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complete care model

Kelly Jones, Ngara Keeler, Chris Morris, David Brennan, Kaye Roberts-Thompson, Lisa Jamieson
OBJECTIVE: To explore and document self-reported factors contributing to Indigenous Australians' attendance and non-attendance at South Australian public dental clinics. METHODS: Semi-structured interviews were conducted with people (18 males and 26 females) referred for oral care through the Aboriginal Liaison Program of the South Australian Dental Service. Thematic analysis was performed on 44 transcribed conversations and a conceptual model developed. RESULTS: Persons completing all recommended treatment reported high self-efficacy, health literacy, social cohesion and previous use of dental services and presence of a health advocate...
2016: Journal of Health Care for the Poor and Underserved
Leonie Segal, Claire Marsh, Rob Heyes
OBJECTIVES: We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. METHODS: The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out...
October 6, 2016: Journal of Health Services Research & Policy
S J H van Erp, L K M P Brakenhoff, M Vollmann, D van der Heijde, R A Veenendaal, H H Fidder, D W Hommes, A A Kaptein, Andrea E van der Meulen-de Jong, M Scharloo
PURPOSE: Patients with inflammatory bowel disease (IBD) often experience severe impairment in different life domains. Psychological factors, such as illness perceptions and coping, may play a role in the adjustment to IBD as indicated by mental and physical health, activity, and work impairment. The present study aimed at examining the assumption of the Common Sense Model (CSM) that coping mediates the relationship between illness perceptions and adjustment in patients with IBD. METHOD: In a cross-sectional design, 211 IBD patients (73 % Crohn's disease, 40 % male, mean age 42...
October 18, 2016: International Journal of Behavioral Medicine
Kelsey M Flint, Sarah J Schmiege, Larry A Allen, Timothy J Fendler, John Rumsfeld, David Bekelman
CONTEXT: Health status (i.e., symptoms, function, and quality of life) is an important palliative care outcome in patients with heart failure, however patterns of health status over time (i.e. trajectories) are not well described. OBJECTIVES: To identify health status trajectories in outpatients with heart failure, and assess whether depression, symptom burden, or sense of peace predict health status trajectory. METHODS: Observational study utilizing data from the Patient-Centered Disease Management for Heart Failure trial...
October 15, 2016: Journal of Pain and Symptom Management
Sarah Mahoney, Ruth M Sladek, Tim Neild
BACKGROUND: Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning. METHODS: There were three groups of participants: medical students (n = 281), who completed a longitudinal survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the beginning and end of the 2013 academic year; private doctors (medical practitioners) in South Australia (n = 78) who completed a survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the end of the students' academic year; and doctors (medical practitioners) from public teaching hospitals (n = 72) in southern Adelaide, South Australia who completed a survey consisting of the Jefferson Scale of Empathy at the end of the students' academic year ...
October 18, 2016: BMC Medical Education
Meri Kankaanpää, Maria Raitakari, Leila Muukkonen, Siv Gustafsson, Merja Heitto, Ari Palomäki, Kimmo Suojanen, Veli-Pekka Harjola
BACKGROUND: To assess whether the use of point-of-care testing (POCT) and early assessment team (EAT) model shortens emergency department (ED) length of stay (LOS). METHODS: This prospective, observational study with comparison between three study periods was performed in three phases in a metropolitan ED with 57,000 annual visits. Data were collected from adult ambulatory patients who were discharged home. Phase 1 served as a control (n = 1559 in one month)...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Tonje Holte Stea, Tommy Haugen, Sveinung Berntsen, Vigdis Guttormsen, Nina Cecilie Øverby, Kristin Haraldstad, Eivind Meland, Eirik Abildsnes
BACKGROUND: In light of the high prevalence of childhood overweight and obesity, there is a need of developing effective prevention programs to address the rising prevalence and the concomitant health consequences. The main aim of the present study is to systematically develop and implement a tailored family-based intervention for improving lifestyle habits among overweight and obese children, aged 6-10 years old, enhancing parental self-efficacy, family engagement and parent-child interaction...
October 18, 2016: BMC Public Health
Aurélie Chauffour, Jérôme Robert, Nicolas Veziris, Alexandra Aubry, Vincent Jarlier
BACKGROUND: The treatment of Buruli ulcer (BU) that is caused by Mycobacterium ulcerans, is currently based on a daily administration of rifampin and streptomycin (RIF-STR). A fully oral intermittent regimen would greatly simplify its treatment on the field. METHODOLOGY/PRINCIPAL FINDINGS: The objective of this study was to assess the bactericidal and sterilizing activities of intermittent oral regimens in a murine model of established M. ulcerans infection. Regimens combining rifapentine (RFP 20 mg/kg) with either moxifloxacin (MXF 200 mg/kg), clarithromycin (CLR 100 mg/kg) or bedaquiline (BDQ 25 mg/kg) were administrated twice (2/7) or three (only for RFP-CLR 3/7) times weekly during 8 weeks...
October 2016: PLoS Neglected Tropical Diseases
Tone Kristin Bergersen, Elisabeth Storheim, Stina Gundersen, Linn Kleven, Maria Johnson, Leiv Sandvik, Kari Jorunn Kvaerner, Nils-Otto Ørjasæter
OBJECTIVE: The aim of this study was to test the efficacy of a wound support network model between the primary home care service and the hospital. The impact on wound healing rate, cost benefit, and transfer of knowledge was investigated. INTERVENTION: The intervention group was exposed to a wound support network (n = 32), and the control group continued standard organization of treatment (n = 21). DESIGN: Nonrandomized controlled study; observations were made before (baseline) and after the implementation of the intervention (12 weeks)...
