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https://www.readbyqxmd.com/read/28651218/urban-water-metabolism-indicators-derived-from-a-water-mass-balance-bridging-the-gap-between-visions-and-performance-assessment-of-urban-water-resource-management
#1
M A Renouf, S Serrao-Neumann, S J Kenway, E A Morgan, D Low Choy
Improving resource management in urban areas has been enshrined in visions for achieving sustainable urban areas, but to date it has been difficult to quantify performance indicators to help identify more sustainable outcomes, especially for water resources. In this work, we advance quantitative indicators for what we refer to as the 'metabolic' features of urban water management: those related to resource efficiency (for water and also water-related energy and nutrients), supply internalisation, urban hydrological performance, sustainable extraction, and recognition of the diverse functions of water...
May 29, 2017: Water Research
https://www.readbyqxmd.com/read/28650922/randomized-trial-of-reducing-ambulatory-malpractice-and-safety-risk-results-of-the-massachusetts-promises-project
#2
Gordon D Schiff, Harry Reyes Nieva, Paula Griswold, Nicholas Leydon, Judy Ling, Frank Federico, Carol Keohane, Bonnie R Ellis, Cathy Foskett, E John Orav, Catherine Yoon, Don Goldmann, Joel S Weissman, David W Bates, Madeleine Biondolillo, Sara J Singer
OBJECTIVE: Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. STUDY SETTING: In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. STUDY DESIGN: Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650872/barriers-and-facilitators-to-implementing-a-change-initiative-in-long-term-care-using-the-interact%C3%A2-quality-improvement-program
#3
Ruth M Tappen, David G Wolf, Zahra Rahemi, Gabriella Engstrom, Carolina Rojido, Jill M Shutes, Joseph G Ouslander
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650413/community-priorities-for-hospital-based-prevention-initiatives-results-from-a-deliberating-public
#4
Marthe R Gold, Lindsey Realmuto, Maya Scherer, Alexandra Kamler, Linda Weiss
CONTEXT: Internal revenue service provisions require not-for-profit hospitals to provide "community benefit." In addition, the Affordable Care Act requires these hospitals to conduct community health needs assessments that involve appropriate stakeholders. These requirements signal government interest in creating opportunities for developing programs that are well tailored and responsive to the needs of the communities served. Gaining meaningful input from residents is a critical aspect of these processes...
June 21, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28650346/real-time-monitoring-through-the-use-of-technology-to-enhance-performances-throughout-hiv-cascades
#5
Matthew Avery, Stephen J Mills, Eric Stephan
PURPOSE OF REVIEW: Controlling the HIV epidemic requires strong linkages across a 'cascade' of prevention, testing, and treatment services. Information and communications technology (ICT) offers the potential to monitor and improve the performance of this HIV cascade in real time. We assessed recent (<18 months) peer-reviewed publications regarding uses of ICT to improve performance through expanded and targeted reach, improved clinical service delivery, and reduced loss to follow-up...
June 23, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28649770/precepting-nurse-practitioner-students-a-new-view-results-of-two-national-surveys-of-nurse-practitioner-preceptors
#6
Mary Ellen Roberts, Kathy J Wheeler, Diane O Tyler, Diane L Padden
PURPOSE: The aim of two national studies was to identify characteristics of nurse practitioners (NPs) who precept and the benefits, incentives, and barriers associated with the NP preceptor role. METHODS: Stratified randomized sampling was used to invite a representative number of NPs from each state to participate in a 2015 survey and a follow-up survey in 2016. These descriptive, exploratory studies distributed electronic questionnaires to 5000 randomly selected NPs in the 2015 survey and 40,000 NPs in the 2016 survey...
June 26, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28649480/the-role-of-organizational-culture-in-operating-room-turnaround-time
#7
David Ninan, Janet Zhu, Amanda Kore, Elizabeth Wasson, Tricia Fullerton, Barbara Ninan
This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital's operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization's culture...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28649454/methods-guiding-stakeholder-engagement-in-planning-a-pragmatic-study-on-changing-stroke-systems-of-care
#8
Sabina B Gesell, Karen Potvin Klein, Jacqueline Halladay, Janet Prvu Bettger, Janet Freburger, Doyle M Cummings, Barbara J Lutz, Sylvia Coleman, Cheryl Bushnell, Wayne Rosamond, Pamela W Duncan
BACKGROUND: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28648700/five-years-of-ema-approved-systemic-cancer-therapies-for-solid-tumours-a-comparison-of-two-thresholds-for-meaningful-clinical-benefit
#9
N Grössmann, J C Del Paggio, S Wolf, R Sullivan, C M Booth, K Rosian, R Emprechtinger, C Wild
OBJECTIVE: Several societies have proposed frameworks to evaluate the benefit of oncology drugs; one prominent tool is the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Our objectives were to investigate the extent of European Medicines Agency (EMA)-approved cancer drugs that meet the threshold for 'meaningful clinical benefit' (MCB), defined by the framework, and determine the change in the distribution of grades when an adapted version that addresses the scale's limitations is applied...
