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https://www.readbyqxmd.com/read/28719758/reflections-on-patient-centered-care-from-the-perspective-of-a-young-otolaryngologist
#1
Nausheen Jamal
It is now well recognized that patient engagement in health care is a key factor in improving satisfaction; however, it is also critical if we are to improve the health outcomes of our patients, as well as the economic and quality outcomes of our health system. Medicine, though, has traditionally resisted a culture of patient-centered or patient-controlled care. What follow are the reflections of one otolaryngologist on the importance and challenges of making the transition to patient-centered care.
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28717651/comparison-of-nonspherical-polyvinyl-alcohol-particles-and-microspheres-for-prostatic-arterial-embolization-in-patients-with-benign-prostatic-hyperplasia
#2
Jin Ho Hwang, Sang Woo Park, Il Soo Chang, Sung Il Jung, Hae Jeong Jeon, Yong Soo Lho, Hyeong Gon Kim, Sung Hyun Paick, Hyoung Keun Park
PURPOSE: To report early results following prostatic artery embolization (PAE) and compare outcomes between nonspherical polyvinyl alcohol (PVA) particles and microspheres to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). METHODS: PAE was performed in nine patients (mean age: 78.1 years) with symptomatic BPH. Embolization was performed using nonspherical PVA particles (250-355 μm) in four patients and microspheres (300-500 μm) in five patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28716519/cost-effectiveness-of-simvastatin-plus-ezetimibe-for-cardiovascular-prevention-in-patients-with-a-history-of-acute-coronary-syndrome-analysis-of-results-of-the-improve-it-trial
#3
Ziyad S Almalki, Jeff Jianfei Guo, Abdullah Alahmari, Nawaf Alotaibi, Hilal Thaibah
BACKGROUND: Simvastatin plus ezetimibe reduced the risk of cardiovascular events in the IMProved Reduction of Outcomes: Vytorin Efficacy International (IMPROVE-IT) study. The aim of this study is to investigate the cost-effectiveness of adding ezetimibe to simvastatin treatment for patients with ACS based on the recently completed IMPROVE-IT trial. METHODS: We constructed a Markov state-transition model to evaluate the costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness (ICER) associated with co-therapy compared with simvastatin alone from a health care perspective...
June 15, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#4
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28711070/female-adolescents-with-chronic-or-end-stage-kidney-disease-and-strategies-for-their-care
#5
Maria E Diaz-Gonzalez De Ferris, Ana Catalina Alvarez-Elías, Michael Ted Ferris, Mara Medeiros
The prevalence of chronic or end-stage kidney disease in pediatric girls is lower than in boys, however, girls have unique morbidities that can have great effect on their quality of life. For female adolescents, creatinine excretion peaks at approximately 14 years of age and is significantly less than males, owing to lower muscle mass. Females have higher nitric oxide activity, and estrogens may contribute to lower blood pressure. Females excrete less growth hormone during the prepubertal and pubertal years...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28707404/sustained-versus-standard-inflations-during-neonatal-resuscitation-to-prevent-mortality-and-improve-respiratory-outcomes
#6
REVIEW
Matteo Bruschettini, Colm Pf O'Donnell, Peter G Davis, Colin J Morley, Lorenzo Moja, Simona Zappettini, Maria Grazia Calevo
BACKGROUND: At birth, infants' lungs are fluid-filled. For newborns to have a successful transition, this fluid must be replaced by air to enable effective breathing. Some infants are judged to have inadequate breathing at birth and are resuscitated with positive pressure ventilation (PPV). Giving prolonged (sustained) inflations at the start of PPV may help clear lung fluid and establish gas volume within the lungs. OBJECTIVES: To assess the efficacy of an initial sustained (> 1 second duration) lung inflation versus standard inflations (≤ 1 second) in newly born infants receiving resuscitation with intermittent PPV...
July 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28707024/experience-of-immediate-ambulation-and-early-discharge-after-tumescent-anesthesia-and-propofol-infusion-in-cosmetic-breast-augmentation
#7
Weiwu Pang, John M Chois, Diana Lambie, Richard Ming-Hui Lin, Zao-Ming Shih
INTRODUCTION: Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol. MATERIALS AND METHODS: Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery...
July 13, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28695714/evaluation-of-specialist-referrals-at-a-rural-health-care-clinic
#8
Mary Ellen Biggerstaff, Nancy Short
PURPOSE: Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. DATA SOURCES: A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers...
