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Transitions in care

M C Van Remmerden, L Hoogland, S E Mous, B Dierckx, M Coesmans, H A Moll, K Lubbers, C R Lincken, A M Van Eeghen
Little is known about care needs of young adults with Fragile X Syndrome (FXS). Patient-driven information is needed to improve understanding and support of young adults with FXS. A qualitative study was performed in 5 young adult patients (aged 18-30), and 33 parents of young adults. Concerns and care needs were categorized using the International Classification of Functioning, Disability, and Health. Results indicated concerns on 14 domains for males, and 13 domains for females, including physical, psychological and socio-economical issues...
March 16, 2019: Journal of Autism and Developmental Disorders
Tom Knauf, Benjamin Bücking, Mathias Bargello, Sebastian Ploch, Christopher Bliemel, Matthias Knobe, Steffen Ruchholtz, Daphne Eschbach
The incidence of hip fractures is increasing due to demographic transition. Data on long-term survival and influencing factors are sparse. Our prospective observational study with 395 patients shows a survival of 38% after 5 years. Significant risk factors were male gender, higher age, lower Barthel Index, lower Charlson Comorbidity Score, lower Mini-Mental State Examination, and delirium during hospitalization. PURPOSE: The incidence of hip fractures is increasing due to demographic transition...
March 16, 2019: Archives of Osteoporosis
J Gigliotti, S Madathil, N Makhoul
While the prognosis for early-stage oral cavity cancer is relatively good; the majority of patients are still diagnosed with advanced-stage disease on presentation with an associated poorer prognosis. The aims of this review are to summarize our current understanding of delays in oral cavity cancer and their impact on stage at diagnosis and survival. The delays pathway can be subdivided into three components: patient, professional, and treatment delays. Patient delay represents the longest interval in the delays pathway usually lasting between 2 and 5 months and being most influenced by cognitive and psychosocial factors...
March 13, 2019: International Journal of Oral and Maxillofacial Surgery
Thomas J Bollyky, Tara Templin, Matthew Cohen, Diana Schoder, Joseph L Dieleman, Simon Wigley
BACKGROUND: Previous analyses of democracy and population health have focused on broad measures, such as life expectancy at birth and child and infant mortality, and have shown some contradictory results. We used a panel of data spanning 170 countries to assess the association between democracy and cause-specific mortality and explore the pathways connecting democratic rule to health gains. METHODS: We extracted cause-specific mortality and HIV-free life expectancy estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 and information on regime type from the Varieties of Democracy project...
March 13, 2019: Lancet
Amy S Kelley, Katelyn B Ferreira, Evan Bollens-Lund, Harriet Mather, Laura C Hanson, Christine S Ritchie
CONTEXT: Identifying the seriously ill population is integral to improving the value of health care. Efforts to identify this population using existing data are anchored to a list of severe medical conditions (SMCs) using diagnostic codes. Published approaches have utilized International Classification of Diseases, Ninth Revision (ICD-9) codes, which has since been replaced by ICD-10. OBJECTIVES: We translated SMCs from ICD-9 to ICD-10 using a refined code list...
March 12, 2019: Journal of Pain and Symptom Management
L Testa, R Seah, K Ludlow, J Braithwaite, R J Mitchell
Care transitions for older people moving from residential aged care facilities (RACFs) to hospital services are associated with greater challenges and poorer outcomes. An integrative review was conducted to investigate models of care designed to avoid or improve transitions for older people residing in RACFs to hospital settings. Twenty-one studies were included in the final analysis. Models of care aimed to either improve or avoid transitions of residents through enhanced primary care in RACFs, promoting quality improvement in RACFs, instilling comprehensive hospital care, conducting outreach services, transferring information, or involved a combination of outreach services and comprehensive hospital care...
March 12, 2019: Geriatric Nursing
Mladen Nisavic, Shamim H Nejad, Benjamin M Isenberg, Ednan Khalid Bajwa, Paul Currier, Paul M Wallace, George Velmahos, Timothy Wilens
BACKGROUND: Benzodiazepine-based protocols offer a standard of care for management of alcohol withdrawal, though they may not be safe or appropriate for all patients. Phenobarbital, a long-acting barbiturate, presents an alternative to conventional benzodiazepine treatment, though existing research offers only modest guidance to the safety and effectiveness of phenobarbital in managing alcohol withdrawal syndrome (AWS) in general hospital settings. METHODS: To compare clinical effectiveness of phenobarbital versus benzodiazepines in managing symptoms of alcohol withdrawal, we conducted a retrospective chart review of 562 patients admitted over a 2-year period to a general hospital and treated for AWS...
