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https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#1
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340193/addressing-structural-barriers-to-hiv-care-among-triply-diagnosed-adults-project-bridge-oakland
#2
Christina Powers, Megan Comfort, Andrea M Lopez, Alex H Kral, Owen Murdoch, Jennifer Lorvick
People who are "triply diagnosed" with HIV, mental health issues, and substance-related disorders face tremendous barriers connecting to and remaining in HIV care. Authors of this article implemented Project Bridge Oakland (PBO), an intervention based on harm reduction and trauma-informed care, to help maintain continuity of care for triply diagnosed adults through cycles of criminal justice involvement. From August 2011 to December 2014, a clinical social worker and an HIV physician provided intensive case management for 19 clients living in Oakland, California...
March 14, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28340185/knowledge-of-opioid-overdose-and-attitudes-to-supply-of-take-home-naloxone-among-people-with-chronic-noncancer-pain-prescribed-opioids
#3
Suzanne Nielsen, Amy Peacock, Nicholas Lintzeris, Raimondo Bruno, Briony Larance, Louisa Degenhardt
Objective.:  Take-home naloxone (THN) is recommended in response to pharmaceutical opioid-related mortality. Some health professionals are reluctant to discuss THN for fear of causing offense. The aims of this study were to assess knowledge of opioid overdose and attitudes toward THN for opioid overdose reversal in people with chronic noncancer pain (CNCP). Design.:  Prospective cohort study. Setting.:  Australia, September to October 2015...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340149/individual-and-regional-determinants-for-physical-therapy-utilization-in-germany-multilevel-analysis-of-national-survey-data
#4
Alexander Rommel, Lars Eric Kroll
Background: Physical therapy (PT) is included in many clinical guidelines and a commonly used health service. However, access to its benefits should not strongly depend on social or demographic factors. Objective: The present study used the Andersen model to explain to what extent PT utilization in Germany depends on factors beyond medical need. Methods: The German Health Interview and Examination Survey for Adults (DEGS, 2008-2011; target population, 18-79 years) is part of the German health-monitoring system...
March 9, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#5
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340108/cigarette-smoking-and-musculoskeletal-pain-severity-among-male-and-female-afghanistan-iraq-era-veterans
#6
Kimberly T Green, Sarah M Wilson, Paul A Dennis, Jennifer J Runnals, Rebecca A Williams, Lori A Bastian, Jean C Beckham, Eric A Dedert, Harold S Kudler, Kristy Straits-Tröster, Jennifer M Gierisch, Patrick S Calhoun
Objective.:  Cigarette smoking and musculoskeletal pain are prevalent among Department of Veterans Affairs (VA) health care system users. These conditions frequently co-occur; however, there is limited empirical information specific to Afghanistan/Iraq era veterans. The present study sought to examine gender differences in the association between cigarette smoking and moderate to severe musculoskeletal pain in US veterans with Afghanistan/Iraq era service. Methods.:  A random sample of 5,000 veterans with service after November 11, 2001, participated in a survey assessing health care needs and barriers to care...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340082/disparities-in-health-care-quality-among-asian-children-with-special-health-care-needs
#7
Esther Son, Susan L Parish, Leah Igdalsky
There is a dearth of information on the quality of health care for Asian American children and particularly Asian children with special health care needs (CSHCN). The goal of this article was to determine whether there were disparities in quality of health care for Asian CSHCN, whose experiences have not been studied. Data were derived from the 2009-2010 National Survey of Children with Special Health Care Needs (ns = 355 non-Hispanic Asian children and 4,343 non-Hispanic white CSHCN). Bivariate and multivariate logistic regression analyses were conducted to examine the relationship between racial identity (that is, non-Hispanic white and non-Hispanic Asian) and quality of health care...
