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https://www.readbyqxmd.com/read/28719660/factors-associated-with-life-sustaining-treatment-restriction-in-a-general-intensive-care-unit
#1
Stein Arve Skjaker, Henrik Hoel, Vegard Dahl, Knut Stavem
PURPOSE: Few previous studies have investigated associations between clinical variables available after 24 hours in the intensive care unit (ICU), including the Charlson Comorbidity Index (CCI), and decisions to restrict life-sustaining treatment. The aim of this study was to identify factors associated with the life-sustaining treatment restriction and to explore if CCI contributes to explaining decisions to restrict life-sustaining treatment in the ICU at a university hospital in Norway from 2007 to 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28719647/morbidity-outcomes-and-cost-benefit-analysis-of-wildlife-rehabilitation-in-catalonia-spain
#2
Rafael Angel Molina-López, Santi Mañosa, Alex Torres-Riera, Manel Pomarol, Laila Darwich
BACKGROUND: There are few studies of careful examination of wildlife casualties in Wildlife Rehabilitation Centers. These studies are essential for detecting menaces to wild species and providing objective criteria about cost-benefit of treatments in those centers. The release rate is considered the main outcome indicator, but other parameters such as length of stay at the center and a cost-benefit index expressed as number of released animals per euro and day, could be used as reliable estimators of the rehabilitation costs...
2017: PloS One
https://www.readbyqxmd.com/read/28719143/osteoporotic-vertebral-fracture-prevalence-varies-widely-between-radiological-assessment-methods-the-rotterdam-study
#3
L Oei, F Koromani, S J Breda, J T Schousboe, E M Clark, Jbj van Meurs, M A Ikram, J H Waarsing, Fja van Rooij, M C Zillikens, G P Krestin, Ehg Oei, F Rivadeneira
BACKGROUND: Accurate diagnosis of vertebral osteoporotic fractures is crucial for the identification of individuals at high risk of future fractures. Different methods for radiological assessment of vertebral fractures exist, but a gold standard is lacking. The aim of our study was to estimate statistical measures of agreement and prevalence of osteoporotic vertebral fractures in the population-based Rotterdam Study, across the two most commonly applied assessment methods. METHODS: The quantitative morphometry (QM) method, evaluates vertebral height loss that affects vertebral shape whereas the algorithm based qualitative (ABQ) method judges endplate integrity and includes guidelines for the differentiation of vertebral fracture and non- fracture deformities...
July 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28718723/core-addiction-medicine-competencies-for-doctors-an-international-consultation-on-training
#4
Astri Parawita Ayu, Nady El-Guebaly, Arnt Schellekens, Cor De Jong, Gabrielle Welle-Strand, William Small, Evan Wood, Walter Cullen, Jan Klimas
BACKGROUND: Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education...
July 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28718491/-hiv-aids-surveillance-among-pregnant-women-assessing-the-quality-of-the-available-information
#5
Maria Quitéria Batista Meirelles, Ana Karla Bezerra Lopes, Kenio Costa Lima
Objective: To analyze the quality of the information available in the Reportable Disease Information System (SINAN) regarding pregnant women with HIV/AIDS in the state of Rio Grande do Norte, Brazil, between 2007 and 2014. Method: The quality of information was analyzed based on completeness (percentage of fields containing values that were not null) of fields (sociodemographic information, epidemiologic maternal history, pre-natal care, and delivery) and on the existence of discrepancy between the data sources analyzed (Natal and Mossoró municipal departments of health, state department of health, and Unified Health System information database, DATASUS)...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28717900/elements-of-program-design-in-medicare-s-value-based-and-alternative-payment-models-a-narrative-review
#6
Karen E Joynt Maddox, Aditi P Sen, Lok Wong Samson, Rachael B Zuckerman, Nancy DeLew, Arnold M Epstein
Increasing emphasis on value in health care has spurred the development of value-based and alternative payment models. Inherent in these models are choices around program scope (broad vs. narrow); selecting absolute or relative performance targets; rewarding improvement, achievement, or both; and offering penalties, rewards, or both. We examined and classified current Medicare payment models-the Hospital Readmissions Reduction Program (HRRP), Hospital Value-Based Purchasing Program (HVBP), Hospital-Acquired Conditions Reduction Program (HACRP), Medicare Advantage Quality Star Rating program, Physician Value-Based Payment Modifier (VM) and its successor, the Merit-Based Incentive Payment System (MIPS), and the Medicare Shared Savings Program (MSSP) on these elements of program design and reviewed the literature to place findings in context...
