consenting youth aged 15-25 years with a sub-syndromal presentation of a potentially severe mental disorder. Survival analysis and odds ratio (OR) for predictors of transition identified from baseline clinical and demographic ratings...
September 2017: BJPsych Open
https://www.readbyqxmd.com/read/28957884/palliative-and-end-of-life-care-for-adults-with-advanced-chronic-obstructive-pulmonary-disease-a-rapid-review-focusing-on-patient-and-family-caregiver-perspectives
#17
Gillian Mathews, Bridget Johnston
PURPOSE OF REVIEW: The aim of the review was to explore patient and family caregiver perspectives on key issues for ensuring quality of end-of-life care for people with chronic obstructive pulmonary disease (COPD). The growing evidence on the value of specialist palliative care services demonstrates significant improvements in treatments and provisions; however, much of the literature is generic in nature or centred on people with a cancer diagnosis. In this review, we examine the literature to ascertain the views and needs of patients and carers affected by advanced COPD, a highly debilitating condition that can have a profoundly negative impact on the quality of end-of-life experience...
September 27, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28957688/pre-admission-functional-decline-in-hospitalized-persons-with-dementia-the-influence-of-family-caregiver-factors
#18
Marie Boltz, Kyung Hee Lee, Tracy Chippendale, Rebecca L Trotta
Older adults with dementia are more likely than those who do not have dementia to be hospitalized. Admission functional (ADL) performance is a salient factor predicting functional performance in older adults at discharge. The days preceding hospitalization are often associated with functional loss related to the acute illness. An understanding of functional changes during this transition will inform interventions to prevent functional decline. This secondary analysis examined data from a study that evaluated a family educational empowerment model and included 136 dyads (persons with dementia and their family caregiver)...
September 21, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28952887/what-happens-during-early-outpatient-palliative-care-consultations-for-persons-with-newly-diagnosed-advanced-cancer-a-qualitative-analysis-of-provider-documentation
#19
Gulcan Bagcivan, J Nicholas Dionne-Odom, Jennifer Frost, Margaret Plunkett, Lisa A Stephens, Peggy Bishop, Richard A Taylor, Zhongze Li, Rodney Tucker, Marie Bakitas
BACKGROUND: Early outpatient palliative care consultations are recommended by clinical oncology guidelines globally. Despite these recommendations, it is unclear which components should be included in these encounters. AIM: Describe the evaluation and treatment recommendations made in early outpatient palliative care consultations. DESIGN: Outpatient palliative care consultation chart notes were qualitatively coded and frequencies tabulated...
September 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28952874/is-the-level-of-education-associated-with-transitions-between-care-settings-in-older-adults-near-the-end-of-life-a-nationwide-retrospective-cohort-study
#20
Susanne Kelfve, Jonas Wastesson, Stefan Fors, Kristina Johnell, Lucas Morin
BACKGROUND: End-of-life transitions between care settings can be burdensome for older adults and their relatives. AIM: To analyze the association between the level of education of older adults and their likelihood to experience care transitions during the final months before death. DESIGN: Nationwide, retrospective cohort study using register data. SETTING/PARTICIPANTS: Older adults (⩾65 years) who died in Sweden in 2013 ( n = 75,722)...
September 1, 2017: Palliative Medicine
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