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https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#1
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28089817/patient-centered-specialty-practice-defining-the-role-of-specialists-in-value-based-healthcare
#2
REVIEW
Lawrence Ward, Rhea E Powell, Michael L Scharf, Andrew Chapman, Mani Kavuru
Healthcare is at a crossroads, under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. Yet primary care accounts for only a small portion of total healthcare spending, and there is a need for policies and frameworks to support high quality, cost-efficient care in specialty practices of the "medical neighborhood". The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance...
January 13, 2017: Chest
https://www.readbyqxmd.com/read/28080012/medicaid-s-future-what-might-aca-repeal-mean
#3
Sara Rosenbaum, Sara Rothenberg, Rachel Gunsalus, Sara Schmucker
Issue: Republicans in Congress are expected to repeal portions of the Affordable Care Act (ACA) using a fast-track process known as budget reconciliation. Goals: This issue brief examines how repeal legislation could affect Medicaid, the nation’s health care safety net, which insured 70 million people in 2016. Findings and Conclusions: Partial-repeal legislation that passed Congress but was vetoed by President Obama in 2016 offers some insight but new legislation could go further. It could repeal the ACA’s Medicaid eligibility expansions for adults and children but also roll back other provisions, such as simplified enrollment and improvements in long-term services and supports for beneficiaries with disabilities...
2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28078110/radioembolization-with-90-y-glass-microspheres-for-the-treatment-of-unresectable-metastatic-liver-disease-from-chemotherapy-refractory-gastrointestinal-cancers-final-report-of-a-prospective-pilot-study
#4
Nicholas Fidelman, Robert K Kerlan, Randall A Hawkins, Miguel Pampaloni, Andrew G Taylor, Maureen P Kohi, K Pallav Kolli, Chloe E Atreya, Emily K Bergsland, R Kate Kelley, Andrew H Ko, W Michael Korn, Katherine Van Loon, Ryan M McWhirter, Jennifer Luan, Curt Johanson, Alan P Venook
BACKGROUND: This prospective pilot single-institution study was undertaken to document the feasibility, safety, and efficacy of radioembolization of liver-dominant metastatic gastrointestinal cancer using (90)Y glass microspheres. METHODS: Between June 2010 and October 2013, 42 adult patients (26 men, 16 women; median age 60 years) with metastatic chemotherapy-refractory unresectable colorectal (n=21), neuroendocrine (n=11), intrahepatic bile duct (n=7), pancreas (n=2), and esophageal (n=1) carcinomas underwent 60 lobar or segmental administrations of (90)Y glass microspheres...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28075363/maternal-and-child-health-of-internally-displaced-persons-in-ukraine-a-qualitative-study
#5
Svitlana Nidzvetska, Jose M Rodriguez-Llanes, Isabelle Aujoulat, Julita Gil Cuesta, Hannah Tappis, Joris A F van Loenhout, Debarati Guha-Sapir
Due to the conflict that started in spring 2014 in Eastern Ukraine, a total of 1.75 million internally displaced persons (IDPs) fled the area and have been registered in government-controlled areas of the country. This paper explores perceived health, barriers to access to healthcare, caring practices, food security, and overall financial situation of mothers and young children displaced by the conflict in Ukraine. This is a qualitative study, which collected data through semi-structured in-depth interviews with nine IDP mothers via Skype and Viber with a convenience sample of participants selected through snowball technique...
January 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28069561/cancer-survivors-experience-with-telehealth-a-systematic-review-and-thematic-synthesis
#6
REVIEW
Anna Cox, Grace Lucas, Afrodita Marcu, Marianne Piano, Wendy Grosvenor, Freda Mold, Roma Maguire, Emma Ream
BACKGROUND: Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors-individuals living with and beyond cancer-to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are "complex," and understanding patient experiences of them is important in evaluating their impact...
