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CARE DELIVERY

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https://www.readbyqxmd.com/read/28241386/randomized-controlled-trial-of-abdominal-binders-for-postoperative-pain-distress-and-blood-loss-after-cesarean-delivery
#1
Samieh Ghana, Sevil Hakimi, Mojgan Mirghafourvand, Fatemeh Abbasalizadeh, Nasser Behnampour
OBJECTIVE: To assess the effect of using abdominal binders on pain, distress, and postpartum hemorrhage after cesarean delivery. METHODS: The present prospective randomized controlled trial enrolled patients undergoing non-emergency cesarean deliveries in Gonbad-e Kavus, Golestan Province, Iran, between January 22 and October 23, 2015. Patients were randomized in a 1:1 ratio by blocks of four or six to a control group or to use an abdominal binder after delivery; all patients received routine care...
February 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28241244/association-of-testosterone-replacement-with-cardiovascular-outcomes-among-men-with-androgen-deficiency
#2
T Craig Cheetham, JaeJin An, Steven J Jacobsen, Fang Niu, Stephen Sidney, Charles P Quesenberry, Stephen K VanDenEeden
Importance: Controversy exists regarding the safety of testosterone replacement therapy (TRT) following recent reports of an increased risk of adverse cardiovascular events. Objective: To investigate the association between TRT and cardiovascular outcomes in men with androgen deficiency. Design, Setting, and Participants: A retrospective cohort study was conducted within an integrated health care delivery system. Men at least 40 years old with evidence of androgen deficiency either by a coded diagnosis and/or a morning serum total testosterone level of less than 300 ng/dL were included...
February 21, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28240568/-re-moving-the-needle-prospects-for-all-oral-treatment-for-multidrug-resistant-tuberculosis
#3
M Milstein, A Brzezinski, F Varaine, C D Mitnick
BACKGROUND: Currently recommended regimens for multidrug-resistant tuberculosis (MDR-TB) contain painful daily injections and are unsuccessful in approximately half of patients. Removal of the injectable agent to fashion all-oral regimens could transform MDR-TB treatment and access to care. OBJECTIVE: To explore evidence for all-oral treatment regimens. DESIGN: We review evidence on drugs that could be included in injection-free MDR-TB regimens...
December 1, 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28240381/the-global-network-neonatal-cause-of-death-algorithm-for-low-resource-settings
#4
Ana L Garces, Elizabeth M McClure, Wilton Pérez, K Michael Hambidge, Nancy F Krebs, Lester Figueroa, Carl L Bose, Waldemar A Carlo, Constance Tenge, Fabian Esamai, Shivaprasad S Goudar, Sarah Saleem, Archana B Patel, Melody Chiwila, Elwyn Chomba, Antoinette Tshefu, Richard J Derman, Patricia L Hibberd, Sherri Bucher, Edward A Liechty, Melissa Bauserman, Janet L Moore, Marion Koso-Thomas, Menachem Miodovnik, Robert L Goldenberg
AIM: This study estimated the causes of neonatal death using an algorithm for low-resource areas, where 98% of the world's neonatal deaths occur. METHODS: We enrolled women in India, Pakistan, Guatemala, the Democratic Republic of Congo, Kenya and Zambia from 2014-2016 and tracked their delivery and newborn outcomes for up to 28 days. Antenatal care and delivery symptoms were collected using a structured questionnaire, clinical observation and, or, a physical examination...
February 27, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28239604/predictors-of-antenatal-care-skilled-birth-attendance-and-postnatal-care-utilization-among-the-remote-and-poorest-rural-communities-of-zambia-a-multilevel-analysis
#5
Choolwe Jacobs, Mosa Moshabela, Sitali Maswenyeho, Nildah Lambo, Charles Michelo
OBJECTIVE: Optimal utilization of maternal health-care services is associated with reduction of mortality and morbidity for both mothers and their neonates. However, deficiencies and disparity in the use of key maternal health services within most developing countries still persist. We examined patterns and predictors associated with the utilization of specific indicators for maternal health services among mothers living in the poorest and remote district populations of Zambia. METHODS: A cross-sectional baseline household survey was conducted in May 2012...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28239509/system-design-and-development-of-a-robotic-device-for-automated-venipuncture-and-diagnostic-blood-cell-analysis
#6
Max L Balter, Alvin I Chen, Alex Fromholtz, Alex Gorshkov, Tim J Maguire, Martin L Yarmush
Diagnostic blood testing is the most prevalent medical procedure performed in the world and forms the cornerstone of modern health care delivery. Yet blood tests are still predominantly carried out in centralized labs using large-volume samples acquired by manual venipuncture, and no end-to-end solution from blood draw to sample analysis exists today. Our group is developing a platform device that merges robotic phlebotomy with automated diagnostics to rapidly deliver patient information at the site of the blood draw...
