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https://www.readbyqxmd.com/read/28647951/complexities-of-care-in-klinefelter-syndrome-an-aprn-perspective
#1
Sharron Close, Amy Talboy, Ilene Fennoy
47,XXY (Klinefelter Syndrome) is associated with a spectrum of complex clinical needs that are associated with variable physical, neurocognitive and psychosocial aspects. For patients and families affected by this sex chromosome trisomy, navigation of health care services is difficult due to lack of 47,XXY awareness among many health care providers and little evidence to support endocrine and additional treatment plans. While endocrine management of androgen deficiency has been the mainstay of treatment for patients from puberty through adulthood, testosterone replacement, alone, fails to mitigate many symptoms and issues...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647948/gender-creative-or-transgender-youth-and-advanced-nursing-practice
#2
Nicole Kirouac, Mabel Tan
The World Professional Association for Transgender Health (WPATH) defines gender dysphoria as "Discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)" (WPATH, 2016). Gender creative (GC) and transgender (TG) youth are at high risk for severe mental health disparities if they don't receive competent and timely gender transitioning care. Although awareness and early care of TG youth in specialty clinics is improving and increasing, there is still much effort that is required to eliminate barriers to care at many levels and thus improve outcomes...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647804/estimating-the-long-term-functional-burden-of-osteoporosis-related-fractures
#3
S Fischer, K A Kapinos, A Mulcahy, L Pinto, O Hayden, R Barron
Although fractures are associated with short-term reductions in functional status, there is limited information on longer-term burden of fracture. This study documents evidence of an association between fractures and significant declines and functional health and activities that persist but attenuate beyond two years. INTRODUCTION: Although fractures are associated with short-term reductions in functional status and may have other short-term effects on healthcare utilization (hospitalization and follow-up care), there is limited information on long-term burden of fracture beyond 12 to 24 months post-fracture...
June 24, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28647693/recognition-investigation-and-management-of-mitochondrial-disease
#4
REVIEW
James E Davison, Shamima Rahman
Mitochondria are dynamic organelles present in virtually all human cells that are needed for a multitude of cellular functions, including energy production, control of cell apoptosis and numerous biochemical catabolic and synthetic pathways that are critical for cellular health. Primary mitochondrial disorders are a group of greater than 200 single gene defects arising from two genomes (nuclear and mitochondrial) leading to mitochondrial dysfunction, and are associated with extremely heterogeneous phenotypes...
June 24, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28647664/patient-perceived-responsiveness-of-primary-care-systems-across-europe-and-the-relationship-with-the-health-expenditure-and-remuneration-systems-of-primary-care-doctors
#5
Anna Maria Murante, Chiara Seghieri, Milena Vainieri, Willemijn L A Schäfer
BACKGROUND: Health systems are expected to be responsive, that is to provide services that are user-oriented and respectful of people. Several surveys have tried to measure all or some of the dimensions of the responsiveness (e.g. autonomy, choice, clarity of communication, confidentiality, dignity, prompt attention, quality of basic amenities, and access to family and community support), however there is little evidence regarding the level of responsiveness of primary care (PC) systems...
June 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28647577/transitions-from-skilled-nursing-facility-to-home-the-relationship-of-early-outpatient-care-to-hospital-readmission
#6
Jennifer L Carnahan, James E Slaven, Christopher M Callahan, Wanzhu Tu, Alexia M Torke
BACKGROUND: Many adults are discharged to skilled nursing facilities (SNFs) prior to returning home from the hospital. Patient characteristics and factors that can help to prevent postdischarge adverse outcomes are poorly understood. OBJECTIVE: To identify whether early post-SNF discharge care reduces likelihood of 30-day hospital readmissions. DESIGN: Secondary data analysis using the Electronic Medical Record, Medicare, Medicaid and the Minimum Data Set...
June 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28647526/national-survey-of-adult-and-pediatric-reference-intervals-in-clinical-laboratories-across-canada-a-report-of-the-cscc-working-group-on-reference-interval-harmonization
#7
Khosrow Adeli, Victoria Higgins, David Seccombe, Christine P Collier, Cynthia Balion, George Cembrowski, Allison A Venner, Julie Shaw
OBJECTIVE: Reference intervals are widely used decision-making tools in laboratory medicine, serving as health-associated standards to interpret laboratory test results. Numerous studies have shown wide variation in reference intervals, even between laboratories using assays from the same manufacturer. Lack of consistency in either sample measurement or reference intervals across laboratories challenges the expectation of standardized patient care regardless of testing location. Here, we present data from a national survey conducted by the Canadian Society of Clinical Chemistry (CSCC) Reference Interval Harmonization (hRI) Working Group that examines the variation in laboratory reference sample measurements, as well as pediatric and adult reference intervals currently used in clinical practice across Canada...
