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https://www.readbyqxmd.com/read/29442175/common-models-used-for-inpatient-diabetes-management
#1
REVIEW
Andjela T Drincic, Padmaja Akkireddy, Jon T Knezevich
PURPOSE OF REVIEW: Diabetes affects about a third of all hospitalized patients and up to 50% of inpatients go on to experience hyperglycemia. Despite strong evidence supporting the importance of adequate glycemic control, as well detailed guidelines from major national organizations, many patients continue to have hypo- and hyperglycemia during their hospital stay. While this may be partially related to provider and patient-specific factors, system-based barriers continue to pose a major obstacle...
February 14, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29428057/the-impact-of-hospital-and-patient-factors-on-the-emergency-department-decision-to-admit
#2
Leah S Honigman Warner, Jessica E Galarraga, Ori Litvak, Samuel Davis, Michael Granovsky, Jesse M Pines
BACKGROUND: Substantial variation exists in rates of emergency department (ED) admission. We examine this variation after accounting for local and community characteristics. OBJECTIVES: Elucidate the factors that contribute to admission variation that are amenable to intervention with the goal of reducing variation and health care costs. METHODS: We conducted a retrospective cross-sectional study of 1,412,340 patient encounters across 18 sites from 2012-2013...
February 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29118275/a-mid-level-dental-provider-in-oregon-dental-hygienists-perceptions
#3
Amy E Coplen, Kathryn Bell, Gail L Aamodt, Lynn Ironside
Purpose: Many states are exploring alternative provider models and examining the role of the dental hygienist to address access to care challenges as the United States continues to face increasing demands for oral healthcare services. The purpose of this study was to assess dental hygienists' opinions in the state of Oregon regarding the current limitations of dental hygienists' scope of practice, perceived need for a mid-level provider in Oregon, and personal interest in becoming a mid-level provider.Methods: In December 2013 a survey was mailed to a sample of 1,231 dental hygienists registered in Oregon representing 30% of the licentiates...
October 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29063228/safety-and-feasibility-of-a-ketamine-package-to-support-emergency-and-essential-surgery-in-kenya-when-no-anesthetist-is-available-an-analysis-of-1216-consecutive-operative-procedures
#4
Thomas F Burke, Sebastian Suarez, Daniel I Sessler, Ayla Senay, Taha Yusufali, Charles Masaki, Moytrayee Guha, Debora Rogo, Pankaj Jani, Brett D Nelson, Khama Rogo
BACKGROUND: Lack of access to emergency and essential surgery is widespread in low- and middle-income countries. Scarce anesthesia services contribute to this unmet need. The aim of this study was to evaluate the safety and feasibility of the Every Second Matters for Emergency and Essential Surgery-Ketamine (ESM-Ketamine) package for emergency and essential procedures when no anesthetist was available. METHODS: From November 2013 to September 2017, the ESM-Ketamine package was used for patients requiring emergency or life-improving surgeries in fifteen selected facilities across Kenya when no anesthetist was available...
December 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28614974/electronic-consultation-system-demonstrates-educational-benefit-for-primary-care-providers
#5
Jonas Kwok, J Nwando Olayiwola, Margae Knox, Elizabeth J Murphy, Delphine S Tuot
Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28461633/should-dental-schools-train-dentists-to-routinely-provide-limited-preventive-primary-medical-care-two-viewpoints-viewpoint-1-dentists-should-be-trained-to-routinely-provide-limited-preventive-primary-care-and-viewpoint-2-dentists-should-be-trained-in-primary
#6
Donald B Giddon, R Bruce Donoff, Paul C Edwards, Lawrence I Goldblatt
This Point/Counterpoint acknowledges the transformation of dental practice from a predominantly technically based profession with primary emphasis on restoration of the tooth and its supporting structures to that of a more medically based specialty focusing on the oral and maxillofacial complex. While both viewpoints accept the importance of this transformation, they differ on the ultimate desired outcome and how changes should be implemented during training of dentists as oral health professionals. Viewpoint 1 argues that, in response to a shortage of both primary care providers and access to affordable oral health care, dentists need to be able and willing to provide limited preventive primary care (LPPC), and dental educators should develop and implement training models to prepare them...
May 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/28406806/improved-hiv-and-tb-knowledge-and-competence-among-mid-level-providers-in-a-cluster-randomized-trial-of-one-on-one-mentorship-for-task-shifting
#7
RANDOMIZED CONTROLLED TRIAL
Sarah Naikoba, Kaggwa D Senjovu, Pallen Mugabe, Carey F McCarthy, Patricia L Riley, Damazo T Kadengye, Shona Dalal
INTRODUCTION: Health worker shortages pose a challenge to the scale up of HIV care and treatment in Uganda. Training mid-level providers (MLPs) in the provision of HIV and tuberculosis (TB) treatment can expand existing health workforce capacity and access to HIV services. METHODS: We conducted a cluster-randomized trial of on-site clinical mentorship for HIV and TB care at 10 health facilities in rural Uganda. Twenty MLPs at 5 randomly assigned to an intervention facilities received 8 hours a week of one-on-one mentorship, every 6 weeks over a 9-month period; and another 20 at 5 control facilities received no clinical mentorship...
