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https://www.readbyqxmd.com/read/28338572/the-drivers-of-medicare-reimbursement-for-thoracolumbar-fusion-an-analysis-of-data-from-the-centers-for-medicare-and-medicaid-services
#1
Krishn Khanna, Eric M Padegimas, Benjamin Zmistowski, Michael Howley, Kushagra Vema
STUDY DESIGN: Retrospective observational OBJECTIVE.: The purpose of this study is to examine the variation in Thoracolumbar Fusion (TLF) payment and determine the drivers of this variation. SUMMARY OF BACKGROUND DATA: As healthcare spending continues to increase, variation in surgical procedures reimbursements has come under more scrutiny. TLF is an example of a high-cost, proven-benefit procedure that is often the focus of Centers for Medicare and Medicaid Services (CMS) administrators...
March 23, 2017: Spine
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#2
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28337038/pilot-study-of-methods-for-assessing-unmet-secondary-health-care-need-in-new-zealand
#3
Philip Bagshaw, Susan Bagshaw, Christopher Frampton, Robin Gauld, Terri Green, Charlotte Harris, Andrew Hornblow, Ben Hudson, Antony Raymont, Ann Richardson, Carl Shaw, Les Toop
AIMS: In this pilot study, the primary aim was to compare four potential methods for undertaking a national survey of unmet secondary healthcare need in New Zealand (one collecting data from GPs, and three from community surveys). The secondary aim was to obtain an estimate of the prevalence of unmet secondary healthcare need, to inform sample size calculations for a national survey. METHODS: An electronic system was set up for GPs in Christchurch (Pegasus PHO) and Auckland (Auckland PHO) to record cases of unmet need as encountered in clinics...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28336478/an-extended-protocol-for-usability-validation-of-medical-devices-research-design-and-reference-model
#4
Martin Schmettow, Raphaela Schnittker, Jan Maarten Schraagen
This paper proposes and demonstrates an extended protocol for usability validation testing of medical devices. A review of currently used methods for the usability evaluation of medical devices revealed two main shortcomings. Firstly, the lack of methods to closely trace the interaction sequences and derive performance measures. Secondly, a prevailing focus on cross-sectional validation studies, ignoring the issues of learnability and training. The U.S. Federal Drug and Food Administration's recent proposal for a validation testing protocol for medical devices is then extended to address these shortcomings: (1) a novel process measure 'normative path deviations' is introduced that is useful for both quantitative and qualitative usability studies and (2) a longitudinal, completely within-subject study design is presented that assesses learnability, training effects and allows analysis of diversity of users...
March 21, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28335763/identification-of-drug-combinations-administered-by-continuous-subcutaneous-infusion-that-require-analysis-for-compatibility-and-stability
#5
Andrew Dickman, Matthew Bickerstaff, Richard Jackson, Jennifer Schneider, Stephen Mason, John Ellershaw
BACKGROUND: A continuous subcutaneous infusion (CSCI) delivered via syringe pump is a method of drug administration used to maintain symptom control when a patient is no longer able to tolerate oral medication. Several classes of drugs, such as opioids, antiemetics, anticholinergics, antipsychotics and benzodiazepines are routinely administered by CSCI alone or in combinations. Previous studies attempting to identify the most-common CSCI combinations are now several years old and no longer reflect current clinical practice...
March 23, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28334994/rural-retention-of-new-medical-graduates-from-the-collaborative-project-to-increase-production-of-rural-doctors-cpird-a-12-year-retrospective-study
#6
Win Techakehakij, Rajin Arora
Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training tracks. No previous research has examined the rural retention of new medical graduates across the CPIRD tracks, compared with those receiving conventional medical education (Normal track). This study examines the public retention of rural physicians from different tracks of entry...
March 16, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334244/cognitive-screening-tests-versus-comprehensive-neuropsychological-test-batteries-a-national-academy-of-neuropsychology-education-paper%C3%A2
#7
Tresa M Roebuck-Spencer, Tannahill Glen, Antonio E Puente, Robert L Denney, Ronald M Ruff, Gayle Hostetter, Kevin J Bianchini
The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations...
