Palliative Care Research

19:10 EST 20th January 2019 | BioPortfolio

Reducing disparity in neurologic care: What can we do?

Reducing neurodisparity: Recommendations of the 2017 AAN Diversity Leadership Program.

Many advances in prevention, diagnosis, and treatment of neurologic disease have emerged in the last few decades, resulting in reduced mortality and decreased disability. However, these advances have not benefitted all populations equally. A growing body of evidence indicates that barriers to care fall along racial and ethnic lines, with persons from minority groups frequently having lower rates o...

Edge effect pinning in mesoscopic superconducting strips with non-uniform distribution of defects.

Transport characteristics of nano-sized superconducting strips and bridges are determined by an intricate interplay of surface and bulk pinning. In the limiting case of a very narrow bridge, the critical current is mostly defined by its surface barrier, while in the opposite case of very wide strips it is dominated by its bulk pinning properties. Here we present a detailed study of the intermediat...

Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions.

To classify NICU interventions for parental distress and quantify their effectiveness.

Big data in IBD: a look into the future.

Big data methodologies, made possible with the increasing generation and availability of digital data and enhanced analytical capabilities, have produced new insights to improve outcomes in many disciplines. Application of big data in the health-care sector is in its early stages, although the potential for leveraging underutilized data to gain a better understanding of disease and improve quality...

Psycho-oncology in dermatological practice : Evaluation of need and care structures.

Psycho-oncological care is a main component of comprehensive oncological care as stated in the National Cancer Plan of the German Federal Government. Correspondingly this goal has been adopted in the strategy of the German Skin Cancer Council. In certified skin cancer centers structural requirements for psycho-oncological care are established. Nevertheless, a large proportion of skin cancer pati...

Effect of preadmission glucocorticoid therapy on 30-day mortality in critically ill patients: a retrospective study of a mixed ICU population in a tertiary hospital.

This study aimed to investigate the association between preadmission glucocorticoid (GC) therapy and 30-day mortality in critically ill patients following admission to an intensive care unit (ICU). We aimed to determine whether this association differed according to daily GC dosage and type. We conducted a retrospective cohort study of adult patients admitted to a single tertiary academic hospital...

Feasibility of an alternative, physiologic, individualized open-lung approach to high-frequency oscillatory ventilation in children.

High-frequency oscillatory ventilation (HFOV) is a common but unproven management strategy in paediatric critical care. Oscillator settings have been traditionally guided by patient age and/or weight rather than by lung mechanics, thereby potentially negating any beneficial effects. We have adopted an open-lung HFOV strategy based on a corner frequency approach using an initial incremental-decreme...

Level of agreement of point-of-care and laboratory HbA1c measurements in the preoperative outpatient clinic in non-diabetic patients who are overweight or obese.

Implementation of point-of-care HbA1c devices in the preoperative outpatient clinic might facilitate the early diagnosis of glycemic disturbances in overweight or obese patients undergoing surgery, but validation studies in this setting do not exist. We determined the level of agreement between a point-of-care and laboratory HbA1c test in non-diabetic patients visiting the outpatient clinic for pr...

Long-term management of chronic heart failure patients in internal medicine.

Chronic heart failure (CHF) is one of the main disabilities in elderly patients requiring frequent hospitalizations with high health care costs. We studied the outcome of CHF outpatient management in reducing hospitalization after discharge from a division of Internal Medicine at a large 3rd referral regional Hospital. 147 CHF inpatients (M:F: 63:84; mean age 76 ± 9.6 years) admitted for acut...

Obesity phenotype and patient-reported outcomes in moderate and severe chronic kidney disease: a cross-sectional study from the CKD-REIN cohort study.

To evaluate the association between obesity phenotypes and health-related quality of life (HRQoL) in non-dialysis-dependent CKD patients.

Modeling strategies to improve parameter estimates in prognostic factors analyses with patient-reported outcomes in oncology.

The inclusion of patient-reported outcome (PRO) questionnaires in prognostic factor analyses in oncology has substantially increased in recent years. We performed a simulation study to compare the performances of four different modeling strategies in estimating the prognostic impact of multiple collinear scales from PRO questionnaires.

Associations Between Maternity Care Practices and 2-Month Breastfeeding Duration Vary by Race, Ethnicity, and Acculturation.

Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012-2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and c...

