Mechanical circulatory support using modified TandemHeart ventricular assist device in neonates with CHD.

TandemHeart, an adult ventricular assist device, is also being used in children for mechanical circulatory support. In this case series, we describe our experience using TandemHeart ventricular assist device with a modified circuit to provide mechanical circulatory support in three neonates for multiple indications. TandemHeart ventricular assist device with a modified circuit can be used successfully to provide extracorporeal support to neonates with complex CHD.

Community-based pediatric palliative care for health related quality of life, hospital utilization and costs lessons learned from a pilot study.

BACKGROUND: Children with chronic complex-medical conditions comprise a small minority of children who require substantial healthcare with major implications for hospital utilization and costs in pediatrics. Community-Based Pediatric Palliative Care (CBPPC) provides a holistic approach to patient care that can improve their quality of life and lead to reduced costs of hospital care. This study's purpose was to analyze and report unpublished evaluation study results from 2007 that demonstrate the potential for CBPPC on Health Related Quality of Life (HRQoL) and hospital utilization and costs in light of the increasing national focus on the care of children with complex-medical conditions, including the Affordable Care Act's emphasis on patient-centered outcomes. METHODS: A multi-method research design used primary data collected from caregivers to determine the Program's potential impact on HRQoL, and administrative data to assess the Program's potential impact on hospital utilization and costs. Caregivers (n=53) of children enrolled in the Northeast Florida CBPPC program (Community PedsCare) through the years 2002-2007 were recruited for the Health Related Quality of Life (HRQoL) study. Children (n=48) enrolled in the Program through years 2000-2006 were included in the utilization and cost study. RESULTS: HRQoL was generally high, and hospital charges per child declined by $1203 for total hospital services (p=.34) and $1047 for diagnostic charges per quarter (p=0.13). Hospital length of stay decreased from 2.92 days per quarter to 1.22 days per quarter (p<.05). CONCLUSION: The decrease in hospital utilization and costs and the high HRQoL results indicate that CBPPC has the potential to influence important outcomes for the quality of care available for children with complex-medical conditions and their caregivers.

Developing weight management messages and interventions for baby boomer men.

The goal of this study was to explore the weight management experiences of Baby Boomer men (born between 1946 and 1964) and to use the information to develop targeted messages and interventions. Twenty men were interviewed. The Health Belief Model was used as the study's theoretical framework. Men correctly identified health risks of being obese. However, most believed that body mass index and weight charts were unrealistic, and a few felt that they would be too "skinny" at the recommended weight. Wives were sources of nutrition information and social support. Perceived benefits of losing weight included reduced risk for health problems and looking good. Perceived barriers included apathy and weight loss programs being "too feminine." Motivators for losing weight included being diagnosed with a health problem, health requirements for work, and financial incentives. The data themes suggest ways to develop male-specific messages and interventions that consider the aging body.