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https://www.readbyqxmd.com/read/28231356/using-ethical-frameworks-in-times-of-transition-and-uncertainty
#1
Eileen M Sullivan-Marx
Health care policy is never easy and always fraught with concerns about quality, access, and cost. Currently, uncertainty abounds regarding new federal and state policies on the horizon for older adult care and quality. Empirics undergird most policy-making decisions regarding risk/benefit, cost, and knowing the best action to put in place for the best results. However, in times of great change in policy direction and political viewpoints, empirical knowledge must be combined with ethical knowledge for planning and implementation...
March 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28231265/resist-diabetes-a-randomized-clinical-trial-for-resistance-training-maintenance-in-adults-with-prediabetes
#2
Brenda M Davy, Richard A Winett, Jyoti Savla, Elaina L Marinik, Mary Elizabeth Baugh, Kyle D Flack, Tanya M Halliday, Sarah A Kelleher, Sheila G Winett, David M Williams, Soheir Boshra
OBJECTIVE: To determine whether a social cognitive theory (SCT)-based intervention improves resistance training (RT) maintenance and strength, and reduces prediabetes prevalence. RESEARCH DESIGN AND METHODS: Sedentary, overweight/obese (BMI: 25-39.9 kg/m2) adults aged 50-69 (N = 170) with prediabetes participated in the 15-month trial. Participants completed a supervised 3-month RT (2×/wk) phase and were randomly assigned (N = 159) to one of two 6-month maintenance conditions: SCT or standard care...
2017: PloS One
https://www.readbyqxmd.com/read/28230644/expanding-the-donor-pool-through-intensive-care-to-facilitate-organ-donation-results-of-a-spanish-multicenter-study
#3
Beatriz Domínguez-Gil, Elisabeth Coll, José Elizalde, Jaime E Herrero, Teresa Pont, Brígida Quindós, Bella Marcelo, María A Bodí, Adolfo Martínez, Agustín Nebra, Francisco Guerrero, José M Manciño, Juan Galán, Miguel Lebrón, Eduardo Miñambres, Rafael Matesanz
BACKGROUND: Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODS: ACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28230561/adolescent-transition-clinic-in-inflammatory-bowel-disease-quantitative-assessment-of-self-efficacy-skills
#4
Anat Yerushalmy-Feler, Yulia Ron, Efrat Barnea, Ayala Nachum, Shay Matalon, Margalit Dali-Levy, Iris Dotan, Shlomi Cohen
OBJECTIVES: There is no model for the process of transition of adolescents with inflammatory bowel diseases (IBD) to the adult care protocol. We recently established a transition clinic where 17-year-old to 18-year-old IBD patients are seen by a multidisciplinary team including pediatric and adult gastroenterologists with expertise in IBD treatments, an IBD nurse, and a psychologist. We quantitatively describe this model and its benefits, and correlate demographic and transition parameters to self-efficacy in IBD adolescent patients before and after transition...
February 22, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28230458/progression-to-type-2-diabetes-and-its-effect-on-health-care-costs-in-low-income-and-insured-patients-with-prediabetes-a-retrospective-study-using-medicaid-claims-data
#5
Jun Wu, Eileen Ward, Tiffaney Threatt, Z Kevin Lu
BACKGROUND: Prediabetes is a high-risk factor for progression to diabetes. Without lifestyle changes, such as weight loss and moderate physical activity, 15%-30% of people with prediabetes are projected to develop type 2 diabetes within 5 years. Progression to diabetes increases the financial burden significantly for patients and health care systems. Populations with low socioeconomic status are associated with a higher risk of diabetes. However, knowledge is limited about the effect of transition to diabetes on future costs incurred in low-income populations...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230438/the-influence-of-placements-on-adult-nursing-graduates-choice-of-first-post
#6
Mark Wareing, Renate Taylor, Aileen Wilson, Adrienne Sharples
BACKGROUND: This article presents findings from a study that sought to explore the extent to which clinical placements have an impact on nursing students' decisions regarding their first staff nurse post. Within the UK, nursing is facing a recruitment crisis with particular difficulty recruiting to areas such as primary care and care of older people. Transitioning into a new role is challenging in any occupation, but it is a particular problem in nursing where the realities of professional practice often differ from students' perception of the staff nurse role as shaped by their clinical placements...
February 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28229478/students-experiences-of-role-relationships-and-learning-in-two-clerkship-models
#7
D Jill Konkin, Carol Suddards
CONTEXT: An increasing number of medical schools around the world are implementing longitudinal integrated clerkships (LICs). The University of Alberta's third-year LIC admits a small group of each class. Those not in the LIC undertake a rotation-based clerkship (RBC). All students have a fourth-year RBC. Meaningful participation in patient care and guidance have been identified as affordances for work-based learning. METHODS: This qualitative study is part of an ongoing research programme conducted in a hermeneutic phenomenological frame...
