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Diabetes care delivery

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https://www.readbyqxmd.com/read/28434870/maternal-socioeconomic-disadvantage-is-associated-with-transcriptional-indications-of-greater-immune-activation-and-slower-tissue-maturation-in-placental-biopsies-and-newborn-cord-blood
#1
Gregory E Miller, Ann E Borders, Amy H Crockett, Kharah M Ross, Sameen Qadir, Lauren Keenan-Devlin, Adam K Leigh, Paula Ham, Jeffrey Ma, Jesusa M G Arevalo, Linda M Ernst, Steve W Cole
Children from economically disadvantaged families experience worse cognitive, psychiatric, and medical outcomes compared to more affluent youth. Preclinical models suggest some of the adverse influence of disadvantage could be transmitted during gestation via maternal immune activation, but this hypothesis has not been tested in humans. It also remains unclear whether prenatal interventions can mitigate such effects. To fill these gaps, we conducted two studies. Study 1 characterized the socioeconomic conditions of 79 women during pregnancy...
April 20, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28428728/randomized-face-to-face-vs-home-exercise-interventions-in-pregnant-women-with-gestational-diabetes
#2
Danielle Symons Downs, Jennifer M Dinallo, Leann L Birch, Ian M Paul, Jan S Ulbrecht
OBJECTIVES: Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). DESIGN: Randomized control trial with two intervention arms and control (standard care). METHOD: Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery...
May 2017: Psychology of Sport and Exercise
https://www.readbyqxmd.com/read/28427311/feasibility-and-acceptability-of-a-clinic-based-mediterranean-style-diet-intervention-to-reduce-cardiovascular-risk-for-hispanic-americans-with-type-2-diabetes
#3
Laura Cubillos, Yanire Estrada Del Campo, Khalil Harbi, Thomas Keyserling, Carmen Samuel-Hodge, Daniel S Reuland
Purpose The purpose of the study was to modify a previously tested Spanish language version of a Mediterranean (Med)-style dietary intervention so that the dietary recommendations align with the cultural and social needs of Hispanic Americans (HAs) with type 2 diabetes (T2D) and evaluate the modified intervention's feasibility and acceptability. Methods In phase I (formative), semi-structured interviews and focus groups were used to refine the intervention content and format for delivery to HAs with T2D receiving care at a large primary care practice...
April 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28420558/maternal-medical-complexity-impact-on-prenatal-health-care-spending-among-women-at-low-risk-for-cesarean-section
#4
Shayna D Cunningham, Carolina Herrera, Ifeyinwa E Udo, Katy B Kozhimannil, Eric Barrette, Urania Magriples, Jeannette R Ickovics
BACKGROUND: Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. OBJECTIVE: The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care spending during the prenatal period among a national sample of 95,663 commercially-insured women at low risk for cesarean delivery...
April 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28413415/effects-of-nursing-home-residency-on-diabetes-care-in-individuals-with-dementia-an-explorative-analysis-based-on-german-claims-data
#5
Larissa Schwarzkopf, Rolf Holle, Michaela Schunk
AIMS: This claims data-based study compares the intensity of diabetes care in community dwellers and nursing home residents with dementia. METHODS: Delivery of diabetes-related medical examinations (DRMEs) was compared via logistic regression in 1,604 community dwellers and 1,010 nursing home residents with dementia. The intra-individual effect of nursing home transfer was evaluated within mixed models. RESULTS: Delivery of DRMEs decreases with increasing care dependency, with more community-living individuals receiving DRMEs...
January 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/28406066/telemedicine-consultation-for-patients-with-diabetes-mellitus-a-cluster-randomised-controlled-trial
#6
Ajay Sood, Sharon A Watts, Julie K Johnson, Stacey Hirth, David C Aron
Introduction There is a widening discrepancy between the increasing number of patients with diabetes mellitus and the health care resources available to manage these patients. Telemedicine has been used in a number of instances to improve and deliver health care where traditional care delivery methods may encounter difficulty. We conducted a cluster randomised controlled trial of telemedicine consultation to manage patients with diabetes mellitus. Methods Eleven primary care centres attached to one Veteran Administration tertiary care centre were randomised to provide patients with diabetes consultation referral either by usual consultation in diabetes clinic or telemedicine consultations via videoconference...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28399772/nurse-led-ranibizumab-intravitreal-injections-in-wet-age-related-macular-degeneration-a-literature-review
#7
Emma Gregg
Aim The aim of this literature review was to explore the development of the role of specialist ophthalmic nurses in delivering ranibizumab intravitreal injections to patients with wet age-related macular degeneration (AMD), and to evaluate their contribution to reducing capacity pressures in medical retina services, while maintaining safe and effective standards of care. Method A systematic literature search was undertaken to identify relevant articles published between January 2000 and June 2015. A search of electronic databases was undertaken, and selected relevant journals were searched manually...
