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https://www.readbyqxmd.com/read/29139336/home-health-aides-perceptions-of-quality-care-goals-challenges-and-implications-for-a-rapidly-changing-industry
#1
Emily Franzosa, Emma K Tsui, Sherry Baron
Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile...
January 1, 2017: New Solutions: a Journal of Environmental and Occupational Health Policy: NS
https://www.readbyqxmd.com/read/29138112/dentists-decision-strategies-for-suspicious-occlusal-caries-lesions-in-a-national-dental-pbrn-study
#2
Sonia K Makhija, Michael E Robinson, James D Bader, Daniel A Shugars, Mark S Litaker, Hong R Im, D Brad Rindal, Daniel J Pihlstrom, Cyril Meyerowitz, Valeria V Gordan, Meredith K Buchberg, Gregg H Gilbert
OBJECTIVE: Case presentations (vignettes) were completed by dentists in the National Dental Practice-Based Research Network study "Decision Aids for the Management of Suspicious Occlusal Caries Lesions (SOCLs)". The objective was to determine dentists' decision strategies for SOCLs). METHODS: 107 dentists viewed a series of 16 vignettes that represented all combinations of 4 clinical cues: color, luster, lesion roughness, and patient-level caries risk. Each vignette included a patient description and a photograph of a tooth presenting the 4 cues...
November 11, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/29136348/outcomes-of-donation-after-circulatory-death-kidneys-undergoing-hypothermic-machine-perfusion-following-static-cold-storage-a-uk-population-based-cohort-study
#3
Kamlesh Patel, Jay Nath, James Hodson, Nick Inston, Andrew Ready
Evidence is currently lacking regarding the outcomes of kidneys undergoing Hypothermic Machine Perfusion (HMP) in the UK. Using the National Health Service Blood and Transplant database, the authors compared outcomes for recipients of single organ Donation after Circulatory Death (DCD) kidneys preserved with HMP to those using only static cold storage (SCS). Between 2007 and 2015, HMP was used in 19.1% (864/4,529) of kidneys. Rates of delayed graft function (DGF) were significantly lower in organs preserved with HMP than for SCS (34...
November 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29133333/barriers-and-facilitators-to-orthopaedic-surgeons-uptake-of-decision-aids-for-total-knee-arthroplasty-a-qualitative-study
#4
Samantha Bunzli, Elizabeth Nelson, Anthony Scott, Simon French, Peter Choong, Michelle Dowsey
OBJECTIVES: The demand for total knee arthroplasty (TKA) is increasing. Differentiating who will derive a clinically meaningful improvement from TKA from others is a key challenge for orthopaedic surgeons. Decision aids can help surgeons select appropriate candidates for surgery, but their uptake has been low. The aim of this study was to explore the barriers and facilitators to decision aid uptake among orthopaedic surgeons. DESIGN: A qualitative study involving face-to-face interviews...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29131849/modelling-the-cost-effectiveness-of-hiv-care-shows-a-clear-benefit-when-transmission-risk-is-considered-in-the-calculations-a-message-for-central-and-eastern-europe
#5
Justyna D Kowalska, Grzegorz Wójcik, Jakub Rutkowski, Magdalena Ankiersztejn-Bartczak, Ewa Siewaszewicz
BACKGROUND: HIV epidemic remains a major global health issue. Data from cost-effectiveness analyses base on CD4+ count and morbidity in patients with symptomatic and asymptomatic HIV infection. The approach adopted in these analyses includes many other factors, previously not investigated. Additionally, we evaluate the impact of sexual HIV transmission due to delayed cART on the cost-effectiveness of care. METHODS: A lifetime Markov model (1-month cycle) was developed to estimate the cost per quality adjusted life years (QALY) for a 1- and 3-year delay in starting cART (as compared to starting immediately at linkage to care) lifetime costs, clinical outcomes and cost-effectiveness...
