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https://www.readbyqxmd.com/read/28221943/food-allergy-knowledge-and-attitudes-of-restaurant-managers-and-staff-an-ehs-net-study
#1
Taylor J Radke, Laura G Brown, E Rickamer Hoover, Brenda V Faw, David Reimann, Melissa R Wong, David Nicholas, Jonathan Barkley, Danny Ripley
Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues...
September 2016: Journal of Food Protection
https://www.readbyqxmd.com/read/28221275/changes-in-emergency-department-utilization-after-early-medicaid-expansion-in-california
#2
Lindsay M Sabik, Peter J Cunningham, Ali Bonakdar Tehrani
BACKGROUND: Medicaid expansions aim to improve access to primary care, which could reduce nonemergent (NE) use of the emergency department (ED). In contrast, Medicaid enrollees use the ED more than other groups, including the uninsured. Thus, the expected impact of Medicaid expansion on ED use is unclear. OBJECTIVES: To estimate changes in total and NE ED visits as a result of California's early Medicaid expansion under the Affordable Care Act. In addition to overall changes in the number of visits, changes by payer and safety net hospital status are examined...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28220021/the-antiproliferative-role-of-lanreotide-in-controlling-growth-of-neuroendocrine-tumors-a-systematic-review
#3
Michael Michael, Rocio Garcia-Carbonero, Matthias M Weber, Catherine Lombard-Bohas, Christos Toumpanakis, Rodney J Hicks
BACKGROUND: Neuroendocrine tumors (NETs) are a heterogeneous group of tumors, with >50% of cases involving the gastrointestinal system or pancreas. Somatostatin analogs (SSAs) are used for treating NET-related secretory syndromes and, more recently, for their antiproliferative effects. We conducted a systematic review of published literature on the antiproliferative efficacy and safety of the SSA lanreotide Autogel in the management of NETs to gain a fuller understanding of the evidence and identify future areas of research...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28212969/lessons-learned-when-introducing-pharmacogenomic-panel-testing-into-clinical-practice
#4
Marc B Rosenman, Brian Decker, Kenneth D Levy, Ann M Holmes, Victoria M Pratt, Michael T Eadon
OBJECTIVES: Implementing new programs to support precision medicine in clinical settings is a complex endeavor. We describe challenges and potential solutions based on the Indiana GENomics Implementation: an Opportunity for the Underserved (INGenious) program at Eskenazi Health-one of six sites supported by the Implementing GeNomics In pracTicE network grant of the National Institutes of Health/National Human Genome Research Institute. INGenious is an implementation of a panel of genomic tests...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212954/evaluation-of-copd-treatments-a-multicriteria-decision-analysis-of-aclidinium-and-tiotropium-in-the-united-states
#5
Kevin Marsh, Erica Zaiser, Panagiotis Orfanos, Suzanne Salverda, Teresa Wilcox, Shawn Sun, Shailja Dixit
BACKGROUND: Comparisons of the use of aclidinium bromide and tiotropium bromide for the treatment of chronic obstructive pulmonary disease often concentrate on key end points (exacerbations) at the expense of other benefits and risks. Multicriteria decision analysis (MCDA) can help overcome this by using stakeholder preferences to combine multiple end points into an overall value estimate. OBJECTIVES: To evaluate the use of aclidinium bromide twice daily via Pressair™ (AstraZeneca Pharmaceuticals LP, Wilmington, DE) and of tiotropium once daily via HandiHaler(®) (Boehringer Ingelheim Pharmaceuticals, Inc...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28207344/the-future-of-the-affordable-care-act-and-insurance-coverage
#6
Sherry Glied, Adlan Jackson
We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage...
