scholarly journals An independently validated survival nomogram for lower-grade glioma

2019 ◽  
Vol 22 (5) ◽  
pp. 665-674 ◽  
Author(s):  
Haley Gittleman ◽  
Andrew E Sloan ◽  
Jill S Barnholtz-Sloan
Keyword(s):  
Health Care ◽  
Brain Tumor ◽  
Health Care Providers ◽  
Molecular Subtype ◽  
Lower Grade ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Lower Grade Glioma ◽  
Grade Ii ◽  
Online Software

Abstract Background Gliomas are the most common primary malignant brain tumor. Diffuse low-grade and intermediate-grade gliomas, which together compose the lower-grade gliomas (LGGs; World Health Organization [WHO] grades II and III), present a therapeutic challenge to physicians due to the heterogeneity of their clinical behavior. Nomograms are useful tools for individualized estimation of survival. This study aimed to develop and independently validate a survival nomogram for patients with newly diagnosed LGG. Methods Data were obtained for newly diagnosed LGG patients from The Cancer Genome Atlas (TCGA) and the Ohio Brain Tumor Study (OBTS) with the following variables: tumor grade (II or III), age at diagnosis, sex, Karnofsky performance status (KPS), and molecular subtype (IDH mutant with 1p/19q codeletion [IDHmut-codel], IDH mutant without 1p/19q codeletion, and IDH wild-type). Survival was assessed using Cox proportional hazards regression, random survival forests, and recursive partitioning analysis, with adjustment for known prognostic factors. The models were developed using TCGA data and independently validated using the OBTS data. Models were internally validated using 10-fold cross-validation and externally validated with calibration curves. Results A final nomogram was validated for newly diagnosed LGG. Factors that increased the probability of survival included grade II tumor, younger age at diagnosis, having a high KPS, and the IDHmut-codel molecular subtype. Conclusions A nomogram that calculates individualized survival probabilities for patients with newly diagnosed LGG could be useful to health care providers for counseling patients regarding treatment decisions and optimizing therapeutic approaches. Free online software for implementing this nomogram is provided: https://hgittleman.shinyapps.io/LGG_Nomogram_H_Gittleman/. Key Points 1. A survival nomogram for lower-grade glioma patients has been developed and externally validated. 2. Free online software for implementing this nomogram is provided allowing for ease of use by practicing health care providers.

Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer

2007 ◽  
Vol 16 (5) ◽  
pp. 474-486 ◽  
Author(s):  
Neeraj K. Arora ◽  
Lila J. Finney Rutten ◽  
David H. Gustafson ◽  
Richard Moser ◽  
Robert P. Hawkins
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Health Care ◽  
Health Care Providers ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Perceived Helpfulness

scholarly journals Naive Expectations to Resignation

2018 ◽  
Vol 5 (3) ◽  
pp. 219-224
Author(s):  
Michael M Evans ◽  
Judith E Hupcey ◽  
Lisa Kitko ◽  
Windy Alonso
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Longitudinal Study ◽  
Health Care Providers ◽  
Secondary Analysis ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Life Activity ◽  
Chronic Group ◽  
Stage D

Purpose: This study examined life descriptions of persons with stage D heart failure (HF) comparing those newly diagnosed to those with chronic HF. Methods: A secondary analysis of interviews from 75 participants followed in a longitudinal study of persons with stage D HF was thematically analyzed. There were 24 participants who were recently diagnosed with stage D HF (less than 2 years) and 51 participants with HF longer than 2 years. Results: Both groups shared life descriptions along a continuum, where recently diagnosed participants described naive expectations with hope for improvement, while the chronic group appeared resigned to their fate and the reality of the limitations of living with HF. Four themes illustrated differences between the groups: outlook on life, activity adjustments, understanding of HF, and mood. Conclusions: Although persons with stage D HF share the same life descriptions, they have differing perspectives of life with HF. Findings from this study can help health-care providers tailor interventions based on the length of time from diagnosis.

scholarly journals Pregnancy Status, Risk Factors, and Opportunities for Referral to Care Among Reproductive-Aged Women With Newly Reported Chronic Hepatitis C Virus Infection in Tennessee

