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https://www.readbyqxmd.com/read/28645288/a-cohort-study-of-a-general-surgery-electronic-consultation-system-safety-implications-and-impact-on-surgical-yield
#1
Jesus G Ulloa, Marika D Russell, Alice Hm Chen, Delphine S Tuot
BACKGROUND: Electronic consultation (eConsult) systems have enhanced access to specialty expertise and enhanced care coordination among primary care and specialty care providers, while maintaining high primary care provider (PCP), specialist and patient satisfaction. Little is known about their impact on the efficiency of specialty care delivery, in particular surgical yield (percent of ambulatory visits resulting in a scheduled surgical case). METHODS: Retrospective cohort of a random selection of 150 electronic consults from PCPs to a safety-net general surgery clinic for the three most common general surgery procedures (herniorrhaphy, cholecystectomy, anorectal procedures) in 2014...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28642372/the-highland-health-advocates-a-preliminary-evaluation-of-a-novel-programme-addressing-the-social-needs-of-emergency-department-patients
#2
Lia Ilona Losonczy, Dennis Hsieh, Michael Wang, Christopher Hahn, Tarak Trivedi, Marcela Rodriguez, Jahan Fahimi, Harrison Alter
OBJECTIVES: Patients commonly come to the emergency department (ED) with social needs. To address this, we created the Highland Health Advocates (HHA), an ED-based help desk and medical-legal partnership using undergraduate volunteers to help patients navigate public resources and provide onsite legal and social work referrals. We were able to provide these services in English and Spanish. We aimed to determine the social needs of the patients who presented to our ED and the potential impact of the programme in resolving those needs and connecting them to a 'medical home' (defined as a consistent, primary source of medical care such as a primary care doctor or clinic)...
June 22, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28634904/capsule-commentary-on-balaban-et-al-impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#3
Michael Hochman
No abstract text is available yet for this article.
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28631003/yoga-physical-therapy-or-education-for-chronic-low-back-pain-a-randomized-noninferiority-trial
#4
Robert B Saper, Chelsey Lemaster, Anthony Delitto, Karen J Sherman, Patricia M Herman, Ekaterina Sadikova, Joel Stevans, Julia E Keosaian, Christian J Cerrada, Alexandra L Femia, Eric J Roseen, Paula Gardiner, Katherine Gergen Barnett, Carol Faulkner, Janice Weinberg
Background: Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga's effectiveness in underserved patients with more severe functional disability and pain. Objective: To determine whether yoga is noninferior to PT for cLBP. Design: 12-week, single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase...
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28629348/applying-the-plan-do-study-act-pdsa-approach-to-a-large-pragmatic-study-involving-safety-net-clinics
#5
Jennifer Coury, Jennifer L Schneider, Jennifer S Rivelli, Amanda F Petrik, Evelyn Seibel, Brieshon D'Agostini, Stephen H Taplin, Beverly B Green, Gloria D Coronado
BACKGROUND: The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings, although its documented use in pragmatic clinical research is rare. A recent pragmatic clinical research study, called the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), used this process to optimize the research implementation of an automated colon cancer screening outreach program in intervention clinics. We describe the process of using this PDSA approach, the selection of PDSA topics by clinic leaders, and project leaders' reactions to using PDSA in pragmatic research...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28628003/clinical-effectiveness-and-cost-effectiveness-results-from-the-randomised-phase-iib-trial-in-previously-untreated-patients-with-chronic-lymphocytic-leukaemia-to-compare-fludarabine-cyclophosphamide-and-rituximab-with-fludarabine-cyclophosphamide-mitoxantrone
#6
Dena R Howard, Talha Munir, Lucy McParland, Andy C Rawstron, Anna Chalmers, Walter M Gregory, John L O'Dwyer, Alison Smith, Roberta Longo, Abraham Varghese, Alexandra Smith, Peter Hillmen
BACKGROUND: The conventional frontline therapy for fit patients with chronic lymphocytic leukaemia (CLL) is fludarabine, cyclophosphamide and rituximab (FCR). Rituximab (Mabthera(®), Roche Products Ltd) targets the CD20 antigen, which is expressed at low levels in CLL. The standard dose of rituximab in CLL (375 mg/m(2) in cycle 1 and 500 mg/m(2) in cycles 2-6) was selected based on toxicity data only. Small doses of rituximab (as low as 20 mg) have biological activity in CLL, with an immediate reduction in circulating CLL cells and down-regulation of CD20...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28624037/trauma-care-in-a-multiethnic-population-effects-of-being-undocumented
#7
Jonathan M Wyrick, Brittany A Kalosza, George N Coritsidis, Raymond Tse, George Agriantonis
BACKGROUND: Epidemiologic studies have shown that undocumented immigrants (UIs) display characteristics of having a low socioeconomic status and are primarily of ethnic minorities. These social determinants of health are known to be associated with diminished health care access and poor clinical outcomes. We therefore investigated the impact of documentation status on the clinical outcomes of patients with traumatic injuries. MATERIALS AND METHODS: We conducted a retrospective review of the trauma registry at our safety net institution for all adult patients who were admitted from 2010 to 2014...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623888/ub-isap-a-streamlined-unix-pipeline-for-mining-unique-viral-vector-integration-sites-from-next-generation-sequencing-data
#8
Atul Kamboj, Claus V Hallwirth, Ian E Alexander, Geoffrey B McCowage, Belinda Kramer
BACKGROUND: The analysis of viral vector genomic integration sites is an important component in assessing the safety and efficiency of patient treatment using gene therapy. Alongside this clinical application, integration site identification is a key step in the genetic mapping of viral elements in mutagenesis screens that aim to elucidate gene function. RESULTS: We have developed a UNIX-based vector integration site analysis pipeline (Ub-ISAP) that utilises a UNIX-based workflow for automated integration site identification and annotation of both single and paired-end sequencing reads...
