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https://www.readbyqxmd.com/read/28916153/improving-provision-of-care-for-long-term-survivors-of-lymphoma
#1
REVIEW
Sabino Ciavarella, Carla Minoia, Angela Maria Quinto, Stefano Oliva, Santa Carbonara, Claudia Cormio, Maria Christina Cox, Elena Bravo, Filippo Santoro, Mariarosaria Napolitano, Michele Spina, Giacomo Loseto, Attilio Guarini
The progressive improvement of lymphoma therapies has led to a significant prolongation of patient survival and life expectancy. However, lymphoma survivors are at high risk of experiencing a range of early and late adverse effects associated with the extent of treatment exposure. Among these, second malignancies and cardiopulmonary diseases can be fatal, and neurocognitive dysfunction, endocrinopathy, muscle atrophy, and persistent fatigue can affect patients' quality of life for decades after treatment. Early recognition and reduction of risk factors and proper monitoring and treatment of these complications require well-defined follow-up criteria, close coordination among specialists of different disciplines, and a tailored model of survivorship care...
August 17, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28915657/the-prevalence-subtypes-and-associated-factors-of-hyperuricemia-in-lupus-nephritis-patients-at-chronic-kidney-disease-stages-1-3
#2
Simeng Liu, Yijun Gong, Hong Ren, Wen Zhang, Xiaonong Chen, Tong Zhou, Xiao Li, Nan Chen
There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there's a dearth of research on HUA's prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28903951/managing-problematic-severe-asthma-beyond-the-guidelines
#3
REVIEW
Katharine C Pike, Mark L Levy, John Moreiras, Louise Fleming
This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management...
September 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#4
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28899444/use-of-implementation-science-for-a-sustained-reduction-of-central-line-associated-bloodstream-infections-in-a-high-volume-regional-burn-unit
#5
Geeta Sood, Julie Caffrey, Kelly Krout, Zeina Khouri-Stevens, Kevin Gerold, Stefan Riedel, Janet McIntyre, Lisa L Maragakis, Renee Blanding, Jonathan Zenilman, Richard Bennett, Peter Pronovost
OBJECTIVE We describe the use of implementation science at the unit level and organizational level to guide an intervention to reduce central-line-associated bloodstream infections (CLABSIs) in a high-volume, regional, burn intensive care unit (BICU). DESIGN A single center observational quasi-experimental study. SETTING A regional BICU in Maryland serving 300-400 burn patients annually. INTERVENTIONS In 2011, an organizational-level and unit-level intervention was implemented to reduce the rates of CLABSI in a high-risk patient population in the BICU...
September 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28887348/population-health-management-in-a-small-health-system-impact-of-controlled-substance-stewardship-in-a-patient-centered-medical-home
#6
Felicity A E Homsted, Chelsea E Magee, Noah Nesin
PURPOSE: The success of a patient-centered medical home in providing population health management (PHM) services through controlled substance stewardship is described. SUMMARY: In 2013, Penobscot Community Health Care (PCHC), in Bangor, Maine, was fully engulfed in the prescription opioid crisis. At PCHC, patients' opioid doses were startlingly high. Within the organization, measures to ensure that prescriptions were being used as prescribed, and not diverted, were underutilized...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28886056/development-and-feasibility-of-inlife-a-pilot-study-of-an-online-social-support-intervention-for-informal-caregivers-of-people-with-dementia
#7
Alieske E H Dam, Martin P J van Boxtel, Nico Rozendaal, Frans R J Verhey, Marjolein E de Vugt
BACKGROUND: Informal caregivers of individuals with dementia have an increased risk to face social isolation due to progression of the disease. Online social media interventions might offer a new opportunity to increase access to social support and enhance positive interactions and openness in dementia care networks. OBJECTIVE: This explorative pilot study describes (1) the development of an online social support intervention Inlife, and (2) the evaluation of the feasibility of this intervention and the measurements to assess its effectiveness...
2017: PloS One
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#8
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28845723/pelvic-floor-muscle-function-and-urinary-incontinence-in-the-female-athlete
#9
Ellen K Casey, Kate Temme
Urinary incontinence, defined as involuntary leakage of urine, is often considered a disorder of post-partum and post-menopausal women. However, this disorder is not exclusive to older women, as recent research has demonstrated a high prevalence of urinary incontinence among young, nulliparous female athletes. In fact, females participating in repetitive, high-impact sports are at the highest risk for urinary incontinence. In these athletes, the absence of sufficient pelvic floor strength and coordination to withstand sport related increases in intra-abdominal pressure results in physical activity related urinary incontinence, and may be a predictor of urinary incontinence in later adulthood...
September 5, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28845354/identifying-and-coordinating-care-for-complex-patients-findings-from-the-leading-edge-of-analytics-and-health-information-technology
#10
Robert S Rudin, Courtney A Gidengil, Zachary Predmore, Eric C Schneider, James Sorace, Rachel Hornstein
In the United States, a relatively small proportion of complex patients---defined as having multiple comorbidities, high risk for poor outcomes, and high cost---incur most of the nation's health care costs. Improved care coordination and management of complex patients could reduce costs while increasing quality of care. However, care coordination efforts face multiple challenges, such as segmenting populations of complex patients to better match their needs with the design of specific interventions, understanding how to reduce spending, and integrating care coordination programs into providers' care delivery processes...
