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Medical research policy in the united states

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https://www.readbyqxmd.com/read/28746074/understanding-the-multidimensional-effects-of-resident-duty-hours-restrictions-a-thematic-analysis-of-published-viewpoints-in-surgery
#1
Katharine S Devitt, Michael J Kim, Lesley Gotlib Conn, Frances C Wright, Carol-Anne Moulton, Itay Keshet, Najma Ahmed
PURPOSE: Individuals representing various surgical disciplines have expressed concerns with the impact of resident duty hours (RDH) restrictions on resident education and patient outcomes. This thematic review of published viewpoints aimed to describe the effects of these restrictions in surgery. METHOD: The authors conducted a qualitative systematic review of non-research-based literature published between 2003 and 2015. Articles were included if they focused on the RDH restrictions in surgery and resident wellness, health promotion, resident safety, resident education and/or training, patient safety, medical errors, and/or heterogeneity regarding training or disciplines...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28724142/the-aging-physician-and-the-medical-profession-a-review
#2
E Patchen Dellinger, Carlos A Pellegrini, Thomas H Gallagher
Importance: The issue of the aging physician and when to cease practice has been controversial for many years. There are reports of prominent physicians who practiced after becoming dangerous in old age, but the profession has not demonstrated the ability to prevent this. A mandatory retirement age could be discriminatory and take many competent physicians out of practice and risk a physician shortage. An increasing body of evidence regarding the relationship between physicians' age and performance has led organizations, such as the American College of Surgeons, to revisit this challenge...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28715062/gestational-weight-gain-historical-evolution-of-a-contested-health-outcome
#3
Edmond D Shenassa, Celena Kinsey, Marian Moser Jones, Jenifer Fahey
The history of research on gestational weight gain (GWG) in the United States and United Kingdom provides a context for current clinical practice. We trace the evolution of research on GWG in scientific literature from the 19th century to the present and examine its implications for contemporary clinical and public health practice. Obstetricians, beginning in the late 1800s, recommended dieting during pregnancy in order to limit GWG to 20 lb or less, driven by a belief that excessive weight gain was a cause of toxemia...
July 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28665069/trends-in-fetal-and-perinatal-mortality-in-korea-2009-2014-comparison-with-japan-and-the-united-states
#4
Young Hwa Song, Gyung Min Lee, Jung Min Yoon, Eun Jung Cheon, Sung Ki Lee, Sung Hoon Chung, Jae Woo Lim
Fetal death is an important indicator of national health care. In Korea, the fetal mortality rate is likely to increase due to advanced maternal age and multiple births, but there is limited research in this field. The authors investigated the characteristics of fetal deaths, the annual changes in the fetal mortality rate and the perinatal mortality rate in Korea, and compared them with those in Japan and the United States. Fetal deaths were restricted to those that occurred at 20 weeks of gestation or more...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28651345/prioritizing-quality-measure-concepts-at-the-interface-of-behavioral-and-physical-healthcare
#5
Harold Alan Pincus, Mingjie Li, Deborah M Scharf, Brigitta Spaeth-Rublee, Matthew L Goldman, Parashar P Ramanuj, Erin K Ferenchick
Objective: Integrated healthcare models can increase access to care, improve healthcare quality, and reduce cost for individuals with behavioral and general medical healthcare needs, yet there are few instruments for measuring the quality of integrated care. In this study, we identified and prioritized concepts that can represent the quality of integrated behavioral health and general medical care. Design: We conducted a literature review to identify candidate measure concepts...
June 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28628660/systematic-review-of-emergency-medicine-clinical-practice-guidelines-implications-for-research-and-policy
#6
Arjun K Venkatesh, Dan Savage, Benjamin Sandefur, Kenneth R Bernard, Craig Rothenberg, Jeremiah D Schuur
INTRODUCTION: Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence...
