The Experts below are selected from a list of 472593 Experts worldwide ranked by ideXlab platform
Christine Cedraschi - One of the best experts on this subject based on the ideXlab platform.
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The Global Spine Care Initiative: Model of Care and implementation
European Spine Journal, 2018Co-Authors: Claire D. Johnson, Scott Haldeman, Roger Chou, Margareta Nordin, Bart N. Green, Pierre Côté, Eric L. Hurwitz, Deborah Kopansky-giles, Emre Acaroğlu, Christine CedraschiAbstract:Purpose Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based Model of Care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health Care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine Care; (2) an evidence-based Model that could be applied globally; and (3) implementation suggestions. Methods The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine Care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final Model of Care and implementation steps. Results Sixty-six experts representing 24 countries participated. The GSCI Model of Care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining. The Model of Care includes a classification system and Care pathway, levels of Care, and a focus on the patient’s journey. The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up. Conclusion The GSCI proposes an evidence-based, practical, sustainable, and scalable Model of Care representing eight core principles with a six-step implementation plan. The aim of this Model is to help transform spine Care globally, especially in low- and middle-income countries and underserved communities. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.
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The Global Spine Care Initiative: Model of Care and implementation
European Spine Journal, 2018Co-Authors: Claire Johnson, Scott Haldeman, Roger Chou, Margareta Nordin, Bart N. Green, Pierre Côté, Eric L. Hurwitz, Deborah Kopansky-giles, Emre Acaroğlu, Christine CedraschiAbstract:Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based Model of Care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health Care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine Care; (2) an evidence-based Model that could be applied globally; and (3) implementation suggestions. The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine Care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final Model of Care and implementation steps. Sixty-six experts representing 24 countries participated. The GSCI Model of Care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining. The Model of Care includes a classification system and Care pathway, levels of Care, and a focus on the patient’s journey. The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up. The GSCI proposes an evidence-based, practical, sustainable, and scalable Model of Care representing eight core principles with a six-step implementation plan. The aim of this Model is to help transform spine Care globally, especially in low- and middle-income countries and underserved communities. These slides can be retrieved under Electronic Supplementary Material.
Jeffrey K Edwards - One of the best experts on this subject based on the ideXlab platform.
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treating syrian refugees with diabetes and hypertension in shatila refugee camp lebanon medecins sans frontieres Model of Care and treatment outcomes
Conflict and Health, 2019Co-Authors: Maysoon Kayali, Krystel Moussally, Chantal Lakis, Mohamad Ali Abrash, Carla Sawan, A J Reid, Jeffrey K EdwardsAbstract:Medecins Sans Frontieres (MSF) has been providing primary Care for non-communicable diseases (NCDs), which have been increasing in low to middle-income countries, in the Shatila refugee camp, Beirut, Lebanon, using a comprehensive Model of Care to respond to the unmet needs of Syrian refugees. The objectives of this study were to: 1) describe the Model of Care used and the Syrian refugee population affected by diabetes mellitus (DM) and/or hypertension (HTN) who had ≥ one visit in the MSF NCD clinic in Shatila in 2017, and 2) assess 6 month treatment outcomes. A descriptive retrospective cohort study using routinely collected program data for a Model of Care for patients with DM and HTN consisting of four main components: case management, patient support and education counseling, integrated mental health, and health promotion. of 2644 Syrian patients with DM and/or HTN, 8% had Type-1 DM, 30% had Type-2 DM, 30% had HTN and 33% had DM + HTN. At intake, patients had a median age of 53, were predominantly females (63%), mostly from outside the catchment area (70%) and diagnosed (97%) prior to enrollment. After 6 months of Care compared to intake: 61% of all patients had controlled DM (HbA1C < 8%) and 50% had controlled blood pressure (BP: < 140/90 mmHg) compared to 29 and 32%, respectively (p < 0.001). Compared to intake, patients with Type-1 DM reached an HbA1C mean of 8.4% versus 9.3% (p = 0.022); Type-2 DM patients had an HbA1C mean of 8.1% versus 9.4% (p = 0.001); and those with DM + HTN reached a mean HbA1C of 7.7% versus 9.0%, (p = 0.003). Reflecting improved control, HTN patients requiring ≥3 medications increased from 23 to 38% (p < 0.001), while DM patients requiring insulin increased from 21 to 29% (p < 0.001). Loss-to-follow-up was 16%. The MSF Model of Care for DM and HTN operating in the Shatila refugee camp is feasible, and showed promising outcomes among enrolled individuals. It may be replicated in similar contexts to respond to the increasing burden of NCDs among refugees in the Middle-East and elsewhere.