2019 ◽  
Vol 135 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Cassandra Oliver ◽  
Jennifer Black ◽  
Shannon De Pont ◽  
Lindsey Sizemore ◽  
Carolyn Wester
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health Care Providers ◽  
Hcv Infection ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Pregnancy Status ◽  
Reproductive Aged Women

Objectives: From 2006 through 2012, the number of acute hepatitis C virus (HCV) infections increased 364% among persons aged ≤30, including reproductive-aged women, in Central Appalachian states. Outreach to reproductive-aged women with newly diagnosed HCV infection affords a unique opportunity to provide counseling, further testing, and linkage to treatment. We modeled a centrally located statewide effort to reach this population and their health care providers to ascertain pregnancy status, HCV risk factors, and opportunities for linkage to additional services. Methods: Using the Tennessee Department of Health’s surveillance database, we identified women aged 18-45 residing in Tennessee with newly reported chronic HCV infection from May through October 2017. We contacted health care providers and patients to request information on pregnancy status and HCV risk factors as well as to provide linkage to treatment services. Results: Of 1548 women included in this study, health care provider or patient contact information was available for 1316 (85.0%) women. Of the 1316 women, 806 (61.2%) women had a health care provider or patient response, of whom 242 (30.0%) were pregnant. Of 296 patients contacted, 194 (65.5%) reported intranasal drug use, 193 (65.2%) reported having been incarcerated for more than 24 hours, and 180 (60.8%) reported injection drug use. Ninety-eight (33.1%) patients were referred for confirmatory testing, and 174 (58.8%) were referred to treatment. Conclusion: A high proportion of reproductive-aged women with newly diagnosed HCV infection were pregnant. Surveillance-informed outreach to this population was feasible and provided opportunities for counseling and linkage to confirmatory testing and treatment. Future studies should evaluate whether a similar model would enhance testing and linkage to care of HCV-exposed infants.

scholarly journals Compassionate and Respectful Care From Clients’ Perspectives in Wollega Zones Hospitals, Wollega, West Ethiopia

2021 ◽  
Author(s):  
Jote Markos Cafo ◽  
Tariku Tesfaye Bekuma ◽  
Tahir Hasen ◽  
Worku Dechasa Yeyi
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Educational Status ◽  
Structured Interview ◽  
Mitigation Measures ◽  
Lower Grade ◽  
Disrespect And Abuse ◽  
Care Providers ◽  
Respectful Care

Abstract Introduction : Compassion is a deep awareness of the suffering of another coupled with the wish and action to relieve it. Respecting the patient’s right to self-determination—that is, supporting decisions that reflect the patient’s personal beliefs, values, and interest’s problems. compassionate, respectful and caring (CRC) health workforce initiative in this plan intends to address the concern of Disrespect and Abuse for clients, including laboring mothers. Objective Aim of the study is to assess the provision of compassionate, respectful and caring health care services among health care providers based on client’s perspective. Methods and materials: Hospital-based cross-sectional study was conducted from December 1-25, 2020. A semi-structured interview administered questionnaire was used to collect data from 351 participants. Epi-Data version and Stata version 14.0 were used for data entry and data analysis, respectively. Bivariable and multivariable logistic regression model was fitted to identify the factors associated with compassionate and respectful care from clinical and non-clinical staff of the selected Hospitals. The Adjusted odds ratio with 95% confidence interval and p-value less than 0.06 were used to declare the strength and association of the factors. Results of health care providers were reflected by their being patient while providing care. Clients who were from the poor socio status category were 3.70 times to report getting non compassionate and respectful care from the health care professionals than the clients who are at a better position of wealth status [AOR=3.70(95%CI; 1.27,10.81)]. Similarly, clients with lower grade educational status did not receive compassionate and respectful care when compared to patients with higher educational status [AOR=0.32(95%CI;0.10, 0.99)]. Conclusion Compassionate and respectful care provided to the patients from health care providers in the selected Hospitals of Western Oromia, Ethiopia was high. However, compassionate and respectful care or services rendered from non-clinician staff was low which suggests that immediate actions are necessary to address compassionate and respectful care at hospitals, and hospital management should adopt mitigation measures and should include non-clinician staff during training on CRC or related topics.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

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