2017: PloS One
https://www.readbyqxmd.com/read/28595110/utilization-of-registered-nurses-in-primary-care-teams-a-systematic-review
#7
REVIEW
Allison Norful, Grant Martsolf, Krystyna de Jacq, Lusine Poghosyan
BACKGROUND: Registered nurses are increasingly becoming embedded in primary care teams yet there is a wide variability in nursing roles and responsibilities across organizations. Policy makers are calling for a closer look at how to best utilize registered nurses in primary care teams. Lack of knowledge about effective primary care nursing roles and responsibilities challenges policy makers' abilities to develop recommendations to effectively deploy registered nurses in primary care needed to assure efficient, evidence-based, and quality health care...
May 20, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28590520/developing-multicenter-consortia-in-liver-disease-in-latin-america-challenges-and-opportunities
#8
REVIEW
Manuel Mendizabal, Marcelo O Silva
Developmentof consortiums have been useful for exploringchallengingscenarios and unchartered territoriesin liver diseases. Several consortia already developed in the United States and Europehave become key factors in patient care decision making processes, medical education and also impacting upon policy makers decisions. In Latin America the situation is different. As a result of a combination of different factors our region has not been able to take off in terms of networking advantages in research and education in liver diseases...
June 7, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28562450/considerations-for-residency-programs-regarding-accepting-undocumented-students-who-are-daca-recipients
#9
Sunny Nakae, Denisse Rojas Marquez, Isha Marina Di Bartolo, Raquel Rodriguez
The Deferred Action for Childhood Arrivals (DACA) initiative provides for the temporary deferral of enforcement of immigration laws for certain undocumented individuals brought to the United States before age 16. More than 50 medical schools now consider applicants who are DACA recipients, and medical school graduates with DACA are eligible to continue their training in graduate medical education. In this article, the authors summarize current policy and provide data on DACA recipients in medical school. They then review the implications for considering DACA recipients in graduate medical education, including employment guidelines, employer responsibilities, training at Veterans Affairs facilities, research funding, and professional licensure...
May 30, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28543411/crowdsourcing-the-moral-limits-of-human-gene-editing
#10
Eric T Juengst
In 2015, a flourish of "alarums and excursions" by the scientific community propelled CRISPR/Cas9 and other new gene-editing techniques into public attention. At issue were two kinds of potential gene-editing experiments in humans: those making inheritable germ-line modifications and those designed to enhance human traits beyond what is necessary for health and healing. The scientific consensus seemed to be that while research to develop safe and effective human gene editing should continue, society's moral uncertainties about these two kinds of experiments needed to be better resolved before clinical trials of either type should be attempted...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#11
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28419268/the-american-society-for-clinical-pathology-s-2015-wage-survey-of-medical-laboratories-in-the-united-states
#12
Edna Garcia, Patrick B Fisher
Objectives: To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. Methods: The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28417658/resident-involvement-in-professional-otolaryngology-organizations-current-trends-in-the-united-states
#13
Kevin Wong, Minyoung Jang, Amir Gilad, Jessica R Levi
Involvement by residents in professional medical organizations can enrich their training, but little data exist regarding the number and types of involvement opportunities available to otolaryngology residents. We sought to fill this gap in knowledge by quantifying the extent to which major otolaryngology-related organizations in the United States provide involvement opportunities to otolaryngology residents. Our analysis included 23 organizations and subspecialty societies. Results showed that many opportunities exist for residents to attend conferences and present research; however, fewer involvement and funding opportunities existed in any other leadership, health policy, or service-learning experiences...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28404533/costs-of-treatment-of-adult-patients-with-cystic-fibrosis-in-poland-and-internationally
#14
Dorota Kopciuch, Tomasz Zaprutko, Anna Paczkowska, Elżbieta Nowakowska
OBJECTIVES: Despite its low prevalence, cystic fibrosis (CF) may have a considerable impact on healthcare system expenditures in terms of direct healthcare costs and lost productivity. This study was aimed at calculation of costs associated with CF treatment in Poland, as well as at comparison of average costs of treatment of CF patients in selected countries, taking into account the purchasing power parity. STUDY DESIGN: Retrospective study. METHODS: The researchers undertook a retrospective study of adult patients with CF taking into account the broadest social perspective possible...