Louise Koelmeyer - One of the best experts on this subject based on the ideXlab platform.
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implementing a prospective surveillance and early intervention Model of Care for breast cancer related lymphedema into clinical practice application of the re aim framework
Supportive Care in Cancer, 2021Co-Authors: Louise Koelmeyer, John Boyages, Katrina Gaitatzis, Sheila H Ridner, Jerrod Nelms, Michael T Hughes, Elisabeth Elder, James French, Nicholas K NguiAbstract:Chronic lymphedema following breast cancer (BC) affects individuals physically, functionally, psychologically, and financially. Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention Model of Care (PSM), bridging the gap between research and clinical practice has been difficult. As part of an international randomized controlled trial (RCT), Australian women with BC from four hospitals were recruited, monitored for lymphedema at regular intervals over a 3-year period, and were provided a compression garment if intervention was triggered. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework was used retrospectively to assess a PSM at the individual and organizational level for those who had completed at least 2-year follow-up (N = 219) in the RCT. The application of the RE-AIM framework retrospectively demonstrated an extensive reach to patients across public and private settings; the effectiveness of prospective surveillance and early intervention was achieved through low progression rates to clinical lymphedema (1.8%), and all hospital sites initially approached adopted the research study. Key implementation strategies necessary for effectiveness of this Model of Care included education to health professionals and patients, staff acceptability, and development of a referral and Care pathway. Maintenance dimensions were evaluated both at the individual level with 92–100% adherence rates for all nonoptional study appointments over the 2-year period, and at the organizational-level, PSM was sustained after recruitment ceased for the research study. The PSM for lymphedema in BC can be successfully implemented using the RE-AIM framework applied retrospectively. The implementation of the PSM used in the RCT has assisted in changing clinical practices and improving the quality and effectiveness of the health Care system.
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Implementing a prospective surveillance and early intervention Model of Care for breast cancer–related lymphedema into clinical practice: application of the RE-AIM framework
Supportive Care in Cancer, 2020Co-Authors: Louise Koelmeyer, John Boyages, Katrina Gaitatzis, Sheila H Ridner, Jerrod Nelms, Elisabeth Elder, James French, Nicholas K Ngui, T. Michael Hughes, Deonni StolldorfAbstract:Purpose Chronic lymphedema following breast cancer (BC) affects individuals physically, functionally, psychologically, and financially. Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention Model of Care (PSM), bridging the gap between research and clinical practice has been difficult. Method As part of an international randomized controlled trial (RCT), Australian women with BC from four hospitals were recruited, monitored for lymphedema at regular intervals over a 3-year period, and were provided a compression garment if intervention was triggered. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework was used retrospectively to assess a PSM at the individual and organizational level for those who had completed at least 2-year follow-up ( N = 219) in the RCT. Results The application of the RE-AIM framework retrospectively demonstrated an extensive reach to patients across public and private settings; the effectiveness of prospective surveillance and early intervention was achieved through low progression rates to clinical lymphedema (1.8%), and all hospital sites initially approached adopted the research study. Key implementation strategies necessary for effectiveness of this Model of Care included education to health professionals and patients, staff acceptability, and development of a referral and Care pathway. Maintenance dimensions were evaluated both at the individual level with 92–100% adherence rates for all nonoptional study appointments over the 2-year period, and at the organizational-level, PSM was sustained after recruitment ceased for the research study. Conclusion The PSM for lymphedema in BC can be successfully implemented using the RE-AIM framework applied retrospectively. The implementation of the PSM used in the RCT has assisted in changing clinical practices and improving the quality and effectiveness of the health Care system.
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Early surveillance is associated with less incidence and severity of breast cancer–related lymphedema compared with a traditional referral Model of Care
Cancer, 2018Co-Authors: Louise Koelmeyer, Caleb J. Winch, Jessica Alcorso, Robert Borotkanics, Philip Prah, Kristine Nakhel, Catherine M. Dean, John BoyagesAbstract:BACKGROUND Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer-related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer-related lymphedema are evaluated in an early surveillance Model of Care compared with a traditional referral Model of Care. METHODS In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the "early surveillance" group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the "traditional referral" group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow-up, and the number of health Care visits. Lymphedema was diagnosed based on BIS measures. RESULTS Women in the early surveillance group received lymphedema Care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I-III, 39 % vs 14%; P < .001) and with greater severity (stage II-III, 24%) compared with those in the early surveillance group (4%). CONCLUSIONS The current findings support the adoption of an early prospective surveillance Model of Care using BIS for the early detection and management of breast cancer-related lymphedema.