August 15, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28272806/a-markov-model-assessing-the-impact-on-primary-care-practice-revenues-and-patient-s-health-when-using-mid-level-providers-lesson-learned-from-the-united-kingdom
#8
Harry Hill, Richard Macey, Paul Brocklehurst
OBJECTIVE: To evaluate the cost-effectiveness of using mid-level providers for dental "check-up" examinations and the treatment of caries in different NHS settings in the United Kingdom. Mid-level providers are a broad category that describes non-dentist members of dental teams. This study focused on the potential use of Dental Hygiene Therapists undertaking dental "check-up" examinations and simple restorative treatment, instead of dentists. METHODS: A Markov model was used to construct the natural history of caries development in adults that visit a dental practice every six months over a five-year period...
March 8, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28210353/prevalence-of-horizontal-violence-among-emergency-attending-physicians-residents-and-physician-assistants
#9
Nico B Volz, Ryan Fringer, Bradford Walters, Terry Kowalenko
INTRODUCTION: Horizontal violence (HV) is malicious behavior perpetrated by healthcare workers against each other. These include bullying, verbal or physical threats, purposeful disruptive behavior, and other malicious behaviors. This pilot study investigates the prevalence of HV among emergency department (ED) attending physicians, residents, and mid-level providers (MLPs). METHODS: We sent an electronic survey to emergency medicine attending physicians (n=67), residents (n=25), and MLPs (n=24) in three unique EDs within a single multi-hospital medical system...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28156583/developing-a-supportive-oncology-program-in-a-cancer-institute-needs-assessment
#10
Tara Liberman, James D'Olimpio, Maria Carney
141 Background: Cancer patients experience significant symptom and psychosocial burden (Temel JS, et. al. N Engl J Med. 2010 Aug 19; 363(8):733-42. Early palliative care for patients with metastatic non-small-cell lung cancer.). Integration of supportive oncology programs within cancer centers has developed since the findings of Temel and Jackson. Addressing a growing need to manage patients comprehensively, the Northwell Health Divisions of Geriatric and Palliative Medicine and Hematology and Oncology partnered to initiate a community-based supportive oncology program...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27998288/factors-influencing-job-preferences-of-health-workers-providing-obstetric-care-results-from-discrete-choice-experiments-in-malawi-mozambique-and-tanzania
#11
Eilish McAuliffe, Marie Galligan, Paul Revill, Francis Kamwendo, Mohsin Sidat, Honorati Masanja, Helen de Pinho, Edson Araujo
BACKGROUND: Task shifting from established health professionals to mid-level providers (MLPs) (professionals who undergo shorter training in specific procedures) is one key strategy for reducing maternal and neonatal deaths. This has resulted in a growth in cadre types providing obstetric care in low and middle-income countries. Little is known about the relative importance of the different factors in determining motivation and retention amongst these cadres. METHODS: This paper presents findings from large sample (1972 respondents) discrete choice experiments to examine the employment preferences of obstetric care workers across three east African countries...
December 20, 2016: Globalization and Health
https://www.readbyqxmd.com/read/27989261/task-shifting-to-clinical-officer-led-echocardiography-screening-for-detecting-rheumatic-heart-disease-in-malawi-africa
#12
Amy Sims Sanyahumbi, Craig A Sable, Melissa Karlsten, Mina C Hosseinipour, Peter N Kazembe, Charles G Minard, Daniel J Penny
BACKGROUND: Echocardiographic screening for rheumatic heart disease in asymptomatic children may result in early diagnosis and prevent progression. Physician-led screening is not feasible in Malawi. Task shifting to mid-level providers such as clinical officers may enable more widespread screening. Hypothesis With short-course training, clinical officers can accurately screen for rheumatic heart disease using focussed echocardiography. METHODS: A total of eight clinical officers completed three half-days of didactics and 2 days of hands-on echocardiography training...
December 19, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27955985/quarterly-reporting-of-computed-tomography-ordering-history-reduces-the-use-of-imaging-in-an-emergency-department
#13
Richard Ehrlichman, Zachary Dezman, Joel Klein, Jean Jeudy, Daniel Lemkin
BACKGROUND: Computed tomography (CT) is a useful and necessary part of many emergency department (ED) assessments. However, the costs of imaging and the health risks associated with radiation exposure have sparked national efforts to reduce CT ordering in EDs. STUDY OBJECTIVE: We analyzed CT ordering habits prior to and following implementation of a feedback tool at a community hospital. METHODS: In this intervention study, we identified the CT-ordering habits of physicians and mid-level care providers (physician assistants and nurse practitioners) at baseline and after implementation of a system that sent quarterly feedback reports comparing their ordering habits with those of their peers...
