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https://www.readbyqxmd.com/read/28728524/what-s-at-stake-in-u-s-health-reform-a-guide-to-the-affordable-care-act-and-value-based-care
#1
Betty A Rambur
The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to "repeal and replace on day one"; Republican congressional leaders' more temperate suggestions in the first weeks of the Trump administration to "repair" the Affordable Care Act (ACA); and President Trump's February 5, 2017 statement-16 days after inauguration-that a Republican replacement for the ACA may not be ready until late 2017 or 2018...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28727900/head-midline-position-for-preventing-the-occurrence-or-extension-of-germinal-matrix-intraventricular-hemorrhage-in-preterm-infants
#2
REVIEW
Olga Romantsik, Maria Grazia Calevo, Matteo Bruschettini
BACKGROUND: Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular venous drainage on the ipsilateral side while increasing intracranial pressure and cerebral blood volume. Thus, it has been suggested that cerebral venous pressure is reduced and hydrostatic brain drainage improved if the patient is in supine midline position with the bed tilted 30°...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28727629/an-automated-inpatient-split-dose-bowel-preparation-system-improves-colonoscopy-quality-and-reduces-repeat-procedures
#3
Rena Yadlapati, Elyse R Johnston, Adam B Gluskin, Dyanna L Gregory, Rachel Cyrus, Lindsay Werth, Jody D Ciolino, David P Grande, Rajesh N Keswani
BACKGROUND/GOALS: Inpatient colonoscopy preparations are often inadequate, compromising patient safety and procedure quality, while resulting in greater hospital costs. The aims of this study were to: (1) design and implement an electronic inpatient split-dose bowel preparation order set; (2) assess the intervention's impact upon preparation adequacy, repeated colonoscopies, hospital days, and costs. STUDY: We conducted a single center prospective pragmatic quasiexperimental study of hospitalized adults undergoing colonoscopy...
July 19, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28727475/guidance-for-supplemental-enteral-nutrition-across-patient-populations
#4
Douglas L Nguyen
Enteral nutrition is preferred over parenteral nutrition as a result of the greater safety of enteral nutrition therapy and comparative convenience. A wide variety of enteral nutrition products have been developed, including disease-specific products to help manage the nutritional needs of patients with kidney failure, liver failure, lung disease, diabetes, and other conditions. An assessment of each patient's nutritional needs and digestive function should be conducted prior to initiation of enteral nutrition therapy...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28724853/school-based-interventions-aimed-at-the-prevention-and-treatment-of-adolescents-affected-by-the-2011-great-east-japan-earthquake-a-three-year-longitudinal-study
#5
Junko Okuyama, Shunichi Funakoshi, Hiroaki Tomita, Takuhiro Yamaguchi, Hiroo Matsuoka
How natural disasters affect the psychological state of adolescents has not been well studied. Thus, we examined the effect of a natural disaster on high-school-aged youth and considered the most effective forms of support following such a disaster. We examined students from two high schools that were near the epicenter of the 9.0-magnitude Great East Japan Earthquake, which struck the Tohoku coastal area on March 11, 2011, causing severe damage to the region. The questionnaires measuring depression, anxiety, and post-traumatic stress reaction (PTSR) was administered to the students 3 times between July 2012 and August 2014; students who scored above the cut-off values of these measures were considered high-risk students...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28724373/changing-nutrition-care-practices-in-hospital-a-thematic-analysis-of-hospital-staff-perspectives
#6
Celia Laur, Renata Valaitis, Jack Bell, Heather Keller
BACKGROUND: Many patients are admitted to hospital and are already malnourished. Gaps in practice have identified that care processes for these patients can be improved. Hospital staff, including management, needs to work towards optimizing nutrition care in hospitals to improve the prevention, detection and treatment of malnutrition. The objective of this study was to understand how staff members perceived and described the necessary ingredients to support change efforts required to improve nutrition care in their hospital...
July 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28723811/the-afya-bora-fellowship-an-innovative-program-focused-on-creating-an-interprofessional-network-of-leaders-in-global-health
#7
Wendy M Green, Carey Farquhar, Yohana Mashalla
PROBLEM: Most current health professions education programs are focused on the development of clinical skills. As a result, they may not address the complex and interconnected nature of global health. Trainees require relevant clinical, programmatic, and leadership skills to meet the challenges of practicing in an increasingly globalized environment. APPROACH: To develop health care leaders within sub-Saharan Africa, the Afya Bora Consortium developed a one-year fellowship for medical doctors and nurses...