March 2, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28340060/physician-dispensing-of-oxycodone-and-other-commonly-used-opioids-2000-2015-united-states
#8
Karin Ann Mack, Christopher McCall Jones, Roderick John McClure
Objective.:  An average of 91 people in the United States die every day from an opioid-related overdose (including prescription opioids and heroin). The direct dispensing of opioids from health care practitioner offices has been linked to opioid-related harms. The objective of this study is to describe the changing nature of the volume of this type of prescribing at the state level. Methods.:  This descriptive study examines the distribution of opioids by practitioners using 1999-2015 Automation of Reports and Consolidated Orders System data...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340059/topic-modeling-of-smoking-and-cessation-related-posts-to-the-american-cancer-society-s-cancer-survivor-network-csn-implications-for-cessation-treatment-for-cancer-survivors-who-smoke
#9
J Lee Westmaas, Bennett McDonald, Ken Portier
Introduction: Smoking is a risk factor in at least 18 cancers, and approximately two-thirds of cancer survivors continue smoking following diagnosis. Text mining of survivors' online posts related to smoking and quitting could inform strategies to reduce smoking in this vulnerable population. Methods: We identified posts containing smoking/cessation-related keywords from the Cancer Survivors Network (CSN), an online cancer survivor community of 166,000 members and over 468,000 posts since inception...
March 15, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28340022/nicotine-content-and-physical-properties-of-large-cigars-and-cigarillos-in-the-united-states
#10
Bartosz Koszowski, Meridith Hill Thanner, Wallace B Pickworth, Kenneth M Taylor, Lynn C Hull, Megan J Schroeder
Introduction: Cigars are combusted tobacco products consisting of filler, binder, and wrapper, which are derived from tobacco. Despite the abundance of literature on the composition of traditional combusted cigarettes, research is limited on the physical and chemical properties of cigars. Therefore, research on cigar properties may be useful to better understand their health impact. Methods: In this study, twenty large cigar and cigarillo products were characterized for physical properties (ie, weight, length, and diameter), filler nicotine content, and tobacco pH...
March 4, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28340010/non-proteinuric-rather-than-proteinuric-renal-diseases-are-the-leading-cause-of-end-stage-kidney-disease
#11
Davide Bolignano, Carmine Zoccali
Proteinuria is a distinguishing feature in primary and secondary forms of chronic glomerulonephritis, which contribute to no more than the 20% of the end-stage kidney disease (ESKD) population. The contribution of non-proteinuric nephropathies to the global ESKD burden is still poorly focused and scarce research efforts are dedicated to the elucidation of risk factors and mechanistic pathways triggering ESKD in these diseases. We abstracted information on proteinuria in the main renal diseases other than glomerulonephritides that may evolve into ESKD...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339966/operational-challenges-and-opportunities-in-pastured-poultry-operations-in-the-united-states
#12
C Elkhoraibi, M Pitesky, N Dailey, D Niemeier
As pastured poultry production has gained increased popularity in the United States in recent years, there is a growing need for research and outreach efforts aimed at this sector of poultry production. In order to get familiarized with American pastured poultry producers, we conducted an online questionnaire aimed primarily at evaluating what operational challenges are faced by producers and what educational opportunities should be initiated by researchers. Results showed that pastured poultry farms largely vary in total number of acres farmed and total number of birds kept...
March 3, 2017: Poultry Science
https://www.readbyqxmd.com/read/28339791/bridg-a-domain-information-model-for-translational-and-clinical-protocol-driven-research
#13
Lauren B Becnel, Smita Hastak, Wendy Ver Hoef, Robert P Milius, MaryAnn Slack, Diane Wold, Michael L Glickman, Boris Brodsky, Charles Jaffe, Rebecca Kush, Edward Helton
Background: It is critical to integrate and analyze data from biological, translational, and clinical studies with data from health systems; however, electronic artifacts are stored in thousands of disparate systems that are often unable to readily exchange data. Objective: To facilitate meaningful data exchange, a model that presents a common understanding of biomedical research concepts and their relationships with health care semantics is required. The Biomedical Research Integrated Domain Group (BRIDG) domain information model fulfills this need...
February 26, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339767/accounting-for-overdispersion-when-determining-primary-care-outliers-for-the-identification-of-chronic-kidney-disease-learning-from-the-national-chronic-kidney-disease-audit
#14
Lois G Kim, Ben Caplin, Faye Cleary, Sally A Hull, Kathryn Griffith, David C Wheeler, Dorothea Nitsch
Background.: Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. Methods.: We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing)...
