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https://www.readbyqxmd.com/read/29443557/adolescent-pregnancy-prevention-among-youths-living-in-group-care-homes-a-cluster-randomized-controlled-trial
#1
Roy F Oman, Sara K Vesely, Jennifer Green, Kristen Clements-Nolle, Minggen Lu
OBJECTIVES: To determine if the Power Through Choices (PTC) intervention can increase the use of birth control and reduce pregnancy among system-involved youths living in group care homes. METHODS: We performed a 2-arm cluster randomized controlled trial involving group care homes operated by child welfare or juvenile justice systems in California, Maryland, and Oklahoma with assessments immediately before and after the intervention, and at 6- and 12-month follow-up...
February 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29417146/associations-of-distance-to-trauma-care-community-income-and-neighborhood-median-age-with-rates-of-injury-mortality
#2
Molly P Jarman, Frank C Curriero, Elliott R Haut, Keshia Pollack Porter, Renan C Castillo
Importance: Rural, low-income, and historically underrepresented minority communities face substantial barriers to trauma care and experience high injury incidence and mortality rates. Characteristics of injury incident locations may contribute to poor injury outcomes. Objective: To examine the association of injury scene characteristics with injury mortality. Design, Setting, and Participants: In this cross-sectional study, data from trauma center and emergency medical services provided by emergency medical services companies and designated trauma centers in the state of Maryland from January 1, 2015, to December 31, 2015, were geocoded by injury incident locations and linked with injury scene characteristics...
February 7, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29389841/emergency-general-surgery-in-geriatric-patients-a-statewide-analysis-of-surgeon-and-hospital-volume-with-outcomes
#3
Ambar Mehta, Linda A Dultz, Bellal Joseph, Joseph K Canner, Kent Stevens, Christian Jones, Elliot R Haut, David T Efron, Joseph V Sakran
INTRODUCTION: Geriatric patients undergoing emergency general surgery (EGS) face significant morbidity and mortality. We assessed how surgeon and hospital volumes affected these outcomes. METHODS: We identified patients at least 65 years old in Maryland's Health Services Cost Review Commission database from 2012-2014 who underwent one of 12 EGS procedures, as defined by the American Association for the Surgery of Trauma, and then calculated four outcomes: mortality rate, the incidence of at least one of eight common in-hospital EGS complications, failure-to-rescue (death after experiencing a postoperative complication), and the 30-day readmission rate...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29388465/understanding-the-impact-of-fibromyalgia-on-men-findings-from-a-nationwide-survey
#4
Daenuka Muraleetharan, Ana Fadich, Colin Stephenson, Whitney Garney
Fibromyalgia (FM) is a serious condition that affects approximately four million people in the United States, and is underdiagnosed in men. The objective of this study was to understand this phenomenon by examining multiple impacts of fibromyalgia on men in regard to interactions in society and the U.S. health system. A qualitative survey was administered to 1,163 respondents both online and in-person in Tennessee, Virginia, Maryland, and Washington, DC. Thematic analyses of the survey responses suggest that men with FM have negative experiences with (1) physical and mental health, (2) quality of life, (3) relationships, and (4) careers as a result of FM...
January 1, 2018: American Journal of Men's Health
https://www.readbyqxmd.com/read/29345494/george-franklin-mccoy-1922-2017
#5
Tom Fagan
Presents an obituary for George Franklin McCoy, who passed away on February 6, 2017, in Tulsa, Oklahoma. McCoy was a citizen of the Cherokee Nation, having been born to Cherokee Nation citizens. He served as school psychologist for the Champaign, Illinois schools (1958-1962) and then began his 18 year career (1962-1980) as a psychology professor at Illinois State Normal University (ISNU, now ISU), where he also served as the school psychologist for the Thomas Metcalf and University High Schools. True to his Cherokee citizenship and Oklahoma roots, in 1980 he joined the United States Indian Health Services (IHS) as a psychologist at the Carl Albert Indian Health Facility in Ada, Oklahoma...