April 12, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#8
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28398196/preconception-care-for-women-with-type-1-or-type-2-diabetes-mellitus-a-mixed-methods-study-exploring-uptake-of-preconception-care
#9
Sarah Earle, Anisah Tariq, Carol Komaromy, Cathy E Lloyd, M Ali Karamat, Jackie Webb, Paramjit S Gill
BACKGROUND: Diabetes mellitus is a global health problem and one of the most common medical conditions in pregnancy. A wide range of modifiable risk factors are associated with diabetes mellitus in pregnancy, and it is widely acknowledged that preconception care (PCC) is beneficial for women with pre-existing diabetes mellitus. However, uptake of PCC services is low. OBJECTIVES: To systematically review qualitative research on PCC for women with pre-existing diabetes mellitus of childbearing age, identify facilitators of and barriers to uptake of PCC and establish themes and gaps in knowledge...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28396109/association-of-unilateral-renal-agenesis-with-adverse-outcomes-in-pregnancy-a-matched-cohort-study
#10
Jessica Kendrick, John Holmen, Zhiying You, Gerard Smits, Michel Chonchol
BACKGROUND: Data regarding the effect of a solitary kidney during pregnancy have come from studies of living kidney donors. We evaluated the risk for adverse pregnancy outcomes in women with a single kidney from renal agenesis. STUDY DESIGN: Matched cohort study. SETTING & PARTICIPANTS: Using data from 7,079 childbirths from an integrated health care delivery system from 1996 through 2015, we identified births from women with renal agenesis...
April 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28393538/racial-ethnic-differences-in-healthcare-use-among-patients-with-uncontrolled-and-controlled-diabetes
#11
Yhenneko J Taylor, Melanie D Spencer, Rohan Mahabaleshwarkar, Thomas Ludden
OBJECTIVES: To examine racial/ethnic differences in healthcare use among patients classified as having controlled and uncontrolled diabetes. DESIGN: Data from the Carolinas HealthCare System electronic data warehouse were used. Glycemic control was defined as glycosylated hemoglobin (HbA1c) < 8% (64 mmol/mol) in 2012 (n = 9996). Patients with HbA1c ≥ 8% (64 mmol/mol) in 2012 were classified as uncontrolled (n = 2576). Race and ethnicity were jointly classified as non-Hispanic Black, non-Hispanic White or Other...
April 10, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28392778/the-challenges-and-recommendations-for-gestational-diabetes-mellitus-care-in-india-a-review
#12
REVIEW
Suman Morampudi, Gayathri Balasubramanian, Arun Gowda, Behsad Zomorodi, Anand Shanthanagowd Patil
Gestational diabetes mellitus (GDM) is a primary concern in India affecting approximately five million women each year. Existing literature indicate that prediabetes and diabetes affect approximately six million births in India alone, of which 90% are due to GDM. Studies reveal that there is no consensus among physicians and health-care providers in India regarding management of GDM prepartum and postpartum despite available guidelines. Also, there is no consensus among physicians as to when a woman should undergo oral glucose tolerance test after delivery...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28392580/pregnancies-in-women-aged-45-years-and-older-a-10-year-retrospective-analysis-in-berlin
#13
Rosa Rendtorff, Larry Hinkson, Verena Kiver, Lisa Antonia Dröge, Wolfgang Henrich
Introduction Improved fertility treatment options and a change in the socio-cultural concept of family planning, especially in industrialized regions, has led to an increasing number of births by women of advanced maternal age, which is associated with a higher rate of complications. The aim of this study was to analyze pregnancy outcomes in women aged ≥ 45 years in an inner-city German hospital and to compare these results to those of a younger cohort. Materials and Methods Over a 10-year period from January 2004 to May 2015, the pregnancy outcomes of all 186 women aged ≥ 45 years who delivered in our hospital were compared in a 1 : 1 ratio to those of a cohort of 29-year old women...