October 2016: Proceedings of the ... IEEE/RSJ International Conference on Intelligent Robots and Systems
https://www.readbyqxmd.com/read/28239449/prevention-is-better-the-case-of-the-underutilized-failure-mode-effect-analysis-in-patient-safety
#7
EDITORIAL
Lewis Goodrum, Prathibha Varkey
Prospective hazard analysis methodologies, like failure modes and effects analysis (FMEA), have been tried and tested in the engineering industry and are more recently gaining momentum in healthcare. Considering FMEA's evidence based successes, this commentary makes the case that healthcare is underutilizing the methodology by relying on retrospective hazard analysis. Healthcare leaders should determine where prospective hazard analysis principles could be better built into care delivery planning and processes that will enhance patient safety...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28239019/specialty-care-access-in-the-safety-net-the-role-of-public-hospitals-and-health-systems
#8
Lena K Makaroun, Chelsea Bowman, Kevin Duan, Nathan Handley, Daniel J Wheeler, Edgar Pierluissi, Alice Hm Chen
Access to specialty care in the United States safety net, already strained, is fac-ing increasing pressure with an influx of patients following the passage of the Affordable Care Act (ACA). We surveyed 18 public hospitals and health systems across the country to describe the current state of specialty care delivery in safety-net systems. We elicited information regarding challenges, provider models, metrics of access and productivity, and strategies for improving access. Based on our findings, we propose a framework for assessing and improving specialty care access with a focus on population health planning...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28238994/can-incentives-reduce-the-barriers-to-use-of-antenatal-care-and-delivery-services-in-kenya-results-of-a-qualitative-inquiry
#9
Eleanor Fleming, Joanna Gaines, Katherine O'Connor, Judith Ogutu, Nancy Atieno, Salimah Atieno, Mary L Kamb, Robert Quick
A qualitative inquiry was used to assess if incentives consisting of a hygiene kit, protein-fortified flour, and delivery kit reduced barriers to antenatal care and delivery services in Nyanza Province, Kenya. We conducted 40 interviews (baseline: five nurses, six mothers, one focus group of five mothers; follow-up: nine nurses, 19 mothers) to assess perceptions of these services. Mothers and nurses identified poor quality of care, fear of HIV diagnosis and stigma, inadequate transport, and cost of care as barriers...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28238633/early-neonatal-death-a-challenge-worldwide
#10
REVIEW
Liisa Lehtonen, Ana Gimeno, Anna Parra-Llorca, Máximo Vento
Early neonatal death (ENND), defined as the death of a newborn between zero and seven days after birth, represents 73% of all postnatal deaths worldwide. Despite a 50% reduction in childhood mortality, reduction of ENND has significantly lagged behind other Millennium Developmental Goal achievements and is a growing contributor to overall mortality in children aged <5 years. The etiology of ENND is closely related to the level of a country's industrialization. Hence, prematurity and congenital anomalies are the leading causes in high-income countries...
February 23, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28238577/geometrical-and-dosimetrical-uncertainties-in-hypofractionated-radiotherapy-of-the-lung-a-review
#11
REVIEW
Marco Schwarz, Giovanni Mauro Cattaneo, Livia Marrazzo
The application of high precision hypofractionated regimes (a.k.a. stereotactic body radiotherapy (SBRT)) to the treatment of lung cancer is a 'success story' of radiotherapy. From the technical perspective, lung SBRT is a challenging technique as all aspects of the treatment workflow, from imaging to dose calculation to treatment delivery, should be carefully handled in order to ensure consistency between planned and delivered dose. In this review such technical aspects are presented and discussed, looking at what has been developed over the years...
February 23, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28238520/precision-surgery-and-avoiding-over-treatment
#12
REVIEW
A Hosseini, A L Khoury, L J Esserman
Over-diagnosis and over-treatment are consequences of greater awareness about breast cancer, more intensive screening, and the resultant identification of more cases of breast cancer that are low or ultralow risk. This area represents an important opportunity to optimize the delivery of appropriate targeted therapy for breast cancer patients. Despite the evolution of breast cancer care over the last few decades and our ability to tailor treatment to biology, a one-size fits all approach is still prevalent in the local and regional management of and screening for breast cancer, failing to reflect the unique biology and tumor characteristics of each patient...
February 11, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28238456/ethical-issues-in-dialysis-therapy
#13
Vivekanand Jha, Dominique E Martin, Joanne M Bargman, Simon Davies, John Feehally, Fred Finkelstein, David Harris, Madhukar Misra, Giuseppe Remuzzi, Adeera Levin
Treatment for end-stage kidney disease is a major economic challenge and a public health concern worldwide. Renal-replacement therapy poses several practical and ethical dilemmas of global relevance for patients, clinicians, and policy makers. These include how to: promote patients' best interests; increase access to dialysis while maintaining procedural and distributive justice; minimise the influence of financial incentives and competing interests; ensure quality of care in service delivery and access to non-dialytic supportive care when needed; minimise the financial burden on patients and health-care system; and protect the interests of vulnerable groups during crisis situations...
