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https://www.readbyqxmd.com/read/28049616/three-decades-of-comprehensive-geriatric-assessment-evidence-coming-from-different-healthcare-settings-and-specific-clinical-conditions
#1
REVIEW
Alberto Pilotto, Alberto Cella, Andrea Pilotto, Julia Daragjati, Nicola Veronese, Clarissa Musacchio, Anna Maria Mello, Giancarlo Logroscino, Alessandro Padovani, Camilla Prete, Francesco Panza
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA...
December 31, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28034774/the-use-of-the-risk-assessment-and-prediction-tool-in-surgical-patients-in-a-bundled-payment-program
#2
James Slover, Kathleen Mullaly, Raj Karia, John Bendo, Patricia Ursomanno, Aubrey Galloway, Richard Iorio, Joseph Bosco
OBJECTIVES: The purpose of this study was to evaluate the relationship between the Risk Assessment and Predictor Tool (RAPT) and patient discharge disposition in an institution participating in bundled payment program for total joint replacement, spine fusion and cardiac valve surgery patients. METHOD: Between April 2014 and April 2015, RAPT scores of 767 patients (535 primary unilateral total joint arthroplasty; 150 cardiac valve replacement; 82 spinal fusions) were prospectively captured...
December 26, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28032558/early-learners-as-health-coaches-for-older-adults-preparing-for-surgery
#3
Jennifer A Kaplan, Zabecca Brinson, Rebecca Hofer, Patricia O'Sullivan, Anna Chang, Helen Horvath, George J Chang, Emily Finlayson
BACKGROUND: Few opportunities exist for early learners to engage in authentic roles on health care teams. In a geriatric optimization clinic for frail high-risk surgical patients, first-year medical and nurse practitioner students were integrated into an interprofessional team as health coaches. MATERIALS AND METHODS: Frail surgical patients with planned operations were referred to a new preoperative optimization clinic to see a geriatrician, occupational, and physical therapists and a nutritionist...
October 20, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#4
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28007756/eular-efort-recommendations-for-management-of-patients-older-than-50%C3%A2-years-with-a-fragility-fracture-and-prevention-of-subsequent-fractures
#5
W F Lems, K E Dreinhöfer, H Bischoff-Ferrari, M Blauth, E Czerwinski, Jap da Silva, A Herrera, P Hoffmeyer, T Kvien, G Maalouf, D Marsh, J Puget, W Puhl, G Poor, L Rasch, C Roux, S Schüler, B Seriolo, U Tarantino, T van Geel, A Woolf, C Wyers, P Geusens
The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients...
December 22, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27994284/assessment-of-ebola-virus-disease-preparedness-in-the-who-south-east-asia-region
#6
Sirenda Vong, Reuben Samuel, Philip Gould, Hammam El Sakka, Bardan J Rana, Vason Pinyowiwat, Supriya Bezbaruah, Roderico Ofrin
OBJECTIVE: To conduct assessments of Ebola virus disease preparedness in countries of the World Health Organization (WHO) South-East Asia Region. METHODS: Nine of 11 countries in the region agreed to be assessed. During February to November 2015 a joint team from WHO and ministries of health conducted 4-5 day missions to Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste. We collected information through guided discussions with senior technical leaders and visits to hospitals, laboratories and airports...
December 1, 2016: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/27991677/a-longitudinal-four-dimensional-computed-tomography-and-cone-beam-computed-tomography-dataset-for-image-guided-radiation-therapy-research-in-lung-cancer
#7
Geoffrey D Hugo, Elisabeth Weiss, William C Sleeman, Salim Balik, Paul J Keall, Jun Lu, Jeffrey F Williamson
PURPOSE: To describe in detail a dataset consisting of serial four-dimensional computed tomography (4DCT) and 4D cone beam CT (4DCBCT) images acquired during chemoradiotherapy of 20 locally-advanced, non-small cell lung cancer patients we have collected at our institution and shared publicly with the research community. ACQUISITION AND VALIDATION METHODS: As part of an NCI-sponsored research study 82 4DCT and 507 4DCBCT images were acquired in a population of 20 locally advanced non-small cell lung cancer patients undergoing radiation therapy...
December 19, 2016: Medical Physics
https://www.readbyqxmd.com/read/27957661/-it-s-been-an-experience-a-life-learning-experience-a-qualitative-study-of-hospitalized-patients-with-substance-use-disorders
#8
Christine M Velez, Christina Nicolaidis, P Todd Korthuis, Honora Englander
BACKGROUND: Individuals with substance use disorders (SUD) have high rates of chronic illness and readmission, yet few are engaged in addiction treatment. Hospitalization may be a reachable moment for initiating and coordinating addiction care, but little is known about motivation for change in the inpatient setting. OBJECTIVE: To explore the experiences of hospitalized adults with SUD and to better understand patient and system level factors impacting readiness for change...
