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https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#1
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29325536/autonomy-and-couples-joint-decision-making-in-healthcare
#2
Pauline E Osamor, Christine Grady
BACKGROUND: Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making...
January 11, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29306990/peer-support-and-the-hiv-continuum-of-care-results-from-a-multi-site-randomized-clinical-trial-in-three-urban-clinics-in-the-united-states
#3
Howard J Cabral, Kendra Davis-Plourde, Mariana Sarango, Jane Fox, Joseph Palmisano, Serena Rajabiun
Racial/ethnic minorities living with HIV and behavioral health co-morbidities are more likely to be disengaged from HIV primary care. Peer programs have been effective in HIV outreach and prevention but effectiveness of such programs for retention in care and viral suppression is understudied. Subjects (n = 348) were randomized in equal allocation to a peer navigation and education intervention versus standard clinical care at three urban clinics in the United States. The intervention group received seven structured interventions plus weekly contact to address medical and social needs...
January 6, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29306921/building-a-high-quality-oncology-nursing-workforce-through-lifelong-learning-the-de-souza-model
#4
Mary Jane Esplen, Jiahui Wong, Esther Green, Joy Richards, Jane Li
AbstractCancer is one of the leading causes of death in the world. Along with increased new cases, cancer care has become increasingly complex due to advances in diagnostics and treatments, greater survival, and new models of palliative care. Nurses are a critical resource for cancer patients and their families. Their roles and responsibilities are expanding across the cancer care continuum, calling for specialized training and support. Formal education prepares nurses for entry level of practice, however, it does not provide the specialized competencies required for quality care of cancer patients...
January 5, 2018: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/29306359/the-culturally-adapted-italian-version-of-the-barthel-index-icabi-assessment-of-structural-validity-inter-rater-reliability-and-responsiveness-to-clinically-relevant-improvements-in-patients-admitted-to-inpatient-rehabilitation-centers
#5
S F Castiglia, G Galeoto, A Lauta, A Palumbo, F Tirinelli, F Viselli, Valter Santilli, M L Sacchetti
The Barthel Index (BI) is widely used to determine eligibility criteria for inpatient rehabilitation and to monitor patients' recovery, irrespective of the illnesses that affect them. The culturally adapted Italian version of the Barthel Index (IcaBI) was recently validated. This paper reports the structural validity and inter-rater reliability of the IcaBI and its responsiveness to the results of inpatient rehabilitation. The IcaBI was administered to a cohort of 264 patients hospitalized in two rehabilitation centers in Rome, Italy...
October 2017: Functional Neurology
https://www.readbyqxmd.com/read/29304827/inequality-of-obstetric-and-gynaecological-workforce-distribution-in-china
#6
Zhenghong Ren, Peige Song, Xinlei Chang, Jiawen Wang, Lin An
BACKGROUND: Women's health is defined as a continuum throughout their whole lives. In China, women receive life-round preventative and curative health care from the health system, although the universal access to reproductive health has already been basically achieved in China, the situation of women's access to curative health care is still unknown. METHODS: Data from the national maternal and child health human resource investigation were analysed. Lorenz curves, Gini coefficients, and Theil L indexes were drawn and calculated to reflect the inequality...
January 5, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29298450/a-statewide-medication-management-system-health-information-exchange-to-support-drug-therapy-optimization-by-pharmacists-across-the-continuum-of-care
#7
Karen Pellegrin, Francis Chan, Natalie Pagoria, Sheena Jolson-Oakes, Reece Uyeno, Andrew Levin
BACKGROUND:  While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthcare system, have not yet been reported. OBJECTIVE:  Our objective is to describe the design, implementation, and use of health information technology to support the hospital and community pharmacists' management of medications for high-risk patients statewide in the "Pharm2Pharm" model of care...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29297390/methodology-for-a-mixed-methods-multi-country-study-to-assess-recognition-of-and-response-to-maternal-and-newborn-illness
#8
Allisyn C Moran, Danielle Charlet, Supriya Madhavan, Kumudha Aruldas, Marie Donaldson, Fatuma Manzi, Monica Okuga, Alfonso Rosales, Vandana Sharma, Michael Celone, Neal Brandes, James M Sherry
BACKGROUND: Although maternal and newborn mortality have decreased 44 and 46% respectively between 1990 and 2015, achievement of ambitious Sustainable Development Goal targets requires accelerated progress. Mortality reduction requires a renewed focus on the continuum of maternal and newborn care from the household to the health facility. Although barriers to accessing skilled care are documented for specific contexts, there is a lack of systematic evidence on how women and families identify maternal and newborn illness and make decisions and subsequent care-seeking patterns...
