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Level of care

Ann Kutney-Lee, Douglas M Sloane, Kathryn H Bowles, Lawton R Burns, Linda H Aiken
BACKGROUND:  Despite evidence suggesting higher quality and safer care in hospitals with comprehensive electronic health record (EHR) systems, factors related to advanced system usability remain largely unknown, particularly among nurses. Little empirical research has examined sociotechnical factors, such as the work environment, that may shape the relationship between advanced EHR adoption and quality of care. OBJECTIVE:  The objective of this study was to examine the independent and joint effects of comprehensive EHR adoption and the hospital work environment on nurse reports of EHR usability and nurse-reported quality of care and safety...
January 2019: Applied Clinical Informatics
Uwe Schmidt, Claudia Capek, Cahit Birdir, Christine Erfurt, Katharina Nitzsche
INTRODUCTION: It can be observed that there is an increase in the methamphetamine (MA) consumption in Saxony (Federal Republic of Germany). There is so far no data available in German speaking countries about the risk of MA consumption in pregnancy or delivery. METHODS: The data from all pregnant women who were examined or delivered at the Clinic for Obstetrics and Gynaecology between 2010-2015 were retrospectively searched for MA consumption. 119 pregnancies with 113 deliveries of 115 women consuming MA could be evaluated...
February 20, 2019: Zeitschrift Für Geburtshilfe und Neonatologie
Mark A Clapp, Kaitlyn E James, Sara V Bates, Anjali J Kaimal
BACKGROUND: Unexpected admissions of term neonates to the neonatal intensive care unit (NICU) and unexpected postnatal complications have been proposed as neonatal-focused quality metrics for intrapartum care. Previous studies have noted significant variation in overall hospital NICU admission rates; however, little is known about the influence of obstetric practices on these rates or whether variation among unanticipated admissions in low risk, term neonates can be attributed to systemic hospital practices...
February 13, 2019: American Journal of Obstetrics and Gynecology
M Laske, N J M Opdam, E M Bronkhorst, J C C Braspenning, M C D N J M Huysmans
To improve patient dental care, it is necessary to identify possible risk factors for the failing of restorations. This practice-based cohort study investigated the performance and influence of possible risk factors at the level of the practice, patient, tooth, and restoration on survival of direct class II restorations. Electronic patient files from 11 Dutch general practices were collected, and 31,472 restorations placed between January 2015 and October 2017 were analyzed. Kaplan-Meier statistics were performed; annual failure rates (AFRs) were calculated; and variables were assessed by multivariable Cox regression analysis...
February 20, 2019: Journal of Dental Research
Lisa Morrissey, Megan Lurvey, Courtney Sullivan, Julia Challinor, Peter W Forbes, Linda Abramovitz, Glenn M Afungchwi, Rachel Hollis, Sara Day
BACKGROUND: In 2014, a task force of the International Society of Paediatric Oncology (SIOP) Paediatric Oncology in Developing Countries Nursing Workgroup published six baseline standards to provide a framework for pediatric oncology nursing care in low- and lower-middle income countries (L/LMIC). We conducted an international survey in 2016-2017 to examine the association between country income level and nurses' resporting of conformity to the standards at their respective institutions...
February 20, 2019: Pediatric Blood & Cancer
L Fiaschi, C Nelson-Piercy, S Deb, R King, L J Tata
OBJECTIVES: To assess how nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) are managed and treated across primary and secondary care. DESIGN: Population-based pregnancy cohort. SETTING: Medical records (CPRD-GOLD) from England. POPULATION: 417,028 pregnancies, during 1998-2014. METHODS: Proportions of pregnancies with recorded NVP/HG diagnoses, primary care treatment and hospital admissions were calculated...
February 20, 2019: BJOG: An International Journal of Obstetrics and Gynaecology
E Carmina, R Azziz, W Bergfeld, H F Escobar Morreale, W Futterweit, H Huddleston, R A Lobo, E Olsen
OBJECTIVE: To determine the current state of knowledge and provide evidence-based recommendations that could be valid for all specialists taking care of female pattern hair loss (FPHL), a common form of hair loss in women that is characterized by the reduction of hair density in the central area of the scalp, while the frontal hairline is generally well conserved. PARTICIPANTS: An expert task force appointed by Androgen Excess and PPCOS society, which included specialists from dermatology, endocrinology, and reproductive endocrinology...
