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Effect of age of healthcare on safety healthcare services

Elin Taube, Jimmie Kristensson, Patrik Midlöv, Ulf Jakobsson
AIM: To investigate the effects of a case management intervention for community-dwelling frail older people, with functional dependency and repeated contacts with the healthcare services, focusing on loneliness, depressive symptoms and life satisfaction. DESIGN: A two-armed, nonblinded, randomised control trial with repeated follow-ups, of N = 153 participants at baseline allocated to an intervention (n = 80) and control (n = 73) group. METHOD: Inclusion criteria were the following: ≥65 years of age, living in ordinary housing, in need of assistance in two or more self-reported activities of daily living, having at least two hospital admissions or at least four visits in outpatient care 12 months prior to enrolment...
September 12, 2017: Scandinavian Journal of Caring Sciences
Ruth Zurbriggen, Brianna Keefe-Oates, Caitlin Gerdts
OBJECTIVE: Legal restrictions on abortion access impact the safety and timing of abortion. Women affected by these laws face barriers to safe care that often result in abortion being delayed. Second-trimester abortion affects vulnerable groups of women disproportionately, and is often more difficult to access. In Argentina, where abortion is legally restricted except in cases of rape or threat to the health of the woman, the Socorristas en Red, a feminist network, offers a model of accompaniment wherein they provide information and support to women seeking second-trimester abortions...
August 8, 2017: Contraception
Alyson L Huntley, Melanie Chalder, Ali R G Shaw, William Hollingworth, Chris Metcalfe, Jonathan Richard Benger, Sarah Purdy
BACKGROUND/OBJECTIVES: There are some older patients who are 'at the decision margin' of admission. This systematic review sought to explore this issue with the following objective: what admission alternatives are there for older patients and are they safe, effective and cost-effective? A secondary objective was to identify the characteristics of those older patients for whom the decision to admit to hospital may be unclear. DESIGN: Systematic review of controlled studies (April 2005-December 2016) with searches in Medline, Embase, Cinahl and CENTRAL databases...
August 1, 2017: BMJ Open
Krista J Siefried, Limin Mao, Stephen Kerr, Lucette A Cysique, Thomas M Gates, John McAllister, Anthony Maynard, John de Wit, Andrew Carr
BACKGROUND: Missing more than one tablet of contemporary antiretroviral therapy (ART) per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings. METHODS: Adults on ART with undetectable viral load (UDVL) were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs...
2017: PloS One
Sharon Goldfeld, Anna Price, Hannah Bryson, Tracey Bruce, Fiona Mensah, Francesca Orsini, Lisa Gold, Harriet Hiscock, Charlene Smith, Lara Bishop, Dianne Jackson, Lynn Kemp
INTRODUCTION: By the time children start school, inequities in learning, development and health outcomes are already evident. Sustained nurse home visiting (SNHV) offers a potential platform for families experiencing adversity, who often have limited access to services. While SNHV programmes have been growing in popularity in Australia and internationally, it is not known whether they can improve children's learning and development when offered via the Australian service system. The right@home trial aims to investigate the effectiveness of an SNHV programme, offered to women from pregnancy to child age 2 years, in improving parent care of and responsivity to the child, and the home learning environment...
March 20, 2017: BMJ Open
Elizabeth Sadock, Paul B Perrin, Renée M Grinnell, Bruce Rybarczyk, Stephen M Auerbach
OBJECTIVE: Despite the recognized importance of integrated behavioral health, particularly in safety net primary care, its effectiveness in real world settings has not been extensively evaluated. This article presents 2 successive studies examining the effectiveness of integrated behavioral care in a safety net setting. METHOD: Study 1 compared the depression and anxiety scores of predominately low-income and minority patients who underwent brief interventions (N = 147) to those of patients from a demographically similar comparison clinic without integrated psychological services, matched on baseline levels of anxiety and depression and length of time between assessments (N = 139)...
February 2, 2017: Journal of Clinical Psychology
Kim Tran, Chaim Bell, Nathan Stall, George Tomlinson, Allison McGeer, Andrew Morris, Michael Gardam, Howard B Abrams
BACKGROUND: Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes. OBJECTIVE: To examine the effect of isolation precautions on hospital-related outcomes and cost of care. DESIGN: Retrospective, propensity-score matched cohort study of inpatients admitted to general internal medicine (GIM) services at three academic hospitals in Toronto, Ontario, Canada between January 2010 and December 2012...