June 21, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28647451/association-of-mitochondrial-dna-in-peripheral-blood-with-depression-anxiety-and-stress-and-adjustment-disorders-in-primary-health-care-patients
#8
Xiao Wang, Kristina Sundquist, Hamideh Rastkhani, Karolina Palmér, Ashfaque A Memon, Jan Sundquist
Mitochondrial dysfunction may result in a variety of diseases. The objectives here were to examine possible differences in mtDNA copy number between healthy controls and patients with depression, anxiety or stress- and adjustment disorders; the association between mtDNA copy number and disease severity at baseline; and the association between mtDNA copy number and response after an 8-week treatment (mindfulness, cognitive based therapy). A total of 179 patients in primary health care (age 20-64 years) with depression, anxiety and stress- and adjustment disorders, and 320 healthy controls (aged 19-70 years) were included in the study...
June 21, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28647272/outcomes-of-preterm-infants-following-discussions-about-withdrawal-or-withholding-of-life-support
#9
Jennifer James, David Munson, Sara B DeMauro, John C Langer, April R Dworetz, Girija Natarajan, Margarita Bidegain, Christine A Fortney, Ruth Seabrook, Betty R Vohr, Jon E Tyson, Edward F Bell, Brenda B Poindexter, Seetha Shankaran, Rosemary D Higgins, Abhik Das, Barbara J Stoll, Haresh Kirpalani
OBJECTIVES: To describe the frequency of postnatal discussions about withdrawal or withholding of life-sustaining therapy (WWLST), ensuing WWLST, and outcomes of infants surviving such discussions. We hypothesized that such survivors have poor outcomes. STUDY DESIGN: This retrospective review included registry data from 18 centers of the National Institute of Child Health and Human Development Neonatal Research Network. Infants born at 22-28 weeks of gestation who survived >12 hours during 2011-2013 were included...
June 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28647213/evaluating-a-medical-directive-for-nurse-initiated-analgesia-in-the-emergency-department
#10
Sebastian Dewhirst, Yuan Zhao, Taryn MacKenzie, Adam Cwinn, Christian Vaillancourt
OBJECTIVES: Although acute pain is a common presentation in the Emergency Department (ED), analgesics are often delayed until the patient is seen by a physician. We assessed the effect of a medical directive for nurse-initiated analgesia on time to first dose of analgesics, proportion of patients receiving analgesics in less than 30min, and total length of stay in the ED. METHODS: A medical directive for nurse-initiated analgesia was introduced in our ED in October 2011...
June 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28647052/outbreaks-of-health-care-associated-influenza-like-illness-in-france-impact-of-electronic-notification
#11
Elodie Munier-Marion, Thomas Bénet, Cédric Dananché, Sophan Soing-Altach, Sylvie Maugat, Sophie Vaux, Philippe Vanhems
BACKGROUND: Mandatory notification of health care-associated (HA) infections, including influenza-like illness (ILI) outbreaks, has been implemented in France since 2001. In 2012, the system moved to online electronic notification of HA infections (e-SIN). The objectives of this study are to describe ILI outbreak notifications to Santé publique France (SPF), the French national public health agency, and to evaluate the impact of notification dematerialization. METHODS: All notifications of HA ILI outbreaks between July 2001 and June 2015 were included...
June 21, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28646921/factors-associated-with-intimate-partner-physical-violence-among-women-attending-antenatal-care-in-shire-endaselassie-town-tigray-northern-ethiopia-a-cross-sectional-study-july-2015
#12
Berhane Hailu Gebrezgi, Marta Berta Badi, Endashaw Admassu Cherkose, Negassie Berhe Weldehaweria
BACKGROUND: Intimate partner physical violence is a common global phenomenon. About 30.00% and 38.83% of women in the world and in sub-Saharan Africa experienced physical violence by their partner respectively in 2013. Though intimate partner violence has serious adverse health consequences, there is limited information about partner violence during pregnancy in Ethiopia. Therefore, the aim of this study was to assess the prevalnce of physical intimate partner violence during pregnancy and associated factors among women attending antenatal care in Shire Endaselassie town, Tigray, northen Ethiopia METHODS: A facility based cross-sectional study was conducted from May 3 to July 6, 2015...
June 24, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28646907/dimensions-of-social-capital-of-families-with-thalassemia-in-an-indigenous-population-in-tamil-nadu-india-a-qualitative-study
#13
Bharathi Palanisamy, Kalpana Kosalram, Vijayaprasad Gopichandran
BACKGROUND: Studies have shown that social capital is positively associated with health, and the association is context-based. Indigenous populations with poor access to health care largely depend on social capital for their health care needs. This study was conducted to explore the dimensions and types of social capital and its utilization by families with thalassemia for their health and well-being in an indigenous population in Tamil Nadu, India. METHODS: The participants in the study were parents who had children with thalassemia, belonged to an indigenous community in Tamil Nadu, were poor and marginalized, and had poor access to health care...
