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Quality in health management

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https://www.readbyqxmd.com/read/28351116/management-of-people-with-early-or-very-early-stage-hepatocellular-carcinoma-an-attempted-network-meta-analysis
#1
REVIEW
Avik Majumdar, Davide Roccarina, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Hepatocellular carcinoma (primary liver cancer) is classified in many ways. The Barcelona Clinic Liver Cancer (BCLC) group staging classifies the cancer based on patient's life expectancy. People with very early- or early-stage hepatocellular carcinoma have single tumour or three tumours of maximum diameter of 3 cm or less, Child-Pugh status A to B, and performance status 0 (fully functional). Management of hepatocellular carcinoma is uncertain. OBJECTIVES: To assess the comparative benefits and harms of different interventions used in the treatment of early or very early hepatocellular carcinoma through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#2
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28346519/views-of-senior-health-personnel-about-quality-of-emergency-obstetric-care-a-qualitative-study-in-nigeria
#3
Friday Okonofua, Abdullahi Randawa, Rosemary Ogu, Kingsley Agholor, Ola Okike, Rukayat Adeola Abdus-Salam, Mohammed Gana, Eghe Abe, Adetoye Durodola, Hadiza Galadanci
BACKGROUND: Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care. OBJECTIVES: To determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria...
2017: PloS One
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#4
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28345890/relationship-of-microbiota-and-cyanobacterial-secondary-metabolites-in-planktothricoides-dominated-bloom
#5
Shu Harn Te, Boon Fei Tan, Janelle Renee Thompson, Karina Yew-Hoong Gin
Identification of phytoplankton species and microbial biodiversity is necessary to assess water ecosystem health and the quality of water resources. We investigated the short-term (2 days) vertical and diel variations in bacterial community structure and microbially-derived secondary metabolites during a cyanobacterial bloom that emerged in a highly urbanized tropical reservoir. The waterbody was largely dominated by the cyanobacteria Planktothricoides spp., together with the Synechococcus, Pseudanabaena, Prochlorothrix and Limnothrix...
March 27, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28345437/clinical-profile-dosing-and-quality-of-life-outcomes-in-primary-immune-deficiency-patients-treated-at-home-with-immunoglobulin-g-data-from-the-ideal-patient-registry
#6
Sean Kearns, Loretta Kristofek, William Bolgar, Luqman Seidu, Samantha Kile
BACKGROUND: Patients with primary immune deficiency (PID) often require immunoglobulin G (IgG, commonly referred to as Ig) replacement therapy to prevent infections and associated comorbidities. Ig therapy can be given either through intravenous or subcutaneous routes, and both can be done in the home setting. There is limited information available on the real-world diagnosis, management, and outcomes of this patient population, given the variable disease presentation and treatment options...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345406/evaluation-of-the-quality-accuracy-and-readability-of-online-patient-resources-for-the-management-of-articular-cartilage-defects
#7
Dean Wang, Rohit G Jayakar, Natalie L Leong, Michael P Leathers, Riley J Williams, Kristofer J Jones
Objective Patients commonly use the Internet to obtain their health-related information. The purpose of this study was to investigate the quality, accuracy, and readability of online patient resources for the management of articular cartilage defects. Design Three search terms ("cartilage defect," "cartilage damage," "cartilage injury") were entered into 3 Internet search engines (Google, Bing, Yahoo). The first 25 websites from each search were collected and reviewed. The quality and accuracy of online information were independently evaluated by 3 reviewers using predetermined scoring criteria...
April 2017: Cartilage
https://www.readbyqxmd.com/read/28344764/atypical-antipsychotics-recent-research-findings-and-applications-to-clinical-practice-proceedings-of-a-symposium-presented-at-the-29th-annual-european-college-of-neuropsychopharmacology-congress-19-september-2016-vienna-austria
#8
REVIEW
Robin Murray, Christoph U Correll, Gavin P Reynolds, David Taylor
Available evidence suggests that second-generation atypical antipsychotics are broadly similar to first-generation agents in terms of their efficacy, but may have a more favourable tolerability profile, primarily by being less likely to cause extrapyramidal symptoms. However, atypical antipsychotics are variably associated with disturbances in the cardiometabolic arena, including increased body weight and the development of metabolic syndrome, which may reflect differences in their receptor binding profiles...
