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https://www.readbyqxmd.com/read/28609229/results-and-implications-of-routine-hiv-testing-in-the-inpatient-setting-a-descriptive-analysis
#1
Jamie L Mignano, Lucy Miner, Kristin Siedl, Travis Brown, Christina Cafeo, Lisa Rowen, Robert R Redfield, Mangla Gulati
Policy changes and scientific advances have guided new methods of diagnosing and managing HIV that reduce mortality, morbidity, and transmission. In a high HIV prevalence urban setting, a hospital initiative was implemented to routinely perform HIV testing and provide linkage to care for those with positive results and for individuals with a prior diagnosis of HIV. Maryland's unique all-payer model presents an opportunity to implement population health initiatives in health systems. The rationale, methodology, results and lessons learned from this approach will be discussed...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28606191/no-calm-after-the-storm-a-systematic-review-of-human-health-following-flood-and-storm-disasters
#2
Dell D Saulnier, Kim Brolin Ribacke, Johan von Schreeb
Introduction How the burden of disease varies during different phases after floods and after storms is essential in order to guide a medical response, but it has not been well-described. The objective of this review was to elucidate the health problems following flood and storm disasters. METHODS: A literature search of the databases Medline (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA); Cinahl (EBSCO Information Services; Ipswich, Massachusetts USA); Global Health (EBSCO Information Services; Ipswich, Massachusetts USA); Web of Science Core Collection (Thomson Reuters; New York, New York USA); Embase (Elsevier; Amsterdam, Netherlands); and PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA) was conducted in June 2015 for English-language research articles on morbidity or mortality and flood or storm disasters...
June 13, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28535103/value-frameworks-for-the-patient-provider-interaction-a-comparison-of-the-asco-value-framework-versus-nccn-evidence-blocks-in-determining-value-in-oncology
#3
Bijal Shah-Manek, Joseph S Galanto, Huong Nguyen, Robert Ignoffo
BACKGROUND: To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28525630/laboratory-integration-and-consolidation-in-a-regional-health-system
#4
Jim Cook
Health systems face intense pressure to decrease costs and improve services as the health care delivery system in the United States undergoes tremendous change due to health care reform. As health systems grow, like any business, they are forced to explore standardization to realize and maintain efficient practices. Clinical services, such as laboratory medicine, are more difficult to integrate due to wider variation in acceptable practice and culture, compared with other services. However, changes to laboratory service are imperative if health care professionals expect to survive and thrive in the new business environment...
May 19, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28448318/two-state-collaborative-study-of-a-multifaceted-intervention-to-decrease-ventilator-associated-events
#5
Nishi Rawat, Ting Yang, Kisha J Ali, Mary Catanzaro, Mariah D Cohen, Donna O Farley, Lisa H Lubomski, David A Thompson, Bradford D Winters, Sara E Cosgrove, Michael Klompas, Kathleen A Speck, Sean M Berenholtz
OBJECTIVES: Ventilator-associated events are associated with increased mortality, prolonged mechanical ventilation, and longer ICU stay. Given strong national interest in improving ventilated patient care, the National Institute of Health and Agency for Healthcare Research and Quality funded a two-state collaborative to reduce ventilator-associated events. We describe the collaborative's impact on ventilator-associated event rates in 56 ICUs. DESIGN: Longitudinal quasi-experimental study...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437523/emergency-department-query-for-patient-centered-approaches-to-sexual-orientation-and-gender-identity-the-equality-study
#6
Adil H Haider, Eric B Schneider, Lisa M Kodadek, Rachel R Adler, Anju Ranjit, Maya Torain, Ryan Y Shields, Claire Snyder, Jeremiah D Schuur, Laura Vail, Danielle German, Susan Peterson, Brandyn D Lau
Importance: The Institute of Medicine and The Joint Commission recommend routine documentation of patients' sexual orientation in health care settings. Currently, very few health care systems collect these data since patient preferences and health care professionals' support regarding collection of data about patient sexual orientation are unknown. Objective: To identify the optimal patient-centered approach to collect sexual orientation data in the emergency department (ED) in the Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity study...
