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https://www.readbyqxmd.com/read/27926810/analysis-of-changes-in-cancer-health-care-system-in-poland-since-the-socio-economic-transformation-in-1989
#1
Dorota Dudek-Godeau, Anna Kieszkowska-Grudny, Katarzyna Kwiatkowska, Joanna Bogusz, Mirosław J Wysocki, Magdalena Bielska-Lasota
Background: The transformation period in Poland is associated with a set of factors seen as ‘socio-economic stress’, which unfavourably influenced cancer treatment and slowed down the progress of the Polish cancer care in the 90’s. These outcomes in many aspects of cancer care may be experienced till today. The results of the international EUROCARE and CONCORD studies based on European data prove evidence that there is a substantial potential for improvement of low 5-year survival rates in Poland...
2016: Roczniki Państwowego Zakładu Higieny
https://www.readbyqxmd.com/read/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#2
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27922723/the-american-indian-and-alaska-native-dentist-workforce-in-the-united-states
#3
Elizabeth Mertz, Cynthia Wides, Paul Gates
OBJECTIVES: The purpose of this article is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. METHODS: A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34 percent response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative...
December 6, 2016: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/27903790/association-between-health-related-beliefs-and-oral-health-behaviors-among-uninsured-primary-care-patients
#4
Akiko Kamimura, Bethany Gull, Shannon Weaver, Lindsey Wright, Jeanie Ashby, Lea E Erickson
INTRODUCTION: The collaborations between dental care providers and other health care providers are especially needed for underserved populations. There is a deficit of research focused on underserved populations who utilize a safety net facility such as a free clinic in the United States. The purpose of this study is to examine the association between health-related beliefs and oral health behaviors among uninsured adults utilizing a primary care free clinic providing oral health care...
November 29, 2016: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/27903138/partnerships-between-health-care-and-legal-providers-in-the-veterans-health-administration
#5
Jack Tsai, Margaret Middleton, Randye Retkin, Cindy Johnson, Kevin Kenneally, Scott Sherman, Robert A Rosenheck
Medical-legal partnerships (MLPs) represent an innovative service model in which lawyers are integrated into health care teams to address diverse legal problems that affect vulnerable populations. The Veterans Health Administration (VHA) operates the largest safety-net health care system in the country and serves many low-income and disabled veterans who could benefit from MLP services. In this column, the authors describe the development and operations of MLPs at four VHA medical centers that serve veterans who are homeless or who have serious mental illness...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27893953/leveraging-telehealth-to-bring-volunteer-physicians-into-underserved-communities
#6
Lori Uscher-Pines, Robert Rudin, Ateev Mehrotra
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute...
November 28, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27882775/association-between-availability-of-care-providers-and-healthcare-utilizations-among-adults-with-asthma
#7
Minchul Kim, Carl V Asche, William Tillis, Jinma Ren
BACKGROUND: Limited accessibility to providers may delay appropriate control of asthma exacerbations. The objective of our study is to estimate the contributors to the hospital/emergency department (ED) visits among adults with asthma focusing on the availability of healthcare providers. METHODS: We conducted a pooled cross-sectional analysis using the 2011-2013 Asthma Call-Back Survey linked with 2012-2016 Area Health Resource Files. We employed multivariable logistic regression with dichotomous outcomes of hospitalization and ED visits...
December 2, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27881926/improving-pain-care-through-implementation-of-the-stepped-care-model-at-a-multisite-community-health-center
#8
Daren R Anderson, Ianita Zlateva, Emil N Coman, Khushbu Khatri, Terrence Tian, Robert D Kerns
PURPOSE: Treating pain in primary care is challenging. Primary care providers (PCPs) receive limited training in pain care and express low confidence in their knowledge and ability to manage pain effectively. Models to improve pain outcomes have been developed, but not formally implemented in safety net practices where pain is particularly common. This study evaluated the impact of implementing the Stepped Care Model for Pain Management (SCM-PM) at a large, multisite Federally Qualified Health Center...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27871919/motivational-interviewing-to-promote-long-acting-reversible-contraception-in-postpartum-teenagers
#9
Kristl Tomlin, Tammalynn Bambulas, Maureen Sutton, Vanessa Pazdernik, Dean V Coonrod
STUDY OBJECTIVE: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing Long-acting Reversible Contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. DESIGN: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting and those enrolled in Standard Prenatal Care. PARTICIPANTS: Adolescents between the ages of 13 and 17 receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014...