June 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/28845339/avoiding-the-tragedy-of-the-commons-in-health-care-policy-options-for-covering-high-cost-cures
#11
Soeren Mattke, Hangsheng Liu, Emily Hoch, Andrew W Mulcahy
In this article, Mattke and his colleagues discuss the risk that strategic behavior by health insurers could unravel the market for curative therapies for chronic diseases. Because the cost of these cures is front-loaded but the benefits accrue over time, insurers might attempt to delay treatment or avoid patients who require it, in the hope that they might change insurers. The authors discuss policy options to remedy this potential free-rider problem through alignment of incentives at the patient level, coordination among payers, and government intervention...
January 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/28835321/managing-chronic-conditions-care-across-primary-care-and-hospital-systems-lessons-from-an-australian-hospital-avoidance-risk-program-using-the-flinders-chronic-condition-management-program
#12
Sharon Lawn, Sara Zabeen, David Smith, Ellen Wilson, Cathie Miller, Malcolm Battersby, Kevin Masman
Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health's Hospital Admission Risk Program (HARP).Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables...
August 24, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#13
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807893/optimizing-the-use-of-electronic-health-records-to-identify-high-risk-psychosocial-determinants-of-health
#14
Nicolas Michel Oreskovic, Jennifer Maniates, Jeffrey Weilburg, Garry Choy
BACKGROUND: Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data. However, not all clinically relevant data reside in claims and formatted data. Recently, there has been increasing interest in including patients with complex psychosocial determinants of health in care coordination programs. Psychosocial risk factors, including social determinants of health, mental health disorders, and substance abuse disorders, are less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data, and due to US Health Insurance Portability and Accountability Act (HIPAA) regulations are often not available as claims data...
August 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#15
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
July 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28797017/how-do-social-capital-and-hiv-aids-outcomes-geographically-cluster-and-which-sociocontextual-mechanisms-predict-differences-across-clusters
#16
Yusuf Ransome, Lorraine T Dean, Natalie D Crawford, David S Metzger, Michael B Blank, Amy S Nunn
BACKGROUND: Place of residence has been associated with HIV transmission risks. Social capital, defined as features of social organization that improve efficiency of society by facilitating coordinated actions, often varies by neighborhood, and hypothesized to have protective effects on HIV care continuum outcomes. We examined whether the association between social capital and 2 HIV care continuum outcomes clustered geographically and whether sociocontextual mechanisms predict differences across clusters...
September 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28792062/housing-and-child-well-being-implications-for-research-policy-and-practice
#17
Patrick J Fowler, Anne F Farrell
Inadequate housing and homelessness represent significant barriers to family stability and child development. An accumulating body of evidence documents the relatively high risk of family separation among families experiencing housing instability and homelessness, the extent of housing problems experienced by families involved in the child welfare system, and the disproportionately high rates of homelessness among youth aging out of foster care. Vulnerable youth and families interact frequently with various social service programs intended to mitigate multifaceted and multilevel risks, however, systems efforts and resources are rarely coordinated and results to date are mixed...
August 9, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28777799/implementation-of-a-diabetes-in-pregnancy-clinical-register-in-a-complex-setting-findings-from-a-process-evaluation
#18
Renae Kirkham, Cherie Whitbread, Christine Connors, Elizabeth Moore, Jacqueline A Boyle, Richa Richa, Federica Barzi, Shu Li, Michelle Dowden, Jeremy Oats, Chrissie Inglis, Margaret Cotter, Harold D McIntyre, Marie Kirkwood, Paula Van Dokkum, Stacey Svenson, Paul Zimmet, Jonathan E Shaw, Kerin O'Dea, Alex Brown, Louise Maple-Brown
BACKGROUND: Rates of diabetes in pregnancy are disproportionately higher among Aboriginal than non-Aboriginal women in Australia. Additional challenges are posed by the context of Aboriginal health including remoteness and disadvantage. A clinical register was established in 2011 to improve care coordination, and as an epidemiological and quality assurance tool. This paper presents results from a process evaluation identifying what worked well, persisting challenges and opportunities for improvement...
2017: PloS One
https://www.readbyqxmd.com/read/28774291/health-service-changes-to-address-diabetes-in-pregnancy-in-a-complex-setting-perspectives-of-health-professionals
#19
R Kirkham, J A Boyle, C Whitbread, M Dowden, C Connors, S Corpus, L McCarthy, J Oats, H D McIntyre, E Moore, K O'Dea, A Brown, L Maple-Brown
BACKGROUND: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional's perceptions of models of care and related quality improvement activities since the implementation of the Partnership...
August 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28762882/acute-pesticide-related-illness-among-farmworkers-barriers-to-reporting-to-public-health-authorities
#20
Joanne Bonnar Prado, Prakash R Mulay, Edward J Kasner, Heidi K Bojes, Geoffrey M Calvert
Farmworkers are at high risk of acute occupational pesticide-related illness (AOPI) and AOPI surveillance is vital to preventing these illnesses. Data on such illnesses are collected and analyzed to identify high-risk groups, high-risk pesticides, and root causes. Interventions to address these risks and root causes include farmworker outreach, education, and regulation. Unfortunately, it is well known that AOPI is underreported, meaning that the true burden of this condition remains unknown. This article reviews the barriers to reporting of farmworker AOPI to public health authorities and provides some practical solutions...
2017: Journal of Agromedicine
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