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https://www.readbyqxmd.com/read/28550701/patient-centred-care-in-canada-key-components-and-the-path-forward
#1
Terrence Montague, Amédé Gogovor, John Aylen, Lisa Ashley, Sara Ahmed, Lesli Martin, Bonnie Cochrane, Owen Adams, Joanna Nemis-White
Canadians' health and its care continue to evolve. Chronic diseases affect more than 50% of our aging population, but the majority of public and professional stakeholders retain a sense of care quality. An emergent issue, however, is generating an increasingly wide debate. It is the concept of patient-centred care, including its definition of key components, and efficacy. To advance the evidence base, the 2013-2014 and 2016 Health Care in Canada (HCIC) surveys measured pan-stakeholder levels of support and implementation priorities for frequently proposed components of patient centricity in healthcare...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550610/association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#2
Justin W Timbie, Peter S Hussey, Claude M Setodji, Amii Kress, Rosalie Malsberger, Tara A Lavelle, Mark W Friedberg, Suzanne G Wensky, Katherine D Giuriceo, Katherine L Kahn
BACKGROUND: Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE: We measured PCMH capabilities in a diverse nationwide sample of FQHCs and assessed the relationship between PCMH capabilities and Medicare beneficiary outcomes. DESIGN: Cross-sectional, propensity score-weighted, multivariable regression analysis...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550027/exceptional-response-to-nivolumab-and-stereotactic-body-radiation-therapy-sbrt-in-neuroendocrine-cervical-carcinoma-with-high-tumor-mutational-burden-management-considerations-from-the-center-for-personalized-cancer-therapy-at-uc-san-diego-moores-cancer-center
#3
Andrew Sharabi, Sangwoo Shawn Kim, Shumei Kato, Philip D Sanders, Sandip Pravin Patel, Parag Sanghvi, Elizabeth Weihe, Razelle Kurzrock
Neuroendocrine carcinoma of the cervix is an ultra-rare malignancy with a poor prognosis and limited treatment options. Checkpoint blockade immunotherapy has rapidly developed into an emerging standard of care for several common disease types. Interestingly, in preclinical and retrospective clinical data, radiation therapy has been demonstrated to synergize with checkpoint inhibitors. Here we report a patient with metastatic, chemotherapy-refractory neuroendocrine carcinoma who presented with partial bowel obstruction due to a large tumor burden...
May 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28550001/more-than-a-text-message-dismantling-digital-triggers-to-curate-behavior-change-in-patient-centered-health-interventions
#4
Frederick Muench, Amit Baumel
Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change...
May 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28549676/exposure-response-relationship-of-regorafenib-efficacy-in-patients-with-hepatocellular-carcinoma
#5
Alexander Solms, Isabel Reinecke, Sabine Fiala-Buskies, Anne Keunecke, Henk-Jan Drenth, Jordi Bruix, Gerold Meinhardt, Adriaan Cleton, Bart Ploeger
PURPOSE: To explore the relationship between regorafenib exposure and efficacy in patients with hepatocellular carcinoma (HCC) who had disease progression during sorafenib treatment (RESORCE). METHODS: Exposure-response (ER) analyses for regorafenib were performed using data from a phase 3, randomized, placebo-controlled trial (RESORCE). Patients received 160mg regorafenib or placebo once daily (3weeks on/1week off in a 4-week cycle) with best supportive care until disease progression, death, or unacceptable toxicity...
May 23, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#6
Moritz Weigeldt, Sabine Lahmann, Konstantin Krieger, Sebastian Buttenberg, Volker Stephan, Brigitte Stiller, Dirk Stengel
BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28549520/-taking-over-somebody-s-life-experiences-of-surrogate-decision-makers-in-the-surgical-intensive-care-unit
#7
Elizabeth J Lilley, Megan A Morris, Nicholas Sadovnikoff, Jamahal M Luxford, Navin R Changoor, Anna Bystricky, Angela M Bader, Zara Cooper
BACKGROUND: Impaired capacity of patients necessitates the use of surrogates to make decisions on behalf of patients. Little is known about surrogate decision-making in the surgical intensive care unit, where the decline to critical illness is often unexpected. We sought to explore surrogate experiences with decision-making in the surgical intensive care unit. METHODS: This qualitative study was performed at 2 surgical intensive care units at a single, tertiary, academic hospital Surrogate decision-makers who had made a major medical decision for a patient in the surgical intensive care unit were identified and enrolled prospectively...
May 23, 2017: Surgery
https://www.readbyqxmd.com/read/28549459/-a-steep-learning-curve-junior-doctor-perspectives-on-the-transition-from-medical-student-to-the-health-care-workplace
#8
Nancy Sturman, Zachary Tan, Jane Turner
BACKGROUND: The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition...
May 26, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28549049/institution-of-a-preoperative-stoma-education-group-class-decreases-rate-of-peristomal-complications-in-new-stoma-patients
#9
Audrey L Stokes, Shelly Tice, Suzi Follett, Diane Paskey, Lini Abraham, Cheryl Bealer, Holly Keister, Walter Koltun, Frances J Puleo
PURPOSE: The purpose of this study was to compare selected postoperative complications (including stomal and peristomal complications), hospital length of stay, and readmission rates in a group of patients who attended a preoperative educational intervention to a retrospective group of patients who did not receive the intervention. DESIGN: Retrospective, comparison cohort study. SUBJECTS AND SETTING: The intervention group comprised 124 patients who attended an educational session for persons with fecal ostomies at a single tertiary care center in the Northeastern United States...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28549019/ocular-genetics-in-taiwan
#10
Yu-Hung Lai, Kwou-Yeung Wu
PURPOSE OF REVIEW: Ocular genetics is an emerging specialty which has accompanied the advancement of modern genetic technology. This review is to understand the current status of practice in ocular genetics in Taiwan. RECENT FINDINGS: There is only one ocular genetics clinic in Taiwan. Certified clinical laboratories provide few gene tests in ocular genetics. Most ocular genetic study is focused on myopia. Financial obstacles are a major problem for patients to seek gene tests...
