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https://www.readbyqxmd.com/read/28431991/molecular-mechanisms-of-trauma-induced-acute-kidney-injury-inflammatory-and-metabolic-insights-from-animal-models
#1
David M Burmeister, Belinda I Gómez, Michael A Dubick
Trauma-induced acute kidney injury (AKI), such as after hemorrhagic shock (HS) or burn, remains a significant problem in the intensive care unit and is associated with increased mortality. The pathophysiology that drives AKI post-trauma is multi factorial, and includes both inflammatory and metabolic alterations. Identifying the systemic profile that contributes to AKI is crucial not only for early diagnosis, but also for identifying treatments that improve kidney function and maintaining long-term patient health...
April 18, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#2
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431546/health-care-public-reporting-utilization-user-clusters-web-trails-and-usage-barriers-on-germany-s-public-reporting-portal-weisse-liste-de
#3
Christoph Pross, Lars-Henrik Averdunk, Josip Stjepanovic, Reinhard Busse, Alexander Geissler
BACKGROUND: Quality of care public reporting provides structural, process and outcome information to facilitate hospital choice and strengthen quality competition. Yet, evidence indicates that patients rarely use this information in their decision-making, due to limited awareness of the data and complex and conflicting information. While there is enthusiasm among policy makers for public reporting, clinicians and researchers doubt its overall impact. Almost no study has analyzed how users behave on public reporting portals, which information they seek out and when they abort their search...
April 21, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28431502/inequalities-in-health-care-utilization-for-common-childhood-illnesses-in-ethiopia-evidence-from-the-2011-ethiopian-demographic-and-health-survey
#4
Asmamaw Atnafu Ayalneh, Dagnachew Muluye Fetene, Tae Jin Lee
BACKGROUND: Globally, 5.9 million children under the age of five died in 2015. More than half and almost one-third of those deaths occurred in sub-Saharan Africa and South Asia, respectively. Diarrhea and Pneumonia, which were the major causes of the problem, accounted for more than two million deaths of the world's youngest children every year. Like other developing countries, child health services utilization is low in Ethiopia. The aim of this study was to identify the determinant factors for the inequalities in medical treatment seeking behavior for common childhood illnesses in Ethiopia...
April 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28430833/on-the-need-for-quantitative-bias-analysis-in-the-peer-review-process
#5
Matthew P Fox, Timothy L Lash
Peer review is central to the process through which epidemiologists generate evidence to inform public health and medical interventions. Reviewers thereby act as critical gatekeepers to high-quality research. They are asked to carefully consider the validity of the proposed work or research findings by paying careful attention to the methodology and critiquing the importance of the insight gained. However, although many have noted problems with the peer-review system for both manuscripts and grant submissions, few solutions have been proposed to improve the process...
April 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28430692/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-postoperative-chronic-opioid-use-among-patients-undergoing-total-knee-arthroplasty-evidence-from-the-marketscan-database
#6
Eric C Sun, Brian T Bateman, Stavros G Memtsoudis, Mark D Neuman, Edward R Mariano, Laurence C Baker
BACKGROUND: Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. METHODS: Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28428922/the-cost-benefit-balance-of-statins-in-hawai-i-a-moving-target
#7
Corey J Lum, Kazuma Nakagawa, Ralph V Shohet, Todd B Seto, Deborah A Taira
Statins are lipid-lowering medications used for primary and secondary prevention of atherosclerotic disease and represent a substantial portion of drug costs in the United States. A better understanding of prescribing patterns and drug costs should lead to more rational utilization and help constrain health care expenditures in the United States. The 2013 Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File for the State of Hawai'i was analyzed. The number of prescriptions for statins, total annual cost, and daily cost were calculated by prescriber specialty and drug...
