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https://www.readbyqxmd.com/read/28340304/family-members-experiences-of-driving-disruption-after-acquired-brain-injury
#1
Phyllis Liang, Jennifer Fleming, Louise Gustafsson, Janelle Griffin, Jacki Liddle
PRIMARY OBJECTIVE: 1) To explore family members' lived experiences of driving disruption at early and later stages of the recovery continuum following acquired brain injury (ABI). 2) To describe health-related quality of life of family members of individuals with ABI who are experiencing driving disruption. RESEARCH DESIGN: Mixed methods phenomenological research approach. METHODS AND PROCEDURES: Semi-structured interviews and health-related quality of life questionnaires were conducted with 15 family members of individuals with ABI (early group: 1-12 months post-injury, n = 6; later group: >1 year post-injury, n = 9)...
March 24, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28340256/sleep-disturbance-of-adults-with-a-brain-tumor-and-their-family-caregivers-a-systematic-review
#2
Megan Soohwa Jeon, Haryana M Dhillon, Meera R Agar
The high incidence and psychophysiological morbidities of sleep disturbance in cancer have been increasingly recognized. Yet, more detailed understanding of sleep disturbance and options for management have been neglected areas in both clinical care and research. Brain tumor patients have been particularly overlooked. A systematic search of the literature from 1990 to 2015 was performed to review sleep disturbance in adults with primary or secondary brain tumor and their family caregivers. Fifty eligible studies were identified, of which 12 focused on sleep, 37 reported sleep items within a health-related quality of life measure and 1 reported caregivers' sleep...
March 15, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28340250/improving-safety-culture-in-hospitals-facilitators-and-barriers-to-implementation-of-systemic-falls-investigative-method-sfim
#3
Aleksandra A Zecevic, Alvin Ho-Ting Li, Charity Ngo, Michelle Halligan, Anita Kothari
Objective: The purpose of this study was to assess the facilitators and barriers to implementation of the Systemic Falls Investigative Method (SFIM) on selected hospital units. Design: A cross-sectional explanatory mixed methods design was used to converge results from a standardized safety culture survey with themes that emerged from interviews and focus groups. Findings were organized by six elements of the Ottawa Model of Research Use framework. Setting: A geriatric rehabilitation unit of an acute care hospital and a neurological unit of a rehabilitation hospital were selected purposefully due to the high frequency of falls...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340247/usability-testing-of-the-iphone-app-to-improve-pain-assessment-for-older-adults-with-cognitive-impairment-prehospital-setting-a-qualitative-study
#4
Rachael E Docking, Matthew Lane, Pat A Schofield
Objectives. : Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340232/a-proposed-set-of-metrics-to-reduce-patient-safety-risk-from-within-the-anatomic-pathology-laboratory
#5
Peter Banks, Richard Brown, Alex Laslowski, Yvonne Daniels, Phil Branton, John Carpenter, Richard Zarbo, Ramses Forsyth, Yan-Hui Liu, Shane Kohl, Joachim Diebold, Shinobu Masuda, Tim Plummer, Eslie Dennis
Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Method: Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes...
March 18, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340193/addressing-structural-barriers-to-hiv-care-among-triply-diagnosed-adults-project-bridge-oakland
#6
Christina Powers, Megan Comfort, Andrea M Lopez, Alex H Kral, Owen Murdoch, Jennifer Lorvick
People who are "triply diagnosed" with HIV, mental health issues, and substance-related disorders face tremendous barriers connecting to and remaining in HIV care. Authors of this article implemented Project Bridge Oakland (PBO), an intervention based on harm reduction and trauma-informed care, to help maintain continuity of care for triply diagnosed adults through cycles of criminal justice involvement. From August 2011 to December 2014, a clinical social worker and an HIV physician provided intensive case management for 19 clients living in Oakland, California...
March 14, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28340161/organizational-benchmarks-for-test-utilization-performance-an-example-based-on-positivity-rates-for-genetic-tests
#7
Joseph Rudolf, Brian R Jackson, Andrew R Wilson, Kristi J Smock, Robert L Schmidt
Objectives: Health care organizations are under increasing pressure to deliver value by improving test utilization management. Many factors, including organizational factors, could affect utilization performance. Past research has focused on the impact of specific interventions in single organizations. The impact of organizational factors is unknown. The objective of this study is to determine whether testing patterns are subject to organizational effects, ie, are utilization patterns for individual tests correlated within organizations...
