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care burden

Cristan Farmer, Margo Thienemann, Collin Leibold, Gabrielle Kamalani, Bethany Sauls, Jennifer Frankovich
Objectives: To establish the psychometric properties of the Caregiver Burden Inventory (CBI) in patients with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), which is characterized by the abrupt onset of obsessive-compulsive disorder and/or restricted eating and at least two additional psychiatric symptoms. Parents of patients with PANS have reported high caregiver burden. However, no validated instrument of burden exists for this population. Methods: Study took place at a community-based PANS clinic where the CBI is administered as part of routine clinical care...
March 14, 2018: Journal of Pediatric Psychology
Sharon Reif, Rachel Sayko Adams, Grant A Ritter, Thomas V Williams, Mary Jo Larson
Introduction: Soldiers are at risk for acute and chronic pain due to the mental and physical challenges of military duties and ongoing training for force readiness. With the burden of pain on any individual attributable across pain sources, a broad perspective that goes beyond prior characterizations of pain is important. We aim to further the understanding of pain's effects among non-deployed active duty soldiers and the Military Health System (MHS), by describing prevalence of 10 painful conditions, reported pain levels, duration of pain and impact of pain on military duty limitations...
March 14, 2018: Military Medicine
M Martínez-García, J Vargas-Barrón, F Bañuelos-Téllez, H González-Pacheco, C Fresno, E Hernández-Lemus, M A Martínez-Ríos, M Vallejo
OBJECTIVE: ST-segment elevation myocardial infarction (STEMI) has an important economic burden that poised the urgent need to evaluate its catastrophic medical expense. This study evaluates the first 5 years of the national health initiative called Popular Insurance (PI) at the National Institute of Cardiology in Mexico. STUDY DESIGN: Retrospective data analysis. METHODS: STEMI patients with (n=317) and without (n=260) PI were selected. Analysed variables included socio-economical context, management care, cost evaluation and three outcomes (mortality, hospital readmission and therapeutic adherence)...
March 13, 2018: Public Health
Yongjian Xu, Jie Ma, Na Wu, Xiaojing Fan, Tao Zhang, Zhongliang Zhou, Jianmin Gao, Jianping Ren, Gang Chen
INTRODUCTION: In 2009, China officially launched the New Health Care Reform (NHCR). One important purpose of the reform was to reduce financial burden of health care through health insurance expansion and health care provider regulations. This study aimed to provide evidence on the effect of the NHCR reform on catastrophic health expenditure (CHE) by comparing the occurrence and inequality of CHE among households with chronic diseases patients before and after the reform. METHODS: This study used the subset of data from the 2008 and 2013 National Health Services Survey conducted in Shaanxi Province...
2018: PloS One
Biemba Maliti, Patience Mbozi
Cancer care is increasingly complicated worldwide by its management with concurrent acute and chronic illness states. In low- and middle-income countries, including those in sub-Saharan Africa, this results in lower overall survival rates and a higher burden of cancer deaths. A case study is presented to highlight the challenges patients with cancer in Zambia-many of whom are also positive for HIV or AIDS-face in relationship to access to care and comanagement of disease states.
April 1, 2018: Clinical Journal of Oncology Nursing
Søren Kudsk-Iversen, Naomi Shamambo, M Dylan Bould
The majority of the world's population lacks access to safe, timely, and affordable surgical care. Although there is a health workforce crisis across the board in the poorest countries in the world, anesthesia is disproportionally affected. This article explores some of the key issues that must be tackled to strengthen the anesthesia workforce in low- and lower-middle-income countries. First, we need to increase the overall number of safe anesthesia providers to match a huge burden of disease, particularly in the poorest countries in the world and in remote and rural areas...
April 2018: Anesthesia and Analgesia
Kresimir Radic, Marko Curkovic, Dario Bagaric, Maja Vilibic, Andrea Tomic, Maja Zivkovic
Patients with schizophrenia, nowadays chronic, frequently disabling mental disorder, get initial treatment after detection of a psychotic episode, seemingly late, potentially preventable stage of illness. As our knowledge about the nature of schizophrenia and other diseases of the spectrum is growing, so are the early interventions becoming more possible, and it is important to conceptualize the clinical, legal and moral issues emerging with new preventive treatments. Every intervention, especially in pre-clinical population, demands a careful risk-benefit assessment and having basic bioethical principles - primacy of patient's welfare, beneficience/non-maleficience, autonomy and justice - in mind...
