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https://www.readbyqxmd.com/read/28935515/template-for-an-antibiotic-stewardship-policy-for-post-acute-and%C3%A2-long-term-care-settings
#1
Robin L P Jump, Swati Gaur, Morgan J Katz, Christopher J Crnich, Ghinwa Dumyati, Muhammad S Ashraf, Elizabeth Frentzel, Steven J Schweon, Philip Sloane, David Nace
In response to a rising concern for multidrug resistance and Clostridium difficile infections, the Centers for Medicare and Medicaid services (CMS) will require all long-term care (LTC) facilities to establish an antibiotic stewardship program by November 2017. Thus far, limited evidence describes implementation of antibiotic stewardship in LTC facilities, mostly in academic- or hospital-affiliated settings. To support compliance with CMS requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at AMDA-The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the LTC setting...
September 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28920549/rupture-of-a-non-traumatic-anterior-communicating-artery-aneurysm-does-location-of-aneurysm-associate-with-functional-independence-following-post-acute-in-patient-neurorehabilitation
#2
Henriette Holm Stabel, Asger Roer Pedersen, Søren Paaske Johnsen, Jørgen Feldbæk Nielsen
OBJECTIVE: Patients with non-traumatic rupture of an aneurysm located at the anterior communicating artery (ACoA) often experience cognitive disabilities. It is unknown whether location of aneurysm also affects the possibility for improvement in functional independence compared to patients with an aneurysmal subarachnoid hemorrhage (a-SAH) located elsewhere. The aim was to explore the association between location of aneurysm (ACoA versus other) and level of functional independence, measured by Functional Independence Measure (FIM), at discharge from rehabilitation...
September 18, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28919774/optimizing-post-acute-care-in-breast-cancer-survivors-a-rehabilitation-perspective
#3
REVIEW
Bhasker Amatya, Fary Khan, Mary P Galea
Breast cancer (BC) is the most common malignancy and a leading cause of morbidity and mortality in women worldwide. Therapeutic advances and improved survival rates of women with BC have implications for long-term impact on disability, psychological function and quality of life (QoL), which may be amenable to rehabilitation. The focus of rehabilitation is on managing disability, reducing sequelae and symptoms, and enhancing participation and societal reintegration, to achieve the highest possible independence and the best QoL...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28918094/post-acute-care-for-children-with-special-health-care-needs
#4
Charles D Phillips, Chau Truong, Hye-Chung Kum, Obioma Nwaiwu, Robert Ohsfeldt
BACKGROUND: Almost all studies of post-acute care (PAC) focus on older persons, frequently those suffering from chronic health problems. Some research is available on PAC for the pediatric population in general. However, very few studies focus on PAC services for children with special health care needs (SHCN). OBJECTIVE: To investigate factors affecting the provision of PAC to children with SHCN. METHODS: Pooled cross-sectional data from Texas Department of State Health Services hospital discharge database from 2011-2014 were analyzed...
September 8, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28913405/post-acute-care-disparities-in-total-joint-arthroplasty
#5
Roy H Lan, Atul F Kamath
BACKGROUND: Understanding the socioeconomic factors that influence hospitalization and post-discharge metrics after joint replacement is important for identifying key areas of improvement in the delivery of orthopaedic care. METHODS: An institutional administrative data set of 2869 patients from an academic arthroplasty referral center was analyzed to quantify the relationship between socioeconomic factors and post-acute rehabilitation care received, length of stay, and cost of care...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28910238/telemanagement-of-heart-failure-patients-across-the-post-acute-care-continuum
#6
Amy Dadosky, Heather Overbeck, Laura Barbetta, Ken Bertke, Maureen Corl, Kathleen Daly, Natasha Hiles, Nancy Rector, Eugene Chung, Santosh Menon
BACKGROUND: Heart failure (HF) is a chronic condition causing nearly 1 million hospital admissions annually in the United States with 25% of patients rehospitalized within 30 days. INTRODUCTION: The purpose of this study was to investigate whether telemanagement of HF patients throughout the post-acute continuum of care would reduce rehospitalization rates and improve patient self-care knowledge and satisfaction. MATERIALS AND METHODS: HF patients discharged to a skilled nursing facility (SNF) received telemanagement by HF clinicians with opportunity for continuation at home with assistance of home healthcare (HHC) nurses...
September 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28905273/early-to-long-term-alterations-of-cns-barriers-after-traumatic-brain-injury-considerations-for-drug-development
#7
Beatriz Rodriguez-Grande, Aleksandra Ichkova, Sighild Lemarchant, Jerome Badaut
Traumatic brain injury (TBI) is one of the leading causes of death and disability, particularly amongst the young and the elderly. The functions of the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier (BCSFB) are strongly impaired after TBI, thus affecting brain homeostasis. Following the primary mechanical injury that characterizes TBI, a secondary injury develops over time, including events such as edema formation, oxidative stress, neuroinflammation, and alterations in paracelullar and transcellular transport...
