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https://www.readbyqxmd.com/read/29143325/physician-practice-transitions-to-system-ownership-do-not-result-in-diminished-practice-responsiveness-to-patients
#1
Bing Ying Poon, Stephen Shortell, Hector P Rodriguez
OBJECTIVE: To examine the extent to which physician-to-system ownership transitions are associated with declines in practice-reported patient responsiveness (PRPR). DATA SOURCES: A longitudinal cohort of practices (n = 897) from the National Survey of Large Physician Organizations/National Survey of Small- and Medium-Sized Physician Organizations (2006/08) and the National Survey of All-Size Physician Organizations (2012/13). STUDY DESIGN: Multivariable regression estimated the effect of ownership on changes in PRPR, controlling for practice size, specialty composition, other practice, and market characteristics...
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29141621/expectations-and-perceptions-of-primary-healthcare-professionals-regarding-their-own-continuous-education-in-catalonia-spain-a-qualitative-study
#2
Xavier Mundet-Tuduri, Ramon Crespo, Ma Luisa Fernandez-Coll, Montserrat Saumell, Flor Millan-Mata, Àngels Cardona, Núria Codern-Bové
BACKGROUND: The planning and execution of continuous education in an organization that provides health services is a complex process. The objectives, learning sequences, and implementation strategies should all be oriented to improving the health of the population. The aim of this study was to analyse the expectations and perceptions of continuous educations by primary healthcare professionals (physicians and nurses) and identify aspects that hinder or encourage the process. METHODS: A qualitative study with 5 focus groups made up of 25 primary healthcare professionals from the Catalan Health Institute, Barcelona (Catalonia, Spain)...
November 15, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29135763/health-system-creation-and-integration-at-a-health-sciences-university-a-five-year-follow-up
#3
Catherine P Slade, Ricardo Azziz, Steven Levin, Gretchen B Caughman, David S Hefner, Kimberly V Halbur, Martha S Tingen, Susan James
Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29124043/activities-of-daily-living-measured-by-the-harvard-automated-phone-task-track-with-cognitive-decline-over-time-in-non-demented-elderly
#4
Gad A Marshall, Sarah L Aghjayan, Maria Dekhtyar, Joseph J Locascio, Kamal Jethwani, Rebecca E Amariglio, Keith A Johnson, Reisa A Sperling, Dorene M Rentz
Background: Impairment in activities of daily living is a major burden to both patients and caregivers. Mild impairment in instrumental activities of daily living is often seen at the stage of mild cognitive impairment. The field of Alzheimer's disease is moving toward earlier diagnosis and intervention and more sensitive and ecologically valid assessments of instrumental or complex activities of daily living are needed. The Harvard Automated Phone Task, a novel performance-based activities of daily living instrument, has the potential to fill this gap...
2017: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/29109839/hearing-and-mortality-outcomes-following-temporal-bone-fractures
#5
Adam Honeybrook, Aniruddha Patki, Nikita Chapurin, Charles Woodard
The aim of this article is to determine hearing and mortality outcomes following temporal bone fractures. Retrospective chart review was performed of 152 patients diagnosed with a temporal bone fracture presenting to the emergency room at a tertiary care referral center over a 10-year period. Utilizing Patients' previously obtained temporal bone computed tomographic scans and audiograms, fractures were classified based on several classification schemes. Correlations between fracture patterns, mortality, and hearing outcomes were analyzed using χ(2) tests...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29102097/management-of-an-entrapped-patient-with-a-field-amputation
#6
John C Bunyasaranand, Erasmo Espino, Kelli A Rummings, Gregory M Christiansen
BACKGROUND: Emergency surgical amputations are rare and resource-intensive lifesaving interventions. Most emergency medical services (EMS) lack a formal protocol to manage these high-risk but low-occurrence events. There has been limited attention in the EMS community to address this issue. Without a literature-based approach, the EMS community has been offered little guidance on managing surgical field amputations. CASE REPORT: A 38-year-old man was terminally entrapped below the waist in an industrial auger...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29096865/cascade-screening-for-familial-hypercholesterolemia-practical-consequences
#7
Leonora Louter, Joep Defesche, Jeanine Roeters van Lennep
Familial Hypercholesterolemia (FH) is an autosomal dominant disorder mainly caused by mutations in the LDLR gene, resulting in elevated serum cholesterol levels and elevated risk of premature cardiovascular disease (CVD). Timely treatment with lipid lowering medication can lower the risk of CVD to the same level of the normal population. Currently the incidence of FH is estimated at 1 in 240 persons in the Caucasian population. A diagnosis of FH can be made on the basis of clinical criteria (including LDL cholesterol and family history) or DNA testing...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29090623/care-transformation-strategies-and-approaches-of-accountable-care-organizations
#8
Valerie A Lewis, Katherine I Tierney, Taressa Fraze, Genevra F Murray
Although accountable care organizations (ACOs) proliferate, little is known about the activities and strategies ACOs are pursuing to meet goals of reducing costs and improving quality. We use semistructured interviews with executives at 16 ACOs to understand ACO approaches. We identified two overarching ACO approaches to changing clinical care: a practice-based transformation approach, working to overhaul care processes and teams from the inside out; and an overlay approach, where ACO activities were centralized and delivered external to physician practices...
