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Home care medicine

Dee Mangin, Jenna Parascandalo, Olga Khudoyarova, Gina Agarwal, Verdah Bismah, Sherrie Orr
OBJECTIVE: There is increasing awareness of the burden of medical care experienced by those with multimorbidity. There is also increasing interest and activity in engaging patients with chronic disease in technology-based health-related activities ('eHealth') in family practice. Little is known about patients' access to, and interest in eHealth, in particular those with a higher burden of care associated with multimorbidity. We examined access and attitudes towards eHealth among patients attending family medicine clinics with a focus on older adults and those with polypharmacy as a marker for multimorbidity...
February 12, 2019: BMJ Open
Barret Rush, Clark Fruhstofer, Keith R Walley, Leo Anthony Celi, Mayur Brahmania
BACKGROUND: Patients with end-stage liver disease (ESLD) have a reduced life expectancy and a significant symptom burden. Our aim is to determine if inpatient palliative care (PC) referral for patients with ESLD is associated with decreased hospital readmission rates. METHODS: The 2013 US Nationwide Readmission Database (NRD) was used for the current analysis. The NRD allows for longitudinal analysis of all patient hospital admissions across 22 states. Patients ≥18 years of age with a diagnosis of ESLD with at least two decompensating events were included in the analysis...
February 13, 2019: BMJ Supportive & Palliative Care
Hilary Stiel, Srivalli V Nagarajan, Benjamin C Forster, Josephine M Clayton
BACKGROUND: As modern medicine extends the life expectancy of patients with life-limiting illnesses and health system resource pressures intensify, palliative care physicians increasingly need to transfer stable patients from specialist palliative care units to nursing homes. The experience of palliative care physicians in decision-making and communicating with patients and families about the need for this transition is underexplored in the literature. AIM: This study aimed to explore the experiences of and communication techniques used by palliative care physicians as they consider and discuss nursing home placements for their patients...
March 2019: Palliative Medicine
Kira L Ryskina, Christine Lam, Hye-Young Jung
IMPORTANCE: While the number of prescribing clinicians (physicians and nurse practitioners) who provide any nursing home care remained stable over the past decade, the number of clinicians who focus their practice exclusively on nursing home care has increased by over 30%. OBJECTIVES: To measure the association between regional trends in clinician specialization in nursing home care and nursing home quality. DESIGN: Retrospective cross-sectional study...
February 7, 2019: Journal of the American Medical Directors Association
Elizabeth Brigham, Jodi Brady, Robert P Olympia
Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via emergency medical services)...
February 9, 2019: NASN School Nurse
Michelle L Balli, Tiffany A Dickey, Rachel S Purvis, T Scott Warmack, Sheldon Riklon, Pearl A McElfish
BACKGROUND: The Marshallese experience high rates of chronic diseases including hypertension and diabetes. Medication adherence is crucial to successful disease management, and healthcare providers play a crucial role in assisting their patients with medication adherence. METHODS: A qualitative study design was used with individual interviews and focus groups with pharmacists and community health workers (CHWs) serving the Marshallese community in Northwest Arkansas...
February 8, 2019: Journal of Racial and Ethnic Health Disparities
Susheel P Patil, Indu A Ayappa, Sean M Caples, R John Kimoff, Sanjay R Patel, Christopher G Harrod
INTRODUCTION: This guideline establishes clinical practice recommendations for positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines in the evaluation and treatment of sleep-disordered breathing in adults. METHODS: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was used to assess the evidence...
February 4, 2019: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Shan Hui Lai, Tung Tsoi, Chao Tian Tang, Richard Jor Yeong Hui, Kim Kiat Tan, Yehudi Wee Shung Yeo, Ee Heok Kua
BACKGROUND: The number of dementia cases is expected to rise exponentially over the years in many parts of the world. Collaborative healthcare partnerships are envisaged as a solution to this problem. Primary care physicians form the vanguard of early detection of dementia and influence clinical care that these patients receive. However, evidence suggests that they will benefit from closer support from specialist services in dementia care. An interdisciplinary, collaborative memory clinic was established in 2012 as a collaborative effort between a large family medicine based service and a specialist geriatric psychiatry service in Singapore...
February 8, 2019: BMC Psychiatry
Günter Polt, Dietmar Weixler, Norbert Bauer
In palliative medicine planning in advance is important for critical care situations. It is highly significant to make useful and by the patient and his relatives desired decisions. These concern transport in a situation of crisis and the venue of death (either death at home or transfer to a hospital).In this study the effect of a new Emergency Information Form about the place of death was examined. The used Emergency Information Form enabled the patient to express a wish on transfer in the case of crisis in advance and communicate this wish to the Emergency system...
February 6, 2019: Wiener Medizinische Wochenschrift
Marko Stojanović, Milica Vuković, Milan Jovanović, Srđan Dimitrijević, Miroslav Radenković
RATIONALE, AIMS, AND OBJECTIVE: There is limited information about the comparative effectiveness of the START/STOPP (Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment) criteria and the Ghent Older People's Prescriptions community Pharmacy Screening tool (GheOP3 S tool) for the screening of potentially inappropriate prescribing (PIP) in the geriatric population. Considering this, the aim of this study was to compare the ability of the START/STOPP criteria and GheOP3 S tool to identify the PIP and potential prescribing omissions (PPOs) among elderly patients visiting their primary care physician...
February 5, 2019: Journal of Evaluation in Clinical Practice
Nicole McDerby, Mark Naunton, Alison Shield, Kasia Bail, Sam Kosari
Older adults are particularly susceptible to iatrogenic disease and communicable diseases, such as influenza. Prescribing in the residential aged care population is complex, and requires ongoing review to prevent medication misadventure. Pharmacist-led medication review is effective in reducing medication-related problems; however, current funding arrangements specifically exclude pharmacists from routinely participating in resident care. Integrating an on-site clinical pharmacist into residential care teams is an unexplored opportunity to improve quality use of medicines in this setting...