December 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29297352/tackling-the-hard-problems-implementation-experience-and-lessons-learned-in-newborn-health-from-the-african-health-initiative
#9
Hema Magge, Roma Chilengi, Elizabeth F Jackson, Bradley H Wagenaar, Almamy Malick Kante
BACKGROUND: The Doris Duke Charitable Foundation's African Health Initiative supported the implementation of Population Health Implementation and Training (PHIT) Partnership health system strengthening interventions in designated areas of five countries: Ghana, Mozambique, Rwanda, Tanzania, and Zambia. All PHIT programs included health system strengthening interventions with child health outcomes from the outset, but all increasingly recognized the need to increase focus to improve health and outcomes in the first month of life...
December 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29296802/patient-centered-care-coordination-in-hematopoietic-cell-transplantation
#10
REVIEW
Nandita Khera, Patricia Martin, Kristen Edsall, Anthony Bonagura, Linda J Burns, Mark Juckett, Olivia King, C Frederick LeMaistre, Navneet S Majhail
Hematopoietic cell transplantation (HCT) is an expensive, resource-intensive, and medically complicated modality for treatment of many hematologic disorders. A well-defined care coordination model through the continuum can help improve health care delivery for this high-cost, high-risk medical technology. In addition to the patients and their families, key stakeholders include not only the transplantation physicians and care teams (including subspecialists), but also hematologists/oncologists in private and academic-affiliated practices...
August 22, 2017: Blood Advances
https://www.readbyqxmd.com/read/29290556/african-american-church-engagement-in-the-hiv-care-continuum
#11
Jennifer M Stewart, Hyejeong Hong, Terrinieka W Powell
Providing comprehensive services across the HIV care continuum through African American churches may improve HIV treatment outcomes for African Americans. We explored the feasibility of a church-led HIV care program in six churches in Baltimore, Maryland. Church leaders (n = 57) participated in focus groups and eight pastors participated in interviews. Data were analyzed by qualitative hybrid thematic analysis. Findings revealed eight themes: four themes were related to linkage to care: being unaware of community resources, concerns about HIV-associated regulations, ongoing personalized contact with HIV-infected persons, and desire for integration of spiritual education; four themes were related to HIV care and support services, including existing church infrastructure, provision of HIV support groups, using the church as an HIV care resource hub, and prevention education for uninfected people...
November 22, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/29286270/landmark-lecture-on-cardiac-intensive-care-and-anaesthesia-continuum-and-conundrums
#12
Peter C Laussen
Cardiac anesthesia and critical care provide an important continuum of care for patients with congenital heart disease. Clinicians in both areas work in complex environments in which the interactions between humans and technology is critical. Understanding our contributions to outcomes (modifiable risk) and our ability to perceive and predict an evolving clinical state (low failure-to-predict rate) are important performance metrics. Improved methods for capturing continuous physiologic signals will allow for new and interactive approaches to data visualization, and for sophisticated and iterative data modeling that will help define a patient's phenotype and response to treatment (precision physiology)...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29284587/current-state-of-knowledge-about-cancer-in-lesbians-gay-bisexual-and-transgender-lgbt-people
#13
REVIEW
Liz Margolies, Carlton G Brown
OBJECTIVE: To review the current state of knowledge about cancer in lesbians, gay, bisexual, and transgender (LGBT) people by focusing on four major issues across the cancer continuum including: 1) lack of data collection on sexual orientation and gender identity; 2) need for a culturally competent workforce; 3) the need for a culturally competent health care system; and 4) creating LGBT tailored patient/client information and education. DATA SOURCES: Published literature...
December 25, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29283955/effects-of-reaching-national-goals-on-hiv-incidence-by-race-and-ethnicity-in-the-united-states
#14
Evin Uzun Jacobson, Katherine A Hicks, Emily L Tucker, Paul G Farnham, Stephanie L Sansom
CONTEXT: Human immunodeficiency virus (HIV) incidence and prevalence in the United States are characterized by significant disparities by race/ethnicity. National HIV care goals, such as boosting to 90% the proportion of persons whose HIV is diagnosed and increasing to 80% the proportion of persons living with diagnosed HIV who are virally suppressed, will likely reduce HIV incidence, but their effects on HIV-related disparities are uncertain. OBJECTIVE: We sought to understand by race/ethnicity how current HIV care varies, the level of effort required to achieve national HIV care goals, and the effects of reaching those goals on HIV incidence and disparities...
