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https://www.readbyqxmd.com/read/29457585/training-nurses-in-a-competency-framework-to-support-adults-with-epilepsy-and-intellectual-disability-the-epaid-cluster-rct
#1
Howard Ring, James Howlett, Mark Pennington, Christopher Smith, Marcus Redley, Caroline Murphy, Roxanne Hook, Adam Platt, Nakita Gilbert, Elizabeth Jones, Joanna Kelly, Angela Pullen, Adrian Mander, Cam Donaldson, Simon Rowe, James Wason, Fiona Irvine
BACKGROUND: People with an intellectual (learning) disability (ID) and epilepsy have an increased seizure frequency, higher frequencies of multiple antiepileptic drug (AED) use and side effects, higher treatment costs, higher mortality rates and more behavioural problems than the rest of the population with epilepsy. The introduction of nurse-led care may lead to improvements in outcome for those with an ID and epilepsy; however, this has not been tested in a definitive clinical trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29457577/space-place-and-waiting-time-reflections-on-health-policy-and-politics
#2
Sally Sheard
Health systems have repeatedly addressed concerns about efficiency and equity by employing trans-national comparisons to draw out the strengths and weaknesses of specific policy initiatives. This paper demonstrates the potential for explicit historical analysis of waiting times for hospital treatment to add value to spatial comparative methodologies. Waiting times and the size of the lists of waiting patients have become key operational indicators. In the United Kingdom, as National Health Service (NHS) financial pressures intensified from the 1970s, waiting times have become a topic for regular public and political debate...
February 19, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29457482/dark-and-bright-two-sides-of-family-centered-care-in-the-nicu-a-qualitative-study
#3
Jila Mirlashari, Sousan Valizadeh, Elham Navab, Jenene W Craig, Fatemeh Ghorbani
Nurses in the Neonatal Intensive Care Unit (NICU) have an important role in implementing family-centered care (FCC). The aim of the study was to explore the lived experiences of NICU nurses on implementing FCC. An interpretative phenomenological study was conducted and 11 employed nurses were interviewed from April 2015 to February 2016. The data were analyzed through the Diekelmann, Allen, and Tanner approach. Four main themes of "strain to achieve stability," "bewildered by taking multiple roles," "accepting the family," and "reaching bright horizon" were extracted...
February 1, 2018: Clinical Nursing Research
https://www.readbyqxmd.com/read/29457244/the-different-moral-bases-of-patient-and-surrogate-decision-making
#4
Daniel Brudney
My topic is a problem with our practice of surrogate decision-making in health care, namely, the problem of the surrogate who is not doing her job-the surrogate who cannot be reached or the surrogate who seems to refuse to understand or to be unable to understand the clinical situation. The analysis raises a question about the surrogate who simply disagrees with the medical team. One might think that such a surrogate is doing her job-the team just doesn't like how she is doing it. My analysis raises the question of whether (or perhaps when) she should be overridden...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457243/raising-the-stakes-for-nondiscrimination-protections-in-the-aca
#5
Kristen Underhill
In the struggle over the durability of the Affordable Care Act, defenders of the ACA stand guard at many fronts. A major contribution of the ACA to nondiscrimination law, however, appears increasingly vulnerable. The ACA established significant new nondiscrimination protections for patients under section 1557 and its implementing regulations. Several of these regulations-including protections on the basis of gender identity and pregnancy termination-are now under reconsideration at the Department of Health and Human Services, after a nationwide injunction lasting almost a year...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457239/patient-care-to-public-health-to-synthetic-biology
#6
EDITORIAL
(no author information available yet)
The January-February 2018 issue of the Hastings Center Report includes pieces addressing patient care concerns that lie at the original core of bioethics and pieces that reflect the field's growing breadth. Among the pieces getting at the original core is an article by philosopher Daniel Brudney on the moral values underpinning surrogate decision-making. The article and the two commentaries that follow it contribute to the debate on the moral authority of surrogate decision-makers. Several items in the issue take up matters of public health and health policy...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457238/rationing-care-through-collaboration-and-shared-values
#7
James E Sabin
Although "rationing" continues to be a dirty word for the public in health policy discourse, Nir Eyal and colleagues handle the concept exactly right in their article in this issue of the Hastings Center Report. They correctly characterize rationing as an ethical requirement, not a moral abomination. They identify the key health policy question as how rationing can best be done, not whether it should be done at all. They make a cogent defense of what they call "rationing through inconvenience" as a justifiable allocational technique...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29455686/cost-utility-analysis-of-private-contracting-to-reduce-public-waiting-times-for-joint-replacement-surgery
#8
Jonathan Karnon, Bahareh Mesgarian Haghighi, Babu Sajjad, Sokunthea Yem, Anuji Gamage, Aaron Thorpe
OBJECTIVES: Earlier treatment of publicly funded patients may achieve health gains that justify the additional costs of reducing waiting times. This study reports on the cost-effectiveness of implementing a private contracting model to meet alternative maximum waiting time targets for publicly funded patients undergoing total knee replacement surgery in Australia. METHODS: A linked decision tree and cohort Markov model was developed and populated and validated using secondary data sources to represent the pathways, costs, and quality adjusted life-years (QALYs) gained of non-urgent patients with alternative waiting times for total knee replacement surgery to a maximum age of 100 years...