March 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28343935/blood-derived-products-in-pediatrics-new-laboratory-tools-for-optimizing-potency-assignment-and-reducing-side-effects
#9
REVIEW
Jean Amiral, Jerard Seghatchian
Neonates and children can develop rare bleeding disorders due to congenital/acquired coagulation Factor deficiencies, or allo-immune/autoimmune complications, or can undergo surgeries at high haemorrhagic risk. They then need specialized transfusion of blood components/products, or purified blood extracted products or recombinant proteins. Blood-derived therapies conventionally used for management of affected infants with genetic/acquired deficiencies, bleeding problems (coagulation Factor reduced or missing) or thrombotic disorders (reduced or missing anticoagulant proteins) pose some additional risks...
March 15, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28343440/early-interventions-to-promote-work-participation-in-people-with-regional-musculoskeletal-pain-a-systematic-review-and-meta-analysis
#10
Andy Cochrane, Niamh M Higgins, Oliver FitzGerald, Pamela Gallagher, Jennifer Ashton, Oriel Corcoran, Deirdre Desmond
OBJECTIVES: To determine the effectiveness of early multidisciplinary interventions in promoting work participation and reducing work absence in adults with regional musculoskeletal pain. DATA SOURCES: Seven databases (CENTRAL, CINAHL, EMBASE, MEDLINE, Scopus, OT Seeker, PEDro; 1990 to December 2016) were searched for eligible studies. REVIEW METHODS: Trials were included if they reported on work-based outcomes for participants experiencing difficulties at work or ≤ three months' sick leave...
March 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28342990/telephone-adapted-mindfulness-based-stress-reduction-tmbsr-for-patients-awaiting-kidney-transplantation
#11
Cynthia R Gross, Maryanne Reilly-Spong, Taehwan Park, Ruizhi Zhao, Olga V Gurvich, Hassan N Ibrahim
BACKGROUND: Patients with progressive kidney disease experience increasing physiologic and psychosocial stressors and declining health-related quality of life (HRQOL). METHODS: We conducted a randomized, active-controlled, open-label trial to test whether a Mindfulness-based Stress Reduction (MBSR) program delivered in a novel workshop-teleconference format would reduce symptoms and improve HRQOL in patients awaiting kidney transplantation. Sixty-three transplant candidates were randomized to one of two arms: i) telephone-adapted MBSR (tMBSR, an 8-week program of meditation and yoga); or ii) a telephone-based support group (tSupport)...
March 22, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28342891/cost-utility-of-group-acceptance-and-commitment-therapy-for-fibromyalgia-versus-recommended-drugs-an-economic-analysis-alongside-a-6-month-randomised-controlled-trial-conducted-in-spain-effigact-study
#12
Juan V Luciano, Francesco D'Amico, Albert Feliu-Soler, Lance M McCracken, Jaume Aguado, María T Peñarrubia-María, Martin Knapp, Antoni Serrano-Blanco, Javier García-Campayo
The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively...
March 22, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28342675/the-digital-heart-manual-a-pilot-study-of-an-innovative-cardiac-rehabilitation-programme-developed-for-and-with-users
#13
C Deighan, L Michalova, C Pagliari, J Elliott, L Taylor, H Ranaldi
OBJECTIVE: Patients are seeking greater choice and flexibility in how they engage with self-management programmes. While digital innovations offer opportunities to deliver supportive interventions to patients undergoing cardiac rehabilitation little is known about how accessible, useful and acceptable they are for this group. This project developed a digital version of a leading evidenced cardiac rehabilitation programme, the Heart Manual (HM). The prototype was developed and evaluated iteratively in collaboration with end users...
March 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28342599/concentrate-supplementation-of-a-diet-based-on-medium-quality-grass-silage-for-4-weeks-prepartum-effects-on-cow-performance-health-metabolic-status-and-immune-function
#14
M W Little, N E O'Connell, M D Welsh, F J Mulligan, C P Ferris
Because negative energy balance (EB) contributes to transition-period immune dysfunction in dairy cows, dietary management strategies should aim to minimize negative EB during this time. Prepartum diets that oversupply energy may exacerbate negative EB in early lactation, with detrimental effects on immune function. However, with lower body condition score (BCS) cows, it has been shown that offering concentrates in addition to a grass silage-based diet when confined during an 8-wk dry period resulted in increased neutrophil function in early lactation...
March 22, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28341615/design-and-usability-of-a-heart-failure-mhealth-system-a-pilot-study
#15
Nagla Alnosayan, Samir Chatterjee, Ala Alluhaidan, Edward Lee, Linda Houston Feenstra
BACKGROUND: Despite the advances in mobile health (mHealth) systems, little is known about patients' and providers' experiences using a new mHealth system design. OBJECTIVE: This study aimed to understand challenges and provide design considerations for a personalized mHealth system that could effectively support heart failure (HF) patients after they transition into the home environment. METHODS: Following exploratory interviews with nurses and preventive care physicians, an mHealth system was developed...