February 23, 2017: Lancet
https://www.readbyqxmd.com/read/28238131/brain-penetrating-nanoparticles-for-analysis-of-the-brain-microenvironment
#14
Elizabeth Nance
The past decade has witnessed explosive growth in the development of nanoparticle-based therapies for the treatment of neurological disorders and diseases. The systemic delivery of therapeutic carriers to the central nervous system (CNS) is hindered by both the blood-brain barrier (BBB) and the porous and electrostatically charged brain extracellular matrix (ECM), which acts as a steric and adhesive barrier. Therapeutic delivery to the brain is influenced by changes in the brain microenvironment, which can occur as a function of physiology, biology, pathology, and developmental age...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28237984/effect-of-a-quality-improvement-program-to-improve-guideline-adherence-and-attainment-of-clinical-standards-in-dialysis-care-report-of-outcomes-in-year-1
#15
Sajeda Youssouf, Azri Nache, Chandrakumaran Wijesekara, Rachel J Middleton, David Lewis, Aladdin E Shurrab, Edmond O'Riordan, Lesley P Lappin, Donal O'Donoghue, Philip A Kalra, Janet Hegarty
BACKGROUND: Best practice in dialysis is synthesised in clear international guidelines. However, a large gap remains between the international guidelines and the actual delivery of care. In this paper, we report outcomes for the first year of a multifaceted dialysis improvement programme in our network. METHODS: One year collaborative involving 3 haemodialysis units and a peritoneal dialysis (PD) programme involving 299 dialysis patients. Each unit addressed a different indicator (unit A - catheter-related bloodstream infection [CRBSI], unit B - pre-dialysis blood pressure [BP], unit C - dialysis dose, unit D - anaemia) with a shared aim to match the top 10% in the UK...
February 25, 2017: Nephron
https://www.readbyqxmd.com/read/28237586/benchmarking-passive-transfer-of-immunity-and-growth-in-dairy-calves
#16
D J Atkinson, M A G von Keyserlingk, D M Weary
Poor health and growth in young dairy calves can have lasting effects on their development and future production. This study benchmarked calf-rearing outcomes in a cohort of Canadian dairy farms, reported these findings back to producers and their veterinarians, and documented the results. A total of 18 Holstein dairy farms were recruited, all in British Columbia. Blood samples were collected from calves aged 1 to 7 d. We estimated serum total protein levels using digital refractometry, and failure of passive transfer (FPT) was defined as values below 5...
February 22, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28237252/effect-of-ebola-virus-disease-on-maternal-and-child-health-services-in-guinea-a-retrospective-observational-cohort-study
#17
Alexandre Delamou, Alison M El Ayadi, Sidikiba Sidibe, Therese Delvaux, Bienvenu S Camara, Sah D Sandouno, Abdoul H Beavogui, Georges W Rutherford, Junko Okumura, Wei-Hong Zhang, Vincent De Brouwere
BACKGROUND: The 2014 west African epidemic of Ebola virus disease posed a major threat to the health systems of the countries affected. We sought to quantify the consequences of Ebola virus disease on maternal and child health services in the highly-affected Forest region of Guinea. METHODS: We did a retrospective, observational cohort study of women and children attending public health facilities for antenatal care, institutional delivery, and immunisation services in six of seven health districts in the Forest region (Beyla, Guéckédou, Kissidougou, Lola, Macenta, and N'Zérékoré)...
February 22, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28237214/advancing-value-assessment-in-the-united-states-a-multistakeholder-perspective
#18
Corinna Sorenson, Gabriela Lavezzari, Gregory Daniel, Randy Burkholder, Marc Boutin, Edmund Pezalla, Gillian Sanders, Mark McClellan
Rising costs without perceived proportional improvements in quality and outcomes have motivated fundamental shifts in health care delivery and payment to achieve better value. Aligned with these efforts, several value assessment frameworks have been introduced recently to help providers, patients, and payers better understand the potential value of drugs and other interventions and make informed decisions about their use. Given their early stage of development, it is imperative to evaluate these efforts on an ongoing basis to identify how best to support and improve them moving forward...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28237212/value-assessment-at-the-point-of-care-incorporating-patient-values-throughout-care-delivery-and-a-draft-taxonomy-of-patient-values
#19
Melissa J Armstrong, C Daniel Mullins
Incorporation of patient values is a key element of patient-centered care, but consistent incorporation of patient values at the point of care is lacking. Shared decision making encourages incorporation of patient values in decision making, but associated tools often lack guidance on value assessment. In addition, focusing on patient values relating only to specific decisions misses an opportunity for a more holistic approach to value assessment that could impact other aspects of clinical encounters, including health care planning, communication, and stakeholder involvement...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28236836/reprint-of-long-term-survivorship-after-hematopoietic-cell-transplantation-roadmap-for-research-and-care
#20
REVIEW
Minoo Battiwalla, André Tichelli, Navneet S Majhail
The number of survivors after hematopoietic cell transplantation (HCT) is expected to dramatically increase over the next decade. Significant and unique challenges confront survivors for decades after their underlying indication (malignancy or marrow failure) has been cured by HCT. The National Institutes of Health (NIH) Late Effects Consensus Conference in June 2016 brought together international experts in the field to plan the next phase of survivorship efforts. Working groups laid out the roadmap for collaborative research and health care delivery...
March 2017: Biology of Blood and Marrow Transplantation
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