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https://www.readbyqxmd.com/read/28073900/the-longer-the-better-an-empirical-study-of-the-extent-and-mechanisms-of-attenuating-biomarker-associations-in-cardiovascular-patient-cohorts
#1
Lutz P Breitling, Ute Mons, Harry Hahmann, Wolfgang Koenig, Dietrich Rothenbacher, Hermann Brenner
BACKGROUND: Identifying novel risk markers in cardiovascular patients remains a research priority. Longer follow-up generally is considered favorable in such studies, but associations of interest may become attenuated with increasing follow-up. This issue has not been adequately addressed in the context of patient cohorts. The current study analyzed the extent and mechanisms of attenuating associations in a cardiovascular patient cohort. METHODS: The associations of numerous biomarkers with all-cause mortality were estimated by multiple Cox regression in the Langzeiterfolge der KARdiOLogischen Anschlussheilbehandlung (KAROLA) prospective cohort study of 1204 patients who had participated in an inpatient rehabilitation program after an acute coronary syndrome (ACS) or coronary bypass operation...
January 10, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28055062/cost-of-joint-replacement-using-bundled-payment-models
#2
Amol S Navathe, Andrea B Troxel, Joshua M Liao, Nan Nan, Jingsan Zhu, Wenjun Zhong, Ezekiel J Emanuel
Importance: Medicare launched the mandatory Comprehensive Care for Joint Replacement bundled payment model in 67 urban areas for approximately 800 hospitals following its experience in the voluntary Acute Care Episodes (ACE) and Bundled Payments for Care Improvement (BPCI) demonstration projects. Little information from ACE and BPCI exists to guide hospitals in redesigning care for mandatory joint replacement bundles. Objective: To analyze changes in quality, internal hospital costs, and postacute care (PAC) spending for lower extremity joint replacement bundled payment episodes encompassing hospitalization and 30 days of PAC...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28033254/efficacy-of-an-early-home-based-cardiac-rehabilitation-program-for-patients-after-acute-myocardial-infarction-a-three-dimensional-speckle-tracking-echocardiography-randomized-trial
#3
Lin Xu, Zekun Cai, Meihua Xiong, Yekuo Li, Guoying Li, Yu Deng, William Kongto Hau, Shuo Li, Wenhua Huang, Jian Qiu
BACKGROUND: The effect of an early short-term home-based cardiac rehabilitation (CR) program on ventricular function in acute myocardial infarction (AMI) patients is not yet clear. The purpose of this study was to evaluate the efficacy of our CR program on the improvement of myocardial function using three-dimensional speckle tracking echocardiography (3D-STE) in AMI patients. METHODS: Fifty-two AMI patients were randomly assigned to 2 groups after discharge: the rehabilitation group, which participated in an early, home-based CR program, and the control group, which received only usual care...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28005410/results-of-a-medicare-bundled-payments-for-care-improvement-initiative-for-copd-readmissions
#4
Surya P Bhatt, J Michael Wells, Anand S Iyer, deNay P Kirkpatrick, Trisha M Parekh, Lauren T Leach, Erica M Anderson, J Greg Sanders, Jessica K Nichols, Cindy C Blackburn, Mark T Dransfield
RATIONALE: Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of COPD are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the United States Centers for Medicare & Medicaid Services (CMS) has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. OBJECTIVES: To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional and outpatient care as part of our institution's BPCI participation initiative would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs...
December 22, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27996218/association-of-early-physical-activity-time-with-pain-activities-of-daily-living-and-progression-of-vertebral-body-collapse-in-patients-with-vertebral-compression-fractures-an-observational-study-at-single-institution
#5
Hideki Kataoka, Tatsunori Ikemoto, Ayana Yoshimura, Mihoko Shibuya, Kyo Goto, Jyunichirou Yamashita, Kaoru Morita, Jyunya Sakamoto, Jiro Nakano, Minoru Okita
BACKGROUND: Physical activity can reduce pain and improve the ability to perform daily activities in patients with acute low back pain (LBP) due to various non-specific causes. The association between physical activity during the early phase of acute vertebral compression fractures (VCFs) and rehabilitation outcomes is unknown. AIM: To investigate the effects of early physical activity time (EPAT) on pain following acute VCFs, recovery of the ability to perform activities of daily living (ADLs), and progression of fractured vertebral body collapse...
December 19, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27986998/are-even-geriatric-patients-becoming-older-and-older-changes-in-the-age-structure-of-geriatric-inpatients-in-the-course-of-two-decades
#6
O Krause, U Junius-Walker, B Wiese, K Hager
BACKGROUND: The life expectancy of the German population has steadily risen in the course of the past decades. As especially the oldest members of the population are treated in geriatric clinics, it would be of interest to investigate whether the increase in population age can also be found among geriatric inpatients. PATIENTS AND METHODS: The demographic data of inpatients of a geriatric clinic in Hannover in the years 1994, 2004 and 2014 were analyzed according to age, gender and classification as acute care or geriatric rehabilitation...
