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https://www.readbyqxmd.com/read/28440663/acupuncture-for-pain-and-nausea-in-the-intensive-care-unit-a-feasibility-study-in-a-public-safety-net-hospital
#1
Colin Feeney, Elizabeth Bruns, Gabrielle LeCompte, Anahita Forati, Thomas Chen, Amy Matecki
OBJECTIVES: To explore the feasibility and acceptability of providing acupuncture treatment to relieve pain and nausea symptoms in intensive care unit (ICU) patients. DESIGN: Prospective feasibility study. SETTINGS/LOCATION: Public safety net hospital with a 20-bed mixed medical/surgical ICU. SUBJECTS: Patients from all services admitted to the ICU from November 14, 2014 to April 2015. INTERVENTIONS: Three 20 min acupuncture treatments given for consented patients who were experiencing pain and/or nausea, in addition to usual care...
April 25, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28438182/forced-fluid-removal-versus-usual-care-in-intensive-care-patients-with-high-risk-acute-kidney-injury-and-severe-fluid-overload-ffaki-study-protocol-for-a-randomised-controlled-pilot-trial
#2
Rasmus E Berthelsen, Theis Itenov, Anders Perner, Jens-Ulrik Jensen, Michael Ibsen, Andreas Emil Kryger Jensen, Morten Bestle
BACKGROUND: Intravenous administration of fluids is an essential part of critical care. While some fluid administration is likely beneficial, there is increasing observational evidence that the development of fluid overload is associated with increased mortality. There are no randomised trials to confirm this association in patients with acute kidney injury. We aim to perform a pilot trial to test the feasibility of forced fluid removal compared to standard care in patients with acute kidney injury and severe fluid overload, the FFAKI trial...
April 24, 2017: Trials
https://www.readbyqxmd.com/read/28437277/the-fragile-balance-of-community-based-health-care-one-community-s-united-response-when-the-hiv-aids-primary-care-safety-net-failed
#3
Matthew Fifolt, D Scott Batey, James L Raper, Jane E Mobley, Lisa C McCormick
No abstract text is available yet for this article.
April 20, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28423478/a-qualitative-study-of-community-nurses-decision-making-around-the-anticipatory-prescribing-of-end-of-life-medications
#4
Ben Bowers, Sarah Redsell
AIMS: To explore community nurses' decision-making processes around the prescribing of anticipatory medications for people who are dying. BACKGROUND: Community nurses frequently initiate the prescribing of anticipatory medications to help control symptoms in those who are dying. However, little is known about their decision-making processes in relation to when they instigate anticipatory prescribing and their discussions with families and General Practitioners. DESIGN: A qualitative interpretive descriptive enquiry...
April 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28423156/creation-of-an-internal-teledermatology-store-and-forward-system-in-an-existing-electronic-health-record-a-pilot-study-in-a-safety-net-public-health-and-hospital-system
#5
Zachary A Carter, Shauna Goldman, Kristen Anderson, Xiaxiao Li, Linda S Hynan, Benjamin F Chong, Arturo R Dominguez
Importance: External store-and-forward (SAF) teledermatology systems operate separately from the primary health record and have many limitations, including care fragmentation, inadequate communication among clinicians, and privacy and security concerns, among others. Development of internal SAF workflows within existing electronic health records (EHRs) should be the standard for large health care organizations for delivering high-quality dermatologic care, improving access, and capturing other telemedicine benchmark data...
April 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28416026/evaluation-of-a-pilot-service-to-facilitate-discharge-of-patients-with-stable-long-term-mental-health-needs-from-secondary-to-primary-care-the-role-of-primary-care-mental-health-specialists
#6
Kate Hamilton-West, Sarah Hotham, Wei Yang, Julie Hedayioglu, Charlotte Brigden
Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. BACKGROUND: Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required...
April 18, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28407650/insurance-coverage-and-utilization-at-a-sexually-transmitted-disease-clinic-in-a-medicaid-expansion-state
#7
Madeline C Montgomery, Julia Raifman, Amy S Nunn, Thomas Bertrand, A Ziggy Uvin, Theodore Marak, Jaime Comella, Alexi Almonte, Philip A Chan
BACKGROUND: In Rhode Island, the Patient Protection and Affordable Care Act has led to over 95% of the state's population being insured. We evaluated insurance coverage and barriers to insurance use among patients presenting for services at the Rhode Island sexually transmitted disease (STD) clinic. METHODS: We analyzed factors associated with insurance coverage and utilization among patients presenting for STD services between July and December 2015. RESULTS: A total of 692 patients had insurance information available; of those, 40% were uninsured...
