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https://www.readbyqxmd.com/read/29324253/a-qualitative-study-comparing-physician-reported-barriers-to-treating-addiction-using-buprenorphine-and-extended-release-naltrexone-in-u-s-office-based-practices
#1
Barbara Andraka-Christou, Matthew J Capone
AIM: Our aim was to compare physician-reported barriers to sublingual buprenorphine (BUP) and extended-release naltrexone (XR-NLT) prescribing in U.S. office-based practices, and to identify potential policies for minimizing these barriers. Only one previous qualitative study has examined physician-reported barriers to prescribing XR-NLT and no qualitative study has compared physician-reported barriers between the two medications. METHODS: Researchers conducted individual semi-structured and in-depth interviews with 20 licensed physicians in four U...
January 8, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29319496/geographic-variations-in-antibiotic-prescription-for-pediatric-acute-upper-respiratory-tract-infections-in-south-korea
#2
Youn Jung, Hyemin Cho, Eunhee Ji, Eun-Ji Park, Sunmee Jang
OBJECTIVE: This study aimed to investigate the factors affecting the geographic differences in antibiotic prescription rates in pediatric upper respiratory tract infections (URI) patients in South Korea. MATERIALS AND METHODS: We performed a nationwide cross-sectional study using 228 administrative districts of Korea, which are the unit of analysis. Prescription rate of antibiotics, the outcome variable, was measured as the proportion of antibiotic prescription days out of total visit days for the treatment of acute URIs using National Health Insurance Service (NHIS) claims data for 2012...
January 10, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29306883/clinical-decisions-presented-to-patients-in-hospital-encounters-a-cross-sectional-study-using-a-novel-taxonomy
#3
Eirik Hugaas Ofstad, Jan C Frich, Edvin Schei, Richard M Frankel, Jūratė Šaltytė Benth, Pål Gulbrandsen
OBJECTIVE: To identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics. DESIGN: Cross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND SETTING: 372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29298708/case-study-of-a-user-driven-prosthetic-arm-design-bionic-hand-versus-customized-body-powered-technology-in-a-highly-demanding-work-environment
#4
Wolf Schweitzer, Michael J Thali, David Egger
BACKGROUND: Prosthetic arm research predominantly focuses on "bionic" but not body-powered arms. However, any research orientation along user needs requires sufficiently precise workplace specifications and sufficiently hard testing. Forensic medicine is a demanding environment, also physically, also for non-disabled people, on several dimensions (e.g., distances, weights, size, temperature, time). METHODS: As unilateral below elbow amputee user, the first author is in a unique position to provide direct comparison of a "bionic" myoelectric iLimb Revolution (Touch Bionics) and a customized body-powered arm which contains a number of new developments initiated or developed by the user: (1) quick lock steel wrist unit; (2) cable mount modification; (3) cast shape modeled shoulder anchor; (4) suspension with a soft double layer liner (Ohio Willowwood) and tube gauze (Molnlycke) combination...
January 3, 2018: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29298365/associations-of-prepregnancy-morbid-obesity-and-prenatal-depression-with-gestational-weight-gain
#5
Hema Chagarlamudi, Juhee Kim, Edward Newton
OBJECTIVES: Pregnancy outcomes and infant growth and development are influenced by various prenatal and postnatal factors. Gestational weight gain (GWG) is an important indicator of pregnancy management and outcomes. Information about the interaction between prenatal obesity and depression on GWG among low-income women is limited. There also is a lack of information about morbid obesity and GWG. The purpose of this study was to examine the associations of prepregnancy weight status, including morbid obesity as a separate group, and prenatal depression with GWG using electronic medical records in an academic prenatal clinic serving a largely low-income population...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29297609/proceedings-beyond-ultrasound-first-forum-on-improving-the-quality-of-ultrasound-imaging-in-obstetrics-and-gynecology
#6
Beryl R Benacerraf, Katherine K Minton, Carol B Benson, Bryann S Bromley, Brian D Coley, Peter M Doubilet, Wesley Lee, Samuel H Maslak, John S Pellerito, James J Perez, Eric Savitsky, Norman A Scarborough, Joseph Wax, Alfred Z Abuhamad
The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The forum brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; in addition to government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound...
