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Integrated Care

Emilie Venables, Jeffrey K Edwards, Saar Baert, William Etienne, Kelly Khabala, Helen Bygrave
INTRODUCTION: The number of people on antiretroviral therapy (ART) for the long-term management of HIV in low- and middle-income countries (LMICs) is continuing to increase, along with the prevalence of Non-Communicable Diseases (NCDs). The need to provide large volumes of HIV patients with ART has led to significant adaptations in how medication is delivered, but access to NCD care remains limited in many contexts. Medication Adherence Clubs (MACs) were established in Kibera, Kenya to address the large numbers of patients requiring chronic HIV and/or NCD care...
2016: PloS One
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
R Pineda, R Guth, A Herring, L Reynolds, S Oberle, J Smith
OBJECTIVE: Very preterm infants hospitalized in the neonatal intensive care unit (NICU) experience alterations in sensory experiences. Defining types, timing and frequency of sensory-based interventions that optimize outcomes can inform environmental modifications. The objective of this study was to conduct an integrative review on sensory-based interventions used with very preterm infants in the NICU to improve infant and parent outcomes. STUDY DESIGN: The data sources include MEDLINE, CINAHL, Cochrane Library and Google Scholar...
October 20, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Michael Hochman, Medell Briggs-Malonson, Erin Wilkes, Jonathan Bergman, Lauren Patty Daskivich, Tannaz Moin, Ilanit Brook, Gery W Ryan, Robert H Brook, Carol M Mangione
In 2007, the Martin Luther King, Jr.-Harbor Hospital (MLK-Harbor), which served a large safety-net population in South Los Angeles, closed due to quality challenges. Shortly thereafter, an agreement was made to establish a new hospital, Martin Luther King, Jr. Community Hospital (MLKCH), to serve the unmet needs of the community. To assist the newly appointed MLKCH Board of Directors in building a culture of quality, we conducted a series of interviews with five high-performing hospital systems. In this report, we describe our findings...
2016: Journal of Health Care for the Poor and Underserved
Chad K Gentry, Robin P Parker, Christian Ketel, S Trent Rosenbloom, Terri D Crutcher, Aaron W Scott, Jannyse L Starks, Heather A Davidson, Bonita A Pilon
This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.
2016: Journal of Health Care for the Poor and Underserved
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
(no author information available yet)
At The Christie NHS Foundation Trust, Manchester, concerns that end of life care discussions were occurring too late in breast cancer cases led to earlier introduction of palliative care. Benefits include reduced hospital admissions during end of life and improved symptom management. The authors encourage nurses to support an integrated approach to enhance care provision for patients.
October 12, 2016: Nursing Standard
Cynthia Formosa, Ryan Muscat
BACKGROUND: This study sought to identify the nature and extent of diabetes-related knowledge and self-care practices in people living with type 2 diabetes who attend primary-care clinics and to determine whether a correlation between the two exists. METHODS: In a nonexperimental prospective study, the Diabetes Knowledge Questionnaire and the Summary of Diabetes Self-care Activities were used to assess knowledge and self-management in 50 patients. RESULTS: The mean diabetes knowledge score was 14...
September 2, 2016: Journal of the American Podiatric Medical Association
Sytske Anne Bergstra, Pedro M M C Machado, Rosaline van den Berg, Robert B M Landewé, Tom W J Huizinga
OBJECTIVES: Ten years ago, the METEOR tool was developed to simulate treatment-to-target and create an international research database. The development of the METEOR tool and database, research opportunities and future perspectives are described. METHODS: The METEOR tool is a free, online, internationally available tool in which daily practice visits of all rheumatoid arthritis patients visiting a rheumatologist can be registered. In the tool, disease characteristics, patient- and physician-reported outcomes and prescribed treatment could be entered...
September 2016: Clinical and Experimental Rheumatology
Fabio S Catarinella, Wouter H Bos
Digital assessment and graphical feedback of patient-reported outcome measures such as the Health Assessment Questionnaire (HAQ) could increase empowerment and involvement of patients in their own care process. The App ecosystem that Reade is building is an example of how digital assessment using mobile devices can be integrated into existing hospital IT infrastructure.
September 2016: Clinical and Experimental Rheumatology
Alessandro Consolaro, Esi M Morgan, Gabriella Giancane, Silvia Rosina, Stefano Lanni, Angelo Ravelli
Information technology in paediatric rheumatology has seen several exciting developments in recent years. The new multidimensional questionnaires for juvenile idiopathic arthritis, juvenile dermatomyositis, and juvenile autoinflammatory diseases integrate all major parent- and child-reported outcomes (PCROs) used in these diseases into a single tool, and provide an effective guide to manage, document change in health, assess effectiveness of therapeutic interventions, and verify the parent and child satisfaction with illness outcome...