March 10, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28333661/does-your-drug-expertise-include-clinical-pharmaceutics
#8
David W Newton
Whose job is it to protect patients from harm from drug instabilities and incompatibilities and other aspects of clinical pharmaceutics? Pharmacists are better educated via multiple required general and organic chemistry prerequisite and professional curricula medicinal chemistry and pharmaceutics courses. Therefore, no healthcare professional other than pharmacists are nicknamed drug experts or are better formally educated to master drug chemistry in the bottle (i.e., injection stability and compatibility/incompatibility clinical pharmaceutics) as a prerequisite for drug administration to cause safe and effective drug chemistry in the body (i...
May 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28333318/a-phase-iii-randomized-controlled-trial-comparing-the-efficacy-safety-and-tolerability-of-oral-dydrogesterone-versus-micronized-vaginal-progesterone-for-luteal-support-in-in-vitro-fertilization
#9
Herman Tournaye, Gennady T Sukhikh, Elke Kahler, Georg Griesinger
STUDY QUESTION: Is oral dydrogesterone 30 mg daily (10 mg three times daily [TID]) non-inferior to micronized vaginal progesterone (MVP) 600 mg daily (200 mg TID) for luteal support in in vitro fertilization (IVF), assessed by the presence of fetal heartbeats determined by transvaginal ultrasound at 12 weeks of gestation? SUMMARY ANSWER: Non-inferiority of oral dydrogesterone versus MVP was demonstrated at 12 weeks of gestation, with a difference in pregnancy rate and an associated confidence interval (CI) that were both within the non-inferiority margin...
March 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28332780/differentiation-of-patented-crystalline-glucosamine-sulfate-from-other-glucosamine-preparations-will-optimize-osteoarthritis-treatment
#10
REVIEW
Sukit Saengnipanthkul, Saranatra Waikakul, Sattaya Rojanasthien, Kitti Totemchokchyakarn, Attarit Srinkapaibulaya, Tai Cheh Chin, Nguyen Mai Hong, Olivier Bruyère, Cyrus Cooper, Jean-Yves Reginster, Myat Lwin
Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium- to long-term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay joint structural changes. Among SYSADOAs, evidence is greatest for the patented crystalline glucosamine sulfate (pCGS) formulation (Mylan). Glucosamine is widely available as glucosamine sulfate (GS) and glucosamine hydrochloride (GH) preparations that vary substantially in molecular form, pharmaceutical formulation and dose regimen...
March 23, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#11
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28327885/prison-nursing-legal-framework-and-care-reality
#12
H Carrasco-Baún
INTRODUCTION: Penitentiary Nursing has experienced during the last decades a deep transformation similar to that experienced by the rest of the Nursing. However, there is a great distance from the protective legislation. OBJECTIVE: To analyze the main legal documents which regulate the functions of Penitentiary Nursing and to compare it with the health care reality of nurses in Spanish prisons. METHODOLOGY: Narrative bibliographic review based on various sources such as Medline, Cuiden, Scielo, Dialnet, etc...
June 2017: Revista Española de Sanidad Penitenciaria
https://www.readbyqxmd.com/read/28326466/a-cost-minimisation-analysis-comparing-sublingual-immunotherapy-to-subcutaneous-immunotherapy-for-the-treatment-of-house-dust-mite-allergy-in-a-swedish-setting
#13
Åse Björstad, Lars-Olaf Cardell, Julie Hahn-Pedersen, Mikael Svärd
BACKGROUND AND OBJECTIVES: In Sweden, approximately 6% of children and 10% of adults suffer from house dust mite (HDM) allergy with symptoms of allergic rhinitis and allergic asthma. Treatment is aimed at reducing HDM exposure and to control the symptoms of allergic rhinitis and allergic asthma by symptom-relieving pharmacotherapy. This pharmacotherapy is often effective, but some patients remain inadequately controlled. For these patients, allergy immunotherapy (AIT, subcutaneous or sublingual) with repeated administration of HDM allergen should be considered...
