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High-value care

Robert G Hahn, Nina Grankvist, Camilla Krizhanovskii
OBJECTIVE: Renal conservation (retention) of fluid might affect the outcome of hospital care and can be indicated by increased urinary concentrations of metabolic waste products. We obtained a reference material for further studies by exploring the prevalence of fluid retention in a healthy population. METHODS: Spot urine sampling was performed in 300 healthy hospital workers. A previously validated algorithm summarized the urine-specific gravity, osmolality, creatinine, and color to a fluid retention index (FRI), where 4...
2016: PloS One
Raffaella Boggia, Federica Turrini, Carla Villa, Chiara Lacapra, Paola Zunin, Brunella Parodi
The aim of this study was to investigate the potential of retrieving polyphenolic antioxidants directly from wet pomegranate marcs: the fresh by-products obtained after pomegranate juice processing. These by-products mainly consist of internal membranes (endocarp) and aril residues. Even if they are still edible, they are usually discharged during juice production and, thus, they represent a great challenge in an eco-sustainable industrial context. Green technologies, such as ultrasound assisted extraction (UAE) and microwave assisted extraction (MAE), have been employed to convert these organic residues into recycled products with high added value...
October 18, 2016: Pharmaceuticals
Denise Dion Hallfors, Bonita J Iritani, Lei Zhang, Shane Hartman, Winnie K Luseno, Elias Mpofu, Simbarashe Rusakaniko
This study examines the association between religious affiliation and reasons for marriage, perceived church attitudes, and reproductive health-seeking behaviors, including HIV testing, among young women in eastern rural Zimbabwe. The sample comprised women (N = 35) who had married by 2012 while participating in a larger randomized controlled trial (RCT) to test the effects of school support on HIV-related risk. The RCT sample was identified in 2007 as all female sixth graders in 25 rural eastern Zimbabwe primary schools whose parents, one or both, had died (N = 328)...
December 2016: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
Pallavi Surase, Gita Nataraj, Sunil Kuyare, Preeti Mehta
OBJECTIVES: The study was carried out to determine the extent and type of contamination of the hands and accessories of staff from different settings and also to determine the phenotypic similarity between the isolates recovered from the same staff. DESIGN: Prospective cross-sectional study. SETTING: Tertiary care center. PARTICIPANTS: Health care workers (HCWs') and administrative staff. METHODS: Samples were collected and processed for bacteriology from the dominant hand, mobiles, aprons, stethoscopes and computer keyboards of 280 staff working in different settings after consent...
August 2016: Journal of the Association of Physicians of India
Cheryl R Laratta, Willis H Tsai, James Wick, Sachin R Pendharkar, Kerri A Johannson, Paul E Ronksley
Obstructive sleep apnea (OSA) is a common condition associated with significant morbidity and health-care utilization. We determined the validity of an algorithm derived from administrative data for identifying OSA using the respiratory disturbance index (RDI) as the reference standard. We conducted a retrospective cohort study of adults in Alberta, Canada referred for facility and community-based sleep diagnostic testing between July 2005 and August 2007. Validity indices were estimated for several case definitions of OSA derived from outpatient physician billing claims and hospital discharge codes...
October 20, 2016: Journal of Sleep Research
Mengjing Wang, Jason Chou, Yongen Chang, Wei L Lau, Uttam Reddy, Connie M Rhee, Jing Chen, Chuanming Hao, Kamyar Kalantar-Zadeh
In the management of patients with chronic kidney diseases (CKD), a low-protein diet usually refers to a diet with protein intake of 0.6 to 0.8 grams per kilogram of body weight per day (g/kg/day) and should include at least 50% high-biologic-value protein. It may be supplemented with essential acids or nitrogen- free ketoanalogues if <0.6 g/kg/d. Low-protein diet can reduce proteinuria especially in non-diabetic CKD patients. In hypoalbuminemic patients it may lead to an increase in serum albumin level...
