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https://www.readbyqxmd.com/read/28350730/pas-in-orthopedics-in-the-vha-s-community-based-outpatient-clinics
#1
Daniel O Reed, Roderick S Hooker
In the Veterans Health Administration (VHA) system, most orthopedic care takes place in the VA medical centers (VAMCs). Because most patients receiving orthopedic care were referred by adult medicine providers, more widely deploying physician assistants (PAs) in orthopedic medicine might help offset this workload. An orthopedic medicine demonstration project recruited, trained, and positioned PAs in community-based outpatient clinics (CBOCs) to improve access to care. The project involved surgeons at the Houston VAMC instructing five newly employed PAs in a wide range of orthopedic evaluation and management strategies before their assignment to a CBOC...
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28350723/reasons-for-interfacility-emergency-department-transfer-and-care-at-the-receiving-facility
#2
Joyce Li, Stephanie Pryor, Ben Choi, Chris A Rees, Mamata V Senthil, Nicholas Tsarouhas, Sage R Myers, Michael C Monuteaux, Richard G Bachur
OBJECTIVES: The aims of this study were to (1) assess the reasons for pediatric interfacility transfers as identified by transferring providers and review the emergency medical care delivered at the receiving facilities and (2) investigate the emergency department (ED) care among the subpopulation of patients discharged from the receiving facility. METHODS: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 US tertiary care pediatric hospitals with a subsequent medical record review at the receiving facility...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28350563/predicting-the-mental-health-and-functioning-of-torture-survivors
#3
Suzan J Song, Andrew Subica, Charles Kaplan, Wietse Tol, Joop de Jong
The psychological effects of war represent a growing public health concern as more refugees and asylum seekers migrate across borders. This study investigates whether sociodemographic, premigration and postmigration, and psychosocial factors predict adverse psychiatric symptoms in refugees and asylum seekers exposed to torture (N = 278). Hierarchical linear regressions revealed that female sex, older age, and unstable housing predicted greater severity of anxiety, posttraumatic stress disorder (PTSD), and depression...
March 27, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28350430/insurance-coverage-access-to-care-and-medical-debt-since-the-aca-a-look-at-california-florida-new-york-and-texas
#4
Munira Z Gunja, Sara R Collins, Michelle McEvoy Doty, Sophie Beutel
ISSUE: The Affordable Care Act has significantly increased health insurance coverage and access to care among U.S. adults nationwide. However, the law gives states flexibility in implementing certain provisions, leading to wide variations between states in consumers’ experiences. GOAL: To examine the differences in insurance coverage, access to care, and medical bill problems in the four largest states—California, Florida, New York, and Texas—all of which have made different choices in implementing the law...
March 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28346416/jacie-accreditation-for-blood-and-marrow-transplantation-past-present-and-future-directions-of-an-international-model-for-healthcare-quality-improvement
#5
J A Snowden, E McGrath, R F Duarte, R Saccardi, K Orchard, N Worel, J Kuball, C Chabannon, M Mohty
Blood and marrow transplantation (BMT) is a complex and evolving medical speciality that makes substantial demands on healthcare resources. To meet a professional responsibility to both patients and public health services, the European Society for Blood and Marrow Transplantation (EBMT) initiated and developed the Joint Accreditation Committee of the International Society for Cellular Therapy and EBMT-better known by the acronym, JACIE. Since its inception, JACIE has performed over 530 voluntary accreditation inspections (62% first time; 38% reaccreditation) in 25 countries, representing 40% of transplant centres in Europe...
March 27, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28346297/exposure-to-mycophenolate-and-fatherhood
#6
Karsten Midtvedt, Stein Bergan, Anna Varberg Reisæter, Bjørn Egil Vikse, Anders Åsberg
BACKGROUND: Mycophenolic acid (MPA) is the active immunosuppressive substance in both mycophenolate mofetil and mycophenolate sodium and it is widely used after organ transplantation. In females taking MPA is teratogenic and may also influence spermatogenesis. There is a lack of knowledge regarding outcome of pregnancies fathered by males exposed to MPA. METHODS: We compared outcomes in pregnancies fathered by renal transplant males per whether they had been exposed to MPA or not at time of conception...