October 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29076113/a-knowledge-modeling-approach-to-integrate-multiple-clinical-practice-guidelines-to-provide-evidence-based-clinical-decision-support-for-managing-comorbid-conditions
#9
Samina Abidi
Clinical management of comorbidities is a challenge, especially in a clinical decision support setting, as it requires the safe and efficient reconciliation of multiple disease-specific clinical procedures to formulate a comorbid therapeutic plan that is both effective and safe for the patient. In this paper we pursue the integration of multiple disease-specific Clinical Practice Guidelines (CPG) in order to manage co-morbidities within a computerized Clinical Decision Support System (CDSS). We present a CPG integration framework-termed as COMET (Comorbidity Ontological Modeling & ExecuTion) that manifests a knowledge management approach to model, computerize and integrate multiple CPG to yield a comorbid CPG knowledge model that upon execution can provide evidence-based recommendations for handling comorbid patients...
October 26, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29066937/empirical-research-on-the-utility-of-a-preparation-manual-for-a-disaster-medical-response-drill
#10
Takao Arai, Shoichi Ohta, Masaki Onishi, Miyu Taniguchi, Junya Tsurukiri, Kenichiro Kumasaka, Katsuhiro Nagata, Kensuke Suzuki, Ken Harigae, Tetsuo Yukioka
PURPOSE: It is difficult for emergency physicians to plan and execute a disaster medical response drill while conducting their daily work activities. Readily available drill preparation manuals are therefore essential, alongside assessment methods to ensure quality. Here, we propose email text analysis as a manual assessment method, and investigate its validity. METHODS: The preparation status of two similar large-scale disaster medical response drills were compared...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29054254/ecg-based-myocardial-infarction-detection-using-hybrid-firefly-algorithm
#11
Padmavathi Kora
BACKGROUND AND OBJECTIVE: Myocardial Infarction (MI) is one of the most frequent diseases, and can also cause demise, disability and monetary loss in patients who suffer from cardiovascular disorder. Diagnostic methods of this ailment by physicians are typically invasive, even though they do not fulfill the required detection accuracy. METHODS: Recent feature extraction methods, for example, Auto Regressive (AR) modelling; Magnitude Squared Coherence (MSC); Wavelet Coherence (WTC) using Physionet database, yielded a collection of huge feature set...
December 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29045237/monoplane-3d-2d-registration-of-cerebral-angiograms-based-on-multi-objective-stratified-optimization
#12
Timur Aksoy, Ziga Spiclin, Franjo Pernus, Gozde Unal
Registration of 3D pre-interventional to 2D intra-interventional medical images has an increasingly important role in surgical planning, navigation and treatment, because it enables the physician to co-locate depth information given by pre-interventional 3D images with the live information in intra-interventional 2D images such as X-ray. Most tasks during image-guided interventions are carried out under a monoplane X-ray, which is a highly ill-posed problem for state-of-the-art 3D to 2D registration methods...
October 18, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29027301/challenges-of-post-authorization-safety-studies-lessons-learned-and-results-of-a-french-study-of-fentanyl-buccal-tablet
#13
REVIEW
Natalie Gavrielov-Yusim, Ilda Bidollari, Sigal Kaplan, Netta Bartov
PURPOSE: Recruiting and retaining participants in real-world studies that collect primary data are challenging. This article illustrates these challenges using a post-authorization safety study (PASS) to assess adverse events (AEs) experienced with fentanyl buccal tablet (FBT) over 3 months of treatment. METHODS: This was an observational, prospective, multicenter study in France conducted over 1 year. The study employed primary data collection in FBT-treated patients and their treating physicians via a site qualification questionnaire and patient log completed by physicians and a questionnaire and pain diary completed by patients...
October 13, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29025302/medical-student-healthcare-consulting-groups-a-novel-way-to-train-the-next-generation-of-physician-executives
#14
Esther Y Hsiang, Andrew G Breithaupt, Peiyi Su, Andrew T Rogers, Niv Milbar, Sanjay V Desai
Meeting the challenges of the evolving healthcare environment requires leadership of physicians well-trained in clinical medicine and healthcare management. However, many physicians lack training in business and leadership. While some residency programs have management tracks, training at the medical school level is currently lacking. We developed the Hopkins Health Management Advisory Group, an extracurricular program at Johns Hopkins University School of Medicine that exposes medical students to healthcare management and fosters development of leadership skills...