January 9, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28069526/opportunities-to-improve-care-of-hepatocellular-carcinoma-in-vulnerable-patient-populations
#7
Richard S Hoehn, Dennis J Hanseman, Vikrom Dhar, Derek E Go, Michael J Edwards, Shimul A Shah
BACKGROUND: Hepatocellular carcinoma (HCC) patients with Medicaid or no health insurance have inferior survival compared to privately-insured patients. Safety-net hospitals that care for these patients are often criticized for their inferior outcomes. We hypothesized that HCC survival was related to appropriate surgical management. STUDY DESIGN: The American College of Surgeons National Cancer Data Base was queried for patients diagnosed with HCC (n=111,481) from 1998-2010...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28069355/double-fellowships-in-radiology-a-survey-of-2014-graduating-fellows
#8
Thomas Y Wong, Andrew Moriarity, Neil Lall, Jason C Hoffmann, Douglas S Katz, Jonathan A Flug
PURPOSE: Radiology fellowship training has evolved from being an uncommon option to being a near requisite for post-training employment in the United States. A subset of fellows elect to pursue second fellowships with potentially substantial implications on both the private sector and academic radiology workforce. The purpose of this study was to assess the proportion of current radiology fellows pursuing multiple years of post-residency fellowship training. MATERIALS AND METHODS: After obtaining IRB approval, an anonymous web-based survey was emailed to 1,269 radiology fellows listed as "completing fellowship" in the American College of Radiology database in June 2014...
November 12, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28069262/advanced-modeling-reconciles-counterintuitive-decisions-in-lead-optimization
#9
REVIEW
Ariel Fernández, L Ridgway Scott
Lead optimization (LO) is essential to fulfill the efficacy and safety requirements of drug-based targeted therapy. The ease with which water may be locally removed from around the target protein crucially influences LO decisions. However, inferred binding sites often defy intuition and the resulting LO decisions are often counterintuitive, with nonpolar groups in the drug placed next to polar groups in the target. We first introduce biophysical advances to reconcile these apparent mismatches. We incorporate three-body energy terms that account for the net stabilization of preformed target structures upon removal of interfacial water concurrent with drug binding...
January 6, 2017: Trends in Biotechnology
https://www.readbyqxmd.com/read/28065558/the-availability-of-community-health-center-services-and-access-to-medical-care
#10
James B Kirby, Ravi Sharma
BACKGROUND: Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period...
January 5, 2017: Healthcare
https://www.readbyqxmd.com/read/28063773/the-implementation-of-a-naloxone-rescue-program-in-university-students
#11
Shannon G Panther, Brenda S Bray, John R White
OBJECTIVE: Responding to the nationwide opioid overdose epidemic, Washington State University initiated a naloxone safety net project intending to increase awareness of opioid overdose, increase the availability of naloxone, and examine university students' perceptions regarding the usefulness of a novel, large-group audience-training model. SETTING: A Washington State University campus. PRACTICE DESCRIPTION: In September 2014, university students were recruited to attended a large-group audience training event which included opioid overdose prevention, recognition, and first response...
January 4, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28060950/comparing-different-suicide-prevention-measures-at-bridges-and-buildings-lessons-we-have-learned-from-a-national-survey-in-switzerland
#12
Alexander Hemmer, Philipp Meier, Thomas Reisch
The goal of the study was to compare the effectiveness of different suicide prevention measures implemented on bridges and other high structures in Switzerland. A national survey identified all jumping hotspots that have been secured in Switzerland; of the 15 that could be included in this study, 11 were secured by vertical barriers and 4 were secured by low-hanging horizontal safety nets. The study made an overall and individual pre-post analysis by using Mantel-Haenszel Tests, regression methods and calculating rate ratios...
2017: PloS One
https://www.readbyqxmd.com/read/28060053/safety-net-hospitals-face-more-barriers-yet-use-fewer-strategies-to-reduce-readmissions
#13
Jose F Figueroa, Karen E Joynt, Xiner Zhou, Endel J Orav, Ashish K Jha
OBJECTIVE: US hospitals that care for vulnerable populations, "safety-net hospitals" (SNHs), are more likely to incur penalties under the Hospital Readmissions Reduction Program, which penalizes hospitals with higher-than-expected readmissions. Understanding whether SNHs face unique barriers to reducing readmissions or whether they underuse readmission-prevention strategies is important. DESIGN: We surveyed leadership at 1600 US acute care hospitals, of whom 980 participated, between June 2013 and January 2014...