October 19, 2016: Panminerva Medica
Margaret Loyet, Amy McLean, Karen Graham, Cheryl Antoine, Kathy Fossick
BACKGROUND: Women carrying a fetus with a suspected or known fetal anomaly have complex needs such as emotional and informational support and help with the logistical aspects of arranging care and treatment from numerous specialists. IMPROVEMENT IN QUALITY OF CARE FOR WOMEN CARRYING A FETUS WITH A SUSPECTED OR KNOWN FETAL ANOMALY:: Our fetal care team was initiated in 2012 to meet the needs of this high-risk pregnant population. The fetal care team nurse coordinator supports the woman and her family through all aspects of care during the pregnancy and neonatal period including scheduling appointments with multiple specialists, being there with her as a support person, keeping her updated, making sure she has accurate information about the fetal diagnosis, and helping her to navigate the complex healthcare system...
November 2016: MCN. the American Journal of Maternal Child Nursing
Louise M Alissa, Danilo G Muniz, Glauco Machado
When there is a temporal trade-off between mating effort and parental care, theoretical models predict that intense sexual selection on males leads to reduced paternal care. Thus, high-quality males should invest more in mating effort because they have higher chances of acquiring mates, whereas low-quality males should bias their investment toward parental care. Once paternal care has evolved, offspring value should also influence males' decisions to invest in offspring attendance. Here we performed a manipulation under field conditions to investigate the factors that influence male allocation in either mating effort or parental care...
October 18, 2016: Journal of Evolutionary Biology
Hiroshi Isono, Shinnosuke Hirata, Tadashi Yamaguchi, Hiroyuki Hachiya
PURPOSE: Chronic liver disease requires careful follow-up during long-term treatment, and development of a quantitative diagnosis method for liver fibrosis based on an ultrasonic imaging system is highly desired. METHODS: Texture analysis using a co-occurrence matrix was applied to both clinical and simulated ultrasonic images of fibrotic livers. A sequence of matrices was generated for pixel-pair distance, r, and texture feature contrast was chosen to examine the response to r in combination with statistical analysis of echo amplitude distribution using a multi-Rayleigh model...
October 18, 2016: Journal of Medical Ultrasonics
Anshu K Jain, Mary L Fennell, Anees B Chagpar, Hannah K Connolly, Ingrid M Nembhard
Effective communication is a requirement in the teamwork necessary for improved coordination to deliver patient-centered, value-based cancer care. Communication is particularly important when care providers are geographically distributed or work across organizations. We review organizational and teams research on communication to highlight psychological safety as a key determinant of high-quality communication within teams. We first present the concept of psychological safety, findings about its communication effects for teamwork, and factors that affect it...
October 18, 2016: Journal of Oncology Practice
Wanli Xu, Stephen Walsh, Xiaomei S Cong
High-risk neonates experience numerous painful/stressful procedures daily in neonatal intensive care units (NICUs). Accumulated pain and stress have a detrimental impact on infants' neurodevelopment. Few valid tools are available to measure accumulated pain/stressors among NICU infants. The aim of this study was to obtain nurses' perceptions about severity and acuity levels regarding each painful/stressful procedure that infants may experience in the NICU. The data will support developing a new instrument, the Accumulated Pain/Stressor Scale (APSS) in NICUs...
October 15, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Chengxiang Tang, Judy Xu, Meng Zhang
BACKGROUND: Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalated after a market-oriented reform was implemented in 2001. Through an experimental approach, this study aims to a better understanding of the dynamic change in preference of health care utilisation among the residents in urban China. METHODS: Based on a discrete choice experiment (DCE) from a random sample of respondents in urban China, the study evaluated preference over health care attributes affecting individuals' choice for the utilisation of hospital health care...
October 18, 2016: BMC Health Services Research
Mette K Axboe, Kaj S Christensen, Poul-Erik Kofoed, Jette Ammentorp
BACKGROUND: The outcome of communication training is widely measured by self-efficacy ratings, and different questionnaires have been used. Nevertheless, none of these questionnaires have been formally validated through systematic measurement of assessment properties. Consequently, we decided to further develop a self-efficacy questionnaire which has been used in previous studies. This study aims to examine the content, internal structure, and relations with other variables of the new version of the self-efficacy questionnaire (SE-12)...
