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https://www.readbyqxmd.com/read/29793213/end-stage-renal-disease-models-in-the-americas-optimizing-resources-to-achieve-better-health-outcomes
#1
Ramiro E Gilardino, Eduardo González-Pier, Claudia Brabata
End-stage renal disease, the last and most severe stage of chronic kidney disease, represents a major and rising concern for countries in Latin America, driven in large part by aging populations and the near-epidemic rises in diabetes, obesity, and hypertension. This places a great clinical, economic, and social burden on the region's health systems. During the ISPOR 6th Latin America Conference held in Sao Paulo, Brazil, in September 2017, an educational forum debated on value-based decision making in the treatment of end-stage renal disease in Latin America...
May 21, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29792835/safety-and-efficacy-of-outpatient-parotidectomy
#2
Andrea Ziegler, Gina Lazzara, Eric Thorpe
PURPOSE: Given the increasing costs of medical care, there has been a shift to outpatient elective surgeries in certain patient populations among all surgical specialties. The goal of this study was to compare the safety and efficacy of outpatient parotidectomy with traditional inpatient parotidectomy. MATERIALS AND METHODS: This is a retrospective chart review of all patients who underwent a parotidectomy at a single tertiary academic center from 2007 through 2017...
May 7, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29792736/overutilization-of-health-care-resources-for-breast-pain
#3
Anne C Kushwaha, Kyungmin Shin, Megan Kalambo, Ravinder Legha, Karen E Gerlach, Megha Madhukar Kapoor, Wei T Yang
OBJECTIVE: The objective of this study is to analyze the incidence of women with breast pain who present to an imaging center and assess the imaging findings, outcomes, and workup costs at breast imaging centers affiliated with one institution. MATERIALS AND METHODS: Demographic characteristics of and imaging findings for female patients presenting with breast pain at three community breast imaging centers between January 1, 2014, and December 31, 2014, were reviewed...
May 24, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#4
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29792460/the-complexity-diversity-and-science-of-primary-care-teams
#5
Kevin Fiscella, Susan H McDaniel
This article examines the past, present and future of primary care and teamwork. It begins with a definition and description of primary care-its uniqueness, diversity and complexity, including the historical role of teams within primary care. The article then reviews the emergence of innovative primary care teams, including those grounded in new processes such as the Patient-Centered Medical Home and interprofessional teams that include new types of health professionals, particularly psychologists and other integrated behavioral health clinicians...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792174/perspectives-on-clinical-use-of-bioimpedance-in-hemodialysis-focus-group-interviews-with-renal-care-professionals
#6
Jenny Stenberg, Catrin Henriksson, Magnus Lindberg, Hans Furuland
BACKGROUND: Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals' perceived barriers and facilitators for use of bioimpedance in clinical practice. METHODS: Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device...
May 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29792063/integrating-childhood-obesity-resources-into-the-patient-centered-medical-home-provider-perspectives-in-the-united-states
#7
Samareh G Hill, Thao-Ly T Phan, George A Datto, Jobayer Hossain, Lloyd N Werk, Diane Abatemarco
Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29792039/identifying-palliative-care-needs-among-older-adults-in-nonclinical-settings
#8
Elissa Kozlov, Anna Cai, Jo Anne Sirey, Angela Ghesquiere, M Carrington Reid
Though palliative care is appropriate for patients with serious illness at any stage of the illness and treatment process, the vast majority of palliative care is currently delivered in inpatient medical settings in the past month of life during an acute hospitalization. Palliative care can have maximal benefit to patients when it is integrated earlier in the illness trajectory. One possible way to increase earlier palliative care use is to screen for unmet palliative care needs in community settings. The goal of this study was to assess the rates of unmet palliative care needs in older adults who attend New York City-based senior centers...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29791941/understanding-refugees-health
#9
Martin Müller, Dana Khamis, David Srivastava, Aristomenis K Exadaktylos, Carmen Andrea Pfortmueller
According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide. Several factors have a major influence on asylum seekers' health; so, their health profile is markedly different from that of the population in the country of asylum. The aim of this study is to review the major issues physicians need to be aware of when treating asylum seekers, with a special focus on the neurological problems of asylum seekers and refugees. The major impact factors on refugees' health are linked to experiences and exposure (1) in the country of origin, (2) in refugee camps and en route to Europe, and (3) in the process of immigration into the host country and living in European asylum centers...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29791930/the-pediatric-emergency-care-applied-research-network-registry-a-multicenter-electronic-health-record-registry-of-pediatric-emergency-care
#10
Sara J Deakyne Davies, Robert W Grundmeier, Diego A Campos, Katie L Hayes, Jamie Bell, Evaline A Alessandrini, Lalit Bajaj, James M Chamberlain, Marc H Gorelick, Rene Enriquez, T Charles Casper, Beth Scheid, Marlena Kittick, J Michael Dean, Elizabeth R Alpern
BACKGROUND:  Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29791899/national-practice-patterns-for-prenatal-monitoring-in-gastroschisis-gastroschisis-outcomes-of-delivery-good-provider-survey
#11
Ruchi Amin, Aaron Domack, Joseph Bartoletti, Erika Peterson, Britton Rink, Jennifer Bruggink, Melissa Christensen, Anthony Johnson, William Polzin, Amy J Wagner
BACKGROUND: Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. MATERIALS AND METHODS: An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan...
