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https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#1
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441618/motivation-deficits-and-use-of-alcohol-and-illicit-drugs-among-individuals-with-schizophrenia
#2
Amber L Bahorik, Catherine G Greeno, Gerald Cochran, Jack R Cornelius, Shaun M Eack
This study examined the impact of substance use on intrinsic motivation and evaluated the association between intrinsic motivation and substance use recovery among individuals with schizophrenia. Alcohol and illicit drug use and intrinsic motivation were evaluated at baseline and 6-months for 1434 individuals with schizophrenia from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) using self-rated substance use assessments and a derived motivation measure from the Heinrichs-Carpenter Quality of Life Scale...
April 5, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28441437/quantitative-modeling-of-responses-to-chronic-ionizing-radiation-exposure-using-targeted-and-non-targeted-effects
#3
Igor Shuryak
The biological effects of chronic ionizing radiation exposure can be difficult to study, but important to understand in order to protect the health of occupationally-exposed persons and victims of radiological accidents or malicious events. They include targeted effects (TE) caused by ionizations within/close to nuclear DNA, and non-targeted effects (NTE) caused by damage to other cell structures and/or activation of stress-signaling pathways in distant cells. Data on radiation damage in animal populations exposed over multiple generations to wide ranges of dose rates after the Chernobyl nuclear-power-plant accident are very useful for enhancing our understanding of these processes...
2017: PloS One
https://www.readbyqxmd.com/read/28441097/antismoking-ads-at-the-point-of-sale-the-influence-of-ad-type-and-context-on-ad-reactions
#4
Annice Kim, James Nonnemaker, Jamie Guillory, Paul Shafer, Sarah Parvanta, John Holloway, Matthew Farrelly
Efforts are underway to educate consumers about the dangers of smoking at the point of sale (POS). Research is limited about the efficacy of POS antismoking ads to guide campaign development. This study experimentally tests whether the type of antismoking ad and the context in which ads are viewed influence people's reactions to the ads. A national convenience sample of 7,812 adult current smokers and recent quitters was randomized to 1 of 39 conditions. Participants viewed one of the four types of antismoking ads (negative health consequences-graphic, negative social consequences-intended emotive, benefits of quitting-informational, benefits of quitting-graphic) in one of the three contexts (alone, next to a cigarette ad, POS tobacco display)...
April 25, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28440572/feasibility-of-a-multidisciplinary-intervention-to-help-cancer-patients-return-to-work
#5
M C J Leensen, I F Groeneveld, T Rejda, P Groenenboom, S van Berkel, T Brandon, A G E M de Boer, M H W Frings-Dresen
This study evaluates feasibility of a multidisciplinary intervention combining occupational counselling with physical exercise to enhance cancer patients' return to work, assesses whether care providers and patients were satisfied with the intervention, and describes barriers to and facilitators of execution. Newly diagnosed cancer patients, treated with chemotherapy and on sick leave from (self-)employment participated. Patients received counselling from an oncological occupational physician (OOP), were assessed by a sports physician, and performed a 12-week training programme supervised by physiotherapists...
April 25, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28440105/effect-of-doxazosin-on-stress-reactivity-and-the-ability-to-resist-smoking
#6
Terril L Verplaetse, Andrea H Weinberger, Lindsay M Oberleitner, Kathryn Mz Smith, Brian P Pittman, Julia M Shi, Jeanette M Tetrault, Meaghan E Lavery, Marina R Picciotto, Sherry A McKee
Preclinical findings support a role for α1-adrenergic antagonists in reducing nicotine-motivated behaviors, but these findings have yet to be translated to humans. The current study evaluated whether doxazosin would attenuate stress-precipitated smoking in the human laboratory. Using a well-validated laboratory analogue of smoking-lapse behavior, this pilot study evaluated whether doxazosin (4 and 8 mg/day) versus placebo attenuated the effect of stress (vs neutral imagery) on tobacco craving, the ability to resist smoking and subsequent ad-libitum smoking in nicotine-deprived smokers ( n=35)...
April 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28439796/adjuvant-endocrine-therapy-in-breast-cancer-evolving-paradigms-in-premenopausal-women
#7
REVIEW
Lorenzo Rossi, Olivia Pagani
In the last few years, new adjuvant endocrine treatment options have become available in young women with early breast cancer, such as the addition of ovarian function suppression to tamoxifen or aromatase inhibitors. Treatment duration has been also adapted in the latest guidelines based on the individual risk of recurrence. The oncologist is therefore challenged to precisely assess the risk of recurrence according to currently available predictive and prognostic factors in order to offer the most appropriate therapeutic option to the individual patient, considering also potential side effects, quality of life, pregnancy planning and patients' preferences...
