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https://www.readbyqxmd.com/read/29342256/comparison-of-pregnancy-outcomes-between-maternity-waiting-home-users-and-non-users-at-hospitals-with-and-without-a-maternity-waiting-home-retrospective-cohort-study
#1
Floris Braat, Tienke Vermeiden, Gashaw Getnet, Rita Schiffer, Thomas van den Akker, Jelle Stekelenburg
Objective: To examine the impact of a maternity waiting home (MWH) by comparing pregnancy outcomes between users and non-users at hospitals with and without an MWH. Methods: We conducted a retrospective cohort study in Ethiopia comparing one hospital with an MWH (Attat) to a second hospital without one (Butajira). A structured questionnaire among sampled women in 2014 and hospital records from 2011 to 2014 were used to compare sociodemographic characteristics and pregnancy outcomes between Attat MWH users and non-MWH users, Attat MWH users and Butajira, and Attat non-MWH users and Butajira...
January 12, 2018: International Health
https://www.readbyqxmd.com/read/29341514/opportunity-costs-in-paediatric-training-the-specialist-registrars-experience
#2
M B O'Neill, T Nabialek, N Kandamany
In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression, 2) perceived functional effectiveness at work, 3) psychological impact of hospital based training, and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships...
August 8, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#3
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29341048/intrapartum-care-working-patterns-of-midwives-the-long-road-to-models-of-care-in-germany
#4
Mechthild M Gross, Claire Michelsen, Bernhard Vaske, Sonja Helbig
INTRODUCTION: Midwifery models of care help to enhance perinatal health outcomes, women's satisfaction, and continuity of care. Despite the ubiquitous presence of certified midwives at births in Germany, no research has investigated the diversity of midwives' practice patterns. Describing the variety of working patterns through which midwives provide intrapartum care may contribute to improving the organisation of midwifery services. METHODS: This cross-sectional survey took place in the region of Hannover and Hildesheim, Germany...
January 16, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29340940/characterizing-potentially-preventable-admissions-a-mixed-methods-study-of-rates-associated-factors-outcomes-and-physician-decision-making
#5
Lisa M Daniels, Atsushi Sorita, Deanne T Kashiwagi, Masashi Okubo, Evan Small, Eric C Polley, Adam P Sawatsky
BACKGROUND: Potentially preventable admissions are a target for healthcare cost containment. OBJECTIVE: To identify rates of, characterize associations with, and explore physician decision-making around potentially preventable admissions. DESIGN: A comparative cohort study was used to determine rates of potentially preventable admissions and to identify associated factors and patient outcomes. A qualitative case study was used to explore physicians' clinical decision-making...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29339650/oral-immunotherapy-in-japanese-children-with-anaphylactic-peanut-allergy
#6
Ken-Ichi Nagakura, Sakura Sato, Noriyuki Yanagida, Makoto Nishino, Tomoyuki Asaumi, Kiyotake Ogura, Motohiro Ebisawa
BACKGROUND: Reports on oral immunotherapy (OIT) for anaphylactic food allergy are lacking. We investigated the efficacy and safety of peanut OIT for anaphylactic patients. METHODS: We enrolled 22 peanut anaphylactic patients who underwent OIT between 2011 and 2013, all of whom demonstrated anaphylaxis during a baseline double-blind, placebo-controlled food challenge. After starting in-hospital OIT, participants gradually increased ingestion to 795 mg of peanut protein per day at home and then took a maintenance dose (795 mg) daily...
January 16, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29339347/hospital-owned-apps-in-taiwan-nationwide-survey
#7
Hao-Yen Liu, Wui-Chiang Lee, Ying-Chou Sun, Jun-Jeng Fen, Tzeng-Ji Chen, Li-Fang Chou, Shinn-Jang Hwang
BACKGROUND: Over the last decade, the use of mobile phone apps in the health care industry has grown rapidly. Owing to the high penetration rate of Internet use in Taiwan, hospitals are eager to provide their own apps to improve the accessibility of medical care for patients. OBJECTIVE: The aims of this study were to provide an overview of the currently available hospital-owned apps in Taiwan and to conduct a cross-hospital comparison of app features. METHODS: In May 2017, the availability of apps from all 414 hospitals in Taiwan was surveyed from the hospital home pages and the Google Play app store...
