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https://www.readbyqxmd.com/read/29040344/dilemmas-for-guardians-of-advanced-dementia-patients-regarding-tube-feeding
#1
Efrat Gil, Maayan Agmon, Ayal Hirsch, Miriam Ziv, Anna Zisberg
Background: advanced dementia is an incurable illness, its last stage marked by inability to eat. Tube feeding was deemed a helpful solution at this stage, but in recent years its inefficiency has been proved, and it is no longer practiced in many countries around the world. In Israel, however, the procedure is still accepted. In the gastroenterology department at the Bnai Zion Medical Center, a serious interaction is ongoing with patients' legal guardians, where detailed information is given about the inefficiency of the tube procedure...
October 13, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#2
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29036936/barriers-and-facilitators-for-health-behavior-change-among-adults-from-multi-problem-households-a-qualitative-study
#3
Gera E Nagelhout, Lette Hogeling, Renate Spruijt, Nathalie Postma, Hein de Vries
Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households...
October 15, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29036895/low-cost-lab-on-chip-for-the-colorimetric-detection-of-nitrate-in-mineral-water-products
#4
Mohammad F Khanfar, Wisam Al-Faqheri, Ala'aldeen Al-Halhouli
The diagnostics of health status and the quality of drinking water are among the most important United Nations sustainable development goals. However, in certain areas, wars and instability have left millions of people setting in refugee camps and dangerous regions where infrastructures are lacking and rapid diagnostics of water quality and medical status are critical. In this work, microfluidic testing chips and photometric setups are developed in cheap and portable way to detect nitrate concentrations in water...
October 14, 2017: Sensors
https://www.readbyqxmd.com/read/29034825/a-tale-of-four-practices
#5
Michelle Miller-Day, Janelle Applequist, Keri Zabokrtsky, Alexandra Dalton, Katherine Kellom, Robert Gabbay, Peter F Cronholm
Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance...
September 18, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29034792/medical-resource-utilization-and-costs-for-total-hip-arthroplasty-benchmarking-an-anterior-approach-technique-in-the-medicare-population
#6
Atul F Kamath, Abhishek S Chitnis, Chantal Holy, Jason Lerner, Brian Curtin, Steve Lochow, Charles DeCook, Joel M Matta
AIMS: The anterior approach (AA) for total hip arthroplasty (THA) is associated with more rapid recovery when compared to traditional approaches. The purpose of this study was to benchmark healthcare resource utilization and costs for patients with THA via AA relative to matched patients. MATERIALS AND METHODS: We queried Medicare claims data (2012-2014) to identify patients who received THA via an AA from experienced surgeons, and matched these patients to a control cohort (all THA approaches)...
October 15, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29034168/quantitative-comparison-of-pzt-and-cmut-probes-for-photoacoustic-imaging-experimental-validation
#7
Maëva Vallet, François Varray, Jérôme Boutet, Jean-Marc Dinten, Giosuè Caliano, Alessandro Stuart Savoia, Didier Vray
Photoacoustic (PA) signals are short ultrasound (US) pulses typically characterized by a single-cycle shape, often referred to as N-shape. The spectral content of such wideband signals ranges from a few hundred kilohertz to several tens of megahertz. Typical reception frequency responses of classical piezoelectric US imaging transducers, based on PZT technology, are not sufficiently broadband to fully preserve the entire information contained in PA signals, which are then filtered, thus limiting PA imaging performance...
December 2017: Photoacoustics
https://www.readbyqxmd.com/read/29033973/comparison-of-central-ambulatory-home-and-office-blood-pressure-measurement-as-risk-markers-for-mild-cognitive-impairment-in-hypertensive-patients
#8
Teodora Yaneva-Sirakova, Latchezar Traykov, Julia Petrova, Dobrin Vassilev
AIMS: We compared the role of central blood pressure (BP), ambulatory BP monitoring (ABPM), home-measured BP (HMBP) and office BP measurement as risk markers for the development of mild cognitive impairment (MCI). METHODS: 70 hypertensive patients on combination medical therapy were studied. Their mean age was 64.97 ± 8.88 years. Eighteen (25.71%) were males and 52 (74.28%) females. All of the patients underwent full physical examination, laboratory screening, echocardiography, and office, ambulatory, home and central BP measurement...
