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https://www.readbyqxmd.com/read/27913765/prevalence-of-chronic-conditions-and-multimorbidities-in-a-geographically-defined-geriatric-population-with-diverse-races-and-ethnicities
#1
Eunjung Lim, Krupa Gandhi, James Davis, John J Chen
OBJECTIVE: The objective of this study is to examine racial/ethnic differences in prevalence of chronic conditions and multimorbidities in the geriatric population of a state with diverse races/ethnicities. METHOD: Fifteen chronic conditions and their dyads and triads were investigated using Hawaii Medicare 2012 data. For each condition, a multivariable logistic regression model was used to investigate differences in race/ethnicity, adjusting for subject characteristics...
December 2, 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/27912776/improving-stroke-prevention-therapy-for-patients-with-atrial-fibrillation-in-primary-care-protocol-for-a-pragmatic-cluster-randomized-trial
#2
Theresa M Lee, Noah M Ivers, Sacha Bhatia, Debra A Butt, Paul Dorian, Liisa Jaakkimainen, Kori Leblanc, Dan Legge, Dante Morra, Alissia Valentinis, Laura Wing, Jacqueline Young, Karen Tu
BACKGROUND: The prevalence of atrial fibrillation (AF) is growing as the population ages, and at least 15% of ischemic strokes are attributed to AF. However, many high-risk AF patients are not offered guideline-recommended stroke prevention therapy due to a variety of system, provider, and patient-level barriers. METHODS: We will conduct a pragmatic, cluster-randomized controlled trial randomizing primary care clinics to test a "toolkit" of quality improvement interventions in primary care...
December 3, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27911951/body-surface-area-and-baseline-blood-pressure-predict-subclinical-anthracycline-cardiotoxicity-in-women-treated-for-early-breast-cancer
#3
Paul Kotwinski, Gillian Smith, Jackie Cooper, Julie Sanders, Louise Ma, Albert Teis, David Kotwinski, Michael Mythen, Dudley J Pennell, Alison Jones, Hugh Montgomery
BACKGROUND AND AIMS: Anthracyclines are highly effective chemotherapeutic agents which may cause long-term cardiac damage (chronic anthracycline cardiotoxicity) and heart failure. The pathogenesis of anthracycline cardiotoxicity remains incompletely understood and individual susceptibility difficult to predict. We sought clinical features which might contribute to improved risk assessment. METHODS: Subjects were women with early breast cancer, free of pre-existing cardiac disease...
2016: PloS One
https://www.readbyqxmd.com/read/27909039/algorithm-for-predicting-death-among-older-adults-in-the-home-care-setting-study-protocol-for-the-risk-evaluation-for-support-predictions-for-elder-life-in-the-community-tool-respect
#4
Amy T Hsu, Douglas G Manuel, Monica Taljaard, Mathieu Chalifoux, Carol Bennett, Andrew P Costa, Susan Bronskill, Daniel Kobewka, Peter Tanuseputro
INTRODUCTION: Older adults living in the community often have multiple, chronic conditions and functional impairments. A challenge for healthcare providers working in the community is the lack of a predictive tool that can be applied to the broad spectrum of mortality risks observed and may be used to inform care planning. OBJECTIVE: To predict survival time for older adults in the home care setting. The final mortality risk algorithm will be implemented as a web-based calculator that can be used by older adults needing care and by their caregivers...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908840/prescription-opioid-taper-support-for-outpatients-with-chronic-pain-a-randomized-controlled-trial
#5
Mark D Sullivan, Judith A Turner, Cory DiLodovico, Angela D'Appolonio, Kari Stephens, Ya-Fen Chan
Patients receiving long-term opioid therapy for chronic pain and interested in tapering their opioid dose were randomly assigned to a 22-week taper support intervention (psychiatric consultation, opioid dose tapering, and 18 weekly meetings with a physician assistant to explore motivation for tapering and learn pain self-management skills) or usual care (N=35). Assessments were conducted at baseline and 22 and 34 weeks after randomization. Using an intention-to-treat approach, we constructed linear regression models to compare groups at each follow-up...
November 28, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27905186/severe-asthma-current-management-targeted-therapies-and-future-directions-a-roundtable-report
#6
REVIEW
Vanessa M McDonald, Steven Maltby, Helen K Reddel, Gregory G King, Peter A B Wark, Lorraine Smith, John W Upham, Alan L James, Guy B Marks, Peter G Gibson
Asthma is a chronic respiratory disease characterized by respiratory symptoms, airway inflammation, airway obstruction and airway hyper-responsiveness. Asthma is common and directly affects 10% of Australians, 1-5% of adults in Asia and 300 million people worldwide. It is a heterogeneous disorder with many clinical, molecular, biological and pathophysiological phenotypes. Current management strategies successfully treat the majority of patients with asthma who have access to them. However, there is a subset of an estimated 5-10% of patients with asthma who have severe disease and are disproportionately impacted by symptoms, exacerbations and overall illness burden...