March 2018: Psychiatria Danubina
Per Bech, Stephen Fitzgerald Austin, Marianne Engelbrecht Lau
INTRODUCTION: Patient-reported outcome measures (PROMs) for anxiety and depressive disorders are an important aspect of measurement-based care. AIM: The aim of the study was to perform a clinimetric analysis of two PROMs scales in patents with depression and anxiety. METHODS: Patients completed a 10-item version (SCL-10) of the Symptom Checklist to measure burden of symptoms and a brief 5-item version of World Health Organization Well-being scale (WHO-5) to measure quality of life...
March 16, 2018: Nordic Journal of Psychiatry
M Chandran, D Tay, X F Huang, Y Hao
Hospital care and mortality of diabetic and non-diabetic osteoporotic Asian patients undergoing hip fracture surgery were explored with no difference in length of hospitalization, incidence of post-operative complications, or mortality between diabetics and non-diabetics seen. Time to operation correlated with post-operative complications occurrence and therefore surgery should be expeditiously done. INTRODUCTION: Whether burden of inpatient care, problems after admission, and mortality rates differ between diabetics and non-diabetics undergoing surgery for osteoporotic hip fractures has not been explored in Asian populations...
March 15, 2018: Archives of Osteoporosis
Lyndsey M Miller, Carol J Whitlatch, Christopher S Lee, Michael S Caserta
Background and Objectives: Persons with dementia (PWDs) often place greater importance on their care values (i.e., maintaining autonomy and social relations, choosing caregivers, avoiding being a burden) than family caregivers (CGs) perceive, which can detract from dementia care planning (e.g., care arrangements or surrogate decisions). Notable variability has been found across family care dyads (PWD and CG) in their perceptions of care values, suggesting that there may be multiple patterns of perception...
March 12, 2018: Gerontologist
Patricia E Molina, Liz Simon, Angela M Amedee, David A Welsh, Tekeda F Ferguson
Alcohol's multisystemic effects impact HIV disease pathogenesis and increase the risk for comorbidities in persons living with HIV (PLWH). The increased number of aging PLWH increases the potential for alcohol to enhance the risk for comorbidities. Integration of epidemiological, preclinical and translational studies provide an overarching view of the impact of heavy alcohol consumption on HIV risk, pathogenesis, treatment and burden of disease. The combined insult of HIV infection, heavy alcohol consumption and toxic effects of antiretroviral therapy in aging PLWH poses a public health challenge through increased disease burden that also impacts quality of life and increases health care costs...
March 13, 2018: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
Noemia Teixeira de Siqueira-Filha, Maria de Fatima Militao de Albuquerque, Laura Cunha Rodrigues, Rosa Legood, Andreia Costa Santos
OBJECTIVE: The objective of this study was to measure the costs of people living with HIV (PLHIV) as well as active tuberculosis (TB/HIV), latent tuberculosis infection (LTBI/HIV) or without TB (HIV/AIDS). METHODS: We analysed the costs through the entire pathway of care during the prediagnosis and treatment periods from the Brazilian public health system perspective. We applied a combination of bottom-up and top-down approaches to capture and estimate direct medical and non-medical costs...
March 15, 2018: Sexually Transmitted Infections
Ignacio Aznar-Lou, Anton Pottegård, Ana Fernández, María Teresa Peñarrubia-María, Antoni Serrano-Blanco, Ramón Sabés-Figuera, Montserrat Gil-Girbau, Marta Fajó-Pascual, Patricia Moreno-Peral, Maria Rubio-Valera
OBJECTIVE: Copayment policies aim to reduce the burden of medication expenditure but may affect adherence and generate inequities in access to healthcare. The objective was to evaluate the impact of two copayment measures on initial medication non-adherence (IMNA) in several medication groups and by income level. DESIGN: A population-based study was conducted using real-world evidence. SETTING: Primary care in Catalonia (Spain) where two separate copayment measures (fixed copayment and coinsurance) were introduced between 2011 and 2013...
