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https://www.readbyqxmd.com/read/28210361/estimating-the-cost-of-care-for-emergency-department-syncope-patients-comparison-of-three-models
#1
Marc A Probst, John K McConnell, Robert E Weiss, Amber L Laurie, Annick N Yagapen, Michelle P Lin, Jeffrey M Caterino, Manish N Shah, Benjamin C Sun
INTRODUCTION: We sought to compare three hospital cost-estimation models for patients undergoing evaluation for unexplained syncope using hospital cost data. Developing such a model would allow researchers to assess the value of novel clinical algorithms for syncope management. METHODS: We collected complete health services data, including disposition, testing, and length of stay (LOS), on 67 adult patients (age 60 years and older) who presented to the emergency department (ED) with syncope at a single hospital...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208195/echocardiography-in-the-risk-assessment-of-acute-pulmonary-embolism
#2
Talal Dahhan, Fawaz Alenezi, Zainab Samad, Sudarshan Rajagopal
Acute pulmonary embolism (PE) is a major cause of morbidity and mortality and is classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk) based on the hemodynamic status and clinical characteristics of the patient. At this time, the management of patients with submassive PE remains controversial and approaches for improving risk assessment are critical. In this review, we discuss several echocardiographic methods to assess right heart function that may aid in the risk assessment of patients with acute PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28204724/inflammatory-milieu-and-cardiovascular-homeostasis-in-children-with-obstructive-sleep-apnea
#3
David F Smith, Md M Hossain, Arjan Hura, Guixia Huang, Keith McConnell, Stacey L Ishman, Raouf S Amin
No abstract text is available yet for this article.
February 13, 2017: Sleep
https://www.readbyqxmd.com/read/28193270/the-experience-of-providing-end-of-life-care-at-a-children-s-hospice-a-qualitative-study
#4
Tracey McConnell, Sam Porter
BACKGROUND: More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a children's hospice. METHODS: Qualitative research incorporating interviews and a focus group. Data were analysed using thematic analysis. Purposeful sampling led to a total of 15 care team staff recruited from a children's hospice offering palliative and specialist care to life-limited children and young people...
February 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28192568/early-performance-in-medicaid-accountable-care-organizations-a-comparison-of-oregon-and-colorado
#5
K John McConnell, Stephanie Renfro, Benjamin K S Chan, Thomas H A Meath, Aaron Mendelson, Deborah Cohen, Jeanette Waxmonsky, Dennis McCarty, Neal Wallace, Richard C Lindrooth
Importance: Several state Medicaid reforms are under way, but the relative performance of different approaches is unclear. Objective: To compare the performance of Oregon's and Colorado's Medicaid Accountable Care Organization (ACO) models. Design, Setting, and Participants: Oregon initiated its Medicaid transformation in 2012, supported by a $1.9 billion investment from the federal government, moving most Medicaid enrollees into 16 Coordinated Care Organizations, which managed care within a global budget...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28188773/maternal-buprenorphine-treatment-and-fetal-neurobehavioral-development
#6
Lauren M Jansson, Martha Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree E Jones, Van L King, Neeraj Gandotra, Lorraine A Milio, Kristin Voegtline, Janet A DiPietro
BACKGROUND: Gestational opioid use/misuse is escalating in the United States, however, little is understood about the fetal effects of medications used to treat maternal opioid use disorders. OBJECTIVE: The purpose of this study was to determine the effect of maternal buprenorphine administration on longitudinal fetal neurobehavioral development. STUDY DESIGN: Forty-nine buprenorphine-maintained women attending a substance use disorder treatment facility with generally uncomplicated pregnancies underwent fetal monitoring for 60 minutes at times of trough and peak maternal buprenorphine levels...
