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Advance care directives

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https://www.readbyqxmd.com/read/28737983/advancing-patient-care-through-specialty-pharmacy-services-in-an-academic-health-system
#1
Autumn Bagwell, Tara Kelley, Alicia Carver, Jennifer B Lee, Brandon Newman
BACKGROUND: With the rapid growth of specialty pharmacies, including those within academic health systems, pharmacists have the opportunity to improve patient care through the management of specialty medications. Specialty pharmacists within academic health systems are uniquely positioned to overcome restrictions to medication access, financial constraints, and provider burdens that often lead to obstacles for patients to start and maintain necessary treatments. The Vanderbilt Specialty Pharmacy (VSP) model at Vanderbilt University Medical Center (VUMC) provides an example of a patient-centered, collaborative care prototype that places pharmacists directly into specialty clinics to assist with comprehensive management of patients on specialty medications...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28736934/using-social-media-to-engage-nurses-in-health-policy-development
#2
Siobhan O'Connor
AIMS: To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development. BACKGROUND: Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence. METHODS: A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software...
July 23, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28736913/a-community-responsive-adaptation-to-reach-and-engage-latino-families-affected-by-maternal-depression
#3
Carmen R Valdez, Alyssa Ramirez Stege, Elizabeth Martinez, Stephanie D'Costa, Thomas Chavez
As family researchers and practitioners seek to improve the quality and accessibility of mental health services for immigrant families, they have turned to culturally adapted interventions. Although many advancements have been made in adapting interventions for such families, we have yet to understand how the adaptation can ensure that the intervention is reaching families identified to be in greatest need within a local system of care and community. We argue that reaching, engaging, and understanding the needs of families entails a collaborative approach with multiple community partners to ensure that adaptations to intervention content and delivery are responsive to the sociocultural trajectory of families within a community...
July 23, 2017: Family Process
https://www.readbyqxmd.com/read/28736684/multimodality-imaging-approaches-for-evaluating-traumatic-extremity-injuries-implications-for-military-medicine
#4
REVIEW
Mitchel R Stacy, Christopher L Dearth
Significance: Military service members are susceptible to traumatic extremity injuries that often result in limb loss. Tremendous efforts have been made to improve medical treatment that supports residual limb function and health. Despite recent improvements in treatment and novel prosthetic devices, many patients experience a wide range of clinical problems within residual limbs that can negatively impact the progress of rehabilitation programs while also impairing functional capacity and overall quality of life...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28736324/survival-and-neurological-outcome-in-the-elderly-after-in-hospital-cardiac-arrest
#5
G Hirlekar, T Karlsson, S Aune, A Ravn-Fischer, P Albertsson, J Herlitz, B Libungan
BACKGROUND: There have been few studies of the outcome in elderly patients who have suffered in-hospital cardiac arrest (IHCA) and the association between cardiac arrest characteristics and survival. AIM: The aim of this large observational study was to investigate the survival and neurological outcome in the elderly after IHCA, and to identify which factors were associated with survival. METHODS: We investigated elderly IHCA patients (≥70years of age) who were registered in the Swedish Cardiopulmonary Resuscitation Registry 2007-2015...
July 20, 2017: Resuscitation
https://www.readbyqxmd.com/read/28730660/bezlotoxumab-a-novel-agent-for-the-prevention-of-recurrent-clostridium-difficile-infection
#6
Wesley D Kufel, Aaron S Devanathan, Ashley H Marx, David J Weber, Lindsay M Daniels
Over the last decade, the incidence and severity of Clostridium difficile infection (CDI) have significantly increased, leading to a rise in CDI-associated hospitalizations, health care costs, and mortality. Although treatment options exist for CDI, recurrence is frequent following treatment. Furthermore, patients with at least one CDI recurrence are at an increased risk of developing additional recurrences. A novel approach to the prevention of recurrent CDI is the use of monoclonal antibodies directed against the toxins responsible for CDI as an adjunct to antibiotic treatment...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28728010/advances-in-point-of-care-technologies-for-molecular-diagnostics
#7
REVIEW
Mohammad Zarei
Advances in miniaturization, nanotechnology, and microfluidics, along with developments in cloud-connected point-of-care (POC) diagnostics technologies are pushing the frontiers of POC devices toward low-cost, user-friendly, and enhanced sensitivity molecular-level diagnostics. The combination of various bio-sensing platforms within smartphone-integrated electronic readers provides accurate on-site and on-time diagnostics based on various types of chemical and biological targets. Further, 3D printing technology shows a huge potential toward fabrication and improving the performance of POC devices...
