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https://www.readbyqxmd.com/read/27922912/the-current-overuse-and-misuse-of-meta-analyses-on-sublingual-immunotherapy-the-case-of-grass-pollen-allergy
#1
Erminia Ridolo, Cristoforo Incorvaia, Bruna Luciana Gritti, Giovanni Passalacqua
PURPOSE OF REVIEW: Meta-analysis provides the highest level of evidence-based efficacy of a medical treatment or intervention. Allergen immunotherapy in its two forms of subcutaneous immunotherapy and sublingual immunotherapy (SLIT) is an effective treatment of respiratory allergy as shown by meta-analyses, but in recent years there has been an overflow of meta-analyses on SLIT, with contrasting results that may generate confusion among physicians. RECENT FINDINGS: It can be observed that flaws are often present in meta-analyses including: incorrect selection of trials, inappropriate use of evaluation parameters for the analysis, and unsuitable analyses...
December 5, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27918403/new-hampshire-nurse-practitioners-take-the-lead-in-forming-an-accountable-care-organization
#2
Wendy L Wright
In 2012, New Hampshire nurse practitioners (NPs), along with Anthem Blue Cross/Blue Shield, formed the first Patient Centered Shared Savings Program in the nation, composed of patients managed by nurse practitioners employed within NP-owned and operated clinics. In this accountable care organization (ACO), NP-attributed patients were grouped into one risk pool. Data from the ACO and the NP risk pool, now in its third year, have produced compelling statistics. Nurse practitioners participating in this program have met or exceeded the minimum scores for 29 quality metrics along with a demonstrated cost-savings in the first 2 years of the program...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27917306/education-and-training-of-emergency-medical-teams-recommendations-for-a-global-operational-learning-framework
#3
Nieves Amat Camacho, Amy Hughes, Frederick M Burkle, Pier Luigi Ingrassia, Luca Ragazzoni, Anthony Redmond, Ian Norton, Johan von Schreeb
An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization's Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs...
October 21, 2016: PLoS Currents
https://www.readbyqxmd.com/read/27913910/a-randomized-trial-of-displaying-paid-price-information-on-imaging-study-and-procedure-ordering-rates
#4
Alyna T Chien, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Meredith B Rosenthal, Thomas D Sequist
BACKGROUND: Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. OBJECTIVE: To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). DESIGN: Block randomized controlled trial for 1 year...
December 2, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27906087/legionella-pneumonia-in-the-niagara-region-ontario-canada-a-case-series
#5
Stephanie Cargnelli, Jeff Powis, Jennifer L Y Tsang
BACKGROUND: Legionella pneumophila, a major cause of Legionnaires' disease, accounts for 2-15 % of all community-acquired pneumonia requiring hospitalization and up to 30 % of community-acquired pneumonia requiring intensive care unit admission. Early initiation of appropriate antimicrobial therapy is a crucial step in the prevention of morbidity and mortality. However, recognition of Legionnaires' disease continues to be challenging because of its nonspecific clinical features. We sought to describe hospitalized community-acquired Legionnaires' disease to increase awareness of this important and potentially lethal disease...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27903757/beyond-hand-hygiene-a-qualitative-study-of-the-everyday-work-of-preventing-cross-contamination-on-hospital-wards
#6
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#7
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27896389/-attitudes-and-experiences-regarding-physician-assisted-suicide-a-survey-among-members-of-the-german-association-for-palliative-medicine
#8
Maximiliane Jansky, Birgit Jaspers, Lukas Radbruch, Friedemann Nauck
BACKGROUND: The need to regulate physician-assisted suicide (PAS) and organizations offering assisted suicide has been controversially debated in Germany. Before the German parliament voted on various drafts in November 2015, the German Association for Palliative Medicine surveyed its members on their attitudes and experiences regarding PAS. METHOD: Items for the survey were derived from the literature and consented in a focus group. LITERATURE SEARCH: 2005-2015 - PubMed: PAS [Title/Abstract] UND survey (all countries), grey literature...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27894606/uncomfortable-trade-offs-canadian-policy-makers-perspectives-on-setting-objectives-for-their-health-systems
#9
Julia Abelson, Sara Allin, Michel Grignon, Dianna Pasic, Marjan Walli-Attaei
BACKGROUND: Although a wide range of health system performance indicators are commonly reported on, there has been little effort to establish their relevance to the objectives that health systems actually pursue. OBJECTIVE: The aim of this study was to identify, explore and better understand health policy makers' views regarding the objectives and outcomes for their health systems, how they are prioritized, and the underlying processes that yield them to inform the development of health system efficiency measures...
October 25, 2016: Health Policy
https://www.readbyqxmd.com/read/27886626/describing-clinical-faculty-experiences-with-patient-safety-and-quality-care-in-acute-care-settings-a-mixed-methods-study
#10
Linda Roney, Catherine Sumpio, Audrey M Beauvais, Eileen R O'Shea
BACKGROUND: A major safety initiative in acute care settings across the United States has been to transform hospitals into High Reliability Organizations. The initiative requires developing cognitive awareness, best practices, and infrastructure so that all healthcare providers including clinical faculty are accountable to deliver quality and safe care. OBJECTIVE: To describe the experience of baccalaureate clinical nursing faculty concerning safety and near miss events, in acute care hospital settings...
November 18, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27870686/era-of-a-single-population-based-payment-to-a-cancer-center-delivering-the-value-of-interventional-oncology-in-accountable-care-organizations
#11
Jemianne B Jia, Riccardo Lencioni, Howard P Forman, Hyun S Kim
To curtail increasing health care costs, the government has ushered in the era of the Accountable care organization (ACO). The purposes of this review are to evaluate the effects the ACO will have on the practice of interventional oncology and its role in cancer care and to explore methods to assimilate. Proposed action points include integration into the modern-day cancer center, adoption of an outpatient clinic, mandatory performance measures, and workflow and cost analysis. If adaptations are made, interventional oncology can continue its role in cancer treatment, will provide more effective care, and reach more patients in the new ACO...
