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https://www.readbyqxmd.com/read/28632953/updates-to-the-us-food-and-drug-administration-regulations-for-mifepristone-implications-for-clinical-practice-and-access-to-abortion
#1
Katherine E Simmonds, Margaret W Beal, Meghan K Eagen-Torkko
This article provides information on recent changes in the US Food and Drug Administration (FDA) labeling and safety regulations for mifepristone (Mifeprex). The revised label now permits midwives, advanced practice nurses, and physician assistants to order and prescribe mifepristone, eliminating the requirement for physician supervision. The updated label also extends eligibility for use from 49 to 70 days' gestation and decreases the number of required visits from 3 to 2. The recommended dose of mifepristone has been reduced, and the dosage, timing, and route of administration for misoprostol have also been changed to reflect current research...
May 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28629916/a-medical-student-perspective-on-physician-assisted-suicide
#2
John Y Rhee, Katharine A Callaghan, Philip Allen, Amanda Stahl, Martin T Brown, Alexandra Tsoi, Grace McInerney, Ana-Maria G Dumitru
Physician assisted suicide and euthanasia (PAS/E) has been increasingly discussed and debated in the public square, including in professional medical organizations. However, the medical student perspective on the debate has been essentially absent. We present a medical student perspective on the PAS/E debate as future doctors and those about to enter the profession. We argue that PAS/E is not in line with the core principles of medicine, and the focus should rather be on providing high-quality end-of-life and palliative care...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28627110/patient-preferences-for-healthcare-delivery-through-community-pharmacy-settings-in-the-usa-a-discrete-choice-study
#3
M Feehan, M Walsh, J Godin, D Sundwall, M A Munger
WHAT IS KNOWN AND OBJECTIVE: In order to improve public health, it is necessary to facilitate patients' easy access to affordable high-quality primary health care, and one enhanced approach to do so may be to provide primary healthcare services in the community pharmacy setting. Discrete choice experiments to evaluate patient demand for services in pharmacy are relatively limited and have been hampered by a focus on only a few service alternatives, most focusing on changes in more traditional pharmacy services...
June 18, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28624047/viscoelastic-monitoring-in-pediatric-trauma-a-survey-of-pediatric-trauma-society-members
#4
Robert T Russell, Ilan I Maizlin, Adam M Vogel
BACKGROUND: Viscoelastic monitoring (VEM), including thromboelastography (TEG) and rotational thromboelastometry (ROTEM) in the setting of goal-directed hemostatic resuscitation has been shown to improve outcomes in adult trauma. The American College of Surgeons (ACS) Committee on Trauma recommends that "thromboelastography should be available at level I and level II trauma centers". The purpose of this study is to determine the current availability and utilization of VEM in pediatric trauma...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622214/acute-care-nurse-practitioners-and-physician-assistants-in-critical-care-transforming-education-and-practice
#5
W Robert Grabenkort, Heather H Meissen, Sara R Gregg, Craig M Coopersmith
No abstract text is available yet for this article.
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28617751/economic-evaluations-of-strategies-to-prevent-hospital-acquired-pressure-injuries
#6
Wrechelle Ocampo, Amanda Cheung, Barry Baylis, Nancy Clayden, John M Conly, William A Ghali, Chester H Ho, Jaime Kaufman, Henry T Stelfox, David B Hogan
GENERAL PURPOSE: To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
July 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28617196/factors-associated-with-having-a-physician-nurse-practitioner-or-physician-assistant-as-primary-care-provider-for-veterans-with-diabetes-mellitus
#7
Perri Morgan, Christine M Everett, Valerie A Smith, Sandra Woolson, David Edelman, Cristina C Hendrix, Theodore S Z Berkowitz, Brandolyn White, George L Jackson
Expanded use of nurse practitioners (NPs) and physician assistants (PAs) is a potential solution to workforce issues, but little is known about how NPs and PAs can best be used. Our study examines whether medical and social complexity of patients is associated with whether their primary care provider (PCP) type is a physician, NP, or PA. In this national retrospective cohort study, we use 2012-2013 national Veterans Administration (VA) electronic health record data from 374 223 veterans to examine whether PCP type is associated with patient, clinic, and state-level factors representing medical and social complexity, adjusting for all variables simultaneously using a generalized logit model...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617109/meet-the-new-team-players-physician-associates
#8
Jamille Paschoal Vicente, Siba Prosad Paul
Physician associates (PAs) were introduced into the NHS to add a new kind of team player to the medical workforce. The role originated in the US where they are known as physician assistants and have been practising since the mid-1960s ( Peate 2016 ).The PA competency and curriculum framework states that a newly qualified PA must be able to perform clinical work 'at the same standard as a newly qualified doctor', and trainees undergo a rigorous two-year postgraduate training ( Peate 2016 ). Before becoming eligible to practise, they must pass a Royal College of Physicians licensing exam and certified PAs are required to retake the examination every six years...
June 15, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28614974/electronic-consultation-system-demonstrates-educational-benefit-for-primary-care-providers
#9
Jonas Kwok, J Nwando Olayiwola, Margae Knox, Elizabeth J Murphy, Delphine S Tuot
Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#10
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28604507/visits-to-registered-nurses-an-opportunity-to-increase-contraceptive-access-in-california
#11
Emese C Parker, Kevin Kong, Leslie A Watts, Eleanor B Schwarz, Philip D Darney, Heike Thiel de Bocanegra
BACKGROUND: In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. AIMS: The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A...