February 14, 2019: Psychosomatics
Deena J Chisolm, Sean P Gleeson, Kelly J Kelleher, Marisa E Domino, Emily Alexy, Wendy Yi Xu, Paula H Song
OBJECTIVES: To describe the extent and implications of "churn" between different Medicaid eligibility classifications in a pediatric population: (1) aged, blind, and disabled (ABD) Medicaid eligibility, determined by disability status and family income; and (2) Healthy Start Medicaid eligibility, determined by family income alone. STUDY DESIGN: As a result of a 2013 policy change, children with ABD eligibility transitioned from fee-for-service to capitated care...
March 2019: American Journal of Managed Care
N Elket, E Kendjo, M Thellier, L Assoumou, V Potard, A Taieb, I Tantaoui, E Caumes, R Piarroux, C Roussel, P Buffet, D Costagliola, S Jauréguiberry
BACKGROUND: Little is known on the use of artesunate compared to quinine for the treatment of imported malaria cases in non-endemic countries with high level of care. Therefore, we compared the two treatments in terms of mortality, hospital and intensive care unit discharge rates. METHODS: We analyzed the cohort of all severe imported malaria patients reported to the French National Reference Center from 2011 to 2017. After controlling for differences between quinine and artesunate treated individuals using the inverse probability of treatment weighting method, 28 day mortality rate was compared between the groups as well as hospital and ICU discharge rates using Kaplan Meier estimation and weighted Cox proportional hazard models...
March 15, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Lauren Goldschen, Wynne Lundblad, Alexis M Fertig, Lauren S Auster, Hannah L Schwarzbach, Judy C Chang
OBJECTIVE: Although developmental milestones have been observed to alter eating disorder (ED) symptom burden, it remains unknown how the transition to university affects symptomatology. To address this gap, we designed a qualitative study to elucidate how students with an ED perceive their general university experience and to describe how the university environment shapes their ED. METHOD: Undergraduate students who self-reported an ED were recruited through fliers, an undergraduate advocacy organization, and local treatment centers...
March 15, 2019: International Journal of Eating Disorders
Hyunah Kim, Hyein Chang
This study examined the longitudinal association between children's early callous-unemotional (CU) traits and social competence in the transition to school-age, and tested whether this relationship was moderated by child executive function and maternal warmth. Participants were 643 children (49% girls) who were part of the Panel Study on Korean Children (PSKC) of the Korea Institute of Child Care and Education (KICCE). Mothers rated children's CU at 5 years and executive function at 8 years, and maternal warmth at 5 years...
2019: Frontiers in Psychology
Muhammad Zulfiqar, Yinchang Zhao, Geng Li, ZhengCao Li, Jun Ni
The successful synthesis of the single to few layer transition metal dichalcogenides has opened a new era in the nanoelectronics. For their efficient implementations in the electronic devices while taking care of their overheating issues, the characterization of their thermal transport properties is extremely vital. So, we have systematically investigated the thermal transport properties of monolayer transition metal dichalcogenides MX2 (M = Mo, W; X = S, Se, Te) by combining the first-principles calculations with Boltzmann transport equation...
March 14, 2019: Scientific Reports
Livia P Carvalho, Marie-Jeanne Kergoat, Aline Bolduc, Mylène Aubertin-Leheudre
BACKGROUND: Older patients experience increased loss of mobility after hospitalization, largely because of physical disabilities and inactivity. There are, however, no current recommendations for prescribing physical activity (PA) at hospital discharge. OBJECTIVES: Develop a decisional tree for the systematic prescription of an individualized, adapted, nonsupervised home-based PA program for older adults after hospital discharge; investigate its feasibility, acceptability, and safety; and estimate its efficacy at improving physical function and mobility...