April 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28427697/health-care-disparities-stemming-from-sexual-orientation-of-italian-patients-with-multiple-sclerosis-a-cross-sectional-web-based-study
#8
Luigi Lavorgna, Marcello Moccia, Antonio Russo, Raffaele Palladino, Lucia Riccio, Roberta Lanzillo, Vincenzo Brescia Morra, Gioacchino Tedeschi, Simona Bonavita
Lesbian, gay, bisexual and transgender (LGBT) patients might experience unique difficulties and barriers to treatment of chronic diseases related to their sexual orientation. Thus, we investigated concerns experienced by LGBT patients with multiple sclerosis (MS). We conducted a web-based survey using a multi-choice questionnaire published in an Italian social-network (www.smsocialnetwork.com) for MS patients. The survey investigated: socio-demographic factors, lifestyle habits, MS-related health status and LGBT specific issues (e...
April 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28427471/quality-of-life-and-healthcare-service-utilization-among-methadone-maintenance-patients-in-a-mountainous-area-of-northern-vietnam
#9
Long Hoang Nguyen, Lan Huong Thi Nguyen, Victoria L Boggiano, Canh Dinh Hoang, Hung Van Nguyen, Huong Thi Le, Hai Quan Le, Tho Dinh Tran, Bach Xuan Tran, Carl A Latkin, Nabil Zary, Minh Thuc Thi Vu
BACKGROUND: The expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam. METHODS: We conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang)...
April 20, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28427367/determinants-of-delayed-care-seeking-for-tb-suggestive-symptoms-in-seru-district-oromiya-region-ethiopia-a-community-based-unmatched-case-control-study
#10
Robel Yirgu, Firaol Lemessa, Selamawit Hirpa, Abraham Alemayehu, Eveline Klinkenberg
BACKGROUND: Early tuberculosis (TB) case finding and adequate chemotherapy are essential for interrupting disease transmission and preventing complications due to delayed care seeking. This study was undertaken in order to provide insights into the magnitude and determinants of patient delay. METHODS: The study was conducted in rural Seru district, employing a population based unmatched case-control study design. The WHO standardized TB screening tool was used to identify presumptive TB cases among the district population ages > 15 years...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28427336/protocol-for-the-home-hazards-removal-program-harp-study-a-pragmatic-randomized-clinical-trial-and-implementation-study
#11
Susan Stark, Emily Somerville, Marian Keglovits, Jane Conte, Melody Li, Yi-Ling Hu, Yan Yan
BACKGROUND: Falls remain the leading cause of injury, long-term disability, premature institutionalization, and injury-related mortality in the older adult population. Home modifications, when delivered by occupational therapists, can reduce falls among high-risk community-dwelling older adults by 39%. However, home-modification implementation is not standard practice in the United States. The goal of the Home Hazard Removal Program (HARP) study is to implement an evidence-based home modification intervention for older adults designed to reduce the incidence of falls through an aging services network...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28427298/recent-advances-in-pediatric-gastrointestinal-endoscopy-an-overview
#12
Salvatore Oliva, Salvatore Cucchiara, Stanley Allen Cohen
Pediatric gastrointestinal endoscopy has become a fundamental component of health care for infants and children. New imaging technologies and creative extraluminal applications have brought exciting and clinically important benefits to pediatric gastrointestinal endoscopy. Areas covered: The impact of different new technologies in pediatric endoscopy and focused on improvements in mucosa visualization and the application of new noninvasive tools and procedures to avoid biopsies or surgery are reviewed. Expert commentary: Enhancement in mucosal visualization and reduction of anesthesia and biopsies are the main goals that guide the endoscopy development in pediatrics...
April 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-pros-into-trauma-registries-the-forte-project
#13
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of post-discharge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project we included patients with an ISS ≥9, admitted to the Brigham and Women's Hospital in Boston, MA who were identified retrospectively using the institutional trauma registry and contacted 6 or 12-months post-injury to participate in a telephone survey evaluating: HRQoL (Short Form-12 [SF-12]), PROs (Trauma Quality of Life [T-QoL]), post-traumatic stress disorder (PTSD), return to work, residential status, and healthcare utilization...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426332/buprenorphine-treatment-and-patient-use-of-health-services-after-the-affordable-care-act-in-an-integrated-health-care-system
#14
Cynthia I Campbell, Sujaya Parthasarathy, Kelly C Young-Wolff, Derek D Satre
The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258)...
