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https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#1
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29339012/patient-rated-access-to-needed-care-patient-centered-medical-home-principles-intertwined
#2
Julian Brunner, Emmeline Chuang, Donna L Washington, Danielle E Rose, Catherine Chanfreau-Coffinier, Jill E Darling, Ismelda A Canelo, Elizabeth M Yano
BACKGROUND: Primary care teams can facilitate access to care by helping patients to determine whether and when care is needed, and coordinating care across multiple clinicians and settings. Appointment availability metrics may or may not capture these contributions, but patients' own ratings of their access to care provide an important alternative view of access that may be more closely related to these key functions of care teams. PROCEDURES: We used a 2015 telephone survey of 1,395 women veterans to examine associations between key care team functions and patient-rated access to needed care...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29334608/factors-associated-with-prolonged-patient-attributable-delay-in-the-diagnosis-of-colorectal-cancer
#3
Irene Zarcos-Pedrinaci, Teresa Téllez, Francisco Rivas-Ruiz, María Del Carmen Padilla-Ruiz, Julia Alcaide, Antonio Rueda, María Luisa Baré, María Manuela Morales Suárez-Varela, Eduardo Briones, Cristina Sarasqueta, Nerea Fernández-Larrea, Antonio Escobar, José María Quintana, Maximino Redondo
Purpose: The delayed diagnosis of colorectal cancer (CRC) may be attributable to sociodemographic characteristics, to aspects of tumour histopathology or to the functioning of the health system. We seek to determine which of these factors most influences prolonged patient-attributable delay (PPAD) in the diagnosis and treatment of CRC. Materials and method: A prospective, multicentre observational study was conducted in 22 Spanish hospitals. In total, 1,785 patients were recruited to the study between 2010 and 2012 and underwent elective or urgent surgery...
January 2, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/29328037/-implementation-of-the-right-for-health-care-for-children-internally-displaced-persons-certain-aspects
#4
S Buletsa, Y Lazur, M Mendzhul, О Pushkarenko
The aim of the article is to do a research on selected issues related to realizing the right for health сare for the children - internally dislocated persons. In order to achieve the given aim statistical data of the quantity of involuntarily dislocated persons including children and also the quantity of children registered with the health-care authority as well as the quantity of their requests for medical care have been analized. It has been determined that in case of involuntary dislocation children are more often exposed to trauma than adults which leads to different emotional disorders...
December 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29324561/nursing-minimum-data-sets-for-documenting-nutritional-care-for-adults-in-primary-healthcare-a-scoping-review
#5
Sasja Jul Håkonsen, Preben Ulrich Pedersen, Merete Bjerrum, Ann Bygholm, Micah D J Peters
OBJECTIVE: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. INTRODUCTION: Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29323989/rapid-response-a-multiprofessional-approach-to-hospital-at-home
#6
Sara Dowell, George Moss, Katy Odedra
The provision of 'hospital at home' is not new to the 21st century but pressure from the reduction in the number of hospital beds, population growth, an ageing population and subsequent extended time living with long-term conditions means such services are increasingly necessary. However, research by the authors found services that already exist do not operate 24 hours a day or provide a single multiprofessional approach. Gloucestershire's rapid response (RR) service provides specialist, coordinated, comprehensive and supportive assessment and treatment 24 hours a day in the patient's own home...
January 11, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29322799/predictors-and-prognostic-implications-of-clinical-decisions-in-patients-with-primary-high-risk-non-muscle-invasive-bladder-cancer-results-of-a-cross-country-retrospective-study
#7
S Poletajew, R Biernacki, P Buraczynski, J Chojnacki, S Czarniecki, D Gajewska, T Pohaba, J Sondka-Migdalska, M Skrzypczyk, T Suchojad, D Wojtkowiak, B Zaforemski, L Zapala, A Zemla, P Radziszewski
Adjuvant diagnostic and therapeutic procedures are available to reduce the risk of recurrence or progression in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). However, their indications and efficacy remain a matter of debate. The aim of this study was to analyze therapeutic decisions in patients with primary high-risk NMIBC and to analyze the adherence to clinical guidelines in this field.545 consecutive patients, aged a median of 70.3 years, diagnosed with primary high-risk NMIBC in thirteen urological institutions, were enrolled into this retrospective study...
