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https://www.readbyqxmd.com/read/29793125/assessment-of-cam-morphology-of-the-hip-with-ultra-sound-imaging-by-physical-therapists-is-reliable-and-valid
#1
Liliane Mandema, Igor Tak, Brigitte Mooij, Ruud Groeneweg, Eric Bakker, Peter van Veldhoven
BACKGROUND: Femoroacetabular impingement syndrome is considered present when a combination of clinical symptoms, signs and morphological features of the hip co-exist. Imaging is increasingly popular in primary health care settings with physical therapists performing ultrasound (US). OBJECTIVE: The aim of this study was to assess the diagnostic accuracy and inter-rater reliability of ultrasound in determining presence of cam morphology. DESIGN: A concurrent validity and inter-rater reliability study...
April 14, 2018: Physical Therapy in Sport
https://www.readbyqxmd.com/read/29791190/the-comprehensive-primary-care-initiative-effects-on-spending-quality-patients-and-physicians
#2
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/29790448/enhancing-outpatient-appointment-scheduling-system-performance-when-patient-no-show-percent-and-lateness-rates-are-high
#3
Mahmoud Barghash, Hanan Saleet
Purpose High lateness and no-show percentages pose great challenges on the patient scheduling process. Usually this is addressed by optimizing the time between patients in the scheduling process and the percent of extra patients scheduled to account for absent patients. However, since the patient no-show and lateness is highly stochastic we might end up with many patients showing up on time which leads to crowded clinics and high waiting times. The clinic might end up as well with low utilization of the doctor time...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790447/data-driven-process-to-improve-va-surgical-flow
#4
Balmatee Bidassie, William Gunnar, Leigh Starr, George Van Buskirk, Lisa Warner, Clifford Anckaitis, Angela Howard
Purpose During years 2014-2016, Veterans Health Administration National Surgery Office conducted a surgical flow improvement initiative (SFII) to assist low-performing surgery programs to improve their operating room efficiency (ORE). The initiative was co-sponsored by VHA National Surgery Office and VHA Office of Systems Redesign and Improvement. The paper aims to discuss this issue. Design/methodology/approach An SFII algorithm, based on first-time-start (FTS), cancellation rate (CR), lag time (LT) and OR utilization, assigned an ORE performance Level (1-low to 4-high) to each VA Medical Center (VAMC)...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790446/ninety-to-nothing-a-pdsa-quality-improvement-project
#5
Gayle Linda Prybutok
Purpose The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total patient visit in the emergency department. Design/methodology/approach A multidisciplinary quality improvement team, using the PDSA (Plan, Do, Study, Act) Cycle, analyzed the emergency department care delivery process and sequentially made process improvements that contributed to project success. Findings The average turnaround time goal of 90 minutes or less per visit was achieved in four months, and the organization enjoyed significant collateral benefits both internal to the organization and for its customers...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790134/-hiv-stigma-and-spiritual-care-in-people-living-with-hiv
#6
Chia-Hui Yu, Yi-Chi Chiu, Su-Fen Cheng, Nai-Ying Ko
HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29788726/dynamics-of-high-risk-clinical-target-volume-reduction-during-brachytherapy-and-impact-on-its-coverage-in-patients-with-inoperable-cervical-cancer
#7
M Pobijakova, D Scepanovic, M Paluga, M Fekete, J Mardiak
Cervical cancer is the third most common cancer in women worldwide. Standard of care for patients with node positive or locally advanced tumors >4 cm is definitive radiotherapy and concurrent chemotherapy. Brachytherapy is an integral part of definitive radiotherapy for cervical cancer. The aim of the study was to show a dynamics of High Risk Clinical Target Volume (HR-CTV) reduction during Brachytherapy (BT) as a part of definitive treatment (External Beam Radiotherapy /EBRT/ +/- Chemotherapy /ChT/) depending on the initial Gross Tumor Volume (GTV) and its impact on HR-CTV coverage in patients with inoperable cervical cancer...