October 18, 2016: BMC Medical Education
Omar Ali Juma, Zachary Obinna Enumah, Hannah Wheatley, Mohamed Yunus Rafiq, Seif Shekalaghe, Ali Ali, Shishira Mgonia, Salim Abdulla
BACKGROUND: Malnutrition has long been associated with poverty, poor diet and inadequate access to health care, and it remains a key global health issue that both stems from and contributes to ill-health, with 50 % of childhood deaths due to underlying undernutrition. The purpose of this study was to determine the prevalence of malnutrition among children under-five seen at Bagamoyo District Hospital (BDH) and three rural health facilities ranging between 25 and 55 km from Bagamoyo: Kiwangwa, Fukayosi, and Yombo...
October 19, 2016: BMC Public Health
Ying P Tabak, Xiaowu Sun, Carlos M Nunez, Vikas Gupta, Richard S Johannes
BACKGROUND: Identifying patients at high risk for readmission early during hospitalization may aid efforts in reducing readmissions. We sought to develop an early readmission risk predictive model using automated clinical data available at hospital admission. METHODS: We developed an early readmission risk model using a derivation cohort and validated the model with a validation cohort. We used a published Acute Laboratory Risk of Mortality Score as an aggregated measure of clinical severity at admission and the number of hospital discharges in the previous 90 days as a measure of disease progression...
October 14, 2016: Medical Care
Alessandra Lodi, Bettina Karsten, Gerardo Bosco, Manuel Gómez-López, Paula Paraguassú Brandão, Antonino Bianco, Antonio Paoli
: The aim of this study was to analyze the effects on blood sugar concentrations through the calculation of the glycemic score (GS) of 10 different high-protein low-carbohydrates (CHOs) proprietary foods that are commonly used as meals during very low-CHO ketogenic diets or during low-CHO diets. Fourteen healthy females were tested for their glycemic response curve elicited by 1000 kJ of glucose three times within a 3-week period (one test each week) compared with one of 10 test foods once on separate days twice a week...
October 18, 2016: Journal of Medicinal Food
Thomas Weber
Validation of a medical device measuring a biomarker is a complex process, involving technical aspects (What is actually measured by the device, and how is this done ? Is the measurement reproducible ? Is there a gold standard for measurement of the particular biomarker ? If yes, how accurate and how precise are the measurements by the device, compared to the gold standard ?) and clinical aspects (Do the measurements predict outcome ? If yes, is there added value, when standard clinical parameters are considered ? Is there a treatment strategy, based on the mesurements of the novel device ? Is this strategy cost-effective ?)...
September 2016: Journal of Hypertension
Marta Erminia Alberto, Jenny Pirillo, Nino Russo, Carlo Adamo
Ru(II) dyads are a class of bioactive molecules of interest as anticancer agents obtained incorporating an organic chromophore in the light-absorbing metallic scaffold. A careful DFT and TDDFT investigation of the photophysical properties of a series of Ru(II)-polypiridyl dyads containing polythiophene chains of different lengths bound to a coordinating imidazo[4,5-f][1,10]phenanthroline ligand is herein reported. The modulation of the crucial chemical and physical properties of the photosensitizer with increasing number of thiophene units has been accurately described by investigating the UV-vis spectra and type I and type II photoreactions, also including spin-orbit coupling values (SOC)...
October 18, 2016: Inorganic Chemistry
Chris S Ivanoff, Krassimira Yaneva, Diana Luan, Bogomil Andonov, Reena R Kumar, Anirudha Agnihotry, Athena E Ivanoff, Dimitrios Emmanouil, Luiz Evaristo Ricci Volpato, Filip Koneski, Ilijana Muratovska, Huda A Al-Shehri, Sara M Al-Taweel, Michele Daly
BACKGROUND: Training culturally competent graduates who can practice effectively in a multicultural environment is a goal of contemporary dental education. The Global Oral Health Initiative is a network of dental schools seeking to promote global dentistry as a component of cultural competency training. OBJECTIVE: Before initiating international student exchanges, a survey was conducted to assess students' awareness of global dentistry and interest in cross-national clerkships...
October 18, 2016: International Dental Journal
Amanda N Fader, Tim Xu, Brian J Dunkin, Martin A Makary
BACKGROUND: Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. METHODS: This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States...
October 17, 2016: Surgical Endoscopy
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