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proactive care

Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
Nikita Barai, Anne Monroe, Catherine Lesko, Bryan Lau, Heidi Hutton, Cui Yang, Anika Alvanzo, Mary Elizabeth McCaul, Geetanjali Chander
Heavy alcohol use has adverse effects in women with HIV. We examined the association between changes in alcohol use (measured with Timeline Followback) and changes in antiretroviral therapy adherence (medication possession ratio) and viral suppression (HIV RNA), measured over 6-month intervals. Among women who were (1) non-adherent or not virologically suppressed and (2) infrequent binge drinkers or non-heavy drinkers at baseline, increasing drinking was significantly associated with lower odds of subsequently improving adherence or viral suppression (OR of becoming adherent of 0...
October 17, 2016: AIDS and Behavior
Beatrice Cl Lim, Chin Ted Chong, Sean Lim
No abstract text is available yet for this article.
September 2016: Annals of the Academy of Medicine, Singapore
Christian Young, Allison Tong, Hasantha Gunasekera, Simone Sherriff, Deanna Kalucy, Peter Fernando, Jonathan C Craig
AIM: To describe the perspectives of health professionals and communities on an innovative health service delivery project, Hearing EAr health and Language Services (HEALS). HEALS was a government funded initiative to improve access to specialist ear, nose and throat and speech pathology services for Aboriginal families living in metropolitan areas. METHODS: Semi-structured interviews were conducted with 21 health-care professionals (clinicians, health service managers and Aboriginal health workers) and 16 care givers of children who participated in HEALS...
October 17, 2016: Journal of Paediatrics and Child Health
Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
October 14, 2016: Blood Purification
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
Priya Sahadeo, Robert J Weber
On March 28, 2014, The United States Pharmacopeia and The National Formulary (USP-NF) published USP General Chapter <800> Hazardous Drugs-Handling in Healthcare Settings, as open for public comment in the USP Pharmacopeial Forum (PF) 40(3). Pharmacy directors must be proactive in understanding the impact that USP <800> will have on their processes for preparing sterile products. USP General Chapter <797> pertains to the compounding of both hazardous and nonhazardous drugs. USP <800> serves as a new standard to guide the handling of hazardous drugs in order to protect patients, health care personnel, and the environment...
November 2015: Hospital Pharmacy
Thomas Volken, Andreas Buser, Damiano Castelli, Stefano Fontana, Beat M Frey, Ilka Rüsges-Wolter, Amira Sarraj, Jörg Sigle, Jutta Thierbach, Tina Weingand, Behrouz Mansouri Taleghani
BACKGROUND: Several studies have raised concerns that future demand for blood products may not be met. The ageing of the general population and the fact that a large proportion of blood products is transfused to elderly patients has been identified as an important driver of blood shortages. The aim of this study was to collect, for the first time, nationally representative data regarding blood donors and transfusion recipients in order to predict the future evolution of blood donations and red blood cell (RBC) use in Switzerland between 2014 and 2035...
September 30, 2016: Blood Transfusion, Trasfusione del Sangue
Laura A Reese, Mark Skidmore, William Dyar, Erika Rosebrook
Companion animal overpopulation is a growing problem in the United States. In addition to strays, an average of 324,500 nonhuman animals are relinquished to shelters yearly by their caregivers due to family disruption (divorce, death), foreclosure, economic problems, or minor behavioral issues. As a result, estimates of animals in shelters range from 3 million to 8 million, and due to overcrowding, euthanasia is common. This analysis seeks to determine the appropriate pricing mechanisms to clear animal shelters of dogs in the manner most desirable-that is, through adoption...
October 7, 2016: Journal of Applied Animal Welfare Science: JAAWS
Jennifer C Nelson, Robert Wellman, Onchee Yu, Andrea J Cook, Judith C Maro, Rita Ouellet-Hellstrom, Denise Boudreau, James S Floyd, Susan R Heckbert, Simone Pinheiro, Marsha Reichman, Azadeh Shoaibi
INTRODUCTION: The large-scale assembly of electronic health care data combined with the use of sequential monitoring has made proactive postmarket drug- and vaccine-safety surveillance possible. Although sequential designs have been used extensively in randomized trials, less attention has been given to methods for applying them in observational electronic health care database settings. EXISTING METHODS: We review current sequential-surveillance planning methods from randomized trials, and the Vaccine Safety Datalink (VSD) and Mini-Sentinel Pilot projects-two national observational electronic health care database safety monitoring programs...
2016: EGEMS
Katia Noyes, Janet Baack-Kukreja, Edward M Messing, Luke Schoeniger, Eva Galka, Wei Pan, Cai Xueya, Fergal J Fleming, John Rt Monson, Supriya G Mohile, Todd Francone
AIMS: To explore the feasibility of recruiting surgical oncology patients and implementing a surgical integrated discharge (SID) programme led by advanced practice providers (APP). BACKGROUND: Burden of illness and complexity of treatment regimen makes it challenging for surgical oncology patients to participate in research. Surgical oncology nurses may have the necessary expertise to overcome this problem. DESIGN: Controlled longitudinal prospective observational study...