June 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#7
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28379933/communities-social-justice-and-academic-health-centers
#8
Philip M Alberti, Karey M Sutton, Lisa A Cooper, Wendy G Lane, Stacey Stephens, Michelle A Gourdine
In November 2015, the Association of American Medical Colleges (AAMC) held its annual meeting in Baltimore, Maryland. In response both to health and health care inequities faced by residents of Baltimore and to the imminent trial of the police officers charged with Freddie Gray's death, AAMC leaders thought it crucial to address issues of health inequity, social injustice, and the role an academic health center (AHC) can play in improving the health of the community it serves. In collaboration with community-engaged researchers from Johns Hopkins University and University of Maryland, Baltimore, AAMC staff interviewed Baltimore residents, soliciting their perspectives on how medical education, clinical care, and research can and should respond to social injustice and the social determinants of health...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28374212/bridging-the-divide-building-infrastructure-to-support-community-academic-partnerships-and-improve-capacity-to-conduct-patient-centered-outcomes-research
#9
Jennifer Huang, Paula Darby Lipman, C Daniel Mullins
For research to be useful, trustworthy, and ultimately lead to greater dissemination of findings to patients and communities, it is important to train and mentor academic researchers to meaningfully engage community members in patient-centered outcomes research (PCOR). Thus, it is necessary for research institutions to strengthen their underlying infrastructure to support PCOR. PATIENTS-PATient-centered Involvement in Evaluating effectiveNess of TreatmentS-at the University of Maryland, Baltimore, focuses on improving PCOR methods and addressing health disparities...
April 3, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28366556/hiv-stigma-retention-in-care-and-adherence-among-older-black-women-living-with-hiv
#10
Thurka Sangaramoorthy, Amelia M Jamison, Typhanye V Dyer
Stigma is recognized as a barrier to the prevention, care, and treatment of HIV, including engagement in the HIV care continuum. HIV stigma in older Black women may be compounded by preexisting social inequities based on gender, age, and race. Using semi-structured interviews and survey questionnaires, we explore experiences of HIV stigma, retention in care, and antiretroviral therapy (ART) adherence in 35 older Black women with HIV from Prince George's County, Maryland. Study findings indicated that older Black women experienced high levels of HIV stigma, retention in care, and ART adherence...
March 18, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28360245/listening-to-paediatric-primary-care-nurses-a-qualitative-study-of-the-potential-for-interprofessional-oral-health-practice-in-six-federally-qualified-health-centres-in-massachusetts-and-maryland
#11
Judith Bernstein, Christina Gebel, Clemencia Vargas, Paul Geltman, Ashley Walter, Raul Garcia, Norman Tinanoff
OBJECTIVES: To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. SAMPLE: Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28285064/patient-perceptions-of-a-pharmacy-star-rating-model
#12
Terri L Warholak, Mira Patel, Meagen Rosenthal, Donna West-Strum, Earl B Ettienne, Gail Nunlee-Bland, David Nau, Ana L Hincapie
OBJECTIVES: To identify patients' understanding of what constitutes a "quality pharmacy" and to obtain their feedback regarding the development and use of the pharmacy star rating model, a pharmacy-specific aggregate performance score based on the Centers for Medicare and Medicaid Services' Medicare Star Rating. DESIGN: Prospective cross-sectional study. SETTING AND PARTICIPANTS: Focus groups were conducted in Arizona, California, Mississippi, Maryland, and the District of Columbia, and one-on-one interviews were conducted in Indiana...
March 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28275952/the-anticonvulsant-screening-program-of-the-national-institute-of-neurological-disorders-and-stroke-nih-history-and-contributions-to-clinical-care-in-the-twentieth-century-and-beyond
#13
Roger J Porter, Harvey J Kupferberg
The anticonvulsant screening program (ASP) of the national institute of neurological disorders and stroke (NINDS), National Institutes of Health has made substantial contributions to the drug armamentarium of the clinical neurologist. This program, originally a part of the overall Drug Development Program of the Epilepsy Branch, has been fortunate to have talented leadership, both at NINDS in Maryland and at the major contract site, the University of Utah-over a remarkable period of more than 40 years. Future discoveries by the ASP (now renamed the Epilepsy Therapy Screening) can be expected to make additional contributions to improving the health of persons with epilepsy...
