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https://www.readbyqxmd.com/read/28526974/the-health-equity-scholars-program-innovation-in-the-leaky-pipeline
#1
Carole C Upshur, Diedra M Wrighting, Gonzalo Bacigalupe, Joan Becker, Laura Hayman, Barbara Lewis, Sylvia Mignon, Megan E Rokop, Elizabeth Sweet, Marie Idali Torres, Paul Watanabe, Cedric Woods
Despite attempts to increase enrollment of under-represented minorities (URMs: primarily Black/African American, Hispanic/Latino, and Native American students) in health professional programs, limited progress has been made. Compelling reasons to rectify this situation include equity for URMs, better prepared health professionals when programs are diverse, better quality and access to health care for UMR populations, and the need for diverse talent to tackle difficult questions in health science and health care delivery...
May 19, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28526671/telehealth-interventions-to-support-self-management-of-long-term-conditions-a-systematic-metareview-of-diabetes-heart-failure-asthma-chronic-obstructive-pulmonary-disease-and-cancer
#2
REVIEW
Peter Hanlon, Luke Daines, Christine Campbell, Brian McKinstry, David Weller, Hilary Pinnock
BACKGROUND: Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. OBJECTIVE: The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support...
May 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526452/gestational-age-at-initiation-of-17-alpha-hydroxyprogesterone-caproate-and-recurrent-preterm-birth
#3
Angela Ning, Catherine J Vladutiu, Sarah K Dotters-Katz, William H Goodnight, Tracy A Manuck
BACKGROUND: Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality in non-anomalous neonates in the US. Women with a previous early spontaneous PTB are at highest risk for recurrence. Weekly intramuscular 17-alpha hydroxyprogesterone caproate (17-OHPC) reduces the risk of recurrent prematurity. Though current guidelines recommend 17-OHPC initiation between 16-20 weeks', in clinical practice, 17-OHPC is started across a spectrum of gestational ages. OBJECTIVE: To examine the relationship between the gestational age at 17-OHPC initiation and recurrent PTB among women a prior spontaneous PTB 16-28 weeks' gestation...
May 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28526169/the-second-victim-a-review
#4
REVIEW
B Coughlan, D Powell, M F Higgins
Amongst the lay and media population there is a perception that pregnancy, labour and delivery is always physiological, morbidity and mortality should be "never events" and that error is the only cause of adverse events. Those working in maternity care know that it is an imperfect art, where adverse outcomes and errors will occur. When errors do occur, there is a domino effect with three groups being involved - the patient (first victim), the staff (second victims) and the organization (third victims). If the perceived expectation of patients on all clinicians is that of perfection, then clinicians may suffer the consequences of adverse outcomes in isolation and silence...
June 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28526152/pharmacologic-properties-of-novel-local-anesthetic-agents-in-anesthesia-practice
#5
REVIEW
Chih H King, Sascha S Beutler, Alan D Kaye, Richard D Urman
Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526095/improving-hospital-based-end-of-life-care-processes-and-outcomes-a-systematic-review-of-research-output-quality-and-effectiveness
#6
Amy Waller, Natalie Dodd, Martin H N Tattersall, Balakrishnan Nair, Rob Sanson-Fisher
BACKGROUND: As in other areas of health delivery, there is a need to ensure that end-of-life care is guided by patient centred research. A systematic review was undertaken to examine the quantity and quality of data-based research aimed at improving the (a) processes and (b) outcomes associated with delivering end-of-life care in hospital settings. METHODS: Medline, EMBASE and Cochrane databases were searched between 1995 and 2015 for data-based papers. Eligible papers were classified as descriptive, measurement or intervention studies...
May 19, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28526039/influences-on-patient-satisfaction-in-healthcare-centers-a-semi-quantitative-study-over-5%C3%A2-years
#7
Ruth D Thornton, Nicole Nurse, Laura Snavely, Stacey Hackett-Zahler, Kenice Frank, Robert A DiTomasso
BACKGROUND: Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. METHODS: A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28526027/description-of-inter-institutional-referrals-after-admission-for-labor-and-delivery-a-prospective-population-based-cohort-study-in-rural-maharashtra-india
#8
Archana B Patel, Amber Abhijeet Prakash, Camille Raynes-Greenow, Yamini V Pusdekar, Patricia L Hibberd
BACKGROUND: In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28525630/laboratory-integration-and-consolidation-in-a-regional-health-system
#9
Jim Cook
Health systems face intense pressure to decrease costs and improve services as the health care delivery system in the United States undergoes tremendous change due to health care reform. As health systems grow, like any business, they are forced to explore standardization to realize and maintain efficient practices. Clinical services, such as laboratory medicine, are more difficult to integrate due to wider variation in acceptable practice and culture, compared with other services. However, changes to laboratory service are imperative if health care professionals expect to survive and thrive in the new business environment...
