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https://www.readbyqxmd.com/read/28427766/evaluation-of-a-model-of-integrated-care-for-patients-with-chronic-medical-and-psychiatric-illness
#1
Aghaegbulam Uga, Shreedhar Kulkarni, Vineka Heeramun, Kathy Bottum
BACKGROUND: Chronic illnesses are prevalent in general medical and psychiatric practices, causing significant disease burden to care givers and providers. Systems of care that treat individuals with mental illness are often separate from general medical systems of care. OBJECTIVE: This study sought to compare the quality of life, satisfaction with care, and utilization of care in patients with comorbid chronic medical and mental illnesses. METHODS: A total of 64 participants from an integrated medicine and psychiatry clinic (med/psych), were compared with 52 patients from separate internal medicine and psychiatry clinics (within the same institution) for quality of life, satisfaction with care, and utilization of care...
February 20, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#2
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28426447/measles-cases-in-children-requiring-hospital-access-in-an-academic-pediatric-hospital-in-italy-2008-2013
#3
Marta Ciofi Degli Atti, Antonietta Filia, Antonino Bella, Annamaria Sisto, Maria Antonietta Barbieri, Antonino Reale, Massimiliano Raponi
BACKGROUND: The Lazio Region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the Emergency Department (ED) of the largest pediatric hospital in Italy, located in Lazio. METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home, to assess possible determinants of hospital admission...
April 18, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28395373/-patient-education-programs-in-child-and-adolescent-rehabilitation
#4
U de Vries, P Hampel, F Petermann
Comprehensive evidence has been provided for the significant increase in most chronic physical illnesses among children and adolescents. Therefore, early diagnosis and multimodal intervention in childhood and adolescence is required to prevent a chronic course of disease. Thus, patient education is essential for the medical child and adolescent rehabilitation. In particular, in developing asthma, atopic dermatitis and obesity training in the past, a basic consensus on the theory and methodology of patient education has emerged...
April 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28378802/histones-from-avian-erythrocytes-exhibit-antibiofilm-activity-against-methicillin-sensitive-and-methicillin-resistant-staphylococcus-aureus
#5
Megan Rose-Martel, Garima Kulshreshtha, Nahom Ahferom Berhane, Joelle Jodoin, Maxwell T Hincke
Staphylococcus aureus, a human pathogen associated with many illnesses and post-surgical infections, can resist treatment due to the emergence of antibiotic-resistant strains and through biofilm formation. The current treatments for chronic biofilm infections are antibiotics and/or surgical removal of the contaminated medical device. Due to higher morbidity and mortality rates associated with overuse/misuse of antibiotics, alternate treatments are essential. This study reports the antibiofilm activity of avian erythrocyte histones against methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA)...
April 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28356337/-maybe-they-don-t-even-know-that-i-exist-challenges-faced-by-family-members-and-friends-of-patients-with-advanced-kidney-disease
#6
Ann M O'Hare, Jackie Szarka, Lynne V McFarland, Elizabeth K Vig, Rebecca L Sudore, Susan Crowley, Lynn F Reinke, Ranak Trivedi, Janelle S Taylor
BACKGROUND AND OBJECTIVES: Family members and friends of patients with advanced chronic illness are increasingly called on to assist with ever more complex medical care and treatment decisions arising late in the course of illness. Our goal was to learn about the experiences of family members and friends of patients with advanced kidney disease. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: As part of a study intended to identify opportunities to enhance advance care planning, we conducted semistructured interviews at the Veterans Affairs Puget Sound Health Care System with 17 family members and friends of patients with advanced kidney disease...
March 29, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28351944/defining-pediatric-chronic-critical-illness-for-clinical-care-research-and-policy
#7
Miriam C Shapiro, Carrie M Henderson, Nancy Hutton, Renee D Boss
Chronically critically ill pediatric patients represent an emerging population in NICUs and PICUs. Chronic critical illness has been recognized and defined in the adult population, but the same attention has not been systematically applied to pediatrics. This article reviews what is currently known about pediatric chronic critical illness, highlighting the unique aspects of chronic critical illness in infants and children, including specific considerations of prognosis, outcomes, and decision-making. We propose a definition that incorporates NICU versus PICU stays, recurrent ICU admissions, dependence on life-sustaining technology, multiorgan dysfunction, underlying medical complexity, and the developmental implications of congenital versus acquired conditions...