February 16, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#7
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28203088/peptide-receptor-radionuclide-therapy-in-the-management-of-gastrointestinal-neuroendocrine-tumors-efficacy-profile-safety-and-quality-of-life
#8
REVIEW
Stefano Severi, Ilaria Grassi, Silvia Nicolini, Maddalena Sansovini, Alberto Bongiovanni, Giovanni Paganelli
Peptide receptor radionuclide therapy (PRRT), developed over the last two decades, is carried out using radiopharmaceuticals such as 90Y-DOTA-Tyr3-octreotide and 177Lu-DOTA-Tyr3-octreotate (177Lu-Dotatate). These radiocompounds are obtained by labeling a synthetic somatostatin analog with a β-emitting radioisotope. The compounds differ from each other in terms of their energetic features (due to the radionuclide) and peptide receptor affinity (due to the analog) but share the common characteristic of binding specific membrane somatostatin receptors that are (generally) overexpressed in neuroendocrine neoplasms (NENs) and their metastases...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28197420/the-challenges-of-electronic-health-records-and-diabetes-electronic-prescribing-implications-for-safety-net-care-for-diverse-populations
#9
REVIEW
Neda Ratanawongsa, Lenny L S Chan, Michelle M Fouts, Elizabeth J Murphy
Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional communication with pharmacy partners; and (5) informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28192632/assessing-the-relative-influence-of-hospital-and-surgeon-volume-on-short-term-mortality-following-radical-cystectomy
#10
Nikhil Waingankar, Katherine Mallin, Marc Smaldone, Brian L Egleston, Andrew Higgins, David P Winchester, Robert Uzzo, Alexander Kutikov
OBJECTIVES: To assess the relationship between surgeon and hospital volume on mortality following radical cystectomy (RC). PATIENTS AND METHODS: We queried the National Cancer Database (NCDB) for adult patients undergoing RC from 2010-2013. We calculated average volume for each surgeon (SV) and hospital (HV). Using propensity-scored weights for combined volume groups with a proportional hazards regression model, we compared association between HV and SV on 90-day survival following RC...
February 13, 2017: BJU International
https://www.readbyqxmd.com/read/28185740/vaccine-adverse-events-in-a-safety-net-healthcare-system-and-a-managed-care-organization
#11
Komal J Narwaney, Kristin Breslin, Colleen A Ross, Jo Ann Shoup, Kris F Wain, Eric S Weintraub, Michael M McNeil, Simon J Hambidge
BACKGROUND: The Institute of Medicine, in a 2013 report, recommended that the Vaccine Safety Datalink (VSD) expand collaborations to include more diversity in the study population. Kaiser Permanente Colorado (KPCO), an established VSD site, partnered with Denver Health (DH), an integrated safety net healthcare system, to demonstrate the feasibility of integrating DH data within the VSD. Prior to incorporating the data, we examined the identification of specific vaccine associated adverse events (VAEs) in these two distinct healthcare systems...
February 6, 2017: Vaccine
https://www.readbyqxmd.com/read/28182863/randomized-controlled-trial-of-a-community-health-worker-self-management-support-intervention-among-low-income-adults-with-diabetes-seattle-washington-2010-2014
#12
Karin Nelson, Leslie Taylor, Julie Silverman, Meghan Kiefer, Paul Hebert, Dan Lessler, James Krieger
INTRODUCTION: Community health workers (CHWs) can improve diabetes outcomes; however, questions remain about translating research findings into practical low-intensity models for safety-net providers. We tested the effectiveness of a home-based low-intensity CHW intervention for improving health outcomes among low-income adults with diabetes. METHODS: Low-income patients with glycated hemoglobin A1c (HbA1c) of 8.0% or higher in the 12 months before enrollment from 3 safety-net providers were randomized to a 12-month CHW-delivered diabetes self-management intervention or usual care...
February 9, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28182803/patient-level-exclusions-from-mhealth-in-a-safety-net-health-system
#13
Keiki Hinami, Bhrandon A Harris, Ricardo Uriostegui, Wilnise Jasmin, Mario Lopez, William E Trick
Excitement about mobile health (mHealth) for improving care transitions is fueled by widespread adoption of smartphones across all social segments, but new disparities can emerge around nonadopters of technology-based communications. We conducted a cross-sectional survey of urban low-income adults to assess inadequate reading health literacy and limited English proficiency as factors affecting access to and engagement with mHealth. Although the proportion owning smartphones were comparable to national figures, adjusted analysis showed fewer patients with inadequate reading health literacy having Internet access (odds ratio [95% confidence interval]: 0...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28181815/onsite-versus-offsite-radiation-treatment-of-malignant-spinal-cord-compression-lessons-from-a-safety-net-health-system
#14
Albert C Chen, Mark D Bonnen, Henry Mok
OBJECTIVE: Metastatic spinal cord compression (MSCC) is an oncologic emergency that often warrants emergent treatment, but it is unclear if radiation treatment can be optimally managed from an offsite radiotherapy facility. METHODS: Patient charts from consecutive MSCC patients that were treated with radiotherapy alone either at an onsite hospital radiation department (from 2008 to 2012) or an offsite radiotherapy center (2012-2015) were reviewed. Patients' clinical parameters were compared across groups with either the Chi-squared test or Fisher's exact test, while survival curves were compared with the log-rank test...
