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https://www.readbyqxmd.com/read/28647933/a-new-system-of-documentation-to-improve-dietitian-physician-crosstalk
#1
Shelly Rachman-Elbaum, Aliza H Stark, Josefa Kachal, Teresa W Johnson, Bat Sheva Porat-Katz
BACKGROUND: Standardization of the dietetic care process allows for early identification of malnutrition and metabolic disorders, interdisciplinary collaboration among the medical team, and improved quality of patient care. Globally, dietitians are adopting a nutrition care model that integrates national regulations with professional scope of practice. Currently, Israel lacks a standardized dietetic care process and documentation terminology. OBJECTIVES: To assess the utilization of a novel sectoral documentation system for nutrition care in Israel...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28647862/investigating-the-relationship-between-costs-and-outcomes-for-english-mental-health-providers-a-bi-variate-multi-level-regression-analysis
#2
Valerie Moran, Rowena Jacobs
Provider payment systems for mental health care that incentivize cost control and quality improvement have been a policy focus in a number of countries. In England, a new prospective provider payment system is being introduced to mental health that should encourage providers to control costs and improve outcomes. The aim of this research is to investigate the relationship between costs and outcomes to ascertain whether there is a trade-off between controlling costs and improving outcomes. The main data source is the Mental Health Minimum Data Set (MHMDS) for the years 2011/12 and 2012/13...
June 24, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#3
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#4
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647537/variation-in-compulsory-psychiatric-inpatient-admission-in-england-a-cross-classified-multilevel-analysis
#5
Scott Weich, Orla McBride, Liz Twigg, Craig Duncan, Patrick Keown, David Crepaz-Keay, Eva Cyhlarova, Helen Parsons, Jan Scott, Kamaldeep Bhui
BACKGROUND: The increasing rate of compulsory admission to psychiatric inpatient beds in England is worrying. Studying variation between places and services could be key to identifying targets for interventions to reverse this trend. We modelled spatial variation in compulsory admissions in England using national patient-level data and quantified the extent to which patient, local-area, and service-setting characteristics accounted for this variation. METHODS: This study is a cross-sectional, multilevel analysis of the 2010-11 Mental Health Minimum Data Set (MHMDS)...
June 21, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#6
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28647418/comparison-of-stroke-prediction-accuracy-of-abcd2-and-abcd3-i-in-patients-with-transient-ischemic-attack-a-meta-analysis
#7
Meng Zhao, Shuo Wang, Dong Zhang, Yan Zhang, Xiaofeng Deng, Jizong Zhao
BACKGROUND: A direct comparison of the stroke prediction utility of the ABCD2 and ABCD3-I scores has not been performed. Thus, we conducted a diagnostic meta-analysis and applied the results to a hypothetical cohort of 1000 patients with transient ischemic attack (TIA) to assess the power of stroke prediction by ABCD2 and ABCD3-I scores. METHODS: Medline, PubMed, Embase, and manuscript references were searched to identify studies that directly compared the stroke predictive powers of ABCD2 and ABCD3-I scores...
June 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28647402/autologous-stem-cell-transplantation-in-patients-with-multiple-myeloma-an-activity-based-costing-analysis-comparing-a-total-inpatient-model-versus-an-early-discharge-model
#8
Massimo Martino, Giuseppe Console, Letteria Russo, Antonella Meliado', Nicola Meliambro, Tiziana Moscato, Giuseppe Irrera, Giuseppe Messina, Antonella Pontari, Fortunato Morabito
BACKGROUND: Activity-based costing (ABC) was developed and advocated as a means of overcoming the systematic distortions of traditional cost accounting. MATERIALS AND METHODS: We calculated the cost of high-dose chemotherapy and autologous stem cell transplantation (ASCT) in patients with multiple myeloma using the ABC method, through 2 different care models: the total inpatient model (TIM) and the early-discharge outpatient model (EDOM) and compared this with the approved diagnosis related-groups (DRG) Italian tariffs...
June 6, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28647202/the-current-state-of-teleophthalmology-in-the-united-states
#9
REVIEW
Siddarth Rathi, Edmund Tsui, Nitish Mehta, Sarwar Zahid, Joel S Schuman
Telemedicine services facilitate the evaluation, diagnosis, and management of the remote patient. Telemedicine has rapidly flourished in the United States and has improved access to care, outcomes, and patient satisfaction. However, the use of telemedicine in ophthalmology is currently in its infancy and has yet to gain wide acceptance. Current models of telemedicine in ophthalmology are largely performed via "store and forward" methods, but remote monitoring and interactive modalities exist. Although studies have examined the effects of telemedicine, few reports have characterized its current status...