March 12, 2018: International Journal of Environmental Research and Public Health
Zeng Jie Ye, Zhang Zhang, Mu Zi Liang, Xiao Xiao Liu, Zhe Sun, Jing Jing Zhao, Guang Yun Hu, Yuan Liang Yu
PURPOSE: This study was designed to report information regarding symptomology of incurable pediatric cancer to promote proactive medicine and support for children and their families in the palliative phase in Mainland China. METHOD: A multi-center retrospective cohort study including 205 children who died from incurable cancer between June 2008 and September 2013 were analyzed. RESULTS: An incurable diagnosis was confirmed between 0 and 1726 (median, 279) days from initial diagnosis with death occurring between 1 and 239(median, 83) days...
February 2019: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Matthew D'Angelo, Matthew Welder, Ravi Chauhan, Michel J Kearns
The coordinated terrorist attacks of 2001 thrust the United States and its allies to war. Through an evolving battlefield, the paradigm of large fixed medical facilities advanced to become nimble surgical and resuscitative platforms, able to provide care far forward. Innovations like tactical combat casualty care, evacuation, fresh whole-blood administration, freeze-dried plasma, and forward surgical care military medicine helped reduce combat mortality to its lowest levels in history. Through the account of a young wounded marine wounded in Iraq, this article examines how innovations on the battlefield saved casualties and explores how these techniques may be applied at home...
March 2019: Anesthesiology Clinics
Bingyu Qin, Ling Ye
Critical care medicine has developed rapidly and has become an indispensable comprehensive subject in clinical medicine at home and abroad. In recent years, the government has vigorously implemented the "Healthy China" strategy and strived to achieve a higher level of national health. The Henan Provincial People's Hospital has set up a network of interconnected "Wisdom Critical Care Medicine Specialist League" to meet the major strategic needs of the country, and to play a role in attracting large hospitals to promote the sinking of quality medical resources and the improvement of grassroots service capabilities...
January 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Leslie Strickler, Tracy Harjo
We present an illustrative case of unintentional burns to the feet of a 15-month-old child following the application of raw garlic as a home remedy for fever. We provide an overview of the historical medicinal uses of garlic as well as its unintended adverse effects. This case underscores the importance of clinicians' ability to recognize unusual presentations of injury due to culturally based practices that require care in emergency settings. This is particularly important in patient populations for whom abusive etiology would be considered...
January 29, 2019: Pediatric Emergency Care
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Fahad Razak
BACKGROUND: Short hospital stays may represent opportunities to avert unnecessary admissions or expedite inpatient care. To inform the design of interventions that target patients with potentially avoidable hospital admissions or brief stays, we examined the patient, physician and situational characteristics associated with short stays among patients admitted to general internal medicine wards and describe the use of hospital resources by these patients. METHODS: This was a multicentre cross-sectional study conducted between Apr...
January 2019: CMAJ Open
Suzanne M Gillespie, Andrea L Moser, Murthy Gokula, Thomas Edmondson, Joseph Rees, Dallas Nelson, Steven M Handler
OBJECTIVES: This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents. SETTINGS AND PARTICIPANTS: Members of the telemedicine workgroup of AMDA-The Society for Post-Acute Long-Term Medicine-developed this guideline through both telephonic and face-to-face meetings between April 2017 and September 2018. The guideline is based on the currently available research, experience, and expertise of the workgroup's members, including a summary of a recently completed systematic mixed studies literature review to determine evidence for telemedicine to reduce emergency department visits or hospitalizations of nursing home residents...
February 2019: Journal of the American Medical Directors Association
Nathan Alexander, Ahmad Boota, Kenderic Hooks, John R White
Pediatric obstructive sleep apnea is known to cause neurocognitive problems, yet it often goes undetected or mistreated. The authors describe 9-year-old twins with snoring, enlarged tonsils, and excessive daytime sleepiness whose symptoms had been previously disregarded by health care professionals. At presentation, a dentist found the patients to be midface deficient and symptomatic. A home sleep test, prescribed by the dentist, revealed apnea-hypopnea index readings of 74/h and 16/h, respectively. The children were referred to an otolaryngologist, and a continuous positive airway pressure therapy trial resulted in improved cognition and temperament...
February 1, 2019: Journal of the American Osteopathic Association
Norihiro Kokudo, Tetsuo Hara
"History, Tradition, and Progress", a grand ceremony in celebration of the 150th Anniversary of the National Center for Global Health and Medicine (NCGM) was held in Tokyo, Japan on December 3, 2018. Hundreds of distinguished guests from home and abroad attended the grand ceremony. The NCGM is a national research and development agency, which is a type of independent administrative entity. The NCGM originated from a temporary army hospital that was established in Tokyo in October 1868. After several rounds of restructuring and reorganization, the facility became the NCGM in April 2015...
January 25, 2019: Bioscience Trends
Mara Buchbinder, Elizabeth R Brassfield, Manisha Mishra
BACKGROUND: The evolving legal landscape for medical aid-in-dying (AID) in the USA raises clinical and public health challenges and concerns regarding how health care providers will accommodate AID while expanding access to high-quality end-of-life care. OBJECTIVE: To describe Vermont health care providers' experiences practicing under the "Patient Choice and Control at End of Life" Act. DESIGN: Qualitative semi-structured interviews analyzed using grounded theory...
January 25, 2019: Journal of General Internal Medicine
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