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https://www.readbyqxmd.com/read/29783126/systemic-therapy-for-intermediate-and-advanced-hepatocellular-carcinoma-sorafenib-and-beyond
#1
REVIEW
Jean-Luc Raoul, Masatoshi Kudo, Richard S Finn, Julien Edeline, Maria Reig, Peter R Galle
The hepatocellular carcinoma (HCC) treatment landscape changed a decade ago, with sorafenib demonstrating survival benefit in the first-line setting and becoming the first systemic therapy to be approved for HCC. More recently, regorafenib and nivolumab have received approval in the second-line setting after sorafenib, with further positive phase 3 studies emerging in the first line (lenvatinib non-inferior to sorafenib) and second line versus placebo (cabozantinib and ramucirumab). A key recommendation in the management of patients receiving sorafenib is to promote close communication between the patient and the physician so that adverse events (AEs) are detected early and severe AEs can be prevented...
May 17, 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#2
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29782065/foley-catheter-vs-oral-misoprostol-to-induce-labour-among-hypertensive-women-in-india-a-cost-consequence-analysis-alongside-a-clinical-trial
#3
Simon Leigh, Paul Granby, Alan Haycox, Shuchita Mundle, Hillary Bracken, Vaishali Khedikar, Jayashree Mulik, Brian Faragher, Thomas Easterling, Mark A Turner, Zarko Alfirevic, Beverly Winikoff, Andrew D Weeks
OBJECTIVE: To determine the effectiveness and economic impact of two methods for induction of labour in hypertensive women, in low-resource settings. DESIGN: Cost-consequence analysis of a previously reported multi-centre, parallel, open-label randomized trial. SETTING & POPULATION: 602 women with a live fetus, aged>18 years requiring delivery for pre-eclampsia or hypertension, in two public hospitals in Nagpur, India. METHODS: We performed a formal economic evaluation alongside the INFORM clinical trial...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29781969/an-ecological-approach-toward-prevention-and-care-of-victims-of-domestic-minor-sex-trafficking
#4
Rosario V Sanchez, Dula F Pacquiao
Sex trafficking is a widespread form of human trafficking that exists globally. The forced sexual exploitation of young women for profit at the hands of traffickers is a human rights violation. Sex trafficking is a form of modern-day slavery where youths are sold as a commodity. It is difficult to determine the wide range of negative health outcomes associated with domestic minor sex trafficking due to the hidden nature of the crime and its lack of statistical data to determine prevalence. Viewing domestic minor sex trafficking through an ecological lens assists in the understanding of the multiple complex interactions between victims, their relationships, and environments that influence their health...
April 2018: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/29781881/individual-and-network-factors-associated-with-hiv-care-continuum-outcomes-among-nigerian-msm-accessing-healthcare-services
#5
Habib O Ramadhani, Nicaise Ndembi, Rebecca G Nowak, Uchenna Ononaku, Jerry Gwamna, Ifeanyi Orazulike, Sylvia Adebajo, Trevor A Crowell, Hongjie Liu, Stefan D Baral, Julie Ake, Man E Charurat
BACKGROUND: and setting: As data on the determinants of the HIV care continuum from key populations such as men who have sex with men (MSM) in resource-limited, settings (RLS) are limited, the study aimed to characterize HIV care continuum outcomes and assess individual and network barriers to progression through the HIV care continuum among MSM in Abuja and Lagos, Nigeria. METHODS: TRUST/RV368 study used respondent-driven-sampling to accrue MSM into community-based clinics in Nigeria...
May 16, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29781685/detection-referral-and-control-of-diabetes-and-hypertension-in-the-rural-eastern-cape-province-of-south-africa-by-community-health-outreach-workers-in-the-rural-primary-healthcare-project-health-in-every-hut
#6
Angela A Morris-Paxton, Paul Rheeder, Rose-Marie G Ewing, Dillon Woods
BACKGROUND:  Non-communicable diseases, mainly cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, are responsible for approximately 63% of all deaths occurring worldwide in any given year. The majority of these deaths have occurred in low- and middle-income countries (LMICs). The latest World Health Organization (WHO) report shows that the increase in diabetes is also most pronounced in the LMICs. The South African Labour and Development Research Unit estimated a 9% prevalence within the adult population in 2016...
