Care Management Practices Research Articles

A systematic review of cost-effectiveness analyses of gene therapy for hemophilia type A and B.

In 2022-2023, the US Food and Drug Administration approved 2 novel gene therapies, valoctocogene roxaparvovec and etranacogene dezaparavovec, for hemophilia A and B, respectively. These one-time-administered gene therapies have been marketed at prices that create financial challenges for payers and patients. Understanding the magnitude and uncertainties around the long-term value of these therapies and how they can potentially relate to managed care practices is of high interest to the payer and patient community. To conduct a systematic review of cost-effectiveness analysis (CEA) studies to assess (1) the long-term value of valoctocogene roxaparvovec and etranacogene dezaparavovec and (2) the relevance and validity of the underlying data and assumptions used in the CEA models and discuss how they relate to the challenges identified for CEAs of gene therapies. A systematic review of cost-effectiveness studies of novel hemophilia A and B gene therapy was conducted. PubMed and Embase were searched for published studies from inception to January 12, 2024. Original research articles published in English that conducted a CEA on gene therapy treatments for hemophilia A and B, with a comparison of incremental costs and health effects, were considered. Critical appraisal of the quality of reporting and the underlying modeling assumptions were conducted to assess the relevance and validity of the results. Two hundred thirty-eight studies were identified, of which 4 met the inclusion criteria. Three studies were conducted from a US health care perspective and 1 from a Dutch societal perspective. Despite the high upfront costs of the gene therapies, all included studies' (3 hemophilia A and 1 hemophilia B) modeled results showed that gene therapies had lower overall costs and better health outcomes compared with factor concentrate replacement therapies and emicizumab. The results were driven by the assumption that gene therapies will have a durable effect of at least 10 years and offset the high cost of the current standard of care. The modeled health improvements varied substantially across studies, showing that the long-term value is sensitive to varying clinical and economic assumptions. The novel hemophilia gene therapy treatments can potentially be a cost-effective use of treatment resources if the treatment effects are durable over time. To reduce the risk for payers while still facilitating patient access, outcomes-based agreements similar to what has recently been proposed by the Centers for Medicare & Medicaid Services for sickle-cell therapies are well supported.

MULTIPROFESSIONAL ICU TEAM AND UNDERSTANDING OF INSTITUTIONAL WELCOME AND CARE PRACTICES

The study aimed to analyze how the multidisciplinary team working in the ICU understands institutional reception and care practices. This is qualitative research, conducted with nine members of the multidisciplinary team who work in the ICU of a hospital in Recife/PE, aged between 22 and 52 years old, mostly married and with children. The responses to the questionnaires and interviews were transcribed and analyzed according to the thematic analysis technique suggested by Minayo. The results revealed that professionals' understanding of institutional reception and care practices is affected by several factors: triple working hours, daily contact with imminent death, limited understanding of the National Humanization Policy - PNH, lack of attention to psychosocial needs of professionals, use of defensive behaviors in relation to finitude and death, resistance to seeking emotional support, aspects related to the lack of professional recognition and few collaborative actions of multi-professional integration. It is concluded that it is crucial to create an environment for listening and psychoeducation of the multidisciplinary team according to the management and health care practices recommended by the PNH, which are still scarce in the Intensive Care Unit - ICU.

A study on care management practices for supporting low-income elderly people in Japan

A study on care management practices for supporting low-income elderly people in Japan

Adoption of Improved Buffalo Husbandry Practices in Peri-Urban Areas of Surat City, Gujarat

The present study was carried out in the peri urban areas of Surat city of Gujarat to find out the adoption of improved buffalo husbandry practices. A random sample of 50 buffalo farm owners were selected and interviewed for the interview schedule prepared about adoption of improved dairy husbandry practices in six major aspects of housing, feeding, breeding, health care, milking and calf rearing management was studied. Housing in separate located place (100%), providing proper floor space (98%) and proper height and ventilation (90%) were more adopted in housing practices. Provision of clean and fresh drinking water (100%), feeding extra ration to advance pregnant animals (64%) and feeding balance concentrate mixture on the basis of milk production (64%) were more adopted in feeding management. In adoption of breeding management, keeping watch on oestrus cycle and heat symptoms of animals (100%), artificial insemination of animals (100%) and practicing pregnancy diagnosis between 60-90 days after service (91%) were more adopted by buffalo owners. Observing animals daily for signs of sickness (100%), timely and regularly vaccination (100%) and treatment of reproductive disorders (75%) were more adopted by respondents in health care management practices. In milking and calf rearing practices, washing pails and hands before milking (100%) and regularity in milking time (100%), early solid feeding (100%) and milk feeding to calves up to three months of age (96%) were more adopted by the buffalo owners.

