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https://www.readbyqxmd.com/read/29785895/complexity-in-pediatric-primary-care
#1
Arwa Nasir, Laeth Nasir, Ariel Tarrell, David Finken, Amy Lacroix, Swetha Pinninti, Sheryl Pitner, Molly McCarthy
BACKGROUND: The management of patients in primary care is often complicated by the presence of multiple chronic conditions and psychosocial issues that increase the complexity of the encounter and have important impacts on care. There is a paucity of literature on this subject in the pediatric population. OBJECTIVES: The aim of this study was to quantify the burden of chronic conditions in pediatric primary care. METHODS: The problem lists of 3995 randomly selected patients from a community pediatric clinic and an academic hospital-based pediatric clinic in the same metropolitan area were analyzed for the presence and number of any chronic condition...
May 22, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29785782/path-analysis-of-caregiver-characteristics-and-neuropsychiatric-symptoms-in-alzheimer-s-disease-patients
#2
Lais L Delfino, Ricardo S Komatsu, Caroline Komatsu, Anita L Neri, Meire Cachioni
AIM: To determine the direct and indirect relationships of sociodemographic, emotional and behavioral characteristics of family caregivers of Alzheimer's disease patients who have neuropsychiatric symptoms. METHODS: A total of 134 family caregivers answered a questionnaire with sociodemographic data, and questions regarding the context of care, Neuropsychiatric Inventory, Zarit Burden Interview, Dementia Management Strategies Scale and the Beck Depression Inventory...
May 22, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29785719/children-s-experiences-and-expectations-of-kidney-transplantation-a-qualitative-interview-study
#3
Rachael C Walker, Derisha Naicker, Tonya Kara, Suetonia C Palmer
RATIONALE AND OBJECTIVE: Kidney transplantation offers improved quality of life and life expectancy compared with dialysis for children. This study aims to understand the experiences and expectations of children during the kidney transplantation process to inform clinical care. STUDY DESIGN: Face-to-face, semi-structured interviews. SETTING AND PARTICIPANTS: We interviewed 13 children and adolescents aged between 7 and 17 years old in New Zealand who had received a kidney transplantation...
May 21, 2018: Nephrology
https://www.readbyqxmd.com/read/29785694/surgical-capacity-at-district-hospitals-in-zambia-from-2012-to-2016
#4
Mweene Cheelo, Ruairi Brugha, Leon Bijlmakers, John Kachimba, Tracey McCauley, Jakub Gajewski
BACKGROUND: Sub-Saharan Africa has one of the highest burdens of surgically treatable conditions in the world and the highest unmet need, especially in rural areas. Zambia is one of the countries in the region taking steps to improve surgical care for its rural populations. AIM: To demonstrate changes in surgical capacity in Zambia's district hospitals over a 3-year period and to provide a baseline from which future interventions in surgical care can be assessed...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29785665/why-weight-an-analytic-review-of-obesity-management-diabetes-prevention-and-cardiovascular-risk-reduction
#5
REVIEW
L I Igel, K H Saunders, J J Fins
PURPOSE OF REVIEW: In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. RECENT FINDINGS: There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29785505/preparing-for-an-insured-old-age-insurance-purchase-and-self-support-in-old-age-in-rural-china
#6
Lihong Shi
This article explores an emerging trend among young and middle-aged rural couples in Northeast China who have purchased recently marketized commercial insurance as a way to prepare for self-support in old age. It discusses how the commercial insurance industry has created a rural elder-care market among a population that traditionally relied on family for support in old age. It also delves into the ways in which the transformations of intergenerational exchange and family structure and a lack of health care access have contributed to the preparation for self-support in old age and have thus fostered the creation of a rural elder-care market for the insurance industry...