John Boyages - One of the best experts on this subject based on the ideXlab platform.
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implementing a prospective surveillance and early intervention Model of Care for breast cancer related lymphedema into clinical practice application of the re aim framework
Supportive Care in Cancer, 2021Co-Authors: Louise Koelmeyer, John Boyages, Katrina Gaitatzis, Sheila H Ridner, Jerrod Nelms, Michael T Hughes, Elisabeth Elder, James French, Nicholas K NguiAbstract:Chronic lymphedema following breast cancer (BC) affects individuals physically, functionally, psychologically, and financially. Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention Model of Care (PSM), bridging the gap between research and clinical practice has been difficult. As part of an international randomized controlled trial (RCT), Australian women with BC from four hospitals were recruited, monitored for lymphedema at regular intervals over a 3-year period, and were provided a compression garment if intervention was triggered. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework was used retrospectively to assess a PSM at the individual and organizational level for those who had completed at least 2-year follow-up (N = 219) in the RCT. The application of the RE-AIM framework retrospectively demonstrated an extensive reach to patients across public and private settings; the effectiveness of prospective surveillance and early intervention was achieved through low progression rates to clinical lymphedema (1.8%), and all hospital sites initially approached adopted the research study. Key implementation strategies necessary for effectiveness of this Model of Care included education to health professionals and patients, staff acceptability, and development of a referral and Care pathway. Maintenance dimensions were evaluated both at the individual level with 92–100% adherence rates for all nonoptional study appointments over the 2-year period, and at the organizational-level, PSM was sustained after recruitment ceased for the research study. The PSM for lymphedema in BC can be successfully implemented using the RE-AIM framework applied retrospectively. The implementation of the PSM used in the RCT has assisted in changing clinical practices and improving the quality and effectiveness of the health Care system.
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Implementing a prospective surveillance and early intervention Model of Care for breast cancer–related lymphedema into clinical practice: application of the RE-AIM framework
Supportive Care in Cancer, 2020Co-Authors: Louise Koelmeyer, John Boyages, Katrina Gaitatzis, Sheila H Ridner, Jerrod Nelms, Elisabeth Elder, James French, Nicholas K Ngui, T. Michael Hughes, Deonni StolldorfAbstract:Purpose Chronic lymphedema following breast cancer (BC) affects individuals physically, functionally, psychologically, and financially. Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention Model of Care (PSM), bridging the gap between research and clinical practice has been difficult. Method As part of an international randomized controlled trial (RCT), Australian women with BC from four hospitals were recruited, monitored for lymphedema at regular intervals over a 3-year period, and were provided a compression garment if intervention was triggered. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework was used retrospectively to assess a PSM at the individual and organizational level for those who had completed at least 2-year follow-up ( N = 219) in the RCT. Results The application of the RE-AIM framework retrospectively demonstrated an extensive reach to patients across public and private settings; the effectiveness of prospective surveillance and early intervention was achieved through low progression rates to clinical lymphedema (1.8%), and all hospital sites initially approached adopted the research study. Key implementation strategies necessary for effectiveness of this Model of Care included education to health professionals and patients, staff acceptability, and development of a referral and Care pathway. Maintenance dimensions were evaluated both at the individual level with 92–100% adherence rates for all nonoptional study appointments over the 2-year period, and at the organizational-level, PSM was sustained after recruitment ceased for the research study. Conclusion The PSM for lymphedema in BC can be successfully implemented using the RE-AIM framework applied retrospectively. The implementation of the PSM used in the RCT has assisted in changing clinical practices and improving the quality and effectiveness of the health Care system.
