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support from hospital to home

Ravi Kalhan, R Kannan Mutharasan
Patients with both chronic obstructive pulmonary disease (COPD) and heart failure (HF) pose particularly high costs to the healthcare system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population. 1: Diagnose the population accurately. 2: Detect admissions for exacerbations early and consider risk-stratification...
June 13, 2018: Chest
Laelia Benoit, Patrick Cottin, Marie R Moro
AIM: Since 1999, the development of more than 100 "Maisons des Adolescents" (MDAs) has enabled young persons to gain access to specific care in integrated youth-friendly facilities in France. To contribute to the development and standardization of international youth-friendly health care services, this review provides insight into the French MDA facilities. METHODS: This socio-historical analysis includes a systematic review of articles referring to the MDAs (selection through title and/or abstract), ministry reports and newspaper articles, from 1999 to 2018...
June 13, 2018: Early Intervention in Psychiatry
Rosemary Saunders, Karla Seaman, Catherine Ashford, Trudy Sullivan, Judith McDowall, Lisa Whitehead, Beverley Ewens, Kathryn Pedler, Karen Gullick
BACKGROUND: Total hip arthroplasty is an effective surgical procedure commonly used worldwide for patients suffering the disabling effects of osteoarthritis when medical therapy is unsuccessful. Traditionally pre- and postoperative information for patients undergoing a hip arthroplasty has been provided by paper-based methods. Electronic health (eHealth) programs to support individualized patient education on preoperative preparation, in-patient care, and home rehabilitation have the potential to increase patient engagement, enhance patient recovery, and reduce potential postoperative complications...
June 12, 2018: JMIR Research Protocols
Jennifer R Foster, Farhana I AlOthmani, Jamie A Seabrook, Tariq AlOfisan, Yasser M AlGarni, Amrita Sarpal
OBJECTIVES: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. DESIGN: Prospective cohort study. SETTING: PICU in a single tertiary care children's hospital. SUBJECTS: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015...
June 11, 2018: Pediatric Critical Care Medicine
Emily Linton, Heather Keller, Lisa Duizer
There is growing interest in use of local food within health care institutions such as hospitals and long-term care homes. This study explored stakeholder perspectives on (i) influences on local food use and (ii) strategies that support success and sustainability of use in health care institutions. Fifteen participants who were institutional leaders with experience in implementing or supporting local food use in health care institutions in Ontario were recruited through purposeful and snowball sampling. A semi-structured interview was conducted by telephone and audio-recorded...
June 12, 2018: Canadian Journal of Dietetic Practice and Research
Teresa Connolly, Ellen Mahoney
AIMS AND OBJECTIVES: This study investigated the experiences of ischemic stroke survivors (ISSs) during the transitional period from the hospital through the first four weeks after discharge home. BACKGROUND: ISSs describe the transition from hospital to home as an important time in their recovery and describe various physical and cognitive concerns early within the recovery period. Adequate transitional care interventions should be informed by such experiences...
June 12, 2018: Journal of Clinical Nursing
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose Pineda, Ross C Brownson, David Limbrick
While most children with mild TBI (mTBI) without intracranial injury (ICI) can be safely discharged home from the emergency department, many are admitted to the hospital. To support evidence-based practice, we developed a decision tool to help guide hospital admission decisions. This study was a secondary analysis of a prospective study conducted in 25 emergency departments. We included children under 18 years who had Glasgow Coma Scale score 13-15 head injuries and normal CT scans or skull fractures without significant depression...
June 8, 2018: Journal of Neurotrauma
Rachel E Lean, Cynthia E Rogers, Rachel A Paul, Emily D Gerstein
Purpose of review: Parents of infants admitted to the Neonatal Intensive Care Unit (NICU) experience psychological distress, loss of the parenting role, and disruptions to parent-infant bonding. The inclusion of evidence-based practices to address these challenges in the NICU has largely been based upon short-term improvements in parent and infant functioning. However, less is known regarding the extent to which family-based interventions may also be associated with longer-term parenting behaviors and children's neurobehavioral outcomes...