March 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28346233/clinical-efficacy-and-tolerability-of-direct-acting-antivirals-in-elderly-patients-with-chronic-hepatitis-c
#7
Jagannath M Sherigar, Vijay Gayam, Arifa Khan, Osama Mukhtar, Yavgeniy Arefiev, Mazin Khalid, Imran Siddiqui, Ayyappa M Rangaraju, Nibash Budhathoki, Mohammed Mansour, Debra Guss, Smruti R Mohanty
BACKGROUND: There is a lack of evidence-based data on aged patients with newer direct-acting antivirals (DAAs) and with shorter duration of treatment regimens involving DAAs with or without ribavirin (RBV) and pegylated interferon (Peg IFN). PATIENTS AND METHODS: Medical records of 240 patients treated with DAAs with or without Peg IFN and RBV between January 2013 and July 2015 were retrospectively analyzed. Patients were divided into two groups: patients aged 65 years and older (N=84) and patients aged younger than 65 years (N=156)...
March 24, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28346048/mabdelivery-administration-routes-for-antibody-therapy-third-labex-mabimprove-industrial-workshop-july-2-2015-tours-france
#8
Elsa Bodier-Montagutelli, Renaud Respaud, Hervé Watier, Audrey Guillon-Munos
The annual "LabEx MAbImprove Industrial Workshops" are primarily intended to provide a comprehensive view about topics of interest for the pharmaceutical industry to scientists involved in research on therapeutic antibodies. The third workshop in this series, held July 2, 2015 in Tours, was dedicated to the optimization of delivery, namely all processes leading monoclonal antibodies to reach their target site. The commonly used intravenous (IV) route, although advantageous in terms of pharmacokinetics and pharmacodynamics, presents some disadvantages in terms of patients' convenience, therapeutic target access or treatment cost...
February 28, 2017: MAbs
https://www.readbyqxmd.com/read/28345742/a-qualitative-exploration-of-chronic-pain-and-opioid-treatment-among-hiv-patients-with-drug-use-disorders
#9
Sarina R Isenberg, Allysha C Maragh-Bass, Kathleen Ridgeway, Mary C Beach, Amy R Knowlton
OBJECTIVE: The study explored high-risk participants' experiences with pain management regarding clinical access to and use of prescription opioids. DESIGN: Qualitative semistructured interviews and focus groups. SETTING: Data were collected August 2014 to May 2015 at an urban community-based research facility in Baltimore City, MD. PARTICIPANTS: HIV participants with chronic pain and a history of illicit drug use. METHODS: Qualitative coding and analysis used an iterative, inductive, and thematic approach and coders achieved inter-coder consistency...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345422/predictors-of-preference-for-caesarean-delivery-among-pregnant-women-in-beijing
#10
Hongwei Zhang, Jing Wu, Jessie Norris, Li Guo, Yifei Hu
Objective To evaluate factors associated with preference for caesarean or vaginal delivery among pregnant Chinese nulliparous and parous women. Methods In this cross-sectional study, a self-administered questionnaire was used to collect information on sociodemographic characteristics, preference/reasons for delivery mode, and knowledge of delivery complications. Results Of the 450 participants, 85 (18.9%) reported a preference for caesarean section (CS) pre-partum. Compared with women who would prefer a vaginal delivery, nulliparous women who preferred CS were more likely to be: ≥35 years; have no medical insurance; have had two or more pregnancies; have access to only one source of information about birthing options; knowledge of the complications of vaginal delivery and think doctors have no right to decide the type of delivery...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28345190/new-medicinal-products-for-chronic-heart-failure-advances-in-clinical-trial-design-and-efficacy-assessment