September 2016: Clinical and Experimental Rheumatology
Amy Blake, Bryan T Carroll
OBJECTIVE: This paper analyses how game theory can provide a framework for understanding the strategic decision-making that occurs in everyday scenarios in medical training and practice, and ultimately serves as a tool for improving the work environment and patient care. Game theory has been applied to a variety of fields outside of its native economics, but has not been thoroughly studied in the context of health care provision. METHODS: The paper discusses four of the most common 'games' and applies each to a scenario in medicine to provide new insight on the incentives and drivers for certain types of behaviour and a deeper understanding of why certain results are valued more strongly than others...
November 2016: Medical Education
Amanda Whittal, Katja Hanke, Sonia Lippke
BACKGROUND: Increased immigration requires successful interaction of different cultures in various life domains, such as health. This study investigates acculturation orientation (AO) of immigrant patients and doctors native to the country, as a potential factor related to perceived medical advice adherence. DATA AND METHODS: N = 171 immigrant patients (M = 54.38 years, SD = 17.94, range = 23-96, 74.3 % female) and their N = 12 doctors (M = 38.88 years, SD = 13...
October 19, 2016: Quality of Life Research
C S Ball, R F Renzi, A Priye, R J Meagher
Check valves are often essential components in microfluidic devices, enabling automated sample processing for diagnostics at the point of care. However, there is an unmet need for a check valve design that is compatible with rigid thermoplastic devices during all stages of development-from initial prototyping with a laser cutter to final production with injection molding. Here, we present simple designs for a passive, normally closed check valve that is manufactured from commonly available materials with a CO2 laser and readily integrated into prototype and production thermoplastic devices...
October 20, 2016: Lab on a Chip
Marianne Williams, Yvonne Barclay, Rosie Benneyworth, Steve Gore, Zoe Hamilton, Rudi Matull, Iain Phillips, Leah Seamark, Kate Staveley, Steve Thole, Emma Greig
BACKGROUND: Irritable bowel syndrome (IBS) costs the National Health Service almost £12 million per annum. Despite national guidelines advising primary care management, these have failed to stem secondary care referrals of patients with likely IBS for unnecessary and costly assessment and investigation without necessarily achieving resolution of their symptoms. METHODS: In 2011, an integrated team from primary and secondary care developed a business case using baseline data to create a Somerset-wide IBS pathway using Clinical Commissioning Group funding...
October 2016: Frontline Gastroenterology
Miia Tuominen, Anne Kaljonen, Pia Ahonen, Juha Mäkinen, Päivi Rautava
INTRODUCTION: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. METHODS: A comparative, register-based cross-sectional design was used...
July 8, 2016: International Journal of Integrated Care
Åsa Larsson, Yvonne Hilli
BACKGROUND: The midwifery profession in Sweden has a history since the early 1700s when government training for midwives began. Midwifery is historically well described, but the idea of caring within midwifery is not described. AIM: The aim was to describe the patterns of ideas of caring as they appeared in midwifery during the first half of the 20th century. RESEARCH DESIGN: This study has a hermeneutic approach and the method is history of ideas...
October 19, 2016: Nursing Ethics
Deborah J Cohen, Sara R Keller, Gillian R Hayes, David A Dorr, Joan S Ash, Dean F Sittig
BACKGROUND: Patient-generated health data (PGHD) are health-related data created or recorded by patients to inform their self-care and understanding about their own health. PGHD is different from other patient-reported outcome data because the collection of data is patient-driven, not practice- or research-driven. Technical applications for assisting patients to collect PGHD supports self-management activities such as healthy eating and exercise and can be important for preventing and managing disease...
October 19, 2016: JMIR Human Factors
Sarah A Weiss, Joseph Han, Farbod Darvishian, Jeremy Tchack, Sung Won Han, Karolina Malecek, Michelle Krogsgaard, Iman Osman, Judy Zhong
BACKGROUND: Age has been reported as an independent prognostic factor for melanoma-specific survival (MSS). We tested the hypothesis that age impacts the host anti-tumor immune response, accounting for age-specific survival outcomes in three unique melanoma patient cohorts. METHODS: We queried the U.S. population-based Surveillance, Epidemiology, and End Results Program (SEER), the prospective tertiary care hospital-based Interdisciplinary Melanoma Cooperative Group (IMCG) biorepository, and the Cancer Genome Atlas (TCGA) biospecimen database to test the association of patient age at time of melanoma diagnosis with clinicopathologic features and survival outcomes...
October 19, 2016: Journal of Translational Medicine
W Holmes, R Shajehan, S Kitnasamy, C Abeywickrama, Y Arsath, F Gnanaraj, S Inbaraj, G Jayakody, K Durrant, S Luchters
: The growing burden of vision impairment (VI) among older people is a development challenge in Asian countries. This study aimed to understand older people's views and experiences about the impact of VI and barriers to eye care to inform policies to address this challenge. We conducted 12 focus group discussions in 2013 with retired Tamil and Sinhala elders in Nuwara Eliya district, Sri Lanka (n = 107). Data were analysed thematically. Older people described the broad impacts VI has on their lives...
October 19, 2016: Global Public Health
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