February 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28186618/study-of-individualization-and-bias-in-nursing-home-fall-prevention-practices
#7
Cathleen S Colón-Emeric, Kirsten Corazzini, Eleanor McConnell, Wei Pan, Mark Toles, Rasheeda Hall, Melissa Batchelor-Murphy, Tracey L Yap, Amber L Anderson, Andrew Burd, Ruth A Anderson
OBJECTIVES: Little is known about how nursing home staff use resident characteristics to individualize care delivery or whether care is affected by implicit bias. DESIGN: Randomized factorial clinical vignette survey. SETTING: Sixteen nursing homes in North Carolina. PARTICIPANTS: Nursing, rehabilitation, and social services staff (n = 433). MEASUREMENTS: Vignettes describing hypothetical residents were generated from a matrix of clinical and demographic characteristics...
February 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28183354/protocol-for-the-analysis-of-a-natural-experiment-on-the-impact-of-the-affordable-care-act-on-diabetes-care-in-community-health-centers
#8
Nathalie Huguet, Heather Angier, Miguel Marino, K John McConnell, Megan J Hoopes, Jean P O'Malley, Lewis A Raynor, Sonja Likumahuwa-Ackman, Heather Holderness, Jennifer E DeVoe
BACKGROUND: It is hypothesized that Affordable Care Act (ACA) Medicaid expansions could substantially improve access to health insurance and healthcare services for patients at risk for diabetes mellitus (DM), with pre-DM, or already diagnosed with DM. The ACA called for every state to expand Medicaid coverage by 2014. In a 2012 legal challenge, the US Supreme Court ruled that states were not required to implement Medicaid expansions. This 'natural experiment' presents a unique opportunity to learn whether and to what extent Medicaid expansion can affect healthcare access and services for patients with DM risk, pre-DM, or DM...
February 10, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28183213/the-ottawa-panel-clinical-practice-guidelines-for-the-management-of-knee-osteoarthritis-part-two-strengthening-exercise-programs
#9
Lucie Brosseau, Jade Taki, Brigit Desjardins, Odette Thevenot, Marlene Fransen, George A Wells, Aline Mizusaki Imoto, Karine Toupin-April, Marie Westby, Inmaculada C Álvarez Gallardo, Wendy Gifford, Lucie Laferrière, Prinon Rahman, Laurianne Loew, Gino De Angelis, Sabrina Cavallo, Shirin Mehdi Shallwani, Ala' Aburub, Kim L Bennell, Martin Van der Esch, Milena Simic, Sara McConnell, Alison Harmer, Glen P Kenny, Gail Paterson, Jean-Philippe Regnaux, Marie-Martine Lefevre-Colau, Linda McLean
OBJECTIVE: To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey...
February 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28183194/the-ottawa-panel-clinical-practice-guidelines-for-the-management-of-knee-osteoarthritis-part-three-aerobic-exercise-programs
#10
Lucie Brosseau, Jade Taki, Brigit Desjardins, Odette Thevenot, Marlene Fransen, George A Wells, Aline Mizusaki Imoto, Karine Toupin-April, Marie Westby, Inmaculada C Álvarez Gallardo, Wendy Gifford, Lucie Laferrière, Prinon Rahman, Laurianne Loew, Gino De Angelis, Sabrina Cavallo, Shirin Mehdi Shallwani, Ala' Aburub, Kim L Bennell, Martin Van der Esch, Milena Simic, Sara McConnell, Alison Harmer, Glen P Kenny, Gail Paterson, Jean-Philippe Regnaux, Marie-Martine Lefevre-Colau, Linda McLean
OBJECTIVES: To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) was used, based on statistical significance ( P < 0...
February 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28183188/the-ottawa-panel-clinical-practice-guidelines-for-the-management-of-knee-osteoarthritis-part-one-introduction-and-mind-body-exercise-programs
#11
Lucie Brosseau, Jade Taki, Brigit Desjardins, Odette Thevenot, Marlene Fransen, George A Wells, Aline Mizusaki Imoto, Karine Toupin-April, Marie Westby, Inmaculada C Álvarez Gallardo, Wendy Gifford, Lucie Laferrière, Prinon Rahman, Laurianne Loew, Gino De Angelis, Sabrina Cavallo, Shirin Mehdi Shallwani, Ala' Aburub, Kim L Bennell, Martin Van der Esch, Milena Simic, Sara McConnell, Alison Harmer, Glen P Kenny, Gail Paterson, Jean-Philippe Regnaux, Marie-Martine Lefevre-Colau, Linda McLean
OBJECTIVE: To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. METHODS: A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey...