May 23, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#12
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29791243/amcp-partnership-forum-managing-care-in-the-wave-of-precision-medicine
#13
(no author information available yet)
Precision medicine, the customization of health care to an individual's genetic profile while accounting for biomarkers and lifestyle, has increasingly been adopted by health care stakeholders to guide the development of treatment options, improve treatment decision making, provide more patient-centered care, and better inform coverage and reimbursement decisions. Despite these benefits, key challenges prevent its broader use and adoption. On December 7-8, 2017, the Academy of Managed Care Pharmacy convened a group of stakeholders to discuss these challenges and provide recommendations to facilitate broader adoption and use of precision medicine across health care settings...
May 23, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29791190/the-comprehensive-primary-care-initiative-effects-on-spending-quality-patients-and-physicians
#14
Deborah Peikes, Stacy Dale, Arkadipta Ghosh, Erin Fries Taylor, Kaylyn Swankoski, Ann S O'Malley, Timothy J Day, Nancy Duda, Pragya Singh, Grace Anglin, Laura L Sessums, Randall S Brown
The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices...
May 23, 2018: Health Affairs
https://www.readbyqxmd.com/read/29791187/a-single-lab-test-to-aid-pierre-robin-sequence-severity-diagnosis
#15
Artur Fahradyan, Beina Azadgoli, Michaela Tsuha, Mark M Urata, Stacey H Francis
OBJECTIVE: The workup of patients with Pierre Robin sequence (PRS) consists of a physical examination, O2 saturation, and polysomnography to determine the severity of respiratory obstruction and need for surgery. We suggest that capillary blood gas (CBG) may be a better physiologic representation of airway obstruction and should be routinely used in the management of patients with PRS. DESIGN: This is a multicenter study based on a retrospective review of medical records...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29791025/factors-associated-with-quality-of-life-of-dementia-caregivers-direct-and-indirect-effects
#16
Hikaru Oba, Teruyuki Matsuoka, Yuka Kato, Jin Narumoto
AIMS: To examine the direct and indirect relationships between the characteristics of patients and caregivers associated with caregivers' quality of life. BACKGROUND: Complex relationships exist among the factors associated with caregivers' quality of life. DESIGN: This study was a retrospective cross-sectional design. METHODS: The data were retrospectively extracted from participants who had visited the Center for Diagnosis of Dementia at Kyoto Prefectural University of Medicine from April 2013 - March 2016...
May 23, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29790905/the-hard-road-to-patient-centered-care-3-or-6-months-of-adjuvant-chemotherapy-for-patients-with-stage-iii-colon-cancer
#17
P Trensz, L Calvel, J E Kurtz
No abstract text is available yet for this article.
May 22, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29790864/implementing-comprehensive-primary-care-referral-tracking-in-a-patient-centered-medical-home
#18
Jenny Spahr, Jennifer Coddington, Nancy Edwards, Sara McComb
The Patient-Centered Medical Home care model emphasizes efficient, coordinated care distributed among interdisciplinary team members. One key function to care coordination is referral/test tracking. This study evaluated the referral practices in a nurse-managed Patient-Centered Medical Home primary care clinic. The major findings corroborate the need for a well-organized referral-tracking system that is centralized and contains safety nets to reduce the number of delayed or missed referrals.
July 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29790137/-diabetic-foot-neuropathy-and-related-factors-in-patients-with-type-2-diabetes-mellitus
#19
Tzu-Yu Chen, Chia-Huei Lin, Yue-Cune Chang, Chih-Hsin Wang, Yi-Jen Hung, Wen-Chii Tzeng
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality. PURPOSE: To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789855/how-does-scorten-score
#20
Sarah Zavala, Megan O'Mahony, Cara Joyce, Anthony J Baldea
The Toxic Epidermal Necrolysis-specific severity of illness score (SCORTEN) was developed to predict mortality in patients with Stevens Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Several studies have attempted to assess the accuracy of SCORTEN with mixed results. The objective of this study is to compare the predicted and actual mortality for patients with SJS/TEN admitted to a single high-volume burn center.This retrospective study included adult and pediatric patients admitted to our burn center with biopsy-confirmed SJS/TEN between February 2008 and February 2016...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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