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https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#1
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28806455/association-of-state-access-standards-with-accessibility-to-specialists-for-medicaid-managed-care-enrollees
#2
Chima D Ndumele, Michael S Cohen, Paul D Cleary
Importance: Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28806371/transgender-veterans-satisfaction-with-care-and-unmet-health-needs
#3
Keren Lehavot, Jodie G Katon, Tracy L Simpson, Jillian C Shipherd
BACKGROUND: Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. OBJECTIVES: This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. RESEARCH DESIGN: We used data from transgender Veterans collected in 2014 through an online, national survey...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806300/improving-benchmarks-for-global-surgery-nationwide-enumeration-of-operations-performed-in-ghana
#4
Adam Gyedu, Barclay Stewart, Cameron Gaskill, Godfred Boakye, Ebenezer Appiah-Denkyira, Peter Donkor, Ronald Maier, Robert Quansah, Charles Mock
OBJECTIVE: To evaluate the operation rate in Ghana and characterize it by types of procedures and hospital level. BACKGROUND: The Lancet Commission on Global Surgery recommended an annual rate of 5000 operations/100,000 people as a benchmark at which low- and middle-income countries could achieve most of the population-wide benefits of surgery, but did not define procedure-type benchmarks. METHODS: Data on operations performed from June 2014 to May 2015 were obtained from representative samples of 48 of 124 district-level (first-level) hospitals, 9 of 11 regional (referral) hospitals, and 3 of 5 tertiary hospitals, and scaled-up to nationwide estimates...
August 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28806278/ce-original-research-the-experience-of-transitioning-to-a-caregiving-role-for-a-family-member-with-alzheimer-s-disease-or-related-dementia
#5
Kathleen Czekanski
Study findings suggest several areas for further research. ABSTRACT: Background: Alzheimer's disease is a chronic, debilitating disease that currently affects an estimated 5.5 million Americans. The majority are being cared for at home by family caregivers, who are known to have higher levels of burden than any other group of caregivers. PURPOSE: The purpose of this phenomenological study was to explore the lived experiences of people who transition to the role of caregiver for a family member with Alzheimer's disease or a related dementia...
August 10, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28806221/admission-to-intensive-care-for-palliative-care-or-potential-organ-donation-demographics-circumstances-outcomes-and-resource-use
#6
Andrew Melville, Gali Kolt, David Anderson, Joanna Mitropoulos, David Pilcher
OBJECTIVES: To describe the characteristics, circumstances, change over time, resource use, and outcomes of patients admitted to ICUs in Australia and New Zealand for the purposes of "palliative care of a dying patient" or "potential organ donation," and compare with actively managed ICU patients. DESIGN: A retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database and a nested cohort analysis of a single center...
August 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28806038/partnership-strategies-of-community-health-centers-building-capacity-in-good-times-and-bad
#7
Maria-Elena Young, Steven P Wallace, Amy Bonilla, Nadereh Pourat, Michael Rodriguez
Federally Qualified Health Centers--commonly referred to as Community Health Centers (CHCs)--serve as critical safety net providers for those who are uninsured or who may become uninsured. This policy brief reports the findings from the Remaining Uninsured Access to Community Health Centers (REACH) research project, which sought to identify the impact of the Affordable Care Act (ACA) on the ability of CHCs to serve the remaining uninsured. We examined strategies undertaken by CHCs in four states to reinforce the local safety net through partnerships, improvements to the local health system, and advocacy...
July 2017: Policy Brief
https://www.readbyqxmd.com/read/28806026/physician-perceptions-of-barriers-to-advance-care-planning
#8
Lauren Fanta, Jill Tyler
BACKGROUND: Numerous studies have confirmed the importance of advance care planning. Despite the benefits of directed end-of-life discussions, a variety of barriers including discomfort with the topic, physician ideology, lack of time and reimbursement, delaying discussions, and lack of training impede physicians from facilitating these crucial conversations with their patients. This study aims to understand physicians' perceptions to additional barriers to advance care planning with patients and their families...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28805983/challenges-of-measuring-accurate-estradiol-levels-in-aromatase-inhibitor-treated-postmenopausal-breast-cancer-patients-on-vaginal-estrogen-therapy
#9
Polly Niravath, Raksha Bhat, Mohamed Al-Ameri, Ahmed AlRawi, Claudette Foreman, Meghana V Trivedi
Breast cancer patients who are taking adjuvant Aromatase Inhibitor (AI) therapy typically have extremely low estradiol levels, which are undetectable by routine clinical laboratories. Thus, it becomes difficult to assess the safety of interventions such as low-dose vaginal estrogen, which may increase estradiol levels. In this study, we aimed to assess the utility of enzyme-linked immunosorbent assay (ELISA) to measure low estradiol concentrations in breast cancer survivors on AI therapy treated with either vaginal estrogen or lubricant for atrophic vaginitis as a part of clinical trial...