February 19, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29454739/spanish-and-catalan-translation-cultural-adaptation-and-validation-of-the-picker-patient-experience-questionnaire-15
#9
M J Bertran, M Viñarás, M Salamero, F Garcia, C Graham, A McCulloch, J Escarrabill
OBJECTIVE: To develop and test a culturally adapted core set of questions to measure patients' experience after in-patient care. MATERIAL AND METHODS: Following the methodology recommended by international guides, a basic set of patient experience questions, selected from Picker Institute Europe questionnaires (originally in English), was translated to Spanish and Catalan. Acceptability, construct validity and reliability of the adapted questionnaire were assessed via a cross-sectional validation study...
February 14, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/29454555/desire-for-patient-centered-hiv-care-among-inconsistently-engaged-racial-and-ethnic-minority-people-living-with-hiv
#10
Jessica Jaiswal, Marybec Griffin-Tomas, Stuart N Singer, Helen-Maria Lekas
Many low-income people of color living with HIV are not virally suppressed. More research is needed to understand how socially marginalized, disengaged, or inconsistently engaged people living with HIV (PLWH) contend with antiretroviral therapy (ART)-related challenges, particularly in the context of interactions with HIV care providers. Twenty-seven semi-structured interviews were conducted with low-income Black and Hispanic PLWH in the New York City area who were currently, or recently, disengaged from outpatient HIV health care at the time of the interview...
January 8, 2018: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/29454383/multidimensional-needs-of-patients-living-and-dying-with-heart-failure-in-kenya-a-serial-interview-study
#11
Kellen N Kimani, Scott A Murray, Liz Grant
BACKGROUND: Heart failure is an emerging challenge for Sub Saharan Africa. However, research on patients' needs and experiences of care is scarce with little evidence available to support and develop services. We aimed to explore the experiences of patients living and dying with heart failure in Kenya. METHODS: We purposively recruited 18 patients admitted with advanced heart failure at a rural district hospital in Kenya. We conducted serial in depth interviews with patients at 0, 3 and 6 months after recruitment, and conducted bereavement interviews with carers...
February 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29453792/impact-of-tsh-during-the-first-trimester-of-pregnancy-on-obstetric-and-fetal-complications-usefulness-of-2-5-miu-l-cut-off-value
#12
Marta Hernández, Carolina López, Berta Soldevila, Laura Cecenarro, María Martínez-Barahona, Elisabet Palomera, Ferran Rius, Albert Lecube, Maria José Pelegay, Jordi García, Dídac Mauricio, Manel Puig Domingo
OBJECTIVE: An association of pregnancy outcomes with subclinical hypothyroidism has been reported, however there still exists a strong controversy regarding whether subclinical hypothyroidism ought to be dealt with or not. The objective of the study was to evaluate the association of fetal-maternal complications with first trimester maternal TSH values. DESIGN: A retrospective study in a single tertiary care hospital was performed. PATIENTS: 1981 pregnant women were studied during 2012...
February 17, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29453507/interprofessional-education-opportunities-and-challenges-for-psychology
#13
Wendy Ward, Alexandra Zagoloff, Cortney Rieck, William Robiner
This manuscript is an outgrowth of an invited panel presentation at the national Association for Psychologists in Academic Health Centers Conference in 2017 on Interprofessional Education (IPE). IPE is a structured and transformative educational strategy designed to provide active learning experiences where trainees from diverse healthcare professions gain shared content knowledge plus collaboration skills as they learn about, from, and with each other. Collaboration skills include understanding professional role distinctions and overlap, effective team-based communication, shared values/ethics and respect for each other's expertise, and teamwork dynamics...
February 16, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29453504/financing-the-primary-care-behavioral-health-model
#14
Dennis S Freeman, Lesley Manson, Jeff Howard, Joel Hornberger
The PCBH model of integrated care blends behavioral health professionals into the primary care team, thereby enhancing the scope of primary care and expanding the range of services provided to the patient. Despite promising evidence in support of the model and a growing number of advocates and practitioners of PCBH integration, current reimbursement policies are not always favorable. As the nation's healthcare system transitions to value-based payment models, new financing strategies are emerging which will further support the viability of PCBH integration...
