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https://www.readbyqxmd.com/read/29475093/nurse-practitioner-independence-health-care-utilization-and-health-outcomes
#1
Jeffrey Traczynski, Victoria Udalova
Many states allow nurse practitioners (NPs) to practice and prescribe drugs without physician oversight, increasing the number of autonomous primary care providers. We estimate the causal impact of NP independence on population health care utilization rates and health outcomes, exploiting variation in the timing of state law passage. We find that NP independence increases the frequency of routine checkups, improves care quality, and decreases emergency room use by patients with ambulatory care sensitive conditions...
January 17, 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29472178/telegerontology-as-a-novel-approach-to-address-health-and-safety-by-supporting-community-based-rural-dementia-care-triads-randomized-controlled-trial-protocol
#2
Elizabeth M Wallack, Chelsea Harris, Michelle Ploughman, Roger Butler
BACKGROUND: Telegerontology is an approach using videoconferencing to connect an interdisciplinary team in a regional specialty center to patients in rural communities, which is becoming increasingly practical for addressing current limitations in rural community-based dementia care. OBJECTIVE: Using the remotely-delivered expertise of the Telegerontology dementia care team, we aim to enhance the caregiver/patient/physician triad and thereby provide the necessary support for the person with dementia to "age in place...
February 22, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29471814/moral-dilemmas-and-conflicts-concerning-patients-in-a-vegetative-state-unresponsive-wakefulness-syndrome-shared-or-non-shared-decision-making-a-qualitative-study-of-the-professional-perspective-in-two-moral-case-deliberations
#3
Conny A M F H Span-Sluyter, Jan C M Lavrijsen, Evert van Leeuwen, Raymond T C M Koopmans
BACKGROUND: Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term care of patients in VS/UWS...
February 22, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29471330/converging-and-diverging-needs-between-patients-and-providers-who-are-collecting-and-using-patient-generated-health-data-an-integrative-review
#4
Meghan J Reading, Jacqueline A Merrill
Objective: This integrative review identifies convergent and divergent areas of need for collecting and using patient-generated health data (PGHD) identified by patients and providers (i.e., physicians, nurses, advanced practice nurses, physician assistants, and dietitians). Methods: A systematic search of 9 scholarly databases targeted peer-reviewed studies published after 2010 that reported patients' and/or providers' needs for incorporating PGHD in clinical care...
February 17, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29471256/consensus-research-priorities-for-paediatric-status-epilepticus-a-delphi-study-of-health-consumers-researchers-and-clinicians
#5
Jeremy Furyk, Robin Ray, Kerriane Watt, Stuart R Dalziel, Ed Oakely, Mark Mackay, Gabriel Dabscheck, Kate Riney, Franz E Babl
PURPOSE: Status epilepticus (SE) is a paediatric emergency with significant morbidity and mortality. Recommendations beyond first line care are not based on high quality evidence. Emergency physicians and neurologists are key stakeholders in managing this condition. A collaborative, widely consulted approach to identifying priorities can help direct limited research funds appropriately. The objectives of this study are to identify consensus research priorities in paediatric SE among experts and health consumers...
February 5, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29470814/continuing-professional-development-in-maternal-health-care-barriers-to-applying-new-knowledge-and-skills-in-the-hospitals-of-rwanda
#6
Germaine Tuyisenge, Celestin Hategeka, Isaac Luginaah, Yolanda Babenko-Mould, David Cechetto, Stephen Rulisa
Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda...
February 22, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29470115/older-adults-social-relationships-and-health-care-utilization-a-systematic-review
#7
Nicole K Valtorta, Danielle Collingridge Moore, Lynn Barron, Daniel Stow, Barbara Hanratty
BACKGROUND: Deficiencies in older people's social relationships (including loneliness, social isolation, and low social support) have been implicated as a cause of premature mortality and increased morbidity. Whether they affect service use is unclear. OBJECTIVES: To determine whether social relationships are associated with older adults' use of health services, independently of health-related needs. SEARCH METHODS: We searched 8 electronic databases (MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, the Cochrane Library, and the Centre for Reviews and Dissemination) for data published between 1983 and 2016...