March 22, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28325112/potential-of-personal-health-record-portals-in-the-care-of-individuals-with-spinal-cord-injuries-and-disorders-provider-perspectives
#14
Jennifer N Hill, Bridget M Smith, Frances M Weaver, Kim M Nazi, Florian P Thomas, Barry Goldstein, Timothy P Hogan
CONTEXT/OBJECTIVE: Although personal health record (PHR) portals are designed for patients, healthcare providers are a key influence in how patients use their features and realize benefits from them. A few studies have examined provider attitudes toward PHR portals, but none have focused on those who care for individuals with spinal cord injuries and disorders (SCI/D). We characterize SCI/D provider perspectives of PHR portals, including perceived advantages and disadvantages of PHR portal use in SCI/D care...
March 21, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28324793/bureaucratization-and-medical-professionals-values-a-cross-national-analysis
#15
Girts Racko
Understanding the impact of the bureaucratization of governance systems on the occupational values of medical professionals is a fundamental concern of the sociological research of healthcare professions. While previous studies have examined the impact of bureaucratized management, organizations, and healthcare fields on medical professionals' values, there is a lack of cross-national research on the normative impact of the bureaucratized systems of national governance. Using the European Social Survey data for 29 countries, this study examines the impact of the bureaucratization of national governance systems on the occupational values of medical professionals...
March 15, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#16
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28323114/physician-activity-during-outpatient-visits-and-subjective-workload
#17
Alan Calvitti, Harry Hochheiser, Shazia Ashfaq, Kristin Bell, Yunan Chen, Robert El Kareh, Mark T Gabuzda, Lin Liu, Sara Mortensen, Braj Pandey, Steven Rick, Richard L Street, Nadir Weibel, Charlene Weir, Zia Agha
We describe methods for capturing and analyzing EHR use and clinical workflow of physicians during outpatient encounters and relating activity to physicians' self-reported workload. We collected temporally-resolved activity data including audio, video, EHR activity, and eye-gaze along with post-visit assessments of workload. These data are then analyzed through a combination of manual content analysis and computational techniques to temporally align streams, providing a range of process measures of EHR usage, clinical workflow, and physician-patient communication...
March 17, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28322242/psychological-distress-and-user-experiences-with-health-care-provision-in-persons-living-with-spinal-cord-injury-for-more-than-20-years
#18
V M Jakimovska, E Kostovski, F Biering-Sørensen, I B Lidal
STUDY DESIGN: Descriptive cross-sectional and retrospective study. OBJECTIVES: To gain more insight into the long-term health status in persons with traumatic spinal cord injury (SCI), especially perceived psychological distress as well as self-reports of utilization of healthcare services. SETTING: Sunnaas Rehabilitation Hospital, Norway. METHODS: In total, 147 persons with SCI were examined for more than 20 years and interviewed (in 2004/2005) using a self-administrated questionnaire and General Health Questionnaire (GHQ-20)...
March 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28319695/suicidal-ideation-reported-on-the-phq9-and-risk-of-suicidal-behavior-across-age-groups
#19
Rebecca C Rossom, Karen J Coleman, Brian K Ahmedani, Arne Beck, Eric Johnson, Malia Oliver, Greg E Simon
OBJECTIVE: The Joint Commission recommends all patients be screened for suicide. However, differences in suicide attempt and death rates may affect how well tools predict risk across age groups. Our objective was to determine whether item 9 of the Patient Health Questionnaire (PHQ9) predicts risk for suicide attempts and deaths across age groups. METHODS: PHQ9s completed by adult outpatients treated for mental health conditions in 2010-2012 at four Mental Health Research Network-affiliated healthcare systems were used to measure depression severity and suicidal ideation...
March 16, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28319477/emerging-techniques-in-truly-minimal-invasive-treatment-options-of-benign-prostatic-obstruction
#20
Karl-Dietrich Sievert, Thomas Kunit
PURPOSE OF REVIEW: Benign prostatic enlargement is a common age-related condition, affecting over 50% of men aged more than 60 years. Side effects of medical therapy and significant morbidity of transurethral resection of the prostate and open surgery led to the development of so-called minimally invasive procedures, with the aim to be efficient but with less morbidity and shorter or no hospitalization. For this review, a systematic literature was performed. We report recent results in different treatment options for benign prostate hypoplasia (BPH) and recommend the best minimal-invasive treatment for BPH...
March 17, 2017: Current Opinion in Urology
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