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https://www.readbyqxmd.com/read/29775994/a-broader-understanding-of-care-managers-attitudes-of-advance-care-planning-a-concurrent-nested-design
#1
Julie Aultman, Kristin R Baughman, Ruth Ludwick
AIMS AND OBJECTIVES: To examine barriers of advance care planning (ACP) experienced by care managers (CMs) through a mixed methods approach. A concurrent nested design was used to acquire a deeper understanding of ACP, and to identify nuances between quantitative and qualitative data. BACKGROUND: Past quantitative studies on providers have identified barriers related to time, culture, knowledge, responsibility, and availability of legal documents. These barriers, and accompanying attitudes and feelings, have been taken at face value without rich qualitative data to identify under what conditions and to what extent a barrier impacts care...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29773084/sexual-and-reproductive-health-concerns-of-persons-with-disability-in-india-an-issue-of-deep-rooted-silence
#2
Seema Sharma, Muthusamy Sivakami
SummaryGlobal estimates suggest that over a billion people live with a disability that is significant enough to affect their daily lives. According to the 2011 Indian Census, India alone has about 26.8 million people with disabilities. Research suggests that persons with disabilities (PwDs) in India are among the most neglected, stigmatized, poor and least educated of the world's population, and women with disabilities in India are the most marginalized, both socially and economically. They bear the triple burden of being discriminated against through being 'women' (socially marginal beings), 'disabled' (incapacitated, inefficient and undesirable) and 'women with disabilities' (the weakest of the weak), often becoming socially invisible...
May 18, 2018: Journal of Biosocial Science
https://www.readbyqxmd.com/read/29770438/health-insurance-and-poverty-in-trajectories-of-out-of-pocket-expenditure-among-low-income-middle-aged-adults
#3
Eunsun Kwon, Sojung Park, Timothy D McBride
OBJECTIVE: To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. DATA SOURCES/STUDY SETTING: Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. STUDY DESIGN: A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures...
May 16, 2018: Health Services Research
https://www.readbyqxmd.com/read/29767766/cost-transparency-in-neurosurgery-a-single-institution-analysis-of-patient-out-of-pocket-spending-in-13-673-consecutive-neurosurgery-cases
#4
Michael A Mooney, Seungwon Yoon, Tyler Cole, John P Sheehy, Michael A Bohl, F David Barranco, Peter Nakaji, Andrew S Little, Michael T Lawton
BACKGROUND: Patient out-of-pocket (OOP) spending is an increasingly discussed topic; however, there is minimal data available on the patient financial burden of surgical procedures. OBJECTIVE: To analyze hospital and surgeon expected payment data and patient OOP spending in neurosurgery. METHODS: This is a retrospective cohort study of neurosurgical patients at a tertiary-referral center from 2013 to 2016. Expected payments, reflecting negotiated costs-of-care, as well as actual patient OOP payments for hospital care and surgeon professional fees were analyzed...
May 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29767375/strategies-to-guide-the-return-of-genomic-research-findings-an-australian-perspective
#5
Lisa Eckstein, Margaret Otlowski
In Australia, along with many other countries, limited guidance or other support strategies are currently available to researchers, institutional research ethics committees, and others responsible for making decisions about whether to return genomic findings with potential value to participants or their blood relatives. This lack of guidance results in onerous decision-making burdens-traversing technical, interpretative, and ethical dimensions-as well as uncertainty and inconsistencies for research participants...
May 16, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29764103/unit-costing-of-health-extension-worker-activities-in-ethiopia-a-model-for-managers-at-the-district-and-health-facility-level
#6
Maureen E Canavan, Erika Linnander, Shirin Ahmed, Halima Mohammed, Elizabeth H Bradley
BACKGROUND: Over the last decade, Ethiopia has made impressive national improvements in health outcomes, including reductions in maternal, neonatal, infant, and child mortality attributed in large part to their Health Extension Program (HEP). As this program continues to evolve and improve, understanding the unit cost of health extension worker (HEW) services is fundamental to planning for future growth and ensuring adequate financial support to deliver effective primary care throughout the country...
September 2, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29761755/a-deadly-wait-for-u-s-health-insurance-coverage-sitting-on-the-couch-with-malaria
#7
Jonathan S Schultz, Adam J Atherly, Andrés F Henao-Martínez
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care...