January 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339721/analysis-of-professional-competencies-for-the-clinical-research-data-management-profession-implications-for-training-and-professional-certification
#15
Meredith N Zozus, Angel Lazarov, Leigh R Smith, Tim E Breen, Susan L Krikorian, Patrick S Zbyszewski, Shelly K Knoll, Debra A Jendrasek, Derek C Perrin, Demetris N Zambas, Tremaine B Williams, Carl F Pieper
Objective: : To assess and refine competencies for the clinical research data management profession. Materials and Methods: : Based on prior work developing and maintaining a practice standard and professional certification exam, a survey was administered to a captive group of clinical research data managers to assess professional competencies, types of data managed, types of studies supported, and necessary foundational knowledge. Results: : Respondents confirmed a set of 91 professional competencies...
February 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339701/comparison-of-three-commercial-knowledge-bases-for-detection-of-drug-drug-interactions-in-clinical-decision-support
#16
Kin Wah Fung, Joan Kapusnik-Uner, Jean Cunningham, Stefanie Higby-Baker, Olivier Bodenreider
Objective: : To compare 3 commercial knowledge bases (KBs) used for detection and avoidance of potential drug-drug interactions (DDIs) in clinical practice. Methods: : Drugs in the DDI tables from First DataBank (FDB), Micromedex, and Multum were mapped to RxNorm. The KBs were compared at the clinical drug, ingredient, and DDI rule levels. The KBs were evaluated against a reference list of highly significant DDIs from the Office of the National Coordinator for Health Information Technology (ONC)...
February 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339695/incidence-and-outcomes-of-infections-caused-by-multidrug-resistant-enterobacteriaceae-in-children-2007-2015
#17
Sharon B Meropol, Allison A Haupt, Sara M Debanne
Background.: The escalating incidence of invasive disease caused by multidrug-resistant Gram-negative enteric Enterobacteriaceae (MDR-GNE) is a global concern. Scant published studies in which the epidemiology of these infections in children is described exist; previous studies focused mainly on adults, described circumscribed populations, or lacked clinical detail. The objective of this study was to examine and describe the incidence, risk factors, and outcomes associated with MDR-GNE infection in children...
February 22, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28339685/information-needs-of-generalists-and-specialists-using-online-best-practice-algorithms-to-answer-clinical-questions
#18
David A Cook, Kristi J Sorensen, Jane A Linderbaum, Laurie J Pencille, Deborah J Rhodes
Objective: : To better understand clinician information needs and learning opportunities by exploring the use of best-practice algorithms across different training levels and specialties. Methods: : We developed interactive online algorithms (care process models [CPMs]) that integrate current guidelines, recent evidence, and local expertise to represent cross-disciplinary best practices for managing clinical problems. We reviewed CPM usage logs from January 2014 to June 2015 and compared usage across specialty and provider type...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339684/embedding-nursing-interventions-into-the-world-health-organization-s-international-classification-of-health-interventions-ichi
#19
Nicola Fortune, Nicholas R Hardiker, Gillian Strudwick
Objective: : The International Classification of Health Interventions, currently being developed, seeks to span all sectors of the health system. Our objective was to test the draft classification's coverage of interventions commonly delivered by nurses, and propose changes to improve the utility and reliability of the classification for aggregating and analyzing data on nursing interventions. Materials and methods: : A 2-phase content mapping method was used: (1) three coders independently applied the classification to a dataset comprising 100 high-frequency nursing interventions; (2) the coders reached consensus for each intervention and identified reasons for initial discrepancies...
February 11, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339632/dosing-down-with-biologic-therapies-a-systematic-review-and-clinicians-perspective
#20
Christopher J Edwards, Bruno Fautrel, Hendrik Schulze-Koops, Tom W J Huizinga, Klaus Kruger
The effectiveness of biologic therapies now means that remission or low disease activity are realistic targets for treatment. However, after achieving remission/low disease activity, the next steps remain unclear. The aim of this publication was to conduct a broad systematic literature review to evaluate dosing down of biologics. After screening papers and abstracts for relevance and application of inclusion/exclusion criteria, a structured extraction process was used to collect information on the included studies...
February 16, 2017: Rheumatology
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