December 16, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27986525/trends-in-prolonged-hospitalizations-in-the-united-states-from-2001-to-2012-a-longitudinal-cohort-study
#7
Lauren Doctoroff, Douglas J Hsu, Kenneth J Mukamal
BACKGROUND: Health policy debate commonly focuses on frequently hospitalized patients, but less research has examined trends in long-stay patients, despite their high cost, effect on availability of hospital beds, and physical and financial implications for patients and hospitals. METHODS: Using the National Inpatient Sample, a nationally-representative sample of acute care hospitalizations in the United States, we examined trends in long-stay hospitalizations from 2001-2012...
December 13, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27979962/healthcare-resource-utilization-and-clinical-outcomes-associated-with-acute-care-and-inpatient-rehabilitation-of-stroke-patients-in-japan
#8
Kyoko Murata, Shiro Hinotsu, Nobutake Sadamasa, Kazumichi Yoshida, Yamagata Sen, Shoji Asari, Susumu Miyamoto, Koji Kawakami
OBJECTIVE: To investigate healthcare resource utilization and changes in functional status in stroke patients during hospitalization in an acute hospital and a rehabilitation hospital. DESIGN: Retrospective cohort study. SETTING: One acute and one rehabilitation hospital in Japan. PARTICIPANTS: Patients who were admitted to the acute hospital due to stroke onset and then transferred to the rehabilitation hospital (n = 263, 56% male, age 70 ± 12 years)...
December 15, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27976930/predicting-length-of-stay-in-specialist-neurological-rehabilitation
#9
Whitney Taiwo, Alexandra Wressle, Lloyd Bradley
AIMS: A retrospective case series was performed to determine which measures of complexity, dependency and function most accurately predict inpatient neurorehabilitation length of stay for individuals with post-acute neurological disorders. METHODS: Sociodemographic, medical and functional variables were extracted from data submitted to the UK Rehabilitation Outcomes Collaborative. Length of stay was calculated as the total number of inpatient days, functional status was measured using Barthel Index, rehabilitation complexity was measured using Extended Rehabilitation Complexity Scale, and nursing dependency was measured using the Northwick Park Dependency Scale...
December 15, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27976928/post-acute-care-referral-and-inpatient-rehabilitation-admission-criteria-for-persons-with-brain-injury-across-two-canadian-provinces
#10
Bonnie Swaine, Nora Cullen, Frédéric Messier, Mark Bayley, André Lavoie, Shawn Marshall, Marie-Josée Sirois, Alexis Turgeon-Fournier, Julie Lamoureux, Priscilla Lam Wai Shun
PURPOSE: Investigate health care providers' perceptions of referral and admission criteria to brain injury inpatient rehabilitation in two Canadian provinces. METHODS: Health care providers (n = 345) from brain injury programs (13 acute care and 16 rehabilitation facilities) participated in a cross-sectional web-based survey. The participants rated the likelihood of patients (traumatic brain injury and cerebral hypoxia) to be referred/admitted to rehabilitation and the influence of 19 additional factors (e...
December 15, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27965854/the-effect-of-an-enriched-environment-on-activity-levels-in-people-with-stroke-in-an-acute-stroke-unit-protocol-for-a-before-after-pilot-study
#11
Ingrid C M Rosbergen, Rohan S Grimley, Kathryn S Hayward, Katrina C Walker, Donna Rowley, Alana M Campbell, Suzanne McGufficke, Samantha T Robertson, Janelle Trinder, Heidi Janssen, Sandra G Brauer
BACKGROUND: Clinical practice guidelines advocate engaging stroke survivors in as much activity as possible early after stroke. One approach found to increase activity levels during inpatient rehabilitation incorporated an enriched environment (EE), whereby physical, cognitive, and social activity was enhanced. The effect of an EE in an acute stroke unit (ASU) has yet not been explored. METHODS/DESIGN: We will perform a prospective non-randomized before-after intervention study...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27964972/why-older-adults-may-decline-offers-of-post-acute-care-services-a-qualitative-descriptive-study
#12
Justine S Sefcik, Ashley Z Ritter, Emilia J Flores, Rebecca H Nock, Jo-Ana D Chase, Christine Bradway, Sheryl Potashnik, Kathryn H Bowles
The most common post-acute care (PAC) services available to patients after hospital discharge include home care, skilled nursing facilities, nursing homes, inpatient rehabilitation, and hospice. Patients who need PAC and receive services have better outcomes, however almost one-third of those offered services decline. Little research exists on PAC decision-making and why patients may decline services. This qualitative descriptive study explored the responses of thirty older adults to the question: "Can you, from the patient point of view, tell me why someone would not want post hospital care?" Three themes emerged...