January 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28165618/experimental-comparison-of-efficacy-for-three-handfeeding-techniques-in-dementia
#12
Melissa K Batchelor-Murphy, Eleanor S McConnell, Elaine J Amella, Ruth A Anderson, Connie W Bales, Susan Silva, Angel Barnes, Cornelia Beck, Cathleen S Colon-Emeric
BACKGROUND: Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. OBJECTIVES: To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand (DH), Over Hand (OH), and Under Hand (UH). DESIGN: A prospective pilot study using a within-subjects experimental Latin square design with randomization to one of three handfeeding technique sequences...
February 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28152170/economic-analysis-of-primary-care-based-physical-activity-counseling-in-older-men-the-va-life-trial
#13
Patricia A Cowper, Matthew J Peterson, Carl F Pieper, Richard J Sloane, Katherine S Hall, Eleanor S McConnell, Hayden B Bosworth, Carola C Ekelund, Megan P Pearson, Miriam C Morey
OBJECTIVES: To perform an economic evaluation of a primary care-based physical activity counseling intervention that improved physical activity levels and rapid gait speed in older veterans. DESIGN: Secondary objective of randomized trial that assessed the effect of exercise counseling (relative to usual care) on physical performance, physical activity, function, disability, and medical resource use and cost. SETTING: Veterans Affairs Medical Center, Durham, North Carolina...
February 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28138051/child-gender-and-parental-reporting-of-illness-symptoms-in-sub-saharan-africa
#14
Peter C Rockers, Margaret McConnell
The overwhelming majority of evidence about the health of children in low- and middle-income countries is based on reports by parents. There is limited evidence on whether these reports suffer from systematic bias, particularly related to the gender of the child. We investigate differences in symptom reporting by child gender in a sample of countries in sub-Saharan Africa. Data from 35 Demographic and Health Surveys and 10 Malaria Indicator Surveys conducted since 2005 were analyzed. Parental reports of child symptoms were compared for girls and boys...
January 30, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28134247/cellular-mechano-environment-regulates-the-mammary-circadian-clock
#15
Nan Yang, Jack Williams, Vanja Pekovic-Vaughan, Pengbo Wang, Safiah Olabi, James McConnell, Nicole Gossan, Alun Hughes, Julia Cheung, Charles H Streuli, Qing-Jun Meng
Circadian clocks drive ∼24 h rhythms in tissue physiology. They rely on transcriptional/translational feedback loops driven by interacting networks of clock complexes. However, little is known about how cell-intrinsic circadian clocks sense and respond to their microenvironment. Here, we reveal that the breast epithelial clock is regulated by the mechano-chemical stiffness of the cellular microenvironment in primary cell culture. Moreover, the mammary clock is controlled by the periductal extracellular matrix in vivo, which contributes to a dampened circadian rhythm during ageing...
January 30, 2017: Nature Communications
https://www.readbyqxmd.com/read/28132410/organisation-of-the-dermal-matrix-impacts-the-biomechanical-properties-of-skin
#16
A K Langton, H K Graham, J C McConnell, M J Sherratt, C E M Griffiths, R E B Watson
BACKGROUND: Human skin has the crucial roles of maintaining homeostasis and protecting against external environment. It offers protection against mechanical trauma due to the reversible deformation of its structure; these biomechanical properties are amenable to dynamic testing using non-invasive devices. OBJECTIVES: To characterise the biomechanical properties of young, white Caucasian and black African/African-Caribbean skin from different anatomical sites; and to relate underlying skin architecture to biomechanical function...