March 2017: Journal of General Internal Medicine
Monika R Asnani, Kim R Quimby, Nadia R Bennett, Damian K Francis
BACKGROUND: Sickle cell disease is a group of genetic diseases which is especially prevalent in tropical and subtropical regions; however, forced migration and ongoing population movement have spread it throughout the world, with estimated birth rates reaching 0.49 per 1000 in the Americas, 0.07 per 1000 in Europe, 0.68 per 1000 in South and Southeast Asia, and 10.68 per 1000 in Africa. Life for individuals with sickle cell disease can be affected by repeated acute complications and compounded by progressive organ damage...
October 6, 2016: Cochrane Database of Systematic Reviews
Joseph E Tanenbaum, Jacob A Miller, Vincent J Alentado, Daniel Lubelski, Benjamin P Rosenbaum, Edward C Benzel, Thomas E Mroz
BACKGROUND CONTEXT: The incidence of adverse care quality events among patients undergoing cervical fusion surgery is unknown using the definition of care quality employed by the Centers for Medicare and Medicaid Services (CMS). The effect of insurance status on the incidence of these adverse quality events is also unknown. PURPOSE: This study determined the incidence of hospital-acquired conditions (HAC) and patient safety indicators (PSI) in patients with cervical spine fusion and analyzed the association between primary payer status and these adverse events...
January 2017: Spine Journal: Official Journal of the North American Spine Society
Anna-Maija Tolppanen, Heidi Taipale, Marjaana Koponen, Piia Lavikainen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen
PURPOSE: The aim of the Medicine use and Alzheimer's disease (MEDALZ) study is to investigate the changes in medication and healthcare service use among persons with Alzheimer's disease (AD) and to evaluate the safety and effectiveness of medications in this group. This is important, because the number of persons with AD is rapidly growing and even though they are a particularly vulnerable patient group, the number of representative, large-scale studies with adequate follow-up time is limited...
2016: BMJ Open
Maharajan Raman, Darren Green, Rachel J Middleton, Philip A Kalra
BACKGROUND: Chronic kidney disease (CKD) is a global problem. With an ageing population the burden on the health services has increased due to the growing number of older people with CKD. This group of individuals is far different to the younger CKD population and their risk of cardiovascular death is far greater than the risk of progressing to end stage kidney disease (ESKD). OBJECTIVE: In this review we explore the role of certain biomarkers and medications in predicting the risk of progression to ESKD and death in old people with CKD...
September 2016: Journal of Renal Care
Shoroq M Altawalbeh, Carolyn T Thorpe, Janice C Zgibor, Sandra Kane-Gill, Yihuang Kang, Joshua M Thorpe
OBJECTIVES: To compare the effectiveness and cardiovascular safety of long-acting beta-agonists (LABAs) with those of leukotriene receptor antagonists (LTRAs) as add-on treatments in older adults with asthma already taking inhaled corticosteroids (ICSs). DESIGN: Retrospective cohort study. SETTING: Medicare fee-for-service (FFS) claims (2009-10) for a 10% random sample of beneficiaries continuously enrolled in Parts A, B, and D in 2009. PARTICIPANTS: Medicare beneficiaries aged 66 and older continuously enrolled in FFS Medicare with Part D coverage with a diagnosis of asthma before 2009 treated exclusively with ICSs plus LABAs or ICSs plus LTRAs (N = 14,702)...
August 2016: Journal of the American Geriatrics Society
Kathryn Hefner, Robert Rosenheck, Jeremy Merrel, Marcedes Coffman, Gerry Valentine, Mehmet Sofuoglu
OBJECTIVE: Individuals with mental illness and substance use disorders smoke at elevated rates and tend to have greater difficulty quitting smoking as compared to the general population. Some believe that e-cigarettes may reduce harm associated with smoking, but little is known about e-cigarette use, perceptions, and motivations for their use among individuals with mental health and/or substance use disorders. METHODS: Rates and correlates of e-cigarette use, perceptions, and sources of information about e-cigarettes among smokers seeking mental health and/or substance use services (N = 188) at the VA Connecticut Healthcare System were assessed via a brief survey...