May 14, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29760606/influence-of-major-coping-strategies-on-treatment-non-adherence-and-severity-of-comorbid-conditions-in-hemodialysis-patients
#8
Hyun Chan Hwang, Hye Ri Kim, Doug Hyun Han, Ji Sun Hong, So-Hee Jeong, Jung-Ho Shin, Su-Hyun Kim, Jin Ho Hwang, Sun Mi Kim
Background: Non-adherence and comorbidities are prevalent among hemodialysis patients and are associated with increased mortality and financial burden. We aimed to investigate the influence of major coping strategies (CSs) on non-adherence and comorbidities in hemodialysis patients. Methods: A total of 49 patients were enrolled. We collected participant data including CS measured by a Korean version of the ways of coping questionnaire (K-WCQ), comorbidities measured by age-adjusted Charlson comorbidity index (CCI), and adherence measured by the 8-item Morisky medication adherence scale (MMAS-8)...
May 14, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29759557/organization-quality-and-cost-of-oncological-home-hospitalization-a-systematic-review
#9
REVIEW
Lieselot Cool, Dominique Vandijck, Philip Debruyne, Melissa Desmedt, Tessa Lefebvre, Michelle Lycke, Pieter Jan De Jonghe, Hans Pottel, Veerle Foulon, Koen Van Eygen
BACKGROUND: Home-hospitalization might be a patient-centred approach facing the increasing burden of cancer on societies. This systematic review assessed how oncological home-hospitalization has been organized and to what extent its quality and costs were evaluated. RESULTS: Twenty-four papers describing parenteral cancer drug administration to adult patients in their homes were included. Most papers concluded oncological home-hospitalization had no significant effect on patient-reported quality of life (7/8 = 88%), but large majority of patients were satisfied (12/13, 92%) and preferred home treatment (7/8, 88%)...
June 2018: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/29759023/embodied-neoliberalism-epidemiology-and-the-lived-experience-of-consumer-debt
#10
Elizabeth Sweet, L Zachary DuBois, Flavia Stanley
A growing set of epidemiological data links personal financial debt to negative mental and physical health outcomes. These findings point to debt as a potentially significant socioeconomic determinant of population health, especially given rising rates of household and consumer debt in industrialized nations. However, the political and economic contexts in which rising consumer debt is embedded and the ways in which it is experienced in everyday life are underexplored in this epidemiological literature. This gap leaves open questions about how best to situate and understand debt as a health determinant with both psychosocial and neo-material attributes...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/29758022/determinants-of-hardship-financing-in-coping-with-out-of-pocket-payment-for-care-seeking-of-under-five-children-in-selected-rural-areas-of-bangladesh
#11
Tazeen Tahsina, Nazia Binte Ali, Md Abu Bakkar Siddique, Sameen Ahmed, Mubashshira Rahman, Sajia Islam, Md Mezanur Rahman, Bushra Amena, D M Emdadul Hoque, Tanvir M Huda, Shams El Arifeen
BACKGROUND: Around 63% of total health care expenditure in Bangladesh is mitigated through out of pocket payment (OOP). Heavy reliance on OOP at the time of care seeking poses great threat for financial impoverishment of the households. Households employ different strategies to cope with the associated financial hardship. OBJECTIVE: The aim of this paper is to understand the determinants of hardship financing in coping with OOP adopted for health care seeking of under five childhood illnesses in rural setting of Bangladesh...
2018: PloS One
https://www.readbyqxmd.com/read/29756684/a-prospective-bottom-up-study-of-the-costs-of-faecal-incontinence-in-ambulatory-patients
#12
Vicki Patton, Katrina Parkin, Kate H Moore
BACKGROUND AND AIM: The few studies that have examined direct costs of faecal incontinence are limited in that they employed retrospective databases, postal surveys, and focused upon institutionalised patients or post partum women. The aim of the current study was to identify the direct pre-treatment costs of faecal incontinence expended by a range of home dwelling patients and identify relationships between costs and severity of incontinence. METHODS: Consecutive patients attending an outpatient clinic for treatment of faecal incontinence were interviewed using a questionnaire, modeled on the Dowel Bryant Incontinence Cost Index...
May 14, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#13
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29754592/general-practitioners-views-on-the-influence-of-cost-on-the-prescribing-of-asthma-preventer-medicines-a-qualitative-study
#14
Jacqueline Tudball, Helen K Reddel, Tracey-Lea Laba, Stephen Jan, Anthony Flynn, Michele Goldman, Kirsty Lembke, Elizabeth Roughead, Guy B Marks, Nick Zwar
Objective Out-of-pocket costs strongly affect patient adherence with medicines. For asthma, guidelines recommend that most patients should be prescribed regular low-dose inhaled corticosteroids (ICS) alone, but in Australia most are prescribed combination ICS-long-acting β2-agonists (LABA), which cost more to patients and government. The present qualitative study among general practitioners (GPs) explored the acceptability, and likely effect on prescribing, of lower patient copayments for ICS alone. Methods Semistructured telephone interviews were conducted with 15 GPs from the greater Sydney area; the interviews were transcribed and thematically analysed...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29753590/adherence-to-biologic-therapy-does-it-vary-with-ethnicity
#15
Muhammad K Nisar, Waqas Mirza, Aneesa Rafiq, Michael Eisenhut
BackgroundPoor adherence to therapy remains a significant barrier to improving clinical outcomes in rheumatic diseases and carries a major financial burden. It has been linked to medication related patient beliefs, which were reported to differ between ethnic groups. Little is known about these variations in biologic therapies cohorts. The purpose of this study was to identify potential determinants of adherence to biologic drugs including an assessment of the influence of beliefs about medicines and compare determinants of adherence between patients of Caucasian versus other ethnicities (OE)...
