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https://www.readbyqxmd.com/read/28544672/providing-end-of-life-care-in-disability-community-living-services-an-organizational-capacity-building-model-using-a-public-health-approach
#1
Andrea Grindrod, Bruce Rumbold
BACKGROUND: There is broad consensus within the disability field that the end-of-life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end-of-life care of people with intellectual disabilities, particularly those in disability community living services. METHODS: A mixed-methods approach was used...
May 24, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28544171/effectiveness-of-shared-goal-setting-and-decision-making-to-achieve-treatment-targets-in-type-2-diabetes-patients-a-cluster-randomized-trial-optimal
#2
Henk Den Ouden, Rimke C Vos, Guy E H M Rutten
OBJECTIVE: About 20% of patients with type 2 diabetes achieve all their treatment targets. Shared decision making (SDM) using a support aid based on the 5-years results of the ADDITION study on multifactorial treatment, could increase this proportion. RESEARCH DESIGN AND METHODS: Cluster-randomized trial in 35 former ADDITION primary care practices. Practices were randomized to SDM or care as usual (1:1). Both ADDITION and non-ADDITION type 2 diabetes patients, 60-80 years, known with diabetes for 8-12 years, were included...
May 24, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#3
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543651/the-past-present-and-future-of-mexico-s-national-bioethics-commission
#4
Manuel Ruiz de Chavez, Aidee Orozco, Gustavo Olaiz
The establishment of Mexico's National Bioethics Commission (Comisión Nacional de Bioética), in 1992, was conceived within the context of a global movement aimed at raising awareness of the ethical implications of technological and scientific development, especially in biomedicine. In 2005, a new decree put the commission under the scope of the Secretariat of Health and granted it technical and operational autonomy, allowing it to become a regulatory agency aimed at promoting a culture of bioethics, encouraging reflection on human health, and developing guidelines for health care, research, and education, through a global, secular, and democratic perspective...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28543629/epidemiology-and-predisposing-factors-for-erythema-toxicum-neonatorum-and-transient-neonatal-pustular-a-multicenter-study
#5
Flávia Pereira Reginatto, Fernanda Mello Muller, Juliano Peruzzo, Tania Ferreira Cestari
BACKGROUND/OBJECTIVES: Erythema toxicum neonatorum (ETN) and transient neonatal pustular melanosis (TNPM) are benign pustular skin conditions that are relatively common in newborns, but the predisposing factors for these conditions are unknown. Our goal was to verify the prevalence of ETN and TNPM and their predisposing factors in a large sample of neonates. METHODS: In this prospective 1-year multicenter study, 2,831 neonates (age ≤72 hours) born in southern Brazil were randomized to undergo skin examination by a dermatologist...
May 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28543410/the-diagnosis-of-equine-insulin-dysregulation
#6
REVIEW
F R Bertin, M A de Laat
Insulin dysregulation is the hallmark of Equine Metabolic Syndrome and has received attention because of its direct association with laminitis. In the absence of an adequate treatment for laminitis, a focus on prophylaxis is needed, making early detection of individuals at risk of developing laminitis one of the main challenges in equine endocrinology. Recent studies have shown that insulin dysregulation goes beyond tissue insulin resistance and it is now demonstrated that the equine enteroinsular axis plays a major role in insulin secretion and equine hyperinsulinaemia...
May 22, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28543369/directing-clinical-care-using-lower-extremity-biomechanics-in-patients-with-ankle-osteoarthritis-and-ankle-arthroplasty
#7
REVIEW
Robin Queen
Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty (TAA), ankle fusion (arthrodesis), and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#8
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542080/manuscript-title-multidisciplinary-point-of-care-testing-in-south-african-primary-healthcare-clinics-accelerates-hiv-art-initiation-but-does-not-alter-retention-in-care
#9
Wendy S Stevens, Natasha M Gous, William B MacLeod, Lawrence C Long, Ebrahim Variava, Neil A Martinson, Ian Sanne, Regina Osih, Lesley E Scott
BACKGROUND: Lack of accessible laboratory infrastructure limits HIV antiretroviral (ART) treatment initiation, monitoring and retention in many resource-limited settings. Point-of-care testing (POCT) is advocated as a mechanism to overcome these limitations. We executed a pragmatic, prospective, randomized, controlled trial comparing the impact of POCT versus standard-of-care (SOC) on treatment initiation and retention in care. METHOD: Selected POC technologies were embedded at 3 primary health clinics in South Africa...