July 17, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28717230/activin-signaling-is-an-essential-component-of-the-tgf-%C3%AE-induced-pro-metastatic-phenotype-in-colorectal-cancer
#7
Jonas J Staudacher, Jessica Bauer, Arundhati Jana, Jun Tian, Timothy Carroll, Georgina Mancinelli, Özkan Özden, Nancy Krett, Grace Guzman, David Kerr, Paul Grippo, Barbara Jung
Advanced colorectal cancer (CRC) remains a critical health care challenge worldwide. Various TGF-β superfamily members are important in colorectal cancer metastasis, but their signaling effects and predictive value have only been assessed in isolation. Here, we examine cross-regulation and combined functions of the two most prominent TGF-β superfamily members activin and TGF-β in advanced colorectal cancer. In two clinical cohorts we observed by immune-based assay that combined serum and tissue activin and TGF-β ligand levels predicts outcome in CRC patients and is superior to single ligand assessment...
July 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28716996/long-term-benzodiazepine-and-z-drugs-use-in-the-uk-a-survey-of-general-practice
#8
James Davies, Todd C Rae, Luke Montagu
BACKGROUND: Current British National Formulary (BNF) guidelines state that benzodiazepines and zolpidem, zopiclone, and zaleplon, commonly known as Z-drugs (BZD), be prescribed for no more than 4 weeks, although anecdotal data suggest that many patients are prescribed BZDs for much longer. As there are no recent, evidence-based estimates of long-term (>12 months) BZD use in the UK, the scale of this potential problem is unknown. AIM: To produce the first reliable, evidence-based estimate of long-term BZD use in the UK...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28716978/how-do-clinicians-prepare-family-members-for-the-role-of-surrogate-decision-maker
#9
Thomas V Cunningham, Leslie P Scheunemann, Robert M Arnold, Douglas White
PURPOSE: Although surrogate decision-making (SDM) is prevalent in intensive care units (ICUs) and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. SUBJECTS AND METHODS: We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death...
July 17, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28716793/the-realities-of-partnership-in-person-centred-care-a-qualitative-interview-study-with-patients-and-professionals
#10
Axel Wolf, Lucy Moore, Doris Lydahl, Öncel Naldemirci, Mark Elam, Nicky Britten
OBJECTIVE: Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships. While this may increase patients' sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice. DESIGN: Qualitative study employing a thematic analysis of semistructured interviews with professionals and patients...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716789/identification-of-the-delivery-of-cognitive-behavioural-therapy-for-psychosis-cbtp-using-a-cross-sectional-sample-from-electronic-health-records-and-open-text-information-in-a-large-uk-based-mental-health-case-register
#11
Craig Colling, Lauren Evans, Matthew Broadbent, David Chandran, Thomas J Craig, Anna Kolliakou, Robert Stewart, Philippa A Garety
OBJECTIVE: Our primary objective was to identify cognitive behavioural therapy (CBT) delivery for people with psychosis (CBTp) using an automated method in a large electronic health record database. We also examined what proportion of service users with a diagnosis of psychosis were recorded as having received CBTp within their episode of care during defined time periods provided by early intervention or promoting recovery community services for people with psychosis, compared with published audits and whether demographic characteristics differentially predicted the receipt of CBTp...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716323/chronic-urinary-retention-in-multiple-sclerosis-patients-physiology-systematic-review-of-urodynamic-data-and-recommendations-for-care
#12
REVIEW
John T Stoffel
Many multiple sclerosis (MS) patients are affected by urinary retention. Common causes include neurogenic underactive bladder and/or bladder outlet obstruction from detrusor sphincter dyssynergia. Systemic review of contemporary MS urodynamic studies demonstrates that 53% of MS patients have detrusor overactivity, 43% have detrusor sphincter dyssynergia, and 12% have atonic bladder (12 studies, 1524 patients). There is no standard definition of MS-related urinary retention, but greater than 300 mL is a proposed threshold value for the condition based on literature review...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716313/telemedicine-for-management-of-inflammatory-bowel-disease-myibdcoach-a-pragmatic-multicentre-randomised-controlled-trial
#13
Marin J de Jong, Andrea E van der Meulen-de Jong, Mariëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens, Astrid van Tubergen, Daisy M Jonkers, Marie J Pierik
BACKGROUND: Tight and personalised control of inflammatory bowel disease in a traditional setting is challenging because of the disease complexity, high pressure on outpatient clinics, and rising incidence. We compared the effects of self-management with a telemedicine system, which was developed for all subtypes of inflammatory bowel disease, on health-care utilisation and patient-reported quality of care versus standard care. METHODS: We did this pragmatic, randomised trial in two academic and two non-academic hospitals in the Netherlands...
