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https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#1
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27914734/applying-a-deliberation-model-to-the-analysis-of-consultations-in-haemophilia-implications-for-doctor-patient-communication
#2
Giulia Lamiani, Sarah Bigi, Maria Elisa Mancuso, Antonio Coppola, Elena Vegni
OBJECTIVE: Literature highlights the importance of communication in order to achieve patient's adherence. However, the specific dialogical components likely to favor patient adherence are not clear. In this study, the deliberation dialogue model was applied as an ideal model of optimal deliberation to real physician-patient consultations in the field of hemophilia in order to identify misalignments with the model and possible improvements in physician-patient communication. METHODS: By applying the deliberation model, we analyzed a corpus of 30 check-up consultations in hemophilia...
November 28, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27914561/standards-for-clinical-trials-in-male-and-female-sexual-dysfunction-i-%C3%A2-phase-i-to-phase-iv-clinical-trial-design
#3
William A Fisher, Ilan Gruenwald, Emmanuele A Jannini, Ahinoam Lev-Sagie, Lior Lowenstein, Robert E Pyke, Yakov Reisman, Dennis A Revicki, Eusebio Rubio-Aurioles
This series of articles outlines standards for clinical trials of treatments for male and female sexual dysfunctions, with a focus on research design and patient-reported outcome assessment. These articles consist of revision, updating, and integration of articles on standards for clinical trials in male and female sexual dysfunction from the 2010 International Consultation on Sexual Medicine developed by the authors as part of the 2015 International Consultation on Sexual Medicine. We are guided in this effort by several principles...
December 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27914560/diagnosis-and-treatment-of-testosterone-deficiency-recommendations-from-the-fourth-international-consultation-for-sexual-medicine-icsm%C3%A2-2015
#4
Mohit Khera, Ganesh Adaikan, Jacques Buvat, Serge Carrier, Amr El-Meliegy, Kostas Hatzimouratidis, Andrew McCullough, Abraham Morgentaler, Luiz Otavio Torres, Andrea Salonia
INTRODUCTION: Testosterone deficiency (TD), also known as hypogonadism, is a condition affecting a substantial proportion of men as they age. The diagnosis and management of TD can be challenging and clinicians should be aware of the current literature on this condition. AIM: To review the available literature concerning the diagnosis and management of TD and to provide clinically relevant recommendations from the Fourth International Consultation for Sexual Medicine (ICSM) meeting...
December 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27910135/towards-a-terminologia-neuroanatomica
#5
Hans J Ten Donkelaar, Jonas Broman, Paul E Neumann, Luis Puelles, Alessandro Riva, R Shane Tubbs, David Kachlik
This article deals with a recent revision of the terminology of the Sections Central Nervous System (CNS; Systema nervosum centrale) and Peripheral Nervous System (PNS; Systema nervosum periphericum) of the Terminologia Anatomica (TA, 1998) and the Terminologia Histologica (TH, 2008). These sections were extensively updated by the Federative International Programme for Anatomical Terminology (FIPAT) Working Group Neuroanatomy of the International Federation of Associations of Anatomists (IFAA). After extensive discussions by FIPAT, and consultation with the IFAA Member Societies, these parts were merged to form a Terminologia Neuroanatomica (TNA)...
November 7, 2016: Clinical Anatomy
https://www.readbyqxmd.com/read/27909632/a-framework-for-navigating-institutional-review-board-irb-oversight-in-the-complicated-zone-of-research
#6
Gretchen E Parker
The treatment therapies and technologies currently emerging from the rapidly evolving health care industry must undergo full examination in a clinical setting if they are to be marketed to the public. All elements of clinical studies involving human subjects must undergo thorough IRB review before study activities can commence. Regulations regarding IRB oversight apply to all clinical studies-including retrospective examinations of private medical data and identifiable biological samples. It is not uncommon for researchers to be unsure whether, or on what level, IRB review and oversight are required for a particular project...
October 25, 2016: Curēus
https://www.readbyqxmd.com/read/27909087/stand-up-and-be-counted-measuring-and-mapping-the-rheumatology-workforce-in-canada
#7
Claire E H Barber, Lauren Jewett, Elizabeth M Badley, Diane Lacaille, Alfred Cividino, Vandana Ahluwalia, Henry Averns, Cory Baillie, Janet Ellsworth, Janet Pope, Deborah Levy, Christine Charnock, Claire McGowan, J Carter Thorne, Cheryl Barnabe, Michel Zummer, Katie Lundon, Robert S McDougall, John G Thomson, Elaine A Yacyshyn, Dianne Mosher, Julie Brophy, Thanu Nadarajah Ruban, Deborah A Marshall
OBJECTIVE: To characterize the practicing rheumatologist workforce, the Canadian Rheumatology Association (CRA) launched the Stand Up and Be Counted workforce survey in 2015. METHODS: The survey was distributed electronically to 695 individuals, of whom 519 were expected to be practicing rheumatologists. Demographic and practice information were elicited. We estimated the number of full-time equivalent rheumatologists per 75,000 population from the median proportion of time devoted to clinical practice multiplied by provincial rheumatologist numbers from the Canadian Medical Association...