February 22, 2017: Medical Education
https://www.readbyqxmd.com/read/28228488/uk-guideline-on-transition-of-adolescent-and-young-persons-with-chronic-digestive-diseases-from-paediatric-to-adult-care
#8
Alenka J Brooks, Philip J Smith, Richard Cohen, Paul Collins, Andrew Douds, Valda Forbes, Daniel R Gaya, Brian T Johnston, Patrick J McKiernan, Charles D Murray, Shaji Sebastian, Monica Smith, Lisa Whitley, Lesley Williams, Richard K Russell, Sara A McCartney, James O Lindsay
The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section...
February 21, 2017: Gut
https://www.readbyqxmd.com/read/28228369/feasibility-of-implementing-a-patient-centered-postoperative-wound-monitoring-program-using-smartphone-images-a-pilot-protocol
#9
Sara Fernandes-Taylor, Rebecca L Gunter, Kyla M Bennett, Lola Awoyinka, Shahrose Rahman, Caprice C Greenberg, K Craig Kent
BACKGROUND: Surgical site infections (SSI) represent a significant public health problem as the most common nosocomial infection and a leading cause of unplanned hospital readmissions among surgical patients. Many develop following hospital discharge and often go unrecognized by patients. Telemedicine offers the opportunity to leverage the mobile technology to remotely monitor wound recovery in the transitional period between hospital discharge and routine clinic follow-up. However, many existing telemedicine platforms are episodic, replacing routine follow-up, rather than equipped for continued monitoring; they include only low-risk patient populations and those who already have access to and comfort with the necessary technology; and transmit no visual information...
February 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28226652/early-warnings-of-heart-rate-deterioration
#10
Vania G Almeida, Ian T Nabney, Vania G Almeida, Ian T Nabney, Ian T Nabney, Vania G Almeida
Hospitals can experience difficulty in detecting and responding to early signs of patient deterioration leading to late intensive care referrals, excess mortality and morbidity, and increased hospital costs. Our study aims to explore potential indicators of physiological deterioration by the analysis of vital-signs. The dataset used comprises heart rate (HR) measurements from MIMIC II waveform database, taken from six patients admitted to the Intensive Care Unit (ICU) and diagnosed with severe sepsis. Different indicators were considered: 1) generic early warning indicators used in ecosystems analysis (autocorrelation at-1-lag (ACF1), standard deviation (SD), skewness, kurtosis and heteroskedasticity) and 2) entropy analysis (kernel entropy and multi scale entropy)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226421/opening-plenary-speaker-human-genomics-precision-medicine-and-advancing-human-health
#11
Eric D Green
Starting with the launch of the Human Genome Project in 1990, the past quarter-century has brought spectacular achievements in genomics that dramatically empower the study of human biology and disease. The human genomics enterprise is now in the midst of an important transition, as the growing foundation of genomic knowledge is being used by researchers and clinicians to tackle increasingly complex problems in biomedicine. Of particular prominence is the use of revolutionary new DNA sequencing technologies for generating prodigious amounts of DNA sequence data to elucidate the complexities of genome structure, function, and evolution, as well as to unravel the genomic bases of rare and common diseases...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225049/prevalence-and-predictors-of-weight-change-post-discharge-from-hospital-a-study-of-the-canadian-malnutrition-task-force
#12
H Keller, M Laporte, H Payette, J Allard, P Bernier, D Duerksen, L Gramlich, K Jeejeebhoy
BACKGROUND/OBJECTIVES: Little is known about factors associated with weight change post discharge from hospital; yet poor nutritional status in the transition from hospital to community can result in readmission. This exploratory study aimed to determine the factors associated with weight change 30 days post discharge defined as weight gain (WG; 5+ pounds), weight loss (WL; 5+pounds) or weight stable (WS). SUBJECTS/METHODS: A total of 922 medical or surgical patients were recruited from 16 acute care hospitals in 8 Canadian provinces...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28224276/preparedness-and-cancer-related-symptom-management-among-cancer-survivors-in-the-first-year-post-treatment
#13
Corinne R Leach, Alyssa N Troeschel, Dawn Wiatrek, Annette L Stanton, Michael Diefenbach, Kevin D Stein, Katherine Sharpe, Kenneth Portier
BACKGROUND: Many cancer survivors feel unprepared for the physical and psychosocial challenges that accompany the post-treatment care transition (i.e., re-entry phase), including management of cancer-related symptoms. Few studies have investigated personal and contextual factors associated with the extent of preparedness for re-entry or how they are related to cancer-related symptom management. PURPOSE: Data from the American Cancer Society's Cancer Survivor Transition Study examined (1) characteristics of breast, prostate, and colorectal cancer survivors (n = 1188) within the first year of completing treatment who are most and least prepared for re-entry; and (2) how preparedness level and other characteristics are related to cancer-related symptom management...