May 21, 2018: Journal of Cross-cultural Gerontology
https://www.readbyqxmd.com/read/29784549/cost-implications-of-varying-the-surgical-technique-surgical-setting-and-anesthesia-type-for-carpal-tunnel-release-surgery
#7
Nikolas H Kazmers, Angela P Presson, Yizhe Xu, Abby Howenstein, Andrew R Tyser
PURPOSE: Carpal tunnel release (CTR) is a common surgical procedure, representing a financial burden to the health care system. The purpose of this study was to test whether the choice of CTR technique (open carpal tunnel release [OCTR] vs endoscopic carpal tunnel release [ECTR]), surgical setting (operating room vs procedure room [PR]), and anesthetic type (local, monitored anesthesia care [MAC], Bier block, general) affected costs or payments. METHODS: Consecutive adult patients undergoing isolated unilateral CTR between July 2014, and October 2017, at a single academic medical center were identified...
May 18, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29784445/hand-hygiene-adherence-in-relation-to-influenza-season-during-6-consecutive-years
#8
Rosamaria Fulchini, Philipp Kohler, Christian R Kahlert, Werner C Albrich, Rolf Kuhn, Matthias Hoffmann, Matthias Schlegel
Hand hygiene (HH) is the single most important measure in reducing the burden of healthcare-acquired infections. Based on 12,740 HH opportunities observed during 6 consecutive years at our tertiary care center, HH adherence among healthcare workers (HCWs) was significantly better during influenza season compared to non-influenza periods, after controlling for important covariables (odds ratio = 1.17, 95% confidence interval 1.05-1.30). This finding suggests that HH awareness is increased during influenza periods, which could have implications for HCW education...
May 18, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29784441/effect-of-methicillin-resistant-staphylococcus-aureus-in-japan
#9
Hironori Uematsu, Kazuto Yamashita, Seiko Mizuno, Susumu Kunisawa, Keigo Shibayama, Yuichi Imanaka
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common antimicrobial-resistant organism identified in Japanese health care facilities. This study analyzed the clinical and economic burdens attributable to methicillin resistance in S aureus in Japanese hospitals. METHODS: We retrospectively investigated data from 14,905 inpatients of 57 hospitals combined with data from nosocomial infection surveillance and administrative claim databases...
May 18, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29784263/tertiary-care-referrals-for-fractures-in-children
#10
Jennifer K Marsh, David J Murray, Anshuman Sharma, Kavya Narayana Reddy, Alyssa Naes
PURPOSE: With limited local access to pediatric subspecialty care outside major metropolitan areas, tertiary care hospitals treat many children originally seen at outside facilities for relatively brief but urgent surgical procedures. This referral-based care imposes significant financial and psychological stress on the families. DESIGN: Prospective, survey methodology was used. METHODS: Families of children aged 0-18 years admitted to the St...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784136/a-nursing-intervention-aimed-at-reducing-symptom-burden-during-chemotherapy-chemo-support-a-mixed-methods-study-of-the-patient-experience
#11
Annemarie Coolbrandt, Koen Milisen, Hans Wildiers, Bert Aertgeerts, Theo van Achterberg, Elisa Van der Elst, Bernadette Dierckx de Casterlé
PURPOSE: CHEMO-SUPPORT is a nursing intervention that supports cancer patients in dealing with chemotherapy-related symptoms at home. The aims of the current study were (1) to determine how patients had experienced the intervention, and (2) to identify and better understand the mechanisms underlying CHEMO-SUPPORT's effects, its essential elements and possible pitfalls. METHODS: All 71 patients who had received the CHEMO-SUPPORT intervention completed a questionnaire, asking their opinion on the helpfulness, strengths, and weaknesses of the individual components of the intervention...
June 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/29784037/pre-and-post-diagnosis-costs-of-tuberculosis-to-patients-on-directly-observed-treatment-short-course-in-districts-of-southwestern-ethiopia-a-longitudinal-study
#12
Abyot Asres, Degu Jerene, Wakgari Deressa
BACKGROUND: Financial burden on tuberculosis (TB) patients results in delayed treatment and poor compliance. We assessed pre- and post-diagnosis costs to TB patients. METHODS: A longitudinal study among 735 new TB cases was conducted from January 2015 through June 2016 in 10 woredas (districts) of southwestern Ethiopia. Direct out-of-pocket, payments, and lost income (indirect cost) were solicited from patients during the first 2 months and at the end of treatment...
