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Aled Jones, Ben Hannigan, Michael Coffey, Alan Simpson
CONTEXT: In response to political and social factors over the last sixty years mental health systems internationally have endeavoured to transfer the delivery of care from hospitals into community settings. As a result, there has been increased emphasis on the need for better quality care planning and care coordination between hospital services, community services and patients and their informal carers. The aim of this systematic review of international research is to explore which interventions have proved more or less effective in promoting personalized, recovery oriented care planning and coordination for community mental health service users...
2018: PloS One
Bethany A Matus, Kayla M Bridges, John V Logomarsino
BACKGROUND: Individualized feeding care plans and safe handling of milk (human or formula) are critical in promoting growth, immune function, and neurodevelopment in the preterm infant. Feeding errors and disruptions or limitations to feeding processes in the neonatal intensive care unit (NICU) are associated with negative safety events. Feeding errors include contamination of milk and delivery of incorrect or expired milk and may result in adverse gastrointestinal illnesses. PURPOSE: The purpose of this review was to evaluate the effect(s) of centralized milk preparation, use of trained technicians, use of bar code-scanning software, and collaboration between registered dietitians and registered nurses on feeding safety in the NICU...
June 21, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Nataskja-Elena Kersting Lie, Per Koren Solvang, May Aasebø Hauken
BACKGROUND: Cancer coordinators (CCs) operate at both patient and system levels in order to provide patients with tailored and coordinated services. In common with international CCs, Norwegian CCs denote notable progress in their patient-focused work, while reporting ongoing challenges in carrying out system-focused tasks. However, little is known about the barriers and facilitators for CCs' system-level work. OBJECTIVE: The aim of this study was to explore Norwegian CCs' experiences of barriers and facilitators for enacting system-focused tasks...
June 22, 2018: Cancer Nursing
Catherine Paterson, Charlotte Primeau, Irene Pullar, Ghulam Nabi
BACKGROUND: An important question revolves around when the most opportune time is to introduce recovery-optimizing behaviors for men opting for radical prostatectomy (RP) for localized prostate cancer (PCa). An emerging field of research describes the role of preoperative strategies to improve treatment tolerance and overall physical and psychological recovery. OBJECTIVE: The aim of this study was to explore the perceptions of a multimodal prehabilitation intervention for men and their partners before RP for localized PCa...
June 22, 2018: Cancer Nursing
M Shimoji, B Ramaswamy, M I Shukoor, P Benhal, A Broda, S Kulkarni, P Malik, B McCaffrey, J-F Lafond, A Nacev, I N Weinberg, B Shapiro, D A Depireux
This paper investigates the safety of a novel 'magnetic injection' method of delivering therapy to the cochlea, in a rodent model. In this method of administration, a magnetic field is employed to actively transport drug-eluting iron oxide-core nanoparticles into the cochlea, where they then release their drug payload (we delivered the steroid prednisolone). Our study design and selection of control groups was based on published regulatory guidance for safety studies that involve local drug delivery. We tested for both single and multiple delivery doses to the cochlea, and found that magnetic delivery did not harm hearing...
June 19, 2018: European Journal of Pharmaceutical Sciences
Melissa J Bond, Andrea Knopp
The number of people in need of palliative care is growing worldwide, particularly in the developing world. The World Health Organization recognises palliative care as a basic human right, but there are many challenges for delivering palliative care in low- and middle-income countries. In the African continent, the African Palliative Care Association (APCA) provides guidance for political advocacy for developing palliative care programmes and has developed the APCA Palliative Outcome Score (POS), an evidence-based tool for measuring outcomes of palliative care...
June 2, 2018: International Journal of Palliative Nursing
Heng Yin, Lei Zhao, Ying Lin, Ying Wang, Yaping Hu, Guoqiang Sun, Mei Xiao
AIM: To compare perinatal outcomes of dinoprostone for induced labor in pregnancies with a borderline versus normal amniotic fluid index (AFI) at term, and to investigate the related factors affecting outcomes of cesarean section. METHODS: The retrospective study was carried out in Hubei Maternal and Child Health Hospital with singleton pregnancies of 37-42 weeks' gestation from January to August 2016. A total of 992 subjects were divided into two groups: borderline AFI group (n =125) with 5 < AFI ≤ 8 and normal AFI group (n = 867) with 8 < AFI ≤ 24...