January 2018: American Psychologist
https://www.readbyqxmd.com/read/29340564/changes-in-health-care-use-associated-with-the-introduction-of-hospital-global-budgets-in-maryland
#6
Eric T Roberts, J Michael McWilliams, Laura A Hatfield, Sule Gerovich, Michael E Chernew, Lauren G Gilstrap, Ateev Mehrotra
Importance: In 2014, the State of Maryland placed the majority of its hospitals under all-payer global budgets for inpatient, hospital outpatient, and emergency department care. Goals of the program included reducing unnecessary hospital utilization and encouraging greater use of primary care. Objective: To compare changes in hospital and primary care use through the first 2 years of Maryland's hospital global budget program among fee-for-service Medicare beneficiaries in Maryland vs matched control areas...
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29316451/an-innovative-model-to-coordinate-healthcare-and-social-services-for-people-with-serious-mental-illness-a-mixed-methods-case-study-of-maryland-s-medicaid-health-home-program
#7
Emma E McGinty, Alene Kennedy-Hendricks, Sarah Linden, Seema Choksy, Elizabeth Stone, Gail L Daumit
OBJECTIVE: We conducted a case study examining implementation of Maryland's Medicaid health home program, a unique model for integration of behavioral, somatic, and social services for people with serious mental illness (SMI) in the psychiatric rehabilitation program setting. METHOD: We conducted interviews and surveys with health home leaders (N=72) and front-line staff (N=627) representing 46 of the 48 total health home programs active during the November 2015-December 2016 study period...
December 16, 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29290177/health-care-resource-utilization-and-costs-among-newly-diagnosed-and-oral-anticoagulant-naive-nonvalvular-atrial-fibrillation-patients-treated-with-dabigatran-or-warfarin-in-the-united-states
#8
Rahul Jain, An-Chen Fu, Jonathan Lim, Cheng Wang, Jessica Elder, Stephen D Sander, Hiangkiat Tan
BACKGROUND: Warfarin has a long history of use to reduce the risk of stroke in patients with atrial fibrillation (AF), but it requires frequent laboratory monitoring to maintain international normalized ratio levels in the therapeutic range. Dabigatran, a novel oral anticoagulant (OAC), has demonstrated efficacy in reducing the risk of stroke and systemic embolism and does not require laboratory monitoring. OBJECTIVE: To compare health care resource utilization (HCRU) and costs of OAC-naive patients newly diagnosed with nonvalvular atrial fibrillation (NVAF), using dabigatran or warfarin...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29246348/effectiveness-of-a-pediatric-primary-care-intervention-to-increase-maternal-folate-use-results-from-a-cluster-randomized-controlled-trial
#9
Nymisha Chilukuri, Tina L Cheng, Kevin J Psoter, Kamila B Mistry, Katherine A Connor, Daniel J Levy, Krishna K Upadhya
OBJECTIVE: To assess the impact of provision of folate vitamins and a preconception health intervention on folate use among mothers bringing infants to pediatric primary care. STUDY DESIGN: We conducted a cluster randomized trial in mothers presenting with their infants (<12 months) at 4 urban pediatric practices in the Baltimore, Maryland, metropolitan area. There were 45 clinicians randomized into an intervention group (15-item preconception health screening and counseling and 90-day multivitamin supply) and control group (preconception health and community resource handouts and 90-day multivitamin supply)...
January 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29223193/quality-indicators-for-evaluating-prehospital-emergency-care-a-scoping-review
#10
Ian Howard, Peter Cameron, Lee Wallis, Maaret Castren, Veronica Lindstrom
Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC...
December 10, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29221501/lean-methodology-reduces-inappropriate-use-of-antipsychotics-for-agitation-at-a-psychiatric-hospital
#11
Joshana K Goga, Antonio Depaolo, Sunil Khushalani, J Ken Walters, Robert Roca, Marc Zisselman, Christopher Borleis
OBJECTIVE: To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. DESIGN: Historically Controlled Study. SETTING: Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29220589/first-year-internal-medicine-residents-reflections-on-nonmedical-home-visits-to-high-risk-patients
#12
Stephanie K Nothelle, Colleen Christmas, Laura A Hanyok
PROBLEM: Patients who are high utilizers of care often experience health-related challenges that are not readily visible in an office setting but paramount for residents to learn. A nonmedical home visit performed at the beginning of residency training may help residents better understand social underpinnings related to their patient's health and place subsequent care within the context of the patient's life. INTERVENTION: First-year internal medicine residents completed a nonmedical home visit to an at-risk patient prior to seeing the patient in the office for his or her first medical visit...