December 12, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27940945/from-care-to-cure-demonstrating-a-model-of-clinical-patient-navigation-for-hepatitis-c-care-and-treatment-in-high-need-patients
#9
Mary M Ford, Nirah Johnson, Payal Desai, Eric Rude, Fabienne Laraque
The NYC Department of Health implemented a patient navigation program, Check Hep C, to address patient and provider barriers to HCV care and potentially lifesaving treatment. Services were delivered at two clinical care sites and two sites that linked patients to off-site care. Working with a multidisciplinary care team, patient navigators provided risk assessment, health education, treatment readiness and medication adherence counseling, and medication coordination. Between March 2014 and January 2015, 388 participants enrolled in Check Hep C, 129 (33%) initiated treatment, and 119 (91% of initiators) had sustained virologic response (SVR)...
December 10, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27940120/integrating-mental-and-physical-health-services-using-a-socio-emotional-trauma-lens
#10
Lauren Dayton, Jen Agosti, Deirdre Bernard-Pearl, Marian Earls, Kate Farinholt, Betsy McAlister Groves, Mark Rains, Barry Sarvet, Holly C Wilcox, Lawrence S Wissow
This article provides a synthesis of the lessons learned from the Pediatric Integrated Care Collaborative (PICC), a SAMHSA-funded project that is part of the National Child Traumatic Stress Network. The high prevalence of trauma exposure in childhood and shortage of mental health services has informed efforts to integrate mental and behavioral health services in pediatric primary care. This article outlines strategies to integrate care following the six goals of the PICC change framework: create a trauma/mental health informed office; involve families in program development; collaborate and coordinate with mental health services; promote resilience and prevent mental health problems through a particular focus on trauma-related risks; assess trauma-related somatic and mental health issues; and address trauma-related somatic and mental heath issues...
December 2016: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/27932017/the-german-and-japanese-health-care-systems-an-international-comparison-using-an-input-output-model
#11
A Rump, O Schöffski
OBJECTIVES: The German and Japanese health care systems have common roots, but have evolved differently. Whereas the German system is often considered as expensive and poorly efficient, people in Japan are viewed as healthy and health care as comparatively cheap. In this study, we compared the quality, the effectiveness and efficiency of the German and Japanese health care systems. STUDY DESIGN: This study includes comparative health care data analysis. METHOD: The quality and effectiveness of the German and Japanese health care systems were analyzed using an input-output model including 12 countries based on health indicators published by the OECD...
December 2016: Public Health
https://www.readbyqxmd.com/read/27931533/care-transition-interventions-for-children-with-asthma-in-the-emergency-department
#12
REVIEW
Molly A Martin, Valerie G Press, Sharmilee M Nyenhuis, Jerry A Krishnan, Kim Erwin, Giselle Mosnaim, Helen Margellos-Anast, S Margaret Paik, Stacy Ignoffo, Michael McDermott
The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many interventions on care transition for pediatric asthma have been tested, only a few were actually conducted in the ED setting. Most of these targeted both care coordination and self-management education but ultimately did not improve attendance at follow-up appointments with primary care providers, improve asthma control, or reduce health care utilization...
December 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27915314/programs-for-detecting-and-treating-retinopathy-of-prematurity-role-of-the-neonatal-team
#13
Sudhanshu Grover, Deeksha Katoch, Mangat R Dogra, Praveen Kumar
High quality perinatal-neonatal care can prevent severe Retinopathy of Prematurity (ROP) in most cases. Preterm infants who do develop retinopathy can also have good visual outcomes if screening and treatment are done timely. National Neonatology Forum published clinical practice guidelines for timely screening and treatment of ROP in neonatal care units in the country in 2010. It is also listed as one of the condition under Rashtriya Bal Swasthya Karyakram for early identification and early intervention, and is currently a focus area under the National Program for Control of Blindness...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27912996/alternative-exercise-traditions-in-cancer-rehabilitation
#14
REVIEW
Kathryn J Ruddy, Daniela L Stan, Anjali Bhagra, Mary Jurisson, Andrea L Cheville
Alternative exercise traditions (AETs) such as Pilates, yoga, Tai Chi Chuan, Qigong, and various forms of dance offer the potential to improve diverse outcomes among cancer survivors by reducing adverse symptoms and mood disorders, and by enhancing function. Additionally AETs have emerged as a potential means to address deficits in current disease-focused care delivery models which are marked by prevalent under-treatment of symptoms and physical impairments. Relative to therapeutic exercise in allopathic models, many AETs are comparatively affordable and accessible...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27911234/ventriculostomy-associated-hemorrhage-a-risk-assessment-by-radiographic-simulation
#15
Faith C Robertson, Muhammad M Abd-El-Barr, Srinivasan Mukundan, William B Gormley
OBJECTIVE Ventriculostomy entry sites are commonly selected by freehand estimation of Kocher's point or approximations from skull landmarks and a trajectory toward the ipsilateral frontal horn of the lateral ventricles. A recognized ventriculostomy complication is intracranial hemorrhage from cortical vessel damage; reported rates range from 1% to 41%. In this report, the authors assess hemorrhagic risk by simulating traditional ventriculostomy trajectories and using CT angiography (CTA) with venography (CTV) data to identify potential complications, specifically from cortical draining veins...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27907013/development-and-implementation-of-the-ebola-traveler-monitoring-program-and-clinical-outcomes-of-monitored-travelers-during-october-may-2015-minnesota
#16
Aaron DeVries, Pamela Talley, Kristin Sweet, Susan Kline, Patricia Stinchfield, Pritish Tosh, Richard Danila
BACKGROUND: In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians...