March 15, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#8
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340107/association-between-the-application-of-iso-9001-2008-alone-or-in-combination-with-health-specific-standards-and-quality-related-activities-in-hungarian-hospitals
#9
Viktor Dombrádi, Orsolya Karola Csenteri, János Sándor, Sándor Godény
Objective: To investigate how International Organization for Standardization (ISO) 9001 and the Hungarian Health Care Standards (HHCS) certifications are associated with quality management, patient safety, patient rights and human resource management activities. Design: A cross-sectional study was implemented using the 2009 Hungarian hospital survey's database. Setting: Hungary. Participants: Fifty-three general hospitals were included in the statistical analysis...
March 7, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340030/effects-of-consumer-oriented-health-information-technologies-in-diabetes-management-over-time-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Da Tao, Tieyan Wang, Tieshan Wang, Shuang Liu, Xingda Qu
Objective: To reveal the effects of consumer-oriented health information technologies (CHITs) on patient outcomes in diabetes management over time through systematic review and meta-analysis. Methods: We searched 5 electronic databases (from database inception to July 2016) for studies that reported on randomized controlled trials examining the effects of CHITs on glycemic control and other patient outcomes in diabetes management. Data were analyzed using either meta-analysis or a narrative synthesis approach...
March 9, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339996/fathers-perceptions-of-change-following-parenting-intervention-randomized-controlled-trial-of-triple-p-for-parents-of-children-with-asthma-or-eczema1
#11
Alina Morawska, Amy E Mitchell, Scott Burgess, Jennifer Fraser
 To test whether families' participation in an evidence-based parenting program can improve health-related outcomes reported by fathers of 2- to 10-year-old children with asthma and/or eczema.  A 2 (Triple P-Positive Parenting Program vs. care as usual) by 3 (baseline, postintervention, 6-month follow-up) design was used, with random group assignment. Of 107 families, 51.4% ( N  = 55) had a father participate alongside the child's mother, who was the primary intervention target. Fathers completed questionnaires assessing illness-related child behavior problems; self-efficacy with illness management and illness-related child behavior problems; and health-related quality of life...
March 2, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28339989/pain-management-strategies-and-health-care-use-in-community-dwelling-individuals-living-with-chronic-pain
#12
Elizabeth G Mann, Ana Johnson, Ian Gilron, Elizabeth G VanDenKerkhof
Objective. : To describe factors associated with high clinic and emergency room (ER) use among individuals with chronic pain. Design. : This study is part of a larger cross-sectional survey on the epidemiology of chronic pain in Canada. The current analysis was guided by the Andersen-Newman Service Utilization Model. Methods. : Respondents (N = 702) were grouped into high (top 10%) and low (bottom 90%) users based on the number of visits made to clinics and ERs over the past year...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339847/telephone-delivered-exercise-advice-and-behavior-change-support-by-physical-therapists-for-people-with-knee-osteoarthritis-protocol-for-the-telecare-randomized-controlled-trial
#13
Rana S Hinman, Belinda J Lawford, Penny K Campbell, Andrew M Briggs, Janette Gale, Caroline Bills, Simon D French, Jessica Kasza, Andrew Forbes, Anthony Harris, Stephen J Bunker, Clare M Delany, Kim L Bennell
Background.: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. Objective.: Determine the effectiveness of incorporating exercise advice and behaviour change support by physical therapists into an existing Australian nurse-led musculoskeletal telephone service for adults with knee OA. Design.: Randomized controlled trial with nested qualitative studies...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339767/accounting-for-overdispersion-when-determining-primary-care-outliers-for-the-identification-of-chronic-kidney-disease-learning-from-the-national-chronic-kidney-disease-audit
#14
Lois G Kim, Ben Caplin, Faye Cleary, Sally A Hull, Kathryn Griffith, David C Wheeler, Dorothea Nitsch
Background.: Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. Methods.: We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing)...