System‐failing creativity in health care

AbstractIntroductionHealth care professionals often generate novel solutions to solve problems during day‐to‐day patient care. However, less is known about generating novel and useful (i.e., creative) ideas in the face of health care system failure. System failures are high‐impact and increasingly frequent events in health care organizations, and front‐line professionals may have uniquely valuable expertise to address such occurrences.MethodsOur interdisciplinary team, blending expertise in health care management, economics, psychology, and clinical practice, reviewed the literature on creativity and system failures in health care to generate a conceptual model that describes this process. Drawing on appraisal theory, we iteratively refined the model by integrating various theories with key concepts of system failures, creativity, and health care worker's well‐being.ResultsThe SFC model provides a conceptualization of creativity from front‐line care professionals as it emerges in situations of failure or crisis. It describes the pathways by which professionals respond proactively to a systems failure with creative ideas to effectively address the situation and affect these workers' well‐being.ConclusionsOur conceptual model guides health care managers and leaders to use managerial practices to shape their systems and support creativity, especially when facing system failures. It introduces a framework for examining system‐failing creativity (SFC) and general creativity, aiming to improve health care quality, health care workers' well‐being, and organizational outcomes.

Home Care Management Practices of Caregivers of Patients Undergoing Hemodialysis

Home Care Management Practices of Caregivers of Patients Undergoing Hemodialysis

Knowledge, attitudes, and current practices toward lung cancer palliative care management in China: A national survey.

11143 Background: To demonstrate the status and differences in knowledge, attitudes, and practices (KAP) of lung cancer palliative care (LCPC) management, and to measure patient controlled analgesia (PCA) in cancer pain management in of China. Methods: A questionnaire on LCPC management was used in this study, which involved a total of 2093 participants from 706 hospitals in China. Seven major components make up the questionnaire, including chi-square tests or Fisher exact probabilities to measure the differences in KAP between hospitals grades. Comparing distributions of ordered data between groups was done using the Kruskal-Wallis H test or the Mann-Whitney U test. Multiple choice questions use multiple response cross analysis. Correlation was evaluated by the Spearman correlation coefficient. Results: 84.2% participants believed that anti-tumor therapy is equally important as palliative care. The satisfaction rate of participants from grade 3 hospitals, which was significantly higher than that of grade 2 and grade 1 hospitals (χ²=27.402, P=0.002). The most common symptoms requiring LCPC was pain. The major barriers toward to LCPC were “Patients and families are concerned about the safety of long-term use of palliative care related drugs”. The most common reasons for the use of PCA treatment were 31.1% participants thought “Patients with systemic application of large doses of opioids or adverse reactions to opioids that cannot be tolerated”. The top three barriers toward PCA treatment of cancer pain were (i) worry about adverse reactions of drug overdose, (ii) worry about opioid addiction, and (iii) increase of patients' economic burden. In the past 24 months, 33.9% of the participants had not participated in online or offline training related to palliative care of lung cancer. Conclusions: Chinese healthcare workers are in need of training for lung cancer palliative care and, in particular, for controlling cancer pain symptoms.

From Institution to Community: Implementing the Pathway Home Approach for High-Risk Members With Behavioral Health Needs Transitioning From an Adult Home.

Coordinated Behavioral Care began using its Pathway Home program to serve a subset of New York State Adult Home Settlement class members. Through its multidisciplinary team approach, Pathway Home is utilizing its multiphase model in assisting individuals with Serious Mental Illness leaving an Adult Home to successfully transition and remain in the community. The Pathway Home program is a community-based service and serves class members wherever is needed to assist in their recovery and transition from an Adult Home. This includes meeting class members in Adult Homes and various settings in the community. The New York State Adult Home Settlement presents a variety of systemic, care management, and individual member challenges. Adding the Pathway Home approach to an already existing, yet insufficient care management model strengthens the initiative's goal to transition and retain members safely into the community. Through the approach's adaptability and flexibility in providing community-based care, Pathway Home's successful cross-system collaboration is worthy of replication for other high need populations. A programmatic review for Pathway Home Adult Home+ teams gleaned the following key points for the field to consider in future care management practices. Class member self-efficacy and cross-system collaboration are essential in facilitating a class member's move into the community. Member choice and educating class members on their rights to move and options as well as community exposure prior to transition are important in assessing how a member fares outside of the Adult Home. Members determining their own care can reduce the risk of adverse outcomes and reinstitutionalization. Current low-touch care management programs are insufficient for members with complex needs living in institutions. These care management programs need to be augmented with a whole person approach, delivered by a multidisciplinary team.