January 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29209899/when-behavioral-health-concerns-present-in-pediatric-primary-care-factors-influencing-provider-decision-making
#13
Elizabeth H Connors, Prerna Arora, Angela M Blizzard, Kelly Bower, Kelly Coble, Joyce Harrison, David Pruitt, Janna Steinberg, Lawrence Wissow
Primary care providers (PCPs) frequently encounter behavioral health (BH) needs among their pediatric patients. However, PCPs report variable training in and comfort with BH, and questions remain about how and when PCPs address pediatric BH needs. Existing literature on PCP decisions to address pediatric BH in-office versus referring to subspecialty BH is limited and findings are mixed. Accordingly, this study sought to examine parameters and contextual factors influencing PCP decisions and practices related to BH care...
December 5, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29189477/remaining-financially-viable-in-a-time-of-healthcare-transition
#14
Barry P Ronan
In an unstable healthcare environment, Western Maryland Health System has been demonstrating stability. We have responded to the many challenges that hospitals face and managed to thrive in the new, value-based world.We made the transition to value-based payment and care delivery models through innovations in Maryland's payment system. In 2010, we recognized that becoming a demonstration project for value-based care would benefit our health system as we dealt with an aging and shrinking regional population...
January 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29152438/barriers-to-timely-completion-of-radiation-therapy-in-patients-with-cervical-cancer-in-an-urban-tertiary-care-center
#15
Justin Cohen, Amy Harper, Elizabeth M Nichols, Gautam G Rao, Pranshu Mohindra, Dana Marie Roque
Background In 2017, there will be an estimated 12,820 women diagnosed with cervical cancer in the United States, causing an estimation of 4,210 deaths. Among U.S. women, there is a 33% greater incidence and 71% higher cervical cancer mortality in high-poverty counties when compared to low-income counties [1]. In those dispositioned to chemoradiation, treatment time of less than eight weeks is associated with compromised pelvic control. We sought to identify patient or disease characteristics and socioeconomic or psychosocial barriers that contribute to delays in treatment completion in order to formulate new policies to address these needs...
September 12, 2017: Curēus
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#16
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29118081/perceptions-of-dental-hygienists-and-dentists-about-preventing-early-childhood-caries-a-qualitative-study
#17
Alice M Horowitz, Dushanka V Kleinman, Wendy Child, Sarah D Radice, Catherine Maybury
Purpose: The objective of this qualitative pilot study was to gain an in-depth understanding of dental hygienists and dentists perspectives regarding children's oral health and what needs to be done to prevent early childhood caries (ECC), the most frequent chronic disease of childhood.Methods: A skilled facilitator conducted four focus groups and four phone interviews with 20 dental hygienists and 17 dentists practicing in a variety of locations within the state of Maryland. The interview guide was based on results from previous state-wide surveys of dental hygienists and dentists...
August 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29116823/infusing-adult-education-principles-into-a-health-insurance-literacy-program
#18
Virginia Brown
Health insurance literacy is an emerging concept in the health education and health promotion field. The passage of the Affordable Care Act highlighted the link between health insurance and health outcomes. However, the law does not specifically address how the public should be educated on choosing an appropriate health insurance plan. Research shows adults, regardless of previous health insurance status, are likely confused and uncertain about their selection. The University of Maryland Extension developed and created health insurance Smart Choice Health Insurance™ to reduce confusion and increase confidence and capability to make this decision...
April 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/29113636/evaluation-of-interventions-in-clinical-pharmacist-led-annual-medicare-wellness-visits-compared-with-usual-care
#19
Regine C Beliard, Jessica W Merrey
OBJECTIVE: Evaluate and compare the number and types of medication and non-medication-related interventions by clinical pharmacists and nonpharmacists conducting an Annual Medicare Wellness Visit (MWV). DESIGN: Multi-center, retrospective case-control study. SETTING: Two community primary care internal medicine clinics in urban Maryland. PARTICIPANTS: Patients who had a MWV performed January 2014 through October 2015...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29073129/receipt-of-selected-preventive-health-services-for-women-and-men-of-reproductive-age-united-states-2011-2013
#20
Karen Pazol, Cheryl L Robbins, Lindsey I Black, Katherine A Ahrens, Kimberly Daniels, Anjani Chandra, Anjel Vahratian, Lorrie E Gavin
PROBLEM/CONDITION: Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services...
October 27, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
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