May 23, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28541957/the-cutting-edge-of-retinopathy-of-prematurity-care-expanding-the-boundaries-of-diagnosis-and-treatment
#10
Yoshihiro Yonekawa, Benjamin J Thomas, Aristomenis Thanos, Bozho Todorich, Kimberly A Drenser, Michael T Trese, Antonio Capone
PURPOSE: To discuss the latest advances and controversies in the diagnosis and care of infants with retinopathy of prematurity (ROP). METHODS: Literature review. RESULTS: Retinopathy of prematurity remains a major global issue. Industrialized nations now treat profoundly premature infants with posterior and aggressive disease, and middle-income nations are experiencing ROP epidemics. Remote digital imaging may address the decreasing ratio of ROP providers to premature infants, in addition to improving patient care...
May 24, 2017: Retina
https://www.readbyqxmd.com/read/28541513/improving-health-literacy-through-adult-basic-education-in-australia
#11
Suzanne Morony, Emma Lamph, Danielle Muscat, Don Nutbeam, Haryana M Dhillon, Heather Shepherd, Sian Smith, Aisha Khan, Julie Osborne, Wedyan Meshreky, Karen Luxford, Andrew Hayen, Kirsten J McCaffery
Adults with low literacy are less empowered to take care of their health, have poorer health outcomes and higher healthcare costs. We facilitated partnerships between adult literacy teachers and community health providers to deliver a health literacy training program in adult basic education classrooms. Following course completion we interviewed 19 adult education teachers (15 delivering the health literacy program; 4 delivering standard literacy classes) and four community health providers (CHPs) about their experiences, and analysed transcripts using Framework analysis...
May 25, 2017: Health Promotion International
https://www.readbyqxmd.com/read/28541371/knowledge-about-the-human-immunodeficiency-syndrome-among-elders-in-a-unit-for-the-care-of-the-elderly
#12
Giovanna Gaudenci Nardelli, Bruna Stephanie Sousa Malaquias, Eliana Maria Gaudenci, Carolina Silva Ledic, Nayara Freitas Azevedo, Vitória Eugênia Martins, Álvaro da Silva Santos
Objective: To analyze the knowledge of elders regarding HIV/AIDS. Methods: Descriptive, cross-sectional, quantitative study, with 457 elders from the Unit for the Care of Elders in Uberaba - Minas Gerais, lasting 3 months. The instruments used were the Mental State Mini-exam and a questionnaire on the human immunodeficiency virus for elders, together with frequency measures for their analysis. Results: Most participants were female (74%), between 60 and 69 y/o (51%)...
May 18, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28541085/distinct-trajectories-of-positive-and-negative-affect-after-colorectal-cancer-diagnosis
#13
Yvette Ciere, Moniek Janse, Josué Almansa, Annemieke Visser, Robbert Sanderman, Mirjam A G Sprangers, Adelita V Ranchor, Joke Fleer
OBJECTIVE: Insight into trajectories of positive affect (PA) and negative affect (NA) across the cancer continuum may improve understanding of the nature of adjustment problems. The primary aim of this study was to identify subgroups of patients with distinct trajectories of PA and NA following diagnosis of colorectal cancer (CRC). Secondary to this aim, the co-occurrence between trajectories and their association with goal-related processes was explored. METHOD: CRC patients (n = 186) completed questionnaires within 1 month, 7 months, and 18 months after diagnosis...