June 22, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28648219/primary-care-collaboration-to-improve-diagnosis-and-screening-for-colorectal-cancer
#10
Gordon D Schiff, Trudy Bearden, Lindsay Swain Hunt, Jennifer Azzara, Jay Larmon, Russell S Phillips, Sara Singer, Brandon Bennett, Jonathan R Sugarman, Asaf Bitton, Andrew Ellner
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer death, reducible by screening and early diagnosis, yet many patients fail to receive recommended screening. As part of an academic improvement collaborative, 25 primary care practices worked to improve CRC screening and diagnosis. METHODS: The project featured triannual learning sessions, monthly conference calls, practice coach support, and monthly reporting. The project phases included literature review and interviews with national leaders/organizations, development of driver diagrams to identify key factors and change ideas, project launch and practice team planning, and a practice improvement phase...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28647916/impact-of-site-selection-and-study-conduct-on-outcomes-in-global-clinical-trials
#11
REVIEW
Chaudhry M S Sarwar, Muthiah Vaduganathan, Javed Butler
PURPOSE OF REVIEW: There are over 25 million patients living with heart failure globally. Overall, and especially post-discharge, clinical outcomes have remained poor in heart failure despite multiple trials, with both successes and failures over the last two decades. Matching therapies to the right patient population, identifying high-quality sites, and ensuring optimal trial design and execution represent important considerations in the development of novel therapeutics in this space...
June 24, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28647727/patients-as-partners-in-enhanced-recovery-after-surgery-a-qualitative-patient-led-study
#12
Chelsia Gillis, Marlyn Gill, Nancy Marlett, Gail MacKean, Kathy GermAnn, Loreen Gilmour, Gregg Nelson, Tracy Wasylak, Susan Nguyen, Edamil Araujo, Sandra Zelinsky, Leah Gramlich
OBJECTIVES: Explore the experience of patients undergoing colorectal surgery within an Enhanced Recovery After Surgery (ERAS) programme. Use these experiential data to inform the development of a framework to support ongoing, meaningful patient engagement in ERAS. DESIGN: Qualitative patient-led study using focus groups and narrative interviews. Data were analysed iteratively using a Participatory Grounded Theory approach. SETTING: Five tertiary care centres in Alberta, Canada, following the ERAS programme...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647722/developing-implementation-strategies-for-firearm-safety-promotion-in-paediatric-primary-care-for-suicide-prevention-in-two-large-us-health-systems-a-study-protocol-for-a-mixed-methods-implementation-study
#13
Courtney Benjamin Wolk, Shari Jager-Hyman, Steven C Marcus, Brian K Ahmedani, John E Zeber, Joel A Fein, Gregory K Brown, Adina Lieberman, Rinad S Beidas
INTRODUCTION: The promotion of safe firearm practices, or firearms means restriction, is a promising but infrequently used suicide prevention strategy in the USA. Safety Check is an evidence-based practice for improving parental firearm safety behaviour in paediatric primary care. However, providers rarely discuss firearm safety during visits, suggesting the need to better understand barriers and facilitators to promoting this approach. This study, Adolescent Suicide Prevention In Routine clinical Encounters, aims to engender a better understanding of how to implement the three firearm components of Safety Check as a suicide prevention strategy in paediatric primary care...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647543/healthy-eating-and-activity-across-the-lifespan-heal-a-call-to-action-to-integrate-research-clinical-practice-policy-and-community-resources-to-address-weight-related-health-disparities
#14
Jerica M Berge, Margaret Adamek, Caitlin Caspi, Katie A Loth, Amy Shanafelt, Steven D Stovitz, Amanda Trofholz, Katherine Y Grannon, Marilyn S Nanney
Despite intense nationwide efforts to improve healthy eating and physical activity across the lifespan, progress has plateaued. Moreover, health inequities remain. Frameworks that integrate research, clinical practice, policy, and community resources to address weight-related behaviors are needed. Implementation and evaluation of integration efforts also remain a challenge. The purpose of this paper is to: (1) Describe the planning and development process of an integrator entity, HEAL (Healthy Eating and Activity across the Lifespan); (2) present outcomes of the HEAL development process including the HEAL vision, mission, and values statements; (3) define the planned integrator functions of HEAL; and (4) describe the ongoing evaluation of the integration process...
