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https://www.readbyqxmd.com/read/28743102/incidence-of-delirium-after-cardiac-surgery-protocol-for-the-delirium-cs-canada-cross-sectional-cohort-study
#1
(no author information available yet)
BACKGROUND: Delirium is a recognized complication of cardiac surgery and is the focus of increasing attention owing to its negative effect on postoperative outcomes. However, little is known about the actual incidence of delirium following cardiac surgery, with published rates ranging widely, from 3%-78%. We describe the protocol for the DELIRIUM-CS Canada study, which will use validated and easily implementable bedside tools to determine the incidence of postoperative delirium in a contemporary cardiac surgery population...
July 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28742535/-anonymous-meltdown-content-themes-emerging-in-a-nonfacilitated-peer-only-unstructured-asynchronous-online-support-group-for-family-caregivers
#2
Cynthia A Diefenbeck, Paula R Klemm, Evelyn R Hayes
By providing care for loved ones in the home, family caregivers save millions of dollars for our overtaxed healthcare system. Support groups can lighten the psychological burden of caregiving. Nonprofessionally facilitated (or peer) online caregiver support groups can help meet a critical need in healthcare as a low-cost resource for caregivers. Online caregiver peer support groups can promote the health and well-being of family caregivers and, by extension, the patients themselves, resulting in cost-savings for society...
July 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28739655/critical-issues-in-food-allergy-a-national-academies-consensus-report
#3
Scott H Sicherer, Katrina Allen, Gideon Lack, Steve L Taylor, Sharon M Donovan, Maria Oria
The National Academies of Sciences, Engineering, and Medicine convened an expert, ad hoc committee to examine critical issues related to food allergy. The authors of the resulting report, "Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy," evaluated the scientific evidence on the prevalence, diagnosis, prevention, and management of food allergy and made recommendations to bring about a safe environment for those affected. The committee recommended approaches to monitor prevalence, explore risk factors, improve diagnosis, and provide evidence-based health care...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28738327/updated-concepts-on-treatment-outcomes-for-obstructive-sleep-apnea
#4
Victor Certal, Robson Capasso
Obstructive sleep apnea is a highly prevalent and poorly understood condition that not only leads to significant individual patient health damage, but carries a large societal cost secondary to excessive healthcare utilization, motor-vehicle accidents, and work absenteeism. While a significant fund of knowledge about its damaging effects on the cardiovascular system and neural pathways has been gathered over the past few decades, the translation to direct patient care still presents numerous challenges. With the exception of clear issues such as socially unacceptable snoring and breathing irregularities, the exact cause and effect relationship between airway narrowing, hypoxemia, and sleep fragmentation with subjective sleep-related complaints and neurocognitive symptoms is less clear...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28733043/perioperative-hypotension-and-discharge-outcomes-in-non-critically-injured-trauma-patients-a-single-centre-retrospective-cohort-study
#5
Nadav Sheffy, Itay Bentov, Brianna Mills, Bala G Nair, G Alec Rooke, Monica S Vavilala
BACKGROUND: There is a lack of information on the effect of age on perioperative care and outcomes after minor trauma in the elderly. We examined the association between perioperative hypotension and discharge outcome among non-critically injured adult patients. METHODS: We conducted a retrospective study of non-critically ill patients (ISS <9 or discharged within less than 24h) who received anaesthesia care for surgery and Recovery Room care at a level-1 trauma centre between 5/1/2012 and 11/30/2013...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#6
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28710219/comparison-of-propofol-and-dexmedetomidine-infused-overnight-to-treat-hyperactive-and-mixed-icu-delirium-a-protocol-for-the-basel-prodex-clinical-trial
#7
Alexa Hollinger, Katrin Ledergerber, Stefanie von Felten, Raoul Sutter, Stephan Rüegg, Lukas Gantner, Sibylle Zimmermann, Andrea Blum, Luzius A Steiner, Stephan Marsch, Martin Siegemund
BACKGROUND/OBJECTIVES: Delirium is a neurobehavioural disturbance that frequently develops particularly in the intensive care unit (ICU) population. It was first described more than half a century ago, where it was already discovered as a state that might come along with serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality. However, in most cases, there is still lack of proof for causal relationship. Its presence frequently remains unrecognised due to suggested predominance of the hypoactive form...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28707707/evidence-for-capitation-reform-in-a-new-rural-cooperative-medical-scheme-in-pudong-new-area-shanghai-a-longitudinal-study
#8
Yanmei Wang, Zhiqun Shu, Jianjun Gu, Xiaoming Sun, Limei Jing, Jie Bai, Xuan Huang, Jiquan Lou, Qunfang Zhang, Ming Li
Currently, China has been experiencing rapid growth of medical costs, serious waste of medical resources, increasing disease burden for residents, and a medical insurance fund deficit. Therefore, an urgent problem that needs to be solved is to choose a rational payment for the insurance system. To empirically evaluate the long-term effects of capitation reform in a New Rural Cooperative Medical Scheme in Pudong New Area, we collected and analysed data regarding financing, fund operation, medical service cost, and medical care-seeking behaviour from 2011 to 2015, a duration that includes data before and after reform...