2017: PloS One
https://www.readbyqxmd.com/read/29128896/discordance-between-oncotype-dx-recurrence-score-and-rspc-for-predicting-residual-risk-of-recurrence-in-er-positive-breast-cancer
#6
Andrew Dodson, David Okonji, Laura Assersohn, Anne Rigg, Amna Sheri, Nick Turner, Ian Smith, Marina Parton, Mitch Dowsett
PURPOSE: Oncotype DX, a gene expression assay widely employed to aid decision making on adjuvant chemotherapy use in patients with primary oestrogen receptor-positive (ER+) breast cancer, produces a recurrence score (RS) related to distant disease recurrence (DR) risk (RS%). In node-negative patients, RS can be integrated with clinicopathological parameters to derive RS-pathology-clinical (RSPC) that improves prognostic accuracy. METHODS: Data were collected on patients having clinically indicated tests with an intermediate clinical risk of distant recurrence, and for whom the decision to prescribe chemotherapy remained unclear...
November 11, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29128582/budget-impact-analysis-of-gene-expression-tests-to-aid-therapy-decisions-for-breast-cancer-patients-in-germany
#7
M P Lux, N Nabieva, T Hildebrandt, H Rebscher, S Kümmel, J-U Blohmer, M G Schrauder
OBJECTIVES: Many women with early-stage, hormone receptor-positive breast cancer may not benefit from adjuvant chemotherapy. Gene expression tests can reduce chemotherapy over- and undertreatment by providing prognostic information on the likelihood of recurrence and, with Oncotype DX, predictive information on chemotherapy benefit. These tests are currently not reimbursed by German healthcare payers. An analysis was conducted to evaluate the budget impact of gene expression tests in Germany...
November 9, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29121178/exploration-of-predictive-biomarkers-of-early-infliximab-response-in-acute-severe-colitis-a-prospective-pilot-study
#8
Lauren Beswick, Ourania Rosella, Gennaro Rosella, Belinda Headon, Miles P Sparrow, Peter R Gibson, Daniel R van Langenberg
Background: Outcomes of acute severe ulcerative colitis (ASUC) appear dependent on early intervention with the first and/or further infliximab(IFX) doses, though parameters to guide decision-making remain uncertain. Aim: To assess whether serum/faecal IFX levels and inflammatory biomarkers early post-IFX dose can predict ASUC outcomes. Methods: This prospective pilot study consecutively recruited inpatients with steroid-refractory ASUC, who then received 1-3 IFX rescue doses (5mg/kg/dose) per treating clinician's discretion...
November 7, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29118115/computational-tools-for-clinical-support-a-multi-scale-compliant-model-for-haemodynamic-simulations-in-an-aortic-dissection-based-on-multi-modal-imaging-data
#9
Mirko Bonfanti, Stavroula Balabani, John P Greenwood, Sapna Puppala, Shervanthi Homer-Vanniasinkam, Vanessa Díaz-Zuccarini
Aortic dissection (AD) is a vascular condition with high morbidity and mortality rates. Computational fluid dynamics (CFD) can provide insight into the progression of AD and aid clinical decisions; however, oversimplified modelling assumptions and high computational cost compromise the accuracy of the information and impede clinical translation. To overcome these limitations, a patient-specific CFD multi-scale approach coupled to Windkessel boundary conditions and accounting for wall compliance was developed and used to study a patient with AD...
November 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/29117022/dementia-decision-making-and-capacity
#10
R Ryan Darby, Bradford C Dickerson
After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making...
November 2017: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29112908/reproductive-decision-making-in-women-living-with-human-immunodeficiency-virus-a-systematic-review
#11
REVIEW
Juan M Leyva-Moral, Patrick A Palmieri, María Feijoo-Cid, Sandra K Cesario, Nataly Julissa Membrillo-Pillpe, Patricia N Piscoya-Angeles, Marilyn Goff, Ana Toledo-Chavarri, Joan E Edwards
OBJECTIVES: Analyze and synthesize the research evidence to understand the reproductive decisions made by women living with HIV from the beginning of the epidemic to the present. Evaluate the barriers and the facilitators for reproductive decision-making. Identify areas of strength, improvement, and those requiring further research. DESIGN AND DATA SOURCES: Systematic review following the PRISMA guideline. PubMed, CINAHL, PsycINFO, Cochrane Library, SocINDEX, Embase, and Scopus databases were searched from 1985 to 2016 using the following Keywords: HIV, AIDS, pregnancy, reproduction, and decision-making...