March 28, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28342626/understanding-the-health-care-utilization-of-children-who-require-medical-technology-a-descriptive-study-of-children-who-require-tracheostomies
#8
Regena Spratling
Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28283007/-mortality-related-factors-in-patients-requiring-hospitalization-for-influenza-like-illness
#9
Lale Özışık, Mine Durusu Tanrıöver, Meral Çıblak Akçay, Kübra Yuntçu, Serhat Ünal, Selim Badur, Banu Çakır
The knowledge about the viral etiologies causing respiratory disease in adults is limited. Viral respiratory diseases may lead deterioration in certain patient populations. The aim of this study was to determine the viral etiologies of influenza-like illness among patients requiring hospitalization and to document the risk factors for mortality. This prospective study was performed in one of the 7 centers in Turkey in the context of influenza surveillance by the Global Influenza Hospital Surveillance Network...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28239407/the-greek-orthodox-version-of-the-brief-religious-coping-b-rcope-instrument-psychometric-properties-in-three-samples-and-associations-with-mental-disorders-suicidality-illness-perceptions-and-quality-of-life
#10
Vassiliki Paika, Elias Andreoulakis, Elisavet Ntountoulaki, Dimitra Papaioannou, Konstantinos Kotsis, Vassiliki Siafaka, Konstantinos N Fountoulakis, Kenneth I Pargament, Andre F Carvalho, Thomas Hyphantis
BACKGROUND: The B-RCOPE is a brief measure assessing religious coping. We aimed to assess the psychometric properties of its Greek version in people with and without long-term conditions (LTCs). Associations between religious coping and mental illness, suicidality, illness perceptions, and quality of life were also investigated. METHODS: The B-RCOPE was administered to 351 patients with diabetes, chronic pulmonary obstructive disease (COPD), and rheumatic diseases attending either the emergency department (N = 74) or specialty clinics (N = 302) and 127 people without LTCs...
2017: Annals of General Psychiatry
https://www.readbyqxmd.com/read/28190410/the-effect-of-older-age-on-ems-use-for-transportation-to-an-emergency-department
#11
Courtney M C Jones, Erin B Wasserman, Timmy Li, Ashley Amidon, Marissa Abbott, Manish N Shah
Introduction Previous studies have found that older adults are more likely to use Emergency Medical Services (EMS) than younger adults, but the reasons for this remain understudied. Hypothesis/Problem This study aimed to determine if older age is associated with using EMS for transportation to an emergency department (ED) after controlling for confounding variables. METHODS: A cross-sectional survey study was conducted at a large academic medical center. Data on previous medical history, chief complaint, self-perceived illness severity, demographic information, and mode of arrival to the ED were collected on all subjects...
February 13, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28187736/thrombocytopenia-on-the-first-day-of-emergency-department-visit-predicts-higher-risk-of-acute-kidney-injury-among-elderly-patients
#12
Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang
BACKGROUND: Few studies have addressed risk factors for acute kidney injury (AKI) in geriatric patients. We investigated whether thrombocytopenia was a risk factor for AKI in geriatric patients with medical illnesses. METHODS: A prospective cohort study was conducted, by recruiting elderly (≥65 years) patients who visited the emergency department (ED) for medical illnesses during 2014. They all received hemogram for platelet count determination, and were stratified according to the presence of thrombocytopenia (platelets, <150 K/μL) during their initial ED evaluation...
February 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28169976/the-impact-of-alternative-payment-in-chronically-ill-and-older-patients-in-the-patient-centered-medical-home
#13
Claudia A Salzberg, Asaf Bitton, Stuart R Lipsitz, Cal Franz, Shimon Shaykevich, Lisa P Newmark, Japneet Kwatra, David W Bates
BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change...
May 2017: Medical Care
https://www.readbyqxmd.com/read/28166464/implementation-of-a-pharmacy-consult-to-reduce-co-prescribing-of-opioids-and-benzodiazepines-in-a-veteran-population
#14
Deborah Pardo, Lacey Miller, Dana Chiulli
BACKGROUND: The dangers of co-administration of opioid pain relievers (OPRs) and benzodiazepines (BZDs) are well documented. The combination of OPRs and BZDs make up the majority of medications involved in prescription drug-related overdose and are often used concomitantly. This pattern is consistent among the veteran population where mental health illness and substance abuse are prominent. The Veterans Health Administration implemented the Opioid Safety Initiative (OSI) aimed at improving patient safety surrounding OPRs...