January 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339685/information-needs-of-generalists-and-specialists-using-online-best-practice-algorithms-to-answer-clinical-questions
#15
David A Cook, Kristi J Sorensen, Jane A Linderbaum, Laurie J Pencille, Deborah J Rhodes
Objective: : To better understand clinician information needs and learning opportunities by exploring the use of best-practice algorithms across different training levels and specialties. Methods: : We developed interactive online algorithms (care process models [CPMs]) that integrate current guidelines, recent evidence, and local expertise to represent cross-disciplinary best practices for managing clinical problems. We reviewed CPM usage logs from January 2014 to June 2015 and compared usage across specialty and provider type...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339483/temporal-evolution-of-vasospasm-and-clinical-outcome-after-intra-arterial-vasodilator-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#16
Laleh Daftari Besheli, Can Ozan Tan, Donnie L Bell, Joshua A Hirsch, Rajiv Gupta
Intra-arterial (IA) vasodilator therapy is one of the recommended treatments to minimize the impact of aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm refractory to standard management. However, its usefulness and efficacy is not well established. We evaluated the effect IA vasodilator therapy on middle cerebral artery blood flow and on discharge outcome. We reviewed records for 115 adults admitted to Neurointensive Care Unit to test whether there was a difference in clinical outcome (discharge mRS) in those who received IA infusions...
2017: PloS One
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#17
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338983/multi-site-clinical-assessment-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome-mcam-design-and-implementation-of-a-prospective-retrospective-rolling-cohort-study
#18
Elizabeth R Unger, Jin-Mann S Lin, Hao Tian, Benjamin H Natelson, Gudrun Lange, Diana Vu, Michelle Blate, Nancy G Klimas, Elizabeth G Balbin, Lucinda Bateman, Ali Allen, Charles W Lapp, Wendy Springs, Andreas M Kogelnik, Catrina C Phan, Joan Danver, Richard N Podell, Trisha Fitzpatrick, Daniel L Peterson, C Gunnar Gottschalk, Mangalathu S Rajeevan
In the Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM), we relied on expert clinician diagnoses to enroll patients from 7 specialty clinics in the United States in order to perform a systematic collection of data on measures of myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS). Healthy persons and those with other illnesses that share some features with ME/CFS were enrolled in comparison groups. The major objectives were to: 1) use standardized questionnaires to measure illness domains of ME/CFS and to evaluate patient heterogeneity overall and between clinics; 2) describe the course of illness, identify the measures that best correlate with meaningful clinical differences, and assess the performances of questionnaires as patient/person-reported outcome measures; 3) describe prescribed medications, orders for laboratory and other tests, and management tools used by expert clinicians to care for persons with ME/CFS; 4) collect biospecimens for future hypothesis testing and for evaluation of morning cortisol profiles; and 5) identify measures that best distinguish persons with ME/CFS from those in the comparison groups and detect subgroups of persons with ME/CFS who may have different underlying causes...
March 17, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28338918/integrated-mirna-and-mrna-expression-profiling-reveals-the-response-regulators-of-a-susceptible-tomato-cultivar-to-early-blight-disease
#19
Deepti Sarkar, Ranjan Kumar Maji, Sayani Dey, Arijita Sarkar, Zhumur Ghosh, Pallob Kundu
Early blight, caused by the fungus Alternaria solani, is a devastating foliar disease of tomatoes, causes massive yield loss each year worldwide. Molecular basis of the compatible host-pathogen interaction was elusive. We adopted next generation sequencing approach to decipher miRNAs and mRNAs that are differentially expressed during Alternaria-stress in tomato. Some of the interesting findings were also validated by alternative techniques. Our analysis revealed 181 known-miRNAs, belonging to 121 miRNA families, of which 67 miRNAs showed at least 2-fold change in expression level with the majority being downregulated...
March 3, 2017: DNA Research: An International Journal for Rapid Publication of Reports on Genes and Genomes
https://www.readbyqxmd.com/read/28338880/the-yield-and-feasibility-of-integrated-screening-for-tb-diabetes-and-hiv-in-four-public-hospitals-in-ethiopia
#20
Degu Jerene, Nebiyu Hiruy, Ilili Jemal, Wondimu Gebrekiros, Tadesse Anteneh, Dereje Habte, Muluken Melese, Pedro Suarez, Gloria Sangiwa
Background: Our objective was to demonstrate the feasibility of integrated care for TB, HIV and diabetes mellitus (DM) in a pilot project in Ethiopia. Methods: Healthcare workers in four hospitals screened patients with TB for HIV and DM; patients with HIV for DM and TB; and patients with DM for TB. Fasting and random plasma glucose (RPG) tests were used to confirm the diagnosis of DM. We used screening checklists for TB and DM, and additional risk scoring criteria to identify patients at risk of DM...
March 2, 2017: International Health
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