December 10, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27932360/the-effects-of-a-high-intensity-functional-exercise-group-on-clinical-outcomes-in-hospitalised-older-adults-an-assessor-blinded-randomised-controlled-trial
#13
Melissa J M Raymond, Kimberley J Jeffs, Adele Winter, Sze-Ee Soh, Peter Hunter, Anne E Holland
OBJECTIVE: to investigate a high-intensity functional exercise (HIFE) group in hospitalised older adults. DESIGN: assessor-blinded, randomised-controlled trial. SETTING: sub-acute wards at a metropolitan rehabilitation hospital. PARTICIPANTS: older adults ≥65 years (n = 468) able to stand with minimum assistance or less from a chair and follow instructions. INTERVENTION: 'group' participants were offered a standing HIFE group three times a week and individual physiotherapy sessions twice a week...
December 7, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27930356/impact-of-insurance-status-on-outcomes-and-use-of-rehabilitation-services-in-acute-ischemic-stroke-findings-from-get-with-the-guidelines-stroke
#14
Laura N Medford-Davis, Gregg C Fonarow, Deepak L Bhatt, Haolin Xu, Eric E Smith, Robert Suter, Eric D Peterson, Ying Xian, Roland A Matsouaka, Lee H Schwamm
BACKGROUND: Insurance status affects access to care, which may affect health outcomes. The objective was to determine whether patients without insurance or with government-sponsored insurance had worse quality of care or in-hospital outcomes in acute ischemic stroke. METHODS AND RESULTS: Multivariable logistic regressions with generalized estimating equations stratified by age under or at least 65 years were adjusted for patient demographics and comorbidities, presenting factors, and hospital characteristics to determine differences in in-hospital mortality and postdischarge destination...
November 14, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27913722/impact-of-a-multidisciplinary-round-visit-for-the-management-of-dysphagia-utilizing-a-wi-fi-based-wireless-flexible-endoscopic-evaluation-of-swallowing
#15
Koichi Sakakura, Masayuki Tazawa, Natsuko Otani, Masato Takagi, Mariko Morita, Minori Kurosaki, Tomoko Chiyoda, Yuri Kanai, Ayaka Endo, Takaaki Murata, Masato Shino, Yuki Yokobori, Kenji Shirakura, Naoki Wada, Kazuaki Chikamatsu
OBJECTIVES: The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi-based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. METHOD: We conducted novel Wi-Fi-based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27912992/brain-tumors-and-metastases
#16
REVIEW
Mary M Vargo
Patients with brain tumor exhibit wide-ranging prognoses and functional implications of their disease and treatments. In general, the supportive care needs of patients with brain tumor, including disabling effects, have been recognized to be high. This review (1) briefly summarizes brain tumor types, treatments, and prognostic information for the rehabilitation clinician; (2) reviews evidence for rehabilitation, including acute inpatient rehabilitation and cognitive rehabilitation, and the approaches to selected common symptom and medical management issues; and (3) examines emerging data about survivorship, such as employment, community integration, and fitness...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#17
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27902744/delirium-detection-and-impact-of-comorbid-health-conditions-in-a-post-acute-rehabilitation-hospital-setting
#18
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
https://www.readbyqxmd.com/read/27894286/the-family-experiences-of-in-hospital-care-questionnaire-in-severe-traumatic-brain-injury-fecq-tbi-a-validation-study
#19
Audny Anke, Unn Sollid Manskow, Oddgeir Friborg, Cecilie Røe, Cathrine Arntzen
BACKGROUND: Family members are important for support and care of their close relative after severe traumas, and their experiences are vital health care quality indicators. The objective was to describe the development of the Family Experiences of in-hospital Care Questionnaire for family members of patients with severe Traumatic Brain Injury (FECQ-TBI), and to evaluate its psychometric properties and validity. METHODS: The design of the study is a Norwegian multicentre study inviting 171 family members...
November 28, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27878598/implementing-the-free-water-protocol-does-not-result-in-aspiration-pneumonia-in-carefully-selected-patients-with-dysphagia-a-systematic-review
#20
Anna Gillman, Renata Winkler, Nicholas F Taylor
The Frazier Free Water Protocol was developed with the aim of providing patients with dysphagia an option to consume thin (i.e. unthickened) water in-between mealtimes. A systematic review was conducted of research published in peer-reviewed journals. An electronic search of the EMBASE, CINAHL and MEDLINE databases was completed up to July 2016. A total of 8 studies were identified for inclusion: 5 randomised controlled trials, 2 cohort studies with matched cases and 1 single group pre-post intervention prospective study...
November 23, 2016: Dysphagia
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