#11
REVIEW
Martin R Cowie, Gerasimos S Filippatos, Maria de Los Angeles Alonso Garcia, Stefan D Anker, Anna Baczynska, Daniel M Bloomfield, Maria Borentain, Karsten Bruins Slot, Maureen Cronin, Pieter A Doevendans, Amany El-Gazayerly, Claudio Gimpelewicz, Narimon Honarpour, Salim Janmohamed, Heidi Janssen, Albert M Kim, Dominik Lautsch, Ian Laws, Martin Lefkowitz, Jose Lopez-Sendon, Alexander R Lyon, Fady I Malik, John J V McMurray, Marco Metra, Santiago Figueroa Perez, Marc A Pfeffer, Stuart J Pocock, Piotr Ponikowski, Krishna Prasad, Isabelle Richard-Lordereau, Lothar Roessig, Giuseppe M C Rosano, Warren Sherman, Wendy Gattis Stough, Karl Swedberg, Benoit Tyl, Faiez Zannad, Caroline Boulton, Pieter De Graeff
Despite the availability of a number of different classes of therapeutic agents with proven efficacy in heart failure, the clinical course of heart failure patients is characterized by a reduction in life expectancy, a progressive decline in health-related quality of life and functional status, as well as a high risk of hospitalization. New approaches are needed to address the unmet medical needs of this patient population. The European Medicines Agency (EMA) is undertaking a revision of its Guideline on Clinical Investigation of Medicinal Products for the Treatment of Chronic Heart Failure...
March 27, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28344706/the-voluntariat-a-frieirean-framework-to-understand-the-nature-of-undergraduate-international-medical-experiences
#12
Seemi Qaiser, Helen Dimaras, Paul Hamel
Despite literature documenting limited and asymmetrical benefits along with ethical issues, short-term international volunteering is increasingly popular among North American university students as a perceived advantage when applying to professional healthcare schools or the job market. Academic institutions are also encouraging students to pursue international experiences in order to cultivate values as global citizens. These experiences are most typically limited to economically privileged students. Furthermore, international activities in developing countries often lack a pedagogy of social justice and may confirm a simplistic understanding of development...
December 2016: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28344694/addressing-gaps-in-physician-knowledge-regarding-transgender-health-and-healthcare-through-medical-education
#13
Deborah McPhail, Marina Rountree-James, Ian Whetter
BACKGROUND: Transgender people (those people whose sex at birth does not "match" their felt gender identity) are a priority group for healthcare as they experience high rates of discrimination and related illnesses. Despite this, there is a trend of poor healthcare access for trans people due, in large part, to the denial of care on the part of physicians. A small body of literature is beginning to suggest that this denial of care may be due to a lack of physician knowledge as well as, in some cases, to transphobia...
October 2016: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28344507/patients-experience-of-using-primary-care-services-in-the-context-of-indonesian-universal-health-coverage-reforms
#14
Fitriana Murriya Ekawati, Mora Claramita, Krishna Hort, John Furler, Sharon Licqurish, Jane Gunn
BACKGROUND: The World Health Organization (WHO) recommendation on universal coverage has been implemented in Indonesia as Jaminan Kesehatan Nasional (JKN). It was designed to provide people with equitable and high-quality health care by strengthening primary care as the gate-keeper to hospitals. However, during its first year of implementation, recruitment of JKN members was slow, and the referral rates from primary to secondary care remained high. Little is known about how the public views the introduction of JKN or the factors that influence their decision to enroll in JKN...