July 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28723722/complementary-and-alternative-medicine-use-and-symptom-burden-in-women-undergoing-chemotherapy-for-breast-cancer-in-malaysia
#8
Ping Lei Chui, Khatijah Lim Abdullah, Li Ping Wong, Nur Aishah Taib
BACKGROUND: Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice. OBJECTIVE: The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy. METHODS: A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients...
July 14, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28722784/the-universal-collaborative-dynamic-model-of-specialist-and-advanced-nursing-and-midwifery-practice-a-way-forward
#9
Laserina O'Connor, Mary Casey, Rita Smith, Gerard Michael Fealy, Denise O' Brien, Denise O'Leary, Diarmuid Stokes, Martin S McNamara, Mary Ellen Glasgow, Andrew Cashin
BACKGROUND: There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish health care system. AIM: The aim of this study was to inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. DESIGN: A qualitative study was conducted to initiate this important area of inquiry...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28720751/exploring-the-perspectives-of-clinical-professionals-and-support-staff-on-implementing-supported-self-management-for-asthma-in-uk-general-practice-an-imp-2-art-qualitative-study
#10
Susan Morrow, Luke Daines, Sharon Wiener-Ogilvie, Liz Steed, Lorna McKee, Ann-Louise Caress, Stephanie J C Taylor, Hilary Pinnock
Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices...
July 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28720452/socioeconomic-predictors-of-human-papillomavirus-vaccination-in-danish-men-a-nationwide-study
#11
Signe Bollerup, Birgitte Baldur-Felskov, Christian Dehlendorff, Susanne K Kjaer
BACKGROUND: The quadrivalent human papillomavirus vaccine was licensed in Denmark in 2006. Unlike women, men are not offered human papillomavirus vaccination free of charge but can have it at their own expense. We investigated human papillomavirus vaccine uptake by men in Denmark and the socioeconomic factors that may predict human papillomavirus vaccination. METHODS: Using the Civil Registration System, we identified all boys and men aged 9-26 years in 2006-2013 and their mothers...
June 2017: Papillomavirus Research
https://www.readbyqxmd.com/read/28720229/perioperative-registered-nurses-knowledge-attitudes-behaviors-and-barriers-regarding-pressure-ulcer-prevention-in-perioperative-patients
#12
Peggy C Tallier, Patricia R Reineke, Kathy Asadoorian, John G Choonoo, Marc Campo, Christine Malmgreen-Wallen
BACKGROUND: Hospital acquired pressure ulcers have a detrimental effect on patient quality of life, morbidity, mortality, and cost to the healthcare industry. Little is known about pressure ulcer prevention in perioperative services. OBJECTIVES: The objectives of this study were to describe perioperative registered nurses (RNs) knowledge, attitudes, behaviors, and barriers about pressure ulcer prevention and to determine if knowledge and the availability of a pressure ulcer staging tool are predictors of pressure ulcer prevention behavior...
August 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#13
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719228/successful-use-of-noninvasive-ventilation-in-chronic-obstructive-pulmonary-disease-how-do-high-performing-hospitals-do-it
#14
Kimberly A Fisher, Kathleen M Mazor, Sarah Goff, Mihaela S Stefan, Penelope S Pekow, Lauren A Williams, Vida Rastegar, Michael B Rothberg, Nicholas S Hill, Peter K Lindenauer
RATIONALE: Noninvasive ventilation (NIV) is a cornerstone of treatment for patients with severe exacerbations of chronic obstructive pulmonary disease (COPD) where it has been shown to reduce the need for intubation, hospital length of stay, and mortality. Despite high quality evidence and strong recommendations in clinical guidelines, use of NIV varies widely across hospitals. OBJECTIVE: To identify approaches used by hospitals which have been successful in implementing NIV to treat patients with severe exacerbations of COPD...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28718188/weaning-premature-infants-from-nasal-continuous-positive-airway-pressure-current-practice-and-scientific-evidence
#15
André Kidszun, Christine Arnold, Julia Winter, Catharina Whybra-Trümpler, Eva Mildenberger
Objective In the past decade, a number of trials have been conducted to determine the optimal strategy of weaning premature infants from nasal continuous airway pressure (nCPAP). However, a paucity of information exists on how weaning is actually performed in clinical routine. Aim of this study was to investigate the current practice of weaning premature infants from nCPAP in Germany. Methods An online survey was performed in German tertiary care neonatal units. Results All 160 German tertiary care units were contacted...