April 25, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28548631/effectiveness-of-a-respiratory-day-hospital-program-to-reduce-admissions-for-exacerbation-in-patients-with-severe-copd-a-prospective-multicenter-study
#11
Daniel Huertas, Concepción Montón, Alicia Marín, Ingrid Solanes, Marta López-Sánchez, Xavier Pomares, Mariana Muñoz-Esquerre, Jordi Dorca, Salud Santos
The respiratory Day Hospital (DH) is a care facility currently operating at various healthcare institutions. It monitors patients with severe chronic obstructive pulmonary disease (COPD) presenting repeated exacerbations with at least two hospital admissions per year. The main aim of the study was to evaluate the effectiveness of the DH program for controlling admissions for COPD exacerbations in this cohort of patients, and to identify clinical factors associated with hospitalizations and mortality. An observational prospective multicenter study was carried out at three hospitals...
June 2017: COPD
https://www.readbyqxmd.com/read/28548603/beyond-demarcation-care-ethics-as-an-interdisciplinary-field-of-inquiry
#12
Carlo Leget, Inge van Nistelrooij, Merel Visse
BACKGROUND: For many years the body of literature known as 'care ethics' or 'ethics of care' has been discussed as regards its status and nature. There is much confusion and little structured discussion. The paper of Klaver et al. (2014) was written as a discussion article to which we respond. OBJECTIVES: We aim to contribute to the ongoing discussion about the status and nature of care ethics. RESEARCH DESIGN: Responding to 'Demarcation of the ethics of care as a discipline' by Klaver et al...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#13
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548368/developing-minimum-clinical-standards-for-physiotherapy-in-south-african-icus-a-qualitative-study
#14
Heleen van Aswegen, Shane Patman, Natascha Plani, Susan Hanekom
RATIONALE, AIMS, AND OBJECTIVES: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients...
May 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28548220/bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department-methodological-and-statistical-issues-on-diagnostic-value
#15
Fatemeh Koohi, Siamak Sabour
We were interested to read the recent paper by Gungor F and colleagues published in May issue of the Acad Emerg Med 2017.(1) The aim of the authors was to evaluate diagnostic value of point-of-care US (POCUS) in clinical decision making of emergency physicians (EPs) for acute appendicitis (AA) in the emergency department (ED).(1) A total of 264 patients were included into a prospective observational clinical study and based on their results 169 (64%) had a diagnosis of AA. This article is protected by copyright...
May 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28548204/endovascular-treatment-for-ruptured-abdominal-aortic-aneurysm
#16
REVIEW
Stephen Badger, Rachel Forster, Paul H Blair, Peter Ellis, Frank Kee, Denis W Harkin
BACKGROUND: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair...
May 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28547926/transdisciplinarity-in-health-care-a-concept-analysis
#17
Vanessa Van Bewer
AIM: To analyze the concept of transdisciplinarity and provide an enhanced definition of transdisciplinarity in health care. BACKGROUND: The term transdisciplinarity is increasingly prevalent in health care research and has been identified as important to improving the effectiveness and efficiency in health care. However, the term continues to be misappropriated and poorly understood by researchers and clinicians alike which hinders its potential use and impact...
May 26, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28547753/the-cost-effectiveness-of-patient-controlled-analgesia-vs-standard-care-in-patients-presenting-to-the-emergency-department-in-pain-who-are-subsequently-admitted-to-hospital
#18
C Pritchard, J E Smith, S Creanor, R Squire, A Barton, J Benger, L Cocking, P Ewings, M Rockett
The clinical effectiveness of patient-controlled analgesia has been demonstrated in a variety of settings. However, patient-controlled analgesia is rarely utilised in the emergency department. The aim of this study was to compare the cost-effectiveness of patient-controlled analgesia vs. standard care in participants admitted to hospital from the emergency department with pain due to traumatic injury or non-traumatic abdominal pain. Pain scores were measured hourly for 12 h using a visual analogue scale. Cost-effectiveness was measured as the additional cost per hour in moderate to severe pain avoided by using patient-controlled analgesia rather than standard care (the incremental cost-effectiveness ratio)...
May 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28547273/case-distribution-and-complications-of-mid-urethral-sling-surgery-in-a-canadian-city-before-and-after-the-health-canada-advisory-on-pelvic-floor-mesh
#19
Kevin Carlson, Richard Baverstock, Andrea Civitarese, R Trafford Crump
INTRODUCTION AND HYPOTHESIS: Increased incidences of complications related to the use of mid-urethral slings (MUS) for the treatment of stress urinary incontinence resulted in both the Food and Drug Administration (FDA) and Health Canada issuing advisories in 2008 and 2010 respectively. The purpose of this study was to assess the effect these advisories had on the number of surgeons performing MUS surgery and post-surgical complications in Calgary, Canada. METHODS: In this study, we conducted a retrospective analysis of administrative data between 2006 and 2011...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#20
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
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