February 22, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#8
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
February 22, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29468664/adverse-mental-health-outcomes-in-a-population-based-cohort-of-survivors-of-childhood-cancer
#9
Paul C Nathan, Alex Nachman, Rinku Sutradhar, Paul Kurdyak, Jason D Pole, Cindy Lau, Sumit Gupta
BACKGROUND: The elevated risk for physical late effects in childhood cancer survivors (CCS) is well documented, but their risk for mental health problems is less well described. METHODS: The authors assembled a cohort of all 5-year CCS who were diagnosed before age 18 years and treated in an Ontario pediatric cancer center between 1987 and 2008. Patients were matched to population controls and linked to health administration databases. The authors calculated rates of mental health care visits (family physician, psychiatrist, emergency department, hospitalization) and the risk for a severe mental health event (emergency department, hospitalization, suicide)...
February 22, 2018: Cancer
https://www.readbyqxmd.com/read/29468074/development-of-a-patient-centred-evidence-based-and-consensus-based-discharge-care-bundle-for-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#10
Maria B Ospina, Marta Michas, Lesly Deuchar, Richard Leigh, Mohit Bhutani, Brian H Rowe, Darcy Marciniuk, Donna Goodridge, Gail Dechman, Jean Bourbeau, Meyer Balter, Pat Camp, Paul Hernandez, Roger S Goldstein, Michael K Stickland
Introduction: Hospital and emergency department discharge for patients with chronic obstructive pulmonary disease (COPD) is often poorly organised. We developed a patient-centred, evidence-based and consensus-based discharge care bundle for patients with acute exacerbations of COPD. Methods: A purposeful sample of clinicians and patients were invited to participate in a two-round Delphi study (July-November 2015). In round 1, participants rated on a seven-point Likert scale (1=not at all important; 7=extremely important) the importance of 29 unique COPD care actions...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29467972/a-qualitative-analysis-of-attending-physicians-use-of-shared-decision-making-implications-for-resident-education
#11
Elizabeth M Schoenfeld, Sarah L Goff, Tala R Elia, Errel R Khordipour, Kye E Poronsky, Kelly A Nault, Peter K Lindenauer, Kathleen M Mazor
Background : Physicians need to rapidly and effectively facilitate patient-centered, shared decision-making (SDM) conversations, but little is known about how residents or attending physicians acquire this skill. Objective : We explored emergency medicine (EM) attending physicians' use of SDM in the context of their experience as former residents and current educators and assessed the implications of these findings on learning opportunities for residents. Methods : We used semistructured interviews with a purposeful sample of EM physicians...
February 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29467971/-jgme-aliem-hot-topics-in-medical-education-an-analysis-of-a-virtual-discussion-on-resident-well-being
#12
Arlene Chung, Nicole Battaglioli, Michelle Lin, Jonathan Sherbino
Background : Physician well-being is garnering increasing attention. In 2016, the Journal of Graduate Medical Education ( JGME ) published a review by Kristin Raj, MD, entitled "Well-Being in Residency: A Systematic Review." There is benefit in contextualizing the literature on resident well-being through an academic journal club. Objective : We summarized an asynchronous, online journal club discussion about this systematic review and highlighted themes that were identified in the review...
February 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29467072/social-gradients-in-myocardial-infarction-and-stroke-diagnoses-in-emergency-medicine
#13
Christoph Hanefeld, Alexander Haschemi, Thomas Lampert, Hans J Trampisch, Andreas Mügge, Janine Miebach, Cordula Kloppe, Renate Klaaßen-Mielke
BACKGROUND: Persons of lower socio-economic status are at higher risk of disease, especially with respect to severe and chronic illnesses. To date, there have not been any studies with large case numbers regarding acute medical emergencies in this population. METHODS: In a retrospective study, data were obtained on all cases treated by emergency physicians in Bochum, Germany, in 2014/2015, including the diagnoses that were made by the emergency physicians. There were a total of 16 767 cases...