March 11, 2019: Journal of the American Medical Directors Association
Ann-Mari Fagerdahl, Vibeke E Knudsen, Ingrid Egerod, Annette E Andersson
INTRODUCTION: Necrotizing soft tissue infection (NSTI) is a severe, life-threatening condition requiring immediate diagnosis and treatment to avoid widespread tissue destruction and death. Current research seeks to explain the complex interaction between patient and disease agent, whereas only few studies have addressed the patient perspective. OBJECTIVE: The present study aimed to describe the patient experience of NSTI in the first six months after diagnosis. METHODS: The study had a qualitative design with patient involvement...
March 12, 2019: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Kathryn M Glaser, Douglas C McDaniel, Suzanne M Hess, Tessa Faye Flores, Denise A Rokitka, Mary E Reid
BACKGROUND: This article describes the development of an integrative survivorship program at an urban National Cancer Institute-designated comprehensive cancer center with three closely linked components: a Survivorship Clinic with dedicated staff, a network of Support Services including Wellness, and an Integrative Medicine Program. DEVELOPMENT: We first defined the parameters of survivorship care and developed a patient-centric model that determined the optimal timeframes for transitioning these patients from the oncology clinic to a centralized survivorship clinic...
March 2019: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Tracey Leone Smith, Bo Kim, Justin K Benzer, Zenab Yusuf, Terri L Fletcher, Annette M Walder
Access to mental health (MH) care is of paramount concern to U.S. health care delivery systems, including the Veterans Health Administration. To improve access, there is a need to better focus existing MH resources toward care for those most in need of specialty-level MH treatment. This article provides early results of Project FLOW's (not an acronym) approach to developing and evaluating electronic medical record (EMR)-based criteria to identify clinically stable patients and promote their effective transition from specialty MH back to primary care (PC)...
March 14, 2019: Psychological Services
Claire Dux, Shu-Chuin Lim, Rosalind Jeffree, Sandra Heaydon, Susan de Jersey
AIM: Neurosurgical patients often transition from enteral nutrition (EN) to oral nutrition (ON) as they recover. Implementing a nurse-led feeding protocol to guide this transition may improve consistency of nutrition care and dietitian workload efficiency. This pragmatic study aimed to evaluate the effect of such a protocol on these outcomes and on nurses' nutrition care attitudes, practices and knowledge. METHODS: Data were collected retrospectively for 1 year pre- and prospectively for 1 year post-implementation of the transition feeding protocol (TFP)...
March 13, 2019: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
Jessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu, Lawrence Marum
BACKGROUND: Saving Mothers, Giving Life (SMGL) significantly reduced maternal and perinatal mortality in Uganda and Zambia by using a district health systems strengthening approach to address the key delays women and newborns face in receiving quality, timely, and appropriate medical care. This article documents the transition of SMGL from pilot to scale in Uganda and Zambia and analyzes the sustainability of the approach, examining the likelihood of maintaining positive trends in maternal and newborn health in both countries...
March 11, 2019: Global Health, Science and Practice
Yi Zhong, Nikita Patel, Maria Ferris, Eniko Rak
This study evaluates the associations of nutrition knowledge and health literacy with health care transition (HCT) readiness and self-management in adolescents and young adults (AYAs) with chronic kidney disease (CKD) or hypertension. Chronically ill AYAs with poor HCT or self-management skills are less likely to achieve favorable health outcomes as they enter adulthood. Health literacy and nutrition knowledge, which are identified as important contributors to health outcomes, may suggest important points of interventions to improve self-management skills...
March 13, 2019: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
Elisabeth Iversen, Beate-Christin H Kolltveit, Ingvild Hernar, Jan Mårtensson, Anne Haugstvedt
AIM: The aim of the present study was to explore how young adults with type 1 diabetes (T1D) experienced the transition from paediatric to adult health care services. DESIGN: A qualitative, explorative design was used. METHODS: Eleven young adults with T1D receiving adult diabetes care at a hospital in western Norway participated in semi-structured interviews. Data were analysed using Interpretive Description, an inductive approach inspired by grounded theory, ethnography and phenomenology, and specifically designed to explore phenomena in clinical practice aiming to generate new knowledge and skills...
March 13, 2019: Scandinavian Journal of Caring Sciences
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