What Are the Best Practices for Nursing Care during an Earthquake? A Scoping Review.

Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze the best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations, to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; and Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: (a) immediate care, (b) intermediate care, (c) psychosocial care, and (d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork, and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed, and the reinforcement of these advanced practices through the systematization of nurses' skills, in order to promote victims' rehabilitation, minimize their suffering, and improve their quality of life during and after an earthquake.

Feathered diplomacy: when birds become main factors of research design and geography on Vigur Island

Vigur Island, situated in Iceland’s Westfjords, is renowned for its diverse avian species, such as Atlantic Puffins and Black Guillemots, and its marine inhabitants including Harbour and Grey Seals. Despite its openness to tourism, the island is a subject of ongoing conservation efforts. This opinion paper argues for a more holistic approach to research on the island, highlighting the complex interplay between human activity and the island’s ecosystem. It critiques the current, often narrow, research methodologies that fail to fully account for the intricate relationships between species and their environment. The paper calls for a re-evaluation of habitat classification to incorporate the significant impact of avian populations and stresses the importance of adhering to Icelandic laws that mandate minimal disturbance to wildlife. With seasonal closures and careful management practices like eiderdown collection, Vigur Island serves as a model for balancing human interests with ecological integrity. This opinion advocates for adaptable, comprehensive research strategies that, while illustrated through the case of Vigur, should be applied universally, urging scientists to embrace broader perspectives in environmental studies globally.

Land Use Planning by Using GIS Techniques for Land Resource Inventory (LRI)- Northern Dry Zone of Karnataka, India

A study was conducted to determine land capability and to develop suitability map based on soil characteristics and climatic factors of watershed area. Detailed soil survey was carried out for Donur-2 micro watershed which comes under Basavana Bagewadi taluka of Vijayapura district, Karnataka to acquire the comprehensive data related land resources. From the study area, it was observed that based on soil-site characteristics four soil series were identified such as Dadamatti, Karjol, Nidoni and Rampur series and mapped into eight mapping units using GIS techniques. Donur-2 watershed area has been grouped into three land capability classes (LCC) viz., II, III and IV with four subclasses IIes, IIIs, IIIse and IVe. Subclass ‘e’ is due to major limitation of soil property group ‘e’ i.e erosion and slope, subclass ‘s’ is due to major limitations group ‘s’ having parameters like texture, depth and gravelliness. Subclass ‘se’ and ‘es’ are due to limitations of both soil parameters group above mentioned, however se and es are different classes which are based major limitation one of the group and followed by other group. Land capability map was developed using GIS techniques which indicates that out of 324.3 ha study area, LCC class IIIs covering major area i.e. 179 ha (55.12%), followed by class IIs i.e. 109 ha (33.51%), class IVe i.e. 23 ha (7.15%) and minor area of 7 ha (2.15%) area is covered by class IIIse. Soil suitability assessment indicates that majority of land is moderately suitable for agriculture. Class III soils are designated as moderately fertile agricultural land with significant constraints. However, with special conservation practices soils under class III can be used for cultivation of different crops. Class IV soils are categorized as reasonably fertile for intermittent cultivation, characterized by significant restrictions that limit crop options but with careful management practices these can be used for cultivation of arable crops. Therefore, the utilization of a land use planning approach (LUP) is instrumental in formulating tailored land resource management strategies to enhance land productivity, mitigate land degradation and attain sustainability goals.

Adoption of health care and feeding management practices by the flood affected dairy farmers

Adoption of health care and feeding management practices by the flood affected dairy farmers

Birth Asphyxia among Neonates Admitted to the Neonatal Intensive Care Unit of a Tertiary Care Hospital.

