Background: Ensuring high-quality patient-centered care for critically ill coronavirus disease 2019 (COVID-19) patients presents unprecedented challenges. Many patients become critically ill unexpectedly and have not previously discussed their health-care wishes. Clinicians lack experience with this illness and therefore struggle to predict patient outcomes.
Measures: Critical care medicine (CCM) providers were surveyed about the effectiveness and efficiency of a pilot intervention.
Intervention: Proactive palliative care rounding with CCM providers on COVID-19 intensive care units.
Outcomes: Fifty-four percent of CCM providers responded to the survey (21/39). CCM providers rated the intervention highly across all domains. CCM providers frequently identified that early palliative involvement was critical to providing families with information and support when separated from their loved ones.
Conclusions/lessons Learned: This pilot study found that proactive rounding improves critical care provider assessments of quality of care for patients and families and allows CCM providers to focus their efforts on managing complex physiology and surges.
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http://dx.doi.org/10.1016/j.jpainsymman.2020.12.014 | DOI Listing |
Int J Equity Health
January 2025
Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
Background: Although the Chronic Care Model (CCM) provides the essential structural components of practice organisation to deliver high-quality type 2 diabetes (T2D) care, little is known about which of its elements are most important, and the extent to which it may reduce social inequities in the quality of T2D care. This study aims to assess the association between the implementation of CCM's structural elements and the quality of T2D care processes and outcomes in Flanders (Belgium), paying specific attention to differences by patients' socioeconomic vulnerability.
Methods: We developed a longitudinal database combining information on primary care practices' CCM implementation, with individual-level health insurance and medical lab data.
Open Access Rheumatol
January 2025
Advocate Health Medical Group, Franklin, WI, USA.
Objective: Underserved populations are often at risk of experiencing systematic healthcare disparities. Existing disparities in care access, quality of care received, and treatment outcomes among patients with rheumatic disease are not well understood.
Methods: We conducted a targeted literature review to understand disparities in health outcomes, treatment patterns, and healthcare management faced by rheumatology patients in the United States, with a focus on rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).
Pain Ther
January 2025
Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Clinical Sciences Centre, University Hospital Aintree, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, L9 7AL, UK.
Fibromyalgia syndrome (FMS) presents a complex and challenging disorder in both the diagnosis and treatment, with emerging evidence suggesting a role of small fibre pathology (SFP) in its pathophysiology. The significance of the role of SFP in FMS remains unclear; however, recent evidence suggests degeneration and dysfunction of the peripheral nervous system, particularly small unmyelinated fibres, which may influence pathophysiology and underlying phenotype. Both skin biopsy and corneal confocal microscopy (CCM) have consistently demonstrated that ~ 50% of people with FMS have SFP.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Plant Experimental Biology, Faculty of Science, Charles University, Viničná 5, 12800, Prague, Czech Republic.
A wide range of portable chlorophyll meters are increasingly being used to measure leaf chlorophyll content as an indicator of plant performance, providing reference data for remote sensing studies. We tested the effect of leaf anatomy on the relationship between optical assessments of chlorophyll (Chl) against biochemically determined Chl content as a reference. Optical Chl assessments included measurements taken by four chlorophyll meters: three transmittance-based (SPAD-502, Dualex-4 Scientific, and MultispeQ 2.
View Article and Find Full Text PDFClin Genitourin Cancer
December 2024
Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy.
The recent evidences provided in metastatic hormone sensitive prostate cancer (nmHSPC) and in nonmetastatic castration resistant (nmCRPC) introduced the possibility to adopt Androgen Receptor Signaling inhibitor (ARSi) alone (both settings) or with chemotherapy (in mHSPC). In daily clinical practice there are some opening questions regarding the inclusion of next generation imaging, mainly PSMA-PET, how integrate local treatment as radiotherapy, how to select patients or drugs in a multiple-choice scenario, and how to manage patients with comorbidities and polypharmacy. These issues led the Italian Society for Uro-Oncology (SIUrO) to develop a consensus project involving all of the most important Italian scientific societies engaged in the multidisciplinary and multiprofessional management of the disease.
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