July 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28695551/cohort-profile-the-kilombero-and-ulanga-antiretroviral-cohort-kiularco-a-prospective-hiv-cohort-in-rural-tanzania
#9
Emilio Letang, Aneth Vedastus Kalinjuma, Tracy R Glass, Anna Gamell, Herry Mapesi, George Rocky Sikalengo, Lameck Bonaventure Luwanda, Dorcas Mnzava, Alex J Ntamatungiro, Regina Ndaki, Gideon Francis, Fiona Vanobberghen, Hansjakob Furrer, Thomas Klimkait, Ingrid Felger, Marcel Tanner, Christoph Hatz, Maja Weisser, Manuel Battegay, Kiularco Study Group
BACKGROUND: The Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) is a single-site, open and ongoing prospective cohort of people living with human immunodeficiency virus (PLWHIV) established in 2005 at the Chronic Diseases Clinic of Ifakara (CDCI), within the Saint Francis Referral Hospital (SFRH) in Ifakara, Tanzania. The objectives of KIULARCO are to (i) provide patient and cohort-level information on the outcomes of HIV treatment; (ii) provide cohort-level information on opportunistic infections and comorbidities; (iii) evaluate aspects of human immunodeficiency virus (HIV) care and treatment that have national or international policy relevance; (iv) provide a platform for studies on improving HIV care and treatment in sub-Saharan Africa; and (v) contribute to generating local capacity to deal with the challenges posed by the HIV/AIDS pandemic in this region...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28694712/creating-physicians-of-the-21st-century-assessment-of-the-clinical-years
#10
Allison A Vanderbilt, Sara Q Perkins, Moriah K Muscaro, Thomas J Papadimos, Reginald F Baugh
Medical education has been under a constant state of revision for the past several years. The overarching theme of the curriculum revisions for medical schools across the USA has been creating better physicians for the 21st century, with the same end result: graduating medical students at the optimal performance level when entering residency. We propose a robust, thorough assessment process that will address the needs of clerkships, residents, students, and, most importantly, medical schools to best measure and improve clinical reasoning skills that are required for the learning outcomes of our future physicians...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28693548/using-a-linked-database-for-epidemiology-across-the-primary-and-secondary-care-divide-acute-kidney-injury
#11
M Johnson, H Hounkpatin, S Fraser, D Culliford, M Uniacke, P Roderick
BACKGROUND: NHS England has mandated the use in hospital laboratories of an automated early warning algorithm to create a consistent method for the detection of acute kidney injury (AKI). It generates an 'alert' based on changes in serum creatinine level to notify attending clinicians of a possible incident case of the condition, and to provide an assessment of its severity. We aimed to explore the feasibility of secondary data analysis to reproduce the algorithm outside of the hospital laboratory, and to describe the epidemiology of AKI across primary and secondary care within a region...
July 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28689361/reviewing-the-quality-health-benefit-and-value-for-money-of-chemotherapy-and-targeted-therapy-for-metastatic-breast-cancer
#12
REVIEW
Xavier Ghislain Léon Victor Pouwels, Bram L T Ramaekers, Manuela A Joore
PURPOSE: To provide an overview of model characteristics and outcomes of model-based economic evaluations concerning chemotherapy and targeted therapy (TT) for metastatic breast cancer (MBC); to assess the quality of the studies; to analyse the association between model characteristics and study quality and outcomes. METHODS: PubMED and NHS EED were systematically searched. Inclusion criteria were as follows: English or Dutch language, model-based economic evaluation, chemotherapy or TT as intervention, population diagnosed with MBC, published between 2000 and 2014, reporting life years (LY) or quality-adjusted life-year (QALY) and an incremental cost-effectiveness ratio...
July 8, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28684928/end-of-life-transitions-and-hospice-utilization-for-adolescents-does-having-a-usual-source-of-care-matter
#13
Jessica Keim-Malpass, Lisa C Lindley
Adolescents with life-limiting illnesses have intensive end-of-life trajectories and could benefit from initiation of hospice services. The medical home model, which includes having a usual source of primary care, may help facilitate quality outcomes at the end-of-life for adolescents. The purpose of this study was to determine the relationship between having a usual source of primary care on hospice utilization and end-of-life transitions among adolescents between 15-20 years with a life-limiting illness. A retrospective cohort design used 2007-2010 California Medicaid claims data (n=585)...
August 2017: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/28682456/how-hospital-clinicians-select-patients-for-skilled-nursing-facilities
#14
Robert E Burke, Emily Lawrence, Amy Ladebue, Roman Ayele, Brandi Lippmann, Ethan Cumbler, Rebecca Allyn, Jacqueline Jones
OBJECTIVE: To understand how hospital-based clinicians evaluate older adults in the hospital and decide who will be transferred to a skilled nursing facility (SNF) for postacute care. DESIGN: Semistructured interviews paired with a qualitative analytical approach informed by Social Constructivist theory. SETTING: Inpatient care units in three hospitals. Purposive sampling was used to maximize variability in hospitals, units within hospitals, and staff on those units...