May 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/29033614/fusion-of-lower-limbs-with-severe-urogenital-malformation-in-a-newborn-a-rare-congenital-clinical-syndrome-case-report
#9
Fatemah Al Hadhoud, Abeer H Kamal, Abdulmohsen Al Anjari, Michael Fe Diejomaoh
BACKGROUND: Fused lower limbs combined with severe urogenital malformation, also known as sirenomelia, is a rare congenital clinical syndrome. The etiology is unknown, and the outcome for the affected fetus is rather uncertain. CASE REPORT: Mrs RB, a Kuwaiti woman primigravida, married to a non-consanguineous husband, had uneventful antenatal care in a private health service, until she was admitted to the Maternity Hospital, Kuwait, at 31 weeks of gestation with a 3-hour history of ruptured membranes...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29033297/no-easy-way-out-a-case-of-physician-assisted-dying-in-the-emergency-department
#10
David H Wang
Currently, 1 out of 6 Americans lives within a jurisdiction in which physician-assisted dying is legally authorized. In most cases, patients ingest lethal physician-assisted dying medications at home without involvement of emergency medical services (EMS) or the emergency department (ED). However, occasionally the dying process is interrupted as a result of incomplete ingestion or vomiting of medications, confusion about timing of dying trajectory, familial emotional distress, and other variables. A case is presented here of a patient who arrived by ambulance to an urban ED after ingesting physician-assisted dying medication...
October 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29032299/association-of-antiplatelet-therapy-with-patient-outcomes-after-out-of-hospital-cardiac-arrest
#11
Alexandro Gianforcaro, Michael Kurz, Francis X Guyette, Clifton W Callaway, Jon C Rittenberger, Jonathan Elmer
BACKGROUND: Cessation of blood flow during out-of-hospital cardiac arrest (OHCA) results in microvascular thrombosis, protracted hypoperfusion after return of spontaneous circulation and damage to vital organs. We tested the hypothesis that pre-arrest antiplatelet and anticoagulant medication use would be associated with less post-arrest organ dysfunction and better outcomes. METHODS: We included OHCA patients treated from January 2005 to October 2014 at a single academic medical center...
October 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29031914/bringing-the-medical-home-back-home-in-the-context-of-population-health-home-based-primary-care-and-home-based-palliative-care
#12
Christine S Ritchie, Bruce Leff
With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care and home-based palliative care. While the type of services provided by home-based primary care and home-based palliative care (together termed "home-based medical care") overlap, home-based primary care tends to encompass longitudinal and preventive care, while home-based palliative care often provides services for shorter durations focused more on distress management and goals of care clarification...
October 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29031752/sleep-and-slow-wave-activity-in-depressed-adolescent-boys-a-preliminary-study
#13
Olena Santangeli, Tarja Porkka-Heiskanen, Jussi Virkkala, Anu E Castaneda, Mauri Marttunen, Tiina Paunio, Anna S Urrila
OBJECTIVE: Adolescence is a vulnerable period of life that is characterized by increasing incidence of depression. Sleep disturbance is one of the diagnostic symptoms of depressive disorder. Adolescence is also characterized by dramatic maturational changes in sleep and its regulation. The goal of this study was to assess sleep macroarchitecture and slow-wave activity (SWA) in depressed adolescent boys. METHODS: Eight non-medicated adolescent boys meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for depressive disorder and 10 age-matched healthy controls (average age 16...
October 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29031542/complications-and-30-day-readmission-rates-after-craniotomy-craniectomy-a-single-institutional-study-of-243-consecutive-patients
#14
Aladine A Elsamadicy, Amanda Sergesketter, Owoicho Adogwa, Michael Ongele, Oren N Gottfried
Early hospital readmission has become a proxy for quality of care and contributes significantly to high health care costs in the United States, with more than $20 billion health care dollars are spent on 30-day readmission annually. Cranial neurosurgical procedures (i.e., craniotomy, craniectomy) are associated with high readmission rates; however, studies examining readmission after cranial procedures are limited and relatively unknown. The aim of this study is to identify the drivers of 30-day unplanned readmission in consecutive patients undergoing craniotomies and craniectomies...