July 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28716949/biochemical-regulatory-features-of-aid-remain-conserved-from-lamprey-to-humans
#16
Emma M Quinlan, Justin J King, Chris T Amemiya, Ellen Hsu, Mani Larijani
Activation induced cytidine deaminase (AID) is a genome-mutating enzyme that initiates class switch recombination and somatic hypermutation of antibodies in jawed vertebrates. We previously described the biochemical properties of human AID and found that it is an unusual enzyme in that it exhibits binding affinities for its substrate DNA and catalytic rates several orders of magnitude higher and lower, respectively, than a typical enzyme. Recently, we solved the functional structure of AID and demonstrated that these properties are due to non-specific DNA binding on its surface, along with a catalytic pocket that predominantly assumes a closed conformation...
July 17, 2017: Molecular and Cellular Biology
https://www.readbyqxmd.com/read/28716108/esoteric-connective-tissue-therapy-for-chronic-low-back-pain-to-reduce-pain-and-improve-functionality-and-general-well-being-compared-with-physiotherapy-study-protocol-for-a-randomised-controlled-trial
#17
Christoph Schnelle, Steffen Messerschmidt, Eunice J Minford, Kate Greenaway-Twist, Maxine Szramka, Marianna Masiorski, Michelle Sheldrake, Mark Jones
BACKGROUND: Low back pain causes more global disability than any other condition. Once the acute pain becomes chronic, about two-thirds of sufferers will not fully recover after 1-2 years. There is a paucity of effective treatments for non-specific, chronic low back pain. It has been noted that low back pain is associated with changes in the connective tissue in the affected area, and a very low-impact treatment, Esoteric Connective Tissue Therapy (ECTT), has been developed to restore flexibility in connective tissue...
July 17, 2017: Trials
https://www.readbyqxmd.com/read/28715122/feasibility-and-acceptability-of-a-telephone-and-face-to-face-delivered-counseling-intervention-for-smoking-cessation-in-dutch-patients-with-coronary-heart-disease
#18
Nadine Berndt, Lilian Lechner, Aart Mudde, Hein De Vries, Catherine Bolman
Intensive behavioral counseling interventions combined with nicotine replacement therapy have increased smoking abstinence rates in cardiac patients, but little is known about their feasibility when initiated upon hospital admission and continued post-discharge. The current study was an evaluation of the use, appreciation, and fidelity of two post-discharge counseling interventions designed for cardiac patients to quit smoking that differed in their delivery mode. In a controlled trial with cross-over randomization at the cardiac unit level, hospitalized smokers in eight cardiac units of eight Dutch hospitals were assigned either telephone counseling (n = 223) or nurse-administered face-to-face counseling (n = 157) using the Ask-Advise-Refer strategy...
July 17, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28715061/physical-activity-assessment-during-gestation-and-its-outcomes-a-review
#19
Wanda Forczek, Marta Curyło, Barbara Forczek
Background: Physical activity recommendations emphasize a positive influence of exercise on health. It is particularly recognized during pregnancy for both the mother and fetus. Aim: This review aims to identify the main trends of activity undertaken by women during gestation and to find out how it affects the expecting mother and her child. Methods: Review of the literature comprising the following databases: PubMed, Academic Search Complete, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition, EMBASE (2000 to May 2013), used detailed search strategies...
July 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28714449/initial-evidence-for-the-reliability-and-validity-of-the-educational-needs-assessment-questionnaire
#20
MyoungJin Kim, Mary J Dyck, Amy Funk
BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the reliability and validity of the revised Educational Needs Assessment (ENA) questionnaire, a 32-item questionnaire designed to assess educational needs of nurses. METHODS: Data were obtained from 317 nursing home nurses in central Illinois and underwent testing for psychometric properties. RESULTS: The principal component analysis yielded a 6-factor solution that explained 65...
December 1, 2016: Journal of Nursing Measurement
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