July 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28679579/teaching-animal-physiology-a-12-year-experience-transitioning-from-a-classical-to-interactive-approach-with-continual-assessment-and-computer-alternatives
#15
Sonja N Kaisarevic, Silvana A Andric, Tatjana S Kostic
In response to the Bologna Declaration and contemporary trends in Animal Physiology education, the Animal Physiology course at the Faculty of Sciences, University of Novi Sad, Serbia, has evolved over a 12-yr period (2001-2012): from a classical two-semester course toward a one-semester course utilizing computer simulations of animal experiments, continual assessment, lectures, and an optional oral exam. This paper presents an overview of student achievement, the impact of reforms on learning outcomes, and lessons that we as educators learned during this process...
September 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/28674136/a-systematic-review-of-the-cost-and-cost-effectiveness-of-electronic-discharge-communications
#16
Laura K Sevick, Rosmin Esmail, Karen Tang, Diane L Lorenzetti, Paul Ronksley, Matthew James, Maria Santana, William A Ghali, Fiona Clement
BACKGROUND: The transition between acute care and community care can be a vulnerable period in a patients' treatment due to the potential for postdischarge adverse events. The vulnerability of this period has been attributed to factors related to the miscommunication between hospital-based and community-based physicians. Electronic discharge communication has been proposed as one solution to bridge this communication gap. Prior to widespread implementation of these tools, the costs and benefits should be considered...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28671909/effectiveness-of-pharmacist-intervention-to-reduce-medication-errors-and-health-care-resources-utilization-after-transitions-of-care-a-meta-analysis-of-randomized-controlled-trials
#17
Gildasio S De Oliveira, Lucas J Castro-Alves, Mark C Kendall, Robert McCarthy
OBJECTIVES: Medication errors are common during transitions of care. The main objective of the current investigation was to examine the effectiveness of pharmacist-based transition of care interventions on the reduction of medication errors after hospital discharge. METHODS: A systematic search was conducted to detect published reports of randomized trials using the National Library of Medicine's PubMed database, the Cochrane Database of Systematic Reviews, and Google Scholar inclusive to July 1, 2015...
June 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28671907/communication-training-adverse-events-and-quality-measures-2-retrospective-database-analyses-in-washington-state-hospitals
#18
Ian R Slade, Sara J Beck, C Bradley Kramer, Rebecca G Symons, Michael Cusumano, David R Flum, Thomas H Gallagher, Emily Beth Devine
OBJECTIVE: Washington State's HealthPact program was launched in 2011 as part of AHRQ's Patient Safety and Medical Liability Reform initiative. HealthPact delivered interdisciplinary communication training to health-care professionals with the goal of enhancing safety. We conducted 2 exploratory, retrospective database analyses to investigate training impact on the frequency of adverse events (AEs) and select quality measures across 3 time frames: pretraining (2009-2011), transition (2012), and posttraining (2013)...
June 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28668449/outcome-evidence-for-structured-pediatric-to-adult-health-care-transition-interventions-a-systematic-review
#19
Phabinly Gabriel, Margaret McManus, Katherine Rogers, Patience White
OBJECTIVE: To identify statistically significant positive outcomes in pediatric-to-adult transition studies using the triple aim framework of population health, consumer experience, and utilization and costs of care. STUDY DESIGN: Studies published between January 1995 and April 2016 were identified using the CINAHL, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases. Included studies evaluated pre-evaluation and postevaluation data, intervention and comparison groups, and randomized clinic trials...
June 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28666368/cost-effectiveness-of-radiation-and-chemotherapy-for-high-risk-low-grade-glioma
#20
Yushen Qian, Satoshi Maruyama, Haju Kim, Erqi L Pollom, Kiran A Kumar, Alexander L Chin, Jeremy P Harris, Daniel T Chang, Allison Pitt, Eran Bendavid, Douglas K Owens, Ben Y Durkee, Scott G Soltys
BACKGROUND: The addition of PCV (procarbazine, lomustine, vincristine) chemotherapy to radiotherapy (RT) for patients with high-risk (≥ 40 years old or sub-totally resected) low-grade glioma (LGG) results in an absolute median survival benefit of over 5 years. We evaluated the cost-effectiveness of this treatment strategy. METHODS: A decision tree with an integrated three-state Markov model was created to follow patients with high risk LGG after surgery treated with RT vs...
June 28, 2017: Neuro-oncology
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