August 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28805961/reducing-branded-prescription-drug-prices-a-review-of-policy-options
#10
G Caleb Alexander, Jeromie Ballreich, Mariana P Socal, Taruja Karmarkar, Antonio Trujillo, Jeremy Greene, Joshua Sharfstein, Gerard Anderson
The high prices of specialty pharmaceuticals are causing some public programs to ration care and many private insurers, including Medicare drug plans, to place specialty drugs on high cost sharing tiers. As a result, access to these drugs is severely restricted, and only a small portion of the population with the disease is receiving treatment. This concern has generated a wide range of proposed solutions. We conducted a literature review and identified fifty-two solutions in the peer reviewed literature that we classified into five broad categories: revising the patent system; encouraging research to increase development of new drugs; altering pharmaceutical regulation; decreasing market demand; and developing innovative pricing strategies...
August 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28805960/factors-associated-with-high-pain-intensity-during-wound-care-procedures-a-model
#11
Sue E Gardner, Linda I Abbott, Catherine A Fiala, Barbara A Rakel
The most common wound care procedures (WPCs) performed on open wounds are dressing changes and wound cleansing. Dressing changes cause moderate to severe pain in 74% of patients, nearly half (36%) of whom experience severe pain (rated as 8-10 on a 10-point numeric rating scale). The purpose of this paper is to propose a model of clinically accessible factors that can be tested in order to develop a clinical tool to identify which patients are likely to experience high intensity pain during nonoperative WCPs, such as dressing changes...
June 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28805702/study-on-the-status-of-health-service-utilization-among-caregivers-of-left-behind-children-in-poor-rural-areas-of-hunan-province-a-baseline-survey
#12
Meimei Ji, Yefu Zhang, Jiaojiao Zou, Tong Yuan, Amber Tang, Jing Deng, Lina Yang, Mingzhi Li, Jihua Chen, Hong Qin, Qian Lin
BACKGROUND: The caregivers of left-behind children (CLBC) in China's poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their health service utilization and to provide a scientific basis for guiding effective implementation of health policy in rural Hunan. METHODS: Random cluster sampling was used to survey CLBC in two rural counties...
August 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28805700/bilp-19-an-ultramicroporous-organic-network-with-exceptional-carbon-dioxide-uptake
#13
Christoph Klumpen, Florian Radakovitsch, Andreas Jess, Jürgen Senker
Porous benzimidazole-based polymers (BILPs) have proven to be promising for carbon dioxide capture and storage. The polarity of their chemical structure in combination with an inherent porosity allows for adsorbing large amounts of carbon dioxide in combination with high selectivities over unpolar guest molecules such as methane and nitrogen. For this reason, among purely organic polymers, BILPs contain some of the most effective networks to date. Nevertheless, they are still outperformed by competitive materials such as metal-organic frameworks (MOFs) or metal doped porous polymers...
August 12, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28805673/alk-status-assessment-with-liquid-biopsies-of-lung-cancer-patients
#14
REVIEW
Paul Hofman
Patients with advanced stage non-small cell lung carcinoma (NSCLC) harboring an anaplastic lymphoma kinase ALK gene rearrangement, detected from a tissue sample, can benefit from targeted ALK inhibitor treatment. However, while treatment is initially effective in most cases, relapse or progression occurs due to different resistance mechanisms including mutations in the tyrosine kinase domain of echinoderm microtubule-associated protein-like 4 (EML44)-ALK. The liquid biopsy concept has recently radically changed the clinical care of NSCLC patients, in particular for those harboring an epidermal growth factor receptor (EGFR) gene mutation...
