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Value-based healthcare

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https://www.readbyqxmd.com/read/29341818/medicine-as-it-should-be-teaching-team-and-teamwork-during-a-palliative-care-clerkship
#1
Barbara A Head, Christian Davis Furman, Andrew M Lally, Kimberly Leake, Mark Pfeifer
BACKGROUND: Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills. OBJECTIVE: Our objective was to assess the learning of senior medical students during a palliative care rotation. DESIGN: A constant comparison method based on grounded theory was used in this qualitative study. SETTING/SUBJECTS: Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship...
January 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29340593/the-clinical-utility-of-methicillin-resistant-staphylococcus-aureus-mrsa-nasal-screening-to-rule-out-mrsa-pneumonia-a-diagnostic-meta-analysis-with-antimicrobial-stewardship-implications
#2
Diane M Parente, Cheston B Cunha, Eleftherios Mylonakis, Tristan T Timbrook
Background: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program (ASP) tool for avoiding unnecessary empiric MRSA therapy for pneumonia, yet current guidelines recommend MRSA therapy based on risk factors. The objective of this meta-analysis was to evaluate the diagnostic value of MRSA nasal screening in MRSA pneumonia. Methods: Pubmed and EMBASE were searched from inception to November 2016 for English studies evaluating MRSA nasal screening and development of MRSA pneumonia...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29338438/challenges-in-adult-vaccination
#3
Eduardo de Gomensoro, Giuseppe Del Giudice, T Mark Doherty
Life-long primary prevention interventions beginning and continuing throughout an individual's lifetime are increasingly seen as key to meeting the global healthcare challenges that accompany demographic changes - a concept referred to as "Healthy aging". In this perspective, vaccination is seen as part of a triad, together with healthy diet and exercise. Current adult vaccine coverage is lower than target vaccination rates in most developed countries, and so vaccine preventable diseases continue to present a substantial burden on health and healthcare resources, especially in older individuals...
January 16, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29331530/a-qualitative-synthesis-of-pharmacist-other-health-professional-and-lay-perspectives-on-the-role-of-community-pharmacy-in-facilitating-care-for-people-with-long-term-conditions
#4
N J Hall, G Donovan, S Wilkes
BACKGROUND: There is increasing interest in an enhanced role for community pharmacy (CP) in facilitating care for people with long-term conditions (LTCs). It is important to understand the perspectives of stakeholders in order to identify key issues that may impact on future development of the role and related services. OBJECTIVES: Explore pharmacist, other health professional and lay perspectives on the role of CP in facilitating care for people with LTCs. METHODS: Synthesis of qualitative research from UK based studies published between 2007 and January 2017 using a meta-ethnographic interpretative approach...
January 4, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29329961/-personalised-health-services-suggestions-for-their-effective-implementation
#5
Armin Töpfer, Georg Brabänder
A strategy of customisation, and its subsequent practical implementation as part of personalised treatment pathways, is an appropriate approach to increase benefits for patients and to strengthen the competitive position of the provider of health services. This requires restructuring and/or reorganising measures to enable variants within the treatment pathway as a value creation process to be adapted to each individual patient and his illness, living conditions and preferences. This 'mass customisation' approach allows us to achieve the objective of a constructive interconnection of customisation and standardisation of health services...
January 9, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29329530/design-and-evaluation-of-a-mobile-application-to-assist-the-self-monitoring-of-the-chronic-kidney-disease-in-developing-countries
#6
Alvaro Sobrinho, Leandro Dias da Silva, Angelo Perkusich, Maria Eliete Pinheiro, Paulo Cunha
BACKGROUND: The chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression. METHODS: A user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016...
January 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29326195/why-do-gps-leave-direct-patient-care-and-what-might-help-to-retain-them-a-qualitative-study-of-gps-in-south-west-england
#7
Anna Sansom, Rohini Terry, Emily Fletcher, Chris Salisbury, Linda Long, Suzanne H Richards, Alex Aylward, Jo Welsman, Laura Sims, John L Campbell, Sarah G Dean
OBJECTIVE: To identify factors influencing general practitioners' (GPs') decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. DESIGN: Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. SETTING: South West England, UK. PARTICIPANTS: 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325536/autonomy-and-couples-joint-decision-making-in-healthcare
#8
Pauline E Osamor, Christine Grady
BACKGROUND: Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making...