October 12, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29017856/planning-an-innovation-marathon-at-an-infectious-disease-conference-with-results-from-the-international-meeting-on-emerging-diseases-and-surveillance-2016-hackathon
#15
John W Ramatowski, Christopher Xiang Lee, Aikaterini Mantzavino, João Ribas, Winter Guerra, Nicholas D Preston, Eva Schernhammer, Lawrence C Madoff, Britta Lassmann
A hackathon is best described as an 'innovation marathon'. Derived from the words 'hacking' and 'marathon', it brings together multidisciplinary teams to collaborate intensely over a short period of time to define a problem, devise a solution, and design a working prototype. International scientific meetings are conducive to successful hackathons, providing an audience of expert professionals who describe challenges and ensure the proposed solutions address end-user needs. Collaborations with local organizations and academic centers are crucial to attracting complementary specialties such as IT advisors, engineers, and entrepreneurs to develop sustainable projects...
October 7, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28971416/vhmentor-an-ontology-supported-mobile-agent-system-for-pervasive-health-care-monitoring
#16
Stella C Christopoulou, Theodore Kotsilieris, Ioannis Anagnostopoulos, Christos-Nikolaos Anagnostopoulos, Phivos Mylonas
Healthcare provision is a set of activities that demands the collaboration of several stakeholders (e.g. physicians, nurses, managers, patients etc.) who hold distinct expertise and responsibilities. In addition, medical knowledge is diversely located and often shared under no central coordination and supervision authority, while medical data flows remain mostly passive regarding the way data is delivered to both clinicians and patients. In this paper, we propose the implementation of a virtual health Mentor (vhMentor) which stands as a dedicated ontology schema and FIPA compliant agent system...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28968749/omics-analysis-system-for-precision-oncology-oasispro-a-web-based-omics-analysis-tool-for-clinical-phenotype-prediction
#17
Kun-Hsing Yu, Michael R Fitzpatrick, Luke Pappas, Warren Chan, Jessica Kung, Michael Snyder
Summary: Precision oncology is an approach that accounts for individual differences to guide cancer management. Omics signatures have been shown to predict clinical traits for cancer patients. However, the vast amount of omics information poses an informatics challenge in systematically identifying patterns associated with health outcomes, and no general-purpose data-mining tool exists for physicians, medical researchers, and citizen scientists without significant training in programming and bioinformatics...
September 12, 2017: Bioinformatics
https://www.readbyqxmd.com/read/28965701/environmental-exposure-to-manganese-in-air-tremor-motor-and-cognitive-symptom-profiles
#18
E S Kornblith, S L Casey, D T Lobdell, M A Colledge, R M Bowler
BACKGROUND: Excessive exposure to manganese (Mn) may cause parkinsonian-like motor and tremor symptoms and adverse cognitive effects, including problems with executive functioning (EF), resembling those found in later-stage Parkinson's disease (PD). Studies seeking to differentiate PD patients into subgroups with associated cognitive and functional outcomes using motor and tremor symptoms identified tremor-dominant (TD) and non-tremor dominant (NTD) subtypes. It is unclear whether differing patterns of pathophysiology and symptoms exist in Mn neurotoxicity, as they do in PD...
September 28, 2017: Neurotoxicology
https://www.readbyqxmd.com/read/28965174/lactate-determination-in-pleural-and-abdominal-effusions-a-quick-diagnostic-marker-of-exudate-a-pilot-study
#19
Giovanni Porta, Fabio G Numis, Valerio Rosato, Antonio Pagano, Mario Masarone, Giorgio Bosso, Claudia Serra, Luca Rinaldi, Maria C Fascione, Annalisa Amelia, Fiorella Paladino, Fernando Schiraldi
Pleural or abdominal effusions are frequent findings in ICU and Internal Medicine patients. Diagnostic gold standard to distinguish between transudate and exudate is represented by "Light's Criteria," but, unfortunately, the chemical-physical examination for their calculation is not a rapid test. Pursuing an acid-base assessment of the fluid by a blood-gas analyzer, an increase of lactate beyond the normal serum range is reported in the exudative effusions. The advantages of this test are that it is a very fast bed-side test, executable directly by the physician...
September 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28886977/an-optimization-model-for-collection-haul-transfer-treatment-and-disposal-of-infectious-medical-waste-application-to-a-greek-region
#20
Gerasimos Mantzaras, Evangelos A Voudrias
The objective of this work was to develop an optimization model to minimize the cost of a collection, haul, transfer, treatment and disposal system for infectious medical waste (IMW). The model calculates the optimum locations of the treatment facilities and transfer stations, their design capacities (t/d), the number and capacities of all waste collection, transport and transfer vehicles and their optimum transport path and the minimum IMW management system cost. Waste production nodes (hospitals, healthcare centers, peripheral health offices, private clinics and physicians in private practice) and their IMW production rates were specified and used as model inputs...
November 2017: Waste Management
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