2018: Neoplasma
https://www.readbyqxmd.com/read/29306903/implementation-of-diagnostic-pauses-in-the-ambulatory-setting
#8
Grace C Huang, Gila Kriegel, Carolyn Wheaton, Scot Sternberg, Kenneth Sands, Jeremy Richards, Katherine Johnston, Mark Aronson
BACKGROUND: Diagnostic errors result in preventable morbidity and mortality. The outpatient setting may be at increased risk, where time constraints, the indolent nature of outpatient complaints and single decision-maker practice models predominate. METHODS: We developed a self-administered diagnostic pause to address diagnostic error. Clinicians (physicians and nurse practitioners) in an academic primary care setting received the tool if they were seeing urgent care patients who had previously been seen in the past two weeks in urgent care...
January 6, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29306587/perioperative-patient-outcomes-in-the-african-surgical-outcomes-study-a-7-day-prospective-observational-cohort-study
#9
Bruce M Biccard, Thandinkosi E Madiba, Hyla-Louise Kluyts, Dolly M Munlemvo, Farai D Madzimbamuto, Apollo Basenero, Christina S Gordon, Coulibaly Youssouf, Sylvia R Rakotoarison, Veekash Gobin, Ahmadou L Samateh, Chaibou M Sani, Akinyinka O Omigbodun, Simbo D Amanor-Boadu, Janat T Tumukunde, Tonya M Esterhuizen, Yannick Le Manach, Patrice Forget, Abdulaziz M Elkhogia, Ryad M Mehyaoui, Eugene Zoumeno, Gabriel Ndayisaba, Henry Ndasi, Andrew K N Ndonga, Zipporah W W Ngumi, Ushmah P Patel, Daniel Zemenfes Ashebir, Akwasi A K Antwi-Kusi, Bernard Mbwele, Hamza Doles Sama, Mahmoud Elfiky, Maher A Fawzy, Rupert M Pearse
BACKGROUND: There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa. METHODS: We did a 7-day, international, prospective, observational cohort study of patients aged 18 years and older undergoing any inpatient surgery in 25 countries in Africa (the African Surgical Outcomes Study). We aimed to recruit as many hospitals as possible using a convenience sampling survey, and required data from at least ten hospitals per country (or half the surgical centres if there were fewer than ten hospitals) and data for at least 90% of eligible patients from each site...
January 3, 2018: Lancet
https://www.readbyqxmd.com/read/29304812/the-cradle-vital-signs-alert-qualitative-evaluation-of-a-novel-device-designed-for-use-in-pregnancy-by-healthcare-workers-in-low-resource-settings
#10
Hannah L Nathan, Helena Boene, Khatia Munguambe, Esperança Sevene, David Akeju, Olalekan O Adetoro, Umesh Charanthimath, Mrutyunjaya B Bellad, Annemarie de Greeff, John Anthony, David R Hall, Wilhelm Steyn, Marianne Vidler, Peter von Dadelszen, Lucy C Chappell, Jane Sandall, Andrew H Shennan
BACKGROUND: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis...
January 5, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29303230/planned-birth-at-or-near-term-for-improving-health-outcomes-for-pregnant-women-with-gestational-diabetes-and-their-infants
#11
REVIEW
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Eugene Dempsey, Pauline Meskell, Valerie Smith, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia...
January 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29302323/the-national-and-subnational-prevalence-and-burden-of-age-related-macular-degeneration-in-china
#12
Peige Song, Yuhang Du, Kit Yee Chan, Evropi Theodoratou, Igor Rudan
Background: Age-related macular degeneration (AMD) is the third most common cause of blindness, and the fourth leading cause of visual impairment worldwide, but little is known about the burden of this disease in the most populous country-China. This study provides the first comprehensive estimates of the prevalence and burden of AMD in China from 1990 to 2015, with projections till 2050. Methods: In this study, a systematic review and meta-analysis was conducted to estimate the prevalence of AMD in China...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29298246/improving-antibiotic-prescribing-for-children-with-urinary-tract-infection-in-emergency-and-urgent-care-settings
#13
Nicole M Poole, Matthew P Kronman, Lori Rutman, Scott J Weissman, Russell T Migita, Derya Caglar, Danielle M Zerr
OBJECTIVES: Children with urinary tract infection (UTI) are often diagnosed in emergency and urgent care settings and increasingly are unnecessarily treated with broad-spectrum antibiotics. This study evaluated the effect of a quality improvement intervention on empiric antibiotic prescribing for the treatment of uncomplicated UTI in children. METHODS: A local clinical pathway for uncomplicated UTI, introduced in June 2010, recommended empiric treatment with cephalexin, a narrow-spectrum (first-generation) cephalosporin antibiotic...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29295829/medication-therapy-management-after-hospitalization-in-ckd-a-randomized-clinical-trial
#14
Katherine R Tuttle, Radica Z Alicic, Robert A Short, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling M McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Cynthia F Corbett
BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited...