December 1, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27905884/the-efficacy-of-pivmecillinam-3%C3%A2-days-or-5%C3%A2-days%C3%A2-t-i-d-against-community-acquired-uncomplicated-lower-urinary-tract-infections-a-randomized-double-blinded-placebo-controlled-clinical-trial-study-protocol
#8
Filip Jansåker, Niels Frimodt-Møller, Lars Bjerrum, Jenny Dahl Knudsen
BACKGROUND: Uncomplicated lower urinary tract infections (LUTI) are very common, and presumably around 200,000 female patients are treated for this annually in Denmark. The current Danish national clinical practice guidelines recommend pivmecillinam as a first-line drug (i.e., 400 mg t.i.d. for 3 days). Pivmecillinam is also one of the first-line drugs recommended in the international guidelines for LUTIs (i.e., 400 mg b.i.d. for 5 days). The international recommended duration is based on evidence saying that a 7-day regimen is better than a 3-day regimen...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27891344/role-of-scrape-cytology-as-an-adjunct-to-fine-needle-aspiration-cytology-in-diagnosis-of-thyroid-lesions
#9
Mehnaaz Sultan Khuroo, Shaista Mushtaq, Summyia Farooq, Ambreen Beigh, Naila Nazir, Ruby Reshi
INTRODUCTION: Scrape cytology is an important diagnostic tool. It has been used in many tissue types as an adjunct or replacement for frozen section/ intra operative consultation. AIM: This study was done to evaluate the role of scrape cytology in the diagnosis of thyroid lesions, its role as an adjunct to Fine Needle Aspiration Cytology (FNAC) and application of this technique for intra-operative consultation. MATERIALS AND METHODS: A prospective study on 50 thyroid neoplasms received over a period of 18 months (Nov 2014- March 2016) was conducted...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891209/feasibility-of-connecting-a-substance-abuse-prevention-program-for-foster-teens-and-their-caregivers
#10
Kevin P Haggerty, Susan E Barkan, Martie Skinner, W Ben Packard, Janice J Cole
OBJECTIVE: To test the feasibility, usability, and proximal outcomes of Connecting, an adaptation of a low-cost, self-directed, family-based substance use prevention program, Staying Connected with Your Teen, with foster families in a randomized, waitlist control pilot study. METHOD: Families (n = 60) fostering teens between 11 and 15 years of age were recruited into the study and randomly assigned into the self-administered program with telephone support from a family consultant (n = 32) or a waitlist control condition (n = 28)...
2016: Journal of the Society for Social Work and Research
https://www.readbyqxmd.com/read/27887680/emergency-video-telemedicine-consultation-for-newborn-resuscitations-the-mayo-clinic-experience
#11
Jennifer L Fang, Christopher A Collura, Robert V Johnson, Garth F Asay, William A Carey, Douglas P Derleth, Tara R Lang, Beth L Kreofsky, Christopher E Colby
OBJECTIVE: To describe the Mayo Clinic experience with emergency video telemedicine consultations for high-risk newborn deliveries. PATIENTS AND METHODS: From March 26, 2013, through December 31, 2015, the Division of Neonatal Medicine offered newborn telemedicine consultations to 6 health system sites. A wireless tablet running secure video conferencing software was used by the local care teams. Descriptive data were collected on all consultations. After each telemedicine consult, a survey was sent to the neonatologist and referring provider to assess the technology, teamwork, and user satisfaction...
November 10, 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27887578/evaluation-of-an-international-educational-programme-for-health-care-professionals-on-best-practice-in-the-management-of-a-perinatal-death-improving-perinatal-mortality-review-and-outcomes-via-education-improve
#12
Paul A Gardiner, Alison L Kent, Viviana Rodriguez, Aleena M Wojcieszek, David Ellwood, Adrienne Gordon, Patricia A Wilson, Diana M Bond, Adrian Charles, Susan Arbuckle, Glenn J Gardener, Jeremy J Oats, Jan Jaap Erwich, Fleurisca J Korteweg, T H Nguyen Duc, Susannah Hopkins Leisher, Kamal Kishore, Robert M Silver, Alexander E Heazell, Claire Storey, Vicki Flenady
BACKGROUND: Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global public health concerns. Careful clinical management after these deaths is required, including appropriate investigation and assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An educational programme for health care professionals working in maternal and child health has been designed to address these needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE)...
November 25, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27885433/discussing-sexuality-with-patients-with-parkinson-s-disease-a-survey-among-dutch-neurologists
#13
Petra J M van Hees, Anton A van der Plas, Gaby F van Ek, Hein Putter, Brenda L Den Oudsten, Marjolein E M den Ouden, Henk W Elzevier
Sexual functioning is often impaired in patients with Parkinson's disease (PD) and may affect quality of life of patients and their spouse. However, little is known about the practice patterns of neurologists with regard to discussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologists discuss sexuality with PD patients. A 22-item questionnaire was sent to 139 neurologists specializing in PD. The survey contained questions about their attitudes, knowledge, and practice patterns with respect to sexual dysfunction (SD) in patients with PD...