May 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28439787/social-withdrawal-among-individuals-receiving-psychiatric-care-derivation-of-a-scale-using-routine-clinical-assessment-data-to-support-screening-and-outcome-measurement
#8
Sebastian Rios, Christopher M Perlman
Social withdrawal is a symptom experienced by individuals with an array of mental health conditions, particularly those with schizophrenia and mood disorders. Assessments of social withdrawal are often lengthy and may not be routinely integrated within the comprehensive clinical assessment of the individual. This study utilized item response and classical test theory methods to derive a Social Withdrawal Scale (SWS) using items embedded within a routine clinical assessment, the RAI-Mental Health (RAI-MH). Using data from 60,571 inpatients in Ontario, Canada, a common factor analysis identified seven items from the RAI-MH that measure social withdrawal...
April 24, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/28439523/tsallis-entropy-and-sparse-reconstructive-dictionary-learning-for-exudate-detection-in-diabetic-retinopathy
#9
Vineeta Das, Niladri B Puhan
Computer-assisted automated exudate detection is crucial for large-scale screening of diabetic retinopathy (DR). The motivation of this work is robust and accurate detection of low contrast and isolated hard exudates using fundus imaging. Gabor filtering is first performed to enhance exudate visibility followed by Tsallis entropy thresholding. The obtained candidate exudate pixel map is useful for further removal of falsely detected candidates using sparse-based dictionary learning and classification. Two reconstructive dictionaries are learnt using the intensity, gradient, local energy, and transform domain features extracted from exudate and background patches of the training fundus images...
April 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28439403/policy-entrepreneurship-and-policy-networks-in-healthcare-systems-the-case-of-israel-s-pediatric-dentistry-reform
#10
Nissim Cohen, Tuvia Horev
BACKGROUND: Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28439351/residents-exposure-to-educational-experiences-in-facilitating-hospital-discharges
#11
Eric Young, Chad Stickrath, Monica McNulty, Aaron J Calderon, Elizabeth Chapman, Jed D Gonzalo, Ethan F Kuperman, Max Lopez, Christopher J Smith, Joseph R Sweigart, Cecelia N Theobald, Robert E Burke
BACKGROUND: There is an incomplete understanding of the most effective approaches for motivating residents to adopt guideline-recommended practices for hospital discharges. OBJECTIVE: We evaluated internal medicine (IM) residents' exposure to educational experiences focused on facilitating hospital discharges and compared those experiences based on correlations with residents' perceived responsibility for safely transitioning patients from the hospital. METHODS: A cross-sectional, multi-center survey of IM residents at 9 US university- and community-based training programs in 2014-2015 measured exposure to 8 transitional care experiences, their perceived impact on care transitions attitudes, and the correlation between experiences and residents' perceptions of postdischarge responsibility...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439248/effects-of-promotion-and-compunction-interventions-on-real-intergroup-interactions-promotion-helps-but-high-compunction-hurts
#12
Katy Greenland, Dimitrios Xenias, Gregory R Maio
HIGHLIGHTS  We show the promotion intervention has positive effects during intergroup contact, but that high levels of compunction can have negative effects. Intergroup contact is probably the longest standing and most comprehensively researched intervention to reduce discrimination. It is also part of ordinary social experience, and a key context in which discrimination is played out. In this paper, we explore two additional interventions which are also designed to reduce discrimination, but which have not yet been applied to real intergroup interactions...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28439242/comprehensive-psychopathological-assessment-based-on-the-association-for-methodology-and-documentation-in-psychiatry-amdp-system-development-methodological-foundation-application-in-clinical-routine-and-research
#13
REVIEW
Rolf-Dieter Stieglitz, Achim Haug, Erdmann Fähndrich, Michael Rösler, Wolfgang Trabert
The documentation of psychopathology is core to the clinical practice of the psychiatrist and clinical psychologist. However, both in initial as well as further training and specialization in their fields, this particular aspect of their work receives scanty attention only. Yet, for the past 50 years, the Association for Methodology and Documentation in Psychiatry (AMDP) System has been in existence and available as a tool to serve precisely the purpose of offering a systematic introduction to the terminology and documentation of psychopathology...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28439162/evaluating-the-effect-of-minimizing-screws-on-stabilization-of-symphysis-mandibular-fracture-by-3d-finite-element-analysis
#14
Ghias Kharmanda, Mohamed-Yaser Kharma
PURPOSE: The objective of this work is to integrate structural optimization and reliability concepts into mini-plate fixation strategy used in symphysis mandibular fractures. The structural reliability levels are next estimated when considering a single failure mode and multiple failure modes. PATIENTS AND METHODS: A 3-dimensional finite element model is developed in order to evaluate the ability of reducing the negative effect due to the stabilization of the fracture...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28439147/a-semi-parametric-transformation-frailty-model-for-semi-competing-risks-survival-data
#15
Fei Jiang, Sebastien Haneuse
In the analysis of semi-competing risks data interest lies in estimation and inference with respect to a so-called non-terminal event, the observation of which is subject to a terminal event. Multi-state models are commonly used to analyse such data, with covariate effects on the transition/intensity functions typically specified via the Cox model and dependence between the non-terminal and terminal events specified, in part, by a unit-specific shared frailty term. To ensure identifiability, the frailties are typically assumed to arise from a parametric distribution, specifically a Gamma distribution with mean 1...