March 2018: Current Treatment Options in Pediatrics
Douglas C Wolf, Srihari Jaganathan, Chakkarin Burudpakdee, Arpamas Seetasith, Robert Low, Edward Lee, Jay Gucky, Mohamed Yassine, David A Schwartz
Background: Patient support programs have a positive effect on adherence to therapy. Certolizumab pegol (CZP) is a tumor necrosis factor antagonist for the treatment of Crohn's disease. Objectives: To assess, using real-world claims data, whether home health nurse assistance had an effect on patients' adherence to CZP and to measure its impact on health care use and costs. Methods: A retrospective analysis of medical and pharmacy claims data from the IQVIA Real-World Data Adjudicated Claims Database was conducted using data from January 1, 2007 through September 30, 2015...
2018: Patient Preference and Adherence
Josephus Fm van den Heuvel, T Katrien Groenhof, Jan Hw Veerbeek, Wouter W van Solinge, A Titia Lely, Arie Franx, Mireille N Bekker
BACKGROUND: Unrestricted by time and place, electronic health (eHealth) provides solutions for patient empowerment and value-based health care. Women in the reproductive age are particularly frequent users of internet, social media, and smartphone apps. Therefore, the pregnant patient seems to be a prime candidate for eHealth-supported health care with telemedicine for fetal and maternal conditions. OBJECTIVE: This study aims to review the current literature on eHealth developments in pregnancy to assess this new generation of perinatal care...
June 5, 2018: Journal of Medical Internet Research
Paula M Lantz, George Miller, Corwin N Rhyan, Sara Rosenbaum, Leighton Ku, Samantha Iovan
Policy Points: The Pay for Success (PFS) financing approach has potential for scaling the implementation of evidence-based prevention interventions in Medicaid populations, including a range of multicomponent interventions for childhood asthma that combine home environment risk mitigation with medical case management. Even though this type of intervention is efficacious and cost-saving among high-risk children with asthma, the main challenges for implementation in a PFS context include legal and regulatory barriers to capturing federal Medicaid savings and using them as a source of private investor repayment...
June 2018: Milbank Quarterly
Patrick Ware, Emily Seto, Heather J Ross
Heart failure represents a significant burden for patients and the Canadian health care system. Home telemonitoring is proposed as an intervention that can improve heart failure outcomes by identifying opportunities for earlier clinical intervention and by providing patients with self-management support between scheduled clinic visits. The objective of this review is to provide clarity with respect to the most recent evidence of the effect of home telemonitoring on heart failure outcomes. Despite some strong evidence that telemonitoring can reduce the risk of mortality and heart failure-related hospitalizations, important inconsistencies exist in the evidence...
January 31, 2018: Canadian Journal of Cardiology
Joseph W Rossano, Ryan S Cantor, Dingwei Dai, Pirouz Shamszad, Yuan-Shung Huang, Matthew Hall, Kimberly Y Lin, R Erik Edens, P Eugene Parrino, James K Kirklin
BACKGROUND: Few data exist on resource utilization with pediatric ventricular assist devices (VADs). We tested the hypothesis that device type and adverse events are associated with increased resource utilization in pediatric patients supported with VADs. METHODS AND RESULTS: The Pediatric Interagency Registry for Mechanically Assisted Circulatory Support, a national registry of VADs in patients <19 years old, and the Pediatric Health Information System, an administrative database, were merged...
June 1, 2018: Journal of the American Heart Association
Emma J Glasson, Kingsley Wong, Helen Leonard, David Forbes, Madhur Ravikumara, Catherine Mews, Peter Jacoby, Jenny Bourke, Julian Trollor, Preeyaporn Srasuebkul, Andrew Wilson, Lakshmi Nagarajan, Jenny Downs
OBJECTIVE: Gastrostomy insertion in pediatrics is usually used in children with complex needs and severe disability. The accessibility and acceptance of the procedure is increasing but population-based occurrence data are lacking and there is limited understanding of its use in clinical subgroups. METHODS: This birth cohort study investigated the trends in first gastrostomy insertion among a pediatric population born between 1983 and 2009 in Western Australia using linked administrative and health data collected over a 32-year period (1983-2014)...