October 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29112539/correlating-abdominal-wall-thickness-and-body-mass-index-to-predict-usefulness-of-right-lower-quadrant-ultrasound-for-evaluation-of-pediatric-appendicitis
#12
Jeannie K Kwon, Nowice Trexler, Joan Reisch, Cory M Pfeifer, Jason Ginos, Jerry Allen Powell, Jennifer Veltkamp, Alvin Anene, Neil Fernandes, Li Ern Chen
OBJECTIVES: To inform selective and efficient use of appendix ultrasound (US) beyond adult parameters of body mass index (BMI) of less than 25 kg/m, we correlate abdominal wall thickness (AWT) with age and BMI to generate parameters for male and female children. Information presented in chart format can aid in the decision to utilize US for the evaluation of appendicitis. METHODS: In this observational study, 1600 pediatric computed tomography scans of the abdomen and pelvis were analyzed to obtain measurements of AWT in the right lower quadrant...
November 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29112469/risk-of-clinically-significant-prostate-cancer-associated-with-prostate-imaging-reporting-and-data-system-category-3-equivocal-lesions-identified-on-multiparametric-prostate-mri
#13
Alison D Sheridan, Sameer K Nath, Jamil S Syed, Sanjay Aneja, Preston C Sprenkle, Jeffrey C Weinreb, Michael Spektor
OBJECTIVE: The objective of this study is to determine the frequency of clinically significant cancer (CSC) in Prostate Imaging Reporting and Data System (PI-RADS) category 3 (equivocal) lesions prospectively identified on multiparametric prostate MRI and to identify risk factors (RFs) for CSC that may aid in decision making. MATERIALS AND METHODS: Between January 2015 and July 2016, a total of 977 consecutively seen men underwent multiparametric prostate MRI, and 342 underwent MRI-ultrasound (US) fusion targeted biopsy...
November 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29111106/2017-comprehensive-update-of-the-canadian-cardiovascular-society-guidelines-for-the-management-of-heart-failure
#14
Justin A Ezekowitz, Eileen O'Meara, Michael A McDonald, Howard Abrams, Michael Chan, Anique Ducharme, Nadia Giannetti, Adam Grzeslo, Peter G Hamilton, George A Heckman, Jonathan G Howlett, Sheri L Koshman, Serge Lepage, Robert S McKelvie, Gordon W Moe, Miroslaw Rajda, Elizabeth Swiggum, Sean A Virani, Shelley Zieroth, Abdul Al-Hesayen, Alain Cohen-Solal, Michel D'Astous, Sabe De, Estrellita Estrella-Holder, Stephen Fremes, Lee Green, Haissam Haddad, Karen Harkness, Adrian F Hernandez, Simon Kouz, Marie-Hélène LeBlanc, Frederick A Masoudi, Heather J Ross, Andre Roussin, Bruce Sussex
Since the inception of the Canadian Cardiovascular Society heart failure (HF) guidelines in 2006, much has changed in the care for patients with HF. Over the past decade, the HF Guidelines Committee has published regular updates. However, because of the major changes that have occurred, the Guidelines Committee believes that a comprehensive reassessment of the HF management recommendations is presently needed, with a view to producing a full and complete set of updated guidelines. The primary and secondary Canadian Cardiovascular Society HF panel members as well as external experts have reviewed clinically relevant literature to provide guidance for the practicing clinician...
November 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29106320/near-infrared-fluorescence-imaging-for-real-time-intraoperative-guidance-in-anastomotic-colorectal-surgery-a-systematic-review-of-literature
#15
Jacqueline van den Bos, Mahdi Al-Taher, Rutger M Schols, Sander van Kuijk, Nicole D Bouvy, Laurents P S Stassen
PURPOSE: The aims of this review are to determine the feasibility of near-infrared fluorescence (NIRF) angiography in anastomotic colorectal surgery and to determine the effectiveness of the technique in improving imaging and quantification of vascularization, thereby aiding in decision making as to where to establish the anastomosis. METHODS: A systematic literature search of PubMed and EMBASE was conducted. Searching through the reference lists of selected articles identified additional studies...