March 9, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28264077/association-of-a-community-campaign-for-better-beverage-choices-with-beverage-purchases-from-supermarkets
#14
Marlene B Schwartz, Glenn E Schneider, Yoon-Young Choi, Xun Li, Jennifer Harris, Tatiana Andreyeva, Maia Hyary, Nicolette Highsmith Vernick, Lawrence J Appel
Importance: Data are needed to evaluate community interventions to reduce consumption of sugary drinks. Supermarket sales data can be used for this purpose. Objective: To compare beverage sales in Howard County, Maryland (HC), with sales in comparison stores in a contiguous state before and during a 3-year campaign to reduce consumption of sugary beverages. Design, Setting, and Partipicants: This observational experiment with a control group included 15 HC supermarkets and 17 comparison supermarkets...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28224441/does-medicaid-insurance-confer-adequate-access-to-adult-orthopaedic-care-in-the-era-of-the-patient-protection-and-affordable-care-act
#15
Joseph T Labrum, Taylor Paziuk, Theresa C Rihn, Alan S Hilibrand, Alexander R Vaccaro, Mitchell G Maltenfort, Jeffrey A Rihn
BACKGROUND: A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). QUESTIONS/PURPOSES: (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? METHODS: Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion...
June 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28219452/stop-stroke-a-brief-report-on-door-to-needle-times-and-performance-after-implementing-an-acute-care-coordination-medical-application-and-implications-to-emergency-medical-services
#16
Robert Dickson, Adrian Nedelcut, Melissa McPeek Nedelcut
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period...
February 21, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28215195/tetanus-a-potential-public-health-threat-in-times-of-disaster
#17
Paige Finkelstein, Laura Teisch, Casey J Allen, Gabriel Ruiz
BACKGROUND: Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient. METHODS: A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords "Tetanus," "Trauma/Surgery," and "Disaster...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28167591/the-arc-of-human-immunodeficiency-virus-capacity-development-insights-from-a-decade-of-partnership-for-medical-education-in-zambia
#18
Cassidy W Claassen, Lottie Hachaambwa, Dorcas Phiri, Douglas C Watson, Devang Patel, Christopher M Bositis, Amy Bositis, Deus Mubangizi, Robert Redfield, Peter Mwaba, Robb Sheneberger
AbstractZambia and other sub-Saharan nations suffer from a critical shortage of trained health-care professionals to combat the human immunodeficiency virus/acquired immunodeficiency syndrome crisis. The University of Maryland and the Zambian Ministry of Health have partnered over the past decade to develop health-care capacity among physicians, nurses, and community health workers. We describe novel interventions to train health-care workers at all levels and argue that our collaboration represents a successful model for such partnerships between western medical institutions and African governmental health agencies...
May 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28134070/earthquake-related-orthopedic-injuries-in-adult-population-a-systematic-review
#19
Michelangelo Bortolin, Ilaria Morelli, Amalia Voskanyan, Nina R Joyce, Gregory R Ciottone
Introduction Earthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in "Mega-Mass-Casualty" earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system. METHODS: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
January 30, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28108621/are-physical-measures-related-to-patient-centred-outcomes-in-ards-survivors
#20
Kitty S Chan, Lisa Aronson Friedman, Victor D Dinglas, Catherine L Hough, Carl Shanholtz, E Wesley Ely, Peter E Morris, Pedro A Mendez-Tellez, James C Jackson, Ramona O Hopkins, Dale M Needham
OBJECTIVE: To inform selection of physical measures for studies of acute respiratory distress syndrome (ARDS) survivors within 12 months of ARDS. METHODS: Secondary analysis of data from 6-month survivors participating in a US multicentre prospective study (ARDSNet Long-Term Outcome Study, N=134) or a multisite prospective study in Baltimore, Maryland, USA (Improving Care of Acute Lung Injury Patients, N=99). Physical measures, assessed at 6-month follow-up, were categorised according to the WHO's International Classification of Disability and Health: body functions and structures, activity and participation...
January 20, 2017: Thorax
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