November 18, 2016: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/27862831/prostatic-urethral-lift-pul-vs-transurethral-resection-of-the-prostate-turp-2-year-results-of-the-bph6-prospective-multi-center-randomised-study
#10
C Gratzke, N Barber, M Speakman, R Berges, U Wetterauer, D Greene, K-D Sievert, C Chapple, J Sonksen
OBJECTIVES: To compare Prostatic Urethral Lift (PUL) to Transurethral Resection of the Prostate (TURP) with regard to symptoms, recovery experience, sexual function, continence, safety, quality of life, sleep and overall patient perception. SUBJECTS/PATIENTS AND METHODS: 80 patients with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) enrolled in a prospective, randomised, controlled, non-blinded study conducted at 10 European centers. The BPH6 responder endpoint assessed symptom relief, quality of recovery, erectile function preservation, ejaculatory function preservation, continence preservation, and safety...
November 14, 2016: BJU International
https://www.readbyqxmd.com/read/27861833/organizational-factors-affect-safety-net-hospitals-breast-cancer-treatment-rates
#11
Nina A Bickell, Alexandra DeNardis Moss, Maria Castaldi, Ajay Shah, Alan Sickles, Peter Pappas, Theophilus Lewis, Margaret Kemeny, Shalini Arora, Lori Schleicher, Kezhen Fei, Rebeca Franco, Ann Scheck McAlearney
OBJECTIVE: To identify key organizational approaches associated with underuse of breast cancer care. SETTING: Nine New York City area safety-net hospitals. STUDY DESIGN: Mixed qualitative-quantitative, cross-sectional cohort. METHODS: We used qualitative comparative analysis (QCA) of key stakeholder interviews, defined organizational "conditions," calibrated conditions, and identified solution pathways. We defined underuse as no radiation after lumpectomy in women <75 years or mastectomy in women with ≥4 positive nodes, or no systemic therapy in women with tumors ≥1 cm...
November 14, 2016: Health Services Research
https://www.readbyqxmd.com/read/27860022/shared-decision-making-with-vulnerable-populations-in-the-emergency-department
#12
Ana Castaneda-Guarderas, Jeffrey Glassberg, Corita R Grudzen, Ka Ming Ngai, Margaret E Samuels-Kalow, Erica Shelton, Stephen P Wall, Lynne D Richardson
The emergency department occupies a unique position within the health care system, serving as a safety net for vulnerable patients, regardless of their race, ethnicity, religion, country of origin, sexual orientation, socioeconomic status or medical diagnosis. Shared decision making (SDM) presents special challenges when used with vulnerable population groups. The differing circumstances, needs and perspectives of vulnerable groups invoke issues of provider bias, disrespect, judgmental attitudes and lack of cultural competence; as well as patient mistrust, and the consequences of their social and economic disenfranchisement...
November 17, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27857269/neuroendocrine-tumors-and-lanreotide-depot-clinical-considerations-and-nurse-and-patient-preferences
#13
Pamela Ryan, Alexandria T Phan, Daphne T Adelman, Michiko Iwasaki
BACKGROUND: Somatostatin analogs (SSAs) are a mainstay therapy for the treatment of carcinoid syndrome associated with neuroendocrine tumors (NETs). They are effective for a range of gastroenteropancreatic NETs (GEP-NETs). Lanreotide depot (Somatuline®) is an SSA that is approved for the treatment of GEP-NETs to improve progression-free survival (PFS). OBJECTIVES: The article reviews the efficacy, safety, and administration of lanreotide depot and relates those attributes to considerations and preferences of oncology nurses and their patients...
December 1, 2016: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27855719/an-illness-focused-interactive-booklet-to-optimise-management-and-medication-for-childhood-fever-and-infections-in-out-of-hours-primary-care-study-protocol-for-a-cluster-randomised-trial
#14
Eefje G P M de Bont, Geert-Jan Dinant, Gijs Elshout, Gijs van Well, Nick A Francis, Bjorn Winkens, Jochen W L Cals
BACKGROUND: Fever is the most common reason for a child to be taken to a general practitioner (GP), especially during out-of-hours care. It is mostly caused by self-limiting infections. However, antibiotic prescription rates remain high, especially during out-of-hours care. Anxiety and lack of knowledge among parents, and perceived pressure to prescribe antibiotics amongst GPs, are important determinants of excessive antibiotic prescriptions. An illness-focused interactive booklet has the potential to improve this by providing parents with information about fever self-management strategies...