July 14, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28706466/modeling-the-potential-impact-of-emerging-innovations-on-achievement-of-sustainable-development-goals-related-to-maternal-newborn-and-child-health
#9
Tara Herrick, Claudia Harner-Jay, Craig Shaffer, Greg Zwisler, Peder Digre, Amie Batson
BACKGROUND: Innovations that improve the affordability, accessibility, or effectiveness of health care played a major role in the Millennium Development Goal achievements and will be critical for reaching the ambitious new Sustainable Development Goal (SDG) health targets. Mechanisms to identify and prioritize innovations are essential to inform future investment decisions. METHODS: Innovation Countdown 2030 crowdsourced health innovations from around the world and engaged recognized experts to systematically assess their lifesaving potential by 2030...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28697752/who-is-responsible-for-providing-care-investigating-the-role-of-care-tasks-and-past-experiences-in-a-cross-sectional-survey-in-the-netherlands
#10
R J Hoefman, T M Meulenkamp, J D De Jong
BACKGROUND: Many countries face substitution from formal to informal care. It is essential that a sufficient number of caregivers, such as family, friends or neighbors, are willing and able to lend care to address the needs of ill or elderly persons. We investigated whether the general public, who might become caregivers in the future, and current informal caregivers align with the shift to more informal caregiving. METHODS: We studied the views on the responsibility for care of the general public versus the government, and whether these views differed among groups with diverse past experiences with care in terms of own health problems or previous caregiving activities...
July 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28693463/descriptive-analysis-of-cochrane-child-relevant-systematic-reviews-an-update-and-comparison-between-2009-and-2013
#11
Katelynn Crick, Denise Thomson, Ricardo M Fernandes, Megan Nuspl, Dean T Eurich, Brian H Rowe, Lisa Hartling
BACKGROUND: Systematic reviews support health systems and clinical decision-making by identifying and summarizing all existing studies on a particular topic. In 2009, a comprehensive description of child-relevant systematic reviews published in the Cochrane Database of Systematic Reviews was compiled. This study aims to provide an update, and to describe these systematic reviews according to their content and methodological approaches. METHODS: All child-relevant systematic reviews published by the Cochrane Collaboration in the Cochrane Database of Systematic Reviews (CDSR) as of March, 2013 were identified and described in relation to their content and methodological approaches...
July 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28692447/communicating-the-benefits-and-risks-of-inflammatory-bowel-disease-therapy-to-patients-and-families
#12
Joseph A Picoraro, Joel R Rosh
PURPOSE OF REVIEW: Treatment options for inflammatory bowel disease (IBD) have rapidly expanded as the treatment paradigm has shifted from controlling symptoms to reducing lifetime inflammatory burden. Families are confronted with the actual and perceived risks of this ever-expanding array of choices. We aim to review the shared decision-making process in pediatric IBD to ensure an optimal therapeutic plan for the child and their family. RECENT FINDINGS: Mucosal healing is a critical treatment target in pediatric IBD but it may not coincide with clinical symptoms...
July 7, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28689568/falls-in-the-aging-population
#13
REVIEW
Kareeann S F Khow, Renuka Visvanathan
The number of people living beyond 65 years of age is increasing rapidly, and they are at increased risk of falls. Falls-related injuries and hospitalizations are steadily increasing. Falls can lead to fear of falling, loss of independence, institutionalization, and death, inevitably posing a significant burden to the health care system. Therefore, screening of people at risk of falls and comprehensive assessment of older people at high risk of falls are critical steps toward prevention. This review evaluates the current knowledge relating to falls, with particular focus on rapid screening, assessment, and strategies to prevent falls in the community...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28676312/multiple-sclerosis-frequency-cost-and-economic-burden-in-the-united-states
#14
Alex Y Chen, Amy O Chonghasawat, Kevin L Leadholm
Multiple sclerosis (MS) is one of the most common neurological diseases, affecting young and middle-aged adults. The full economic cost of managing chronic MS is substantial. To investigate the recent trend of medical cost and economic burden of MS management in the United States (U.S.), we inquired for available data from the National Inpatient Sample database (NIS; from 1994 to 2013). The annual rates of changes were determined by linear regression analysis. We found an estimated half million increase in MS admissions, annually, which was projected to exceed 43...