March 15, 2018: BMJ Quality & Safety
E K Yeoh, Martin C S Wong, Eliza L Y Wong, Carrie Yam, C M Poon, Roger Y Chung, Marc Chong, Yuan Fang, Harry H X Wang, Miaoyin Liang, Wilson W L Cheung, Chun Hei Chan, Benny Zee, Andrew J Stewart Coats
BACKGROUND: Chronic Care Model (CCM) has been developed to improve patients' health care by restructuring health systems in a multidimensional manner. This systematic review aims to summarize and analyse programs specifically designed and conducted for the fulfilment of multiple CCM components. We have focused on programs targeting diabetes mellitus, hypertension and cardiovascular disease. METHOD AND RESULTS: This review was based on a comprehensive literature search of articles in the PubMed database that reported clinical outcomes...
May 1, 2018: International Journal of Cardiology
Rajkumar Doshi, Jay Shah, Varun Jauhar, Dean Decter, Rajiv Jauhar, Perwaiz Meraj
BACKGROUND: The aim of this study was to analyze the indications for using bare metal stents (BMSs) in hospitalizations with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS: The study cohorts were identified from the National Inpatient Sample database from 2010-2014 using appropriate, International Classification of Diseases, 9th Revision, Clinical Modification, diagnostic and procedural codes. RESULTS: A total of 123,487 hospitalizations were identified for this study...
March 12, 2018: Heart & Lung: the Journal of Critical Care
Gunta Laizane, Anda Kivite, Inese Stars, Marita Cikovska, Ilze Grope, Dace Gardovska
BACKGROUND: Rotavirus is the leading cause of severe diarrhea in young children and infants worldwide, representing a heavy public health burden. Limited information is available regarding the impact of rotavirus gastroenteritis on the quality of life of affected children and their families. The objectives of study were to estimate the impact of rotavirus infection on health-related quality of life (HRQL), to assess the social and emotional effects on the families of affected children...
March 15, 2018: BMC Pediatrics
Annika Scholl, Frank de Wit, Naomi Ellemers, Adam K Fetterman, Kai Sassenberg, Daan Scheepers
Power usually lowers stress responses. In stressful situations, having high (vs. low) power heightens challenge and lowers threat. Yet, even power-holders may experience threat when becoming aware of the responsibility that accompanies their power. Power-holders can construe (i.e., understand) a high-power position primarily as opportunity to "make things happen" or as responsibility to "take care of things." Power-holders construing power as responsibility (rather than opportunity) may be more likely to experience demands-such as taking care of important decisions under their control-as outweighing their resources, resulting in less challenge and more threat...
March 1, 2018: Personality & Social Psychology Bulletin
Patricia C Griffiths, Mariya Kovaleva, Melinda Higgins, Ashley H Langston, Kenneth Hepburn
INTRODUCTION: This study examined the feasibility and efficacy of Tele-Savvy, an online version of the Savvy Caregiver Program, a psychoeducation program for caregivers caring for a person with dementia. METHODS: A convenience sample of 22 caregivers from the Atlanta VA and 42 caregivers from 14 different states enrolled in Tele-Savvy. Pre- and post-program evaluations assessed caregiver burden, caregiver competency, and frequency of behavioral and psychological symptoms of dementia (BPSD)...
January 1, 2018: American Journal of Alzheimer's Disease and Other Dementias
Hendramoorthy Maheswaran, Stavros Petrou, Danielle Cohen, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Aileen Clarke
INTRODUCTION: Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence...
2018: PloS One
Nils Große Hokamp, Alexandra Hellerbach, Andreas Gierich, David W Jordan, Veerle Visser-Vandewalle, David Maintz, Stefan Haneder
OBJECTIVES: The aim of this study was to evaluate the reduction of artifacts from deep brain stimulation electrodes (DBS) using an iterative metal artifact reduction algorithm (O-MAR), virtual monoenergetic images (VMI), and both in combination in postoperative spectral detector computed tomography using a dual-layer detector (spectral detector computed tomography [SDCT]) of the head. MATERIAL AND METHODS: Nonanthropomorphic phantoms with different DBS leads were examined on SDCT; in 1 phantom periprocedural bleeding was simulated...
March 14, 2018: Investigative Radiology
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