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https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#1
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28213813/waiting-time-variation-in-early-intervention-psychosis-services-longitudinal-evidence-from-the-sepea-naturalistic-cohort-study
#2
James B Kirkbride, Y Hameed, L Wright, K Russell, C Knight, J Perez, P B Jones
PURPOSE: Early Intervention Psychosis [EIP] services have gained traction internationally, but are currently undergoing various forms of reconfiguration. In England, such services are now mandated to ensure 50% of accepted referrals commence care within 14 days, but no empirical evidence exists. We sought to estimate waiting times to EIP services in a large, representative epidemiological cohort in England, and investigate possible reasons for any variation. METHODS: We estimated median waiting time from referral to acceptance by EIP services and investigated whether this varied by clinical, demographic or neighbourhood-level factors, amongst 798 participants, 16-35 years old, presenting to six EIP services over 3...
February 18, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28213596/white-cell-count-in-the-normal-range-and-short-term-and-long-term-mortality-international-comparisons-of-electronic-health-record-cohorts-in-england-and-new-zealand
#3
Anoop Dinesh Shah, Simon Thornley, Sheng-Chia Chung, Spiros Denaxas, Rod Jackson, Harry Hemingway
OBJECTIVES: Electronic health records offer the opportunity to discover new clinical implications for established blood tests, but international comparisons have been lacking. We tested the association of total white cell count (WBC) with all-cause mortality in England and New Zealand. SETTING: Primary care practices in England (ClinicAl research using LInked Bespoke studies and Electronic health Records (CALIBER)) and New Zealand (PREDICT). DESIGN: Analysis of linked electronic health record data sets: CALIBER (primary care, hospitalisation, mortality and acute coronary syndrome registry) and PREDICT (cardiovascular risk assessments in primary care, hospitalisations, mortality, dispensed medication and laboratory results)...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28212638/commissioning-for-health-improvement-following-the-2012-health-and-social-care-reforms-in-england-what-has-changed
#4
E W Gadsby, S Peckham, A Coleman, D Bramwell, N Perkins, L M Jenkins
BACKGROUND: The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reforms have altered public health commissioning. METHODS: We conducted multi-methods research over 33 months, incorporating national surveys of Directors of Public Health and local council elected members at two time-points, and in-depth case studies in five purposively selected geographical areas...
February 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28212116/developing-a-community-of-practice-for-hiv-care-supporting-knowledge-translation-in-a-regional-training-initiative
#5
Donna M Gallagher, Lisa R Hirschhorn, Laura S Lorenz, Priyatam Piya
INTRODUCTION: Ensuring knowledgeable, skilled HIV providers is challenged by rapid advances in the field, diversity of patients and providers, and the need to retain experienced providers while training new providers. These challenges highlight the need for education strategies, including training and clinical consultation to support translation of new knowledge to practice. New England AIDS Education and Training Center (NEAETC) provides a range of educational modalities including academic peer detailing and distance support to HIV providers in six states...
February 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28210564/more-misinformation-on-breast-cancer-screening
#6
COMMENT
Daniel B Kopans
Unfortunately, a great deal of misinformation has accumulated in the breast cancer screening literature that is based on flawed analyses in an effort to reduce access to screening. Quite remarkably, much of this has come from publications in previously highly respected medical journals. In several papers the intervention (mammography screening) is faulted yet the analyses provided no data on who participated in mammography screening, and which cancers were detected by mammography screening. It is remarkable that a highly respected journal can fault an intervention with no data on the intervention...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28198331/story-in-numbers
#7
(no author information available yet)
New NHS England figures on A&E targets, hospital admissions and delayed transfers of care.
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28196811/the-heart-failure-epidemic-a-uk-perspective
#8
REVIEW
Martin R Cowie
Heart failure is appropriately described as an epidemic, with 1-2% of healthcare expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE) has issued guidance on best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and access to this (with our without biochemical testing using natriuretic peptides) is key to high quality and speedy diagnosis...
February 14, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28196680/trajectories-of-substance-use-frequency-among-adolescents-seen-in-primary-care-implications-for-screening
#9
Scott E Hadland, Sarah H Copelas, Sion K Harris
OBJECTIVE: To identify trajectories of substance use in a prospective cohort of adolescent primary care patients one year after a clinic visit. STUDY DESIGN: We recruited 12- to 18-year-olds from 9 New England practices between 2005 and 2008 and identified 5 trajectories of substance use. We first distinguished adolescents with no past-year use at a baseline clinic visit and at 12-month follow-up (trajectory A). For adolescents who used substances, we assessed past 90-day use at both timepoints, and identified the remaining 4 trajectories based on frequency of use...