April 11, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29781469/environmental-stewardship-the-nurse-s-role-in-sustainability
#7
Julie Kleber
With the largest body of employees in U.S. health care, the nursing profession is well positioned to tackle the challenges of waste reduction within hospital systems. The healthcare sector generates a massive amount of waste, contributing to environmental issues, such as air and water pollution. By unifying and engaging staff through shared governance models, nurses can reduce the overhead costs associated with waste management and help maintain fiscal integrity. Nurses have the ability to use their trusted skill sets and lead the way for sustainable, healthy communities and environments in which they serve...
June 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29781380/finally-a-regimen-to-extend-human-life-expectancy
#8
James Larrick, Andrew R Mendelsohn
The US has the most expensive healthcare system worldwide. Yet measures of healthspan and life expectancy are well below the major industrialized nations. With the US population aged 65 and older projected to double by mid-century a healthcare crisis is looming. Within this context huge interest and investment has emerged in technologies and drugs to address aging with an expected benefit to healthspan. The thesis being that such basic interventions will reduce morbidity caused by many chronic diseases where biological age itself is the major risk factor...
May 21, 2018: Rejuvenation Research
https://www.readbyqxmd.com/read/29781145/core-outcome-set-for-gene-therapy-in-haemophilia-results-of-the-corehem-multistakeholder-project
#9
A Iorio, M W Skinner, E Clearfield, D Messner, G F Pierce, M Witkop, S Tunis
BACKGROUND: Gene therapy trial results show potential to cure haemophilia A and haemophilia B. Securing broad access to a cure for a lifelong chronic disease is anticipated to face barriers at the individual and healthcare system levels, which can be partly mitigated by harmonized planning of clinical research studies. The aim of the coreHEM project was to determine the set of outcome measures required to evaluate efficacy, safety, comparative effectiveness and value of gene therapy for haemophilia...
May 20, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29779917/antimicrobial-resistance-among-migrants-in-europe-a-systematic-review-and-meta-analysis
#10
Laura B Nellums, Hayley Thompson, Alison Holmes, Enrique Castro-Sánchez, Jonathan A Otter, Marie Norredam, Jon S Friedland, Sally Hargreaves
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings...
May 17, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29779723/checking-the-potential-shift-to-perceived-usefulness-the-analysis-of-users-response-to-the-updated-electronic-health-record-core-features
#11
Petar Rajković, Dejan Aleksić, Dragan Janković, Aleksandar Milenković, Ivan Petković
OBJECTIVE: The primary objective of this paper is to identify the main factors which have an impact on the users' attitude towards the functionalities representing the perceived ease of use and to those representing the perceived usefulness. Another objective is to examine whether there occurred a shift towards the perceived usefulness of users' behavior over a period of time. To support these objectives, two different cases are examined - the case in which users are simultaneously offered basic and updated functionalities, and the one in which users are offered a completely new set of features...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29779710/comorbidity-network-for-chronic-disease-a-novel-approach-to-understand-type-2-diabetes-progression
#12
Arif Khan, Shahadat Uddin, Uma Srinivasan
BACKGROUND: Chronic diseases management outside expensive hospital settings has become a major target for governments, funders and healthcare service providers. It is well known that chronic diseases such as Type 2 Diabetes (T2D) do not occur in isolation, and has a shared aetiology common to many other diseases and disorders. Diabetes Australia reports that it is associated with a myriad of complications, which affect the feet, eyes, kidneys, and cardiovascular health. For instance, nerve damage in the lower limbs affects around 13% of Australians with diabetes, diabetic retinopathy occurs in over 15% of Australians with diabetes, and diabetes is now the leading cause of end-stage kidney disease...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29779553/social-work-student-and-practitioner-roles-in-integrated-care-settings
#13
Erin P Fraher, Erica Lynn Richman, Lisa de Saxe Zerden, Brianna Lombardi
INTRODUCTION: Social workers are increasingly being deployed in integrated medical and behavioral healthcare settings but information about the roles they fill in these settings is not well understood. This study sought to identify the functions that social workers perform in integrated settings and identify where they acquired the necessary skills to perform them. METHODS: Master of social work students (n=21) and their field supervisors (n=21) who were part of a Health Resources and Services Administration-funded program to train and expand the behavioral health workforce in integrated settings were asked how often they engaged in 28 functions, where they learned to perform those functions, and the degree to which their roles overlapped with others on the healthcare team...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779550/peer-workers-in-the-behavioral-and-integrated-health-workforce-opportunities-and-future-directions
