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https://www.readbyqxmd.com/read/28918604/symptom-experience-of-multiple-myeloma-symmex-patients-treated-with-autologous-stem-cell-transplantation-following-high-dose-melphalan-a-descriptive-longitudinal-study
#1
Matthias Naegele, Monika Kirsch, Gabriele Ihorst, Katharina Fierz, Monika Engelhardt, Sabina De Geest
PURPOSE: High-dose melphalan and autologous stem cell transplantation (ASCT) are associated with high symptom burden. This study aimed to explore multiple myeloma (MM) patients' experience of symptom frequency, intensity, and distress during therapy. METHODS: This descriptive longitudinal study enrolled 29 MM patients who completed the 43-item PROVIVO questionnaire, measuring symptom experience across the dimensions of frequency, intensity, and distress at four assessment points: hospital admission (T0), leucocyte nadir (T1), discharge (T2), and 30 days post discharge (T3)...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28918550/advance-care-planning-challenges-at-the-emergency-department-of-a-cancer-care-center
#2
Maria T Cruz-Carreras, Patrick Chaftari, Jayne Viets-Upchurch
INTRODUCTION: Code status discussions form an important part of advance care planning (ACP) as it enables physicians to respect the patient's wishes for end-of-life care. However, in some cases, code status discussions can be challenging causing the physician to go against the patient's wishes and the code of medical ethics. This is especially true in an emergency setting. In this paper, we will discuss three cases of advanced cancer patients, where code status discussions posed challenges to healthcare providers...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28918412/prediction-of-early-unplanned-intensive-care-unit-readmission-in-a-uk-tertiary-care-hospital-a-cross-sectional-machine-learning-approach
#3
Thomas Desautels, Ritankar Das, Jacob Calvert, Monica Trivedi, Charlotte Summers, David J Wales, Ari Ercole
OBJECTIVES: Unplanned readmissions to the intensive care unit (ICU) are highly undesirable, increasing variance in care, making resource planning difficult and potentially increasing length of stay and mortality in some settings. Identifying patients who are likely to suffer unplanned ICU readmission could reduce the frequency of this adverse event. SETTING: A single academic, tertiary care hospital in the UK. PARTICIPANTS: A set of 3326 ICU episodes collected between October 2014 and August 2016...
September 15, 2017: BMJ Open
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
#4
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/28917611/end-of-life-practice-patterns-at-u-s-adult-cystic-fibrosis-care-centers-a-national-retrospective-chart-review
#5
Elaine Chen, Karen Homa, Jessica Goggin, Kathryn A Sabadosa, Sarah Hempstead, Bruce C Marshall, Albert Faro, Elisabeth P Dellon
BACKGROUND: There are many challenges to providing end-of-life care (EOLC) to people with cystic fibrosis (CF). METHODS: Chart abstraction was used to examine EOLC in adults with CF who died between 2011 and 2013. RESULTS: We reviewed 248 deaths from 71 CF care centers. Median age at death was 29years (range 18-73). While median FEV1 was in the severe lung disease category (FEV1<40%), 38% had mild or moderate lung disease in the year preceding death...
September 13, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28917384/serious-infections-among-a-large-cohort-of-subjects-with-systemically-treated-psoriasis
#6
Allison S Dobry, Charles P Quesenberry, G Thomas Ray, Jamie L Geier, Maryam M Asgari
BACKGROUND: Biologic therapy is effective for treatment of moderate-to-severe psoriasis but may be associated with an increased risk for serious infection. OBJECTIVE: To estimate the serious infection rate among patients with psoriasis treated with biologic as compared with nonbiologic systemic agents within a community-based health care delivery setting. METHODS: We identified 5889 adult Kaiser Permanente Northern California health plan members with psoriasis who had ever been treated with systemic therapies and calculated the incidence rates and 95% confidence intervals (CIs) for serious infections over 29,717 person-years of follow-up...
September 13, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28917359/dance-is-more-than-therapy-qualitative-analysis-on-therapeutic-dancing-classes-for-parkinson-s
#7
Priscila A Rocha, Susan C Slade, Jodie McClelland, Meg E Morris
OBJECTIVES: To understand the benefits and limitations of therapeutic dancing classes for people with Parkinson's disease (PD) and how best to design and implement classes. DESIGN: A stakeholder forum explored the opinions of 18 allied health clinicians, dance instructors, people with PD and caregivers. Data were thematically analysed and interpreted within a grounded theory framework. RESULTS: Four main themes were identified: (1) the need to consider the stage of disease progression when designing classes; (2) recognition that dance is more than just therapy; (3) the benefits of carefully selecting music to move by; (4) ways to design classes that are both feasible and engaging...