May 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27613894/the-difference-a-decade-makes-smoking-cessation-counseling-and-screening-at-pediatric-visits
#14
Philip B Cawkwell, Lily Lee, Jenni Shearston, Scott E Sherman, Michael Weitzman
INTRODUCTION: There has been a sharp decline in adolescents who smoke cigarettes but no national-level study evaluating the impact of smoking cessation counseling by pediatricians or other clinicians who care for children. METHODS: Combined data from ambulatory portions of the National Hospital Ambulatory Care Survey and National Ambulatory Medical Care Survey from 1997-1999 and 2009-2011 were analyzed to determine changes in the frequency of pediatric visits that included clinician-reported tobacco counseling and how such counseling varied by child, family, and clinician characteristics...
November 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/27503328/district-health-manager-and-mid-level-provider-perceptions-of-practice-environments-in-acute-obstetric-settings-in-tanzania-a-mixed-method-study
#15
Njoki Ng'ang'a, Mary Woods Byrne, Margaret E Kruk, Aloisia Shemdoe, Helen de Pinho
BACKGROUND: In sub-Saharan Africa, the capacity of human resources for health (HRH) managers to create positive practice environments that enable motivated, productive, and high-performing HRH is weak. We implemented a unique approach to examining HRH management practices by comparing perspectives offered by mid-level providers (MLPs) of emergency obstetric care (EmOC) in Tanzania to those presented by local health authorities, known as council health management teams (CHMTs). METHODS: This study was guided by the basic strategic human resources management (SHRM) component model...
August 8, 2016: Human Resources for Health
https://www.readbyqxmd.com/read/27497453/patient-perceptions-of-weight-loss-implications-for-patients-providers-and-trainees
#16
David A Nelson, Leslie A Ruffalo, Alexandra J Dyer, Karen H Nelson
OBJECTIVES: The prevalence of overweight and obese individuals in the United States is growing, and primary health care represents a setting in which providers may address weight with their patients. However, many providers and medical trainees feel ill-prepared to address the full scope of complexities associated with weight loss. This study sought to investigate patients' perceptions of the barriers and facilitators they encountered in their weight loss journeys. The results of the mixed-methods study will be used to inform a better understanding among providers and medical students of how to address weight loss with their patients...
May 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/27367866/the-impact-of-using-mid-level-providers-in-face-to-face-primary-care-on-health-care-utilization
#17
Hangsheng Liu, Michael Robbins, Ateev Mehrotra, David Auerbach, Brandi E Robinson, Lee F Cromwell, Douglas W Roblin
BACKGROUND: There has been concern that greater use of nurse practitioners (NP) and physician assistants (PA) in face-to-face primary care may increase utilization and spending. OBJECTIVE: To evaluate a natural experiment within Kaiser Permanente in Georgia in the use of NP/PA in primary care. STUDY DESIGN: From 2006 through early 2008 (the preperiod), each NP or PA was paired with a physician to manage a patient panel. In early 2008, NPs and PAs were removed from all face-to-face primary care...
January 2017: Medical Care
https://www.readbyqxmd.com/read/27175461/development-of-a-question-prompt-sheet-for-cancer-patients-receiving-outpatient-palliative-care
#18
Joseph Arthur, Sriram Yennurajalingam, Janet Williams, Kimberson Tanco, Diane Liu, Saneese Stephen, Eduardo Bruera
BACKGROUND: A question prompt sheet (QPS) is a structured list of potential questions available for patients to ask their doctor during a clinical encounter. Although it has been shown to improve physician-patient interaction during clinical consultations, there is paucity of data on its use in the palliative care setting. The aim of this study was to develop a single-page consensus list of prompt questions for use by patients attending outpatient palliative care. METHOD: An expert group of experienced physicians and mid-level providers were invited to participate in the study conducted in three Delphi rounds...
August 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27105788/low-income-parents-perceptions-of-oral-health-and-acceptance-of-mid-level-dental-providers
#19
Kerri Leyda Nicoll, Elizabeth Phillips, H Luke Shaefer, Teague Simoncic
PURPOSE: The purpose of this study was to explore low-income parents' perceptions of oral health and of mid-level dental providers as a means of improving access to care. As states increasingly consider adding mid-level providers to the dental workforce, understanding the views of potential patients toward such providers is important, since the success of this strategy will depend, in part, upon the willingness of potential patients to be treated by them. METHODS: Because little is known about the social acceptability of mid-level dental providers, the researchers employed a qualitative methodology, conducting in-depth interviews with 20 low-income parents in order to assess their perceptions of oral health, access to and need for dental care, and potential acceptance of mid-level dental providers...
April 2016: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/27014367/why-don-t-humanitarian-organizations-provide-safe-abortion-services
#20
Therese McGinn, Sara E Casey
BACKGROUND: Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'. DISCUSSION: However, each of these reasons is based on false premises...
2016: Conflict and Health
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