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Early surveillance is associated with less incidence and severity of breast cancer–related lymphedema compared with a traditional referral Model of Care
Cancer, 2018Co-Authors: Louise Koelmeyer, Caleb J. Winch, Jessica Alcorso, Robert Borotkanics, Philip Prah, Kristine Nakhel, Catherine M. Dean, John BoyagesAbstract:BACKGROUND Bioimpedance spectroscopy (BIS) has enabled the early identification of breast cancer-related lymphedema. In this study, differences in health service metrics and in the incidence of breast cancer-related lymphedema are evaluated in an early surveillance Model of Care compared with a traditional referral Model of Care. METHODS In a retrospective analysis of data from 753 women who underwent BIS measures between January 1, 2007 and December 31, 2016, 188 women were assigned to the "early surveillance" group if they began lymphedema monitoring presurgery (n = 121) or within 90 days postsurgery (n = 67), and 285 women were assigned to the "traditional referral" group if they began monitoring after 90 days postsurgery. Health service metrics were calculated as the time to the first BIS measure after 90 days postsurgery, the median follow-up, and the number of health Care visits. Lymphedema was diagnosed based on BIS measures. RESULTS Women in the early surveillance group received lymphedema Care significantly earlier than those in the traditional referral group. However, there was no difference in the number of visits per year to the clinic between groups. Significantly more women in the traditional referral group were diagnosed with clinical lymphedema (stage I-III, 39 % vs 14%; P < .001) and with greater severity (stage II-III, 24%) compared with those in the early surveillance group (4%). CONCLUSIONS The current findings support the adoption of an early prospective surveillance Model of Care using BIS for the early detection and management of breast cancer-related lymphedema.
Nicholas K Ngui - One of the best experts on this subject based on the ideXlab platform.
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implementing a prospective surveillance and early intervention Model of Care for breast cancer related lymphedema into clinical practice application of the re aim framework
Supportive Care in Cancer, 2021Co-Authors: Louise Koelmeyer, John Boyages, Katrina Gaitatzis, Sheila H Ridner, Jerrod Nelms, Michael T Hughes, Elisabeth Elder, James French, Nicholas K NguiAbstract:Chronic lymphedema following breast cancer (BC) affects individuals physically, functionally, psychologically, and financially. Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention Model of Care (PSM), bridging the gap between research and clinical practice has been difficult. As part of an international randomized controlled trial (RCT), Australian women with BC from four hospitals were recruited, monitored for lymphedema at regular intervals over a 3-year period, and were provided a compression garment if intervention was triggered. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework was used retrospectively to assess a PSM at the individual and organizational level for those who had completed at least 2-year follow-up (N = 219) in the RCT. The application of the RE-AIM framework retrospectively demonstrated an extensive reach to patients across public and private settings; the effectiveness of prospective surveillance and early intervention was achieved through low progression rates to clinical lymphedema (1.8%), and all hospital sites initially approached adopted the research study. Key implementation strategies necessary for effectiveness of this Model of Care included education to health professionals and patients, staff acceptability, and development of a referral and Care pathway. Maintenance dimensions were evaluated both at the individual level with 92–100% adherence rates for all nonoptional study appointments over the 2-year period, and at the organizational-level, PSM was sustained after recruitment ceased for the research study. The PSM for lymphedema in BC can be successfully implemented using the RE-AIM framework applied retrospectively. The implementation of the PSM used in the RCT has assisted in changing clinical practices and improving the quality and effectiveness of the health Care system.
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Implementing a prospective surveillance and early intervention Model of Care for breast cancer–related lymphedema into clinical practice: application of the RE-AIM framework
Supportive Care in Cancer, 2020Co-Authors: Louise Koelmeyer, John Boyages, Katrina Gaitatzis, Sheila H Ridner, Jerrod Nelms, Elisabeth Elder, James French, Nicholas K Ngui, T. Michael Hughes, Deonni StolldorfAbstract:Purpose Chronic lymphedema following breast cancer (BC) affects individuals physically, functionally, psychologically, and financially. Despite national guidelines and evidence-based research supporting a prospective surveillance and early intervention Model of Care (PSM), bridging the gap between research and clinical practice has been difficult. Method As part of an international randomized controlled trial (RCT), Australian women with BC from four hospitals were recruited, monitored for lymphedema at regular intervals over a 3-year period, and were provided a compression garment if intervention was triggered. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework was used retrospectively to assess a PSM at the individual and organizational level for those who had completed at least 2-year follow-up ( N = 219) in the RCT. Results The application of the RE-AIM framework retrospectively demonstrated an extensive reach to patients across public and private settings; the effectiveness of prospective surveillance and early intervention was achieved through low progression rates to clinical lymphedema (1.8%), and all hospital sites initially approached adopted the research study. Key implementation strategies necessary for effectiveness of this Model of Care included education to health professionals and patients, staff acceptability, and development of a referral and Care pathway. Maintenance dimensions were evaluated both at the individual level with 92–100% adherence rates for all nonoptional study appointments over the 2-year period, and at the organizational-level, PSM was sustained after recruitment ceased for the research study. Conclusion The PSM for lymphedema in BC can be successfully implemented using the RE-AIM framework applied retrospectively. The implementation of the PSM used in the RCT has assisted in changing clinical practices and improving the quality and effectiveness of the health Care system.