March 14, 2018: Neoplasma
https://www.readbyqxmd.com/read/29788313/defining-value-of-cancer-therapeutics-a-health-system-perspective
#8
Christine Leopold, Jeffrey M Peppercorn, S Yousuf Zafar, Anita K Wagner
Because of the rising costs of cancer care and ongoing challenges in ensuring access to quality care, there is an increasing need to prioritize spending and define the benefits of therapy in proportion to costs. The term "value" has gained favor as means to define the relative utility of a medical intervention in terms of benefits, risks, and financial costs, which in turn can help clinicians, patients, and policy makers prioritize "high-value" care. While numerous value concepts have been proposed, a comprehensive discussion of value initiatives along the care continuum is missing...
May 18, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29788284/military-service-and-decision-quality-in-the-management-of-knee-osteoarthritis
#9
Eric R Henderson, Alexander J Titus, Benjamin J Keeney, Philip P Goodney, Jon D Lurie, Said A Ibrahim
Background: Decision quality measures the degree to which care decisions are knowledge-based and value-aligned. Because military service emphasizes hierarchy, command, and mandates some healthcare decisions, military service may attenuate patient autonomy in healthcare decisions and lower decision quality. VA is the nation's largest provider of orthopedic care. We compared decision quality in a sample of VA and non-VA patients seeking care for knee osteoarthritis. Methods: Our study sample consisted of patients newly referred to our orthopedic clinic for the management of knee osteoarthritis...
May 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29787490/clinical-performance-of-a-new-bitangential-mini-scleral-lens
#10
Henny M Otten, Bart J J J van der Linden, Esther-Simone Visser
SIGNIFICANCE: New bitangential mini-scleral lens designs provide a highly precise fit, follow the scleral shape, are comfortable to wear, and can correct residual astigmatism. This new scleral lens design complements the arsenal of medical contact lenses available to eye care practitioners. PURPOSE: The aim of this study was to evaluate the subjective and objective performance of a new mini-scleral lens design with a bitangential periphery. METHODS: In this observational study, data were collected for up to 15 months (median, 84 days; interquartile range, 76 days) from the left eyes of 133 patients fitted with this newly designed lens...
May 21, 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/29785772/getting-the-picture-visual-interpretation-in-ophthalmology-residency-training
#11
Adam D Baim
OBJECTIVES: Visual interpretation is essential in many fields of health care. Although diagnostic competency can be measured as an educational outcome, few accounts have addressed tacit aspects of visual interpretation in clinical training; these include the disciplining of the trainee's attentions and the trainee's acculturation into expected styles of communicating visual interpretations to others. This paper describes values and dispositions that are taught to ophthalmology trainees as they learn to reason through visual information, and explores how these qualities are evaluated during residency training...
May 21, 2018: Medical Education
https://www.readbyqxmd.com/read/29785141/validity-of-a-method-for-the-self-screening-of-cardiovascular-risk
#12
María Barroso, Silvia Pérez-Fernández, M Mar Vila, M Dolors Zomeño, Ruth Martí-Lluch, Ferran Cordon, Rafel Ramos, Roberto Elosua, Irene R Degano, Montse Fitó, Carmen Cabezas, Gemma Salvador, Conxa Castell, María Grau
Background: The validity of a cardiovascular risk self-screening method was assessed. The results obtained for self-measurement of blood pressure, a point-of-care system's assessment of lipid profile and glycated hemoglobin, and a self-administered questionnaire (sex, age, diabetes, tobacco consumption) were compared with the standard screening (gold standard) conducted by a health professional. Methods: Crossover clinical trial on a population-based sample from Girona (north-eastern Spain), aged 35-74, with no cardiovascular disease at recruitment...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29784628/why-physics-in-medicine
#13
Ehsan Samei, Thomas M Grist
Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences...
