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Advance care directives

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https://www.readbyqxmd.com/read/28918387/prospective-comparative-effectiveness-cohort-study-comparing-two-models-of-advance-care-planning-provision-for-australian-community-aged-care-clients
#1
Karen Margaret Detering, Rachel Zoe Carter, Marcus William Sellars, Virginia Lewis, Elizabeth Anne Sutton
OBJECTIVES: Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. METHODS: This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week...
September 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28915078/pediatric-specific-end-of-life-care-quality-measures-an-unmet-need-of-a-vulnerable-population
#2
Emily E Johnston, Abby R Rosenberg, Arif H Kamal
We must ensure that the 20,000 US children (age 0 to 19 years) who die as a result of serious illness annually receive high-quality end-of-life care. Ensuring high-quality end-of-life care requires recognition that pediatric end-of-life care is conceptually and operationally different than that for adults. For example, in-hospital adult death is considered an outcome to be avoided, whereas many pediatric families may prefer hospital death. Because pediatric deaths are comparatively rare, not all centers offer pediatric-focused palliative care and hospice services...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28914948/nanotopography-mediated-osteogenic-differentiation-of-human-dental-pulp-derived-stem-cells
#3
Akash Bachhuka, Bahman Delalat, Soraya Rasi Ghaemi, Stan Gronthos, Nicolas H Voelcker, Krasimir Vasilev
Advanced medical devices, treatments and therapies demand an understanding of the role of interfacial properties on the cellular response. This is particularly important in the emerging fields of cell therapies and tissue regeneration. In this study, we evaluate the role of surface nanotopography on the fate of human dental pulp derived stem cells (hDPSC). These stem cells have attracted interest because of their capacity to differentiate to a range of useful lineages but are relatively easy to isolate. We generated and utilized density gradients of gold nanoparticles which allowed us to examine, on a single substrate, the influence of nanofeature density and size on stem cell behavior...
September 15, 2017: Nanoscale
https://www.readbyqxmd.com/read/28910802/effects-of-expanded-hemodialysis-therapy-on-clinical-outcomes
#4
Sandip Mitra, Kunaal Kharbanda
The invention of dialysis has been a phenomenal advance in the treatment of kidney failure. The introduction of artificial kidneys in clinical care remains one of the most successful lifesaving interventions in modern medicine. Its glory, however, has been tempered by poor long-term outcomes and a negative qualitative impact on the lives of patients who suffer from an extremely complex, burdensome, and restricted life on dialysis. There remains a huge gap in patient well-being and outcomes between artificial kidney treatments and kidney transplantation...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910509/the-experience-of-palliative-care-service-provision-for-people-with-non-malignant-respiratory-disease-and-their-family-carers-an-all-ireland-qualitative-study
#5
Clare Mc Veigh, Joanne Reid, Philip Larkin, Sam Porter, Peter Hudson
AIM: To explore specialist and generalist palliative care provision for people with non-malignant respiratory disease, in rural and urban areas in the North and Republic of Ireland. BACKGROUND: Globally, palliative care is recommended as an appropriate healthcare option for people with advanced non- malignant lung disease. Yet, there is limited evidence regarding the integration of palliative care for this client group. DESIGN: Qualitative study...
September 14, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28904846/analyzing-the-historical-development-and-transition-of-the-korean-health-care-system
#6
Sang-Yi Lee, Chul-Woung Kim, Nam-Kyu Seo, Seung Eun Lee
OBJECTIVES: Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system. METHODS: We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power...
August 2017: Osong Public Health and Research Perspectives
https://www.readbyqxmd.com/read/28903729/dynamic-etl-a-hybrid-approach-for-health-data-extraction-transformation-and-loading
#7
Toan C Ong, Michael G Kahn, Bethany M Kwan, Traci Yamashita, Elias Brandt, Patrick Hosokawa, Chris Uhrich, Lisa M Schilling
BACKGROUND: Electronic health records (EHRs) contain detailed clinical data stored in proprietary formats with non-standard codes and structures. Participating in multi-site clinical research networks requires EHR data to be restructured and transformed into a common format and standard terminologies, and optimally linked to other data sources. The expertise and scalable solutions needed to transform data to conform to network requirements are beyond the scope of many health care organizations and there is a need for practical tools that lower the barriers of data contribution to clinical research networks...