June 24, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28646857/overview-of-post-discharge-predictors-for-psychiatric-re-hospitalisations-a-systematic-review-of-the-literature
#14
R Sfetcu, S Musat, P Haaramo, M Ciutan, G Scintee, C Vladescu, K Wahlbeck, H Katschnig
BACKGROUND: High levels of hospital readmission (rehospitalisation rates) is widely used as indicator of a poor quality of care. This is sometimes also referred to as recidivism or heavy utilization. Previous studies have examined a number of factors likely to influence readmission, although a systematic review of research on post-discharge factors and readmissions has not been conducted so far. The main objective of this review was to identify frequently reported post-discharge factors and their effects on readmission rates...
June 24, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28646726/trends-in-admission-rates-and-in-hospital-stay-for-venous-thromboembolism
#15
Sola Mansour, Ghazi Alotaibi, Cynthia Wu, Michael Sean McMurtry
BACKGROUND: Acute venous thromboembolism leads to significant morbidity and mortality. Advances in pharmacotherapy facilitate outpatient care in low-risk acute venous thromboembolism. The proportion of hospitalized acute venous thromboembolism cases and the average length of stay are not known. We sought to identify predictors of hospitalization, changes in hospitalization rates and length of stay of acute venous thromboembolism over a decade in Alberta, Canada. METHODS: Using linked administrative health databases, we identified adult patients diagnosed primarily with acute venous thromboembolism between April 2002 and March 2012...
June 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28646519/the-association-of-health-literacy-with-preventable-ed-visits-a-cross-sectional-study
#16
Meenakshi P Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, Donna L Carden
BACKGROUND: Policy-makers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. OBJECTIVE: To determine the association of health literacy and preventable ED visits...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28646443/recent-discoveries-in-monogenic-disorders-of-childhood-bone-fragility
#17
REVIEW
Riikka E Mäkitie, Anders J Kämpe, Fulya Taylan, Outi Mäkitie
PURPOSE OF REVIEW: This review summarizes our current knowledge on primary osteoporosis in children with focus on recent genetic findings. RECENT FINDINGS: Advances in genetic research, particularly next-generation sequencing, have found several genetic loci that associate with monogenic forms of inherited osteoporosis, widening the scope of primary osteoporosis beyond classical osteogenesis imperfecta. New forms of primary osteoporosis, such as those related to WNT1, PLS3, and XYLT2, have identified defects outside the extracellular matrix components and collagen-related pathways, in intracellular cascades directly affecting bone cell function...
June 23, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28646442/variability-of-adverse-events-in-the-public-health-care-service-of-the-tuscany-region
#18
Sara Albolino, Riccardo Tartaglia, Tommaso Bellandi, Elisa Bianchini, Giancarlo Fabbro, Silvia Forni, Giulia Cernuschi, Annibale Biggeri
The objective of the study is to analyze the variation of adverse events (AEs) according to the different structure of hospitals. The study is a multicenter, retrospective study. It involves 4 teaching hospitals (THs) and 32 community hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional Healthcare Service (RHS). A random sample of the clinical records of patients admitted in LTs and THs in 2008 was selected from the database of the hospital discharge records of the centers. Among 11,293 clinical records included, a total of 354 adverse events were identified...
June 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28646287/assessing-the-effects-of-price-regulation-and-freedom-of-choice-on-quality-evidence-from-the-physiotherapy-market
#19
Piia Pekola, Ismo Linnosmaa, Hennamari Mikkola
In health care, many aspects of the delivery of services are subject to regulation. Often the purpose of the regulated health care system is to encourage providers to keep costs down without skimping on quality. The purpose of this paper is to analyse the effect of price regulation and free choice on quality in physiotherapy organised by the Social Insurance Institution of Finland for the disabled individuals.We use the difference-in-differences method in our effort to isolate the effect of the regulation and for this task we have defined the regulated and non-regulated firms and their quality before and after the regulation...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28646242/the-role-of-health-plans-in-supporting-behavioral-health-integration
#20
Maureen T Stewart, Constance M Horgan, Amity E Quinn, Deborah W Garnick, Sharon Reif, Timothy B Creedon, Elizabeth L Merrick
Health plan policies can influence delivery of integrated behavioral health and general medical care. This study provides national estimates for the prevalence of practices used by health plans that may support behavioral health integration. Results indicate that health plans employ financing and other policies likely to support integration. They also directly provide services that facilitate integration. Behavioral health contracting arrangements are associated with use of these policies. Delivery of integrated care requires systemic changes by both providers and payers thus health plans are key players in achieving this goal...
June 23, 2017: Administration and Policy in Mental Health
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