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https://www.readbyqxmd.com/read/29453622/cognitive-mediators-of-change-in-physical-functioning-in-response-to-a-multifaceted-intervention-for-managing-osteoarthritis
#1
Shannon Stark Taylor, Eugene Z Oddone, Cynthia J Coffman, Amy S Jeffreys, Hayden B Bosworth, Kelli D Allen
PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-efficacy, perceived pain control, and pain catastrophizing mediated changes in physical functioning following an osteoarthritis intervention involving weight management, physical activity, and cognitive-behavioral pain management. METHOD: Three hundred Veteran patients of 30 primary care providers with knee and/or hip OA were cluster randomized to an OA intervention group or usual care...
February 16, 2018: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/29452972/does-preoperative-opioid-use-increase-the-risk-of-early-revision-total-hip-arthroplasty
#2
Nicholas A Bedard, David E DeMik, S Blake Dowdle, Jessell M Owens, Steve S Liu, John J Callaghan
BACKGROUND: The purpose of this study is to evaluate the impact of preoperative opioid use on the risk of subsequent revison after primary total hip arthroplasty (THA). METHODS: The Humana database was queried for unilateral THA between 2007-2015. Patients were tracked for the occurrence of an ipsilateral revision THA for 2. Factors analyzed included preoperative opioid use (defined as a history of opioid prescription filled within 3 months preceding primary THA), age, sex, diabetes, anxiety/depression, chronic kidney disease, and obesity (body mass index > 30 kg/m 2 )...
February 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452789/informal-caregiving-and-metabolic-markers-in-the-uk-household-longitudinal-study
#3
Rebecca E Lacey, Anne McMunn, Elizabeth A Webb
OBJECTIVES: Informal caregiving is associated with poorer mental and physical health. Little research has yet focused on objectively measured health risk factors, such as metabolic markers. The aim of this study was to investigate whether informal caregiving was associated with markers of metabolism in a large, representative UK longitudinal study. We also investigated whether more intensive caregiving, as indicated by more caregiving hours, was associated with a less favourable metabolic profile...
March 2018: Maturitas
https://www.readbyqxmd.com/read/29452576/assessing-retention-in-care-after-12-months-of-the-pediatric-development-clinic-implementation-in-rural-rwanda-a-retrospective-cohort-study
#4
Scheilla Bayitondere, Francois Biziyaremye, Catherine M Kirk, Hema Magge, Katrina Hann, Kim Wilson, Christine Mutaganzwa, Eric Ngabireyimana, Fulgence Nkikabahizi, Evelyne Shema, David B Tugizimana, Ann C Miller
BACKGROUND: In Africa, a high proportion of children are at risk for developmental delay. Early interventions are known to improve outcomes, but they are not routinely available. The Rwandan Ministry of Health with Partners In Health/Inshuti Mu Buzima created the Pediatric Development Clinic (PDC) model for providing interdisciplinary developmental care for high-risk infants in rural settings. As retention for chronic care has proven challenging in many settings, this study assesses factors related to retention to care after 12 months of clinic enrollment...
February 16, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#5
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452396/changes-in-access-to-primary-care-in-europe-and-its-patterning-2007-12-a-repeated-cross-sectional-study
#6
Klára Dimitrovová, Julian Perelman
Background: The strengthening of primary care (PC) has been encouraged as a strategy to achieve more efficient and equitable health systems. However, the Great Recession may have reduced access to PC. This paper analyses the change in access to PC and its patterning in 28 European countries between 2007 and 2012. Methods: We used data from the 2007 and 2012 waves of the EU-SILC questionnaire (n = 687 170). The dependent variable was the self-reported access to PC ('easy' vs...
February 14, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29451830/quality-of-life-and-african-american-women-who-are-family-caregivers-a-literature-review-with-implications-for-psychiatric-mental-health-advanced-practice-registered-nurses
#7
Shaquita A Starks, Freida Outlaw, J Carolyn Graff, Wendy Likes, Shelley White-Means, Laura Melaro, Mona N Wicks
PURPOSE: To identify factors affecting the quality of life (QOL) of African American women (AAW) family caregivers of individuals with kidney failure. METHODS: Ferrans' Conceptual Model of QOL provided the framework for this literature review. Included studies were (a) peer- reviewed, (b) published within the last ten years, (c) written in English, and (d) examined QOL of AAW family caregivers. Using CINAHL© and PubMed©, we found 14 studies that described factors associated with these caregivers' QOL...