June 17, 2017: BMC Bioinformatics
https://www.readbyqxmd.com/read/28622094/self-care-behavior-change-and-depression-among-low-income-predominantly-hispanic-patients-in-safety-net-clinics
#9
Hyunsung Oh, Kathleen Ell, Lawrence A Palinkas
This study examined whether changes in self-care behaviors during a 12-month period predicted the likelihood of screening positive for depression concurrently and prospectively among low-income Hispanic patients with diabetes. Secondary analyses were conducted with longitudinal data collected from a randomized controlled trial that had tested effectiveness of collaborative depression care. We examined whether changes in self-care behaviors observed during the 12 months after baseline predicted the likelihood of screening positive for depression at 12-, 18-, and 24-month follow-up...
June 16, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28618290/defining-trauma-in-complex-care-management-safety-net-providers-perspectives-on-structural-vulnerability-and-time
#10
Ariana Thompson-Lastad, Irene H Yen, Mark D Fleming, Meredith Van Natta, Sara Rubin, Janet K Shim, Nancy J Burke
In this paper, we delineate how staff of two complex care management (CCM) programs in urban safety net hospitals in the United States understand trauma. We seek to (1) describe how staff in CCM programs talk about trauma in their patients' lives; (2) discuss how trauma concepts allow staff to understand patients' symptoms, health-related behaviors, and responses to care as results of structural conditions; and (3) delineate the mismatch between long-term needs of patients with histories of trauma and the short-term interventions that CCM programs provide...
June 12, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28618127/regional-citrate-anticoagulation-in-membrane-based-plasma-exchange-safety-efficacy-and-effect-on-calcium-balance
#11
Daniel Christiadi, Chari Mercado, Richard Singer
AIM: To assess the efficacy, safety and calcium balance of a membrane based regional citrate anticoagulation plasma exchange protocol METHODS: This was an observational, prospective, single center study of membrane separation plasma exchange using regional citrate anticoagulation. It was performed using a fixed dose pre-filter citrate infusion that was based on the plasma flow rate. Patients received a post filter calcium infusion which was modified during treatment based on systemic ionized calcium monitoring...
June 15, 2017: Nephrology
https://www.readbyqxmd.com/read/28609176/mothers-of-infants-with-congenital-diaphragmatic-hernia-describe-breastfeeding-in-the-neonatal-intensive-care-unit-as-long-as-it-s-my-milk-i-m-happy
#12
Elizabeth B Froh, Janet A Deatrick, Martha A Q Curley, Diane L Spatz
BACKGROUND: Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births...
June 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28608262/healthful-cultural-foods-and-safety-net-use-among-cambodian-and-brazilian-immigrant-communities-in-massachusetts
#13
L S Cordeiro, L Sibeko, J Nelson-Peterman
Declining health and food security status among low-income immigrants in the U.S. may result from limited access to healthful, cultural foods and safety net programs. We held focus group discussions with low-income Cambodian and Brazilian immigrants (11 groups, n = 84) living in Massachusetts. Cambodians and Brazilians valued healthful, cultural foods, emphasizing their beliefs that cultural foods are healthier and beneficial for weight management and aging. Although both groups could access these foods, some individuals had difficulty affording them...
June 12, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/28605216/drug-avoidance-self-efficacy-among-exclusive-cannabis-users-vs-other-drug-users-visiting-the-emergency-department
#14
Sarah E Clingan, Susan I Woodruff
BACKGROUND: Medical care in the emergency department (ED) is a growing and complex area of outpatient care, with about 256 visits made to EDs every minute in 2013. Studies report that, compared to people who do not use drugs, people who use illicit drugs are more likely to use the ED for their medical care. Self-efficacy has been shown to be a predictor of abstinence or reduced use among drug-using individuals. OBJECTIVES: The current study describes drug avoidance self-efficacy among exclusive cannabis-using individuals and other drug-using individuals who use the ED for any reason...