April 2016: Journal of Dual Diagnosis
Karen B Farris, Teresa M Salgado, Nadia Aneese, Vincent D Marshall, Jane F Pendergast, Jessica Frank, Elizabeth A Chrischilles, William R Doucette
BACKGROUND: Comprehensive medication reviews (CMRs) consist of in-depth reviews of patients' medications to identify effectiveness or safety problems and often generate cost savings for individuals. Despite their advantages, CMRs are not widely obtained. Previous studies found that older age, female sex, and experience of side effects were associated with obtaining a medication review. OBJECTIVE: To quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a CMR among Medicare Part D beneficiaries...
April 2016: Journal of Managed Care & Specialty Pharmacy
Sharmani Barnard, Caron Kim, Min Hae Park, Thoai D Ngo
BACKGROUND: The World Health Organization recommends that abortion can be provided at the lowest level of the healthcare system. Training mid-level providers, such as midwives, nurses and other non-physician providers, to conduct first trimester aspiration abortions and manage medical abortions has been proposed as a way to increase women's access to safe abortion procedures. OBJECTIVES: To assess the safety and effectiveness of abortion procedures administered by mid-level providers compared to doctors...
2015: Cochrane Database of Systematic Reviews
Carmel T Collins, Maria Makrides, Andrew J McPhee
BACKGROUND: Early discharge of stable preterm infants still requiring gavage feeds offers the benefits of uniting families sooner and reducing healthcare and family costs compared with discharge home when on full sucking feeds. Potential disadvantages of early discharge include increased care burden for the family and risk of complications related to gavage feeding. OBJECTIVES: To determine the effects of a policy of early discharge of stable preterm infants with home support of gavage feeding compared with a policy of discharge of such infants when they have reached full sucking feeds...
2015: Cochrane Database of Systematic Reviews
Luzhao Feng, Peng Yang, Tao Zhang, Juan Yang, Chuanxi Fu, Ying Qin, Yi Zhang, Chunna Ma, Zhaoqiu Liu, Quanyi Wang, Genming Zhao, Hongjie Yu
Influenza, caused by the influenza virus, is a respiratory infectious disease that can severely affect human health. Influenza viruses undergo frequent antigenic changes, thus could spread quickly. Influenza causes seasonal epidemics and outbreaks in public gatherings such as schools, kindergartens, and nursing homes. Certain populations are at risk for severe illness from influenza, including pregnant women, young children, the elderly, and people in any ages with certain chronic diseases.
2015: Human Vaccines & Immunotherapeutics
Erin Reiney, Jennifer Allison, Rebekah Hunt
STATEMENT OF PURPOSE: Every year, one in nine young people is injured seriously enough to require medical attention, and nearly 320,000 injury-related hospitalizations occur. Injuries are a leading cause of medical spending for children and adolescents, a burden estimated at $4 billion in annual healthcare costs for hospitalizations alone. By focusing on the reduction of injury-related hospitalizations, public health professionals can significantly reduce the toll of injuries in the U...
April 2015: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Øystein Døhl, Helge Garåsen, Jorid Kalseth, Jon Magnussen
This study reports an analysis of factors associated with home care use in a setting in which long-term care services are provided within a publicly financed welfare system. We considered two groups of home care recipients: elderly individuals and intellectually disabled individuals. Routinely collected data on users of public home care in the municipality of Trondheim in October 2012, including 2493 people aged 67 years or older and 270 intellectually disabled people, were used. Multivariate regression analysis was used to analyse the relationship between the time spent in direct contact with recipients by public healthcare personnel and perceived individual determinants of home care use (i...
May 2016: Health & Social Care in the Community
Roni Evans, Corrie Vihstadt, Kristine Westrom, Lori Baldwin
INTRODUCTION: The world's population is aging quickly, leading to increased challenges of how to care for individuals who can no longer independently care for themselves. With global social and economic pressures leading to declines in family support, increased reliance is being placed on community- and government-based facilities to provide long-term care (LTC) for many of society's older citizens. Complementary and integrative healthcare (CIH) is commonly used by older adults and may offer an opportunity to enhance LTC residents' wellbeing...
January 2015: Global Advances in Health and Medicine: Improving Healthcare Outcomes Worldwide
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