July 2016: Nurs Open
Pei-Chao Lin, Chich-Hsiu Hung, Te-Fu Chan, Kuan-Chia Lin, Yu-Yun Hsu, Ya-Ling Tzeng
OBJECTIVE: To investigate the risk factors for developing GDM among Taiwanese pregnant women. DESIGN: A retrospective cohort and case-control study. SETTING: At a medical centre in Southern Taiwan. PARTICIPANTS: The hospitalised pregnant women who were diagnosed with either GDM or normal glucose tolerance (NGT) between 1997 and 2011. The glucose tolerance test results were interpreted according to criteria established by the National Diabetes Data Group for GDM...
September 22, 2016: Midwifery
Marlene Malmström, Bodil Ivarsson, Rosemarie Klefsgård, Kerstin Persson, Ulf Jakobsson, Jan Johansson
BACKGROUND: Following oesophagectomy, a major surgical procedure, it is known that patients suffer from severely reduced quality of life and have an unmet need for postoperative support. Still, there is a lack of research testing interventions aiming to enhance the patients' life situation after this surgical procedure. AIM: The aim of the study was to evaluate the effect of a nurse led telephone supportive care programme on quality of life (QOL), received information and the number of healthcare contacts compared to conventional care following oesophageal resection for cancer...
September 13, 2016: International Journal of Nursing Studies
Joanne Jordan, Louise Rose, Katie N Dainty, Jane Noyes, Bronagh Blackwood
BACKGROUND: Prolonged mechanical ventilation is associated with a longer intensive care unit (ICU) length of stay and higher mortality. Consequently, methods to improve ventilator weaning processes have been sought. Two recent Cochrane systematic reviews in ICU adult and paediatric populations concluded that protocols can be effective in reducing the duration of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions...
October 4, 2016: Cochrane Database of Systematic Reviews
Wanli Li, Xinjiang An, Mingyu Fu, Chunli Li
Pneumonia refers to lung inflammation caused by different pathogens or other factors, and is a common pediatric disease occurring in infants and young children. It is closely related to the anatomical and physiological characteristics of infants and young children and is more frequent during winter and spring, or sudden changes in temperature. Pneumonia is a serious disease that poses a threat to children's health and its morbidity and mortality rank first, accounting for 24.5-65.2% of pediatric inpatients...
October 2016: Experimental and Therapeutic Medicine
Ging-Long Wang, Chih-Tao Cheng, An-Chen Feng, Sheng-Hui Hsu, Yi-Chen Hou, Chiu-Yuan Chiu
OBJECTIVE: Beginning in 2007, all newly diagnosed cancer patients at the Koo Foundation Sun Yat-Sen Cancer Center (KF-SYSCC) were screened for psychosocial distress. Our social workers, as part of the psychosocial care team (PCT), have engaged in proactive outreach with patients identified as distressed. The goal of the present study was to assess the prevalence of psychosocial distress and the extent of contact between the PCT and distressed patients. METHOD: Newly diagnosed patients who were treated at KF-SYSCC between 2007 and 2010 for cancer were eligible if there were at least 100 patients with the same type of cancer...
October 4, 2016: Palliative & Supportive Care
Aaron L Leppin, Cara Fernandez, Jon C Tilburt
CONTEXT: Treatment of pain in cancer is a clinical priority. Many cancer patients seek and use complementary and alternative medicine (CAM) therapies. OBJECTIVES: To describe the role CAM plays in oncology clinicians' approaches to pain management and its alignment with patient preference and self-care. METHODS: We used quantitative criteria to identify patients with high, self-reported pain and reduced quality of life. For these patients, we merged quantitative and qualitative data from encounter audio recordings, patient surveys, and the medical record...
September 29, 2016: Journal of Pain and Symptom Management
Steve W Parry, Harry Hill, Joanna Lawson, Nick Lawson, David Green, Heidi Trundle, Judith McNaught, Victoria Strassheim, Alma Caldwell, Richard Mayland, Phillip Earley, Peter McMeekin
National and international evidence and guidelines on falls prevention and management in community-dwelling elderly adults recommend that falls services should be multifactorial and their interventions multicomponent. The way that individuals are identified as having had or being at risk of falls in order to take advantage of such services is far less clear. A novel multidisciplinary, multifactorial falls, syncope, and dizziness service model was designed with enhanced case ascertainment through proactive, primary care-based screening (of individual case notes of individuals aged ≥60) for individual fall risk factors...
September 27, 2016: Journal of the American Geriatrics Society
Kori A LaDonna, Christopher J Watling, Susan L Ray, Christine Piechowicz, Shannon L Venance
BACKGROUND: Patient-centered care for individuals with myotonic dystrophy (DM1) and Huntington's disease (HD)-chronic, progressive, and life-limiting neurological conditions-may be challenged by patients' cognitive and behavioral impairments. However, no research has explored health care providers' (HCPs') perspectives about patient-centered care provision for these patients along their disease trajectory. METHODS: Constructivist grounded theory informed the iterative data collection and analysis process...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Camilla L Wong, Raghda AlAtia, Amanda McFarlan, Holly Y Lee, Christina Valiaveettil, Barbara Haas
BACKGROUND: Proactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS. METHODS: We assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013)...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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