May 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28406394/a-randomised-controlled-trial-to-compare-the-safety-effectiveness-and-cost-effectiveness-of-doxycycline-200%C3%A2-mg-day-with-that-of-oral-prednisolone-0-5%C3%A2-mg-kg-day-for-initial-treatment-of-bullous-pemphigoid-the-bullous-pemphigoid-steroids-and-tetracyclines-blister
#8
Joanne R Chalmers, Fenella Wojnarowska, Gudula Kirtschig, James Mason, Margaret Childs, Diane Whitham, Karen Harman, Anna Chapman, Shernaz Walton, Enno Schmidt, Thomas R Godec, Andrew J Nunn, Hywel C Williams
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with increased morbidity and mortality in the elderly. OBJECTIVES: To evaluate the effectiveness, safety and cost-effectiveness of a strategy of initiating BP treatment with oral doxycycline or oral prednisolone. We hypothesised that starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral prednisolone...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28395357/development-of-the-safety-score-a-clinical-screening-tool-for-predicting-future-firearm-violence-risk
#9
Jason E Goldstick, Patrick M Carter, Maureen A Walton, Linda L Dahlberg, Steven A Sumner, Marc A Zimmerman, Rebecca M Cunningham
Background: Interpersonal firearm violence among youth is a substantial public health problem, and emergency department (ED) physicians require a clinical screening tool to identify high-risk youth. Objective: To derive a clinically feasible risk index for firearm violence. Design: 24-month prospective cohort study. Setting: Urban level 1 ED. Participants: Substance-using youths, age 14 to 24 years, seeking ED care for an assault-related injury and a proportionately sampled group of non-assault-injured youth enrolled from September 2009 through December 2011...
April 11, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28395014/low-value-medical-services-in-the-safety-net-population
#10
Michael L Barnett, Jeffrey A Linder, Cheryl R Clark, Benjamin D Sommers
Importance: National patterns of low-value and high-value care delivered to patients without insurance or with Medicaid could inform public policy but have not been previously examined. Objective: To measure rates of low-value care and high-value care received by patients without insurance or with Medicaid, compared with privately insured patients, and provided by safety-net physicians vs non-safety-net physicians. Design, Setting, and Participants: This multiyear cross-sectional observational study included all patients ages 18 to 64 years from the National Ambulatory Medical Care Survey (2005-2013) and the National Hospital Ambulatory Medical Care Survey (2005-2011) eligible for any of the 21 previously defined low-value or high-value care measures...
April 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28394752/the-risks-of-opioid-treatment-perspectives-of-primary-care-practitioners-and-patients-from-safety-net-clinics
#11
Emily E Hurstak, Margot Kushel, Jamie Chang, Rachel Ceasar, Kara Zamora, Christine Miaskowski, Kelly Knight
BACKGROUND: Patients with a history of substance use are more likely than those without substance use to experience chronic noncancer pain (CNCP), to be prescribed opioids, and to experience opioid misuse or overdose. Primary care practitioners (PCPs) in safety-net settings care for low-income patients with CNCP and substance use, usually without specialist consultation. To inform communication related to opioid risk, we explored PCPs' and patients' perceptions of the risks of chronic opioid therapy...
April 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28379357/the-german-long-term-care-insurance-program-evolution-and-recent-developments
#12
Pamela Nadash, Pamela Doty, Matthias von Schwanenflügel
Background and Objectives: Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing sustainability. Research Design and Methods: The study reviews legislative and programmatic changes, using program data, as well as legislative documents and program reports...
April 4, 2017: Gerontologist
https://www.readbyqxmd.com/read/28376457/updated-priorities-among-effective-clinical-preventive-services
#13
Michael V Maciosek, Amy B LaFrance, Steven P Dehmer, Dana A McGree, Thomas J Flottemesch, Zack Xu, Leif I Solberg
PURPOSE: The Patient Protection and Affordable Care Act's provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28369066/socioeconomic-factors-explain-suboptimal-adherence-to-antiretroviral-therapy-among-hiv-infected-australian-adults-with-viral-suppression
#14
Krista J Siefried, Limin Mao, Stephen Kerr, Lucette A Cysique, Thomas M Gates, John McAllister, Anthony Maynard, John de Wit, Andrew Carr
BACKGROUND: Missing more than one tablet of contemporary antiretroviral therapy (ART) per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings. METHODS: Adults on ART with undetectable viral load (UDVL) were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs...