June 22, 2018: Journal of Obstetrics and Gynaecology Research
Melissa J Palmer, Sharmani Barnard, Pablo Perel, Caroline Free
BACKGROUND: Cardiovascular disease (CVD) is a major cause of disability and mortality globally. Premature fatal and non-fatal CVD is considered to be largely preventable through the control of risk factors via lifestyle modifications and preventive medication. Lipid-lowering and antihypertensive drug therapies for primary prevention are cost-effective in reducing CVD morbidity and mortality among high-risk people and are recommended by international guidelines. However, adherence to medication prescribed for the prevention of CVD can be poor...
June 22, 2018: Cochrane Database of Systematic Reviews
David A Marker, Russ Mardon, Frank Jenkins, Joanne Campione, Jennifer Nooney, Jane Li, Sharon Saydeh, Xuanping Zhang, Sundar Shrestha, Deborah Rolka
Many statisticians and policy researchers are interested in using data generated through the normal delivery of health care services, rather than carefully designed and implemented population-representative surveys, to estimate disease prevalence. These larger databases allow for the estimation of smaller geographies, for example, states, at potentially lower expense. However, these health care records frequently do not cover all of the population of interest and may not collect some covariates that are important for accurate estimation...
June 22, 2018: Statistics in Medicine
R Perera, N Oliver, E Wilmot, C Marriott
Since the introduction of real-time continuous glucose monitoring (CGM) systems more than 15 years ago and, more recently, flash glucose monitoring (Flash-GM), clinical studies have observed reductions in HbA1c , independent of insulin delivery method, with decreasing time spent in hypoglycaemia [1] and reduction in glycaemic variability [2]. CGM can improve quality of life and reduce diabetes-related distress [3], including fear of hypoglycaemia [4,5]. Despite these benefits, CGM has yet to be fully implemented as part of the standard of care for people living with Type 1 diabetes in England, and there is considerable variation in how it is funded through local payer organizations...
June 22, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Elisabeth Simoes, Joachim Graf, Alexander N Sokolov, Eva-Maria Grischke, Andreas D Hartkopf, Markus Hahn, Martin Weiss, Harald Abele, Harald Seeger, Sara Y Brucker
PURPOSE: Pregnancy-associated breast cancer (PABC) is considered the second most common malignancy affecting pregnancy. The limited knowledge as to long-term survival is nonuniform. This retrospective study aims to contribute by a follow-up of pregnancies of breast cancer patients treated at a single university centre with focus on maternal long-term survival in relation to time point of diagnosis (before, during, and after pregnancy). METHODS: Data of 25 patients were reviewed for the period between 2000 and 2009 in relation to their neonatal and maternal outcome parameters as well as their maternal breast cancer outcomes by assessing maternal mortality at annual intervals up to a maximum of 10 years follow-up...
June 21, 2018: Archives of Gynecology and Obstetrics
Christine M McDonald, Sarah West, David Dushenski, Stephen E Lapinsky, Christine Soong, Kate van den Broek, Melanie Ashby, Gillian Wilde-Friel, Carrie Kan, Mark McIntyre, Andrew Morris
Objective: To develop a triage-based screening algorithm and treatment order-sets aimed at improving the quality of care of all patients with sepsis presenting to our emergency department (ED). Design: Retrospective cohort study conducted during a pre-intervention period from 1 April 2010 to 31 March 2011 and a post-intervention period from 1 September 2014 to 30 April 2015. Setting: A large teaching hospital located in Toronto, Ontario, Canada with a 35-bed ED...
June 20, 2018: International Journal for Quality in Health Care
Xiaolin Wang, Da Zhao, Duc T T Phan, Jingquan Liu, Xiang Chen, Bin Yang, Christopher C W Hughes, Weijia Zhang, Abraham P Lee
Autonomous and self-powered micropumps are in critical demand for versatile cell- and tissue-based applications as well as for low-cost point-of-care testing (POCT) in microfluidics fields. The hydrostatic pressure-driven passive micropumps are simple and widely used, but they cannot maintain steady and continuous flow for long periods of time. Here, we propose a hydrostatic pressure-driven passive micropump enhanced with siphon-based autofill function, which can realize the autonomous and continuous perfusion with well-controlled steady flow over an extended time without electric power consumption...