March 2017: Scandinavian Journal of Statistics, Theory and Applications
https://www.readbyqxmd.com/read/28438728/designing-patient-centered-text-messaging-interventions-for-increasing-physical-activity-among-participants-with-type-2-diabetes-qualitative-results-from-the-text-to-move-intervention
#16
Gabrielle N Horner, Stephen Agboola, Kamal Jethwani, Aswita Tan-McGrory, Lenny Lopez
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a disease affecting approximately 29.1 million people in the United States, and an additional 86 million adults have prediabetes. Diabetes self-management education, a complex health intervention composed of 7 behaviors, is effective at improving self-care behaviors and glycemic control. Studies have employed text messages for education, reminders, and motivational messaging that can serve as "cues to action," aiming to improve glucose monitoring, self-care behaviors, appointment attendance, and medication adherence...
April 24, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28438557/the-isozyme-selective-phosphodiesterase-4-inhibitor-abi-4-attenuates-the-effects-of-lipopolysaccharide-in-human-cells-and-rodent-models-of-peripheral-and-cns-inflammation
#17
Joseph R Hedde, Ashley N Hanks, Christopher J Schmidt, Zoë A Hughes
Inhibitors of phosphodiesterase-4 (PDE4) have been approved for the treatment of inflammatory disorders, but are associated with dose-limiting nausea and vomiting. These side effects are hypothesized to be mediated by inhibition of the PDE4D isozyme. Here we demonstrate the anti-inflammatory effects of the novel brain penetrant PDE4D-sparing PDE4 inhibitor, ABI-4. ABI-4 was a potent (EC50 ∼14 nM) inhibitor of lipopolysaccharide (LPS) induced TNF-α release from mouse microglia and human PBMCs. ABI-4 (0.32 mg/kg) blocked LPS-induced release of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) in blood and brain of mice...
April 21, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28438395/motivation-for-orthognathic-treatment-and-anticipated-satisfaction-levels-a-two-centre-cross-national-audit
#18
Raphael Patcas, Susan J Cunningham, Justin Shute, Timothy Lloyd, Joachim A Obwegeser, Lida Arjomand, Sujata Sharma
PURPOSE: This audit investigated factors which motivate patients to seek orthognathic treatment, assessed how confident patients were that they would be satisfied with the outcome of treatment, and explored possible influencing factors. MATERIALS AND METHODS: Questionnaires were distributed to pre-surgical patients at two centres (United Kingdom and Switzerland); questions asked what patients wished to gain from orthognathic treatment and how confident they were that they would be satisfied with treatment outcome...
March 27, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28438243/factors-which-motivate-the-use-of-social-networks-by-students
#19
Mercedes González Sanmamed, Pablo C Muñoz Carril, Isabel Dans Álvarez de Sotomayor
BACKGROUND: The aim of this research was to identify those factors which motivate the use of social networks by 4th year students in Secondary Education between the ages of 15 and 18. METHOD: 1,144 students from 29 public and private schools took part. The data were analysed using Partial Least Squares Structural Equation Modelling technique. RESULTS: Versatility was confirmed to be the variable which most influences the motivation of students in their use of social networks...
May 2017: Psicothema
https://www.readbyqxmd.com/read/28438240/an-explanatory-model-of-maths-achievement-perceived-parental-involvement-and-academic-motivation
#20
Susana Rodríguez, Isabel Piñeiro, Mª L Gómez-Taibo, Bibiana Regueiro, Iris Estévez, Antonio Valle
BACKGROUND: Although numerous studies have tried to explain performance in maths very few have deeply explored the relationship between different variables and how they jointly explain mathematical performance. METHOD: With a sample of 897 students in 5th and 6th grade in Primary Education and using structural equation modeling (SEM), this study analyzes how the perception of parents’ beliefs is related to children´s beliefs, their involvement in mathematical tasks and their performance...
May 2017: Psicothema
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