January 16, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29338914/prophylactic-antibiotics-following-radical-cystectomy-reduces-urinary-tract-infections-and-readmission-for-sepsis-from-a-urinary-source
#8
Ryan P Werntz, Ann Martinez-Acevedo, Hamed Amadi, Ryan Kopp, Jeffrey La Rochelle, Theresa Koppie, Christopher Amling, Kamran P Sajadi
INTRODUCTION: Urinary tract infections (UTI) and sepsis contribute significantly to the morbidity associated with cystectomy and urinary diversion in the first 30 days. We hypothesized that continuous antibiotic prophylaxis decreased UTIs in the first 30 days following radical cystectomy. METHODS: Patients with urothelial carcinoma of the bladder who underwent a radical cystectomy with urinary diversion for bladder cancer at Oregon Health and Science University from January 2014 to May 2015 were included in the study...
January 12, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29338602/sequential-drug-treatment-algorithm-for-agitation-and-aggression-in-alzheimer-s-and-mixed-dementia
#9
Simon Jc Davies, Amer M Burhan, Donna Kim, Philip Gerretsen, Ariel Graff-Guerrero, Vincent L Woo, Sanjeev Kumar, Sarah Colman, Bruce G Pollock, Benoit H Mulsant, Tarek K Rajji
INTRODUCTION: Behavioural and psychological symptoms of dementia (BPSD) include agitation and aggression in people with dementia. BPSD is common on inpatient psychogeriatric units and may prevent individuals from living at home or in residential/nursing home settings. Several drugs and non-pharmacological treatments have been shown to be effective in reducing behavioural and psychological symptoms of dementia. Algorithmic treatment may address the challenge of synthesizing this evidence-based knowledge...
January 1, 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29337859/effects-of-pharmacists-interventions-on-inappropriate-drug-use-and-drug-related-readmissions-in-people-with-dementia-a-secondary-analysis-of-a-randomized-controlled-trial
#10
Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jörn Schneede, Hugo Lövheim
Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug-drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists' interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions...
January 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29336981/challenges-and-opportunities-for-the-subcutaneous-delivery-of-therapeutic-proteins
#11
REVIEW
Michael R Turner, Sathy V Balu-Iyer
Biotherapeutics are a rapidly growing drug class and well over 200 biotherapeutics have already obtained approval, with about fifty of these being approved in 2015 and 2016 alone 1. Several hundred protein therapeutic products are still in the pipeline, including interesting new approaches to treatment. Due to patients' convenience of at home administration and reduced number of hospital visits as well as the reduction in treatment costs, subcutaneous (SC) administration of biologics is of increasing interest...
January 11, 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29334724/disparity-in-crohn-s-disease-activity-between-home-and-clinics-is-associated-with-unscheduled-hospital-visits-due-to-disease-flares
#12
Eun Soo Kim, Yoo Jin Lee, Byung Ik Jang, Kyeong Ok Kim, Eun Young Kim, Hyun Seok Lee, Seong Woo Jeon, Sang Gyu Kwak
Background/Aims: E-health technologies have been implemented for the management of Crohn's disease (CD). We aimed to identify differences between patient activities at home and at routine clinic visits using a web-based self-reporting CD symptom diary (CDSD) and to determine the impact of this disparity on clinical outcomes. Methods: Patients with CD from three tertiary hospitals were invited to assess their symptoms at least once a week using CDSD. We identified patients who showed disparities in disease activity (high activity at home but normal at the next hospital visit) and evaluated clinical outcomes of these patients such as unscheduled visits due to flares using Kaplan-Meier analyses...