October 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28917256/postoperative-stereotactic-body-radiotherapy-for-spinal-metastases
#8
Majed Alghamdi, Chia-Lin Tseng, Sten Myrehaug, Pejman Maralani, Chris Heyn, Hany Soliman, Young Lee, Mark Ruschin, Leodante Da Costa, Victor Yang, Mikki Campbell, Arjun Sahgal
Spine is a common site of metastases in cancer patients. Spine surgery is indicated for select patients, typically those with mechanical instability and/or malignant epidural spinal cord (or cauda equina) compression. Although post-operative conventional palliative external beam radiation therapy has been the standard of care, technical improvements in radiation planning and image-guided radiotherapy have allowed for the application of stereotactic body radiotherapy (SBRT) to the spine. Spine SBRT is intended to ablate residual tumor and optimize local control by delivering several fold greater biologically effective doses...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28916882/evaluating-a-mental-health-program-for-palestinian-refugees-in-lebanon
#9
Nasser Yassin, Asma A Taha, Zeina Ghantous, Mia Malda Atoui, Fabio Forgione
Medecins sans Frontière, an international non-governmental organization, initiated a mental health program for Palestinian refugees living in Lebanon. To evaluate the impact of the program after its completion, focus groups were conducted with three target groups: (1) patients, (2) staff, and (3) local community stakeholders. Participants voiced overall satisfaction with the program. The program provided easy access, good quality care, decreased stigma, as perceived by participants, and revealed a sense of community contentedness...
September 15, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/28916581/optimising-impact-and-sustainability-a-qualitative-process-evaluation-of-a-complex-intervention-targeted-at-compassionate-care
#10
Jackie Bridges, Carl May, Alison Fuller, Peter Griffiths, Wendy Wigley, Lisa Gould, Hannah Barker, Paula Libberton
BACKGROUND: Despite concerns about the degree of compassion in contemporary healthcare, there is a dearth of evidence for health service managers about how to promote compassionate healthcare. This paper reports on the implementation of the Creating Learning Environments for Compassionate Care (CLECC) intervention by four hospital ward nursing teams. CLECC is a workplace educational intervention focused on developing sustainable leadership and work-team practices designed to support team relational capacity and compassionate care delivery...
September 15, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28916246/pre-clinical-toxicology-considerations-for-vaccine-development
#11
REVIEW
Nabil Al-Humadi
Vaccine development requires pre-clinical toxicology studies, following good laboratory practice (GLP), before first in human (phase I) use. Many factors are critical in the final outcome of any pre-clinical toxicology study. The study design is one of these critical factors and should be carefully planned to avoid any false negative and/or false positive results. Preparation is another most critical factor in a successful study. Major changes in any procedure during the course of study should be avoided by all means...
September 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28916237/ethics-and-palliative-care-in-the-perinatal-world
#12
REVIEW
Colleen M Marty, Brian S Carter
The perinatal world is unique in its dutiful consideration of two patients along the lines of decision-making and clinical management - the fetus and the pregnant woman. The potentiality of the fetus-newborn is intertwined with the absolute considerations for the woman as autonomous patient. From prenatal diagnostics, which may be quite extensive, to potential interventions prenatally, postnatal resuscitation, and neonatal management, the fetus and newborn may be anticipated to survive with or without special needs and technology, to have a questionable or guarded prognosis, or to live only minutes to hours...
September 13, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28916216/coronary-artery-bypass-grafting-bundled-payment-proposal-will-have-significant-financial-impact-on-hospitals
#13
Robert B Hawkins, J Hunter Mehaffey, Kenan W Yount, Leora T Yarboro, Clifford Fonner, Irving L Kron, Mohammed Quader, Alan Speir, Jeffrey Rich, Gorav Ailawadi
OBJECTIVES: The Centers for Medicare and Medicaid Services plans to institute a 5-year trial of bundled payments for coronary artery bypass grafting through 90 days after discharge. To investigate the impact, we reviewed actual inpatient costs for patients undergoing bypass surgery relative to the target price. METHODS: A total of 13,276 Medicare patients with estimated cost data underwent isolated coronary artery bypass grafting from 2008 to 2015 in 18 hospitals over 8 Medicare-defined regions within the Commonwealth of Virginia...
