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https://www.readbyqxmd.com/read/28107264/readmission-and-late-mortality-after-critical-illness-in-childhood
#1
Mary E Hartman, Mohammed J Saeed, Tellen Bennett, Katri Typpo, Renee Matos, Margaret A Olsen
OBJECTIVES: Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. DESIGN: Retrospective observational cohort study. SETTING: This study was performed using administrative claims data from 2006-2013 obtained from the Truven Health Analytics MarketScan Database...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28106518/a-case-report-cornerstone-health-care-reduced-the-total-cost-of-care-through-population-segmentation-and-care-model-redesign
#2
Dale E Green, Bruce H Hamory, Grace E Terrell, Jasmine O'Connell
Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28104694/patient-perceptions-of-continuity-of-health-care-and-associated-factors-cross-sectional-study-in-municipalities-of-central-colombia-and-north-eastern-brazil
#3
Ingrid Vargas, Irene Garcia-Subirats, Amparo Susana Mogollón-Pérez, Pierre De Paepe, Maria Rejane Ferreira da Silva, Jean-Pierre Unger, M B Aller, María Luisa Vázquez
Despite the fragmentation of healthcare provision being considered one of the main obstacles to attaining effective health care in Latin America, very little is known about patients' perceptions. This paper analyses the level of continuity of health care perceived by users and explores influencing factors in two municipalities of Colombia and Brazil, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had suffered at least one health problem within the previous three months (2163 in Colombia; 2167 in Brazil)...
January 18, 2017: Health Policy and Planning
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
#4
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...
January 9, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28096029/nurses-perspectives-of-a-new-individualized-nursing-care-intervention-for-copd-patients-in-primary-care-settings-a-mixed-method-study
#5
Saskia W M Weldam, Jan-Willem J Lammers, Marieke Zwakman, Marieke J Schuurmans
BACKGROUND: The major challenges in Chronic Obstructive Pulmonary Disease (COPD) care are guiding a patient in daily living with the consequences of the disease, reducing the impact of symptoms and improving Health Related Quality of Life (HRQoL). The new nurse-led COPD-Guidance, Research on an Illness Perception (COPD-GRIP) intervention translates the evidence concerning illness perceptions and Health Related Quality of Life (HRQoL) into a practice nurse intervention. The aim is to explore the nurses' experiences with applying the new COPD-GRIP intervention...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095832/cost-effectiveness-of-using-a-motion-sensor-biofeedback-treatment-approach-for-the-management-of-sub-acute-or-chronic-low-back-pain-economic-evaluation-alongside-a-randomised-trial
#6
Terry Haines, Kelly-Ann Bowles
BACKGROUND: Low back pain is a common and costly condition internationally. There is high need to identify effective and economically efficient means for managing this problem. This study aimed to explore the cost-effectiveness of a novel motion-sensor biofeedback treatment approach in addition to guidelines-based care compared to guidelines-based care alone, from a societal perspective over a 12 month time horizon. METHOD: This was an incremental cost-effectiveness analysis conducted concurrently with a pilot, cluster randomized controlled trial...
January 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28095706/translation-and-pilot-testing-of-a-measure-to-assess-hypertension-self-care-activities-among-hispanics
#7
Jan Warren-Findlow, Maren J Coffman, Celia A Karp
OBJECTIVE: Hispanics in the US have high rates of uncontrolled hypertension in comparison to non-Hispanic whites. This pilot study reports on the translation of a validated measure, the Hypertension Self-Care Activity Level Effects (H-SCALE), for use with Spanish speakers. The H-SCALE assesses Hispanics' adherence to lifestyle activities that contribute to primary and secondary risk reduction of high blood pressure. DESIGN: Cross-sectional data were collected from Hispanic primary care patients attending a free health clinic in Charlotte, NC...
January 17, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28094172/interval-changes-in-myocardial-performance-index-predict-outcome-in-severe-sepsis
#8
Junaid Nizamuddin, Feroze Mahmood, Avery Tung, Ariel Mueller, Samuel M Brown, Shahzad Shaefi, Michael O'Connor, Daniel Talmor, Sajid Shahul
OBJECTIVES: Septic cardiomyopathy is a well-described consequence of septic shock and is associated with increased sepsis-related mortality. The myocardial performance index (MPI), a parameter derived from echocardiographic tissue Doppler measurements, allows for a more sensitive assessment of global cardiac function than do traditional metrics for cardiac function. The authors hypothesized that changes in left ventricular MPI in patients with severe sepsis would be associated with a higher 90-day mortality...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28093430/development-and-validation-of-a-prediction-model-for-gestational-hypertension-in-a-ghanaian-cohort
#9
Edward Antwi, Rolf H H Groenwold, Joyce L Browne, Arie Franx, Irene A Agyepong, Kwadwo A Koram, Kerstin Klipstein-Grobusch, Diederick E Grobbee
OBJECTIVE: To develop and validate a prediction model for identifying women at increased risk of developing gestational hypertension (GH) in Ghana. DESIGN: A prospective study. We used frequencies for descriptive analysis, χ(2) test for associations and logistic regression to derive the prediction model. Discrimination was estimated by the c-statistic. Calibration was assessed by calibration plot of actual versus predicted probability. SETTING: Primary care antenatal clinics in Ghana...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092419/improving-access-to-health-care-for-chronic-hepatitis-b-among-migrant-chinese-populations-a-systematic-mixed-methods-review-of-barriers-and-enablers
#10
Alicia Vedio, Eva Zhi Hong Liu, Andrew Ck Lee, Sarah Salway
Migrant Chinese populations in Western countries have a high prevalence of chronic hepatitis B but often experience poor access to healthcare and late diagnosis. This systematic review aimed to identify obstacles and supports to timely and appropriate health service use among these populations. Systematic searches resulted in 48 relevant studies published between 1996 and 2015. Data extraction and synthesis were informed by models of healthcare access that highlight the interplay of patient, provider and health system factors...