May 19, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#10
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#11
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525291/the-state-of-opioid-agonist-therapy-in-canada-20-years-after-federal-oversight
#12
Joseph K Eibl, Kristen Morin, Esa Leinonen, David C Marsh
Opioid agonist therapy was introduced in Canada in 1959 with the use of methadone for the treatment of opioid dependence. The regulation of methadone was the responsibility of Health Canada until 1995, when oversight was transferred to the provincial health systems. During the more than 20 years since the federal health authority transferred oversight of methadone to the provincial level, methadone programming has evolved differently in every province. The landscape of opioid dependence treatment is varied across the country, with generally increasing treatment capacity in all provinces and dramatic increases in some...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28525286/cancer-patient-experience-in-the-teenage-young-adult-population-key-issues-and-trends-over-time-an-analysis-of-the-united-kingdom-national-cancer-patient-experience-surveys-2010-2014
#13
Caroline L Furness, Lesley Smith, Eva Morris, Caroline Brocklehurst, Sasha Daly, Rachael E Hough
Improving outcomes for teenagers and young adults (TYA) with cancer is a key element of the national cancer strategy in England. Recognition of the unique needs of this group has led to the development of recommendations for specific models of care and delivery of this care through the provision of dedicated clinical units in principal treatment centers (PTCs) across the United Kingdom. The aim of this study was to understand the current cancer patient experience for this patient group. We aimed to determine whether treatment experience is influenced by place of treatment and whether it has changed over time using patient-reported data from national cancer patient experience surveys...
May 19, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28524902/health-literacy-assessment-feasibility-in-a-breast-surgical-oncology-clinic%C3%A2
#14
Jessica Keim-Malpass, Aubrey Doede, Christine Kennedy, Shayna L Showalter
Health literacy is recognized as an integral component of high-quality health care. However, health literacy has been understudied in the context of cancer care delivery and surgical decision making. The goal of this article is to outline a process for implementation of a health literacy screening assessment within the routine practices of an academic breast surgical oncology clinic. The self-reported health literacy assessment is feasible, particularly with integration of the health literacy screen in the electronic health record...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28524786/variation-in-management-of-in-hospital-newborn-falls-a-single-center-experience
#15
Doron J Kahn, Paul D Fisher, Dean A Hertzler
OBJECTIVE There are only 3 small case series in the literature that report on the management of in-hospital newborn falls (NFs), and recommendations are unclear. The authors performed a retrospective review to determine outcome and differences in management and to understand why management of NFs varies at their institution. METHODS All NFs occurring within the authors' institution over a 3.5-year period were reviewed. Post-fall management and outcomes of each incident were compared. RESULTS There were 24 NFs out of 40,349 deliveries (5...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28524763/emergency-department-visits-for-postpartum-hypertension
#16
E Christine Brousseau, Valery Danilack, Fei Cai, Kristen Matteson
OBJECTIVE: To describe the characteristics of women diagnosed with postpartum hypertension in an emergency department (ED) to better inform postpartum care. METHODS: Women with an ED diagnosis of hypertension were compared to women with all other ED diagnoses. RESULTS: Among 252 postpartum women who presented for ED care, 52 were given a diagnosis of hypertension. Women with hypertension had some recognizable risk factors and presented on average within one week of delivery...
May 19, 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28524668/emerging-trends-in-micro-and-nanoscale-technologies-in-medicine-from-basic-discoveries-to-translation
#17
Mario M Alvarez, Joanna Aizenberg, Mostafa Analoui, Anne M Andrews, Gili Bisker, Edward S Boyden, Roger D Kamm, Jeffrey M Karp, David J Mooney, Rahmi Oklu, Dan Peer, Michelle Stolzoff, Michael S Strano, Grissel Trujillo-de Santiago, Thomas J Webster, Paul S Weiss, Ali Khademhosseini
We discuss the state of the art and innovative micro- and nanoscale technologies that are finding niches and opening up new opportunities in medicine, particularly in diagnostic and therapeutic applications. We take the design of point-of-care applications and the capture of circulating tumor cells as illustrative examples of the integration of micro- and nanotechnologies into solutions of diagnostic challenges. We describe several novel nanotechnologies that enable imaging cellular structures and molecular events...
May 19, 2017: ACS Nano
https://www.readbyqxmd.com/read/28524616/how-to-implement-live-video-recording-in-the-clinical-environment-a-practical-guide-for-clinical-services
#18
Adam Lloyd, Alistair Dewar, Simon Edgar, Dave Caesar, Paul Gowens, Gareth Clegg
BACKGROUND: The use of video in healthcare is becoming more common, particularly in simulation and educational settings. However, video recording live episodes of clinical care is far less routine. AIM: To provide a practical guide for clinical services to embed live video recording. MATERIALS AND METHODS: Using Kotter's 8-step process for leading change, we provide a 'how to' guide to navigate the challenges required to implement a continuous video-audit system based on our experience of video recording in our emergency department resuscitation rooms...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#19
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28524254/migraine-nurses-in-primary-care-costs-and-benefits
#20
Jan S P van den Berg, Timothy J Steiner, Petra J L Veenstra, Boudewijn J Kollen
OBJECTIVE: We examined the costs and benefits of introducing migraine nurses into primary care. BACKGROUND: Migraine is one of the most costly neurological diseases. METHODS: We analyzed data from our earlier nonrandomized cohort study comparing an intervention group of 141 patients, whose care was supported by nurses trained in migraine management, and a control group of 94 patients receiving usual care. Estimates of per-person direct costs were based on nurses' salaries and referrals to neurologists...
May 19, 2017: Headache
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