March 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28383389/outcomes-of-twin-pregnancies-in-women-45-years-of-age-or-older
#14
Rachel S Gerber, Jessica C Fields, Andrea L Barberio, Kimberly Bodenlos, Nathan S Fox
OBJECTIVE: To investigate outcomes of twin gestations in women 45 years or older at the time of delivery. METHODS: This was a retrospective cohort study of 139 women with twin gestations who were at least 45 years old when they delivered. They were cared for at two referral centers between 2005 and 2016. Analysis included baseline characteristics and pregnancy outcomes including mode of delivery, gestational age at delivery, hypertensive disease in pregnancy, gestational diabetes, and fetal growth restriction...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28373288/status-update-on-translation-of-integrated-primary-dental-medical-care-delivery-for-management-of-diabetic-patients
#15
Ingrid Glurich, Gregory Nycz, Amit Acharya
Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bidirectional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: 1) current cross-disciplinary practice patterns, 2) epidemiological updates, 3) status on risk assessment and screening for dysglycemia in the dental setting, 4) status on implementation of quality metrics for oral health, 5) care model pilots, and 6) public health perspectives...
April 3, 2017: Clinical Medicine & Research
https://www.readbyqxmd.com/read/28371686/investigating-the-management-of-diabetes-in-nursing-homes-using-a-mixed-methods-approach
#16
L Hurley, M O'Donnell, R O'Caoimh, S F Dinneen
AIMS: As populations age there is an increased demand for nursing home (NH) care and a parallel increase in the prevalence of diabetes. Despite this, there is growing evidence that the management of diabetes in NHs is suboptimal. The reasons for this are complex and poorly understood. This study aimed to identify the current level of diabetes care in NHs using a mixed methods approach. METHODS: The nursing managers at all 44 NHs in County Galway in the West of Ireland were invited to participate...
March 21, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28369064/the-uk-pharmacy-care-plan-service-description-recruitment-and-initial-views-on-a-new-community-pharmacy-intervention
#17
Michael J Twigg, David Wright, Charlotte L Kirkdale, James A Desborough, Tracey Thornley
INTRODUCTION: The UK government advocates person-centred healthcare which is ideal for supporting patients to make appropriate lifestyle choices and to address non-adherence. The Community Pharmacy Future group, a collaboration between community pharmacy companies and independents in the UK, introduced a person-centred service for patients with multiple long-term conditions in 50 pharmacies in Northern England. OBJECTIVE: Describe the initial findings from the set up and delivery of a novel community pharmacy-based person-centred service...
2017: PloS One
https://www.readbyqxmd.com/read/28368774/pregnancy-outcomes-following-ulipristal-acetate-emergency-contraception-failure-a-report-of-five-cases
#18
Zeynep Ozturk, Emine Akgul
INTRODUCTION: The emergency contraceptive ulipristal acetate (UPA) 30 mg is increasingly used by women, but there is no published data on UPA exposure in pregnancy. CASE REPORT: Here we describe five cases of unintended pregnancies following the use of UPA for emergency contraception. Of five pregnant women exposed to UPA, one decided to terminate the pregnancy for personal reasons. Two of them experienced premature rupture of membranes and the babies were born large for gestational age (LGA)...
April 3, 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28367358/perinatal-and-neonatal-outcomes-of-triplet-gestations-based-on-chorionicity
#19
Maureen Downing, Suela Sulo, Barbara V Parilla
Objective To compare perinatal and neonatal outcomes of dichorionic (DC) and monochorionic (MC) with trichorionic (TC) triplet gestations. Methods A retrospective cohort study of DC + MC versus TC triplet gestations delivered at a tertiary care hospital from 2009 to 2015. The results include 42 sets of triplets (TC, n = 26; DC + MC, n = 16). Maternal demographics and pregnancy data were compared. Neonatal outcomes were assessed using composite morbidity and mortality. Results Maternal baseline characteristics including age, mode of conception, race, parity, body mass index, and previous preterm delivery were statistically comparable...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28364355/population-health-management-for-diabetes-health-care-system-level-approaches-for-improving-quality-and-addressing-disparities
#20
REVIEW
Julie A Schmittdiel, Anjali Gopalan, Mark W Lin, Somalee Banerjee, Christopher V Chau, Alyce S Adams
PURPOSE OF REVIEW: Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are increasingly focused on managing chronic disease care at the health system level. This review outlines the key elements of population care approaches for diabetes in the current health care environment...
May 2017: Current Diabetes Reports
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