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https://www.readbyqxmd.com/read/28340479/additive-effects-prevail-the-response-of-biota-to-multiple-stressors-in-an-intensively-monitored-watershed
#1
Alexander Gieswein, Daniel Hering, Christian K Feld
Freshwater ecosystems are impacted by a range of stressors arising from diverse human-caused land and water uses. Identifying the relative importance of single stressors and understanding how multiple stressors interact and jointly affect biology is crucial for River Basin Management. This study addressed multiple human-induced stressors and their effects on the aquatic flora and fauna based on data from standard WFD monitoring schemes. For altogether 1095 sites within a mountainous catchment, we used 12 stressor variables covering three different stressor groups: riparian land use, physical habitat quality and nutrient enrichment...
March 21, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28340232/a-proposed-set-of-metrics-to-reduce-patient-safety-risk-from-within-the-anatomic-pathology-laboratory
#2
Peter Banks, Richard Brown, Alex Laslowski, Yvonne Daniels, Phil Branton, John Carpenter, Richard Zarbo, Ramses Forsyth, Yan-Hui Liu, Shane Kohl, Joachim Diebold, Shinobu Masuda, Tim Plummer, Eslie Dennis
Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Method: Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes...
March 18, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#3
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#4
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333869/macra-a-new-age-for-physician-payments
#5
Kent Kwasind Huston
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 introduced a new system of physician payments in the United States. This legislation and the complex rules written to enact the law intend to force a shift away from volume-based payments and into so called value-based payments. Physicians and other clinicians will be graded via quality and cost metrics and payments will be adjusted based on performance. Robust use of certified electronic health records is required under MACRA. Physicians will follow one of two payment reform tracks known as the Merit-Based Incentive Payment System (MIPS) and the Alternative Payment Model (APM) pathways...
April 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28331951/failure-to-rescue-the-elderly-a-superior-quality-metric-for-trauma-centers
#6
G Barmparas, E J Ley, M J Martin, A Ko, M Harada, D Weigmann, K R Catchpole, B L Gewertz
BACKGROUND: Trauma centers require reliable metrics to better compare the quality of care delivered. We compared mortality after a reported complication, termed failure to rescue (FTR), and FTR in the elderly (age >65 years) (FTRE) to determine which is a superior metric to assess quality of care delivered by trauma centers. METHODS: This was a retrospective review of the National Trauma Databank (NTDB) research data sets 2010 and 2011. Patients ≥16 years admitted to centers reporting ≥80% of AIS and/or ≥ 20% of comorbidities with > 200 subjects in the NTDB were selected...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28330832/virtual-versus-in-person-focus-groups-comparison-of-costs-recruitment-and-participant-logistics
#7
Douglas J Rupert, Jon A Poehlman, Jennifer J Hayes, Sarah E Ray, Rebecca R Moultrie
BACKGROUND: Virtual focus groups-such as online chat and video groups-are increasingly promoted as qualitative research tools. Theoretically, virtual groups offer several advantages, including lower cost, faster recruitment, greater geographic diversity, enrollment of hard-to-reach populations, and reduced participant burden. However, no study has compared virtual and in-person focus groups on these metrics. OBJECTIVE: To rigorously compare virtual and in-person focus groups on cost, recruitment, and participant logistics...
March 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28327978/a-dataset-of-images-and-morphological-profiles-of-30-000-small-molecule-treatments-using-the-cell-painting-assay
#8
Mark-Anthony Bray, Sigrun M Gustafsdottir, Vebjorn Ljosa, Shantanu Singh, Katherine L Sokolnicki, Joshua A Bittker, Nicole E Bodycombe, Vlado Dancík, Thomas P Hasaka, C Suk-Yee Hon, Melissa M Kemp, Kejie Li, Deepika Walpita, Mathias J Wawer, Todd R Golub, Stuart L Schreiber, Paul A Clemons, Alykhan F Shamji, Anne E Carpenter
Background: Large-scale image sets acquired by automated microscopy of perturbed samples enable a detailed comparison of cell states induced by each perturbation, such as a small molecule from a diverse library. Highly multiplexed measurements of cellular morphology can be extracted from each image and subsequently mined for a number of applications. Findings: This microscopy data set includes 919,874 five-channel fields of view representing 30,616 tested compounds, available at 'The Cell Image Library' repository...