July 11, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28727486/association-of-physician-orders-for-life-sustaining-treatment-form-use-with-end-of-life-care-quality-metrics-in-patients-with-cancer
#8
Sandra L Pedraza, Stacey Culp, Mark Knestrick, Evan Falkenstine, Alvin H Moss
PURPOSE: Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs). METHODS: We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28726804/diagnostic-cytogenetic-testing-following-positive-noninvasive-prenatal-screening-results-a-clinical-laboratory-practice-resource-of-the-american-college-of-medical-genetics-and-genomics-acmg
#9
Athena M Cherry, Yassmine M Akkari, Kimberly M Barr, Hutton M Kearney, Nancy C Rose, Sarah T South, James H Tepperberg, Jeanne M Meck
Disclaimer: ACMG Clinical Laboratory Practice Resources are developed primarily as an educational tool for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these practice resources is voluntary and does not necessarily assure a successful medical outcome. This Clinical Laboratory Practice Resource should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results...
July 20, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28726790/improvements-in-the-delivery-of-resuscitation-and-newborn-care-after-helping-babies-breathe-training
#10
B D Kamath-Rayne, S Josyula, A R L Rule, J C Vasquez
BACKGROUND: To evaluate changes in neonatal resuscitation and postnatal care following Helping Babies Breathe (HBB) training at a community hospital in rural Honduras. We hypothesized that HBB training would improve resuscitation and essential newborn care interventions. METHODS: Direct observation and video recording of delivery room care spanned before and after an initial HBB workshop held in August 2013. Rates of essential newborn care interventions were compared in resuscitations performed by individuals who had and had not received HBB training, and run charts recording performance of newborn care practices over time were developed...
July 20, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28725482/systems-biology-driving-drug-development-from-design-to-the-clinical-testing-of-the-anti-erbb3-antibody-seribantumab-mm-121
#11
REVIEW
Birgit Schoeberl, Art Kudla, Kristina Masson, Ashish Kalra, Michael Curley, Gregory Finn, Emily Pace, Brian Harms, Jaeyeon Kim, Jeff Kearns, Aaron Fulgham, Olga Burenkova, Viara Grantcharova, Defne Yarar, Violette Paragas, Jonathan Fitzgerald, Marisa Wainszelbaum, Kip West, Sara Mathews, Rachel Nering, Bambang Adiwijaya, Gabriela Garcia, Bill Kubasek, Victor Moyo, Akos Czibere, Ulrik B Nielsen, Gavin MacBeath
The ErbB family of receptor tyrosine kinases comprises four members: epidermal growth factor receptor (EGFR/ErbB1), human EGFR 2 (HER2/ErbB2), ErbB3/HER3, and ErbB4/HER4. The first two members of this family, EGFR and HER2, have been implicated in tumorigenesis and cancer progression for several decades, and numerous drugs have now been approved that target these two proteins. Less attention, however, has been paid to the role of this family in mediating cancer cell survival and drug tolerance. To better understand the complex signal transduction network triggered by the ErbB receptor family, we built a computational model that quantitatively captures the dynamics of ErbB signaling...
2017: NPJ Systems Biology and Applications
https://www.readbyqxmd.com/read/28724363/comparing-patient-and-healthcare-worker-experiences-during-a-dengue-outbreak-in-singapore-understanding-the-patient-journey-and-the-introduction-of-a-point-of-care-test-poct-toward-better-care-delivery
#12
Qinghui Tan, Zoe J-L Hildon, Shweta Singh, Jin Jing, Tun Linn Thein, Richard Coker, Hubertus J M Vrijhoef, Yee Sin Leo
BACKGROUND: In the aftermath of an upsurge in the number of dengue cases in 2013 and 2014, the SD BIOLINE Dengue Duo rapid diagnostic Point-of-Care Test (POCT) kit was introduced in Tan Tock Seng Hospital, Singapore in June 2013. It is known that the success of POCT usage is contingent on its implementation within the health system. We evaluated health services delivery and the Dengue Duo rapid diagnostic test kit application in Singapore from healthcare workers' perspectives and patient experiences of dengue at surge times...
