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complete care model

Ebele M Umeukeje, Marcus G Wild, Saugar Maripuri, Teresa Davidson, Margaret Rutherford, Khaled Abdel-Kader, Julia Lewis, Consuelo H Wilkins, Kerri Cavanaugh
BACKGROUND AND OBJECTIVES: Incidence of ESKD is three times higher in black Americans than in whites, and CKD prevalence continues to rise among black Americans. Community-based kidney disease screening may increase early identification and awareness of black Americans at risk, but it is challenging to implement. This study aimed to identify participants' perspectives of community kidney disease screening. The Health Belief Model provides a theoretic framework for conceptualization of these perspectives and optimization of community kidney disease screening activities...
March 15, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Aida Kamišalić, David Riaño, Tatjana Welzer
BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions...
May 2018: Computer Methods and Programs in Biomedicine
David J Tennent, Stefanie M Shiels, Jessica A Jennings, Warren O Haggard, Joseph C Wenke
BACKGROUND: Contaminated traumatic open orthopedic wounds are frequently complicated by polymicrobial contamination and infection. In high-risk wounds, the standard of care comprises debridement and irrigation combined with antibiotics which can be applied directly or combined with systemic antibiotics. Recently, bioabsorbable chitosan sponges have been shown to be an effective single-agent delivery device for local antibiotics with and without negative pressure wound therapy (NPWT). Severely contaminated orthopedic wounds, however, are often complicated by polymicrobial infections, necessitating multiple antibiotic agents...
March 15, 2018: Journal of Orthopaedic Surgery and Research
Felix Miedaner, Ludwig Kuntz, Christian Enke, Bernhard Roth, Anika Nitzsche
BACKGROUND: Physician and nursing shortages in acute and critical care settings require research on factors which might drive their commitment, an important predictor of absenteeism and turnover. However, the degree to which the commitment of a physician or a nurse is driven by individual or organizational characteristics in hospitals remains unclear. In addition, there is a need for a greater understanding of how antecedent-commitment relationships differ between both occupational groups...
March 15, 2018: BMC Health Services Research
Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
Laura J Olivieri, David Zurakowski, Karthik Ramakrishnan, Lillian Su, Fahad A Alfares, Matthew R Irwin, Jenna Heichel, Axel Krieger, Dilip S Nath
BACKGROUND: Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery. METHODS: Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Anne Munck, Rym Boulkedid, Laurence Weiss, Pierre Foucaud, Nathalie Wizla-Derambure, Philippe Reix, François Bremont, Jocelyne Derelle, Julien Schroedt, Corinne Alberti
OBJECTIVE: To evaluate nutritional status and associated factors in a cystic fibrosis (CF) cohort diagnosed by newborn screening and followed up to month 24. METHODS: A prospective longitudinal multicenter study assessing nutritional status according to pancreatic status, feeding modalities, prescriptions, pulmonary outcome and biological nutritional parameters. RESULTS: One-hundred-and-five infants were recruited and 99 completed the study...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
Sana B Ali, Juana Romero, Kevin Morrison, Baria Hafeez, Jessica S Ancker
OBJECTIVES:  Although electronic patient portals are offered by most health care organizations, poor usability and poor fit to patient needs may pose barriers to adoption. We collaborated with an academic hospital to conduct iterative user evaluation of a newly deployed portal designed to deliver inpatient data upon hospital discharge. METHODS:  Three evaluators applied heuristic usability evaluation and conducted 23 individual user testing sessions with patients with chronic disease or managing the care of family members with chronic disease...
January 2018: Applied Clinical Informatics
Melissa Zajdel, Vicki S Helgeson, Howard J Seltman, Mary T Korytkowski, Leslie R M Hausmann
Background: Adjusting to the challenges of a chronic illness does not affect patients alone but also influences social network members-most notably spouses. One interpersonal framework of coping with a chronic illness is communal coping, described as when a problem is appraised as joint and the couple collaborates to manage the problem. Purpose: We sought to determine whether daily communal coping was linked to daily mood and self-care behavior and examined one potential mechanism that may explain these links: perceived emotional responsiveness...
February 17, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
Silvia de Souza Campos Fernandes, Dirceu Solé, Paulo Camargos, Cláudia Ribeiro de Andrade, Cássio da Cunha Ibiapina
OBJECTIVE: To evaluate risk factors associated with asthma symptoms in adolescents in the 13- to 14-year age bracket. METHODS: This was a cross-sectional study involving adolescents enrolled in randomly selected public schools in the city of Belo Horizonte, Brazil, and conducted with the use of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and its supplementary module for risk factor assessment. The ISAAC questionnaire was completed by the students themselves, whereas the supplementary questionnaire was completed by their parents or legal guardians...
January 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Julie Franks, Sharon B Mannheimer, Yael Hirsch-Moverman, Eleanor Hayes-Larson, Paul W Colson, Hugo Ortega, Wafaa M El-Sadr
INTRODUCTION: Black men who have sex with men and transgender women are at high risk for HIV infection, but are more likely to be unaware of their infection or not in care for diagnosed HIV compared to other races. Respondent driven sampling has been advanced as a method to reach stigmatized and hidden populations for HIV testing. We compared strategies to recruit black, substance-using men who have sex with men and transgender women to identify newly diagnosed HIV infection, or those previously diagnosed but not in care...