Birth asphyxia causes significant morbidity and mortality among neonates, especially in low-income and middle-income countries like Nepal. However, there is a paucity of data regarding its burden. This study aimed to find the prevalence of birth asphyxia among neonates admitted to the neonatal intensive care unit of a tertiary care hospital. This descriptive cross-sectional study was conducted among neonates at a tertiary care hospital between 15 January 2022 to 14 January 2023 after obtaining ethical approval from the Institutional Review Committee. Neonates with gestational age ≥35 weeks were included and those with major congenital anomalies were excluded. A convenience sampling method was used. A point estimate was calculated at a 95% Confidence Interval. Among 902 neonates, 120 (13.30%) (11.08-15.52, 95% Confidence Interval) had birth asphyxia. A total of 108 (90%) were outborn, and 84 (70%) were males. HIE stage-I, II and III were seen in 47 (39.17%), 64 (53.33%) and 9 (7.50%) of the asphyxiated neonates respectively. Poor suck 92 (76.67%), seizures 73 (60.83%) and lethargy 70 (58.33%) were common abnormal neurological findings. Death occurred in 15 (12.50%) neonates in the hospital. The prevalence of birth asphyxia was found to be similar to other studies done in similar settings. The high burden underscores an urgent need to implement better perinatal care and delivery room management practices. hypoxic-ischemic encephalopathy; neonates; prevalence.

Chedi,The Plant Care and Crop Prediction App

The research behind the Chedi App stems from a comprehensive exploration of modern plant care and agriculture management practices. Focused on leveraging cutting-edge technologies, including machine learning, image recognition, and real-time monitoring, the research aims to revolutionize the way users interact with and care for indoor plants. Rooted in the principles of sustainability and community, the Chedi App seeks to provide a user-friendly and informative platform that not only assists in plant care but also fosters a shared passion for nature among a diverse user community. The research is driven by a commitment to creating an innovative, responsive, and future-proof application that addresses the evolving needs of plant enthusiasts and agricultural practitioners.

Child Care Management from The Point Of View Of The Book Of Ihya' 'Ulūm Al-Dīn In Malaysia

This research investigates the management of child care from the perspective of the Book of Ihya' 'Ulūm al-Dīn in Malaysia. Against the backdrop of a country rich in Islamic heritage and cultural diversity, this study explores the relevance of the concepts in the Book of Ihya' 'Ulūm al-Dīn in the context of childcare in Malaysia. The library research research method is used to collect, evaluate and analyze related literature, including relevant primary and secondary sources. The results of the analysis show that concepts such as religious education, character formation, and the development of moral values in the Book of Ihya' 'Ulūm al-Dīn have a strong suitability to the life of Malaysian society. This research also highlights the important role of parents, teachers and society in implementing Islamic principles in child care management practices. The implications of the findings of this research include the need to integrate the values of the Book of Ihya' 'Ulūm al-Dīn in educational policies and community development programs to form a generation with noble and responsible morals. In conclusion, this research provides an in-depth understanding of the contribution of Islamic teachings in the management of child care in Malaysia and paves the way for further research in understanding the practical application of these values in society.

Spatial cross-correlation of surface soil physicochemical properties with soil erosion estimated by fallout radionuclides in croplands in a semi-humid region of Iran

Most attempts to correlate soil erosion rates with soil physiochemical properties have not fully succeeded. We employed 137Cs and 210Pbex tracers to understand the interactive impacts of medium- to long-term soil erosion rates on soil texture, structure, and composition in different cropping management systems and slope gradients. To do so, cultivated areas of a sub-watershed were subdivided into three iso-sectors based on slope gradient and typical cropping systems in the region: dry farming with slopes of 10–30 and < 10 % and irrigated farming with a slope of < 10 %. Some soil physiochemical properties were assessed, including particle size distribution, organic carbon (OC), aggregate percolation stability (PS), sealing index (SI), and semi-quantitative XRD of clays. The weighted average net erosion rates in cultivated lands estimated by 137Cs and 210Pbex methods were 26.3 and 31.4 Mg ha−1 yr−1, respectively. Among studied iso-sectors, the dry farming site with a slope of < 10 % had the highest net soil erosion rates and the lowest values for PS and SI, highlighting that land management is a more influential factor on soil erosion than the slope gradient. Both Pearson coefficient and spatial cross-correlation index (SCI) showed a negative correlation between clay content, aggregate stability and soil erosion due to the abundance of expandable clays in the region. However, unlike the Pearson coefficient, SCI showed that the soil loss rates had the strongest association with PS in space, but very weak ones with OC and SI, highlighting PS as a promising indicator of soil quality. SCI proved a superior analysis, which provides the spatial causality between the two variables in space. Findings suggest that to ensure food security in the face of future climate change, careful management practices should be implemented in dry farming lands with high amounts of expandable clays, making them prone to aggregate breakdown and soil erosion.

