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Zsofia Orosz, Amy Porteous, Melissa Donskov, Tracy Luciani, Peter Walker
Ontario has eight designated Specialized Units (SUs) located in Long-Term Care (LTC) homes. Each unit serves a well-defined group of residents whose needs go beyond what regular LTC homes can offer but do not require the complexity and range of care provided in hospitals. An applied qualitative research project looked at the realities of designated SUs, explored their role in health system capacity planning, and created a tool kit to help stakeholders navigate the designation process. Results outline the benefits and challenges experienced by the existing SUs that provide care to clients with severe responsive behaviours or dialysis needs and the units' potential to address current and future healthcare system gaps...
October 20, 2016: Healthcare Management Forum
Pamela A Lowry, Morganna L Freeman, Jeffery S Russell
Merkel cell carcinoma (MCC) is a rare and lethal skin cancer with few known treatment options. Management of this disease is challenging, and oncology nurses must understand the medical, physical, and psychosocial burden that MCC places on the patient and family caregivers. Patients must navigate a complex medical and insurance network that often fails to support patients with rare cancers. Nurses must advocate for these patients to ensure quality comprehensive cancer care.
November 1, 2016: Oncology Nursing Forum
Margaret Loyet, Amy McLean, Karen Graham, Cheryl Antoine, Kathy Fossick
BACKGROUND: Women carrying a fetus with a suspected or known fetal anomaly have complex needs such as emotional and informational support and help with the logistical aspects of arranging care and treatment from numerous specialists. IMPROVEMENT IN QUALITY OF CARE FOR WOMEN CARRYING A FETUS WITH A SUSPECTED OR KNOWN FETAL ANOMALY:: Our fetal care team was initiated in 2012 to meet the needs of this high-risk pregnant population. The fetal care team nurse coordinator supports the woman and her family through all aspects of care during the pregnancy and neonatal period including scheduling appointments with multiple specialists, being there with her as a support person, keeping her updated, making sure she has accurate information about the fetal diagnosis, and helping her to navigate the complex healthcare system...
November 2016: MCN. the American Journal of Maternal Child Nursing
Abby R Rosenberg, Joanne Wolfe, Lori Wiener, Maureen Lyon, Chris Feudtner
Importance: For clinicians caring for adolescent patients living with progressive, life-threatening illness, discussions regarding prognosis, goals of care, and treatment options can be extremely challenging. While clinicians should respect and help to facilitate adolescents' emerging autonomy, they often must also work with parents' wishes to protect patients from the emotional distress of hearing bad news. Observations: We reviewed the ethical justifications for and against truth-telling, and we considered the published ethical and practice guidance, as well as the perspectives of patients, parents, and clinicians involved in these cases...
October 17, 2016: JAMA Pediatrics
Karen Stanic, Natalia Saldivia, Benjamín Förstera, Marcela Torrejón, Hernán Montecinos, Teresa Caprile
Extracellular matrix (ECM) molecules are pivotal for central nervous system (CNS) development, facilitating cell migration, axonal growth, myelination, dendritic spine formation, and synaptic plasticity, among other processes. During axon guidance, the ECM not only acts as a permissive or non-permissive substrate for navigating axons, but also modulates the effects of classical guidance cues, such as netrin or Eph/ephrin family members. Despite being highly important, little is known about the expression of ECM molecules during CNS development...
2016: Frontiers in Neuroanatomy
Jennifer Hulme, Catherine Moravac, Farah Ahmad, Shelley Cleverly, Aisha Lofters, Ophira Ginsburg, Sheila Dunn
BACKGROUND: Breast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low. The objective of this qualitative study was to better understand how Chinese and South Asian immigrants - the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening...
October 13, 2016: BMC Public Health
Andrea Ghazzawi, Craig Kuziemsky, Tracey O'Sullivan
BACKGROUND: Family caregivers provide the stroke survivor with social support and continuity during the transition home from a rehabilitation facility. In this exploratory study we examined family caregivers' perceptions and experiences navigating the stroke rehabilitation system. The theories of continuity of care and complex adaptive systems were integrated to examine the transition from a stroke rehabilitation facility to the patient's home. This study provides an understanding of the interacting complexities at the macro and micro levels...
October 1, 2016: BMC Health Services Research
Natasha Bingham
This article analyzes print media interviews of Moscow lesbians in Moskovsky Komsomolets in 2004 and 2005 using qualitative content analysis. The qualitative content analysis shows recurring and consistent themes: (1) the stereotypes lesbians face; (2) public negativity toward same-sex relations and the impact on their families; (3) the expectations of heterosexuality and all that that entails; (4) the existence of lesbian-only spaces in Russia and the importance of those spaces; and (5) the complexities of navigating motherhood, previous heterosexual relationships, and current partnerships...
October 6, 2016: Journal of Lesbian Studies
Melanie Gleason, Lisa Cicutto, Christy Haas-Howard, Bridget M Raleigh, Stanley J Szefler
Asthma is one of the most common illnesses of school-aged children and can lead to both health and educational disparities. Children from low socioeconomic backgrounds and racial/ethnic minorities suffer the greatest impact. They often lack the asthma self-management skills to successfully monitor, navigate, and negotiate appropriate asthma care. School settings are a strategic point of contact for this additional support. School nurses can monitor for signs of asthma worsening, manage symptoms, provide care coordination, and reinforce self-management skills...