January 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28048177/th-d-brb-04-pinnacle-scripting-improving-efficiency-while-maintaining-safety
#14
J Moore
: Scripting capabilities and application programming interfaces (APIs) are becoming commonly available in modern treatment planning systems. These links to the treatment planning system (TPS) allow users to read data from the TPS, and in some cases use TPS functionality and write data back to the TPS. Such tools are powerful extensions, allowing automation of routine clinical tasks and supporting research, particularly research involving repetitive tasks on large patient populations. The data and functionality exposed by scripting/API capabilities is vendor dependent, as are the languages used by script/API engines, such as the Microsoft ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28041570/a-collaborative-care-team-to-integrate-behavioral-health-care-and-treatment-of-poorly-controlled-type-2-diabetes-in-an-urban-safety-net-primary-care-clinic
#15
Lydia A Chwastiak, Sara L Jackson, Joan Russo, Pamela DeKeyser, Meghan Kiefer, Brittaney Belyeu, Kathleen Mertens, Lisa Chew, Elizabeth Lin
OBJECTIVE: Demonstrate the feasibility of implementing a collaborative care program for poorly-controlled type 2 diabetes and complex behavioral health disorders in an urban academically-affiliated safety net primary care clinic. METHODS: This retrospective cohort study evaluates multidisciplinary team care approach to diabetes in a safety net clinic, and included 634 primary care clinic patients with hemoglobin A1c (HbA1c)>9%. HbA1c, blood pressure, and depression severity were assessed at the initial visit and at the end of treatment, and compared to those of patients who were not referred to the team...
January 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28040840/black-patients-with-colorectal-cancer-have-more-advanced-cancer-stage-at-time-of-diagnosis-a-community-based-safety-net-hospital-experience
#16
Chuck Chan, Aristeo Lopez, Garland Castaneda, Taft Bhuket, Benny Liu, Stephen Yee, David Irwin, Robert J Wong
Colorectal cancer (CRC) remains a leading cause of morbidity and mortality in the U.S. Disparities in access to care contribute to advanced CRC stage at diagnosis, and these disparities are most pronounced among underserved populations and ethnic minorities. We aim to evaluate race/ethnicity-specific disparities in CRC stage at diagnosis among an ethnically diverse, urban safety-net hospital. We retrospectively evaluated all adult CRC patients diagnosed from January 1, 2009 to October 1, 2015. CRC cases were confirmed by histopathology specimens from biopsies and/or surgical resection...
December 31, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/28028130/does-tax-based-health-financing-offer-protection-from-financial-catastrophe-findings-from-a-household-economic-impact-survey-of-ischaemic-heart-disease-in-malaysia
#17
Surianti Sukeri, Masoud Mirzaei, Stephen Jan
BACKGROUND: Malaysia is an upper-middle income country with a tax-based health financing system. Health care is relatively affordable, and safety nets are provided for the needy. The objectives of this study were to determine the out-of-pocket health spending, proportion of catastrophic health spending (out-of-pocket spending >40% of non-food expenditure), economic hardship and financial coping strategies among patients with ischaemic heart disease (IHD) in Malaysia under the present health financing system...
December 26, 2016: International Health
https://www.readbyqxmd.com/read/28025830/the-hispanic-and-latino-dentist-workforce-in-the-united-states
#18
Elizabeth Mertz, Cynthia Wides, Jean Calvo, Paul Gates
OBJECTIVES: The purpose of this paper is to describe the Hispanic/Latino (H/L) dentist workforce, their general practice patterns, and their contributions to oral health care for H/L and underserved patients. METHODS: A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 35.4 percent response rate for self-reported H/L dentists. Data were weighted for selection and response bias to be nationally representative. A workforce profile of H/L dentists was created using descriptive and multivariable statistics and published data...
December 26, 2016: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28019015/factors-associated-with-oral-health-related-quality-of-life-among-safety-net-clinic-patients
#19
Akiko Kamimura, Bethany Gull, Shannon Weaver, Lindsey Wright, Alysa Edwards, Kimiya Nourian, Jeanie Ashby, Lea E Erickson
OBJECTIVES: Oral health-related quality of life (OHRQoL) is an important health indicator not only for individuals but also for oral health care providers to treat a person holistically. Previous studies focused on OHRQoL do not provide comprehensive knowledge regarding low-income patients in the United States, many of whom have chronic health conditions that can affect their oral health. The purpose of this study is to examine factors associated with OHRQoL among low-income, uninsured patients of safety-net providers, which provide free or reduced fee medical and/or dental care to underserved populations...
December 26, 2016: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28017158/amphiphilic-cyclodextrin-derivatives-for-targeted-drug-delivery-to-tumors
#20
Nazlı Erdoğar, Gamze Işık, Erem Bilensoy
Villiers has extensively studied cyclodextrins, a family of macrocyclic oligosaccharides linked by α-1,4 glycosidic bonds, in different fields since their discovery in 1891. The unique structure enabling inclusion complexation for natural cyclodextrins and cyclodextrin derivatives make them attractive for novel drug delivery systems. Cyclodextrins can be modified with long aliphatic chains to render an amphiphilic property and these different amphiphilic cyclodextrins are able to form nanoparticles without surfactants...
December 21, 2016: Current Topics in Medicinal Chemistry
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