January 11, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29325398/health-priorities-in-french-speaking-swiss-cantons
#9
Philippe Chastonay, Jean Simos, Nicolas Cantoreggi, Rudolf Zurkinden, Thomas Mattig
In Switzerland, the federal authorities, the cantons, and the communes share the responsibility of healthcare, disease prevention and health promotion policies. Yet, the cantons are in most health matters independent in their decisions, thus defining as a matter of fact their own health priorities. We examined and analysed the content of the disease prevention and health promotion plans elaborated during the last decade in six French-speaking cantons with different political contexts and resources, but quite similar population health data, in order to identify the set health priorities...
July 31, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29322928/constraint-based-perturbation-analysis-with-cluster-newton-method-a-case-study-of-personalized-parameter-estimations-with-irinotecan-whole-body-physiologically-based-pharmacokinetic-model
#10
Shun Asami, Daisuke Kiga, Akihiko Konagaya
BACKGROUND: Drug development considering individual varieties among patients becomes crucial to improve clinical development success rates and save healthcare costs. As a useful tool to predict individual phenomena and correlations among drug characteristics and individual varieties, recently, whole-body physiologically based pharmacokinetic (WB- PBPK) models are getting more attention. WB-PBPK models generally have a lot of drug-related parameters that need to be estimated, and the estimations are difficult because the observed data are limited...
December 21, 2017: BMC Systems Biology
https://www.readbyqxmd.com/read/29320539/the-impact-of-electronic-consultation-on-a-canadian-tertiary-care-pediatric-specialty-referral-system-a-prospective-single-center-observational-study
#11
Lillian Lai, Clare Liddy, Erin Keely, Amir Afkham, Julia Kurzawa, Nishard Abdeen, Tobey Audcent, Matthew Bromwich, Jason Brophy, Sasha Carsen, Annick Fournier, Leigh Fraser-Roberts, Hazen Gandy, Charles Hui, Donna Johnston, Kathryn Keely, Ken Kontio, Christine Lamontagne, Nathalie Major, Michael O'Connor, Dhenuka Radhakrishnan, Joe Reisman, Marjorie Robb, Lindy Samson, Erick Sell, William Splinter, Judy van Stralen, Sunita Venkateswaran, Kimmo Murto
BACKGROUND: Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. OBJECTIVE: To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults...
2018: PloS One
https://www.readbyqxmd.com/read/29317276/accuracy-of-the-enhanced-liver-fibrosis-test-vs-fibrotest-elastography-and-indirect-markers-in-detection-of-advanced-fibrosis-in-patients-with-alcoholic-liver-disease
#12
Maja Thiele, Bjørn Stæhr Madsen, Janne Fuglsang Hansen, Sönke Detlefsen, Steen Antonsen, Aleksander Krag
BACKGROUND & AIMS: Alcohol is the leading cause of cirrhosis and liver-related mortality, but we lack serum markers to detect compensated disease. We compared the accuracy of the Enhanced Liver Fibrosis test (ELF), the FibroTest, liver stiffness measurements (made by transient elastography and 2-dimensional shear-wave elastography), and 6 indirect marker tests in detection of advanced liver fibrosis (Kleiner stage ≥F3). METHODS: We performed a prospective study of 10 liver fibrosis markers (patented and not), all performed on the same day...
January 6, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29315414/cost-effectiveness-research-in-neurosurgery-we-can-and-we-must
#13
Sherman C Stein
Rapid advancement of medical and surgical therapies, coupled with the recent preoccupation with limiting healthcare costs, makes a collision of the 2 objectives imminent. This article explains the value of cost-effectiveness analysis (CEA) in reconciling the 2 competing goals, and provides a brief introduction to evidence-based CEA techniques. The historical role of CEA in determining whether new neurosurgical strategies provide value for cost is summarized briefly, as are the limitations of the technique. Finally, the unique ability of the neurosurgical community to provide input to the CEA process is emphasized, as are the potential risks of leaving these important decisions in the hands of others...
January 5, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29313963/reverse-translation-the-art-of-cyclical-learning
#14
EDITORIAL
Sreeneeranj Kasichayanula, Karthik Venkatakrishnan
We live in an era of precision therapeutics, value-based healthcare, patient-participatory research, and enhanced clinical trial transparency, with explosive increases in our ability to access and analyze multiscale biological and clinical data from diverse ecosystems. To discover and develop truly transformative medicines with a patient-centric sense of urgency, we will need to exploit data that lie far beyond the confines of laboratory-based experimental models and controlled clinical trials, dynamically maximizing the value of information in real-world data from clinical practice settings and even social media...