November 30, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#7
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27903043/a-nurse-led-model-of-chronic-disease-management-in-general-practice-patients-perspectives
#8
Jacqueline Young, Diann Eley, Elizabeth Patterson, Catherine Turner
BACKGROUND: Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community. OBJECTIVE: The objective of this article is to examine patients' perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia. METHODS: This article reports on the second phase of a mixed-methods study in which semi-structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27901398/discriminating-between-neuropathic-pain-and-sensory-hypersensitivity-using-the-chronic-pain-questions-cpq
#9
Karin S Coyne, Brooke M Currie, Sean Donevan, Joseph C Cappelleri, Rozelle Hegeman-Dingle, Lucy Abraham, Christine Thompson, Alesia Sadosky, Marina Brodsky
OBJECTIVE: The Chronic Pain Questions (CPQ) were developed for clinical use with the aim of supporting primary care physicians in the screening, assessment and monitoring of patients with chronic pain. The purpose of this study was to examine the ability of the CPQ to discriminate between patients with neuropathic pain (NeP) versus those with sensory hypersensitivity (SH). METHODS: Adult men and women with a diagnosis of a NeP or SH condition were recruited from 5 clinical sites across the United States...
November 30, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27901208/gastric-and-renal-effects-of-cox-2-selective-and-non-selective-nsaids-in-rats-receiving-low-dose-aspirin-therapy
#10
Marcella Goetz Moro, Paula Katherine Vargas Sanchez, Mayara Vitorino Gevert, Emeline Maria Baller, Ana Flávia Tostes, Ana Caroline Lupepsa, Sinvaldo Baglie, Gilson Cesar Nobre Franco
The consumption of low-dose aspirin (LDA) to prevent cardiovascular disease continues to increase worldwide. Consequently, the number of chronic LDA users seeking dental procedures that require complementary acute anti-inflammatory medication has also grown. Considering the lack of literature evaluating this interaction, we analyzed the gastric and renal effects caused by a selective COX-2 inhibitor (etoricoxib) and a non-selective COX-2 inhibitor (ibuprofen) nonsteroidal anti-inflammatory drug (NSAID) in rats receiving chronic LDA therapy...
November 28, 2016: Brazilian Oral Research
https://www.readbyqxmd.com/read/27900672/the-identification-and-management-of-substance-use-disorders-in-anesthesiologists
#11
Lisa G Lefebvre, I Michael Kaufmann
PURPOSE: The purpose of this article is to review current evidence for the identification and management of substance use disorders in anesthesiologists and to describe an approach to return to practice. PRINCIPAL FINDINGS: Anesthesiologists experience substance use disorders at a rate reported to be 2.7 times that of other physicians. Effective evidence-based treatment is available for physicians with substance use disorders, including anesthesiologists. Significant barriers preventing access to such treatment still exist, some of which are specific to the physician cohort...
November 29, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27899470/i-trach-validating-a-tool-for-predicting-prolonged-mechanical-ventilation
#12
Paul A Clark, Ryan C Inocencio, Christopher J Lettieri
PURPOSE: We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS: A prospective, observational study of 225 consecutive adult medical intensive care unit patients requiring MV. Utilizing the original 6 variables used in the I-TRACH model (Intubation in the ICU, Tachycardia [heart rate > 110], Renal dysfunction [blood urea nitrogen > 25], Acidemia [pH < 7...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27899205/development-and-validation-of-the-new-icnarc-model-for-prediction-of-acute-hospital-mortality-in-adult-critical-care
#13
Paloma Ferrando-Vivas, Andrew Jones, Kathryn M Rowan, David A Harrison
PURPOSE: To develop and validate an improved risk model to predict acute hospital mortality for admissions to adult critical care units in the UK. MATERIALS AND METHODS: 155,239 admissions to 232 adult critical care units in England, Wales and Northern Ireland between January and December 2012 were used to develop a risk model from a set of 38 candidate predictors. The model was validated using 90,017 admissions between January and September 2013. RESULTS: The final model incorporated 15 physiological predictors (modelled with continuous nonlinear models), age, dependency prior to hospital admission, chronic liver disease, metastatic disease, haematological malignancy, CPR prior to admission, location prior to admission/urgency of admission, primary reason for admission and interaction terms...
November 21, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27898687/effects-of-chronologic-age-and-young-child-exposure-on-respiratory-syncytial-virus-disease-among-us-preterm-infants-born-at-32-to-35-weeks-gestation
#14
Eric A F Simões, Evan J Anderson, Xionghua Wu, Christopher S Ambrose
OBJECTIVE: To estimate the incidence of respiratory syncytial virus (RSV) disease as a function of chronologic age and exposure to young children in US preterm infants. METHODS: In the RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study, preterm infants born at 32-35 weeks gestational age (wGA) were enrolled from 188 US clinics and followed September-May of 2009-2010 or 2010-2011. Infants with medically-attended acute respiratory illness had nasal/pharyngeal swabs collected for viral testing...