July 14, 2017: Lancet
https://www.readbyqxmd.com/read/28716293/costs-of-providing-infusion-therapy-for-rheumatoid-arthritis-in-a-hospital-based-infusion-center-setting
#14
Jordana Schmier, Kristine Ogden, Nancy Nickman, Michael T Halpern, Mary Cifaldi, Arijit Ganguli, Yanjun Bao, Vishvas Garg
PURPOSE: Many hospital-based infusion centers treat patients with rheumatoid arthritis (RA) with intravenous biologic agents, yet may have a limited understanding of the overall costs of infusion in this setting. The purposes of this study were to conduct a microcosting analysis from a hospital perspective and to develop a model using an activity-based costing approach for estimating costs associated with the provision of hospital-based infusion services (preparation, administration, and follow-up) in the United States for maintenance treatment of moderate to severe RA...
July 14, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28716128/tobacco-dependence-among-people-with-mental-illness-a-facility-based-cross-sectional-study-from-southwest-ethiopia
#15
Zemenay Molla, Lamesa Dube, Wolfgang Krahl, Matiwos Soboka
BACKGROUND: Tobacco smoking is a health care issue in developed as well as in developing countries. Tobacco smoking among people with mental illness is significantly higher than in the general population. Tobacco smoking has negative effects on physical, mental and financial well-being of people with mental illness but little is known about tobacco dependence among mental health service users in sub-Saharan African countries, including Ethiopia. Therefore, this study attempted to assess the prevalence of tobacco dependence and associated factors among mental health service users at Jimma University teaching hospital...
July 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28716022/crisis-resolution-and-home-treatment-stakeholders-views-on-critical-ingredients-and-implementation-in-england
#16
Nicola Morant, Brynmor Lloyd-Evans, Danielle Lamb, Kate Fullarton, Eleanor Brown, Beth Paterson, Hannah Istead, Kathleen Kelly, David Hindle, Sarah Fahmy, Claire Henderson, Oliver Mason, Sonia Johnson
BACKGROUND: Crisis resolution teams (CRTs) can provide effective home-based treatment for acute mental health crises, although critical ingredients of the model have not been clearly identified, and implementation has been inconsistent. In order to inform development of a more highly specified CRT model that meets service users' needs, this study used qualitative methods to investigate stakeholders' experiences and views of CRTs, and what is important in good quality home-based crisis care...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28714903/sensing-responses-based-on-transfer-characteristics-of-inas-nanowire-field-effect-transistors
#17
Alex C Tseng, David Lynall, Igor Savelyev, Marina Blumin, Shiliang Wang, Harry E Ruda
Nanowire-based field-effect transistors (FETs) have demonstrated considerable promise for a new generation of chemical and biological sensors. Indium arsenide (InAs), by virtue of its high electron mobility and intrinsic surface accumulation layer of electrons, holds properties beneficial for creating high performance sensors that can be used in applications such as point-of-care testing for patients diagnosed with chronic diseases. Here, we propose devices based on a parallel configuration of InAs nanowires and investigate sensor responses from measurements of conductance over time and FET characteristics...
July 16, 2017: Sensors
https://www.readbyqxmd.com/read/28714831/improving-the-quality-of-nutrition-in-pediatric-trauma
#18
Alice Wang, Helena Pelletier, Diana Calligan, Angela Coates, Karen Allison Bailey
Purpose Nutrition plays a key role in the recovery of pediatric trauma patients. A catabolic state in trauma patients may hinder recovery and inadequate nutrition may increase morbidity, mortality and length of hospital stay. The purpose of this paper is to review the current nutrition support practices for pediatric trauma patients at McMaster Children's Hospital (MCH), describe patient demographics and identify areas to improve the quality of patient care. Design/methodology/approach A retrospective chart review was conducted on pediatric trauma patients (age<18 years) identified through the trauma registry of MCH...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28713517/developing-the-concept-of-caring-in-nursing-education
#19
Maryam Salehian, Abbas Heydari, Hossein Karimi Moonaghi, Nahid Aghebati
BACKGROUND: Caring is a value-based concept in the nursing field and in education. Exact understanding of caring in education and developing this concept in nursing will result in the evolution of the position of nursing science and profession. AIM: The aim of this study was to attempt to develop the concept of caring in nursing education. METHODS: This qualitative study was conducted in 2016 using directed content analysis. Participants were thirteen subjects (6 instructors and 7 senior and junior nursing students) who were selected using purposeful sampling method...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28713443/e-healthcare-for-diabetes-mellitus-type-2-patients-a-randomised-controlled-trial-in-slovenia
#20
Rade Iljaž, Andrej Brodnik, Tatjana Zrimec, Iztok Cukjati
BACKGROUND: Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM). A new approach in treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study. METHOD: Fifteen Slovene family practices enrolled 120 DM patients treated only with a diet regime and/or tablets into the study...
September 2017: Zdravstveno Varstvo
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