June 22, 2018: Lab on a Chip
Samuel I Watson, Harvir Sahota, Celia A Taylor, Yen-Fu Chen, Richard J Lilford
Background: Low and middle income countries (LMICs) face severe resource limitations but the highest burden of disease. There is a growing evidence base on effective and cost-effective interventions for these diseases. However, questions remain about the most cost-effective method of delivery for these interventions. We aimed to review the scope, quality, and findings of economic evaluations of service delivery interventions in LMICs. Methods: We searched PUBMED, MEDLINE, EconLit, and NHS EED for studies published between 1st January 2000 and 30th October 2016 with no language restrictions...
2018: Global Health Research and Policy
Andrew J Knighton, Kimberly D Brunisholz, Samuel T Savitz
Introduction: Socio-economic status (SES) and low health literacy (LHL) are closely correlated. Both are directly associated with clinical and behavioral risk factors and healthcare outcomes. Learning healthcare systems are introducing small-area measures to address the challenges associated with maintaining patient-reported measures of SES and LHL. This study's purpose was to measure the association between two available census block measures associated with SES and LHL. Understanding the relationship can guide the identification of a multi-purpose area based measure for delivery system use...
December 15, 2017: EGEMS
Sally H Adams, M Jane Park, Lauren Twietmeyer, Claire D Brindis, Charles E Irwin
PURPOSE: Despite decades of emphasizing the delivery of adolescent preventive care visits and evidence that many preventive services reduce risk, little evidence links preventive visits to increased preventive service delivery. This study examined whether a preventive healthcare visit versus any nonpreventive healthcare visit was associated with higher rates of adolescent and young adult preventive services. METHODS: Analyzed Medical Expenditure Panel Survey data (2013-2015) to determine whether those with a preventive versus nonpreventive healthcare visit had higher rates of past-year preventive services receipt; adolescents (N = 8,474, ages 10-17) and young adults (N = 5,732, ages 18-25)...
June 19, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Jason M Satterfield, Steven E Gregorich, Sara Kalkhoran, Paula J Lum, Jessica Bloome, Nicholas Alvarado, Ricardo F Muñoz, Maya Vijayaraghavan
INTRODUCTION: Although evidence-based, the 5A's (Ask, Advise, Assess, Assist, and Arrange) for smoking cessation are often incompletely delivered by primary care providers. This study examines whether a computer tablet 5A's intervention improves primary care provider adherence to the 5A's. STUDY DESIGN: Cluster RCT. SETTING/PARTICIPANTS: All primary care providers in three urban, adult primary care clinics were randomized for participation...
July 2018: American Journal of Preventive Medicine
Vivek Shetty, John Yamamoto, Kenneth Yale
The convergent forces of rising costs, growing consumerism, expensive new treatments, sociodemographic shifts and increasing health disparities are exerting intense and unsustainable pressures on healthcare systems. As with the other health domains, these disruptive forces demand new approaches and delivery models for oral healthcare. Technological innovations and practices borrowed from the e-commerce and tech sectors could facilitate the move to a sustainable 21st century oral healthcare system, one that delivers high-quality, value-based care to wider groups of patients...
July 2018: Journal of Dentistry
Cara L Wallace, Dulce M Cruz-Oliver, Jennifer E Ohs, Leslie Hinyard
BACKGROUND: Although practitioners overwhelmingly agree on the importance of advance care planning (ACP) and preparing for the end of life (EOL), the process is fraught with barriers. OBJECTIVE: The goal of this research was to explore potential connections between providers' own personal experiences and current professional practices in ACP and EOL care. DESIGN: A cross-sectional survey design, gathering voluntary, anonymous responses from participants between August and December 2016...
January 1, 2018: American Journal of Hospice & Palliative Care
Evan C Chen, Amir T Fathi, Andrew M Brunner
Despite increasing understanding of the pathobiology of acute myeloid leukemia (AML), outcomes remain dismal particularly for patients over the age of 60 years, a population enriched for therapy-related AML (tAML) and secondary AML (sAML). For decades, the standard of care for AML has been the combination of cytarabine and daunorubicin, typically delivered in combination as "7 + 3" induction. In 2017, a liposomal-encapsulated combination of daunorubicin and cytarabine (CPX-351, Vyxeos) was approved by the US Food and Drug Administration (FDA) for use in the treatment of newly diagnosed tAML or AML with myelodysplasia-related changes (AML-MRCs)...
2018: OncoTargets and Therapy
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