June 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28540341/reflections-on-hip-fracture-recovery-from-older-adults-enrolled-in-a-clinical-trial
#14
Sarah Stott-Eveneshen, Joanie Sims-Gould, Megan M McAllister, Lena Fleig, Heather M Hanson, Wendy L Cook, Maureen C Ashe
This study describes patients' perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic), compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups) twice over 12 months. A total of 32 women (64%) and 18 men (36%) participated in the study with a mean age at baseline of 82 (range = 65-98) years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28540115/the-benefits-of-streamlined-hip-fracture-management-in-a-regional-hospital
#15
T C Mow, Jen Lukeis, A G Sutherland
INTRODUCTION: Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. METHODS: Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28539691/goals-set-by-patients-using-the-icf-model-before-receiving-botulinum-injections-and-their-relation-to-spasticity-distribution
#16
Kevin Choi, Jaclyn Peters, Andrew Tri, Elizabeth Chapman, Ayako Sasaki, Farooq Ismail, Chris Boulias, Shannon Reid, Chetan P Phadke
Purpose: Goal Attainment Scaling (GAS) is used to assess functional gains in response to treatment. Specific characteristics of the functional goals set by individuals receiving botulinum toxin type A (BoNTA) injections for spasticity management are unknown. The primary objectives of this study were to describe the characteristics of the goals set by patients before receiving BoNTA injections using the International Classification of Functioning, Disability and Health (ICF) and to determine whether the pattern of spasticity distribution affected the goals set...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/28539204/nurses-perceptions-of-caring-for-parents-of-children-with-chronic-medical-complexity-in-the-pediatric-intensive-care-unit
#17
Gabrielle Denis-Larocque, Karl Williams, Isabelle St-Sauveur, Margaret Ruddy, Janet Rennick
OBJECTIVES: The aim of this study was to explore nurses' perceptions of caring for parents of children with medical complexity [CMC] in the pediatric intensive care unit [PICU]. RESEARCH METHODOLOGY: An interpretive descriptive design was used to explore nurses' perceptions of caring for parents of CMC in the PICU. Semi-structured interviews were conducted with ten nurses. Interview data were collected and analyzed using qualitative inductive content analysis. FINDINGS: Nurses revealed that their experiences of caring for parents of CMC evolved over time as they learned to tailor a caregiving partnership based on trust...
May 20, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28539069/real-world-challenges-for-hepatitis-c-virus-medications-a-critical-overview
#18
Imran Shahid, Waleed Hassan AlMalki, Sajida Hassan, Muhammad Hassan Hafeez
From 2010, the landscape of hepatitis C therapeutics has been changed rapidly, and today we are standing at a cusp of a pharmacological revolution where highly effective and interferon (IFN)-free direct acting antivirals (DAAs) are already on the market. Such treatment paradigms attain 90-95% sustained virologic response (SVR; undetectable viral load at week 12 or 24 at the end of therapy) rates in treated individuals compared to 50-70% with treatment completion of dual-therapy-pegylated interferon (PEG-IFN) and ribavirin (RBV)...
May 25, 2017: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/28538786/routine-hiv-testing-in-men-who-have-sex-with-men-from-risk-to-prevention
#19
Bruna Robba Lara Redoschi, Eliana Miura Zucchi, Claudia Renata Dos Santos Barros, Vera Silvia Facciolla Paiva
We conducted a critical review of the literature on recurrent use of HIV testing in men who have sex with men (MSM). We performed a narrative review of the literature in which we analyzed the various conceptions on frequent testing over time, the implications for health programs, and the main social markers that influence the incorporation of HIV testing as routine care. Although it has existed since the 1990s, recurrent testing among MSM was frequently interpreted as increased exposure to HIV due to lack of condom use, and therefore as "unnecessary" testing...
May 18, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28538496/committee-opinion-no-702-female-athlete-triad
#20
(no author information available yet)
The female athlete triad is a medical condition observed in physically active females involving three components: 1) low energy availability with or without disordered eating, 2) menstrual dysfunction, and 3) low bone density. An individual does not need to show clinical manifestations of all three components of the female athlete triad simultaneously to be affected by the condition. Consequences of these clinical conditions may not be completely reversible, so prevention, early diagnosis, and intervention are critical...
June 2017: Obstetrics and Gynecology
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