January 17, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#13
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29333486/ethical-considerations-when-delivering-behavior-analytic-services-for-problem-behavior-via-telehealth
#14
Patrick W Romani, Kelly M Schieltz
Delivery of healthcare services via telehealth has been growing in popularity, and work completed by behavior analytic researchers and practitioners have supported this trend. Behavior analysts at the University of Iowa Children's Hospital (UICH) developed a telehealth model of service delivery to build upon their already established in-clinic and in-home services. Results from their telehealth studies showed positive effects. Social functions were identified for most children, and problem behavior decreased by an average of 94...
November 2017: Behavior Analysis (Washington, D.C.)
https://www.readbyqxmd.com/read/29330731/human-plant-exposures-reported-to-a-regional-southwestern-poison-control-center-over-8%C3%A2-years
#15
Ben Enfield, Daniel E Brooks, Sharyn Welch, Maureen Roland, Jane Klemens, Kim Greenlief, Rachel Olson, Richard D Gerkin
BACKGROUND: There is little published data about human plant exposures reported to US poison control centers (PCCs). METHODS: A retrospective chart review of all reported plant exposures to a single regional PCC between January 1, 2003 and December 31, 2010 was done to understand better the characteristics of plant exposure cases. Specific generic plant codes were used to identify cases. Recorded variables included patient demographics, plant involved, exposure variables, symptoms, management site, treatments, and outcome...
January 12, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29328018/-a-day-in-the-life-of-a-medical-resident-on-the-ward
#16
A R Schuurman, S A Bos, K de Wit, R de Graaf, W J Wiersinga
OBJECTIVE: To investigate how internal medicine residents allocate their time during a hospital dayshift on the wards. DESIGN: Prospective observational cohort study (time and motion study). METHODS: Data were collected from 36 internal medicine residents working at the Internal Medicine Department of the Academic Medical Centre in Amsterdam, the Netherlands. Trained observers monitored 22 residents using a newly developed smartphone-application, registering their dayshift activities (meetings and education, direct patient contact, administrative tasks, lunch/break, other) and location (workstation, conference room, ward and patient rooms, other)...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29326306/weekly-standard-kt-vurea-and-clinical-outcomes-in-home-and-in-center-hemodialysis
#17
Matthew B Rivara, Vanessa Ravel, Elani Streja, Yoshitsugu Obi, Melissa Soohoo, Alfred K Cheung, Jonathan Himmelfarb, Kamyar Kalantar-Zadeh, Rajnish Mehrotra
BACKGROUND AND OBJECTIVES: Patients undergoing hemodialysis with a frequency other than thrice weekly are not included in current clinical performance metrics for dialysis adequacy. The weekly standard Kt/Vurea incorporates treatment frequency, but there are limited data on its association with clinical outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used multivariable regression to examine the association of dialysis standard Kt/Vurea with BP and metabolic control (serum potassium, calcium, bicarbonate, and phosphorus) in patients incidental to dialysis treated with home (n=2373) or in-center hemodialysis (n=109,273)...
January 11, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29326190/a-qualitative-study-of-patients-feedback-about-outpatient-parenteral-antimicrobial-therapy-opat-services-in-northern-england-implications-for-service-improvement
#18
Maureen Twiddy, Carolyn J Czoski Murray, Samantha J Mason, David Meads, Judy M Wright, Elizabeth D Mitchell, Jane Minton
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#19
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29325534/increasing-trend-in-hospital-deaths-consistent-among-older-decedents-in-korea-a-population-based-study-using-death-registration-database-2001-2014
#20
Tran Thi Xuan Mai, Eunsook Lee, Hyunsoon Cho, Yoon Jung Chang
BACKGROUND: With improvement in hospice palliative care services and long-term care, Republic of Korea (hereafter South Korea) has recorded significant changes in places of death (e.g., hospital, home), especially among older adults. Over the last few decades, the most common places of death in South Korea were hospitals. However, Koreans, especially older adults, reportedly prefer to receive terminal care and eventually die at home. This study was conducted to investigate trends in places of death among older Korean adults and factors associated therewith...
January 11, 2018: BMC Palliative Care
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