February 20, 2019: Journal of Clinical Endocrinology and Metabolism
Daniel Vigo, Laura Jones, Daniel E Maidana, Michael Krausz, Devora Kestel
The objective of this study is to provide an estimate of the burden of disease related to mental health in Argentina, in order to provide elements for the rational prioritization of resource allocation and the development of services. Based on the estimations made by the Study of the Global Burden of Disease (1) we add an analysis of the load product of: a) self-injuries and suicide; b) common neurological disorders with severe psychological and behavioral manifestations; c) somatic consequences of alcohol use disorder; and iv) an estimate of the disorder by somatic symptoms with prominent pain...
November 2018: Vertex: Revista Argentina de Psiquiatriá
Samuel Chatio, Paul Welaga, Philip Teg-Nefaah Tabong, Patricia Akweongo
BACKGROUND: An increasing demand for health care services and getting health care closer to doorsteps of communities has made health managers to use trained community-based health volunteers to support in providing health services to people in rural communities. Community volunteerism in Ghana has been identified as an effective strategy in the implementation of Primary Health Care activities since 1970s. However, little is known about the performance of these volunteers engaged in health interventions activities at the community level...
2019: PloS One
Martina Ventura, Valeria Belleudi, Paolo Sciattella, Riccardo Di Domenicantonio, Mirko Di Martino, Nera Agabiti, Marina Davoli, Danilo Fusco
BACKGROUND: The relationship between guideline adherence and outcomes in patients with acute myocardial infarction (AMI) has been widely investigated considering the emergency, acute, post-acute phases separately, but the effectiveness of the whole care process is not known. AIM: The study aim was to evaluate the effect of the multicomponent continuum of care on 1-year survival after AMI. METHODS: We conducted a cohort study selecting all incident cases of AMI from health information systems during 2011-2014 in the Lazio region...
2019: PloS One
Mineaki Kitamura, Yoko Obata, Yuki Ota, Kumiko Muta, Hiroshi Yamashita, Takashi Harada, Hiroshi Mukae, Tomoya Nishino
Subepithelial deposits are observed in rare adult IgA nephropathy (IgAN) cases and are a key diagnostic finding in IgA-dominant infection-related glomerulonephritis (IgA-IRGN). Sometimes, it is difficult to distinguish IgA-IRGN from IgAN without a precise clinical history. We hypothesized that some IgA-IRGN cases might be diagnosed as IgAN with subepithelial deposits (IgAN-SD) and aimed to clarify the significance of subepithelial deposits in patients diagnosed with IgAN. We examined 464 patients diagnosed with IgAN at Nagasaki University Hospital and affiliated hospitals between 1996 and 2013...
2019: PloS One
Mariangela Lanfredi, Maria Elena Ridolfi, Giorgia Occhialini, Laura Pedrini, Clarissa Ferrari, Antonio Lasalvia, John G Gunderson, Donald W Black, Roberta Rossi
Negative attitudes toward borderline personality disorder (BPD) can present a barrier to those seeking care. We explored caring attitudes toward BPD among 860 mental health professionals, including psychiatrists, psychologists, social health educators, nurses, and social workers. The results showed that social workers and nurses scored significantly lower on caring attitudes than psychiatrists, social health educators, and psychologists. Our analysis showed that the more BPD patients treated in the past year, more years of experience in mental health, and having prior BPD training were positively associated with caring attitudes scores...
February 20, 2019: Journal of Personality Disorders
Neal Sikka, Liqi Shu, Brandon Ritchie, Richard L Amdur, Ali Pourmand
STUDY OBJECTIVE: Pain management in emergency department (ED) patients is challenging. Although both pharmacological and nonpharmacological therapies exist, they are often suboptimal. Immersive virtual reality (VR) uses distraction and possible other methods to reduce perceptions of pain. The purpose of the study is to evaluate the usability and acceptability of VR applications in ED patients by assessing patient-reported changes in pain, anger, and anxiety levels. METHODS: This is a prospective cohort study at a single academic urban tertiary care center among ED patients with a pain score ≥3 on a numeric rating scale (0-10 integers) for any reason...