February 16, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29449200/mhealth-technology-and-nurse-health-coaching-to-improve-health-in-diabetes-protocol-for-a-randomized-controlled-trial
#8
Sheridan Miyamoto, Madan Dharmar, Sarina Fazio, Yajarayma Tang-Feldman, Heather M Young
BACKGROUND: Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. OBJECTIVE: The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus...
February 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29448957/brain-region-specific-enhancement-of-remyelination-and-prevention-of-demyelination-by-the-csf1r-kinase-inhibitor-blz945
#9
Nicolau Beckmann, Elisa Giorgetti, Anna Neuhaus, Stefan Zurbruegg, Nathalie Accart, Paul Smith, Julien Perdoux, Ludovic Perrot, Mark Nash, Sandrine Desrayaud, Peter Wipfli, Wilfried Frieauff, Derya R Shimshek
Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system (CNS). While multiple effective immunomodulatory therapies for MS exist today, they lack the scope of promoting CNS repair, in particular remyelination. Microglia play a pivotal role in regulating myelination processes, and the colony-stimulating factor 1 (CSF-1) pathway is a key regulator for microglia differentiation and survival. Here, we investigated the effects of the CSF-1 receptor kinase inhibitor, BLZ945, on central myelination processes in the 5-week murine cuprizone model by non-invasive and longitudinal magnetic resonance imaging (MRI) and histology...
February 15, 2018: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/29447397/barriers-and-facilitators-of-diabetes-services-in-nepal-a-qualitative-evaluation
#10
Nicole Ide, James P LoGerfo, Biraj Karmacharya
For the past three decades, the burden of diabetes in Nepal has been steadily increasing, with an estimated 3% annual increase since the year 2000. Although the burden is increasing, the methods of addressing the challenge have remained largely unchanged. This study sought to assess the current state of diabetes services provided by health facilities and to identify the major barriers that people with diabetes commonly face in Nepal. For this qualitative study, we selected five health facilities of varying levels and locations...
February 13, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29447257/access-to-health-insurance-coverage-among-sub-saharan-african-migrants-living-in-france-results-of-the-anrs-parcours-study
#11
Nicolas Vignier, Annabel Desgrées du Loû, Julie Pannetier, Andrainolo Ravalihasy, Anne Gosselin, France Lert, Nathalie Lydié, Olivier Bouchaud, Rosemary Dray Spira
BACKGROUND: Migrants' access to care depends on their health insurance coverage in the host country. We aimed to evaluate in France the dynamic and the determinants of health insurance coverage acquisition among sub-Saharan migrants. METHODS: In the PARCOURS life-event retrospective survey conducted in 2012-2013 in health-care facilities in the Paris region, data on health insurance coverage (HIC) each year since arrival in France has been collected among three groups of sub-Saharan migrants recruited in primary care centres (N = 763), centres for HIV care (N = 923) and for chronic hepatitis B care (N = 778)...
2018: PloS One
https://www.readbyqxmd.com/read/29447231/preparedness-of-lower-level-health-facilities-and-the-associated-factors-for-the-outpatient-primary-care-of-hypertension-evidence-from-tanzanian-national-survey
#12
Deogratius Bintabara, Bonaventura C T Mpondo
INTRODUCTION: Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. METHODS: This study used data from the 2014-2015 Tanzania Service Provision Assessment survey...
2018: PloS One
https://www.readbyqxmd.com/read/29447220/the-relationship-between-context-structure-and-processes-with-outcomes-of-6-regional-diabetes-networks-in-europe
#13
Mahdi Mahdavi, Jan Vissers, Sylvia Elkhuizen, Mattees van Dijk, Antero Vanhala, Eleftheria Karampli, Raquel Faubel, Paul Forte, Elena Coroian, Joris van de Klundert
BACKGROUND: While health service provisioning for the chronic condition Type 2 Diabetes (T2D) often involves a network of organisations and professionals, most evidence on the relationships between the structures and processes of service provisioning and the outcomes considers single organisations or solo practitioners. Extending Donabedian's Structure-Process-Outcome (SPO) model, we investigate how differences in quality of life, effective coverage of diabetes, and service satisfaction are associated with differences in the structures, processes, and context of T2D services in six regions in Finland, Germany, Greece, Netherlands, Spain, and UK...
2018: PloS One
https://www.readbyqxmd.com/read/29444705/health-economic-evaluation-of-moist-wound-care-in-chronic-cutaneous-leishmaniasis-ulcers-in-afghanistan
#14
Hans-Christian Stahl, Faridullah Ahmadi, Sami Mohammad Nahzat, Heng-Jin Dong, Kurt-Wilhelm Stahl, Rainer Sauerborn
BACKGROUND: The present health economic evaluation in Afghanistan aims to support public health decision makers and health care managers to allocate resources efficiently to appropriate treatments for cutaneous leishmaniasis (CL) elicited by Leishmania tropica or Leishmania major. METHODS: A decision tree was used to analyse the cost and the effectiveness of two wound care regimens versus intra-lesional antimony in CL patients in Afghanistan. Costs were collected from a societal perspective...