Study on Pattern of Self-Management Practices in Patients of Diabetes in Rural Population in Aligarh

Self care involves all decisions which individuals, families,take for their own health particularly their own physical andmental well being. Staying fit, exercising, avoiding hazardous behavior etc. will all compound to self care.The aim ofthis study is to find the pattern of self care management practices in patients of Diabetes. A cross sectional study wasdone in registered villages of Rural Health Training Centre and 316 population was covered. All patients of the selectednon communicable diseases above 18 years of age were selected who gave their consent. Self care practice assessmentwas done by including: Diabetes specific section including SDSCA measure - Summary of Diabetes Self- Care ActivitiesQuestionnaire. The findings showed that the prevalence of self-care practices in patients of diabetes was not very high.Slightly more than 50% diabetics were following good levels of self-care practices. Individual levels of self-care practiceslike medication, physical activity/ exercise, adequate diet, risky behaviours of tobacco intake and alcohol consumption,monitoring blood pressure/ blood sugar/ symptoms of COPD, weight management etc. showed varied prevalence.Mostly the patients with any non-communicable disease were found adherent to their medications. In patients ofdiabetes; age group, presently attending any health facility for disease management and receiving health care provider’sadvice for lifestyle modifications were associated significantly with self-care practices.

Study on Pattern of Self-Management Practices in Patients of Diabetes in Rural Population in Aligarh

Self care involves all decisions which individuals, families,take for their own health particularly their own physical andmental well being. Staying fit, exercising, avoiding hazardous behavior etc. will all compound to self care.The aim ofthis study is to find the pattern of self care management practices in patients of Diabetes. A cross sectional study wasdone in registered villages of Rural Health Training Centre and 316 population was covered. All patients of the selectednon communicable diseases above 18 years of age were selected who gave their consent. Self care practice assessmentwas done by including: Diabetes specific section including SDSCA measure - Summary of Diabetes Self- Care ActivitiesQuestionnaire. The findings showed that the prevalence of self-care practices in patients of diabetes was not very high.Slightly more than 50% diabetics were following good levels of self-care practices. Individual levels of self-care practiceslike medication, physical activity/ exercise, adequate diet, risky behaviours of tobacco intake and alcohol consumption,monitoring blood pressure/ blood sugar/ symptoms of COPD, weight management etc. showed varied prevalence.Mostly the patients with any non-communicable disease were found adherent to their medications. In patients ofdiabetes; age group, presently attending any health facility for disease management and receiving health care provider’sadvice for lifestyle modifications were associated significantly with self-care practices.

Sex workers in the Brazilian pandemic: effects on and relations with health

This paper describes the results of the study I Want More! The Lives of Sex Workers During the COVID-19 Pandemic, which is part of the EPIC community research program. The study analyzed the effects of the pandemic on the lives of cis, trans and travesti sex workers in nine Brazilian states and 11 cities throughout 2020 and 2021. This article focuses on the qualitative component of the study, which was based on semi-structured, remote and face-to-face interviews carried out with 43 sex workers, and its comparison with the quantitative component. The effects are analyzed in relation to the Brazilian pandemic framework, considering the social, economic and political dimensions of the COVID-19 virus. Some of the key themes of the analysis are cases of illness, specific social isolation practices, prevention and care management practices, individual vaccination and collective vaccination strategies. We also share the daily and activist responses drawn up by sex workers in a political agenda that opposes the individualistic, familialist, domestic, and neoliberal logic of isolation by adopting community care perspectives, which was the only line of health action for this work category during the pandemic. Collective actions reposition sex work at the interface between public health and human rights and take as their principle the "street knowledge", from activism, and the workers' power of decision over their own bodies.

Buffalo calf health care management practices followed by the farmers in Namakkal districts of Tamil Nadu

Buffalo calf health care management practices followed by the farmers in Namakkal districts of Tamil Nadu