May 9, 2018: Biologicals: Journal of the International Association of Biological Standardization
https://www.readbyqxmd.com/read/29753357/personal-income-before-and-after-diagnosis-of-multiple-sclerosis
#16
Erik Landfeldt, Anna Castelo-Branco, Axel Svedbom, Emil Löfroth, Andrius Kavaliunas, Jan Hillert
BACKGROUND: Multiple sclerosis (MS) is associated with serious morbidity and labor force absenteeism, but little is known of the long-term impact of the disease on personal income. OBJECTIVES: To assess long-term consequences of MS on personal salary and disposable income. METHODS: Patients with MS in Sweden were identified in a nationwide, disease-specific register and matched with general population controls. We assessed mean annual personal gross salary and disposable income each year before and after index (i...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29752337/oa-gl21-a-novel-bioactive-peptide-from-odorrana-andersonii-accelerated-the-healing-of-skin-wounds
#17
Wenxin Bian, Buliang Meng, Xiaojie Li, Siyuan Wang, Xiaoqing Cao, Naixin Liu, Meifeng Yang, Jing Tang, Ying Wang, Xinwang Yang
Nowadays, the number of chronic trauma cases caused by variety of factors such as the world's population-aging and chronic diseases is increasing steadily, and thus effective treatment for chronic wounds has become a severe clinical challenge, which also burdens the patient both physically and financially. Therefore, it is urgent to develop new drugs to accelerate the healing of wounds. Bioactive peptides, which are relatively low cost, easy to produce, store and transport, have become an excellent choice. In this research, we identified a novel peptide OA-GL21, with an amino acid sequence of 'GLLSGHYGRVVSTQSGHYGRG', from the skin secretions of Odorrana andersonii...
May 11, 2018: Bioscience Reports
https://www.readbyqxmd.com/read/29752321/redefining-quality-measurement-in-cancer-care
#18
Elizabeth A Nardi, James McCanney, Katy Winckworth-Prejsnar, Alyssa A Schatz, Kerin Adelson, Marcus Neubauer, Mary Lou Smith, Ronald Walters, Robert W Carlson
Quality measurement in oncology is increasing in significance as payment schemes shift from volume to value. As demand for quality measures increases, challenges in the development of quality measures, standardization across measures, and the limitations of health information technology have become apparent. Moreover, the time and financial burden associated with developing, tracking, and reporting quality measures are substantial. Despite these challenges, best practices and leaders in the field of quality measurement in oncology have emerged...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29749757/characteristics-associated-with-family-money-management-for-persons-with-psychiatric-disorders
#19
Travis Labrum
BACKGROUND: Persons with psychiatric disorders (PD) commonly have their money officially or unofficially managed by others, with money managers most commonly being family members. AIMS: (i) Identify characteristics of persons with PD, adult family members, and interactions with each other significantly associated with family money management (FMM). (ii) Identify significant differences in aforementioned characteristics between official versus unofficial FMM. METHODS: Five hundred and seventy-three adults residing in USA with an adult relative with PD completed a survey...
May 11, 2018: Journal of Mental Health
https://www.readbyqxmd.com/read/29749459/ctrp9-ameliorates-cellular-senescence-via-pgc%C3%A2-1%C3%AE-ampk-signaling-in-mesenchymal-stem-cells
#20
Qun Li, Zhangzhang Zhu, Chengde Wang, Lin Cai, Jianglong Lu, Yongchun Wang, Jiadong Xu, Zhipeng Su, Weiming Zheng, Xianbin Chen
Stroke is the second most common cause of death worldwide, and thus, it imposes great financial burdens on both individuals and society. Mesenchymal stem cell (MSC) therapy is a promising approach for ischemic brain injury. However, MSC treatment potential is progressively reduced with age, limiting their therapeutic efficacy for brain repair post‑stroke. C1q and tumor necrosis factor‑related protein 9 (CTRP9) is a novel cytoprotective cytokine with antioxidant effects, which is highly expressed in brain tissue...
May 9, 2018: International Journal of Molecular Medicine
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