September 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28901750/synthesis-assembly-and-applications-of-hybrid-nanostructures-for-biosensing
#8
Shuaidi Zhang, Ren Geryak, Jeffrey Geldmeier, Sunghan Kim, Vladimir V Tsukruk
The robust, sensitive, and selective detection of targeted biomolecules in their native environment by prospective nanostructures holds much promise for real-time, accurate, and high throughput biosensing. However, in order to be competitive, current biosensor nanotechnologies need significant improvements, especially in specificity, integration, throughput rate, and long-term stability in complex bioenvironments. Advancing biosensing nanotechnologies in chemically "noisy" bioenvironments require careful engineering of nanoscale components that are highly sensitive, biorecognition ligands that are capable of exquisite selective binding, and seamless integration at a level current devices have yet to achieve...
September 13, 2017: Chemical Reviews
https://www.readbyqxmd.com/read/28901283/a-systematic-review-of-religious-beliefs-about-major-end-of-life-issues-in-the-five-major-world-religions
#9
Rajshekhar Chakraborty, Areej R El-Jawahri, Mark R Litzow, Karen L Syrjala, Aric D Parnes, Shahrukh K Hashmi
OBJECTIVE: The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL). METHOD: This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus...
October 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28898796/transjugular-biopsy-case-report-of-inferior-vena-cava-hepatocellular-carcinoma-with-intracardiac-extension
#10
Laurence Weinberg, Diana Abu-Ssaydeh, Chris Macgregor, Jason Wang, Clarence Wong, Manfred Spanger, Vijayragavan Muralidharan
BACKGROUND: Diagnosis of hepatocellular carcinoma (HCC) can be established with near certainty by correlating radiological imaging with clinical presentation. However, in the absence of diagnostic certainty, biopsy of liver tissue is mandatory for optimal management. We present our management of a patient with advanced liver disease who presented with an IVC mass extending into the right atrium, with co-existing liver lesions not meeting criteria for an imaging diagnosis of HCC. CASE PRESENTATION: A 62-year-old male with Child-Pugh C liver cirrhosis presented with decompensated liver failure...
September 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28895039/wheezing-in-infancy-an-overview-of-recent-literature
#11
REVIEW
Christine Muglia, John Oppenheimer
PURPOSE OF REVIEW: Wheezing in infancy is a common presentation with many potential causes. In writing this review, we sought to summarize the newest recommendations and testing available for the more common etiologies of wheezing. RECENT FINDINGS: Regarding the diagnosis of asthma, the modified asthma predictive index has recently been established as a useful predictive tool. Non-breath held multidetector CT with 3D volume rendering airway images is also a newer helpful diagnostic tool for tracheomalacia due to ease of use and its 100% positive predictive value...
September 11, 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28894744/advances-in-mobile-mental-health-opportunities-and-implications-for-the-spectrum-of-e-mental-health-services
#12
REVIEW
Donald M Hilty, Steven Chan, Tiffany Hwang, Alice Wong, Amy M Bauer
Mobile health (mHealth), telemedicine and other technology-based services facilitate mental health service delivery and may be considered part of an e-mental health (eMH) spectrum of care. Web- and Internet-based resources provide a great opportunity for the public, patients, healthcare providers and others to improve wellness, practice prevention and reduce suffering from illnesses. Mobile apps offer portability for access anytime/anywhere, are inexpensive versus traditional desktop computers, and have additional features (e...
2017: MHealth
https://www.readbyqxmd.com/read/28894637/epidermal-stem-cells-in-skin-wound-healing
#13
REVIEW
Yuanyuan Li, Jamie Zhang, Jiping Yue, Xuewen Gou, Xiaoyang Wu
Significance: Skin serves as a protective barrier for mammals. Epidermal stem cells are responsible for maintaining skin homeostasis. When cutaneous injuries occur, skin homeostasis and integrity are damaged, leading to dire consequences such as acute, chronic, or infected wounds. Skin wound healing is an intrinsic self-saving chain reaction, which is crucial to facilitating the replacement of damaged or lost tissue. Recent Advances: An immense amount of research has uncovered the underlying mechanisms behind the complex and highly regulated wound healing process...