June 12, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28604458/factors-associated-with-radiation-treatment-compliance-for-women-with-cervical-cancer-in-a-safety-net-health-system
#15
Alfredo Echeverria, Haley Manley, Barrett OʼDonnell, Joshua Asper, Mark Bonnen, Michelle Ludwig
OBJECTIVE: The aim of the study was to determine whether patient characteristics are associated with radiation treatment noncompliance. METHODS/MATERIALS: We retrospectively studied 244 patients with cervical cancer treated with chemoradiation between May 2006 and August 2015 at a safety net health center. Compliance with treatment was defined as missing less than 2 days of scheduled radiation. RESULTS: Treatment records revealed a compliance rate of 50...
June 10, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28603432/household-food-insecurity-is-associated-with-both-body-mass-index-and-middle-upper-arm-circumference-of-mothers-in-northwest-ethiopia-a-comparative-study
#16
Achenef Motbainor, Alemayehu Worku, Abera Kumie
BACKGROUND: Food insecurity and associated malnutrition result in serious health problems in developing countries. This study determined levels of maternal undernutrition and its association with food insecurity in northwest Ethiopia. MATERIALS AND METHODS: This was a community-based comparative cross-sectional study conducted May 24-July 20, 2013. Multistage random sampling was used to select 4,110 samples. Availability of Ethiopia's Productive Safety Net Programme was used for grouping the study areas...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28602461/adapting-systems-of-care-for-people-aging-with-hiv
#17
Eugenia L Siegler, Mark Brennan-Ing
People aging with HIV have medical and psychosocial needs that require more than the HIV services network can provide. HIV providers may lack experience managing multimorbidity or the functional consequences of aging. Social support services may be unable to provide necessary services for people living with HIV (PLWH) who are becoming increasingly frail or facing cognitive impairment. HIV providers will be caring for aging PLWH whose HIV management may seem simple compared with the significant burdens of stigma, mental health needs, social isolation, multimorbidity, and aging-related syndromes...
May 26, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28602142/safety-and-efficacy-of-percutaneous-coronary-intervention-via-transradial-versus-transfemoral-approach-in-bypass-grafts
#18
Yuxiang Dai, Chenguang Li, Feng Zhang, Ji'e Yang, Shufu Chang, Hao Lu, Hongbo Yang, Zheyong Huang, Juying Qian, Lei Ge, Junbo Ge
We compared the efficacy and safety of the transradial approach percutaneous coronary intervention (TRA-PCI) and transfemoral approach percutaneous coronary intervention (TFA-PCI) for bypass grafts lesions. Patients (n = 184) were retrospectively enrolled. Less contrast was used during the procedure in the TRA group than in the TFA group, 201.5 (45.5) mL versus 221.5 (49.1) mL, P = .004, although fluoroscopy time was longer in the TRA group, 22.5 (6.3) minutes versus 20.3 (6.1) minutes; P = .017. The incidence of net adverse clinical events (NACEs) was lower in the TRA group than in the TFA group (3...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28599142/opioid-pharmacovigilance-a-clinical-social-history-of-the-changes-in-opioid-prescribing-for-patients-with-co-occurring-chronic-non-cancer-pain-and-substance-use
#19
Kelly R Knight, Margot Kushel, Jamie S Chang, Kara Zamora, Rachel Ceasar, Emily Hurstak, Christine Miaskowski
There is growing concern among US-based clinicians, patients, policy makers, and in the media about the personal and community health risks associated with opioids. Perceptions about the efficacy and appropriateness of opioids for the management of chronic non-cancer pain (CNCP) have dramatically transformed in recent decades. Yet, there is very little social scientific research identifying the factors that have informed this transformation from the perspectives of prescribing clinicians. As part of an on-going ethnographic study of CNCP management among clinicians and their patients with co-occurring substance use, we interviewed 23 primary care clinicians who practice in safety-net clinical settings...
May 23, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28597203/assessing-patient-activation-among-high-need-high-cost-patients-in-urban-safety-net-care-settings
#20
Tessa M Napoles, Nancy J Burke, Janet K Shim, Elizabeth Davis, David Moskowitz, Irene H Yen
We sought to examine the literature using the Patient Activation Measure (PAM) or the Patient Enablement Instrument (PEI) with high-need, high-cost (HNHC) patients receiving care in urban safety net settings. Urban safety net care management programs serve low-income, racially/ethnically diverse patients living with multiple chronic conditions. Although many care management programs track patient progress with the PAM or the PEI, it is not clear whether the PAM or the PEI is an effective and appropriate tool for HNHC patients receiving care in urban safety net settings in the United States...
June 8, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
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