2017: PloS One
https://www.readbyqxmd.com/read/28364372/the-latino-physician-shortage-how-the-affordable-care-act-increases-the-value-of-latino-spanish-speaking-physicians-and-what-efforts-can-increase-their-supply
#15
David A Daar, Miguel Alvarez-Estrada, Abigail E Alpert
The United States Latino population is growing at a rapid pace and is set to reach nearly 30% by 2050. The demand for culturally and linguistically competent health care is increasing in lockstep with this growth; however, the supply of doctors with skills and experience suited for this care is lagging. In particular, there is a major shortage of Latino Spanish-speaking physicians, and the gap between demand and supply is widening. The implementation of the Affordable Care Act (ACA) has increased the capacity of the US healthcare system to care for the growing Latino Spanish-speaking population, through health insurance exchanges, increased funding for safety net institutions, and efforts to improve efficiency and coordination of care, particularly with Accountable Care Organizations and the Hospital Readmissions Reduction Program...
March 31, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28359835/reasons-for-non-initiation-and-non-completion-of-hpv-vaccine-among-english-and-spanish-speaking-parents-of-adolescent-girls-a-qualitative-study
#16
Karen Albright, Juliana Barnard, Sean O'Leary, Steven Lockhart, Andrea Jimenez-Zambrano, Shannon Stokley, Amanda Dempsey, Allison Kempe
OBJECTIVE: The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) vaccination for females aged 11-12 years, yet vaccination rates remain low. We conducted a qualitative study to understand English- and Spanish-speaking parents' reasons for non-initiation or non-completion of the HPV vaccine series for their daughters. METHODS: Parents of females aged 12-15 years who had not initiated or not completed the HPV vaccine series were identified through administrative data in two large urban safety net health care systems in Colorado...
March 27, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28351344/why-do-women-choose-an-unregulated-birth-worker-to-birth-at-home-in-australia-a-qualitative-study
#17
Elizabeth Christine Rigg, Virginia Schmied, Kath Peters, Hannah Grace Dahlen
BACKGROUND: In Australia the choice to birth at home is not well supported and only 0.4% of women give birth at home with a registered midwife. Recent changes to regulatory requirements for midwives have become more restrictive and there is no insurance product that covers private midwives for intrapartum care at home. Freebirth (planned birth at home with no registered health professional) with an unregulated birth worker who is not a registered midwife or doctor (e.g. Doula, ex-midwife, lay midwife etc...
March 28, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28346590/implementation-and-evaluation-of-a-large-scale-teleretinal-diabetic-retinopathy-screening-program-in-the-los-angeles-county-department-of-health-services
#18
Lauren P Daskivich, Carolina Vasquez, Carlos Martinez, Chi-Hong Tseng, Carol M Mangione
Importance: Diabetic retinopathy (DR) is the leading cause of blindness in adults of working age in the United States. In the Los Angeles County safety net, a nonvertically integrated system serving underinsured and uninsured patients, the prevalence of DR is approximately 50%, and owing to limited specialty care resources, the average wait times for screening for DR have been 8 months or more. Objective: To determine whether a primary care-based teleretinal DR screening (TDRS) program reduces wait times for screening and improves timeliness of needed care in the Los Angeles County safety net...
March 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28346579/seeing-the-effect-of-health-care-delivery-innovation-in-the-safety-net
#19
Courtney Lyles, Urmimala Sarkar
No abstract text is available yet for this article.
March 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28342190/expanded-medicaid-dental-coverage-under-the-affordable-care-act-an-analysis-of-minnesota-emergency-department-visits
#20
Nadia Laniado, Victor M Badner, Ellen Johnson Silver
OBJECTIVES: Hospital emergency departments (EDs) function as the safety net for patients with non-traumatic dental conditions (NTDCs). With the implementation of Medicaid expansion under the Affordable Care Act (ACA) many adults became eligible for dental benefits. We examined the impact of "early" Medicaid expansion in Minnesota on ED visits for NTDCs from 2008 (prereform) to 2014 (postreform). METHODS: Data from the State Emergency Department Databases for Minnesota were analyzed for 2 years: 2008 and 2014...
March 24, 2017: Journal of Public Health Dentistry
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