#14
Cheryl A Gagne, Wanda L Finch, Keris J Myrick, Livia M Davis
The growth of the peer workforce in behavioral health services is bringing opportunities to organizations and institutions that serve people living with mental and substance use disorders and their families. Peer workers are defined as people in recovery from mental illness or substance use disorders or both that possess specific peer support competencies. Similar roles are identified for families of people in recovery. Peer support has been implemented in a vast range of behavioral health services, including in the relatively new use of peer support in criminal justice and emergency service environments...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779548/utilization-and-economic-contribution-of-psychiatric-mental-health-nurse-practitioners-in-public-behavioral-health-services
#15
Susan A Chapman, Bethany J Phoenix, Talia E Hahn, Deborah C Strod
INTRODUCTION: Expanded insurance coverage through the Affordable Care Act and parity in behavioral health coverage have increased demand for services. Yet there is a persistent shortage in the behavioral health workforce. Psychiatric Mental Health Nurse Practitioners (PMHNPs) may be part of the solution to shortages but are not yet fully utilized. The purpose of this study was to describe how PMHNPs are utilized, identify barriers to full utilization, and assess PMHNPs' economic contribution in public behavioral health systems...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779547/policy-pathways-to-address-provider-workforce-barriers-to-buprenorphine-treatment
#16
Rebecca L Haffajee, Amy S B Bohnert, Pooja A Lagisetty
At least 2.3 million people in the U.S. have an opioid use disorder, less than 40% of whom receive evidence-based treatment. Buprenorphine used as part of medication-assisted treatment has high potential to address this gap because of its approval for use in non-specialty outpatient settings, effectiveness at promoting abstinence, and cost effectiveness. However, less than 4% of licensed physicians are approved to prescribe buprenorphine for opioid use disorder, and approximately 47% of counties lack a buprenorphine-waivered physician...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779546/state-legislative-approach-to-enumerating-behavioral-health-workforce-shortages-lessons-learned-in-new-mexico
#17
Deborah B Altschul, Caroline A Bonham, Martha J Faulkner, Amy W Farnbach Pearson, Jessica Reno, Wayne Lindstrom, Shelley M Alonso-Marsden, Annette Crisanti, Julie G Salvador, Richard Larson
Nationally, the behavioral health workforce is in crisis because of a lack of resources, culturally responsive services, quality clinical supervision, sufficient training in evidence-based practices, and targeted recruitment and retention. Disparities in access to behavioral health care are particularly significant in New Mexico, where 25% of the population live in rural areas, and behavioral health shortages are among the highest in the nation. Additionally, as a Medicaid expansion state, New Mexico providers experience increased demand for services at a time when the state is challenged with limited workforce capacity...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779542/improving-data-for-behavioral-health-workforce-planning-development-of-a-minimum-data-set
#18
Angela J Beck, Phillip M Singer, Jessica Buche, Ronald W Manderscheid, Peter Buerhaus
The behavioral health workforce, which encompasses a broad range of professions providing prevention, treatment, and rehabilitation services for mental health conditions and substance use disorders, is in the midst of what is considered by many to be a workforce crisis. The workforce shortage can be attributed to both insufficient numbers and maldistribution of workers, leaving some communities with no behavioral health providers. In addition, demand for behavioral health services has increased more rapidly as a result of federal legislation over the past decade supporting mental health and substance use parity and by healthcare reform...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779180/the-impact-of-an-adolescent-depressive-disorders-clinical-pathway-on-healthcare-utilization
#19
Brooke Lifland, Davene R Wright, Rita Mangione-Smith, Arti D Desai
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions...
May 19, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29778819/detection-of-tem-and-ctx-m-genes-from-ciprofloxacin-resistant-proteus-mirabilis-and-escherichia-coli-isolated-on-urinary-tract-infections-utis
#20
Govindan Rajivgandhi, Muthuchamy Maruthupandy, Natesan Manoharan
The multidrug resistant Gram negative bacteria (MDRGNB) is an emerging burden and now represents a daily challenge for the management of antimicrobial therapy in healthcare settings. The present study was aimed to detect the prevalence of TEM and CTX-M type genes from GNB on urinary tract infection (UTIs). The ciprofloxacin resistant uropathogens were detected by HEXA UTI 5 disc diffusion method. The phenotypic detection of uropathogens producing extended spectrum beta lactamases (ESBLs) was confirmed by double disc combination (DDCT) and phenotype confirmation methods (PCT)...
May 17, 2018: Microbial Pathogenesis
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