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Critical care burden

Lavi Oud
BACKGROUND The demand for critical care services among elderly with dementia outpaces that of their non-dementia elderly counterparts. However, there are scarce data on the corresponding attributes among ICU-managed patients with dementia. MATERIAL AND METHODS We used the Texas Inpatient Public Use Data File to examine temporal trends of the demographics, burden of comorbidities, measures of severity of illness, use of healthcare resources, and short-term outcomes among hospitalizations aged 65 years or older with a reported diagnosis of dementia, who were admitted to ICU (D-ICU hospitalizations) between 2001 and 2010...
October 20, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Madhukar Pai, Mark P Nicol, Catharina C Boehme
Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement...
October 2016: Microbiology Spectrum
Bishal Gyawali, Alessandra Ferrario, Edwin van Teijlingen, Per Kallestrup
BACKGROUND AND OBJECTIVES: Diabetes has become an increasingly prevalent and severe public health problem in Nepal. The Nepalese health system is struggling to deliver comprehensive, quality treatment and services for diabetes at all levels of health care. This study aims to review evidence on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact...
2016: Global Health Action
Lauren Ball, Katelyn Barnes, Michael Leveritt, Lana Mitchell, Lauren T Williams, Dianne Ball, Elizabeth Patterson
Research priority setting is an important component of research planning, particularly when research options exceed available resources. This study identified the research priorities for supporting healthy lifestyle behaviours in the Australian primary healthcare setting. A five-step stakeholder engagement process was undertaken. Ten stakeholder organisations participated in the process, including patient representatives, health professional associations, health educators, researchers, government advisors and policymakers...
October 17, 2016: Australian Journal of Primary Health
Olatunde Adesoro, Constance Shumba, John Kpamor, Jane Achan, Harriet Kivumbi, John Dada, Kolawole Maxwell, James Tibenderana, Madeline Marasciulo, Prudence Hamade, Olusola Oresanya, Joanita Nankabirwa, Ebenezer Baba
BACKGROUND: Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging...
October 12, 2016: BMC Health Services Research
Rasmus Bo Hasselbalch, Louis Lind Plesner, Mia Pries-Heje, Lisbet Ravn, Morten Lind, Rasmus Greibe, Birgitte Nybo Jensen, Lars S Rasmussen, Kasper Iversen
BACKGROUND: Crowding in the emergency department (ED) is a well-known problem resulting in an increased risk of adverse outcomes. Effective triage might counteract this problem by identifying the sickest patients and ensuring early treatment. In the last two decades, systematic triage has become the standard in ED's worldwide. However, triage models are also time consuming, supported by limited evidence and could potentially be of more harm than benefit. The aim of this study is to develop a quicker triage model using data from a large cohort of unselected ED patients and evaluate if this new model is non-inferior to an existing triage model in a prospective randomized trial...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Robert Moss, James M McCaw, Allen C Cheng, Aeron C Hurt, Jodie McVernon
BACKGROUND: Many nations maintain stockpiles of neuraminidase inhibitor (NAI) antiviral agents for use in influenza pandemics to reduce transmission and mitigate the course of clinical infection. Pandemic preparedness plans include the use of these stockpiles to deliver proportionate responses, informed by emerging evidence of clinical impact. Recent uncertainty about the effectiveness of NAIs has prompted these nations to reconsider the role of NAIs in pandemic response, with implications for pandemic planning and for NAI stockpile size...
October 10, 2016: BMC Infectious Diseases
Linda M Richter, Bernadette Daelmans, Joan Lombardi, Jody Heymann, Florencia Lopez Boo, Jere R Behrman, Chunling Lu, Jane E Lucas, Rafael Perez-Escamilla, Tarun Dua, Zulfiqar A Bhutta, Karin Stenberg, Paul Gertler, Gary L Darmstadt
Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children...
October 3, 2016: Lancet
Mark Tambe Keboa, Natalie Hiles, Mary Ellen Macdonald
INTRODUCTION: Improving the oral health of refugees and asylum seekers is a global priority, yet little is known about the overall burden of oral diseases and their causes for this population. OBJECTIVE: To synthesize available evidence on the oral health of, and access to oral health care by this population. METHODS: Using a scoping review methodology, we retrieved 3321 records from eight databases and grey literature; 44 publications met the following inclusion criteria: empirical research focused on refugees and/or asylum seekers' oral health, published between 1990 and 2014 in English, French, Italian, Portuguese, or Spanish...
October 7, 2016: Globalization and Health
S M Klein, L Prantl, S Geis, O Felthaus, J Dolderer, A Anker, K Zeitler, E Alt, J Vykoukal
BACKGROUND: Duchenne muscular dystrophy (DMD) consists of a lack in the expression of the subsarcolemmal protein dystrophin causing progressive muscle dysfunction. Among the widely applied animal models in DMD research is the C57BL/1010ScSn-Dmdmdx mouse, commonly referred to as the "mdx mouse". The potential benefit of novel interventions in this model is often assessed by variables such as functional improvement, histological changes, and creatine kinase (CK) serum levels as an indicator for the extent of in situ muscle damage...