February 6, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28166331/the-illness-experience-of-undocumented-immigrants-with-end-stage-renal-disease
#15
Lilia Cervantes, Stacy Fischer, Nancy Berlinger, Maria Zabalaga, Claudia Camacho, Stuart Linas, Debora Ortega
Importance: The exclusion of undocumented immigrants from Medicare coverage for hemodialysis based on a diagnosis of end-stage renal disease (ESRD) requires physicians in some states to manage chronic illness in this population using emergent-only hemodialysis. Emergent-only dialysis is expensive and burdensome for patients. Objective: To understand the illness experience of undocumented immigrants with ESRD who lack access to scheduled hemodialysis. Design, Setting, and Participants: A qualitative, semistructured, interview study was conducted in a Colorado safety-net hospital from July 1 to December 31, 2015, with 20 undocumented immigrants (hereinafter referred to as undocumented patients) with ESRD and no access to scheduled hemodialysis...
April 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28162841/adherence-to-attention-deficit-hyperactivity-disorder-medication-during-the-transition-to-college
#16
Megan R Schaefer, Alana Resmini Rawlinson, Scott T Wagoner, Steven K Shapiro, Jan Kavookjian, Wendy N Gray
PURPOSE: The present study explores the medication self-management experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) during their transition to young adulthood in college. METHODS: Participants were college freshmen with ADHD prescribed daily medication for their condition. Ten individual interviews were conducted using a semistructured interview script. Measures related to ADHD medication management were also completed. Qualitative data were analyzed via directed content analysis and quantitative data via descriptive statistics...
February 2, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28158200/impact-of-online-patient-reminders-to-improve-asthma-care-a-randomized-controlled-trial
#17
Andrew C Pool, Jennifer L Kraschnewski, Jennifer M Poger, Joshua Smyth, Heather L Stuckey, Timothy J Craig, Erik B Lehman, Chengwu Yang, Christopher N Sciamanna
IMPORTANCE: Asthma is one of the most burdensome chronic illnesses in the US. Despite widespread dissemination of evidence-based guidelines, more than half of the adults with asthma have uncontrolled symptoms. OBJECTIVE: To examine the efficacy of an online tool designed to improve asthma control. DESIGN: 12-month single blind randomized controlled trial of the online tool (Intervention condition, IC) versus an active control tool (CC). SETTING: Patients enrolled in an insurance plan...
2017: PloS One
https://www.readbyqxmd.com/read/28108265/palliative-care-and-parkinson-s-disease-meeting-summary-and-recommendations-for-clinical-research
#18
REVIEW
Benzi M Kluger, Siobhán Fox, Suzanne Timmons, Maya Katz, Nicholas B Galifianakis, Indu Subramanian, Julie H Carter, Miriam J Johnson, Edward W Richfield, David Bekelman, Jean S Kutner, Janis Miyasaki
INTRODUCTION: Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson's disease (PD) and outpatient palliative care services are now offered by several movement disorders centers...
January 11, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28097328/diabetes-outpatient-care-and-acute-complications-before-and-after-high-deductible-insurance-enrollment-a-natural-experiment-for-translation-in-diabetes-next-d-study
#19
J Frank Wharam, Fang Zhang, Emma M Eggleston, Christine Y Lu, Stephen Soumerai, Dennis Ross-Degnan
Importance: High-deductible health plans (HDHPs) have expanded under the Affordable Care Act and are expected to play a major role in the future of US health policy. The effects of modern HDHPs on chronically ill patients and adverse outcomes are unknown. Objective: To determine the association of HDHP with high-priority diabetes outpatient care and preventable acute complications. Design, Setting, and Participants: Controlled interrupted-time-series study using a large national health insurer database from January 1, 2003, to December 31, 2012...
March 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28040411/emergency-department-critical-care-unit-for-critically-ill-cardiovascular-patients-an-observation-study
#20
Ken-Hui Fu, Yin-Ru Chen, Ju-Shin Fan, Yen-Chia Chen, Hsien-Hao Huang, Chorng-Kuang How, David Hung-Tsang Yen, Si-An Chen, Mu-Shun Huang
BACKGROUND: We investigated an intensive care model for acute critically cardiovascular emergency patients in the emergency department (ED) as compared with those in the coronary care unit (CCU) after ED visits. METHODS: We performed a retrospective cohort analysis of patients with acute cardiovascular emergency admitted to the intensive care unit in the ED (EICU) or CCU from January 1, 2010 to March 31, 2011 in an university-affiliated medical center. All clinical characteristics or predictors possibly related to in-hospital mortality were documented, completed, and measured via electronic medical records review...
December 28, 2016: Journal of the Chinese Medical Association: JCMA
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