February 10, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28196198/en-face-doppler-optical-coherence-tomography-measurement-of-total-retinal-blood-flow-in-diabetic-retinopathy-and-diabetic-macular-edema
#10
ByungKun Lee, Eduardo A Novais, Nadia K Waheed, Mehreen Adhi, Talisa E de Carlo, Emily D Cole, Eric M Moult, WooJhon Choi, Mark Lane, Caroline R Baumal, Jay S Duker, James G Fujimoto
Importance: Alterations in ocular blood flow play an important role in the pathogenesis and progression of diabetic retinopathy (DR). However, the measurement of retinal blood flow in clinical studies has been challenging. En face Doppler optical coherence tomography (OCT) provides an effective method for measuring total retinal blood flow (TRBF) in the clinic. Objective: To investigate TRBF in eyes with DR of varying severity, with or without diabetic macular edema (DME), using en face Doppler OCT...
February 9, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28195910/quality-and-safety-in-health-care-part-xxiii-bypass-leg-surgery
#11
Jay A Harolds
The efforts of the Vascular Quality Initiative of the Society for Vascular Surgery and its regional groups, including the Vascular Study Group of New England, have been very helpful in furthering medical knowledge in multiple areas of vascular surgery and hopefully in improving quality and safety. One of the areas focused on has been leg bypass surgery. The American College of Surgeons National Surgical Quality Improvement Program has also provided information relevant to leg bypass surgery quality improvement, but there are differences between this program and that from the Vascular Quality Initiative...
February 13, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28195908/quality-and-safety-in-health-care-part-xxiv-more-on-vascular-surgery
#12
Jay A Harolds
The use of registries such as the Vascular Quality Initiative and its regional groups, such as the Vascular Study Group of New England, have been very helpful in investigating problems related to quality and safety in vascular surgery. This article discusses some of their contributions regarding carotid artery procedures, the use of certain medications in the perioperative period, and the risk factors for sustaining a major cardiac complication while in the hospital after vascular surgery.
February 13, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28195680/disparities-in-the-incidence-of-acute-myocardial-infarction-long-term-trends-from-the-hunter-region
#13
Allan J Davies, Crystal Naudin, Mohammed Al Omari, Arshad Khan, Chris Oldmeadow, Mark Jones, Bruce Bastian, Rohan Bhagwandeen, Peter Fletcher, James Leitch, Andrew Boyle
BACKGROUND: Trends in the incidence of Acute Myocardial Infarction (AMI) provide important information for health care providers and can allow for accurate planning of future health needs and targeted interventions in areas with an excess burden of cardiovascular disease AIMS: To investigate the regional variations in AMI incidence in the Hunter region METHODS: Incident cases of AMI identified between 1996 and 2013 from the Hunter New England Health Cardiac and Stroke Outcomes Unit were prospectively collected for this study...
February 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28190947/acceptability-of-a-positive-parenting-programme-on-a-mother-and-baby-unit-q-methodology-with-staff
#14
Hannah Butler-Coyne, Dougal Hare, Samantha Walker, Angelika Wieck, Anja Wittkowski
The Baby Triple P Positive Parenting Programme, a new addition to the established Triple P programmes, is currently being considered for a trial in a Mother and Baby Unit with the aim of exploring its benefits to mothers presenting with severe mental illness. The aim of the current study was to investigate staff views of the acceptability and feasibility of a parenting programme such as the Baby Triple P Positive Parenting Programme in a Mother and Baby Unit. Q-methodology, using an 88-item Q-sort, was employed to explore the opinions of 16 staff working in a Mother and Baby Unit in the North West of England...