September 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28891842/the-american-society-of-colon-and-rectal-surgeons-clinical-practice-guidelines-for-the-treatment-of-colon-cancer
#14
Jon D Vogel, Cagla Eskicioglu, Martin R Weiser, Daniel L Feingold, Scott R Steele
The American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines Committee is composed of society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#15
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28888213/occurrence-fate-and-transformation-of-emerging-contaminants-in-water-an-overarching-review-of-the-field
#16
REVIEW
John Wilkinson, Peter S Hooda, James Barker, Stephen Barton, Julian Swinden
Many of the products and drugs used commonly contain chemical components which may persist through sewage treatment works (STW) and eventually enter the aquatic environment as parent compounds, metabolites, or transformation products. Pharmaceuticals and personal care products (PPCPs) and other emerging contaminants (ECs) have been detected in waters (typically ng/L) as well as more recently bound to sediment and plastic particles (typically ng/g). Despite significant advancement of knowledge since the late 1990s, the fate of these contaminants/transformation products once introduced into the aquatic environment remains relatively unresolved...
September 6, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28887268/association-of-advance-directives-completion-with-the-utilization-of-life-sustaining-treatments-during-the-end-of-life-care-in-older-patients
#17
Yung-Feng Yen, Li-Ying Huang, Hsiao-Yun Hu, Wen-Jung Sun, Ming-Chung Ko, Ya-Ling Lee, Sheng-Jean Huang, Dachen Chu
CONTEXT: Evidence is mixed regarding the impact of advance directives (AD) on the utilisation of end-of-life treatments. OBJECTIVES: This study evaluated the effect of AD on the utilization of end-of-life treatments during the last month of life in older patients. METHODS: Taipei City Hospital initiated an advance care planning (ACP) program to promote AD for admitted patients in 2015. This prospective study recruited deceased older patients who completed ACP communication between 2015 and 2016...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28885240/advancing-value-based-population-health-management-through-payer-provider-partnerships-improving-outcomes-for-children-with-complex-conditions
#18
Pamela Peele, Donna Keyser, John Lovelace, Deborah Moss
Population health management (PHM) approaches to improve cost and quality remain limited. To address this gap, stakeholders within an integrated delivery and financing system in Western Pennsylvania designed, implemented, and tested a value-based care model for children with medically complex conditions that could be scaled across the broader pediatric population. The model included: (1) a multilevel, interdisciplinary infrastructure; (2) actionable analytics reports to guide continuous quality improvement; (3) alternative provider payments; (4) consumer-directed spending accounts; and (5) shared savings with practices...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28884751/tuberculous-meningitis
#19
REVIEW
Robert J Wilkinson, Ursula Rohlwink, Usha Kant Misra, Reinout van Crevel, Nguyen Thi Hoang Mai, Kelly E Dooley, Maxine Caws, Anthony Figaji, Rada Savic, Regan Solomons, Guy E Thwaites
Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In patients who are co-infected with HIV-1, TBM has a mortality approaching 50%. Study of TBM pathogenesis is hampered by a lack of experimental models that recapitulate all the features of the human disease. Diagnosis of TBM is often delayed by the insensitive and lengthy culture technique required for disease confirmation...
September 8, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28880145/-dementia-care-in-germany
#20
M H van der Vaart
In Germany there are approximately 1.6 million people with dementia. A quarter of them live in a care home, often alongside residents who have a physical condition. The quality of nursing for physical conditions is good; although specialised dementia care is less developed, this lag is slowly being addressed. Medical care in German care homes is delivered by GPs. Preservation of life is the norm. Due to the lack of both advance care planning and a non-resuscitation policy, many care home residents with dementia undergo life-extending measures...
2017: Nederlands Tijdschrift Voor Geneeskunde
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