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101.
Robert B. Schonberger MD MHS Amit Bardia MD Feng Dai PhD George Michel MS MBA David Yanez PhD Jeptha P. Curtis MD Michelle T. Vaughn MPH Matthew M. Burg PhD Michael Mathis MD Sachin Kheterpal MD MBA Shamsuddin Akhtar MD PhD Nirav Shah MD 《Journal of the American Geriatrics Society》2021,69(8):2195-2209
102.
Malaz Boustani MD MPH Jürgen Unützer MD MPH MA Luci K. Leykum MD MBA MSc 《Journal of the American Geriatrics Society》2021,69(7):1755-1762
Most innovations developed to reduce the burden of Alzheimer disease and other related dementias (ADRD) are difficult to implement, diffuse, and scale. The consequences of such challenges in design, implementation, and diffusion are suboptimal care and resulting harm for people living with ADRD and their caregivers. National experts identified four factors that contribute to our limited ability to implement and diffuse of evidence-based services and interventions for people living with ADRD: (1) limited market demand for the implementation and diffusion of effective ADRD interventions; (2) insufficient engagement of persons living with ADRD and those caring for them in the development of potential ADRD services and interventions; (3) limited evidence and experience regarding scalability and sustainability of evidence-based ADRD care services; and (4) difficulties in taking innovations that work in one context and successfully implementing them in other contexts. New investments in the science of human-centered design, implementation, and diffusion are crucial for meeting the goals of the National Plan to Address Alzheimer's Disease under the auspices of the National Alzheimer's Project Act. 相似文献
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Berger WE 《Current allergy and asthma reports》2001,1(6):498-505
Epidemiologic and pathophysiologic evidence indicates that allergic rhinitis, whether seasonal or perennial, is one piece
of a larger atopic clinical picture that often occurs concomitantly with asthma. Allergic rhinitis usually develops during
childhood and has a prevalence of up to 40% in the pediatric population. Careful attention to food allergies and the presence
of household allergens during infancy and early childhood may limit potential sensitizations. Many antihistamines and topical
corticosteroids now are available for the treatment of allergic rhinitis in children, which is all the more important because
optimal management may improve quality of life and curtail the development of serious sequelae. 相似文献
109.
Pediatric patients who receive antibiotics for fever and neutropenia in less than 60 min have decreased intensive care needs 下载免费PDF全文
Jennifer L. Salstrom MD PhD Rebecca L. Coughlin MEd Kathleen Pool MSN CPNP Melissa Bojan BSN Camille Mediavilla BSN William Schwent MBA Michael Rannie MS Dawn Law MBA Michelle Finnerty BS Joanne Hilden MD 《Pediatric blood & cancer》2015,62(5):807-815
Background
Antibiotic delivery to patients with fever and neutropenia (F&N) in <60 min is an increasingly important quality measure for oncology centers, but several published reports indicate that a time to antibiotic delivery (TTA) of <60 min is quite difficult to achieve. Here we report a quality improvement (QI) effort that sought to decrease TTA and assess associated clinical outcomes in pediatric patients with cancer and F&N.Procedure
We used Lean‐Methodology and a Plan‐Do‐Study‐Act approach to direct QI efforts and prospectively tracked TTA measures and associated clinical outcomes (length of stay, duration of fever, use of imaging studies to search for occult infection, bacteremia, intensive care unit (ICU) consultation or admission, and mortality). We then performed statistical analysis to determine the impact of our QI interventions on total TTA, sub‐process times, and clinical outcomes.Results
Our QI interventions significantly improved TTA such that we are now able to deliver antibiotics in <60 min nearly 100% of the time. All TTA sub‐process times also improved. Moreover, achieving TTA <60 min significantly reduced the need for ICU consultation or admission (P = 0.003) in this population.Conclusion
Here we describe our QI effort along with a detailed assessment of several associated clinical outcomes. These data indicate that decreasing TTA to <60 min is achievable and associated with improved outcomes in pediatric patients with cancer and F&N. Pediatr Blood Cancer 2015;62:807–815. © 2015 The Authors. Pediatric Blood & Cancer, published by Wiley Periodicals, Inc. 相似文献110.
Hemophagocytic lymphohistiocytosis in a female patient due to a heterozygous XIAP mutation and skewed X chromosome inactivation 下载免费PDF全文