2016: PloS One
https://www.readbyqxmd.com/read/27906788/ds02r1-improvements-to-atomic-bomb-survivors-input-data-and-implementation-of-dosimetry-system-2002-ds02-and-resulting-changes-in-estimated-doses
#17
H M Cullings, E J Grant, S D Egbert, T Watanabe, T Oda, F Nakamura, T Yamashita, H Fuchi, S Funamoto, K Marumo, R Sakata, Y Kodama, K Ozasa, K Kodama
Individual dose estimates calculated by Dosimetry System 2002 (DS02) for the Life Span Study (LSS) of atomic bomb survivors are based on input data that specify location and shielding at the time of the bombing (ATB). A multi-year effort to improve information on survivors' locations ATB has recently been completed, along with comprehensive improvements in their terrain shielding input data and several improvements to computational algorithms used in combination with DS02 at RERF. Improvements began with a thorough review and prioritization of original questionnaire data on location and shielding that were taken from survivors or their proxies in the period 1949-1963...
January 2017: Health Physics
https://www.readbyqxmd.com/read/27884801/effect-of-flexible-duty-hour-policies-on-length-of-stay-for-complex-intra-abdominal-operations-a-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial-analysis
#18
Jonah J Stulberg, Emily S Pavey, Mark E Cohen, Clifford Y Ko, David B Hoyt, Karl Y Bilimoria
BACKGROUND: Changes to resident duty hour policies in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial could impact hospitalized patients' length of stay (LOS) by altering care coordination. Length of stay can also serve as a reflection of all complications, particularly those not captured in the FIRST trial (eg pneumothorax from central line). Programs were randomized to either maintaining current ACGME duty hour policies (standard arm) or more flexible policies waiving rules on maximum shift lengths and time off between shifts (flexible arm)...
November 21, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27879074/s1-guidelines-on-the-diagnosis-and-treatment-of-scabies-short-version
#19
Cord Sunderkötter, Hermann Feldmeier, Regina Fölster-Holst, Bertram Geisel, Sabine Klinke-Rehbein, Alexander Nast, Sandra Philipp, Bernhardt Sachs, Julia Stingl, Johanna Stoevesandt, Henning Hamm
The goals of this German guideline are the improvement of diagnosis and therapy of scabies, the implementation of a coordinated action in outbreaks of scabies, and the control of this infestation in large migration or refugee flows.Sarcoptes scabiei var. hominis is transmitted by direct skin-to-skin contact of sufficient duration. The infectivity of female mites when removed from patients does not exceed 48 hours at room temperature (21°C) and relative humidity of 40-80%. The risk of infection rises proportionally to the number of mites on the skin and is particularly high in crusted scabies...
November 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27876403/characterizing-the-high-risk-homebound-patients-in-need-of-nurse-practitioner-co-management
#20
Masha G Jones, Katherine A Ornstein, David M Skovran, Theresa A Soriano, Linda V DeCherrie
By providing more frequent provider visits, prompt responses to acute issues, and care coordination, nurse practitioner (NP) co-management has been beneficial for the care of chronically ill older adults. This paper describes the homebound patients with high symptom burden and healthcare utilization who were referred to an NP co-management intervention and outlines key features of the intervention. We compared demographic, clinical, and healthcare utilization data of patients referred for NP co-management within a large home-based primary care (HBPC) program (n = 87) to patients in the HBPC program not referred for co-management (n = 1027)...
November 19, 2016: Geriatric Nursing
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