July 29, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28916005/massachusetts-child-psychiatry-access-project-2-0-a-case-study-in-child-psychiatry-access-program-redesign
#14
REVIEW
Barry D Sarvet, Marcy Ravech, John H Straus
The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28915890/barriers-and-enablers-for-the-development-and-implementation-of-allied-health-clinical-practice-guidelines-in-south-african-primary-healthcare-settings-a-qualitative-study
#15
J M Dizon, K Grimmer, Q Louw, S Machingaidze, H Parker, H Pillen
BACKGROUND: The South African allied health (AH) primary healthcare (PHC) workforce is challenged with the complex rehabilitation needs of escalating patient numbers. The application of evidence-based care using clinical practice guidelines (CPGs) is one way to make efficient and effective use of resources. Although CPGs are common for AH in high-income countries, there is limited understanding of how to do this in low- to middle-income countries. This paper describes barriers and enablers for AH CPG uptake in South African PHC...
September 15, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28915850/-love-me-parents-impact-evaluation-of-a-national-social-and-behavioral-change-communication-campaign-on-maternal-health-outcomes-in-tanzania
#16
Michelle R Kaufman, Jennifer J Harman, Marina Smelyanskaya, Jennifer Orkis, Robert Ainslie
BACKGROUND: Despite marked improvements over the last few decades, maternal mortality in Tanzania remains among the world's highest at 454 maternal deaths per 100,000 live births. Many factors contribute to this disparity, such as a lack of attendance at antenatal care (ANC) services and low rates of delivery at a health facility with a skilled provider. The Wazazi Nipendeni (Love me, parents) social and behavioral change communication campaign was launched in Tanzania in 2012 to improve a range of maternal health outcomes, including individual birth planning, timely ANC attendance, and giving birth in a healthcare facility...
September 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28915518/-primary-care-in-germany-equal-access-for-everyone
#17
Jan Bauer, Werner Maier, Ruth Müller, David A Groneberg
Background Access to primary care plays an important role in medical care provision in Germany. Therefore, current health care planning aims at providing equal access for every patient in Germany no matter where they live. Objective This study examined accessibility of primary care and compared the result with current primary care planning data. Materials and Methods Spatial accessibility to primary care was measured by the integrated Floating Catchment Area method ("accessibility index") using a geographical information system at the level of square kilometers cells (hectare grid cells for major urban areas)...
September 15, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28914585/planning-future-care-services-analyses-of-investments-in-norwegian-municipalities
#18
Terje P Hagen, Laila Tingvold
AIMS: To analyse whether the Norwegian Central Government's goal of subsidizing 12,000 places in nursing homes or sheltered housing using an earmarked grant was reached and to determine towards which group of users the planned investments were targeted. METHODS: Data from the investment plans at municipal level were provided by the Norwegian Housing Bank and linked to variables describing the municipalities' financial situation as well as variables describing the local needs for services provided by Statistics Norway...
September 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28914385/multiple-sclerosis-and-rehabilitation-an-overview-of-the-different-rehabilitation-settings
#19
Andrea Tacchino, Giampaolo Brichetto, Paola Zaratin, Mario Alberto Battaglia, Michela Ponzio
To date, a lack of accurate information about how the different rehabilitation settings are actually delivered to people with multiple sclerosis (PwMS) is still present. Here, we described how PwMS use the different rehabilitation settings in Italy. An observational retrospective study was designed and data collected through an anonymous questionnaire distributed attending MS clinical centers, rehabilitation units, or among PwMS affiliated to the Italian MS Society. We considered as settings: out-patient ambulatory therapy (OUT), hospitalized therapy (HOSP, in-patient and out-patient hospitalized therapy), and home-based therapy (HOME)...
September 15, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28914187/improving-quality-and-outcomes-of-stroke-care-in-hospitals-protocol-and-statistical-analysis-plan-for-the-stroke123-implementation-study
#20
Dominique A Cadilhac, Nadine E Andrew, Monique F Kilkenny, Kelvin Hill, Brenda Grabsch, Natasha A Lannin, Amanda G Thrift, Craig S Anderson, Geoffrey A Donnan, Sandy Middleton, Rohan Grimley
Rationale The effectiveness of clinician-focused interventions to improve stroke care is uncertain. Aims To determine whether an organizational intervention can improve the quality of stroke care over usual care. Sample size estimates To detect an absolute 10% difference in overall performance (composite outcome), a minimum of 21 hospitals and 843 patients per group was determined. Methods and design Before and after controlled design in hospitals in Queensland, Australia. Intervention Externally facilitated program (StrokeLink) using outreach workshops incorporating clinical performance feedback, patient outcomes (survival, quality of life at 90-180 days), local barrier assessments to best practice care, action planning, and ongoing support...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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