September 13, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28903412/acute-atorvastatin-treatment-restores-the-cardioprotective-effects-of-ischemic-postconditioning-in-hyperlipidemic-rats
#8
Tao Sun, Hong-Ju Zhang, Chayakrit Krittanawong, Su Wang, Ying Tao, Zhao Li, Qiancheng Yin, Donghua Zhang, Qian Wang, Ji Huang, Jingmei Zhang, Zhizhong Li, Yutong Cheng
BACKGROUND: Ischemic Postconditioning (IPC) reduces ischemia/reperfusion (I/R) injury under normal conditions. HMG-CoA reductase inhibitors (statins), which inhibit the synthesis of mevalonate, can interfere with the cardioprotective effect of IPC. However, the beneficial role of IPC in hyperlipidemic patients, post-acute administration of statins remains unknown. This study was to determine if acute administration of atorvastatin affect the infarct size-limiting effect of IPC in hyperlipidemic rats...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#9
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28899392/care-beyond-the-hospital-ward-understanding-the-socio-medical-trajectory-of-herpes-simplex-virus-encephalitis
#10
Jessie Cooper, Ciara Kierans, Sylviane Defres, Ava Easton, Rachel Kneen, Tom Solomon
BACKGROUND: Herpes simplex virus (HSV) encephalitis is a life-threatening infection of the brain, which has significant physical, cognitive and social consequences for survivors. Despite increasing recognition of the long-term effects of encephalitis, research and policy remains largely focused on its acute management, meaning there is little understanding of the difficulties people face after discharge from acute care. This paper aims to chart the problems and challenges which people encounter when they return home after treatment for HSV encephalitis...
September 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28898132/staged-residential-post-acute-rehabilitation-for-adults-following-acquired-brain-injury-a-comparison-of-functional-gains-rated-on-the-uk-functional-assessment-measure-uk-fim-fam-and-the-mayo-portland-adaptability-inventory-mpai-4
#11
Diana Jackson, Karla Seaman, Kristylee Sharp, Rachel Singer, Janet Wagland, Lynne Turner-Stokes
OBJECTIVE: To compare the UK Functional Assessment Measure (UK FIM+FAM) and Mayo-Portland Adaptability Inventory (MPAI-4) as measures of functional change in patients with brain injury receiving a staged residential post-acute community-based rehabilitation programme. RESEARCH DESIGN: Longitudinal cohort study of consecutive admissions (N = 42) over 3 years. METHODS: Patients were assessed at admission and discharge/annual review. We examined groups according to stage of independence on admission: Maximum support (stages 1 and 2: N = 17); moderate/maximum self-care/household support (stage 3: N = 15); minimal self-care and moderate household/community support (stages 4-6: N = 10)...
September 12, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28895488/a-systematic-review-of-psychological-interventions-for-sleep-and-fatigue-after-mild-traumatic-brain-injury
#12
Karen Sullivan, Hannah Blaine, Sherrie-Anne Kaye, Alice Theadom, Catherine Haden, Simon Smith
This review evaluated the evidence for psychological interventions to improve sleep and reduce fatigue after mild traumatic brain injury (TBI). Eight electronic databases were searched up until August 2016 for studies that: (1) included adults; (2) tested intervention effectiveness on sleep quality and fatigue, post-acutely; (3) applied a broadly-defined psychological intervention (e.g., cognitive behavioural therapy [CBT], counselling, or education). Only randomized controlled trials were eligible for inclusion...
September 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28893258/epidemiological-and-clinical-assessment-of-a-shared-territorial-malaria-guideline-in-the-10%C3%A2-years-of-its-implementation-barcelona-north-metropolitan-area-catalonia-spain-2007-2016
#13
Josep M Mòdol, Sílvia Roure, Àlex Smithson, Gema Fernández-Rivas, Anna Esquerrà, Neus Robert, María Méndez, Javier Ramos, Anna Carreres, Lluís Valerio
BACKGROUND: Malaria remains a major source of morbi-mortality among travellers. In 2007, a consensual multicenter Primary Care-Hospital shared guideline on travel-prior chemoprophylaxis, diagnosis and clinical management of imported malaria was set up in the Barcelona North Metropolitan area. The aim of the study is to assess the evolution of malaria cases in the area as well as its clinical management over the 10 years of its implementation. RESULTS: A total of 190 malaria cases, all them imported, have been recorded...
September 11, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28891345/comparison-of-the-sensitivity-to-change-of-the-functional-independence-measure-with-the-assessment-of-motor-and-process-skills-within-different-rehabilitation-populations
#14
Silvana X Choo, Paul Stratford, Julie Richardson, Jackie Bosch, Susan M Pettit, Barbara J Ansley, Jocelyn E Harris
PURPOSE: To determine whether there was a difference in the sensitivity to change of the subscales of the Functional Independence Measure and the Assessment of Motor and Process Skills within three different post-acute inpatient rehabilitation populations. MATERIAL AND METHODS: We conducted retrospective chart review of patients consecutively admitted to inpatient rehabilitation units, with both admission and discharge Functional Independence Measure and Assessment of Motor and Process Skills scores...