February 16, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29452702/the-value-proposition-of-simulation-based-education
#15
David A Cook, Dana K Andersen, John R Combes, David L Feldman, Ajit K Sachdeva
Simulation has become an integral part of physician education, and abundant evidence confirms that simulation-based education improves learners' skills and behaviors and is associated with improved patient outcomes. The resources required to implement simulation-based education, however, have led some stakeholders to question the overall value proposition of simulation-based education. This paper summarizes the information from a special panel on this topic and defines research priorities for the field. Future work should focus on both outcomes and costs, with robust measurement of resource investments, provider performance (in both simulation and real settings), patient outcomes, and impact on the health care organization...
February 13, 2018: Surgery
https://www.readbyqxmd.com/read/29452562/deciphering-the-sunshine-act-transparency-regulation-and-financial-conflicts-in-health-care
#16
Richard S Saver
The Physician Payments Sunshine Act ("Sunshine Act"), enacted to address financial conflicts in health care, is the first comprehensive federal legislation mandating public reporting of payments between drug companies, device manufacturers, and medicine. This article analyzes the Sunshine Act's uneven record, exploring how the law serves as an intriguing example of the uncertain case for transparency regulation in health care. The Sunshine Act's bumpy rollout demonstrates that commanding transparency through legislation can be arduous because of considerable implementation challenges...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452268/high-prevalence-of-liver-fibrosis-among-european-adults-with-unknown-liver-disease-a-population-based-study
#17
Llorenç Caballería, Guillem Pera, Ingrid Arteaga, Lluís Rodríguez, Alba Alumà, Rosa Ma Morillas, Napoleón de la Ossa, Alba Díaz, Carmen Expósito, Dolores Miranda, Carmen Sánchez, Rosa Ma Prats, Marta Urquizu, Angels Salgado, Magda Alemany, Alba Martinez, Irfan Majeed, Núria Fabrellas, Isabel Graupera, Ramón Planas, Isabel Ojanguren, Miquel Serra, Pere Torán, Juan Caballería, Pere Ginès
BACKGROUND AND AIMS: Liver fibrosis is the main determinant of long-term outcome in chronic liver diseases. Little is known about prevalence of liver fibrosis in general population. Aim of the study was to investigate the prevalence of liver fibrosis in general adult population with unknown liver disease. METHODS: Population-based, cross-sectional study, performed in Barcelona metropolitan area. Subjects aged 18-75yr were identified randomly from citizens included in primary health care registry...
February 13, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29451814/variability-in-asthma-quality-and-costs-in-children-with-different-medicaid-insurance-plans-in-maricopa-county
#18
Matthew Rank, Natalie Landman, Gevork Harootunian, Michelle Winscott, Neil Jain, Keith Frey, Gena Wilson, Rupali Drewek, Lilia Parra-Roide, Charlton Wilson, Robert Smoldt, Denis Cortese
OBJECTIVE: To describe the variation in asthma quality and costs among children with different Medicaid insurance plans. METHODS: We used 2013 data from the Center for Health Information and Research, which houses a database that includes individuals who have Medicaid insurance in Arizona. We analyzed children ages 2-17 years-old who lived in Maricopa County, Arizona. Asthma medication ratio (AMR, a measure of appropriate asthma medication use), outpatient follow-up within 2 weeks after asthma-related hospitalization (a measure of continuity of care), asthma-related hospitalizations, and all emergency department (ED) visits were the primary quality metrics...
February 16, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29451088/a-marginalized-two-part-model-with-heterogeneous-variance-for-semicontinuous-data
#19
Valerie A Smith, John S Preisser
Semicontinuous data, characterized by a point mass at zero followed by a positive, continuous distribution, arise frequently in medical research. These data are typically analyzed using two-part mixtures that separately model the probability of incurring a positive outcome and the distribution of positive values among those who incur them. In such a conditional specification, however, standard two-part models do not provide a marginal interpretation of covariate effects on the overall population. We have previously proposed a marginalized two-part model that yields more interpretable effect estimates by parameterizing the model in terms of the marginal mean...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29451078/oncologists-perceptions-of-drug-affordability-using-nccn-evidence-blocks-results-from-a-national-survey
#20
Bijal Shah-Manek, William Wong, Arliene Ravelo, Marco DiBonaventura
BACKGROUND: The increasing prevalence of cancer coupled with approvals of new drugs and technologies used in therapy have brought increased scrutiny to the cost and value of treatments in oncology. To address the rising concern about oncology drug costs, several organizations have developed value frameworks to help assess the value of oncology regimens. The objective of this study was to assess oncologists' perceptions, awareness, and knowledge of all oncology value frameworks in the United States and to understand oncologists' perceptions of affordability in the context of National Comprehensive Cancer Network (NCCN) Evidence Blocks...
February 16, 2018: Journal of Managed Care & Specialty Pharmacy
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