February 20, 2019: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Tracey Bleakley, Heather Richardson, Shaun O'Leary, Caroline Scates, Karen Harrison Dening, Kerry Harrison
Foreword Hospice UK's annual conference is the national hospice and palliative care charity's flagship event, bringing together everyone involved in leading hospice, palliative and end-of-life care for adults, children and young people. In 2018, the conference spanned two days and was held at the International Centre in Telford, Shropshire. Its theme was Transforming Palliative Care and it provided a unique forum for delegates to discuss current and forthcoming issues facing the hospice and palliative care community, and to discover new ways of thinking from outside of the sector...
February 2, 2019: International Journal of Palliative Nursing
Mary Jo Kreitzer, Susan Telke, Linda Hanson, Brent Leininger, Roni Evans
OBJECTIVES: CaringBridge (CB) is a web-based social network where people share information, enlist support, and access resources following a difficult diagnosis; it can also be used to disseminate supportive self-care tools, such as a gratitude practice, for its users. Gratitude practices are shown to reduce stress and fear, improve sleep, and increase positive emotions and overall well-being. The purpose of this article was to report the findings of a brief gratitude intervention delivered to CB users...
February 20, 2019: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Kwonsang Lee, Scott A Lorch, Dylan S Small
Two problems that arise in making causal inferences for nonmortality outcomes such as bronchopulmonary dysplasia (BPD) are unmeasured confounding and censoring by death, ie, the outcome is observed only when subjects survive. In randomized experiments with noncompliance and no censoring by death, instrumental variable (IV) methods can be used to control for the unmeasured confounding. But, when there is censoring by death, the average causal treatment effect cannot be identified under usual assumptions but can be studied for a specific subpopulation by using sensitivity analysis with additional assumptions...
February 20, 2019: Statistics in Medicine
Jose F Figueroa, Daniel M Blumenthal, Yevgeniy Feyman, Austin B Frakt, Alexander Turchin, Gheorghe Doros, Qi Gao, Yang Song, Karen E Joynt Maddox
Importance: One-third of Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private plan option. Medicare Advantage incentivizes performance on evidence-based care, but limited information exists using reliable clinical data to determine whether this translates into better quality for patients with coronary artery disease (CAD) enrolled in MA compared with those enrolled in traditional fee-for-service (FFS) Medicare. Objective: To determine differences in evidence-based secondary prevention treatments and intermediate outcomes among patients with CAD enrolled in MA vs FFS Medicare...
February 20, 2019: JAMA Cardiology
Claudia Ramirez-Perdomo, Alix Perdomo-Romero, María Rodríguez-Vélez
OBJECTIVE: Describe the knowledge and practices performed by people for diabetic foot prevention. METHODS: This was a cross-sectional, descriptive study, with a random stratified sample, comprised of 304 people with type 2 diabetes mellitus. The information was collected through an instrument designed by the researchers that assessed sociodemographic aspects, and level of knowledge and practices of the participants in diabetic foot care prevention. RESULTS: In the assessment of diabetic foot care prevention, there was a low and average level of knowledge, whereas practices were moderately adequate...
February 18, 2019: Revista Gaúcha de Enfermagem
Renata Olzon Dionysio de Souza, Amanda Aparecida Borges, Maria Aparecida Bonelli, Giselle Dupas
OBJECTIVE: To know the composition and functioning of the social support used by the family of children with pneumonia. METHODS: A qualitative study was carried out with fourteen families of children under five years old hospitalized for pneumonia, coming from regions of greater social vulnerability in a city in the state of São Paulo, from November 2015 to May 2016. The theoretical reference used was the Calgary Family Assessment Model, and the Bardin Thematic Content Analysis was used as method...
February 18, 2019: Revista Gaúcha de Enfermagem
Janet Schloss, Erica McIntyre, Amie Steel, Ryan Bradley, Joanna Harnett, Rebecca Reid, Jason Hawrelak, Joshua Goldenberg, Claudine Van De Venter, Kieran Cooley
INTRODUCTION: Naturopathy is a mixture of both traditional and complementary medicine. It incorporates a broad set of health care practices that may or may not be traditional to that country or conventional medicine and are not fully integrated into the dominant health care system. Research required to evaluate or substantiate naturopathic medicine may not fall under the testing of randomized clinical trials, which opens up discussions on what is the best practice for research in naturopathic medicine...
February 2019: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
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