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https://www.readbyqxmd.com/read/28351119/biotechnology-and-consumer-decision-making
#1
Joanna K Sax
Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value...
2017: Seton Hall Law Review
https://www.readbyqxmd.com/read/28351118/how-will-repealing-the-aca-affect-medicaid-impact-on-health-care-coverage-delivery-and-payment
#2
Sara Rosenbaum, Sara Rothenberg, Sara Schmucker, Rachel Gunsalus, J. Zoë Beckerman
ISSUE: The Affordable Care Act enhanced Medicaid's role as a health care purchaser by expanding eligibility and broadening the range of tools and strategies available to states. All states have embraced delivery and payment reform as basic elements of their programs. GOAL: To examine the effects of reducing the size and scope of Medicaid under legislation to repeal the ACA. FINDINGS AND CONCLUSIONS: Were the ACA's Medicaid expansion to be eliminated and were federal Medicaid funding to experience major reductions through block grants or per capita caps, the effects on system transformation would be significant...
March 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28351063/from-communication-skills-to-skillful-communication-a-longitudinal-integrated-curriculum-for-critical-care-medicine-fellows
#3
Amanda L Roze des Ordons, Christopher J Doig, Philippe Couillard, Jason Lord
PROBLEM: Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. APPROACH: In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#4
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350948/bending-the-cost-curve-establishing-value-in-spine-surgery
#5
Scott L Parker, Silky Chotai, Clinton J Devin, Lindsay Tetreault, Thomas E Mroz, Darrel S Brodke, Michael G Fehlings, Matthew J McGirt
BACKGROUND: As publically promoted by all stakeholders in health care reform, prospective outcomes registry platforms lie at the center of all current evidence-driven value-based models. OBJECTIVE: To demonstrate the variability in outcomes and cost at population level and individual patient level for patients undergoing spine surgery for degenerative diseases. METHODS: Retrospective analysis of prospective longitudinal spine registry data was conducted...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350942/prevention-of-surgical-site-infection-in-spine-surgery
#6
Paul A Anderson, Jason W Savage, Alexander R Vaccaro, Kristen Radcliff, Paul M Arnold, Brandon D Lawrence, Mohammed F Shamji
BACKGROUND: Spine surgery is complicated by an incidence of 1% to 9% of surgical site infection (SSI). The most common organisms are gram-positive bacteria and are endogenous, that is are brought to the hospital by the patient. Efforts to improve safety have been focused on reducing SSI using a bundle approach. The bundle approach applies many quality improvement efforts and has been shown to reduce SSI in other surgical procedures. OBJECTIVE: To provide a narrative review of practical solutions to reduce SSI in spine surgery...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#7
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350820/antibiotic-prescribing-for-acute-lower-respiratory-tract-infections-lrti-guideline-adherence-in-the-german-primary-care-setting-an-analysis-of-routine-data
#8
Eva Maria Kraus, Steffen Pelzl, Joachim Szecsenyi, Gunter Laux
OBJECTIVES: Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care. METHODS: Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine...
2017: PloS One
https://www.readbyqxmd.com/read/28350667/acellular-hypothermic-extracorporeal-perfusion-extends-allowable-ischemia-time-in-a-porcine-whole-limb-replantation-model
#9
Maximilian Kueckelhaus, Alexander Dermietzel, Muayyad Alhefzi, Mario A Aycart, Sebastian Fischer, Nicco Krezdorn, Luccie Wo, Omar H Maarouf, Leonardo V Riella, Reza Abdi, Ericka M Bueno, Bohdan Pomahac
BACKGROUND: One of the major challenges in traumatic amputation is the need to keep ischemia time brief (4 to 6 hours) to avoid ischemic damage and enable successful replantation. The current inability to meet this challenge often leads to traumatic limb loss, which has a considerable detrimental impact on the quality of life of patients. METHODS: The authors' team built a portable extracorporeal membrane oxygenator device for the perfusion of amputated extremities with oxygenated acellular solution under controlled parameters...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350645/the-use-of-bowel-protocols-in-critically-ill-adult-patients-a-systematic-review-and-meta-analysis
#10
Simon J W Oczkowski, Erick H Duan, Amy Groen, Dawn Warren, Deborah J Cook
OBJECTIVE: Constipation is common among critically ill patients and has been associated with adverse patient outcomes. Many ICUs have developed bowel protocols to treat constipation; however, their effect on clinical outcomes remains uncertain. We conducted a systematic review to determine the impact of bowel protocols in critically ill adults. DATA SOURCES: We searched MEDLINE, Embase, CINAHL, CENTRAL, ISRCTN, ClinicalTrials.gov, and conference abstracts until January 2016...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28350636/the-impact-of-hospital-health-network-affiliation-on-discharge-communication-preferences-of-primary-care-providers
#11
David Y Ming, Alyssa M Stephany, John A Gallis, Benjamin J Powers
Primary care physicians (PCPs) experience differential postdischarge access to electronic health records, depending upon affiliation with the discharging hospital's health network. To better understand whether this affiliation impacts discharge communication preferences, we surveyed a convenience sample of PCPs in and out of our hospital's health network. We also surveyed hospitalists and compared PCPs' and hospitalists' responses. We found that PCP discharge communication preferences differed by hospital health network affiliation...