October 3, 2016: Clinical Hemorheology and Microcirculation
Akhil Narang, Shashank S Sinha, Bharath Rajagopalan, Nkechinyere N Ijioma, Natalie Jayaram, Aaron P Kithcart, Varsha K Tanguturi, Michael W Cullen
As the burden of cardiovascular disease in the United States continues to increase, uncertainty remains on how well-equipped the cardiovascular workforce is to meet the challenges that lie ahead. In a time when health care is rapidly shifting, numerous factors affect the supply and demand of the cardiovascular workforce. This Council Commentary critically examines several factors that influence the cardiovascular workforce. These include current workforce demographics and projections, evolving health care and practice environments, and the increasing burden of cardiovascular disease...
October 11, 2016: Journal of the American College of Cardiology
Nahla Tayyib, Fiona Coyer
BACKGROUND: Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention...
October 6, 2016: Worldviews on Evidence-based Nursing
Nathan S Bertelsen, Elizabeth Selden, Polina Krass, Eva S Keatley, Allen Keller
Effective screening in primary care among asylum-seekers in the US is critical as this population grows. This study aimed to evaluate disease prevalence and screening methods in this high-risk group. Two hundred ten new clients from 51 countries, plus Tibet, who were accepted into a program for asylum seekers from 2012 to 2014 were included. Screening rates and outcomes for infectious, non-communicable, and mental illnesses were evaluated. Screening rates were highest for PTSD, depression, hepatitis B, and latent tuberculosis...
October 4, 2016: Journal of Immigrant and Minority Health
Ann C Long, Erin K Kross, J Randall Curtis
PURPOSE OF REVIEW: Family-centered outcomes during and after critical illness assess issues that are most important to family members. An understanding of family-centered outcomes is necessary to support the provision of family-centered care and to foster development of interventions to improve care and communication in the ICU. RECENT FINDINGS: Current family-centered outcomes in critical care include satisfaction with care, including end-of-life care, symptoms of psychological distress, and health-related quality of life...
September 28, 2016: Current Opinion in Critical Care
Lioudmila V Karnatovskaia, Margaret M Johnson, Travis J Dockter, Ognjen Gajic
PURPOSE: Survivors of critical illness are frequently unable to return to their premorbid level of psychocognitive functioning following discharge. Therefore, we aimed to evaluate the burden of psychological trauma experienced by patients in the intensive care unit (ICU) as perceived by clinicians to assess factors that can impede its recognition and treatment in the ICU. MATERIALS AND METHODS: Two distinct role-specific Web-based surveys were administered to critical care physicians and nurses in medical and surgical ICUs of 2 academic medical centers...
September 14, 2016: Journal of Critical Care
Brittney J Sullivan, Janet Prvu Bettger
BACKGROUND: Honduras is the second poorest country in Central America. The already high burden of disease is disproportionately worse among individuals with less education and limited access to health care. Community engagement is needed to bridge the gap in health care resources with the need for health promotion and education. Culturally relevant health promotion activities can foster transcultural partnerships. PURPOSE: The purpose of this study was to partner nursing students with village leaders to assess a community's health needs and implement health promotion activities in Honduras...
September 26, 2016: Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society
Adam Lustig, Michael Ogden, Robert W Brenner, Jerry Penso, Kimberly D Westrich, Robert W Dubois
BACKGROUND: In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications and pharmacological treatment. As provider groups, hospital systems, and integrated delivery networks optimize their care processes to promote population health activities in support of the accountable care organization (ACO) model of care, managing hypertension and other chronic diseases will be essential to their success...
October 2016: Journal of Managed Care & Specialty Pharmacy
Lisa M Blackburn, Nicole Bauchmire, Sarah Bender, Kelly Tomlinson-Pinkham, Scott Roberts, Sherry Rosan
BACKGROUND: Acute promyelocytic leukemia (APL), once the most lethal form of adult acute leukemia, has become the most curable. The goal of early and well-managed treatment induction is to reduce the malignant burden of promyelocytes to below the cytologically detectable level. OBJECTIVES: Oncology nurses who care for patients with APL need to be acutely aware of the basic differences in this disease from other forms of leukemia, including the two main complications for the newly diagnosed patient...
October 1, 2016: Clinical Journal of Oncology Nursing
Cátia Jesus, Inês Jesus, Mark Agius
BACKGROUND: Bipolar disorder (BD), also known as manic-depressive illness, is a condition characterized by unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Bipolar disorder is known to be a chronic and disabling disease associated with higher incidence of obesity, diabetes, metabolic syndrome, dyslipidemias, hypertension and tobacco use which all together are known risk factors for the development of Cardiovascular diseases. With this research we wish to collect evidence to show how Cardiovascular diseases (CVD) affect Patients with Bipolar disease, the burden it can have in patients lives, to understand how this problem has been assessed so far and present suggestions that may improve the health care of these patients...
September 2016: Psychiatria Danubina
Aruna Kumar, Neha Agrawal
PURPOSE: Maternal brought in dead are the patient who dies in the need of adequate medical care. These deaths are often not analyzed sincerely as they are not institutional deaths. Our aim is to find out actual life threatening cause of delay leading to death. METHOD: Patients brought dead to casualty were seen by the doctors on duty in Department of Obstetrics and Gynaecology,Gandhi Medical College, Bhopal round the clock. Cause of death was analyzed by verbal autopsy of attendants and referral letter from the institute...
October 2016: Journal of Obstetrics and Gynaecology of India
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