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In recent years, due to advancing technology and diagnostic and therapeutic techniques, medicine and health care have become more patient-oriented. This concept of personalized medicine or theranostics can be traced back to the beginnings of nuclear medicine when radioisotopes were uncovered as diagnostic and therapeutic tools. Nowadays, the field of theranostics is in flux, as new techniques and materials allow a growing range of applications beneficial for patients. This book examines new developments in theranostics and provides a comprehensive overview of the state of the art in this exciting discipline.

Patient-centered health care.

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BACKGROUND: The impact of peripheral artery disease (PAD) on patients' health status and the processes of PAD care have not been prospectively documented in patients with new or worsening claudication. OBJECTIVES: The PORTRAIT (Patient-centered Outcomes Related to TReatment Practices in Peripheral Artery Disease: Investigating Trajectories) study prospectively defined health status outcomes and then related aspects of patient care to these outcomes in patients with new-onset or worsening claudication. In phase I, we developed and tested the study's design. We are now reporting on phase II, in which we expanded the study to 10 US PAD specialty clinics. The following are our research questions: (Aim 1) Do PAD treatments differ by patient characteristics? (Aim 2) Is earlier, rather than later, revascularization associated with more rapid improvements in patients' health status? (Aim 3) Does treatment of PAD vary by physician and health system? (Aim 4) Are variations in care associated with differences in patients' outcomes? (Aim 5) We created educational materials to inform future PAD treatments. METHODS: PORTRAIT enrolled 797 patients with new or worsening claudication symptoms from 10 US PAD specialty clinics. Before treatment, we interviewed patients and abstracted clinical services information from their medical records. We collected health status information at 3, 6, and 12 months follow-up. RESULTS: PAD specialist referred about 1 in 5 patients for an invasive treatment but only less than 2% patients for supervised exercise therapy. Adherence to individual PAD performance measures was relatively high for antiplatelet therapy (84%) and statin use (90%). When we defined perfect care as meeting 4 quality measures of PAD care (statin therapy, antiplatelet therapy, smoking cessation, supervised exercise therapy), only 4.6% of patients received perfect care (aim 1). The magnitude of change in patients' PAD-specific health status scores was greater at 3, 6, and 12 months follow-up in patients who underwent invasive treatment vs those who did not receive invasive treatment (aim 2). Adherence to individual PAD performance measures varied considerably across enrolling PAD clinics (aim 3). Patients who had been receiving evidence-based care (a statin and antiplatelet therapy) had better health status scores at baseline and at all time points except for 12 months (Peripheral Artery Questionnaire summary scores), as compared with those who were not receiving these measures. Associations between perfect care (4 quality measures) and health status outcomes were less clear (aim 4). Women and minority-race patients had consistently lower baseline and follow-up health status scores (aim 5). We created the framework for patient educational materials in collaboration with patient advisors. CONCLUSIONS: While prescription rates for the medical management of the cardiovascular risk in PAD were relatively high, supervised exercise therapy--a performance measure--was seldom prescribed. Women and minority-race patients were at risk of experiencing a lower health status level. Receiving better quality of care following PAD evaluation at baseline was associated with better health status levels at 3-month and 6-month follow-up. Educational materials will be used to share insights learned from PORTRAIT. LIMITATIONS: Findings can be generalized only to the specialist care setting; in an observational study, the potential for residual confounding and selection bias mandates cautious interpretation; further cross-validation of risk estimates derived from health status prediction models in PORTRAIT is needed.

Patient-centered health care.

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In recent years, due to advancing technology and diagnostic and therapeutic techniques, medicine and health care have become more patient-oriented. This concept of personalized medicine or theranostics can be traced back to the beginnings of nuclear medicine when radioisotopes were uncovered as diagnostic and therapeutic tools. Nowadays, the field of theranostics is in flux, as new techniques and materials allow a growing range of applications beneficial for patients. This book examines new developments in theranostics and provides a comprehensive overview of the state of the art in this exciting discipline.

Patient-centered health care.

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Cet ouvrage présente les fondements des « nouveaux modèles de soins », une thématique en plein essor sur le plan international. Jusqu'alors, le modèle traditionnel des soins était tourné vers les notions de maladie et de traitement curatif, occultant progressivement la personne soignée sous le poids de la technicité scientifique. A contrario, tout en assumant pleinement les exigences d'ordre scientifique, ces nouveaux modèles convergent autour de préoccupations au cœur des exigences de la clinique et des attentes sociétales : appui sur les ressources et aspirations de la personne soignée, reconnaissance de son histoire et de son expérience comme sources essentielles de savoir, implication de cette personne comme acteur décisionnel en fonction de ses valeurs, attention au clinicien comme personne et à l'impact de la relation soignant-soigné, réhabilitation des méthodes qualitatives et du recours aux sciences humaines. L'influence de ce changement de paradigme, véritable révolution scientifique, est appelée à s'exercer sur toutes les disciplines concernées par les soins, en particulier celles relevant directement des sciences médicales, sociales ou infirmières. Pour la première fois, cet ouvrage met en relation les principes communs à ces modèles, présente les plus dynamiques d'entre eux, met en évidence leurs développements cliniques concrets et souligne leur synergie avec la clinique fondée sur les données probantes. Rassemblant des auteurs de référence issus de multiples disciplines, cet ouvrage s'adresse aux professionnels intervenant dans les domaines médical, sanitaire et médicosocial (médecins de toutes spécialités, infirmiers, psychologues, éducateurs), mais aussi aux chercheurs en sciences sociales (philosophes, sociologues), acteurs institutionnels et décideurs en santé. Il sera également d'un grand intérêt pour les étudiants qui se destinent à ces professions en les ouvrant aux horizons les plus prometteurs pour un exercice correspondant à leur vocation.

Medical personnel and patient. --- Patient-centered health care.

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In an era when capitalism leaves so many to suffer and to die, with neoliberal 'self-care' offering little more than a bandaid, how can we take health and care back into our hands? In The Hologram, Cassie Thornton puts forward a bold vision for revolutionary care: a viral, peer-to-peer feminist health network. The premise is simple: three people - a 'triangle' - meet on a regular basis, digitally or in person, to focus on the physical, mental and social health of a fourth - the 'hologram'. The hologram, in turn, teaches their caregivers how to give and also receive care; each member of their triangle becomes a hologram for another, different triangle, and so the system expands. Drawing on radical models developed in the Greek solidarity clinics during a decade of crisis, and directly engaging with discussions around mutual aid and the coronavirus pandemic, The Hologram develops the skills and relationships we desperately need for the anti-capitalist struggles of the present, and the post-capitalist society of the future. One part art, one part activism, one part science fiction, this book offers the reader a guide to establishing a Hologram network as well as reflections on this cooperative work in progress.

Patient-centered health care. --- Feminist theory. --- Patient-Centered Care.