October 2016: Current Allergy and Asthma Reports
Jessica R Gorman, Brian W Whitcomb, Daniel Standridge, Vanessa L Malcarne, Sally A D Romero, Samantha A Roberts, H Irene Su
PURPOSE: We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children. METHODS: After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups...
September 30, 2016: Journal of Cancer Survivorship: Research and Practice
Kristen Moeller-Saxone, Louise McCutcheon, Stephen Halperin, Helen Herrman, Andrew M Chanen
BACKGROUND: Young people in out-of-home care, especially those with a history of multiple placements, typically have numerous and complex health needs, and worse health outcomes than their peers who grow up within a family of origin. A significant proportion of this can be attributed to policy failures and poor interagency communication. OBJECTIVE: The objective of this article is to describe the factors that contribute to the health needs of young people in out-of-home care and the tools available to support general practitioners (GPs) to provide care...
October 2016: Australian Family Physician
Kim Foster, Alexandra Young, Rebecca Mitchell, Connie Van, Kate Curtis
INTRODUCTION: Physical injury is a leading cause of death and disability among children worldwide and the largest cause of paediatric hospital admission. Parents of critically injured children are at increased risk of developing mental and emotional distress in the aftermath of child injury. In the Australian context, there is limited evidence on parent experiences of child injury and hospitalisation, and minimal understanding of their support needs. The aim of this investigation was to explore parents' experiences of having a critically injured child during the acute hospitalisation phase of injury, and to determine their support needs during this time...
September 23, 2016: Injury
Srijita Sen-Chowdhry, Daniel Jacoby, James C Moon, William J McKenna
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment...
November 2016: Nature Reviews. Cardiology
Dianne Goeman, J Michael, J King, Huy Luu, Claire Emmanuel, S Koch
OBJECTIVE: The aim of the Vietnamese Dementia talking-book was to address low health literacy in older people of Vietnamese background living with dementia through the provision of an online resource to help individuals, their families and carers better understand and manage this condition and provide information about available dementia services. DESIGN: This qualitative study used codesign and participatory action research to develop and refine the talking-book in consultation with expert stakeholders, a consumer advocacy group and the Vietnamese community to assess its utility and ensure cultural and linguistic appropriateness and relevance...
2016: BMJ Open
Deborah McIntyre, Jennifer Fleming, Michele Foster, Sean Tweedy
PURPOSE: Many adults aged less than 65 years with high-care needs resulting from acquired disabilities are unable to access age-appropriate housing and support, and reside in residential aged care or live with family members who may struggle to navigate the disability support system. This qualitative study aimed to investigate the experiences of adults with high-care needs and their family members regarding pathways related to housing and support. METHOD: Two in-depth semi-structured interviews were conducted six months apart with 21 people aged 18 to 65 with high-care needs of varying etiology and living in different housing settings...
September 23, 2016: Disability and Rehabilitation
Melissa J BLoomer, Ruth Endacott, Kristen Ranse, Maureen A Coombs
AIM: The aim of this study was to explore how nurses navigate communication with families during withdrawal of life-sustaining treatment in Intensive Care. BACKGROUND: Death in the intensive care unit is seldom unexpected and often happens following the withdrawal of life-sustaining treatment. A family-centred approach to care relies on the development of a therapeutic relationship and understanding of what is happening to the patient. Whilst previous research has focused on the transition from cure to palliation and the nurse's role in supporting families, less is known about how nurses navigate communication with families during treatment withdrawal...
September 20, 2016: Journal of Clinical Nursing
Lenore A Hawley
Traumatic brain injury (TBI) can result in long-term injury-related disabilities. Individuals with TBI and their families must often advocate for themselves to secure resources to address their postinjury needs. However, the ability to advocate may be compromised by the effects of the injury. The Self-Advocacy for Independent Life (SAIL) program aims to empower individuals and families with the skills of self-advocacy so they can navigate life after brain injury in a self-efficacious manner.
August 11, 2016: Journal of Social Work in Disability & Rehabilitation
Coleen Ranaghan, Kathleen Boyle, Maureen Meehan, Shadiatu Moustapha, Patrice Fraser, Catherine Concert
BACKGROUND: One approach to overcoming healthcare system barriers and facilitating timely access to quality care and patient satisfaction is with a patient navigator. A patient navigator is a trained person who individually assists patients, families and caregivers navigate the healthcare system barriers efficiently and effectively at any point along the care continuum, improving patient care at all levels of an organization. OBJECTIVES: To synthesize the best available evidence on the effectiveness of a patient navigator on patient satisfaction in adult patients 18 years and older in ambulatory care settings...
August 2016: JBI Database of Systematic Reviews and Implementation Reports
Maria Teresa Coutinho, Sheryl J Kopel, Brittney Williams, Katie Dansereau, Daphne Koinis-Mitchell
INTRODUCTION: In this study, we examined the associations between caregiver empowerment, child-asthma symptoms, and emergency-department (ED) use in a sample of school-age urban children with asthma. We examined differences in caregiver empowerment, and in the associations among caregiver empowerment, proportion of days with child-asthma symptoms, and ED use as a function of caregiver nativity. METHOD: Participants for this study were part of a larger longitudinal study and included Latino, African American and non-Latino White urban caregivers and their children with asthma (ages 7-9; N = 130)...
September 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
S Hodgetts, D McConnell, L Zwaigenbaum, D Nicholas
BACKGROUND: Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD...
September 12, 2016: Child: Care, Health and Development
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