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https://www.readbyqxmd.com/read/28531643/lipid-based-nutrient-supplements-containing-vitamins-and-minerals-attenuate-renal-electrolyte-loss-in-hiv-aids-patients-starting-antiretroviral-therapy-a-randomized-controlled-trial-in-zambia
#1
D Munkombwe, T L Muungo, C Michelo, P Kelly, S Chirwa, S Filteau
BACKGROUND & AIMS: Advanced HIV infection combined with undernutrition and antiretroviral therapy (ART) places HIV/AIDS patients at high risk of electrolyte abnormalities and increased morbidity and mortality. Here, in a sub-study of a large published randomized trial, we evaluated if nutritional supplements will help curtail renal electrolyte loss in HIV/AIDS patients starting ART. METHODS: 130 malnourished HIV-positive patients referred for ART received lipid-based nutrient supplements alone (LNS, n = 63) or together with vitamins and minerals (LNS-VM, n = 67)...
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#2
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530212/-measurements-of-vancomycin-concentrations-in-the-blood-a-method-of-personalization-the-antibiotic-therapy-in-patients-with-chronic-kidney-disease
#3
Joanna Pondel, Piotr Krajewski, Natalia Królikowska, Aleksandra Tobiasz, Hanna Augustyniak-Bartosik, Magdalena Hurkacz
Therapeutic Drug Monitoring is a recognized method of personalizing treatment, having particular application in patients with chronic kidney disease who have frequent infections, requiring administration of vancomycin. International guidelines indicate the need to adjust the dose of the drug to the state of renal function. The recommended therapeutic ranges of minimum and maximum levels should be achieved in order to increase the effectiveness and safety of treatment. AIM: The aim of this study was to evaluate the usefulness of measuring the concentration of vancomycin in patients with chronic kidney disease due to bacterial infection...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28529546/disease-management-programs-for-patients-with-type-2-diabetes-mellitus-in-germany-a-longitudinal-population-based-descriptive-study
#4
Michael Mehring, Ewan Donnachie, Florian Cornelius Bonke, Christoph Werner, Antonius Schneider
BACKGROUND: The primary aim of the disease management program (DMP) for patients with diabetes mellitus type 2 is to improve the quality of health care and the treatment process. 12 years after its introduction in Germany, there is still no consensus as to whether DMP has been effective in reaching these goals. METHODS: A retrospective longitudinal population-based study between 2004 and 2015 were conducted to evaluate the DMP for type 2 diabetes in Bavaria using routinely collected patient medical records hold from the National Association of Statutory Health Insurance Physicians of Bavaria...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28529358/how-do-psychiatrists-in-india-construct-their-professional-identity-a-critical-literature-review
#5
Clement Bayetti, Sushrut Jadhav, Smita N Deshpande
Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections...
January 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28529048/laboratory-based-performance-evaluation-of-pima-cd4-t-lymphocyte-count-point-of-care-by-lay-counselors-in-kenya
#6
Clement Zeh, Charles E Rose, Seth Inzaule, Mitesh A Desai, Fredrick Otieno, Felix Humwa, Benta Akoth, Paul Omolo, Robert T Chen, Yenew Kebede, Taraz Samandri
BACKGROUND: CD4+ T-lymphocyte count testing at the point-of-care (POC) may improve linkage to care of persons diagnosed with HIV-1 infection, but the accuracy of POC devices when operated by lay-counselors in the era of task-shifting is unknown. We examined the accuracy of Alere's Pima™ POC device on both capillary and venous blood when performed by lay-counselors and laboratory technicians. METHODS: In Phase I, we compared the perfomance of POC against FACSCalibur™ for 280 venous specimens by laboratory technicians...
May 18, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28528753/healthcare-access-and-quality-index-based-on-mortality-from-causes-amenable-to-personal-health-care-in-195-countries-and-territories-1990-2015-a-novel-analysis-from-the-global-burden-of-disease-study-2015
#7
(no author information available yet)
BACKGROUND: National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015...
May 18, 2017: Lancet
https://www.readbyqxmd.com/read/28528623/organizational-perspectives-of-nurse-executives-in-15-hospitals-on-the-impact-and-effectiveness-of-rapid-response-teams
#8
Patricia L Smith, Jean McSweeney
BACKGROUND: Many hospitals use rapid response teams (RRTs) to respond to deteriorating patients, but it remains unclear what organizations actually monitor. Understanding what organizations value in an RRT may help clarify measurement choices. Interviews were conducted to determine how organizational leaders perceived and evaluated their hospitals' RRTs. METHODS: The study used a descriptive, qualitative design. Participants were nurse executives and key informants in 300- to 500-bed hospitals in the south-central United States and were recruited using purposive and snowball sampling...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#9
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28528585/why-patients-should-be-involved-in-health-technology-assessment
#10
Janet Wale, Anna Mae Scott, Bjørn Hofmann, Sarah Garner, Eric Low, Lloyd Sansom
OBJECTIVES: Some countries make considerable effort to involve patients and patient groups in their health technology assessment (HTA) processes; others are only just considering or are yet to consider patient involvement in HTA. METHODS: This commentary offers four arguments why patient involvement should be prioritized by those HTA agencies that do not yet involve patients: (1) from a patients' rights perspective, (2) based on patient and community values, (3) centering on evidentiary contributions, and (4) from a methodological perspective...