March 24, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28341524/a-clinical-care-algorithmic-toolkit-for-promoting-screening-and-next-level-assessment-of-pediatric-depression-and-anxiety-in-primary-care
#16
Lisa Honigfeld, Susan J Macary, Damion J Grasso
With a documented shortage in youth mental health services, pediatric primary care (PPC) providers face increased pressure to enhance their capacity to identify and manage common mental health problems among youth, such as anxiety and depression. Because 90% of U.S. youth regularly see a PPC provider, the primary care setting is well positioned to serve as a key access point for early identification, service provision, and connection to mental health services. In the context of task shifting, we evaluated a quality improvement project designed to assist PPC providers in overcoming barriers to practice-wide mental health screening through implementing paper and computer-assisted clinical care algorithms...
March 21, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28341473/pneumonia-after-cardiac-surgery-experience-of-the-national-institutes-of-health-canadian-institutes-of-health-research-cardiothoracic-surgical-trials-network
#17
Gorav Ailawadi, Helena L Chang, Patrick T O'Gara, Karen O'Sullivan, Y Joseph Woo, Joseph J DeRose, Michael K Parides, Vinod H Thourani, Sophie Robichaud, A Marc Gillinov, Wendy C Taddei-Peters, Marissa A Miller, Louis P Perrault, Robert L Smith, Lyn Goldsmith, Keith A Horvath, Kristen Doud, Kim Baio, Annetine C Gelijns, Alan J Moskowitz, Emilia Bagiella, John H Alexander, Alexander Iribarne
RATIONALE: Pneumonia remains the most common major infection after cardiac surgery despite numerous preventive measures. OBJECTIVES: To prospectively examine the timing, pathogens, and risk factors, including modifiable management practices, for postoperative pneumonia and estimate its impact on clinical outcomes. METHODS: A total of 5158 adult cardiac surgery patients were enrolled prospectively in a cohort study across 10 centers. All infections were adjudicated by an independent committee...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28341194/outcomes-of-open-staged-corrective-surgery-in-the-setting-of-adult-spinal-deformity
#18
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Breton Line, Bassel Diebo, Paul Park, Robert Hart, Douglas Burton, Frank Schwab, Virginie Lafage, Shay Bess, Thomas Errico
BACKGROUND CONTEXT: Adult spinal deformity (ASD) represents a constellation of complex mal-alignments affecting the spinal column. Corrective surgical procedures aimed at improving ASD can be equally challenging, and commonly require multiple index procedures and potential revisions prior to definitive management. There is a paucity of data comparing the outcomes of same-day (simultaneous) and two-day (staged) procedures for long spinal-fusions for ASD. Utilizing a large patient cohort with surgeon and patient-reported outcomes will be particularly useful in determining the utility and effect of staging long spine fusions for ASD...
March 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28340888/veterinary-aspects-of-bird-of-prey-reproduction
#19
REVIEW
Tom A Bailey, Michael Lierz
Captive breeding has contributed to successful restoration of many species of birds of prey. Avicultural techniques pioneered by raptor breeders include double clutching, direct fostering, cross-fostering, hatch and switch, hacking, imprinting male and female falcons for semen collection, and artificial insemination techniques. However, reproductive failure occurs related to management problems, including hygiene measures, food quality issues, breeding flock structure, or individual health issues of breeding birds...
May 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28340625/habit-training-versus-habit-training-with-direct-visual-biofeedback-in-adults-with-chronic-constipation-study-protocol-for-a-randomised-controlled-trial
#20
Christine Norton, Anton Emmanuel, Natasha Stevens, S Mark Scott, Ugo Grossi, Sybil Bannister, Sandra Eldridge, James M Mason, Charles H Knowles
BACKGROUND: Constipation affects up to 20% of adults. Chronic constipation (CC) affects 1-2% of adults. Patient dissatisfaction is high; nearly 80% feel that laxative therapy is unsatisfactory and symptoms have significant impact on quality of life. There is uncertainty about the value of specialist investigations and whether equipment-intensive therapies using biofeedback confer additional benefit when compared with specialist conservative advice. METHODS/DESIGN: A three-arm, parallel-group, multicentre randomised controlled trial...
March 24, 2017: Trials
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