July 19, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28722784/the-universal-collaborative-dynamic-model-of-specialist-and-advanced-nursing-and-midwifery-practice-a-way-forward
#13
Laserina O'Connor, Mary Casey, Rita Smith, Gerard Michael Fealy, Denise O' Brien, Denise O'Leary, Diarmuid Stokes, Martin S McNamara, Mary Ellen Glasgow, Andrew Cashin
BACKGROUND: There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish health care system. AIM: The aim of this study was to inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. DESIGN: A qualitative study was conducted to initiate this important area of inquiry...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28721340/post-intensive-care-syndrome-an-overview
#14
Gautam Rawal, Sankalp Yadav, Raj Kumar
Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28720629/a-group-visit-initiative-improves-advance-care-planning-documentation-among-older-adults-in-primary-care
#15
Hillary D Lum, Rebecca L Sudore, Daniel D Matlock, Elizabeth Juarez-Colunga, Jacqueline Jones, Molly Nowels, Robert S Schwartz, Jean S Kutner, Cari R Levy
INTRODUCTION: Group visits for advance care planning (ACP) may help patients document preferences for decision makers and future care. We assessed the impact of a primary care-based ACP group visit (ACP-GV) intervention on older adults' ACP documentation and why patients participated. METHODS: Older adults (>65 years) in primary care participated in a 2-session ACP-GV intervention that promotes group dynamics, peer-based learning, and goal setting. Charts were reviewed at baseline, 3 months, and 12 months for documentation of decision makers and ACP forms...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28716621/healthcare-professionals-attitudes-about-physician-assisted-death-an-analysis-of-their-justifications-and-the-roles-of-terminology-and-patient-competency
#16
Derek W Braverman, Brian S Marcus, Paul G Wakim, Mark R Mercurio, Gary S Kopf
CONTEXT: Healthcare professionals (HCPs) are crucial to physician-assisted death (PAD) provision. OBJECTIVES: To quantitatively assess the favorability of justifications for or against PAD legalization among HCPs, the effect of the terms "suicide" and "euthanasia" on their views, and their support for three forms of PAD. METHODS: Our questionnaire presented three cases: physician-assisted suicide, euthanasia for a competent patient, and euthanasia for an incompetent patient with an advance directive for euthanasia...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28714427/discrepancy-between-information-provided-and-information-required-by-emergency-physicians-for-long-term-care-patients
#17
Richa Parashar, Shelley McLeod, Don Melady
OBJECTIVES: The primary objective of this study was to identify information included in long-term care (LTC) transfer documentation and to compare it to the information required by local emergency department (ED) physicians to provide optimal care and make decisions for LTC patients. METHODS: A retrospective chart review was conducted for a sample of LTC residents transferred by ambulance to the ED of an academic, tertiary care hospital over a 1-year period. All emergency physicians working at the institution were invited to complete an online questionnaire about information included in LTC transfer documentation and information required by emergency physicians to provide care for LTC patients...
July 17, 2017: CJEM
https://www.readbyqxmd.com/read/28714419/design-of-multi-target-agents-for-the-treatment-of-alzheimer-s-disease-based-on-tacrine
#18
Hongzhi Lin, Qi Li, Kai Gu, Jie Zhu, Xueyang Jiang, Yao Chen, Haopeng Sun
Alzheimer's disease (AD) is one of the most common forms of dementia in elderly people. To date, efficacious therapeutic agent for the treatment of AD is still very limited, so it has long been a challenging and attractive task to discover new anti-AD drugs. Considering the multifactorial nature of AD, recently, the concept of multi-target-directed ligands (MTDLs) has emerged as a new strategy for designing therapeutic agents on AD. MTDLs are believed to exert their effects through simultaneously affecting multiple targets which contribute to etiology of AD...
July 17, 2017: Current Topics in Medicinal Chemistry
https://www.readbyqxmd.com/read/28713683/do-we-really-care-about-incidental-lung-nodules-review-of-atypical-lung-carcinoid-and-a-proposal-for-systematic-patient-follow-up
#19
Henal Motiwala, Itisha Bansal, Pradeep Goyal, Olena Dorokhova, Yogesh Kumar, Thomas D Olsavsky, Albert DiMeo, Nishant Gupta
Atypical lung carcinoids are intermediate-grade neuroendocrine tumors (NETs) with malignant potential. They are often detected incidentally on imaging done for non-related causes, as the patients are frequently asymptomatic. Histopathology is required to confirm the diagnosis with immunohistochemistry (IHC). Due to their indolent nature, these are often diagnosed only in the advanced stages. Treatment options include chemoradiation for widespread disease versus surgery for local or minimally invasive disease...
June 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28713032/psychosocial-rehabilitation-after-war-trauma-with-adaptive-disclosure-design-and-rationale-of-a-comparative-efficacy-trial
#20
Julie D Yeterian, Danielle S Berke, Brett T Litz
BACKGROUND: Posttraumatic stress disorder (PTSD) from warzone exposure is associated with chronic and disabling social and occupational problems. However, functional impairment is rarely assessed or targeted directly in PTSD treatments, which instead focus on symptom reduction. Trauma-related contributors to diminished functioning, including guilt, shame, and anger resulting from morally compromising or loss-based war experiences, are also underemphasized. The goal of this clinical trial is to fill a substantial gap in the treatment of military-related PTSD by testing a modified Adaptive Disclosure (AD) therapy for war-related PTSD stemming from moral injury and traumatic loss focused on improving psychosocial functioning AD...
July 14, 2017: Contemporary Clinical Trials
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