August 12, 2017: Cancers
https://www.readbyqxmd.com/read/28805545/rural-family-physicians-are-twice-as-likely-to-use-telehealth-as-urban-family-physicians
#15
Anuradha Jetty, Miranda A Moore, Megan Coffman, Stephen Petterson, Andrew Bazemore
BACKGROUND: Telehealth has the potential to reduce health inequities and improve health outcomes among rural populations through increased access to physicians, specialists, and reduced travel time for patients. INTRODUCTION: Although rural telehealth services have expanded in several specialized areas, little is known about the attitudes, beliefs, and uptake of telehealth use in rural American primary care. This study characterizes the differences between rural and urban family physicians (FPs), their perceptions of telehealth use, and barriers to further adoption...
August 14, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28805414/a-culturally-adapted-family-intervention-for-rural-pacific-island-veterans-with-ptsd
#16
Julia M Whealin, Athena C Yoneda, Dawna Nelson, Todd S Hilmes, Michelle M Kawasaki, Oscar H Yan
The Veterans Affairs mission to provide equitable, accessible, and patient-centered care necessitates that culturally appropriate interventions are available when cultural differences may jeopardize engagement in care. However, within the VA, wounded warriors residing in rural areas in the Pacific Islands have been offered interventions that were developed and tested using largely urban mainland populations. The objectives of this article were to (a) document the cultural adaptation of a cognitive-behavioral clinical intervention for use by rural Pacific Island veterans, and (b) report feasibility data for the intervention...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805412/factors-impacting-rural-pacific-island-veterans-access-to-care-a-qualitative-examination
#17
Julia M Whealin, Dawna Nelson, Michelle M Kawasaki, Michael A Mahoney
Pacific Island veterans suffer from greater severity of posttraumatic stress disorder (PTSD) compared with Caucasian veterans but face substantial barriers to mental health care. However, the factors that may dissuade or facilitate veterans in the Pacific Islands from seeking mental health care are not known. The main aim of this study was to identify how internal and external factors interact to impact wounded warriors' access to and use of mental health services. Veterans residing in 5 rural Pacific Island locations were mailed recruitment materials...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805411/rural-american-indian-and-alaska-native-veterans-telemental-health-a-model-of-culturally-centered-care
#18
Cynthia W Goss, W J Buck Richardson, Nancy Dailey, Byron Bair, Herbert Nagamoto, Spero M Manson, Jay H Shore
American Indian and Alaska Native (AI/AN) veterans living in rural areas have unique health care needs and face numerous barriers to accessing health care services. Among these needs is a disproportionate prevalence of posttraumatic stress disorder and other mental illnesses. Since 2001, 14 rural communities have partnered with the U.S. Department of Veterans Affairs and the Centers for American Indian and Alaska Native Health at the University of Colorado Anschutz Medical Campus to extend telemental health clinics to American Indian veterans...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805410/american-akicita-indigenous-american-warriors-and-military-service
#19
J Douglas McDonald
Indigenous Americans (i.e., Native/American Indians, AK natives, Pacific Islanders) have consistently volunteered for military service at greater rates than any other ethnic group, including the majority culture, since the early days of the country. This article is an introduction to the special section which includes a number of outstanding papers that provide an innovative and compelling effort to overcome the challenges of casualties from war and render effective and culturally informed care. These manuscripts describe culturally appropriate considerations of suicide (O'Keefe), family involvement and access to care (Whealin), and telehealth for treatment of rural Native veterans (Goss)...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805405/understanding-integrated-mental-health-care-in-real-world-primary-care-settings-what-matters-to-health-care-providers-and-clients-for-evaluation-and-improvement
#20
Allyson Ion, Nadiya Sunderji, Gwen Jansz, Abbas Ghavam-Rassoul
PURPOSE: The integration of mental health specialists into primary care has been widely advocated to deliver evidence-based mental health care to a defined population while improving access, clinical outcomes, and cost efficiency. Integrated care has been infrequently and inconsistently translated into real-world settings; as a result, the key individual components of effective integrated care remain unclear. METHOD: This article reports findings from a qualitative study that explored provider and client experiences of integrated care...
August 14, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
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