October 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29030932/a-prospective-audit-of-pain-profiles-following-general-and-urological-surgery-in-children
#15
Caroline A Wilson, David Sommerfield, Thomas F E Drake-Brockman, Claudia Lagrange, Anoop Ramgolam, Britta S von Ungern-Sternberg
BACKGROUND: Postoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short- and long-term consequences for children, their families, and the healthcare system. A greater understanding of procedure-specific postoperative pain trajectories is required to improve pain management. AIM: To determine the duration and severity of acute postoperative pain experienced by children undergoing 8 different general and urological procedures (primary outcomes)...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29028462/older-adults-with-alzheimer-s-disease-who-have-used-an-automatic-medication-dispenser-for-3-or-more-years
#16
Tomoko Kamimura
This article describes four older adults with Alzheimer's disease and comorbidities who used an automatic medication dispenser (AMD) to continue pharmacotherapy for these chronic diseases and who remained at home living either alone or with an older spouse. The AMDs were used for 3 to 4.5 years. The patients scored at least 21 on the Mini-Mental State Examination, and their dosing regimen involved taking the medication once or twice per day throughout this period. The caregivers filled the devices with medications once every 1 to 2 weeks and continuously monitored the patients' conditions nearly every day...
June 30, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/29028282/characteristics-of-quality-improvement-champions-in-nursing-homes-a-systematic-review-with-implications-for-evidence-based-practice
#17
Kyungmi Woo, Gvira Milworm, Dawn Dowding
BACKGROUND: Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality. AIMS: To identify the role, use and preparation of champions in a nursing home setting as a way of informing future QI strategies in nursing homes...
October 13, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29027836/developing-macroindicators-of-palliative-care-development-in-africa-a-process-with-in-country-and-international-experts
#18
John Y Rhee, Eduardo Garralda, Eve Namisango, Emmanuel Luyirika, Liliana de Lima, Richard A Powell, Carlos Centeno
BACKGROUND: Indicators specific to the African context are important to measure palliative care (PC) development accurately. OBJECTIVE: To describe the process used to develop a set of PC macroindicators for Africa. DESIGN: Open-ended interviews on national PC development were conducted with five African Country Experts. Indicators were rated (1-4) by 14 Country Experts for validity and feasibility. An additional 11 interviews were conducted to ensure indicator saturation...
October 13, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29027607/developing-a-patient-reported-outcome-measure-for-hiv-care-on-perceived-barriers-to-antiretroviral-adherence-assessing-the-needs-of-hiv-clinicians-through-qualitative-analysis
#19
Isabelle Toupin, Kim Engler, David Lessard, Leo Wong, Andràs Lènàrt, Bruno Spire, François Raffi, Bertrand Lebouché
PURPOSE: To identify HIV clinicians' needs for the clinical use of a new patient-reported outcome measure (PRO) on barriers to antiretroviral therapy (ART) adherence. METHODS: In 2015, five focus groups with 31 clinicians from France were transcribed, coded with Atlas.ti, and submitted to a typological analysis. RESULTS: The analysis identified seven patient profiles, each tied to distinct barriers to adherence and to specific needs for the PRO's content, data collection and transmission...
October 13, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/29027477/a-previsit-screening-checklist-improves-teamwork-and-access-to-preventive-services-in-a-medical-home-serving-low-income-adolescent-and-young-adult-patients
#20
Sophie H Allende-Richter, Sydney T Johnson, Mariam Maloyan, Patricia Glidden, Kerrilynn Rice, Alexandra Epee-Bounya
Publicly insured adolescents and young adults experience significant obstacles in accessing primary care services. As a result, they often present to their medical appointments with multiple unmet needs, adding time and complexity to the visit. The goal of this project was to optimize team work and access to primary care services among publicly insured adolescents and young adults attending an urban primary care clinic, using a previsit screening checklist to identify patient needs and delegate tasks within a care team to coordinate access to health services at the time of the visit...
October 1, 2017: Clinical Pediatrics
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