September 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28890805/outcome-after-post-acute-spinal-cord-specific-rehabilitation-a-german-single-center-study
#15
Matthias Ponfick
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study was to analyze single center outcome measures of spinal cord injury (SCI)-specific rehabilitation (SCISR) in Germany. SETTING: The study was conducted at an SCI specialized rehabilitation center. METHODS: Nonparametric tests for outcome description such as SCIM and length of stay. Logistic regression for outcome prediction was used. RESULTS: One hundred and sixty patients (113 men, 47 women) with a mean age of 64...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28890380/risk-of-exclusion-from-stroke-rehabilitation-in-the-oldest-old
#16
Paola Forti, Fabiola Maioli, Elisabetta Magni, Letizia Regazzoni, Roberto Piperno, Marco Zoli, Maura Coveri, Gaetano Procaccianti
OBJECTIVE: To investigate whether oldest-old age (≥85 yr) is an independent predictor of exclusion from stroke rehabilitation. DESIGN: Retrospective cohort study. SETTING: Stroke Unit (SU) of an Italian tertiary hospital. PARTICIPANTS: 1055 elderly patients (age 65-74 yr, n=230; age, 75-84 yr, n=432; age ≥ 85 yr, n=393), who, between 2009 and 2012, were admitted to SU with acute stroke and evaluated by a multiprofessional team for access to rehabilitation...
September 7, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28887069/better-respiratory-education-and-treatment-help-empower-breathe-study-methodology-and-baseline-characteristics-of-a-randomized-controlled-trial-testing-a-transitional-care-program-to-improve-patient-centered-care-delivery-among-chronic-obstructive-pulmonary
#17
H Aboumatar, M Naqibuddin, S Chung, H Adebowale, L Bone, T Brown, L A Cooper, A P Gurses, A Knowlton, D Kurtz, L Piet, N Putcha, C Rand, D Roter, E Shattuck, C Sylvester, A Urteaga-Fuentes, R Wise, J L Wolff, T Yang, J Hibbard, E Howell, M Myers, K Shea, J Sullivan, L Syron, Wang Nae-Yuh, P Pronovost
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of hospitalizations. Interventional studies focusing on the hospital-to-home transition for COPD patients are few. In the BREATHE (Better Respiratory Education and Treatment Help Empower) study, we developed and tested a patient and family-centered transitional care program that helps prepare hospitalized COPD patients and their family caregivers to manage COPD at home. METHODS: In the study's initial phase, we co-developed the BREATHE transitional care program with COPD patients, family-caregivers, and stakeholders...
September 5, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28887021/improving-value-in-total-joint-arthroplasty-a-comprehensive-patient-education-and-management-program-decreases-discharge-to-post-acute-care-facilities-and-post-operative-complications
#18
Christopher E Pelt, Jeremy M Gililland, Jill A Erickson, Dory E Trimble, Mike B Anderson, Christopher L Peters
BACKGROUND: A step-by-step approach to creating a comprehensive patient education, expectation, and management program is described with the aim of reducing discharges to post-acute care centers (PACs) following total joint arthroplasty (TJA). We hypothesized that by lowering discharges to PACs, readmissions and reoperations would also decrease. METHODS: Following the implementation of a multi-faceted patient education and management program, we retrospectively reviewed 927 TJAs who underwent surgery 12 months before (n = 465) and after (n = 462) the program was implemented...
August 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28881821/radial-artery-intima-media-thickness-regresses-after-secondary-prevention-interventions-in-patients-post-acute-coronary-syndrome-and-is-associated-with-cardiac-and-kidney-biomarkers
#19
Damilola D Adingupu, Helena U Westergren, Santosh Dahgam, Ann-Cathrine Jönsson-Rylander, Juuso Blomster, Per Albertsson, Elmir Omerovic, Sara Svedlund, Li-Ming Gan
BACKGROUND: Radial artery intima-media thickness (rIMT) measured by ultra-high-resolution ultrasound is associated with increased cardiovascular risk and predicts outcomes. We performed non-invasive high-resolution ultrasound of the radial artery to investigate vascular changes in subjects presenting with acute coronary syndrome (ACS) and who had undergone percutaneous coronary intervention (PCI). PURPOSE: In the present work, we aimed to follow rIMT change over time post-acute coronary syndrome as a tool to monitor potential response to intensified medical therapy...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28870798/pattern-of-mas-expression-in-acute-and-post-acute-stage-of-nerve-injury-in-mice
#20
Alex Dias Assis, Fernanda de Assis Araújo, Robson Augusto Souza Dos Santos, Silvia Passos Andrade, Renata Graciele Zanon
Angiotensin-(1-7) (Ang [1-7]) and its receptor Mas are involved in a number of physiological processes, including control of arterial pressure and modulation of nervous system actions. However, the involvement of the Ang-(1-7)/Mas axis in peripheral nerve injury has not been investigated. Using a model of sciatic nerve injury in mice, we demonstrated opposing changes in Mas receptor expression at days 2 and 14 post-injury. Mas receptor expression was more intense 2days after the nerve lesion, compared with the intensity of the intact nerve...
September 1, 2017: Peptides
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