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29294866/the-association-between-intimate-partner-violence-and-signs-of-depression-during-pregnancy-in-kilimanjaro-region-northern-tanzania
#15
Rachel Manongi, Jane Rogathi, Geofrey Sigalla, Declare Mushi, Vibeke Rasch, Tine Gammeltoft, Dan W Meyrowitsch
Intimate partner violence (IPV) against pregnant women is common with severe health consequences to women and their babies. The aim of the present study is to measure the association between IPV and signs of depression among pregnant women attending antenatal care in a semi-urban setting in northern Tanzania. A cross-sectional study was conducted from March 1, 2014, to May 30, 2015, among pregnant women attending routine antenatal care in Moshi Municipality, Tanzania. During their third trimester, self-reported exposure to IPV was assessed using a validated structured questionnaire adopted from the World Health Organization's (WHO) Multi-Country Study on Women's Health and Domestic Violence...
August 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29283670/home-based-physical-activity-coaching-physical-activity-and-healthcare-utilization-in-copd-copd-smart-secondary-outcomes
#16
David B Coultas, Bradford E Jackson, Rennie Russo, Jennifer Peoples, Karan P Singh, John Sloan, Minyong Uhm, Jamile A Ashmore, Steven N Blair, Sejong Bae
RATIONALE: Physical inactivity among patients with chronic obstructive pulmonary disease (COPD) is associated with exacerbations requiring high-cost healthcare utilization including urgent, emergent, and hospital care. OBJECTIVE: To examine the effectiveness of a behavioral lifestyle physical activity intervention combined with COPD self-management education to prevent high-cost healthcare utilization. METHODS: This was an analysis of secondary outcomes of the Chronic Obstructive Pulmonary Disease Self-Management Activation Research Trial, a two-arm randomized trial of stable adult outpatients with COPD recruited from primary care and pulmonary clinics...
December 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29282114/risk-factors-for-addiction-among-patients-receiving-prescribed-opioids-a-systematic-review-protocol
#17
Amber Cragg, Jeffrey P Hau, Stephanie A Woo, Christine Liu, Mary M Doyle-Waters, Corinne M Hohl
BACKGROUND: Opioid addiction prevention has become an urgent public health priority, with several countries declaring a state of emergency due to rising death tolls from opioid abuse. Reducing the risk of developing addiction among opioid-naïve patients exposed to prescribed opioids during the process of medical care may be an important primary prevention strategy. Our objective is to synthesize the available evidence about factors associated with the development of addiction among patients first exposed to prescribed opioids, with a focus on opioid-naïve patients...
December 28, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29278566/job-openings-for-pas-by-specialty
#18
Perri Morgan, Brandi Leach, Kristine Himmerick, Christine Everett
OBJECTIVE: Physician assistants (PAs) have adapted to roles in virtually every practice specialty. One factor that has affected PAs' specialty choices has been the availability of jobs. We describe 2014 job postings for PAs at the national level by practice specialty. METHODS: National data on 2014 job postings for PAs were obtained from a leading labor analytics firm. Each job posting (N = 34,137) was coded with regard to practice specialty and analyzed descriptively...
January 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29277424/unplanned-admissions-to-inpatient-psychiatric-treatment-and-services-received-prior-to-admission
#19
Solveig Osborg Ose, Jorid Kalseth, Marian Ådnanes, Tone Tveit, Solfrid E Lilleeng
BACKGROUND: Inpatient bed numbers are continually being reduced but are not being replaced with adequate alternatives in primary health care. There is a considerable risk that eventually all inpatient treatment will be unplanned, because planned or elective treatments are superseded by urgent needs when capacity is reduced. AIMS OF THE STUDY: To estimate the rate of unplanned admissions to inpatient psychiatric treatment facilities in Norway and analyse the difference between patients with unplanned and planned admissions regarding services received during the three months prior to admission as well as clinical, demographical and socioeconomic characteristics of patients...
December 20, 2017: Health Policy
https://www.readbyqxmd.com/read/29275460/implementation-of-a-regional-perinatal-data-repository-from-clinical-and-billing-records
#20
Eric S Hall, James M Greenberg, Louis J Muglia, Parth Divekar, Janet Zahner, Jay Gholap, Matt Leonard, Keith Marsolo
Objectives To describe the implementation of the first phase of a regional perinatal data repository and to provide a roadmap for others to navigate technical, privacy, and data governance concerns in implementing similar resources. Methods Our implementation integrated regional physician billing records with maternal and infant electronic health records from an academic delivery hospital. These records, representing births during 2013-2015, constituted a data core supporting linkage to additional ancillary data sets...
December 23, 2017: Maternal and Child Health Journal
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