May 22, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#11
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28527564/prospective-comparison-of-perioperative-antibiotic-management-protocols-in-oncological-head-and-neck-surgery
#12
Alexander K Bartella, Mohammad Kamal, Jan Teichmann, Anita Kloss-Brandstätter, Timm Steiner, Frank Hölzle, Bernd Lethaus
OBJECTIVES: The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients. MATERIAL AND METHODS: In this prospective study 75 consecutive patients, who underwent major oncological head and neck surgery were included and divided in three groups, each containing 25 patients...
April 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28527495/consumer-mobile-health-apps-current-state-barriers-and-future-directions
#13
REVIEW
Cheng-Kai Kao, David M Liebovitz
This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28526865/realization-of-large-energy-proportion-in-the-central-lobe-by-coherent-beam-combination-based-on-conformal-projection-system
#14
Dong Zhi, Zhixin Zhang, Yanxing Ma, Xiaolin Wang, Zilun Chen, Wuming Wu, Pu Zhou, Lei Si
In this paper, we experimentally validate a tiled-aperture conformal projection system with the largest array filling factor and element beam truncation factor to the best of our knowledge. The conformal projection system, which is made up of a hexagonal adaptive fiber-optics collimator (AFOC) array with the proximate ideal intensity distributions, is fabricated and the performance of output beam is tested and evaluated properly and carefully. Both of the active phase-locking control and precise tip-tilt control are implemented successfully in the CBC of the hexagonal seven-beam-array...
May 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#15
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28525464/the-cardiac-rehabilitation-model-improves-fitness-quality-of-life-and-depression-in-breast-cancer-survivors
#16
Lianne B Dolan, Danielle Barry, Teresa Petrella, Lindsay Davey, Ann Minnes, Allison Yantzi, Susan Marzolini, Paul Oh
PURPOSE: Exercise is a demonstrated, therapeutic strategy for cancer survivors to minimize many treatment-induced side effects and may decrease risk of recurrence. Nonetheless, structured programs that combine exercise and education are not yet standardized within cancer care. The Health, Exercise, Active Living, Therapeutic lifestyle (HEALTh) program is a clinical exercise program based on the established cardiac rehabilitation model, but customized for female breast cancer survivors...
May 18, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28525404/growth-hormone-treatment-for-growth-hormone-deficiency-and-idiopathic-short-stature-new-guidelines-shaped-by-the-presence-and-absence-of-evidence
#17
Adda Grimberg, David B Allen
PURPOSE OF REVIEW: The Pediatric Endocrine Society recently published new guidelines for the use of human growth hormone (hGH) and human insulin-like growth factor-I (hIGF-I) treatment for growth hormone deficiency, idiopathic short stature, and primary IGF-I deficiency in children and adolescents. This review places the new guidelines in historical contexts of the life cycle of hGH and the evolution of US health care, and highlights their future implications. RECENT FINDINGS: The new hGH guidelines, the first to be created by the Grading of Recommendations Assessment, Development and Evaluation approach, are more conservative than their predecessors...
May 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28524031/-predictive-value-of-cerebrospinal-fluid-lactate-for-the-diagnosis-of-bacterial-meningitis-in-patients-post-neurosurgical-operation-with-blood-contaminated-cerebrospinal-fluid
#18
Yufang Wang, Lingyan Wang, Jingchao Li, Lei Shi, Mingli Yao, Xiangdong Guan, Bin Ouyang
OBJECTIVE: To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). METHODS: A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523474/perceptions-of-successful-aging-among-older-adults-in-bangladesh-an-exploratory-study
#19
Iftekhar Amin
To analyze older adults' definitions of successful aging in Bangladesh. The purposively selected study sample comprised twelve participants who were aged over 60. Interviews using in-depth semi-structured questionnaires were conducted based on participants' chosen mode, either face-to-face, or by phone. Findings of this study support that successful aging is multidimensional - that is - for Bangladeshis successful aging encompasses dimensions such as adaptation to an aging body, financial security, family and intergenerational care, and social participation...
May 18, 2017: Journal of Cross-cultural Gerontology
https://www.readbyqxmd.com/read/28523452/training-for-leadership-roles-in-academic-medicine-opportunities-for-psychologists-in-the-aamc-lead-program
#20
Donna LaPaglia, Britta Thompson, Janet Hafler, Sheila Chauvin
Psychologists' roles within academic medicine have expanded well beyond research and scholarship. They are active as providers of patient care, medical education, and clinical supervision. Although the number of psychologists in academic health centers continues to grow, they represent a small portion of total medical school faculties. However, with the movement toward collaborative care models, emphasis on interprofessional teams, and increased emphasis on psychological science topics in medical curricula, psychologists are well-positioned to make further contributions...
May 18, 2017: Journal of Clinical Psychology in Medical Settings
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