April 20, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28424063/clinical-and-cost-effectiveness-analysis-of-early-detection-of-patients-at-nutrition-risk-during-their-hospital-stay-through-the-new-screening-method-cipa-a-study-protocol
#15
José Pablo Suárez-Llanos, Néstor Benítez-Brito, Laura Vallejo-Torres, Irina Delgado-Brito, Adriá Rosat-Rodrigo, Carolina Hernández-Carballo, Yolanda Ramallo-Fariña, Francisca Pereyra-García-Castro, Juan Carlos-Romero, Nieves Felipe-Pérez, Jennifer García-Niebla, Eduardo Mauricio Calderón-Ledezma, Teresa de Jesús González-Melián, Ignacio Llorente-Gómez de Segura, Manuel Ángel Barrera-Gómez
BACKGROUND: Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient's recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28424052/using-implementation-facilitation-to-foster-clinical-practice-quality-and-adherence-to-evidence-in-challenged-settings-a-qualitative-study
#16
Mona J Ritchie, Louise E Parker, Carrie N Edlund, JoAnn E Kirchner
BACKGROUND: We evaluated a facilitation strategy to help clinical sites likely to experience challenges implement evidence-based Primary Care-Mental Health Integration (PC-MHI) care models within the context of a Department of Veterans Affairs (VA) initiative. This article describes our assessment of whether implementation facilitation (IF) can foster development of high quality PC-MHI programs that adhere to evidence, are sustainable and likely to improve clinical practices and outcomes...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28423818/an-approach-for-enhancing-adoption-use-and-utility-of-shared-digital-health-records-in-rural-australian-communities
#17
Helen Almond, Elizabeth Cummings, Paul Turner
Internationally, shared digital health records are considered an important addition to improving modern health care provision. Australia launched its version, My Health Record (MyHR), in 2012 but has experienced low adoption and challenges in practical implementation and evaluation. Individuals living with complex and chronic conditions in rural and remote communities often experience challenges in obtaining equitable access to health care provision. They are also supposed to face additional barriers to adopting and using eHealth services...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423772/integrit-towards-utilizing-the-swedish-national-health-information-exchange-platform-for-clinical-research
#18
Maria Hägglund, Therese Scott Duncan, Karin Kai-Larsen, Gunilla Hedlin, Ingvar Krakau
This paper describes how the Swedish national Health Information Exchange platform can be used to facilitate clinical research in the future. Different e-services for different user groups are being developed using a user-centered design approach. The main user groups are study participants, clinical researchers and healthcare professionals. The different e-services are based on an in-depth analysis of the clinical research process, and the main identified needs relate to recruitment of study participants, access to clinical data from different sources as well as improved tools for patients' self-reporting...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423043/essential-neonatal-care-utilization-and-associated-factors-among-mothers-in-public-health-facilities-of-aksum-town-north-ethiopia-2016
#19
Megbey Berhe, Araya Abraha Medhaniye, Gizienesh Kahsay, Ermyas Birhane, Mebrahtu Abay
BACKGROUND: Globally, neonatal death accounts about 44% of child death in 2013. Ethiopia is one of the ten countries with the highest number of neonatal death. Worldwide, more than 43% of deaths among under five year children is contributed by neonates. Half of the neonatal death occur in the first day of life. Recommendations about newborn care practices may conflict with local beliefs and practices. So, it is important to understand the existing newborn care practice and factors affecting it in order to take interventions so as to decrease neonatal death...
2017: PloS One
https://www.readbyqxmd.com/read/28422894/impact-of-telephone-based-problem-solving-treatment-on-the-use-of-medical-and-psychological-services-in-the-military
#20
John S Richardson, Jesse R Fann, Kathleen R Bell, Nancy Temkin
OBJECTIVE: To explore the impact of problem-solving treatment (PST) for mild traumatic brain injury in active duty service members on the use of medical and psychological services. PARTICIPANTS: Service members who had a mild traumatic brain injury during their last deployment and enrolled in the CONcussion Treatment After Combat Trauma (CONTACT) study. DESIGN: Secondary analysis of a randomized clinical trial. Participants were assigned to telephone-based PST, or e-mailed or mailed education only over the course of 6 months...
April 18, 2017: Journal of Head Trauma Rehabilitation
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