February 14, 2018: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/29443839/how-common-and-how-serious-is-clostridium-difficile-colitis-after-geriatric-hip-fracture-findings-from-the-nsqip-dataset
#15
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29443716/time-for-an-acute-focus-on-chronic-care-in-undergraduate-medical-education
#16
Connie R Shi, Vinod E Nambudiri
As the burdens of chronic disease rise in the United States, both undergraduate and graduate medical education must adapt to adequately equip future physicians with the skills to manage the increasingly complex health needs affecting the population. However, traditional models of undergraduate medical education (UME) have made focusing on chronic care education challenging. In this Invited Commentary, the authors advocate for strengthening UME based upon five approaches to engage trainees in learning about chronic care across both the preclinical and clinical phases of their education: (1) introducing chronic care in the preclinical years; (2) prioritizing chronic care education across all specialties; (3) maximizing the fourth year of medical school through a chronic care focus; (4) creating chronic disease-focused advanced clerkships; and (5) leveraging technology for education...
February 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29443486/effects-on-patients-of-variations-in-the-implementation-of-a-cardiometabolic-risk-intervention-program-in-montr%C3%A3-al
#17
Marie-Ève Beauregard, Sylvie Provost, Raynald Pineault, Dominique Grimard, José Pérez, Michel Fournier
INTRODUCTION: In 2011, the Agence de la santé et des services sociaux de Montréal (ASSSM), in partnership with the region's Centres de santé et de services sociaux (CSSS), coordinated the implementation of a program on cardiometabolic risk based on the Chronic Care Model. The program, intended for patients suffering from diabetes or hypertension, involved a series of individual follow-up appointments, group classes and exercise sessions. Our study assesses the impact on patient health outcomes of variations in the implementation of some aspects of the program among the six CSSSs taking part in the study...
February 2018: Health Promotion and Chronic Disease Prevention in Canada
https://www.readbyqxmd.com/read/29443059/in-vivo-electrophysiological-measurement-of-the-rat-ulnar-nerve-with-axonal-excitability-testing
#18
Brandon M Wild, Renée Morris, Mihai Moldovan, Christian Krarup, Arun V Krishnan, Ria Arnold
Electrophysiology enables the objective assessment of peripheral nerve function in vivo. Traditional nerve conduction measures such as amplitude and latency detect chronic axon loss and demyelination, respectively. Axonal excitability techniques "by threshold tracking" expand upon these measures by providing information regarding the activity of ion channels, pumps and exchangers that relate to acute function and may precede degenerative events. As such, the use of axonal excitability in animal models of neurological disorders may provide a useful in vivo measure to assess novel therapeutic interventions...
February 6, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29440471/clinical-and-demographic-characteristics-associated-with-suboptimal-primary-stroke-and-transient-ischemic-attack-prevention-retrospective-analysis
#19
Grace M Turner, Melanie Calvert, Max G Feltham, Ronan Ryan, Samuel Finnikin, Tom Marshall
BACKGROUND AND PURPOSE: Primary prevention of stroke and transient ischemic attack (TIA) is important to reduce the burden of these conditions; however, prescribing of prevention drugs is suboptimal. We aimed to identify individual clinical and demographic characteristics associated with potential missed opportunities for prevention therapy with lipid-lowering, anticoagulant, or antihypertensive drugs before stroke/TIA. METHODS: We analyzed anonymized electronic primary care records from a UK primary care database that covers 561 family practices...
February 13, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29439705/chronic-morbidity-deprivation-and-primary-medical-care-spending-in-england-in-2015-16-a-cross-sectional-spatial-analysis
#20
Evangelos Kontopantelis, Mamas A Mamas, Harm van Marwijk, Andrew M Ryan, Peter Bower, Bruce Guthrie, Tim Doran
BACKGROUND: Primary care provides the foundation for most modern health-care systems, and in the interests of equity, it should be resourced according to local need. We aimed to describe spatially the burden of chronic conditions and primary medical care funding in England at a low geographical level, and to measure how much variation in funding is explained by chronic condition prevalence and other patient and regional factors. METHODS: We used multiple administrative data sets including chronic condition prevalence and management data (2014/15), funding for primary-care practices (2015-16), and geographical and area deprivation data (2015)...
February 14, 2018: BMC Medicine
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