March 2018: Journal of the International AIDS Society
Tiffany A Radcliff, Karen Chu, Claudia Der-Martirosian, Aram Dobalian
INTRODUCTION: Although little research has examined impacts of disasters on scheduled ambulatory care services, routine care delivery is important for emergency planning and response because missed or delayed care can lead to more urgent care needs. This article presents potential measures of ambulatory care recovery and resilience and applies the measures to data around a recent disaster. METHODS: We conceptualize "ambulatory care recovery" as the change in median business days to complete appointments that were canceled, and "ambulatory care resiliency" as the change in percentage of completed appointments in time frames before, during, and after disasters...
March 2018: Journal of the American Board of Family Medicine: JABFM
Patrick T Reeves, Matthew A Borgman, Nicole W Caldwell, Leela Patel, James Aden, John P Duggan, Maria L Serio-Melvin, Elizabeth A Mann-Salinas
OBJECTIVE: The Advanced Burn Life Support (ABLS) program is a burn-education curriculum nearly 30 years in the making, focusing on the unique challenges of the first 24h of care after burn injury. Our team applied high fidelity human patient simulation (HFHPS) to the established ABLS curriculum. Our hypothesis was that HFHPS would be a feasible, easily replicable, and valuable adjunct to the current curriculum that would enhance learner experience. METHODS: This prospective, evidenced-based practice project was conducted in a single simulation center employing the American Burn Association's ABLS curriculum using HFHPS...
March 10, 2018: Burns: Journal of the International Society for Burn Injuries
Jane M Garbutt, Sherry Dodd, Emily Walling, Amanda A Lee, Katharine Kulka, Rebecca Lobb
BACKGROUND: The national guideline for use of the vaccine targeting oncogenic strains of the human papillomavirus (HPV) is an evidence-based practice that is poorly implemented in primary care. Recommendations include completion of the vaccine series before the 13th birthday for girls and boys, giving the first dose at the 11- to 12-year-old check-up visit, concurrent with other recommended vaccines. Interventions to increase implementation of this guideline have had little impact, and opportunities to prevent cancer continue to be missed...
March 13, 2018: Implementation Science: IS
Richard A Crosby, Leandro Mena, Rachel Vickers Smith
The aim of this study is to determine, among young Black men who have sex with men (YBMSM), the 12-month efficacy of a single-session, clinic-based intervention promoting condom use to enhance sexual pleasure (purpose 1) and the use of condoms from the start-to-finish of anal sex (purpose 2). A pre-test, post-test randomized controlled trial was conducted, using a 12-month period of follow-up observation, in STI clinics. Data from 394 YBMSM completing baseline and 12-month follow-up assessments were analyzed...
March 9, 2018: Health Education Research
Samantha Shawley-Brzoska, Ranjita Misra
This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia...
March 13, 2018: Journal of Clinical Medicine
Rachel Bennett, Philippa Waterhouse
Understanding the transition to adulthood has important implications for supporting young adults and understanding the roots of diversity in wellbeing later in life. In South Africa, the end of Apartheid means today's youth are experiencing their transition to adulthood in a changed social and political context which offers opportunities compared to the past but also threats. This paper presents the first national level analysis of the patterning of key transitions (completion of education, entry into the labour force, motherhood and marriage or cohabitation), and the association between the different pathways and health amongst young women...
March 2, 2018: Social Science & Medicine
Easter Joury, Eduardo Bernabe, Jennifer E Gallagher, Wagner Marcenes
Little is known about the burden and impact of orofacial pain in deprived areas, and whether it mediates the relationship between socio-economic position (SEP) and impacts on daily life. We analysed data from a representative sample of 2,168 adults, aged 16-65 years, from the East London Oral Health Inequality study. Participants completed a validated questionnaire on demographics, SEP (area deprivation), orofacial pain (by anatomical site) in the past month and impacts related to oral conditions on daily life...
March 12, 2018: Pain
Sunil H Adwani, Cai Yuan, Leen Alsaleh, Julie Pepe, Khalid Abusaada
RATIONALE, AIMS, AND OBJECTIVES: Several studies have looked at patient-related variables influencing hospital length of stay (LOS) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, there has been increasing recognition that physician-related factors also play a significant role. This study aims to evaluate differences in practice patterns between teaching and nonteaching services and their effect on LOS in a large community hospital. METHODS: A retrospective study of 354 patients admitted to Florida Hospital, Orlando, with AECOPD between January 2009 and December 2011...
March 13, 2018: Journal of Evaluation in Clinical Practice
Stuart Keel, Pei Ying Lee, Jane Scheetz, Zhixi Li, Mark A Kotowicz, Richard J MacIsaac, Mingguang He
The purpose of this study is to evaluate the feasibility and patient acceptability of a novel artificial intelligence (AI)-based diabetic retinopathy (DR) screening model within endocrinology outpatient settings. Adults with diabetes were recruited from two urban endocrinology outpatient clinics and single-field, non-mydriatic fundus photographs were taken and graded for referable DR ( ≥ pre-proliferative DR). Each participant underwent; (1) automated screening model; where a deep learning algorithm (DLA) provided real-time reporting of results; and (2) manual model where retinal images were transferred to a retinal grading centre and manual grading outcomes were distributed to the patient within 2 weeks of assessment...
March 12, 2018: Scientific Reports
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