2017: Asia Pacific Family Medicine
https://www.readbyqxmd.com/read/28343954/a-new-whole-mitochondrial-genome-qpcr-wmg-qpcr-with-sybr-green-%C3%A2-to-identify-phlebotomine-sand-fly-blood-meals
#15
Ana Caroline Moura Rodrigues, Rafaela Damasceno Magalhães, Kalil Andrade Mubarac Romcy, Jeferson Lucas Sousa Freitas, Ana Carolina Fonseca Lindoso Melo, Fernanda Cristina Macedo Rodon, Claudia Maria Leal Bevilaqua, Luciana Magalhães Melo
Phlebotomine sand flies are blood-feeding insects of marked medical and veterinary significance. Investigations on the biology of these insects hold great importance for both ecological and epidemiological purposes. The present work describes a new approach for real-time PCR (qPCR) with SYBR Green(®), named WMG-qPCR, to identify phlebotomine blood meals. The novelty of the assay was to design primers based on the Whole Mitochondrial Genome (WMG) of the potential hosts (human, dog, cat, brown rat and chicken) aiming to amplify through qPCR the regions of mitochondrial DNA (mtDNA) which are less conserved among all species...
March 9, 2017: Veterinary Parasitology
https://www.readbyqxmd.com/read/28343793/critical-analysis-and-review-of-the-literature-on-healthcare-privatization-and-its-association-with-access-to-medical-care-in-saudi-arabia
#16
REVIEW
Abdulwahab A Alkhamis
This paper is a review of the literature on hospitals privatization to assess the influence of privatization on access to medical care. The results are used to complete further analysis on the situation in Saudi Arabia. Over 979 references were initially identified through a database search, and an additional 237 were included from other sources. From these sources, only 11 articles were considered for review after excluding the ineligible articles, such as those that did not meet the hospitals privatization's definition or other exclusion criteria...
March 23, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28343746/preliminary-development-of-an-advanced-modular-pressure-relief-cushion-testing-and-user-evaluation
#17
Tyler Freeto, Steven J Mitchell, Kath M Bogie
STUDY AIM: Effective pressure relief cushions are identified as a core assistive technology need by the World Health Organization Global Cooperation on Assistive Technology. High quality affordable wheelchair cushions could provide effective pressure relief for many individuals with limited access to advanced assistive technology. MATERIALS: Value driven engineering (VdE) principles were employed to develop a prototype modular cushion. Low cost dynamically responsive gel balls were arranged in a close packed array and seated in bilayer foam for containment and support...
March 20, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28343649/increasing-access-to-auricular-acupuncture-for-postoperative-nausea-and-vomiting
#18
Chad B Moore, Anita H Hickey
PURPOSE: Postoperative nausea and vomiting (PONV) affects more than 30% of surgical patients. Auricular acupuncture (AA) has been shown to decrease the incidence of PONV in select populations. DESIGN: An evidence-based quality improvement project made AA available to all adult surgical patients, and the results were recorded in a database. A retrospective between-groups analysis of 210 database entries was conducted, of those 25 receiving AA. FINDINGS: More risk factors for PONV were present in the AA group (P < ...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28343554/prioritization-of-patients-for-publicly-funded-ivf-in-ontario-a-survey-of-fertility-centres
#19
Tamas Gotz, Claire Jones
OBJECTIVE: On December 21, 2015, Ontario began funding one cycle of IVF for any Ontarian under age 43, with a program cap of 5000 cycles per year, which is below expected demand. Our objective was to determine how fertility clinics are prioritizing patients for limited-funded IVF cycles. METHODS: An electronic survey was emailed to medical directors of all 25 fertility clinics providing funded IVF in Ontario. RESULTS: From January to March 2016, 22 (88%) of the clinics responded...
March 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28343424/biosimilar-biologic-drugs-a-new-frontier-in-medical-care
#20
Daniel M Geynisman, Guillermo de Velasco, K Lea Sewell, Ira Jacobs
Physicians in training are expected to be aware of the newest developments in patient care. Biologic therapies have changed treatment of many diseases by specifically targeting key disease mediators, but patient access to these therapies can be limited. As patents for the first biologic therapies are expiring, the development and approval of products known as biosimilars is rapidly gaining momentum. A biosimilar is a biologic product that is highly similar to a reference product (a licensed biologic product), notwithstanding minor differences in clinically inactive components...
March 27, 2017: Postgraduate Medicine
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