January 7, 2017: GigaScience
https://www.readbyqxmd.com/read/28325712/enlight-a-comprehensive-quality-and-therapeutic-potential-evaluation-tool-for-mobile-and-web-based-ehealth-interventions
#9
Amit Baumel, Keren Faber, Nandita Mathur, John M Kane, Fred Muench
BACKGROUND: Studies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined. OBJECTIVE: The aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects...
March 21, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28324982/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#10
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324322/measurement-invariance-of-the-satisfaction-with-life-scale-reviewing-three-decades-of-research
#11
REVIEW
Scott D Emerson, Martin Guhn, Anne M Gadermann
PURPOSE: The Satisfaction with Life Scale (SWLS) is a widely used measure of life satisfaction, a key aspect in quality of life. The SWLS has been used across many socio-demographic groups. Comparison of life satisfaction across different subgroups (e.g., cultures) is meaningful to researchers; such cross-group comparison presupposes that validity of the inferences from SWLS scores holds across various subgroups (measurement invariance: MI). The aim of the present review was to identify, summarize, and evaluate research testing measurement invariance of the SWLS...
March 21, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28323821/comparing-resting-state-fmri-de-noising-approaches-using-multi-and-single-echo-acquisitions
#12
Ottavia Dipasquale, Arjun Sethi, Maria Marcella Laganà, Francesca Baglio, Giuseppe Baselli, Prantik Kundu, Neil A Harrison, Mara Cercignani
Artifact removal in resting state fMRI (rfMRI) data remains a serious challenge, with even subtle head motion undermining reliability and reproducibility. Here we compared some of the most popular single-echo de-noising methods-regression of Motion parameters, White matter and Cerebrospinal fluid signals (MWC method), FMRIB's ICA-based X-noiseifier (FIX) and ICA-based Automatic Removal Of Motion Artifacts (ICA-AROMA)-with a multi-echo approach (ME-ICA) that exploits the linear dependency of BOLD on the echo time...
2017: PloS One
https://www.readbyqxmd.com/read/28323607/language-based-inequity-in-health-care-who-is-the-poor-historian
#13
Alexander R Green, Chijioke Nze
Patients with limited English proficiency (LEP) are among the most vulnerable populations. They experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive lower quality of care by other metrics. However, we have yet to take the issue of linguistic inequities seriously in the medical system and in medical education, tacitly accepting that substandard care is either unavoidable or not worth the cost to address. We argue that we have a moral imperative to provide high-quality care to patients with LEP and to teach our medical trainees that such care is both expected and feasible...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323084/integration-of-in-hospital-cardiac-arrest-contextual-curriculum-into-a-basic-life-support-course-a-randomized-controlled-simulation-study
#14
Elizabeth A Hunt, Jordan M Duval-Arnould, Nnenna O Chime, Kareen Jones, Michael Rosen, Merona Hollingsworth, Deborah Aksamit, Marida Twilley, Cheryl Camacho, Daniel P Nogee, Julianna Jung, Kristen Nelson-McMillan, Nicole Shilkofski, Julianne S Perretta
OBJECTIVE: To compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). DESIGN: Prospective, randomized, controlled curriculum evaluation. SETTING: Johns Hopkins Medicine Simulation Center. SUBJECTS: One hundred twenty-two first year medical students divided into fifty-nine teams...