January 16, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28089200/limitations-of-the-current-standards-of-care-for-treating-gout-and-crystal-deposition-in-the-primary-care-setting-a-review
#11
Robert T Keenan
PURPOSE: This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. METHODS: [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]...
January 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28086976/impact-of-a-tailored-program-on-the-implementation-of-evidence-based-recommendations-for-multimorbid-patients-with-polypharmacy-in-primary-care-practices-results-of-a-cluster-randomized-controlled-trial
#12
Cornelia Jäger, Tobias Freund, Jost Steinhäuser, Christian Stock, Johannes Krisam, Petra Kaufmann-Kolle, Michel Wensing, Joachim Szecsenyi
BACKGROUND: Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previously identified determinants of practice. The aim of this study was to assess the effect of a tailored program to improve the implementation of three important processes of care for this patient group: (a) structured medication counseling including brown bag reviews, (b) the use of medication lists, and (c) structured medication reviews to reduce potentially inappropriate medication...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28086870/a-pilot-study-of-a-community-health-agent-led-type-2-diabetes-self-management-program-using-motivational-interviewing-based-approaches-in-a-public-primary-care-center-in-s%C3%A3-o-paulo-brazil
#13
Thais Moura Ribeiro do Valle Nascimento, Ken Resnicow, Marcia Nery, Alexandra Brentani, Elizabeth Kaselitz, Pooja Agrawal, Simanjit Mand, Michele Heisler
BACKGROUND: Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086853/taking-action-to-reduce-pain-action-study-rationale-design-and-protocol-of-a-randomized-trial-of-a-proactive-telephone-based-coaching-intervention-for-chronic-musculoskeletal-pain-among-african-americans
#14
Rozina H Bhimani, Lee J S Cross, Brent C Taylor, Laura A Meis, Steven S Fu, Kelli D Allen, Sarah L Krein, Tam Do, Robert D Kerns, Diana J Burgess
BACKGROUND: Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. METHODS/DESIGN: The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain...
January 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28086812/person-centred-care-in-chronic-kidney-disease-a-cross-sectional-study-of-patients-desires-for-self-management-support
#15
Kathryn Havas, Clint Douglas, Ann Bonner
BACKGROUND: People with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS). METHODS: A cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#16
T T Paary, M S Kalaiselvan, M K Renuka, A S Arunkumar
Introduction: Sepsis is the leading cause of intensive care unit (ICU) admissions and is associated with high mortality. Objectives: To identify the incidence, risk factors and outcome of patients with severe sepsis and septic shock. Methods: A prospective observational study was done in a multidisciplinary ICU over a period of 18 months. We included all adult patients admitted to ICU with features of severe sepsis and septic shock as per SCCM/ACCP guidelines...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28078090/the-effect-of-ongoing-feedback-on-physical-activity-levels-following-an-exercise-intervention-in-older-adults-a-randomised-controlled-trial-protocol
#17
Katie-Jane Brickwood, Stuart T Smith, Greig Watson, Andrew D Williams
BACKGROUND: Physical inactivity ranks as a major contributing factor in the development and progression of chronic disease. Lifestyle interventions reduce the progression of chronic disease, however, compliance decreases over time and health effects only persist as long as the new lifestyle is maintained. Telephone counselling (TC) is an effective way to provide individuals with ongoing support to maintain lifestyle changes. Remote physical activity monitoring and feedback (RAMF) via interactive technologies such as activity trackers and smartphones may be a cost-effective alternative to TC, however, this comparison has not been made...
2017: BMC Sports Science, Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28076526/perception-of-pre-and-post-hiv-test-counseling-among-patients-diagnosed-with-aids-in-adolescence-hiv-test-counseling-for-adolescents
#18
Stella Regina Taquette, Adriana de Oliveira Rodrigues, Lívia Rocha Bortolotti
Pre- and post-HIV test counseling has singular importance in adolescence, since it is a phase of great changes, and AIDS is an incurable chronic disease. In order to comprehend the perception of young people with AIDS diagnosed in adolescence regarding the counseling received upon testing, we conducted 39 in-depth interviews, with 23 in female patients and 16 male patients, and then analyzed the data with extensive reading, categorization and interpretation on a comprehensive basis. The results revealed that less than one third received pre-test counseling (30...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28076251/comparison-of-medical-diagnoses-among-same-sex-and-opposite-sex-partnered-patients
#19
Katie M Heiden-Rootes, Joanne Salas, Jeffrey F Scherrer, F David Schneider, Craig W Smith
BACKGROUND: Health disparities for gay and lesbian individuals are well documented in survey research. However, a limitation throughout the existing literature is the reliance on self-reported health conditions. This study used medical record diagnoses for gay and lesbian patients seen in primary care clinics. METHODS: This study used medical records of primary care patients (n = 31,569) seen at Midwestern, university-affiliated primary care clinics. First, all records with information about the sexual partnering of the patient were identified (n = 13,509)...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28074987/-towards-universal-access-to-health-care-incorporation-of-advanced-practice-nurses-in-primary-care
#20
Francisca Aguirre-Boza, Bernardita Achondo
To move towards universal access to health, the Pan American Health Organization recommends strengthening primary health care (PHC). One of the strategies is to increase the number qualified professionals, both medical and non-medical, working in PHC. In Chile there is a lack of professionals in this level of care, hampering the provision of health. Physicians still prefer secondary and tertiary levels of health. International experience has shown that advanced practice nurses (APN), specialists in PHC are cost-effective professionals able to deliver a complete and quality care to patients...
October 2016: Revista Médica de Chile
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