November 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29104903/biomarkers-for-prostate-biopsy-and-risk-stratification-of-newly-diagnosed-prostate-cancer-patients
#16
Stacy Loeb
Introduction: Many new markers are now available as an aid for decisions about prostate biopsy for men without prostate cancer, and/or to improve risk stratification for men with newly diagnosed prostate cancer. Methods: A literature review was performed on currently available markers for use in decisions about prostate biopsy and initial prostate cancer treatment. Results: Although total prostate-specific antigen cutoffs were traditionally used for biopsy decisions, PSA elevations are not specific...
July 2017: Urology Practice
https://www.readbyqxmd.com/read/29103857/phenotype-management-and-predictors-of-outcome-in-a-large-cohort-of-adult-congenital-heart-disease-patients-with-heart-failure
#17
Alexander Van De Bruaene, Edward J Hickey, Adrienne H Kovacs, Andrew M Crean, Rachel M Wald, Candice K Silversides, Andrew N Redington, Heather J Ross, Ana Carolina Alba, Filio Billia, Krishnakumar Nair, Lee Benson, Eric Horlick, Mark Osten, Jack Colman, Jane Heggie, Erwin N Oechslin, S Lucy Roche
OBJECTIVE: Although heart failure (HF) is the leading cause of premature death in adult congenital heart disease (ACHD), little population-specific data exist. This study reports early experience from a dedicated, sub-specialty adult congenital heart disease-heart failure (ACHD-HF) clinic, aiming to identify risk factors for adverse outcome. METHODS: Between 2012 and 2015, 126 patients (57% male) attended the ACHD-HF clinic. Baseline and follow-up data were analysed and compared across 4 anatomical/physiological subgroups: cyanotic ACHD, Fontan circulation (1V), biventricular circulation with a subaortic right ventricle (2V-RV) and biventricular circulation with a subaortic left ventricle (2V-LV)...
October 31, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29102996/prostatectomy-versus-radiotherapy-for-early-stage-prostate-cancer-prepare-study-protocol-for-a-mixed-methods-study-of-treatment-decision-making-in-men-with-localised-prostate-cancer
#18
Allan Ben Smith, Pascal Mancuso, Mark Sidhom, Karen Wong, Megan Berry, Orlando Rincones, Dion Forstner, Lesley Bokey, Afaf Girgis
BACKGROUND: Men diagnosed with localised prostate cancer (LPC) wanting curative treatment face a highly preference-sensitive choice between prostatectomy and radiotherapy, which offer similar cure rates but different side effects. This study aims to determine the information, decision-making needs and preferences of men with LPC choosing between robotic prostatectomy and standard external beam or stereotactic radiotherapy. METHODS AND ANALYSIS: This study will be conducted at a large public teaching hospital in Australia offering the choice between robotic prostatectomy and radiotherapy from early 2017...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29102097/management-of-an-entrapped-patient-with-a-field-amputation
#19
John C Bunyasaranand, Erasmo Espino, Kelli A Rummings, Gregory M Christiansen
BACKGROUND: Emergency surgical amputations are rare and resource-intensive lifesaving interventions. Most emergency medical services (EMS) lack a formal protocol to manage these high-risk but low-occurrence events. There has been limited attention in the EMS community to address this issue. Without a literature-based approach, the EMS community has been offered little guidance on managing surgical field amputations. CASE REPORT: A 38-year-old man was terminally entrapped below the waist in an industrial auger...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29102063/video-based-patient-decision-aids-a-scoping-review
#20
REVIEW
Karin Winston, Petra Grendarova, Doreen Rabi
OBJECTIVE: This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. METHOD: The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016...
October 18, 2017: Patient Education and Counseling
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