January 28, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28124799/a-randomized-control-intervention-trial-to-improve-social-skills-and-quality-of-life-in-pediatric-brain-tumor-survivors
#17
Maru Barrera, Eshetu G Atenafu, Lillian Sung, Ute Bartels, Fiona Schulte, Joanna Chung, Danielle Cataudella, Kelly Hancock, Laura Janzen, Amani Saleh, Douglas Strother, Andrea Downie, Shayna Zelcer, Juliette Hukin, Dina McConnell
BACKGROUND: To determine if a group social skills intervention program improves social competence and quality of life (QOL) in pediatric brain tumor survivors (PBTS). METHODS: We conducted a randomized control trial in which PBTS (8-16 years old, off therapy for over 3 months) were allocated to receive social skills training (eg, cooperation, assertion, using social cognitive problem solving strategies, role playing, games, and arts and crafts) in 8 weekly 2-hour sessions, or an attention placebo control (games and arts and crafts only)...
January 26, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28122091/d-cycloserine-augmentation-of-exposure-based-cognitive-behavior-therapy-for-anxiety-obsessive-compulsive-and-posttraumatic-stress-disorders-a-systematic-review-and-meta-analysis
#18
David Mataix-Cols, Lorena Fernández de la Cruz, Benedetta Monzani, David Rosenfield, Erik Andersson, Ana Pérez-Vigil, Paolo Frumento, Rianne A de Kleine, JoAnn Difede, Boadie W Dunlop, Lara J Farrell, Daniel Geller, Maryrose Gerardi, Adam J Guastella, Stefan G Hofmann, Gert-Jan Hendriks, Matt G Kushner, Francis S Lee, Eric J Lenze, Cheri A Levinson, Harry McConnell, Michael W Otto, Jens Plag, Mark H Pollack, Kerry J Ressler, Thomas L Rodebaugh, Barbara O Rothbaum, Michael S Scheeringa, Anja Siewert-Siegmund, Jasper A J Smits, Eric A Storch, Andreas Ströhle, Candyce D Tart, David F Tolin, Agnes van Minnen, Allison M Waters, Carl F Weems, Sabine Wilhelm, Katarzyna Wyka, Michael Davis, Christian Rück
Importance: Whether and under which conditions D-cycloserine (DCS) augments the effects of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders is unclear. Objective: To clarify whether DCS is superior to placebo in augmenting the effects of cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders and to evaluate whether antidepressants interact with DCS and the effect of potential moderating variables...
January 25, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28120156/investigating-the-value-of-right-heart-echocardiographic-metrics-for-detection-of-pulmonary-hypertension-in-patients-with-advanced-lung-disease
#19
Myriam Amsallem, David Boulate, Zoe Kooreman, Roham T Zamanian, Guillaume Fadel, Ingela Schnittger, Elie Fadel, Michael V McConnell, Gundeep Dhillon, Olaf Mercier, François Haddad
This study determined whether novel right heart echocardiography metrics help to detect pulmonary hypertension (PH) in patients with advanced lung disease (ALD). We reviewed echocardiography and catheterization data of 192 patients from the Stanford ALD registry and echocardiograms of 50 healthy controls. Accuracy of echocardiographic right heart metrics to detect PH was assessed using logistic regression and area under the ROC curves (AUC) analysis. Patients were divided into a derivation (n = 92) and validation cohort (n = 100)...
January 24, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28119166/in-vitro-toxicological-evaluation-of-ncs-382-a-high-affinity-antagonist-of-%C3%AE-hydroxybutyrate-ghb-binding
#20
K R Vogel, G R Ainslie, J-B Roullet, A McConnell, K M Gibson
γ-Hydroxybutyric acid (GHB), a minor metabolite of the inhibitory neurotransmitter GABA, can accumulate to significant concentrations in the heritable disorder of GABA degradation, succinic semialdehyde dehydrogenase (SSADH) deficiency (SSADHD). Moreover, GHB may be employed in therapeutic settings (treatment of narcolepsy), as well as instances of illicit activity, including acquaintance sexual assault and the induction of euphoria. High-affinity binding sites for GHB in the brain have been identified, although the absolute identity of these receptors remains unclear...
January 22, 2017: Toxicology in Vitro: An International Journal Published in Association with BIBRA
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