November 2016: Advances in Skin & Wound Care
Heather F McClintock, Jibby E Kurichi, Pui L Kwong, Dawei Xie, Joel E Streim, Liliana E Pezzin, Sean Hennessey, Ling Na, Hillary R Bogner
OBJECTIVE: The aim of this study was to examine whether activity limitation stages were associated with patient-reported trouble getting needed health care among Medicare beneficiaries. DESIGN: This was a population-based study (n = 35,912) of Medicare beneficiaries who participated in the Medicare Current Beneficiary Survey for years 2001-2010. Beneficiaries were classified into an activity limitation stage from 0 (no limitation) to IV (complete) derived from self-reported or proxy-reported difficulty performing activities of daily living and instrumental activities of daily living...
October 13, 2016: American Journal of Physical Medicine & Rehabilitation
Katherine Clark, Lawrence T Lam, Nicholas J Talley, Jane L Phillips, David C Currow
OBJECTIVE: The aim of this work was to investigate whether variables identified as likely to impact the experience of constipation in other clinical settings similarly affected the experiences of constipated palliative care patients. BACKGROUND: The majority of palliative care patients with cancer are likely to be bothered by constipation symptoms at some point in their disease trajectory. Despite this, it remains unclear as to which factors predict more severe problems...
October 18, 2016: Journal of Palliative Medicine
Peter Rijnbeek
Massive numbers of electronic health records are currently being collected globally, including structured data in the form of diagnoses, medications, laboratory test results, and unstructured data contained in clinical narratives. This opens unprecedented possibilities for research and ultimately patient care. However, actual use of these databases in a multi-center study is severely hampered by a variety of challenges, e.g., each database has a different database structure and uses different terminology systems...
September 2016: Journal of Hypertension
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
Chun Chang, Qingqi Zeng, Ying Ji, Xinying Sun, Yuhui Shi, Yanlin Wang, Chengcheng Han, Xiuqin Wen
OBJECTIVE: To exam whether health literacy mediated the association between intervention and blood pressure control and to better understand the relationship between health literacy and health outcome for hypertensive. DESIGN AND METHOD: A before-after designed one-year community-based intervention program including patient education and patient-centered goal support were conducted in a primary care setting. A face-to-face interview were completed among 468 hypertensives before intervention and 406 after intervention...
September 2016: Journal of Hypertension
Marc Auerbach, Joanne Cole, Pina Violano, Linda Roney, Catherine Doherty, Michael Shepherd, Ralph MacKinnon
OBJECTIVES: Thousands of head-injured children are cared for by interprofessional teams in emergency departments every day. Teams must balance performing time-consuming interventions with safe transport for neuroimaging. This study aims to describe and compare providers' perspectives on the transfer of head-injured children to neuroimaging and factors contributing to delays. METHODS: Participants were interprofessional health care providers involved in the care of head-injured children at sites in the United Kingdom, the United States, and New Zealand...
October 8, 2016: Pediatric Emergency Care
Kartavya J Vyas, Susan F Fesperman, Bonnie J Nebeker, Steven K Gerard, Nicholas D Boyd, Eileen M Delaney, Jennifer A Webb-Murphy, Scott L Johnston
The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program...
October 2016: Military Medicine
Bernt Johan von Scholten, Frederik Persson, Signe Rosenlund, Peter Hovind, Jens Faber, Tine Willum Hansen, Peter Rossing
AIMS: Patients with type 2 diabetes and albuminuria have high cardiorenal morbidity and mortality despite multifactorial treatment. Short-term reduction in albuminuria is considered suggestive of long-term renoprotective effects. We evaluated the renal effects of the glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide on top of multifactorial care, including renin-angiotensin-system (RAS)-inhibition. MATERIALS AND METHODS: Randomised, double-blind, placebo-controlled, cross-over trial including patients with type 2 diabetes and persistent albuminuria (urinary albumin-to-creatinine ratio > 30 mg/g) and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1...
October 17, 2016: Diabetes, Obesity & Metabolism
Michael Popovich, Brandy Altstadter, Lara Hargraves Popovich, B S Biology
The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health. Stage 2 of Meaningful Use focused on compliance to sending of information to public health...
2016: Online Journal of Public Health Informatics
Michele L Shaffer, Erika M C D'Agata, Daniel Habtemariam, Susan L Mitchell
PURPOSE: Methodological approaches to examine the association between antimicrobial exposure and multidrug-resistant organism (MDRO) acquisition are complex. This report's objectives are to review approaches used in and findings of prior studies in the long-term care setting, illustrate how these challenges were addressed in a recently completed large prospective study, and discuss strategies for future studies. METHODS: Key design and analytic approaches used in studies conducted since 2000 examining the association between antimicrobial exposure and MDRO acquisition in the long-term care setting were reviewed...
September 23, 2016: Annals of Epidemiology
Kristi E Gamarel, Larry Brown, Christopher W Kahler, M Isabel Fernandez, Douglas Bruce, Sharon Nichols
OBJECTIVES: The purpose of this study was to better understand the prevalence and correlates of substance use behaviors among HIV-infected adolescents in HIV care settings. METHODS: A cross-sectional sample of 2216 youth living with HIV (YLWH; ages 12-26) were recruited through the Adolescent Trials Network for HIV Interventions. Participants completed a one-time survey on sociodemographic factors, substance use and health behaviors. We used logistic regression models to understand the correlates of substance use outcomes...
October 11, 2016: Drug and Alcohol Dependence
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