November 2016: Cancer Journal
https://www.readbyqxmd.com/read/27870676/bundled-payments-for-care-improvement-lessons-learned-in-the-first-year
#12
Peter L Althausen, Lisa Mead
The Bundled Payments for Care Improvement (BPCI) initiative is the latest cost-saving program developed by the Center for Medicare and Medicaid Innovation. This model is intended to create a system for higher quality and more coordinated care at a lower cost to Medicare. It is currently an optional program for physician groups, hospitals and post-acute care providers to benefit financially from improved care models and cost containment measures. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27864208/payer-view-of-personalized-medicine
#13
Edmund J Pezalla
PURPOSE: The process and methods used by payers when evaluating coverage of personalized medicine testing are described. SUMMARY: Personalized medicine encompasses a number of diagnostic tools that measure drug metabolism, genetic risk for disease development, and tumor type or markers that can guide oncology treatments. However, whole genome testing, tumor marker testing, and testing for drug metabolism are additional costs to the healthcare system. In order to justify these costs, payers and health technology assessment bodies must evaluate the individual tests or groups of tests on their own merits...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27860079/perceptions-of-schizophrenia-and-coping-styles-in-caregivers-comparison-between-india-and-switzerland
#14
S Rexhaj, A E Jose, P Golay, J Favrod
: WHAT IS KNOWN ON THE SUBJECT?: Negative perceptions of illnesses can increase caregivers' use of ineffective coping strategies, which may increase their burdens and distress. Scientific and theoretical framework showed that culture and health organization system influence perception of illnesses and thus also has an impact on the coping strategies used. There is a lack of data on comparative perceptions of illnesses and coping styles between India and Switzerland and that is why this hypothesis needs to be confirmed...
November 2016: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/27859970/barriers-for-guideline-adherence-in-knee-osteoarthritis-care-a-qualitative-study-from-the-patients-perspective
#15
David Spitaels, Patrik Vankrunkelsven, Jurgen Desfosses, Frank Luyten, Sabine Verschueren, Dieter Van Assche, Bert Aertgeerts, Rosella Hermens
RATIONALE, AIMS AND OBJECTIVES: Guidelines for patients with knee osteoarthritis (OA) are suboptimally implemented in clinical care. To improve guideline adherence, patients' perceived barriers and facilitators in current care were investigated. METHODS: Eleven patients with knee OA were extensively interviewed using a semistructured script based on quality indicators. Directed content analysis, within the framework of Grol and Wensing, was performed to describe barriers and facilitators in 6 domains: guideline, health care professional, patient, social environment, organization, and financial context...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27847192/trends-in-1029-trauma-deaths-at-a-level-1-trauma-center-impact-of-a-bleeding-control-bundle-of-care
#16
Blessing T Oyeniyi, Erin E Fox, Michelle Scerbo, Jeffrey S Tomasek, Charles E Wade, John B Holcomb
BACKGROUND: Over the last decade the age of trauma patients and injury mortality has increased. At the same time, many centers have implemented multiple interventions focused on improved hemorrhage control, effectively resulting in a bleeding control bundle of care. The objective of our study was to analyze the temporal distribution of trauma-related deaths, the factors that characterize that distribution and how those factors have changed over time at our urban level 1 trauma center...
November 3, 2016: Injury
https://www.readbyqxmd.com/read/27846324/count-on-this-no-matter-who-wins-the-election
#17
EDITORIAL
John Hickner
The Accountable Care Organization demonstrations around the country have shown that some, but not all, health care organizations are able to bend the steep cost incline downward using incentives, bundled payments, excellent primary care access, and care coordination.
October 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/27845810/communication-between-acute-care-hospitals-and-skilled-nursing-facilities-during-care-transitions-a-retrospective-chart-review
#18
Cheryl Jusela, Laura Struble, Nancy Ambrose Gallagher, Richard W Redman, Rosemary A Ziemba
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS XX contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
November 15, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27843325/the-role-of-the-multidisciplinary-health-care-team-in-the-management-of-patients-with-marfan-syndrome
#19
REVIEW
Yskert von Kodolitsch, Meike Rybczynski, Marina Vogler, Thomas S Mir, Helke Schüler, Kerstin Kutsche, Georg Rosenberger, Christian Detter, Alexander M Bernhardt, Axel Larena-Avellaneda, Tilo Kölbel, E Sebastian Debus, Malte Schroeder, Stephan J Linke, Bettina Fuisting, Barbara Napp, Anna Lena Kammal, Klaus Püschel, Peter Bannas, Boris A Hoffmann, Nele Gessler, Eva Vahle-Hinz, Bärbel Kahl-Nieke, Götz Thomalla, Christina Weiler-Normann, Gunda Ohm, Stefan Neumann, Dieter Benninghoven, Stefan Blankenberg, Reed E Pyeritz
Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS...
2016: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/27836081/local-initiatives-to-access-emergency-obstetric-and-neonatal-care-in-burkina-faso
#20
Wambi M E Yaméogo, Talatou M Ouédraogo, Seni Kouanda
OBJECTIVE: To describe the various local initiatives to access emergency obstetric and neonatal care in Burkina Faso. METHODS: An existing framework was used to review the three processes for local initiatives: emergence, formulation, and implementation. Multiple case studies were conducted, followed by literature review and semi-structured interviews with key informants. RESULTS: Sixteen districts had implemented local initiatives, including cost sharing, free care for women and children, and free care for delivery and cesareans...
November 2016: International Journal of Gynaecology and Obstetrics
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