June 21, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28647137/apneic-oxygenation-reduces-the-incidence-of-hypoxemia-during-emergency-intubation-a-systematic-review-and-meta-analysis
#10
REVIEW
Ivan Pavlov, Sofia Medrano, Scott Weingart
STUDY OBJECTIVE: Apneic oxygenation has been advocated for the prevention of hypoxemia during emergency endotracheal intubation. Because of conflicting results from recent trials, the efficacy of apneic oxygenation remains unclear. We performed a systematic review and meta-analysis to investigate the effect of apneic oxygenation on the incidence of clinically significant hypoxemia during emergency endotracheal intubation. METHODS: MEDLINE, EMBASE, and PubMed databases were searched without language and time restrictions for studies of apneic oxygenation performed in a critical care setting...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28647076/european-society-of-thoracic-surgeons-risk-scores
#11
REVIEW
Alessandro Brunelli
Risk-adjusted outcome analysis is pivotal for monitoring and improving quality of care. The European Society of Thoracic Surgeons established an online database more than 15 years ago. Several risk models and a composite score have been generated from the data included in the database. This report reviews the methods and applications of these risk scores.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647068/risk-adjustment-and-performance-measurement-for-esophageal-cancer-resection
#12
REVIEW
Stephanie G Worrell, Andrew C Chang
Achieving high-quality care for all patients undergoing esophageal cancer requires identifying and modifying risk factors associated with poor outcomes. These factors occur at different time points from the preoperative to the postoperative periods. A straightforward model for predicting outcomes has proved difficult to identify. This article reviews the current studies addressing risk adjustment and performance measurement for esophageal cancer resection.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647020/reprint-of-a-comprehensive-review-of-group-level-model-performance-in-the-presence-of-heteroscedasticity-can-a-single-model-control-type-i-errors-in-the-presence-of-outliers
#13
Jeanette A Mumford
Even after thorough preprocessing and a careful time series analysis of functional magnetic resonance imaging (fMRI) data, artifact and other issues can lead to violations of the assumption that the variance is constant across subjects in the group level model. This is especially concerning when modeling a continuous covariate at the group level, as the slope is easily biased by outliers. Various models have been proposed to deal with outliers including models that use the first level variance or that use the group level residual magnitude to differentially weight subjects...
July 1, 2017: NeuroImage
https://www.readbyqxmd.com/read/28646936/surgical-flow-disruptions-during-robotic-assisted-radical-prostatectomy
#14
Christopher J Dru, Jennifer T Anger, Colby P Souders, Catherine Bresee, Matthias Weigl, Elyse Hallett, Ken Catchpole
INTRODUCTION: We sought to apply the principles of human factors research to robotic-assisted radical prostatectomy to understand where training and integration challenges lead to suboptimal and inefficient care. MATERIALS AND METHODS: Thirty-four robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissections over a 20 week period were observed for flow disruptions (FD) - deviations from optimal care that can compromise safety or efficiency. Other variables - physician experience, trainee involvement, robot model (S versus Si), age, body mass index (BMI), and American Society of Anesthesiologists (ASA) physical status - were used to stratify the data and understand the effect of context...
June 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28646809/efficacy-of-fascial-distortion-model-treatment-for-acute-nonspecific-low-back-pain-in-primary-care-a-prospective-controlled-trial
#15
Detlef Richter, Matthias Karst, Hartmut Buhck, Matthias G Fink
Context • Low-back pain (LBP) is a prevalent and potentially crippling condition for which treatment is often unsatisfactory from the perspectives of physicians, patients, and payers. The application of the fascial distortion model (FDM), an integrated concept for the diagnosis and manipulative treatment of musculoskeletal disorders, is conceptually promising for LBP but has not been investigated systematically. Objective • The study intended to provide proof of concept to establish the noninferiority of the FDM treatment as opposed to the therapy recommended by the German National Disease Management Guideline (NDMG) for acute LBP...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646775/consequences-of-intensive-forest-harvesting-on-the-recovery-of-swedish-lakes-from-acidification-and-on-critical-load-exceedances
#16
Filip Moldan, Johanna Stadmark, Jens Fölster, Sara Jutterström, Martyn N Futter, Bernard J Cosby, Richard F Wright
Across much of the northern hemisphere, lakes are at risk of re-acidification due to incomplete recovery from historical acidification and pressures associated with more intensive forest biomass harvesting. Critical load (CL) calculations aimed at estimating the amount of pollutants an ecosystem can receive without suffering adverse consequences are dependent on these factors. Here, we present a modelling study of the potential effects of intensified forest harvesting on re-acidification of a set of 3239 Swedish lakes based on scenarios with varying intensities of forest biomass harvest and acid deposition...