2017: Journal of Child and Family Studies
https://www.readbyqxmd.com/read/28186939/cardiac-diagnostic-work-up-for-atrial-fibrillation-after-transient-ischaemic-attacks-in-england-and-wales-results-from-a-cross-sectional-survey
#15
Olivia Geraghty, Eleni Korompoki, Filippos T Filippidis, Anthony Rudd, Roland Veltkamp
OBJECTIVES: Transient ischaemic attacks (TIAs) are an important precursor of stroke. Atrial fibrillation (AF) is among the most dangerous aetiologies shared between TIAs and strokes. Detection of AF after TIAs is essential for the initiation of oral anticoagulants. We aimed to identify variations in the use of cardiac investigations used to detect AF and cardiac pathology in patients with TIA in the UK. SETTING: All TIA clinical leads in England and Wales received an invitation by email to participate in an online survey in February 2015...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28183806/commissioning-through-competition-and-cooperation-in-the-english-nhs-under-the-health-and-social-care-act-2012-evidence-from-a-qualitative-study-of-four-clinical-commissioning-groups
#16
Pauline Allen, Dorota Osipovič, Elizabeth Shepherd, Anna Coleman, Neil Perkins, Emma Garnett, Lorraine Williams
OBJECTIVE: The Health and Social Care Act 2012 ('HSCA 2012') introduced a new, statutory, form of regulation of competition into the National Health Service (NHS), while at the same time recognising that cooperation was necessary. NHS England's policy document, The Five Year Forward View ('5YFV') of 2014 placed less emphasis on competition without altering the legislation. We explored how commissioners and providers understand the complex regulatory framework, and how they behave in relation to competition and cooperation...
February 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28178437/gerald-loewi-a-major-contributor-to-the-new-era-of-rheumatology-thinking
#17
Michael Denman
Dr Gerald Loewi was Senior Research Scientist and Consultant Pathologist at the Medical Research Council (MRC) Rheumatism Research Unit at Taplow, England and subsequently the MRC Clinical Research Centre, Harrow, England. An immunologist with a background in pathology, he made major contributions to our understanding of the immunopathology of rheumatoid arthritis and other rheumatic disorders. With his colleagues, he developed a more sophisticated concept of what were initially thought to be primary autoimmune or degenerative diseases but are now recognized as much more complex disease processes...
January 30, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28169922/choroidal-vessel-diameters-in-pseudoexfoliation-and-pseudoexfoliation-glaucoma-analyzed-using-spectral-domain-optical-coherence-tomography
#18
Soshian Sarrafpour, Mehreen Adhi, Jason Y Zhang, Jay S Duker, Chandrasekharan Krishnan
PURPOSE OF THE STUDY: The purpose of the study was to analyze choroidal vessel diameters in pseudoexfoliation (PXF) and pseudoexfoliation glaucoma (PXFG) using spectral-domain optical coherence tomography (SD-OCT). MATERIALS AND METHODS: Fifty patients (100 eyes) with PXF and PXFG who underwent high-definition 1-line raster SD-OCT imaging at New England Eye Center, Boston, were retrospectively identified and divided into unilateral PXFG (26 patients, 52 eyes), unilateral PXF (4 patients, 8 eyes), bilateral PXFG (4 patients, 8 eyes), and bilateral PXF (16 patients, 32 eyes)...
February 6, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28169842/challenges-in-management-of-squamous-cell-carcinoma-of-the-anus-in-new-england-and-across-the-united-states-a-review-of-the-national-cancer-data-base
#19
Victor E Pricolo, Kyle L Viani, Matteo Bonvini, Carlo F Abelli, Tracey J McDuffie
BACKGROUND: Management of squamous cell carcinoma of the anus (SCCA) is becoming more relevant, as its incidence continues to increase. The purpose of this study was to evaluate regional and national data to assess trends in epidemiology, access to cancer center care, and overall management strategies in SCCA. STUDY DESIGN: A review of available data from the American College of Surgeons Committee on Cancer National Cancer Data Base focused on incidence, sex, age, stage at diagnosis, distance traveled for care, and utilization of therapy as first course of treatment (FCT)...
February 6, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28163563/testing-a-brief-substance-misuse-preventive-intervention-for-parents-of-pre-adolescents-feasibility-acceptability-preliminary-efficacy
#20
Margie R Skeer, Konstantina E Yantsides, Misha Eliasziw, Allison Carlton-Smith, Migdalia Tracy, Anthony Spirito
Evidence-based interventions to reduce substance misuse among adolescents are resource and time intensive. We conducted a pilot RCT to evaluate a novel, adaptable, and resource-efficient substance misuse preventive intervention for parents/guardians, focusing on talking with children about substance use and on eating family meals. We randomized 70 parents of children in third-through-sixth grades within a large, urban public school system in New England to the intervention or control condition. Over a six-month follow-up period, we assessed feasibility and acceptability of the intervention and examined frequency of parent-child conversations about alcohol, marijuana, and other drugs, and frequency and duration of family meals...
December 2016: Journal of Child and Family Studies
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