February 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29306878/seasonal-variation-in-home-blood-pressure-findings-from-nationwide-web-based-monitoring-in-japan
#15
Toshiyuki Iwahori, Katsuyuki Miura, Keiichi Obayashi, Takayoshi Ohkubo, Hiroshi Nakajima, Toshikazu Shiga, Hirotsugu Ueshima
OBJECTIVES: Our aim was to assess seasonal variation in home blood pressure (BP) among free-living nationwide participants using home BP values accumulated from a web-based healthcare platform established in Japan. SETTINGS: An observational study. OMRON Healthcare Co., Ltd. has been developing web-based personal healthcare record systems in Japan since November 2010; over two million voluntary participants had joined this platform in September 2015. Nationwide home BP measurements made by oscillometric-type electronic sphygmomanometers from over 110 000 voluntary participants have been transmitted to the system from devices...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29306100/nursing-students-perceptions-of-a-video-based-serious-game-s-educational-value-a-pilot-study
#16
Hege M Johnsen, Mariann Fossum, Pirashanthie Vivekananda-Schmidt, Ann Fruhling, Åshild Slettebø
BACKGROUND: Despite an increasing number of serious games (SGs) in nursing education, few evaluation studies specifically address their educational value in terms of face, content, and construct validity. OBJECTIVES: To assess nursing students' perceptions of a video-based SG in terms of face, content, and construct validity. In addition, the study assessed perceptions of usability, individual factors, and preferences regarding future use. DESIGN: A pilot study was conducted...
December 28, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29305175/an-overview-of-anti-diabetic-plants-used-in-gabon-pharmacology-and-toxicology
#17
REVIEW
B Bading Taika, M Bouckandou, A Souza, H P Bourobou Bourobou, L MacKenzie, L Lione
ETHNOPHARMACOLOGICAL RELEVANCE: The management of diabetes mellitus management in African communities, especially in Gabon, is not well established as more than 60% of population rely on traditional treatments as primary healthcare. The aim of this review was to collect and present the scientific evidence for the use of medicinal plants that are in currect by Gabonese traditional healers to manage diabetes or hyperglycaemia based here on the pharmacological and toxicological profiles of plants with anti-diabetic activity are presented in order to promote their therapeutic value, ensure a safer use by population and provide some bases for further study on high potential plants reviewed...
January 2, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29302926/the-cost-effectiveness-of-lubiprostone-in-chronic-idiopathic-constipation
#18
Becky Pennington, Emily-Ruth Marriott, Peter Lichtlen, Ayesha Akbar, Anthony J Hatswell
OBJECTIVE: The objective of this study was to evaluate the cost effectiveness of lubiprostone, prucalopride, placebo and immediate referral to secondary care in chronic idiopathic constipation (CIC) in an economic model that was used by the UK National Institute for Health and Care Excellence (NICE) in developing guidance. METHODS: We developed a cohort state-transition model to reflect the treatment pathway in CIC from the UK NHS and personal social services perspective...
January 4, 2018: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29301539/development-of-an-inventory-of-goals-using-the-international-classification-of-functioning-disability-and-health-in-a-population-of-non-ambulatory-children-and-adolescents-with-cerebral-palsy-treated-with-botulinum-toxin-a
#19
Linda Nguyen, Ronit Mesterman, Jan Willem Gorter
BACKGROUND: In the management of hypertonicity in children with cerebral palsy (CP), goals should be clearly identified in order to evaluate the effectiveness of botulinum toxin A (BoNT-A) treatment, specifically in non-ambulatory children and adolescents, Gross Motor Function Classification System (GMFCS), level IV or V. A retrospective chart review (Mesterman et al., 2013) identified the need for the development of a set of specific and meaningful goals linked to the International Classification of Functioning, Disability and Health (ICF) for future goal setting and evaluation in this population...
January 4, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29288920/diagnostic-potential-and-future-directions-of-biomarkers-in-gingival-crevicular-fluid-and-saliva-of-periodontal-diseases-review-of-the-current-evidence
#20
REVIEW
Noha Ayman Ghallab
OBJECTIVES: The holy grail of biomarker research in periodontology is to develop a high impact diagnostics which have a significant impact on clinical decision-making, patient outcomes and healthcare providers. In the field of periodontal diagnostics, oral fluid-based biomarkers have been studied mainly in the gingival crevicular fluid (GCF) and saliva. METHODS: A literature search was performed using the Cochrane library and PubMed databases from 2000 to January 2017...
December 23, 2017: Archives of Oral Biology
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