Safety and Feasibility of Early Mobilization in Patients with Subarachnoid Hemorrhage and External Ventricular Drain.

In November 2014, our Neurointensive Care Unit began a multi-phased progressive early mobilization initiative for patients with subarachnoid hemorrhage and an external ventricular drain (EVD). Our goal was to transition from a culture of complete bed rest (Phase 0) to a physical and occupational therapy (PT/OT)-guided mobilization protocol (Phase I), and ultimately to a nurse-driven mobilization p...

The KEEP SIMPLEST Study: Improving In-House Delays and Periinterventional Management in Stroke Thrombectomy-A Matched Pair Analysis.

Although the treatment window for mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) has been extended in recent years, it has been proven that recanalizing treatment must be administered as soon as possible. We present a new standard operating procedure (SOP) to reduce in-house delay, standardize periinterventional management and improve patient safety during MT.

Healthcare Providers Underestimate Patients' Glucocorticoid Use in Crohn's Disease.

One of the therapy goals for Crohn's disease (CD) is glucocorticoid-free remission. Studies have shown care setting-specific variations in inflammatory bowel disease (IBD) management.

Patient and Oncologist Preferences for the Treatment of Adults with Advanced Soft Tissue Sarcoma: A Discrete Choice Experiment.

There has been no single standard-of-care treatment of patients with advanced/metastatic soft tissue sarcoma (STS). This study was designed to understand patient and oncologist preferences in the advanced/metastatic setting.

The PIRP project (Prevenzione Insufficienza Renale Progressiva): how to integrate hospital and community maintenance treatment for chronic kidney disease.

Chronic kidney disease (CKD) represents a global health burden with great economic impact on healthcare and therefore it requires appropriate interventions by Health Care Systems. The PIRP (Prevenzione Insufficienza Renale Progressiva) project is endorsed and funded by the Emilia-Romagna Regional Health Board and involves all the Nephrology Units of the Emilia-Romagna Region (Italy). The project h...

The character of sexual function of women who have sex with women.

This paper will discuss the character of sexual relationships between women, considering their social and cultural context. The problem is still little known also to experts dealing with mental and sexual health. This may have serious consequences for the process of correct diagnosis of sexuality-related issues reported by those women. The article focuses on selected factors that have an impact on...

A novel approach to outpatient clinic management.

I read with great interest the study by Khoury et al in the BJD on the safety of patient-initiated care consultations (PICC) for psoriasis patients, though has wider implications for all patients with chronic conditions. There are over 15 million people in England with chronic conditions, accounting for 64% of outpatient appointments, and with future trends suggesting a further increase. This arti...

Dyadic Yoga Program for Patients Undergoing Thoracic Radiotherapy and their Family Caregivers: Results of a Pilot Randomized Controlled Trial.

Thoracic radiotherapy (TRT) may result in toxicities that are associated with performance declines and poor quality of life (QOL) for patients and their family caregivers. The purpose of this randomized controlled trial was to establish feasibility and preliminary efficacy of a dyadic Yoga (DY) intervention as a supportive care strategy.

Validity and Reliability of a Point-of-care Nerve Conduction Device in Diabetic Patients.

Although nerve conduction study using a standard electromyography system is considered to be the gold standard in evaluating diabetic polyneuropathy, this examination requires expensive equipment and well-trained technicians. We aimed to validate a point-of-care device, NC-stat/DPNCheck , that has been developed for widespread use of nerve conduction study in diabetic polyneuropathy.

ABC (Atrial fibrillation Better Care) pathway and healthcare costs in atrial fibrillation. The ATHERO-AF study.

The Atrial fibrillation Better Care (ABC) pathway for the integrated approach to the management of patients with atrial fibrillation has been proposed to streamline patient management in an integrated, holistic manner, as follows: 'A' Avoid stroke with Anticoagulation; 'B' Better symptom management, with rate or rhythm control; 'C' Cardiovascular risk and comorbidity management, including lifestyl...

Consumer-Directed Health Care: The Uncertain Future of Price Transparency Initiatives.

Influence of bacterial resistance on mortality in intensive care units: A registry study from 2000 to 2013 (IICU Study).

Bacterial resistance to antibiotics is a daily concern in intensive care units. However, few data are available concerning the clinical consequences of in vitro defined resistance. This study aimed to compare the mortality of patients with nosocomial infections according to bacterial resistance profiles.

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