March 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#15
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28315673/chromosomal-microarray-detection-of-constitutional-copy-number-variation-using-saliva-dna
#16
Jennifer Reiner, Lisa Karger, Ninette Cohen, Lakshmi Mehta, Lisa Edelmann, Stuart A Scott
Chromosomal microarray (CMA) testing to detect copy number aberrations among individuals with multiple congenital anomalies and/or developmental delay is typically performed on peripheral blood DNA. However, the use of saliva DNA may be preferred for some patients, which prompted our validation study using six saliva DNA samples with a range of bacterial content (approximately 3% to 21%) and 20 paired blood and saliva specimens on the Agilent Technologies, Illumina, and Affymetrix CMA platforms. Ten of the 20 paired specimens were previously determined to carry clinically significant copy number aberrations by clinical CMA testing on blood DNA (100 kb to 2...
March 15, 2017: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/28315634/comparing-mutation-calls-in-fixed-tumour-samples-between-the-affymetrix-oncoscan%C3%A2-array-and-pcr-based-next-generation-sequencing
#17
Henry M Wood, Joseph M Foster, Morag Taylor, Emma Tinkler-Hundal, Fiona S Togneri, Paula Wojtowicz, Assa Oumie, Karen G Spink, Fiona Brew, Philip Quirke
BACKGROUND: The importance of accurate and affordable mutation calling in fixed pathology samples is becoming increasingly important as we move into the era of personalised medicine. The Affymetrix OncoScan® Array platform is designed to produce actionable mutation calls in archival material. METHODS: We compared calls made using the OncoScan platform with calls made using a custom designed PCR panel followed by next-generation sequencing (NGS), in order to benchmark the sensitivity and specificity of the OncoScan calls in a large cohort of fixed tumour samples...
March 18, 2017: BMC Medical Genomics
https://www.readbyqxmd.com/read/28301432/patient-reported-outcomes-of-quality-of-life-functioning-and-gi-psychiatric-symptom-severity-in-patients-with-inflammatory-bowel-disease-ibd
#18
Waguih W IsHak, Dana Pan, Alexander J Steiner, Edward Feldman, Amy Mann, James Mirocha, Itai Danovitch, Gil Y Melmed
BACKGROUND: Patients with inflammatory bowel disease (IBD) are at risk for psychiatric disorders that impact symptom experience and health-related quality of life (HRQOL). Therefore, comprehensive biopsychosocial assessments should be considered in ambulatory care settings. Patient-Reported Outcomes Measurement Information System (PROMIS) measures created by the National Institutes of Health have shown construct validity in a large IBD internet-based cohort, but their validity in ambulatory settings has not been examined...
March 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28301279/integrating-palliative-care-services-in-ambulatory-oncology-an-application-of-the-edmonton-symptom-assessment-system
#19
Sherri L Rauenzahn, Susanne Schmidt, Ifeoma O Aduba, Jessica T Jones, Nazneen Ali, Laura L Tenner
PURPOSE: Research in palliative care demonstrates improvements in overall survival, quality of life, symptom management, and reductions in the cost of care. Despite the American Society of Clinical Oncology recommendation for early concurrent palliative care in patients with advanced cancer and high symptom burden, integrating palliative services is challenging. Our aims were to quantitatively describe the palliative referral rates and symptom burden in a South Texas cancer center and establish a palliative referral system by implementing the Edmonton Symptom Assessment Scale (ESAS)...
March 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28298481/categorization-of-national-pediatric-quality-measures
#20
Samantha A House, Eric R Coon, Alan R Schroeder, Shawn L Ralston
BACKGROUND AND OBJECTIVE: The number of quality measures has grown dramatically in recent years. This growth has outpaced research characterizing content and impact of these metrics. Our study aimed to identify and classify nationally promoted quality metrics applicable to children, both by type and by content, and to analyze the representation of common pediatric issues among available measures. METHODS: We identified nationally applicable quality measure collections from organizational databases or clearinghouses, federal Web sites, and key informant interviews and then screened each measure for pediatric applicability...
March 15, 2017: Pediatrics
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