May 21, 2018: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29783981/implementing-integrated-services-for-people-with-epilepsy-in-primary-care-in-ethiopia-a-qualitative-study
#13
Raquel Catalao, Tigist Eshetu, Ruth Tsigebrhan, Girmay Medhin, Abebaw Fekadu, Charlotte Hanlon
BACKGROUND: In order to tackle the considerable treatment gap for epilepsy in many low- and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services. However, there are limited data on implementation and impact of such services in LMICs. Our study aimed to explore the perspectives of service users and caregivers on the accessibility, experience and perceived impact of epilepsy treatment received in a task-shared model in a rural district of Ethiopia...
May 21, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29783963/he-tamariki-kokoti-tau-tackling-preterm-a-data-linkage-methodology-to-explore-the-clinical-care-pathway-in-preterm-deliveries
#14
Sara Filoche, Fiona Cram, Angela Beard, Dalice Sim, Stacie Geller, Liza Edmonds, Bridget Robson, Beverley Lawton
BACKGROUND: Significant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand - and in particular around a premature (preterm) delivery. Māori babies are more likely to be born preterm (8.1%, compared to an overall rate of 7.4%) and they are more likely to have a preterm death. An essential part of redressing these disparities is to examine the clinical care pathway and outcomes associated with preterm deliveries. This paper describes a protocol utilising national and local health collections to enable such a study...
May 21, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29783896/projections-of-hip-arthroplasty-in-oecd-countries-up-to-2050
#15
Christof Pabinger, Harold Lothaller, Nicole Portner, Alexander Geissler
OBJECTIVE: The study aims to estimate the future demand of hip arthroplasty for OECD countries and to compare the results with earlier studies. DESIGN: Based on data availability and validity 20 countries out of the OECD sample have been selected for projection analysis. Using historic data (1995-2012) and multiple linear regression technics a projection model was designed by an iterative process considering different explanatory variables such as health care expenditure, age groups, and projection time frames...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29783235/-statistical-information-about-the-inflammatory-processes-of-the-jaw-facial-part-in-children
#16
Pavlo I Tkachenko, Serhii O Bilokon, Nataliia M Lokhmatova, Vitalina O Dobroskok, Olha B Dolenko, Nataliia M Korotych, Yuliia V Popelo
OBJECTIVE: Introduction: The acute and chronic inflammatory processes prevail in the structure of the dental surgical diseases in children. Notably, various forms of lymphadenitis, adenophlegmon and odontogenous osteomyelitis dominate in the specialized surgical units; however, it is not possible to resolve a number of organizational problems without clear understanding of the statistical situation. The aim: The paper is aimed at the analysis of the incidence rate of major nosological forms of the acute suppurative inflammations of the maxillofacial area in children for the prospective planning of arrangements to provide them with high-quality specialized care...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#17
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#18
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29783004/-the-thing-that-really-gets-me-is-the-future-symptomatology-in-older-homeless-adults-in-the-hope-home-study
#19
Adam Bazari, Maria Patanwala, Lauren M Kaplan, Colette L Auerswald, Margot B Kushel
CONTEXT: The homeless population is aging. Older homeless adults experience premature development of age-related conditions and an elevated symptom burden. Little is known about symptom experience among older homeless adults. OBJECTIVES: To characterize the experience, understanding, and management of physical, psychological, social (e.g. loneliness), and existential (e.g. regret, loss of dignity) symptoms among older homeless adults. METHODS: We conducted semi-structured interviews from June 2016 through March 2017 with a purposive sample of participants from the HOPE HOME cohort, a longitudinal study of homeless adults ages 50 and older...
May 18, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29782464/use-of-probiotics-in-the-prevention-of-nosocomial-infections
#20
Ivana Trivić, Iva Hojsak
Nosocomial, hospital-acquired or health care-associated infections occur worldwide, affecting both developed and developing countries. This results in a prolonged hospital stay, increased antimicrobial resistance, increased mortality rate, and significant financial burden on the health care system. Routine preventive measures have led to the decrease in infection spreading; however, it cannot successfully prevent all of them, making a place for the development of new strategies, including probiotics. The aim of this review was to summarize available evidence of the role of probiotics in the prevention of nosocomial infections in children...
May 18, 2018: Journal of Clinical Gastroenterology
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