February 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28168590/meeting-women-where-they-are-integration-of-care-as-the-foundation-of-treatment-for-at-risk-pregnant-and-postpartum-women
#15
Melanie Thomas, Margaret Hutchison, Gloria Castro, Melissa Nau, Martha Shumway, Naomi Stotland, Anna Spielvogel
Purpose In these times of rapidly changing health care policies, those involved in the health care of women, especially during the reproductive years, have a unique and daunting opportunity. There is great potential to positively impact women's health through focus on prevention, attention to addressing disparities, and new focus on the integration of behavioral health care in primary care settings. Description In this report from the field, we suggest that the integration of mental health care into other health services and addressing underlying social needs by partnering with community-based organizations should be a top priority for all settings seeking to provide excellent health care for women...
February 6, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28168395/barriers-to-colorectal-cancer-screening-in-a-racially-diverse-population-served-by-a-safety-net-clinic
#16
Elizabeth Nagelhout, Kristen Comarell, N Jewel Samadder, Yelena P Wu
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the US, yet screening rates remain low among minority populations. The purpose of the current study was to identify differences in the endorsement of barriers to CRC screening and to evaluate the association between provider recommendation and CRC screening adherence among Hispanic, Pacific Islander and White patients. This study utilized a cross sectional survey design to identify patient-reported barriers to CRC screening. Logistic regression was utilized to evaluate the association between patient demographic characteristics (race/ethnicity, gender, age), having received provider recommendation, and patient awareness of CRC screening...
February 6, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28166784/randomized-controlled-trial-of-a-coordinated-care-intervention-to-improve-risk-factor-control-after-stroke-or-transient-ischemic-attack-in-the-safety-net-secondary-stroke-prevention-by-uniting-community-and-chronic-care-model-teams-early-to-end-disparities
#17
Amytis Towfighi, Eric M Cheng, Monica Ayala-Rivera, Heather McCreath, Nerses Sanossian, Tara Dutta, Bijal Mehta, Robert Bryg, Neal Rao, Shlee Song, Ali Razmara, Magaly Ramirez, Theresa Sivers-Teixeira, Jamie Tran, Elizabeth Mojarro-Huang, Ana Montoya, Marilyn Corrales, Beatrice Martinez, Phyllis Willis, Mireya Macias, Nancy Ibrahim, Shinyi Wu, Jeremy Wacksman, Hilary Haber, Adam Richards, Frances Barry, Valerie Hill, Brian Mittman, William Cunningham, Honghu Liu, David A Ganz, Diane Factor, Barbara G Vickrey
BACKGROUND: Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease...
February 6, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28166671/the-unintended-consequences-of-the-centers-for-medicare-and-medicaid-services-pay-for-performance-structures-on-safety-net-hospitals-and-the-low-income-medically-vulnerable-population
#18
Elmer B Fos
Safety-net hospitals are hospitals with patient mix that is substantially composed of the uninsured, underinsured, and low-income, medically vulnerable patient populations. They are the hospitals of last resort for poor patients. This article examined the impact of The Centers for Medicare and Medicaid Services pay-for-performance reimbursement policies on the financial viability of safety-net hospitals. Studies showed that these policies, which are based on the principle of reward and punishment, might have unintentionally placed safety-net hospitals on financial disadvantage compared to other hospital organizations...
February 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28166331/the-illness-experience-of-undocumented-immigrants-with-end-stage-renal-disease
#19
Lilia Cervantes, Stacy Fischer, Nancy Berlinger, Maria Zabalaga, Claudia Camacho, Stuart Linas, Debora Ortega
Importance: The exclusion of undocumented immigrants from Medicare coverage for hemodialysis based on a diagnosis of end-stage renal disease (ESRD) requires physicians in some states to manage chronic illness in this population using emergent-only hemodialysis. Emergent-only dialysis is expensive and burdensome for patients. Objective: To understand the illness experience of undocumented immigrants with ESRD who lack access to scheduled hemodialysis. Design, Setting, and Participants: A qualitative, semistructured, interview study was conducted in a Colorado safety-net hospital from July 1 to December 31, 2015, with 20 undocumented immigrants (hereinafter referred to as undocumented patients) with ESRD and no access to scheduled hemodialysis...
February 6, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28164824/medical-care-for-undocumented-immigrants-national-and-international-issues
#20
REVIEW
Teresa L Beck, Thien-Kim Le, Queen Henry-Okafor, Megha K Shah
The number of undocumented immigrants (UIs) varies worldwide, and most reside in the United States. With more than 12 million UIs in the United States, addressing the health care needs of this population presents unique challenges and opportunities. Most UIs are uninsured and rely on the safety-net health system for their care. Because of young age, this population is often considered to be healthier than the overall US population, but they have specific health conditions and risks. Adequate coverage is lacking; however, there are examples of how to better address the health care needs of UIs...
March 2017: Primary Care
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