January 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29295501/the-herb-drug-pharmacokinetic-interaction-of-5-fluorouracil-and-its-metabolite-5-fluoro-5-6-dihydrouracil-with-a-traditional-chinese-medicine-in-rats
#7
Ju-Han Liu, Yung-Yi Cheng, Chen-Hsi Hsieh, Tung-Hu Tsai
BACKGROUND: Xiang-Sha-Liu-Jun-Zi-Tang (XSLJZT) is the most common traditional formula given to colorectal and breast cancer patients in Taiwan, according to a statistical study of the National Health Insurance Research Database. 5-Fluorouracil (5-FU) is widely used as the first line of treatment for colorectal cancer. Thus, the aim of study is to investigate the pharmacokinetic interaction of XSLJZT and 5-FU. METHODS: To investigate the herb-drug interaction of XSLJZT with 5-FU as well as its metabolite 5-fluoro-5,6-dihydrouracil (5-FDHU) using pharmacokinetics, a high-performance liquid chromatography (HPLC) system coupled with a photodiode array detector was developed to monitor 5-FU and 5-FDHU levels in rat blood...
December 23, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29280052/patient-and-provider-perspectives-on-the-development-of-personalized-medicine-a-mixed-methods-approach
#8
Lauren Puryear, Natalie Downs, Andrea Nevedal, Eleanor T Lewis, Kelly E Ormond, Maria Bregendahl, Carlos J Suarez, Sean P David, Steven Charlap, Isabella Chu, Steven M Asch, Neda Pakdaman, Sang-Ick Chang, Mark R Cullen, Latha Palaniappan
While genetic testing gains adoption in specialty services such as oncology, neurology, and cardiology, use of genetic and genomic testing has yet to be adopted as widely in primary care. The purpose of this study is to identify and compare patient and primary care provider (PCP) expectations of genetics services in primary care. Patient and PCP perspectives were assessed through a mixed-method approach combining an online survey and semi-structured interviews in a primary care department of a large academic medical institution...
December 27, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/29278980/clinic-level-population-health-intervention-by-pgy2-ambulatory-care-pharmacy-residents-to-optimize-medication-management-in-a-self-insured-employer-health-plan-population
#9
Joseph Vande Griend, Danielle R Fixen, Cy W Fixen, Jason Zupec, Joseph J Saseen
BACKGROUND: Postgraduate year 2 ambulatory care pharmacy residents (PGY2 residents) may be able to improve healthcare quality by providing clinical pharmacy services provided to self-insured employer health plan patients. The objectives of this study are to describe this care delivery in a family medicine clinic, and to identify patients most likely to benefit from the service. METHODS: From October 1, 2014 till June 30, 2015, comprehensive medication review was completed by PGY2 residents for patients insured by CU Anthem at the University of Colorado Westminster Family Medicine...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29277629/patterns-and-correlates-of-cervical-cancer-screening-initiation-in-a-large-integrated-healthcare-system
#10
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 United States Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community, and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year-olds between 2000 (2...
December 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29248989/stratified-prevention-opportunities-and-limitations-report-on-the-1st-interdisciplinary-cardiovascular-workshop-in-augsburg
#11
Gregor Kirchhof, Josef Franz Lindner, Stephan Achenbach, Klaus Berger, Stefan Blankenberg, Heiner Fangerau, Henner Gimpel, Ulrich M Gassner, Jens Kersten, Dorothea Magnus, Herbert Rebscher, Heribert Schunkert, Stephan Rixen, Paulus Kirchhof
Sufficient exercise and sleep, a balanced diet, moderate alcohol consumption and a good approach to handle stress have been known as lifestyles that protect health and longevity since the Middle Age. This traditional prevention quintet, turned into a sextet by smoking cessation, has been the basis of the "preventive personality" that formed in the twentieth century. Recent analyses of big data sets including genomic and physiological measurements have unleashed novel opportunities to estimate individual health risks with unprecedented accuracy, allowing to target preventive interventions to persons at high risk and at the same time to spare those in whom preventive measures may not be needed or even be harmful...
December 16, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29248393/primary-care-physicians-decision-making-regarding-initial-oncology-referral-for-adolescents-and-young-adults-with-cancer
#12
Lynne M Gordon, Rebecca H Johnson, Margaret A Au, Shelby L Langer, Karen H Albritton
PURPOSE: The objectives of this study were to determine whether pediatricians are more likely than other primary care physicians (PCPs) to refer newly diagnosed adolescent and young adult patients with cancer to pediatric oncological specialists, and to assess the physician and patient characteristics that affect patterns of referral. METHODS: A cross-sectional vignette survey was mailed to PCPs to examine hypothetical referral decisions as a function of physician characteristics and patient characteristics, including diagnosis, age, gender, race/ethnicity, family support, transportation, insurance, and patient preference for site of care...
December 13, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29246706/how-well-informed-do-patients-feel-about-their-breast-cancer-surgery-options-findings-from-a-nationwide-survey-of-women-after-lumpectomy-and-or-mastectomy
#13
Sunny Mitchell, Jennifer Gass, Michael Hanna
BACKGROUND: Women diagnosed with breast cancer often describe the process of treatment decision making as bewildering and worrisome. Patients who do not feel completely informed about their surgical options might make choices that are suboptimal or regretted later. The Institute of Medicine has called for more research on why breast cancer patients are inadequately informed about treatment options. The aims of the study were to explore how women become informed about their breast cancer surgery treatment options and to identify improvement opportunities...