March 27, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28350632/30-day-readmission-after-spine-surgery-an-analysis-of-1400-consecutive-spine-surgery-patients
#12
Owoicho Adogwa, Aladine A Elsamadicy, Jing L Han, Isaac O Karikari, Joseph Cheng, Carlos A Bagley
STUDY DESIGN: Retrospective cohort review. OBJECTIVE: To identify the rates, causes, and risk factors for 30-day unplanned readmissions in after elective spine surgery at our institution. SUMMARY OF BACKGROUND DATA: Early readmission after spine surgery is being used as a proxy for quality of care. One-fifth of patients are rehospitalized within 30 days after spine surgery. Nearly 60% of these readmissions are unplanned, which translates into billions of dollars in healthcare costs...
April 1, 2017: Spine
https://www.readbyqxmd.com/read/28350561/reducing-pediatric-sternal-wound-infections-a-quality-improvement-project
#13
Claudia Delgado-Corcoran, Charlotte S Van Dorn, Charles Pribble, Emily A Thorell, Andrew T Pavia, Camille Ward, Randall Smout, Susan L Bratton, Phillip T Burch
OBJECTIVES: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery. DESIGN: This is a pre- and postintervention quality improvement study. SETTING: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital. PATIENTS: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included...
March 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28350476/initial-experience-with-honoring-choices-wisconsin-implementation-of-an-advance-care-planning-pilot-in-a-tertiary-care-setting
#14
Wendy L Peltier, Faiz Gani, Jennifer Blissitt, Katherine Walczak, Kristi Opper, Arthur R Derse, Fabian M Johnston
BACKGROUND: Although previous research on advance care planning (ACP) has associated ACP with improved quality of care at the end of life, the appropriate use of ACP remains limited. OBJECTIVE: To evaluate the impact of a pilot program using the "Honoring Choices Wisconsin" (HCW) model for ACP in a tertiary care setting, and to understand barriers to system-wide implementation. DESIGN: Retrospective review of prospectively collected data. SETTING/SUBJECTS: Patients who received medical or surgical oncology care at Froedtert and the Medical College of Wisconsin...
March 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28346948/putting-patients-first-by-reducing-administrative-tasks-in-health-care-a-position-paper-of-the-american-college-of-physicians
#15
Shari M Erickson, Brooke Rockwern, Michelle Koltov, Robert McLean
This American College of Physicians (ACP) position paper, initiated and written by ACP's Medical Practice and Quality Committee and approved by the Board of Regents on 21 January 2017, reports policy recommendations to address the issue of administrative tasks to mitigate or eliminate their adverse effects on physicians, their patients, and the health care system as a whole. The paper outlines a cohesive framework for analyzing administrative tasks through several lenses to better understand any given task that a clinician and his or her staff may be required to perform...
March 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28346851/aquatic-therapy-for-people-with-lymphedema-a-systematic-review-and-meta-analysis
#16
Wai Yeung, Adam I Semciw
BACKGROUND: Aquatic therapy has several proposed benefits for people with lymphedema. A systematic review of the evidence for aquatic therapy in lymphedema management has not been conducted. METHOD AND RESULTS: Systematic review and meta-analysis were conducted. Five electronic databases were searched to identify randomized controlled trials (RCTs) of people with lymphedema, which compared aquatic therapy with other lymphedema interventions. Qualitative analysis was undertaken where quantitative analysis was not possible...
March 27, 2017: Lymphatic Research and Biology
https://www.readbyqxmd.com/read/28346623/family-medicine-maternity-care-call-to-action-moving-toward-national-standards-for-training-and-competency-assessment
#17
Susanna R Magee, W Suzanne Eidson-Ton, Larry Leeman, Michael Tuggy, Thomas O Kim, Melissa Nothnagle, Joseph Breuner, Mark Loafman
Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346622/future-of-family-medicine-faculty-development-in-sub-saharan-africa
#18
Paul R Larson, Patrick Chege, Bruce Dahlman, Christine Gibson, Ann Evensen, Maria C Colon-Gonzalez, Stephanie Onguka, Roberta Lamptey, William E Cayley, Bich-May Nguyen, Brian Johnson, Sawra Getnet, Memoona Hasnain
BACKGROUND AND OBJECTIVES: High-quality family medicine education is needed in sub-Saharan Africa to facilitate the future growth of primary care health systems. Current faculty educators recognize the value of dedicated teacher training and ongoing faculty development. However, they are constrained by inadequate faculty development program availability and institutional support. METHODS: A cross-sectional study design was used to conduct a qualitative needs assessment comprised of 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346620/varied-rates-of-implementation-of-patient-centered-medical-home-features-and-residents-perceptions-of-their-importance-based-on-practice-experience
#19
M Patrice Eiff, Larry A Green, Geoff Jones, Alex Verdieck Devlaeminck, Elaine Waller, Eve Dexter, Miguel Marino, Patricia A Carney
BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346574/size-matters-differences-in-nutritional-care-between-small-medium-and-large-nursing-homes-in-germany
#20
C Burger, E Kiesswetter, A Gietl, U Pfannes, U Arens-Azevedo, C C Sieber, D Volkert
OBJECTIVES: The aim of this study is to comprehensively describe nutritional care in German nursing homes (NHs) and to examine if nutritional care differs between small, medium and large NHs. DESIGN: Nationwide cross-sectional postal survey. SETTING: Nursing homes. PARTICIPANTS: 541 NHs across Germany. MEASUREMENTS: Information on structural NH characteristics and nutritional care (food provision and menu planning, nursing care, and management and quality assurance) was collected by means of a questionnaire addressed to the management of a random sample of German NHs...
2017: Journal of Nutrition, Health & Aging
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