January 26, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29467048/pregnancy-associated-spontaneous-coronary-artery-dissection-pascad-an-etiology-for-chest-pain-in-the-young-peripartum-patient
#14
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
https://www.readbyqxmd.com/read/29466818/development-and-validation-of-a-natural-language-processing-tool-to-identify-patients-treated-for-pneumonia-across-va-emergency-departments
#15
B E Jones, B R South, Y Shao, C C Lu, J Leng, B C Sauer, A V Gundlapalli, M H Samore, Q Zeng
BACKGROUND:  Identifying pneumonia using diagnosis codes alone may be insufficient for research on clinical decision making. Natural language processing (NLP) may enable the inclusion of cases missed by diagnosis codes. OBJECTIVES:  This article (1) develops a NLP tool that identifies the clinical assertion of pneumonia from physician emergency department (ED) notes, and (2) compares classification methods using diagnosis codes versus NLP against a gold standard of manual chart review to identify patients initially treated for pneumonia...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29466590/administrative-costs-associated-with-physician-billing-and-insurance-related-activities-at-an-academic-health-care-system
#16
Phillip Tseng, Robert S Kaplan, Barak D Richman, Mahek A Shah, Kevin A Schulman
Importance: Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. Objective: To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. Design, Setting, and Participants: This study used time-driven activity-based costing...
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29466514/basic-ultrasound-training-assessment-in-the-initial-abdominal-trauma-screening
#17
Luan Geraldo Ocaña Oliveira, Debora Tagliari, Mariana Juliato Becker, Thiago Adame, José Cruvinel Neto, Fernando Antônio Campelo Spencer Netto
OBJECTIVE: to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma) for emergency physicians in the primary evaluation of abdominal trauma. METHODS: a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT). FAST results started to be collected two months after the course...
February 19, 2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29466477/mysinusitiscoach-patient-empowerment-in-chronic-rhinosinusitis-using-mobile-technology
#18
S F Seys, J Bousquet, C Bachert, W J Fokkens, I Agache, M Bernal-Sprekelsen, I Callebaut, L O Cardel, S Carrie, P Castelnuovo, R Cathcart, J Constantinidis, L Cools, M Cornet, G Clement, J C de Sousa, T Cox, M Doulaptsi, P Gevaert, C Hopkins, V Hox, T Hummel, W Hosemann, R Jacobs, M Jorissen, B N Landis, A Leunig, V J Lund, J Mullol, M Onerci, S Palkonen, I Proano, E Prokopakis, D Ryan, H Riechelmann, J Saevels, C Segboer, K Speleman, E A Steinsvik, P Surda, P V Tomasiz, O Vanderveken, L Van Gerven, T Van Zele, B Verhaeghe, K Vierstraete, S Vlaminck, J Wilkinson, S Williams, B Pugin, P W Hellings
Mobile health technology is emerging to take a prominent position in the management of chronic diseases. These technologies aim at enhancing patient empowerment via education and self-management. To date, of all the different apps available for patients with sinus disease, none were developed by medical experts dealing with chronic rhinosinusitis (CRS). The European Forum for Research and Education in Allergy and Airway diseases (EUFOREA) has undertaken a multi-stakeholder approach for designing, developing and implementing a tool to support CRS patients in monitoring their symptoms and to provide patients with a digital support platform containing reliable medical information about their disease and treatment options...
February 21, 2018: Rhinology
https://www.readbyqxmd.com/read/29466377/understanding-the-psychiatric-effects-of-concussion-on-constructed-identity-in-hockey-players-implications-for-health-professionals
#19
Ryan Todd, Shree Bhalerao, Michael T Vu, Sophie Soklaridis, Michael D Cusimano
OBJECTIVE: The following study was undertaken to investigate the effect of concussion and psychiatric illness on athletes and their caregivers. METHODS: Semi-structured interviews with 20 ice hockey stakeholders (17 men and 3 women) including minor and professional players, coaches, parents, and physicians were conducted over two years (2012-2014). These interviews were analyzed using grounded theory. RESULTS: From this analysis, a common biographical theme emerged whereby the subject's identity as a hockey player, constructed early in life over many years, was disrupted by concussion...
2018: PloS One
https://www.readbyqxmd.com/read/29465664/knowledge-practices-and-barriers-to-hiv-pre-exposure-prophylaxis-prep-prescribing-among-washington-state-medical-providers
#20
Brian R Wood, Vanessa M McMahan, Kelly Naismith, Jonathan B Stockton, Lori A Delaney, Joanne D Stekler
BACKGROUND: We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. METHODS: In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. RESULTS: Of 735 eligible providers, 64...
January 4, 2018: Sexually Transmitted Diseases
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