June 10, 2017: Nursing Research
https://www.readbyqxmd.com/read/28603465/spinal-cord-as-an-adjunct-to-brain-magnetic-resonance-imaging-in-defining-no-evidence-of-disease-activity-in-multiple-sclerosis
#12
Subhash Tummala, Tarun Singhal, Vinit V Oommen, Gloria Kim, Fariha Khalid, Brian C Healy, Rohit Bakshi
ACTIVITY AVAILABLE ONLINE: To access the article, post-test, and evaluation online, go to http://www.cmscscholar.org. TARGET AUDIENCE: The target audience for this activity is physicians, physician assistants, nursing professionals, and other health-care providers involved in the management of patients with multiple sclerosis (MS). LEARNING OBJECTIVES: 1) Describe the concept of "no evidence of disease activity" in MS.2) Recognize the role of spinal cord imaging in routine monitoring of MS disease activity...
May 2017: International Journal of MS Care
https://www.readbyqxmd.com/read/28602803/patient-preference-in-primary-care-provider-type
#13
Brandi Leach, Margaret Gradison, Perri Morgan, Christine Everett, Michael J Dill, Justine Strand de Oliveira
BACKGROUND: Given the growing roles of nurse practitioners (NPs) and physician assistants (PAs), patients are increasingly able to choose their primary care provider type. Studies examining patient preferences among provider types are limited and ours is the first to examine reasons for patients' provider type preferences. METHODS: Using data from the 2014 Association of American Medical Colleges' (AAMC) Consumer Survey of Health Care Access, we used qualitative analysis to identify themes in open text responses of reasons for respondents' provider type preference (N = 4220)...
June 8, 2017: Healthcare
https://www.readbyqxmd.com/read/28602582/examining-the-gap-compensation-disparities-between-male-and-female-physician-assistants
#14
Noël Smith, James F Cawley, Timothy C McCall
BACKGROUND: Compensation disparities between men and women have been problematic for decades, and there is considerable evidence that the gap cannot be entirely explained by nongender factors. The current study examined the compensation gap in the physician assistant (PA) profession. METHODS: Compensation data from 2014 was collected by the American Academy of PAs in 2015. Practice variables, including experience, specialty, and hours worked, were controlled for in an ordinary least-squares sequential regression model to examine whether there remained a disparity in total compensation...
June 9, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28600370/substituting-physicians-with-nurse-practitioners-physician-assistants-or-nurses-in-nursing-homes-protocol-for-a-realist-evaluation-case-study
#15
Marleen Hermien Lovink, Anke Persoon, Anneke Jah van Vught, Lisette Schoonhoven, Raymond Tcm Koopmans, Miranda Gh Laurant
INTRODUCTION: In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare...
June 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28598775/rheumatologists-guideline-adherence-in-rheumatoid-arthritis-a-randomised-controlled-study-on-electronic-decision-support-education-and-feedback
#16
Nienke Lesuis, Ronald F van Vollenhoven, Reinier P Akkermans, Lise M Verhoef, Marlies E Hulscher, Alfons A den Broeder
OBJECTIVES: To assess the effects of education, feedback and a computerised decision support system (CDSS) versus education and feedback alone on rheumatologists' rheumatoid arthritis (RA) guideline adherence. METHODS: A single-centre, randomised controlled pilot study was performed among clinicians (rheumatologists, residents and physician assistants; n=20) working at the study centre, with a 1:1 randomisation of included clinicians. A standardized sum score (SSS) on guideline adherence was used as the primary outcome (patient level)...
June 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28593172/allied-health-professional-support-in-pediatric-inflammatory-bowel-disease-a-survey-from-the-canadian-children-inflammatory-bowel-disease-network-a-joint-partnership-of-cihr-and-the-ch-i-l-d-foundation
#17
Wael El-Matary, Eric I Benchimol, David Mack, Hien Q Huynh, Jeff Critch, Anthony Otley, Colette Deslandres, Kevan Jacobson, Jennifer deBruyn, Matthew W Carroll, Eytan Wine, Johan Van Limbergen, Mary Sherlock, Kevin Bax, Sally Lawrence, Ernest Seidman, Robert Issenman, Thomas D Walters, Peter Church, Anne M Griffiths
OBJECTIVES: The current number of healthcare providers (HCP) caring for children with inflammatory bowel disease (IBD) across Canadian tertiary-care centres is underinvestigated. The aim of this survey was to assess the number of healthcare providers (HCP) in ambulatory pediatric IBD care across Canadian tertiary-care centres. METHODS: Using a self-administered questionnaire, we examined available resources in academic pediatric centres within the Canadian Children IBD Network...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28590563/a-multi-state-initiative-to-implement-pediatric-oral-health-in-primary-care-practice-and-clinical-education
#18
Hugh Silk, Ellen Sachs Leicher, Veronica Alvarado, Elizabeth Cote, Susan Cote
OBJECTIVES: To implement and study the effect of improving pediatric oral health by training primary care practices and training programs. METHOD: In six New England States, primary care practices and clinical training programs (medical schools, residencies, physician assistant programs) were recruited and trained to incorporate pediatric oral health into medical practice. We measured the results of varying practice recruitment approaches and measured training outcomes based on self-reported implementation and state reported EPSDT CMS oral health claims...
June 7, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28587644/current-and-future-perspectives-on-the-management-of-polypharmacy
#19
Mariam Molokhia, Azeem Majeed
BACKGROUND: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death...
June 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28586817/trends-in-visits-to-specialist-physicians-involving-nurse-practitioners-and-physician-assistants-2001-to-2013
#20
Kristin N Ray, Grant R Martsolf, Ateev Mehrotra, Michael L Barnett
No abstract text is available yet for this article.
June 5, 2017: JAMA Internal Medicine
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