June 21, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28646878/achieving-sustainability-in-health-information-systems-a-field-tested-measure-of-country-ownership
#15
Stephanie Watson-Grant, Khou Xiong, James C Thomas
BACKGROUND: A country will trust, value, and use, its health information system (HIS) to the extent it has had a role in its creation and maintenance. A sense of ownership contributes in turn to the long-term sustainability of the HIS, and thus the country's ability to monitor and evaluate population health and health services. To facilitate progress toward greater ownership, we developed and tested a tool to measure the country's ownership of its monitoring and evaluation (M&E) system...
June 24, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28646574/a-novel-habitat-based-approach-to-predict-impacts-of-marine-protected-areas-on-fishers
#16
João B Teixeira, Rodrigo L Moura, Morena Mills, Carissa Klein, Christopher J Brown, Vanessa M Adams, Hedley Grantham, Matthew Watts, Deborah Faria, Gilberto M Amado-Filho, Alex C Bastos, Reinaldo Lourival, Hugh P Possingham
While marine protected areas (MPAs) can simultaneously contribute to biodiversity conservation and fisheries management, the global network is biased towards particular ecosystem types, as it was largely established in an ad hoc fashion. The optimization of trade-offs between biodiversity benefits and socio-economic values increases implementation success and minimizes enforcement costs in the long run, but is often neglected in marine spatial planning (MSP). Although the acquisition of spatially explicit socioeconomic data is often perceived as a costly/secondary step in MSP, it is critical to account for lost opportunities by people whose activities will be restricted, especially fishers...
June 24, 2017: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/28645986/feasibility-study-of-a-randomised-controlled-trial-to-investigate-the-effectiveness-of-using-a-humanoid-robot-to-improve-the-social-skills-of-children-with-autism-spectrum-disorder-kaspar-rct-a-study-protocol
#17
Silvana E Mengoni, Karen Irvine, Deepshikha Thakur, Garry Barton, Kerstin Dautenhahn, Karen Guldberg, Ben Robins, David Wellsted, Shivani Sharma
INTRODUCTION: Interventions using robot-assisted therapy may be beneficial for the social skills development of children with autism spectrum disorder (ASD); however, randomised controlled trials (RCTs) are lacking. The present research aims to assess the feasibility of conducting an RCT evaluating the effectiveness of a social skills intervention using Kinesics and Synchronisation in Personal Assistant Robotics (Kaspar) with children with ASD. METHODS AND ANALYSIS: Forty children will be recruited...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645984/facilitators-and-barriers-to-participation-of-private-sector-health-facilities-in-government-led-schemes-for-maternity-services-in-india-a-qualitative-study
#18
Vikas Yadav, Somesh Kumar, Sudharsanam Balasubramaniam, Ashish Srivastava, Suranjeen Pallipamula, Parvez Memon, Dinesh Singh, Saurabh Bhargava, Greeshma Ann Sunil, Bulbul Sood
OBJECTIVE: Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645974/assessing-medical-student-knowledge-and-attitudes-about-shared-decision-making-across-the-curriculum-protocol-for-an-international-online-survey-and-stakeholder-analysis
#19
Marie-Anne Durand, Renata Yen, Paul J Barr, Nan Cochran, Johanna Aarts, France Légaré, Malcolm Reed, A James O'Malley, Peter Scalia, Geneviève Painchaud Guérard, Glyn Elwyn
INTRODUCTION: Shared decision making (SDM) is a goal of modern medicine; however, it is not currently embedded in routine care. Barriers include clinicians’ attitudes, lack of knowledge and training and time constraints. Our goal is to support the development and delivery of a robust SDM curriculum in medical education. Our objective is to assess undergraduate medical students’ knowledge of and attitudes towards SDM in four countries. METHODS AND ANALYSIS: The first phase of the study involves a web-based cross-sectional survey of undergraduate medical students from all years in selected schools across the United States (US), Canada and undergraduate and graduate students in the Netherlands...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645969/protocol-for-the-residents-in-action-pilot-cluster-randomised-controlled-trial-riat-evaluating-a-behaviour-change-intervention-to-promote-walking-reduce-sitting-and-improve-mental-health-in-physically-inactive-older-adults-in-retirement-villages
#20
Cecilie Thøgersen-Ntoumani, Ashlene Wright, Eleanor Quested, Elissa Burton, Keith D Hill, Ester Cerin, Stuart J H Biddle, Nikos Ntoumanis
INTRODUCTION: Ageing is accompanied by increased risks of chronic disease, declined functioning and increased dependency. Physical activity is critical to retaining health and independence, but the majority of older people are insufficiently physically active to achieve these benefits and have high levels of sedentary (sitting) time. Activity programmes are often offered in retirement villages; however, their uptake is limited. Furthermore, although the physical environment in and around these villages can play an important role in decisions to be physically active, its role is often overlooked by research in these settings...
June 23, 2017: BMJ Open
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