May 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
Janne L Gjerde, Guri Rortveit, Mulat Adefris, Tadesse Belayneh, Astrid Blystad
BACKGROUND: Women living in resource constrained settings often have limited knowledge of and access to surgical treatment for pelvic organ prolapse. Additionally, little is known about experiences during recovery periods or about the reintegration process for women who do gain access to medical services, including surgery. This study aimed to explore women's experiences related to recovery and reintegration after free surgical treatment for pelvic organ prolapse in a resource-constrained setting...
May 29, 2018: BMC Women's Health
Bao-Huan Yang, Chia-Ying Chung, Yuh-Shiow Li
PURPOSES: At present, there is still controversy between parents of children with muscular dystrophy (MD) and healthcare professionals on care issues. Partnerships can connect the affected children and their families to appropriate healthcare services, to jointly face the care environment together and thereby improve the quality of life of children with MD. Therefore, the objective of this study is to explore partnerships between families and healthcare professionals from the perspectives of parents of children with MD...
May 25, 2018: Asian Nursing Research
Yoshiyuki Takami, Naoki Hoshino, Yasuchika Kato, Yusuke Sakurai, Kentaro Amano, Yoshiro Higuchi, Masato Tochii, Michiko Ishida, Hiroshi Ishikawa, Yasushi Takagi, Yukio Ozaki
INTRODUCTION: Ventricular assist device is used in the patients with severe heart failure due to cardiotoxicity of anthracyclines, which are widely used chemotherapeutic agents for a wide range of malignant tumors. However, recovery of cardiac function is rare. METHODS: We present the clinical course of a 43-year-old woman in remission from diffuse large B-cell lymphoma after the chemotherapy including anthracyclines, who presented in cardiogenic shock 8 months after the end of chemotherapy...
May 1, 2018: International Journal of Artificial Organs
Michael J Pennock, Zhongyuan Yu, Karen B Hirschman, Kara Pepe, Mark V Pauly, Mary D Naylor, William B Rouse
While the use of evidence-based interventions (EBIs) has been advocated by the medical research community for quite some time, uptake of these interventions by healthcare providers has been slow. One possible explanation is that it is challenging for providers to estimate impacts of a specific EBI on their particular organization. To address that concern, we developed and evaluated a type of simulation called a policy flight simulator to determine if it could improve the adoption decision about a specific EBI, the transitional care model (TCM)...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Maria Monberg Feenstra, Mette Jørgine Kirkeby, Marianne Thygesen, Dorthe B Danbjørg, Hanne Kronborg
OBJECTIVES: Breastfeeding problems are common and associated with early cessation. Still length of postpartum hospital stay has been reduced. This leaves new mothers to establish breastfeeding at home with less support from health care professionals. The objective was to explore mothers' perspectives on when breastfeeding problems were the most challenging and prominent early postnatal. The aim was also to identify possible factors associated with the breastfeeding problems. METHODS: In a cross-sectional study, a mixed method approach was used to analyse postal survey data from 1437 mothers with full term singleton infants...
June 2018: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
Shoshana Hahn-Goldberg, Lianne Jeffs, Amy Troup, Rasha Kubba, Karen Okrainec
BACKGROUND: An admission to hospital for acute illness can be difficult for patients and lead to high levels of anxiety. Patients are given a lot of information throughout their hospital stay and instructions at discharge to follow when they get home. For complex medical patients, the ability to retain, understand, and adhere to these instructions is a critical marker of a successful transition. This study was undertaken to explore factors impacting the ability of patients to understand and adhere to instructions...
2018: PloS One
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