December 27, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29282052/identifying-gaps-in-the-continuum-of-care-for-hypertension-and-diabetes-in-two-indian-communities
#15
Rose Gabert, Marie Ng, Ruchi Sogarwal, Miranda Bryant, R V Deepu, Claire R McNellan, Sunil Mehra, Bryan Phillips, Marissa Reitsma, Blake Thomson, Shelley Wilson, Alexandra Wollum, Emmanuela Gakidou, Herbert C Duber
BACKGROUND: Non-communicable diseases (NCDs) represent the largest, and fastest growing, burden of disease in India. This study aimed to quantify levels of diagnosis, treatment, and control among hypertensive and diabetic patients, and to describe demand- and supply-side barriers to hypertension and diabetes diagnosis and care in two Indian districts, Shimla and Udaipur. METHODS: We conducted household and health facility surveys, as well as qualitative focus group discussions and interviews...
December 27, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29281681/depression-and-alcohol-use-disorder-at-antiretroviral-therapy-initiation-led-to-disengagement-from-care-in-south-africa
#16
Cody Cichowitz, Noriah Maraba, Robin Hamilton, Salome Charalambous, Christopher J Hoffmann
We sought to assess mental health at the time of antiretroviral therapy (ART) initiation and subsequent retention in care over a six-month follow-up period. A total of 136 people living with HIV in South Africa were administered surveys measuring demographic information and mental health indicators at the time of ART initiation. Follow-up was completed via chart abstraction to assess for six-month outcomes of retention in care and viral suppression. At enrollment, 45/136 (33%), 67/136 (49%), and 45/136 (33%) participants screened positive for depression, anxiety, and alcohol use disorder, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/29278544/self-management-strategies-in-chronic-obstructive-pulmonary-disease-a-first-step-toward-personalized-medicine
#17
Miriam Barrecheguren, Jean Bourbeau
PURPOSE OF REVIEW: Self-management has gained increased relevance in the management of chronic obstructive pulmonary disease patients. The heterogeneity in self-management interventions has complicated the development of recommendations for clinical practice. In this review, we present the latest findings regarding conceptual definition, effectiveness of self-management interventions and self-management strategies in chronic obstructive pulmonary disease as a first step toward personalized medicine: what, how and to whom? RECENT FINDINGS: Self-management interventions have shown benefits in improving health-related quality of life and reducing hospital admissions...
December 22, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29276706/a-cyclical-approach-to-continuum-modeling-a-conceptual-model-of-diabetic-foot-care
#18
Martha L Carvour, Allyssa Chiu
"Cascade" or "continuum" models have been developed for a number of diseases and conditions. These models define the desired, successive steps in care for that disease or condition and depict the proportion of the population that has completed each step. These models may be used to compare care across subgroups or populations and to identify and evaluate interventions intended to improve outcomes on the population level. Previous cascade or continuum models have been limited by several factors. These models are best suited to processes with stepwise outcomes-such as screening, diagnosis, and treatment-with a single defined outcome (e...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/29275135/effect-of-a-multifaceted-social-franchising-model-on-quality-and-coverage-of-maternal-newborn-and-reproductive-health-care-services-in-uttar-pradesh-india-a-quasi-experimental-study
#19
Sarah Tougher, Varun Dutt, Shreya Pereira, Kaveri Haldar, Vasudha Shukla, Kultar Singh, Paresh Kumar, Catherine Goodman, Timothy Powell-Jackson
BACKGROUND: How to harness the private sector to improve population health in low-income and middle-income countries is heavily debated and one prominent strategy is social franchising. We aimed to evaluate whether the Matrika social franchising model-a multifaceted intervention that established a network of private providers and strengthened the skills of both public and private sector clinicians-could improve the quality and coverage of health services along the continuum of care for maternal, newborn, and reproductive health...
December 20, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/29273141/the-optimal-age-for-screening-adolescents-and-young-adults-without-identified-risk-factors-for-hiv
#20
Anne M Neilan, Richard Dunville, M Cheryl Bañez Ocfemia, Joshua A Salomon, Jordan A Francke, Alexander J B Bulteel, Li Yan Wang, Katherine K Hsu, Elizabeth A DiNenno, Rochelle P Walensky, Robert A Parker, Kenneth A Freedberg, Andrea L Ciaranello
PURPOSE: To assess the optimal age at which a one-time HIV screen should begin for adolescents and young adults (AYA) in the U.S. without identified HIV risk factors, incorporating clinical impact, costs, and cost-effectiveness. METHODS: We simulated HIV-uninfected 12-year-olds in the U.S. without identified risk factors who faced age-specific risks of HIV infection (.6-71.3/100,000PY). We modeled a one-time screen ($36) at age 15, 18, 21, 25, or 30, each in addition to current U...
January 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
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