June 21, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28646739/contribution-of-pharmaceuticals-and-personal-care-products-ppcps-to-whole-toxicity-of-water-samples-collected-in-effluent-dominated-urban-streams
#17
Ikumi Tamura, Yusuke Yasuda, Kei-Ichiro Kagota, Saori Yoneda, Norihide Nakada, Vimal Kumar, Yutaka Kameda, Kumiko Kimura, Norihisa Tatarazako, Hiroshi Yamamoto
Water samples were collected from effluent-dominated urban streams in Tokushima, Kyoto, and Saitama in Japan to roughly determine the contribution of pharmaceuticals and personal care products (PPCPs) and surfactants to whole toxicity of the water. Approximately 100 PPCPs including anionic surfactants such as linear alkylbenzene sulfonate (LAS), were chemically analyzed. Using 14 water samples, chronic or sub-chronic toxicity tests were conducted on three aquatic species, the green alga Raphidocelis subcapitata, the cladoceran Ceriodaphnia dubia, and the zebrafish Danio rerio...
June 21, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28646710/psychological-distress-and-the-incident-risk-of-functional-disability-in-elderly-survivors-after-the-great-east-japan-earthquake
#18
Fumiya Tanji, Yumi Sugawara, Yasutake Tomata, Takashi Watanabe, Kemmyo Sugiyama, Yu Kaiho, Hiroaki Tomita, Ichiro Tsuji
BACKGROUND: We conducted a prospective cohort study to investigate whether psychological distress would have increased the incident risk of functional disability after the 2011 Great East Japan Earthquake. METHODS: First phase data pertaining to psychological distress and other lifestyle factors were collected from 1037 subjects aged ≥ 65 years, from June to December 2011, in four affected areas of Miyagi prefecture in Japan. Psychological distress was measured by the Kessler 6-item psychological distress scale (K6), and classified into three categories (K6 score ≤ 9, 10-12, ≥ 13)...
June 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28646495/nursing-philosophy-of-community-mental-health-nurses-in-japan-a-qualitative-descriptive-study
#19
Koji Tanaka, Masami Hasegawa, Yutaka Nagayama, Masato Oe
The present study reports the findings of a qualitative, descriptive study that sought to clarify nursing philosophy for community mental health nurses (CMHN) working at independent psychiatric home-visit nursing agencies in Japan. We carried out participant observation and semistructured interviews with 13 CMHN in rural and urban areas. We identified eight subthemes and three higher-order themes based on these subthemes. CMHN embraced a nursing philosophy in which they: (i) have respect for consumers' ways of life and their self-realization; (ii) find harmony between view of life and work; and (iii) build communities where residents support each other beyond their roles...
June 23, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28646454/the-oswestry-disability-index-confirmatory-factor-analysis-in-a-sample-of-35-263-verifies-a-one-factor-structure-but-practicality-issues-remain
#20
Charles Philip Gabel, Antonio Cuesta-Vargas, Meihua Qian, Rok Vengust, Ulrich Berlemann, Emin Aghayev, Markus Melloh
PURPOSE: To analyze the factor structure of the Oswestry Disability Index (ODI) in a large symptomatic low back pain (LBP) population using exploratory (EFA) and confirmatory factor analysis (CFA). METHODS: Analysis of pooled baseline ODI LBP patient data from the international Spine Tango registry of EUROSPINE, the Spine Society of Europe. The sample, with n = 35,263 (55.2% female; age 15-99, median 59 years), included 76.1% of patients with a degenerative disease, and 23...
June 23, 2017: European Spine Journal
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