July 2017: Public Health
https://www.readbyqxmd.com/read/28399859/sex-differences-in-healthcare-expenditures-among-adults-with-diabetes-evidence-from-the-medical-expenditure-panel-survey-2002-2011
#15
Joni S Williams, Kinfe Bishu, Clara E Dismuke, Leonard E Egede
BACKGROUND: The evidence assessing differences in medical costs between men and women with diabetes living in the United States is sparse; however, evidence suggests women generally have higher healthcare expenditures compared to men. Since little is known about these differences, the aim of this study was to assess differences in out-of-pocket (OOP) and total healthcare expenditures among adults with diabetes. METHODS: Data were used from 20,442 adults (≥18 years of age) with diabetes from the 2002-2011 Medical Expenditure Panel Survey...
April 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28393587/addressing-discriminatory-benefit-design-for-people-living-with-hiv-a-california-case-study
#16
Sara B McMenamin, Riti Shimkhada, Sarah P Hiller, Garen Corbett, Ninez Ponce
Concern is growing in the United States regarding the potential for health insurance benefit designs to discriminate against persons living with HIV as research demonstrates that such practices are occurring. A recent complaint filed against health insurers in seven states alleges that some health insurance companies have been using benefit designs that discourage enrollment of people living with HIV either by not covering essential HIV medications or by requiring cost-sharing for these prohibitively expensive medications...
April 9, 2017: AIDS Care
https://www.readbyqxmd.com/read/28369692/age-of-migration-life-expectancy-with-functional-limitations-and-morbidity-in-mexican-americans
#17
Marc A Garcia, Luis M Valderrama-Hinds, Chi-Tsun Chiu, Miriam S Mutambudzi, Nai-Wei Chen, Mukaila Raji
The U.S. Mexican American population enjoys longer life expectancies relative to other racial/ethnic groups but is disproportionately affected by chronic conditions and functional limitations. Studying the impact of heterogeneity in age, time and other characteristics of migration among older Mexican Americans can inform our understanding of health disparities and healthcare needs in later-life. This research used 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess the proportion of life spent with functional limitations and one or more morbidity (according to age of migration and sex) in the U...
July 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28351177/direct-and-indirect-cost-of-managing-alzheimer-s-disease-and-related-dementias-in-the-united-states
#18
REVIEW
Arijita Deb, James Douglas Thornton, Usha Sambamoorthi, Kim Innes
Care of individuals with Alzheimer's Disease and Related Dementias (ADRD) poses special challenges. As the disease progresses, individuals with ADRD require increasing levels of medical care, caregiver support, and long-term care which can lead to substantial economic burden. Areas covered: In this expert review, we synthesized findings from studies of costs of ADRD in the United States that were published between January 2006 and February 2017, highlighted major sources of variation in costs, identified knowledge gaps and briefly outlined directions for future research and implications for policy and program planning...
April 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28339797/the-american-society-for-clinical-pathology-s-2015-wage-survey-of-medical-laboratories-in-the-united-states
#19
Edna Garcia, Patrick B Fisher
Objectives: To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. Methods: The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, & Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois...
April 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28335754/the-structural-and-health-policy-environment-for-delivering-integrated-hiv-and-substance-use-disorder-treatments-in-puerto-rico
#20
Jared A Leff, Diana Hernández, Paul A Teixeira, Pedro C Castellón, Daniel J Feaster, Allan E Rodriguez, Jorge L Santana-Bagur, Sandra Miranda De León, José Vargas Vidot, Lisa R Metsch, Bruce R Schackman
BACKGROUND: HIV prevalence in Puerto Rico is nearly twice that of the mainland United States, a level that was substantially fueled by injection drug use. Puerto Rico has a longstanding history of health provision by the public sector that directly affects how HIV and substance use disorder (SUD) treatment services are provided and funded. As part of pre-implementation research for a randomized trial of a community-level intervention to enhance HIV care access for substance users in San Juan, Puerto Rico, we sought to understand the structural and health policy environment for providing HIV and SUD treatments...
March 23, 2017: BMC Health Services Research
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