November 24, 2016: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27884492/what-women-want-exploring-pregnant-women-s-preferences-for-alternative-models-of-maternity-care
#14
Christopher Godfrey Fawsitt, Jane Bourke, Jennifer E Lutomski, Sarah Meaney, Brendan McElroy, Rosemary Murphy, Richard Anthony Greene
Depending on obstetric risk, maternity care may be provided in one of two locations at hospital level: a consultant-led unit (CLU) or a midwifery-led unit (MLU). Care in a MLU is sparsely provided in Ireland, comprising as few as two units out of a total 21 maternity units. Given its potential for greater efficiencies of care and cost-savings for the state, there has been an increased interest to expand MLUs in Ireland. Yet, very little is known about women's preferences for midwifery-led care, and whether they would utilise this service when presented with the choice of delivering in a CLU or MLU...
November 8, 2016: Health Policy
https://www.readbyqxmd.com/read/27884137/early-identification-in-primary-health-care-of-people-at-risk-for-sick-leave-due-to-work-related-stress-study-protocol-of-a-randomized-controlled-trial-rct
#15
Kristina Holmgren, Christine Sandheimer, Ann-Charlotte Mårdby, Maria E H Larsson, Ute Bültmann, Dominique Hange, Gunnel Hensing
BACKGROUND: Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population...
November 25, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27883198/reflections-on-a-community-psychology-setting-and-the-future-of-the-field
#16
Joy S Kaufman, Christian M Connell, Cindy A Crusto, Derrick M Gordon, Carolyn E Sartor, Patricia Simon, Michael J Strambler, Tami P Sullivan, Nadia L Ward, Nicole Holland Weiss, Jacob Kraemer Tebes
The 50th anniversary of the Swampscott Conference offers an opportunity to reflect on a community psychology setting, The Consultation Center at Yale, that was formed in response to the 1963 Community Mental Health Act and the 1965 Swampscott Conference. The Center has flourished as a community psychology setting for practice, research, and training for 39 of the 50 years since Swampscott. Its creation and existence over this period offers an opportunity for reflection on the types of settings needed to sustain the field into the future...
November 24, 2016: American Journal of Community Psychology
https://www.readbyqxmd.com/read/27882864/patient-participation-in-palliative-care-decisions-an-ethnographic-discourse-analysis
#17
Emmanuelle Bélanger, Charo Rodríguez, Danielle Groleau, France Légaré, Mary Ellen MacDonald, Robert Marchand
The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team...
2016: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/27882837/determining-multiple-sclerosis-phenotype-from-electronic-medical-records
#18
Richard E Nelson, Jorie Butler, Joanne LaFleur, Kristin Knippenberg, Aaron W C Kamauu, Scott L DuVall
BACKGROUND: Multiple sclerosis (MS), a central nervous system disease in which nerve signals are disrupted by scarring and demyelination, is classified into phenotypes depending on the patterns of cognitive or physical impairment progression: relapsing-remitting MS (RRMS), primary-progressive MS (PPMS), secondary-progressive MS (SPMS), or progressive-relapsing MS (PRMS). The phenotype is important in managing the disease and determining appropriate treatment. The ICD-9-CM code 340.0 is uninformative about MS phenotype, which increases the difficulty of studying the effects of phenotype on disease...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27880082/perceived-performance-and-impact-of-a-non-physician-led-interprofessional-team-in-a-trauma-clinic-setting
#19
Julia Driessen, Johanna E Bellon, Joel Stevans, Raquel M Forsythe, Benjamin R Reynolds, A Everette James
Faced with the challenge of meeting the wide degree of post-discharge needs in their trauma population, the University of Pittsburgh Medical Center (UPMC) developed a non-physician-led interprofessional team to provide follow-up care at its UPMC Falk Trauma Clinic. We assessed this model of care using a survey to gauge team member perceptions of this model, and used clinic visit documentation to apply a novel approach to assessing how this model improves the care received by clinic patients. The high level of perceived team performance and cohesion suggests that this model has been successful thus far from a provider perspective...
November 23, 2016: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27879543/enzymopenic-congenital-methemoglobinemia-in-children-of-the-republic-of-sakha-yakutia
#20
Tatiana E Burtseva, Tatiana N Ammosova, Natalia N Protopopova, Svetlana Y Yakovleva, Maya P Slobodchikova
Type I congenital methemoglobinemia is an autosomal recessive disorder. A high frequency of congenital methemoglobinemia has been reported among Native Americans inhabiting the Yukon-Kuskokwim Delta. Other rare cases of congenital methemoglobinemia of types I and II have been reported in Japan and other countries. In Russia-namely, in Yakutia-a high frequency of type I congenital methemoglobinemia has been reported. In 2009, the Consultation Polyclinic of the Pediatric Center in Yakutsk city established a registry of children with congenital methemoglobinemia...
November 22, 2016: Journal of Pediatric Hematology/oncology
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