February 21, 2017: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/28223862/whose-responsibility-is-medication-reconciliation-physicians-pharmacists-or-nurses-a-survey-in-an-academic-tertiary-care-hospital
#14
Amna Al-Hashar, Ibrahim Al-Zakwani, Tommy Eriksson, Mohammed Al Za'abi
Background: Medication errors occur frequently at transitions in care and can result in morbidity and mortality. Medication reconciliation is a recognized hospital accreditation requirement and designed to limit errors in transitions in care. Objectives: To identify beliefs, perceived roles and responsibilities of physicians, pharmacists and nurses prior to the implementation of a standardized medication reconciliation process. Methods: A survey was distributed to the three professions: pharmacists in the pharmacy and physicians and nurses in hospital in-patient units...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28223372/perspectives-of-low-socioeconomic-status-mothers-of-premature-infants
#15
Elizabeth Enlow, Laura J Faherty, Sara Wallace-Keeshen, Ashley E Martin, Judy A Shea, Scott A Lorch
BACKGROUND AND OBJECTIVES: Transitioning premature infants from the NICU to home is a high-risk period with potential for compromised care. Parental stress is high, and families of low socioeconomic status may face additional challenges. Home visiting programs have been used to help this transition, with mixed success. We sought to understand the experiences of at-risk families during this transition to inform interventions. METHODS: Mothers of infants born at <35 weeks' gestation, meeting low socioeconomic status criteria, were interviewed by telephone 30 days after discharge to assess caregiver experiences of discharge and perceptions of home visitors (HVs)...
February 21, 2017: Pediatrics
https://www.readbyqxmd.com/read/28222271/pathways-to-lung-cancer-diagnosis-a-qualitative-study-of-patients-and-general-practitioners-about-diagnostic-and-pre-treatment-intervals
#16
Nicole M Rankin, Sarah York, Emily Stone, David Barnes, Deborah McGregor, Michelle Lai, Tim Shaw, Phyllis N Butow
RATIONALE: Pathways to lung cancer diagnosis and treatment are complex. International evidence shows significant variations in pathways. Qualitative research investigating pathways to lung cancer diagnosis rarely considers both patient and general practitioner views simultaneously. OBJECTIVES: To describe the lung cancer diagnostic pathway, focusing on the perspective of patients and general practitioners about diagnostic and pre-treatment intervals. METHODS: This qualitative study of lung cancer patients and general practitioners in Australia used qualitative interviews or a focus group in which participants responded to a semistructured questionnaire designed to explore experiences of the diagnostic pathway...
February 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28220340/preventing-youth-from-falling-through-the-cracks-between-child-adolescent-and-adult-mental-health-services-a-systematic-review-of-models-of-care
#17
Tram Nguyen, Mark G Embrett, Neil G Barr, Gillian M Mulvale, Diana K Vania, Glen E Randall, Briano DiRezze
Optimizing the transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) is a priority for healthcare systems. The purpose of this systematic review is to: (1) identify and compare models of care that may be used to facilitate the transition from CAMHS to AMHS; and (2) discuss trends and implications to inform future research and practice. Results identified three models of care which move beyond healthcare services and incorporate a broader range of services that better meet the dynamic needs of transition-aged youth...
February 20, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28219846/changing-caregiving-relationships-for-older-home-based-chinese-people-in-a-transitional-stage-trends-factors-and-policy-implications
#18
Lijuan Gu, Mark W Rosenberg, Juxin Zeng
BACKGROUND: In the transitional stage of socioeconomic development, the traditional practice of home-based care in China is being tested. The evolution and factors of home-based care utilization are the prerequisites for the formulation of a support policy. However, no extant research has studied home-based elder care on a national scale. AIM: This paper aims to examine changing caregiving relationships nationwide for home-based elderly individuals and investigate the changing factors of care utilization in a ten-year period, with special attention to the effects of "location" on care patterns...
February 11, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28219776/deactivation-in-the-posterior-mid-cingulate-cortex-reflects-perceptual-transitions-during-binocular-rivalry-evidence-from-simultaneous-eeg-fmri
#19
Abhrajeet Roy, Keith Jamison, Sheng He, Steve Engel, Bin He
Binocular rivalry is a phenomenon in which perception spontaneously shifts between two different images that are dichoptically presented to the viewer. By elucidating the cortical networks responsible for these stochastic fluctuations in perception, we can potentially learn much about the neural correlates of visual awareness. We obtained concurrent EEG-fMRI data for a group of 20 healthy human subjects during the continuous presentation of dichoptic visual stimuli. The two eyes' images were tagged with different temporal frequencies so that eye specific steady-state visual evoked potential (SSVEP) signals could be extracted from the EEG data for direct comparison with changes in fMRI BOLD activity associated with binocular rivalry...
February 17, 2017: NeuroImage
https://www.readbyqxmd.com/read/28219383/the-alice-springs-hospital-readmission-prevention-project-ashrapp-a-randomised-control-trial
#20
Gabrielle Diplock, James Ward, Simon Stewart, Paul Scuffham, Penny Stewart, Carole Reeve, Lea Davidson, Graeme Maguire
BACKGROUND: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context...
February 20, 2017: BMC Health Services Research
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