December 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29241286/-humor-in-medicine-the-art-of-leaping-over-the-shadows
#14
Barbara Wild
Humor and laughter are integral parts of human life and communication - and so of course they occur in medical contacts.Humor is defined as a personality based cognitive emotional style of processing situations, characterized by the ability to find positive aspects even in negative situations, and the ability to communicate this point of view to others and to cheer them up. Humor can support healing processes and coping with illness. Humor and jokes reduce anxiety and stress (for patients and doctors). Humorous people have a more realistic, flexible and less fearful behaviour...
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29240330/regulating-black-box-medicine
#15
W Nicholson Price
Data drive modern medicine. And our tools to analyze those data are growing ever more powerful. As health data are collected in greater and greater amounts, sophisticated algorithms based on those data can drive medical innovation, improve the process of care, and increase efficiency. Those algorithms, however, vary widely in quality. Some are accurate and powerful, while others may be riddled with errors or based on faulty science. When an opaque algorithm recommends an insulin dose to a diabetic patient, how do we know that dose is correct? Patients, providers, and insurers face substantial difficulties in identifying high-quality algorithms; they lack both expertise and proprietary information...
2017: Michigan Law Review
https://www.readbyqxmd.com/read/29239587/redefining-medical-care
#16
Lauren R Roth
President Donald J. Trump has said he will repeal the Affordable Care Act (ACA) and replace it with health savings accounts (HSAs). Conservatives have long preferred individual accounts to meet social welfare needs instead of more traditional entitlement programs. The types of "medical care" that can be reimbursed through an HSA are listed in section 213(d) of the Internal Revenue Code (Code) and include expenses "for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body...
2017: Cornell Journal of Law and Public Policy
https://www.readbyqxmd.com/read/29237654/investigating-the-effect-of-sociodemographic-factors-on-30-day-hospital-readmission-among-medical-patients-in-toronto-canada-a-prospective-cohort-study
#17
Robert W Smith, Kerry Kuluski, Andrew P Costa, Samir K Sinha, Richard H Glazier, Alan Forster, Lianne Jeffs
OBJECTIVE: To examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Patients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control...
December 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29234722/physician-industry-collaboration-organizational-considerations-for-the-future-of-innovation-and-growth-in-dermatology
#18
EDITORIAL
Wendy E Roberts, Neil S Sadick, Wilma F Bergfeld, Amy S Paller, Valerie D Callender, Lynn A Drake
The U.S. medical environment continues to evolve with issues from Privacy to EMR, Insurance regulations, Physician Access and Healthcare Reform, and MACRA (Medicare Access and CHIP Reauthorization Act) on the discussion table. Not since the advent of Medicare and Medicaid in the mid 1960's, have we seen such widespread changes in the medical healthcare environment (Centers for Medicare and Medicaid Services). Physicians, industry, patients and consumers are affected by the changes. These four groups have historically worked as separate entities, but are now key stakeholders in the future of dermatology...
December 2017: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/29234362/chinese-herbal-medicine-as-an-adjunctive-therapy-ameliorated-the-incidence-of-chronic-hepatitis-in-patients-with-breast-cancer-a-nationwide-population-based-cohort-study
#19
Kuo-Chin Huang, Hung-Rong Yen, Jen-Huai Chiang, Yuan-Chih Su, Mao-Feng Sun, Hen-Hong Chang, Sheng-Teng Huang
We conducted a National Health Insurance Research Database-based Taiwanese nationwide population-based cohort study to evaluate whether Chinese herbal medicine (CHM) treatment decreased the incidence of chronic hepatitis in breast cancer patients receiving chemotherapy and/or radiotherapy. A total of 81171 patients were diagnosed with breast cancer within the defined study period. After randomly equal matching, data from 13856 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence and therapeutic potential of CHM in patients with breast cancer...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29230550/-acupuncture-covered-by-statutory-health-insurance-in-germany-an-observational-study-based-on-claims-data
#20
L Hickstein, S Kiel, C Raus, S Heß, J Walker, J-F Chenot
BACKGROUND: The coverage for acupuncture for chronic lower back or knee pain by the statutory health insurance was introduced in 2007. The aim of this study was to investigate characteristics of patients and providers of acupuncture and temporal and regional trends in the utilization of acupuncture. METHODS: This retrospective observational study used anonymized statutory health insurance claims data from a sample of roughly four million subjects. The sample is representative of the German population regarding age and gender in 2013...
December 11, 2017: Der Schmerz
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