July 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28670961/rationales-and-choices-for-the-treatment-of-patients-with-nyha-class-ii-heart-failure
#15
Edward M Gilbert, Weining David Xu
Heart failure (HF) in the United States represents a significant burden for patients and a tremendous strain on the healthcare system. Patients receiving a diagnosis of HF can be placed into 1 of 4 New York Heart Association (NYHA) Functional Classifications; the greatest proportion of patients are in the NYHA class II category, which is defined as patients having a slight limitation of physical activity but who are comfortable at rest, and for whom ordinary physical activity results in symptoms of HF. Because the severity of NYHA class II HF may be perceived as mild or unalarming by this definition, the urgency to treat this type of HF may be overlooked...
July 3, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28667221/effectiveness-of-behavioural-change-techniques-in-physiotherapy-interventions-to-promote-physical-activity-adherence-in-patients-with-hip-and-knee-osteoarthritis-a-systematic-review-protocol
#16
Matthew Willett, Joan Duda, Charlotte Gautrey, Sally Fenton, Carolyn Greig, Alison Rushton
INTRODUCTION: Osteoarthritis (OA) is a common degenerative articular disease, the highest cause of individual level disability and a significant socioeconomic burden to healthcare services. Patient education and physical activity (PA) prescription are recommended components of interventions in several healthcare guidelines and are commonly provided by physiotherapists. However, these interventions lack long-term clinical effectiveness. Patient adherence to PA prescription requires patients to modify their PA behaviour and appears critical in maintaining symptomatic improvements...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28666449/impact-of-health-workforce-availability-on-health-care-seeking-behavior-of-patients-with-diabetes-mellitus-in-china
#17
Yinzi Jin, Weiming Zhu, Beibei Yuan, Qingyue Meng
BACKGROUND: China has a high burden of diabetes mellitus (DM), and a large proportion of DM patients remain untreated for various reasons, including low availability of primary health care providers. DM patient management is one of the priorities in China's national essential public health programs. Shortage of health workforce has been a major barrier to improving access to health care for DM patients. This study examines the impact of the health workforce on outpatient utilization of DM patients...
July 1, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28662926/defining-the-burden-scope-and-future-of-vascular-acute-care-surgery
#18
Donald G Harris, Anthony Herrera, Charles B Drucker, Richa Kalsi, Nandakumar Menon, Shahab Toursavadkohi, Jose J Diaz, Robert S Crawford
OBJECTIVE: The paradigm of acute care surgery has revolutionized nonelective general surgery. Similarly, nonelective vascular surgery may benefit from specific management and resource capabilities. To establish the burden and scope of vascular acute care surgery, we analyzed the characteristics and outcomes of patients hospitalized for vascular surgical procedures in Maryland. METHODS: A retrospective analysis of a statewide inpatient database was performed to identify patients undergoing noncardiac vascular procedures in Maryland from 2009 to 2013...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28653434/injury-from-falls-in-infants-under-one-year
#19
Christopher S Mulligan, Susan Adams, Dimitra Tzioumi, Julie Brown
AIM: Falls in infants are a common cause of injury. Compared to older children, infants under age one are likely to have distinctive causation and injury patterns, as they are pre-mobile or have limited independent mobility and falls are more directly the responsibility of the care giver. There is little known about the mechanistic factors, predictors of injury and injury patterns in this age group. METHODS: We conducted a retrospective review of infants under age one who presented after a fall to a paediatric trauma centre in Sydney, Australia...
June 26, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28640670/rationale-and-design-of-the-lung-cancer-screening-implementation-evaluation-of-patient-centered-care-study
#20
Leah S Miranda, Santanu Datta, Anne C Melzer, Renda Soylemez Wiener, James M Davis, Betty C Tong, Sara E Golden, Christopher G Slatore
Screening for lung cancer using low-dose computed tomography (LDCT) has been demonstrated to reduce lung cancer-related mortality and is being widely implemented. Further research in this area is needed to assess the impact of screening on patient-centered outcomes. Here we describe the design and rationale for a new study entitled Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. The protocol is composed of an interconnected series of studies evaluating patients and clinicians who are engaged in lung cancer screening in real-world settings...
June 22, 2017: Annals of the American Thoracic Society
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