May 18, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29784214/implementing-non-violent-resistance-a-method-to-cope-with-aggression-in-child-and-adolescent-residential-care-exploration-of-staff-members-experiences
#14
Kirsten van Gink, Katharina Visser, Arne Popma, Robert R J M Vermeiren, Lieke van Domburgh, Ber van der Stegen, Lucres M C Jansen
Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29782405/the-impact-of-anesthesia-influenced-process-measure-compliance-on-length-of-stay-results-from-an-enhanced-recovery-after-surgery-for-colorectal-surgery-cohort
#15
Michael C Grant, Claro M Pio Roda, Joseph K Canner, Philip Sommer, Daniel Galante, Deborah Hobson, Susan Gearhart, Christopher L Wu, Elizabeth Wick
BACKGROUND: Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. METHODS: From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS)...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781688/-he-should-feel-your-pain-patient-insights-on-patient-provider-communication-in-rwanda
#16
Vincent K Cubaka, Michael Schriver, Janvier B Kayitare, Phil Cotton, Helle T Maindal, Laetitia Nyirazinyoye, Per Kallestrup
BACKGROUND:  Patient-provider communication is an interpersonal interaction between a patient and a health care provider. OBJECTIVE:  This study explored patients' communication preferences and perceptions on what factors influence the patient-provider communication in primary health care settings in Rwanda. METHODS:  In-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used...
April 16, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29781571/new-approach-to-accurate-interpretation-of-sickle-cell-disease-newborn-screening-by-applying-multiple-of-median-cutoffs-and-ratios
#17
Bichr Allaf, Franck Patin, Jacques Elion, Nathalie Couque
BACKGROUND: The main goal of newborn screening (NBS) for sickle cell disease (SCD) is to detect affected neonates so that specific preventive care can be implemented. High-performance liquid chromatography (HPLC) used for NBS has high sensitivity and specificity, but we lack guidelines for quantitative hemoglobin (Hb) fraction interpretation. The purpose of this study was to determine cutoff values to standardize quantitative interpretation in SCD NBS for different clinical situation such as, red blood cell transfusion or beta-thalassemia, which can be real screening pitfalls...
May 21, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29780601/a-comparison-of-apache-ii-bisap-ranson-s-score-and-modified-ctsi-in-predicting-the-severity-of-acute-pancreatitis-based-on-the-2012-revised-atlanta-classification
#18
Anubhav Harshit Kumar, Mahavir Singh Griwan
Objective: Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Bedside Index of Severity in Acute Pancreatitis (BISAP), Ranson's score and modified Computed Tomography Severity Index (CTSI) in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India. Methods: Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29780244/severity-of-acidosis-affects-long-term-survival-in-copd-patients-with-hypoxemia-after-intensive-care-unit-discharge
#19
Sinem Gungor, Feyza Kargin, Ilim Irmak, Fulya Ciyiltepe, Eylem Acartürk Tunçay, Pinar Atagun Guney, Emine Aksoy, Birsen Ocakli, Nalan Adiguzel, Zuhal Karakurt
Background: Patients admitted to the intensive care unit (ICU) with acute respiratory failure (ARF) due to COPD have high mortality and morbidity. Acidosis has several harmful effects on hemodynamics and metabolism, and the current knowledge regarding the relationship between respiratory acidosis severity on the short- and long-term survival of COPD patients is limited. We hypothesized that COPD patients with severe acidosis would have a poorer short- and long-term prognosis compared with COPD patients with mild-to-moderate acidosis...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29780097/-required-support%C3%A3-an-examination-of-the-subjective-quality-of-life-and-related-factors-in-elderly-people-eith-a-high-functional-capacity-who-need-mild-care
#20
Katsuki Nakamura, Yoshiki Abe, Taiga Shibayama, Kikue Hidaka
AIM: We aimed to investigate subjective quality of life (QOL) and related factors in elderly people with a high functional capacity using daycare centers who require support and mild long-term care. METHODS: We collected data on the basic attributes, social background (hobbies, JST-Index of Competence), and subjective QOL (Revision PGC Morale Scale) through interviews with 238 people ≥65 years of age using daycare centers who required support and long-term care (level 1, 2)...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
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