2016: PloS One
https://www.readbyqxmd.com/read/27896838/children-with-medical-complexity-a-scoping-review-of-interventions-to-support-caregiver-stress
#15
REVIEW
H Edelstein, J Schippke, S Sheffe, S Kingsnorth
BACKGROUND: Caring for children with chronic and complex medical needs places extraordinary stress on parents and other family members. A scoping review was undertaken to identify and describe the full range of current interventions for reducing caregiver stress. METHODS: Applying a broad definition of caregiver stress, a systematic search of three scientific databases (CINAHL, Embase and Ovid Medline), a general internet search and hand searching of key peer-reviewed articles were conducted...
November 29, 2016: Child: Care, Health and Development
https://www.readbyqxmd.com/read/27895895/allergy-immunotherapy-across-the-life-cycle-to-promote-active-and-healthy-ageing-from-research-to-policies-an-airways-integrated-care-pathways-icps-programme-item-action-plan-b3-of-the-european-innovation-partnership-on-active-and-healthy-ageing-and-the-global
#16
REVIEW
M A Calderon, P Demoly, T Casale, C A Akdis, C Bachert, M Bewick, B M Bilò, B Bohle, S Bonini, A Bush, D P Caimmi, G W Canonica, V Cardona, A M Chiriac, L Cox, A Custovic, F De Blay, P Devillier, A Didier, G Di Lorenzo, G Du Toit, S R Durham, P Eng, A Fiocchi, A T Fox, R Gerth van Wijk, R M Gomez, T Haathela, S Halken, P W Hellings, L Jacobsen, J Just, L K Tanno, J Kleine-Tebbe, L Klimek, E F Knol, P Kuna, D E Larenas-Linnemann, A Linneberg, M Matricardi, H J Malling, R Moesges, J Mullol, A Muraro, N Papadopoulos, G Passalacqua, E Pastorello, O Pfaar, D Price, P Rodriguez Del Rio, R Ruëff, B Samolinski, G K Scadding, G Senti, M H Shamji, A Sheikh, J C Sisul, D Sole, G J Sturm, A Tabar, R Van Ree, M T Ventura, C Vidal, E M Varga, M Worm, T Zuberbier, J Bousquet
Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4) the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing...
2016: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/27893500/the-effect-of-reported-sleep-perceived-fatigue-and-sleepiness-on-cognitive-performance-in-a-sample-of-emergency-nurses
#17
Lisa A Wolf, Cydne Perhats, Altair Delao, Zoran Martinovich
OBJECTIVE: The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, and cognitive performance. BACKGROUND: Although evidence suggests that fatigue and sleepiness affect the provision of care in inpatient units, there is a lack of research on the sleep patterns of emergency nurses and the effects of disturbed sleep and fatigue on their cognitive abilities and susceptibility to medical errors. METHODS: A quantitative correlational design was used in this study; in each of 7 different statistical models, zero-order relationships between predictors and the dependent variable were examined with appropriate inferential tests...
November 23, 2016: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27891605/are-two-heads-better-than-one-or-do-too-many-cooks-spoil-the-broth-the-trade-off-between-physician-division-of-labor-and-patient-continuity-of-care-for-older-adults-with-complex-chronic-conditions
#18
Kenton J Johnston, Jason M Hockenberry
OBJECTIVE: To examine the effects of physician division of labor and patient continuity of care (COC) on the care quality and outcomes of older adults with complex chronic conditions. DATA SOURCES/STUDY SETTING: Seven years (2006-2012) of panel data from the Medicare Current Beneficiary Survey (MCBS). STUDY DESIGN: Regression models were used to estimate the effect of the specialty-type of physicians involved in annual patient evaluation and management, as well as patient COC, on simultaneous care processes and following year outcomes...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27889288/quiet-dissent-the-attitudes-beliefs-and-behaviours-of-uk-osteopaths-who-reject-low-back-pain-guidance-a-qualitative-study
#19
Joanna Figg-Latham, Dévan Rajendran
INTRODUCTION: Clinical guidelines are derived from best research evidence and aim to: improve quality of non-specific low back pain (nsLBP) management and identify patients at risk of suffering chronic pain. However, guideline discordant attitudes and beliefs have been identified in healthcare students and practitioners, including osteopaths. DESIGN: A qualitative approach with elements of grounded theory was used to explore underlying attitudes and beliefs of practitioners/students working in a British osteopathic education institution...
October 18, 2016: Manual Therapy
https://www.readbyqxmd.com/read/27888170/a-predictive-model-for-medical-events-based-on-contextual-embedding-of-temporal-sequences
#20
Wael Farhan, Zhimu Wang, Yingxiang Huang, Shuang Wang, Fei Wang, Xiaoqian Jiang
BACKGROUND: Medical concepts are inherently ambiguous and error-prone due to human fallibility, which makes it hard for them to be fully used by classical machine learning methods (eg, for tasks like early stage disease prediction). OBJECTIVE: Our work was to create a new machine-friendly representation that resembles the semantics of medical concepts. We then developed a sequential predictive model for medical events based on this new representation. METHODS: We developed novel contextual embedding techniques to combine different medical events (eg, diagnoses, prescriptions, and labs tests)...
November 25, 2016: JMIR Medical Informatics
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