November 17, 2016: Trials
https://www.readbyqxmd.com/read/27851859/hospital-factors-associated-with-care-discontinuity-following-emergency-general-surgery
#15
Joaquim M Havens, Olubode A Olufajo, Thomas C Tsai, Wei Jiang, Alexandra B Columbus, Stephanie L Nitzschke, Zara Cooper, Ali Salim
Importance: Although there is evidence that changes in clinicians during the continuum of care (care discontinuity) are associated with higher mortality and complications among surgical patients, little is known regarding the drivers of care discontinuity among emergency general surgery (EGS) patients. Objective: To identify hospital factors associated with care discontinuity among EGS patients. Design, Setting, and Participants: We performed a retrospective analysis of the 100% Medicare inpatient claims file, from January 1, 2008, to November 30, 2011, and matched patient details to hospital information in the 2011 American Hospital Association Annual Survey database...
November 16, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27845516/community-health-centers-play-a-critical-role-in-caring-for-the-remaining-uninsured-in-the-affordable-care-act-era
#16
Steven P Wallace, Marie-Elena Young, Michael A Rodriguez
Federally Qualified Health Centers--commonly referred to as Community Health Centers (CHCs)--serve as a safety net for people who did not gain health insurance under the Affordable Care Act (ACA), including those immigrants not eligible for Medicaid or health insurance exchange coverage. ACA-driven changes in health insurance coverage, funding, and related policy have created new challenges for these safety net organizations. This policy brief reports the findings from analyses of the U.S. HRSA Uniform Data System and interviews conducted in 2014-16 with the leadership of 31 CHCs...
October 2016: Policy Brief
https://www.readbyqxmd.com/read/27833068/cost-benefit-analysis-of-establishing-an-inferior-vena-cava-filter-clinic
#17
Joshua D Dowell, Summit H Shah, Kyle J Cooper, Vedat Yıldız, Xueliang Pan
PURPOSE: Adverse events associated with retrievable inferior vena cava filters (IVCFs) have generated an increased interest in improving IVCF retrieval rates to improve patient safety and quality care. This study aims to demonstrate the cost-benefit of implementing an IVCF clinic to improve patient care in an institution in the United States. METHODS: An IVCF clinic was established at a single institution in September 2012 and for ten months referring physicians were contacted to facilitate retrieval when appropriate...
November 11, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27831945/the-lorenz-curve-a-novel-method-for-understanding-viral-load-distribution-at-the-population-level
#18
Katerina Christopoulos, Wendy Hartogensis, David V Glidden, Christopher D Pilcher, Monica Gandhi, Elvin H Geng
Existing HIV care cascade metrics fail to capture whether viremia is equally distributed in a population or concentrated within groups. We applied the Lorenz cure, which has been used to describe disparities in the distribution of income and other resources, to the distribution of viremia in a safety-net HIV clinic in 2012. Among 1,855 established clinic patients, 1% of the population held 50% of the virus and 10% of the population held 94% of virus.
November 7, 2016: AIDS
https://www.readbyqxmd.com/read/27831547/recombinant-tissue-plasminogen-activator-to-restore-catheter-patency-efficacy-and-safety-analysis-from-a-multihospital-nicu-system
#19
D M Scott, C Y Ling, B C MacQueen, V L Baer, E Gerday, R D Christensen
OBJECTIVE: In 2001, the US Food and Drug Administration approved recombinant tissue plasminogen activator (alteplase, Cathflo Activase) to reestablish patency of central catheters occluded, presumably, by a fibrin clot. We conducted a multicenter quality improvement study to determine the value of this procedure in our Neonatal Intensive Care Unit (NICUs), including analyses of efficacy, safety and costs. STUDY DESIGN: We conducted a retrospective quality analysis of neonates in level III NICUs, who received alteplase for the purpose of reestablishing patency of occluded central catheters...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27825963/mailed-outreach-program-increases-ultrasound-screening-of-patients-with-cirrhosis-for-hepatocellular-carcinoma
#20
Amit G Singal, Jasmin A Tiro, Jorge A Marrero, Katharine McCallister, Caroline Mejias, Brian Adamson, Wendy Pechero Bishop, Noel O Santini, Ethan A Halm
BACKGROUND & AIMS: Surveillance of patients with cirrhosis increases early detection of hepatocellular carcinoma (HCC) and prolongs survival. However, its effectiveness is limited by underuse, particularly among racial/ethnic minorities and individuals of low socioeconomic status. We compared effectiveness of mailed outreach strategies, with and without patient navigation, in increasing the numbers of patients with cirrhosis undergoing surveillance for HCC in a racially diverse and socioeconomically disadvantaged cohort...
November 5, 2016: Gastroenterology
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