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https://www.readbyqxmd.com/read/28346946/association-between-a-virtual-glucose-management-service-and-glycemic-control-in-hospitalized-adult-patients-an-observational-study
#1
Robert J Rushakoff, Mary M Sullivan, Heidemarie Windham MacMaster, Arti D Shah, Alvin Rajkomar, David V Glidden, Michael A Kohn
Background: Inpatient hyperglycemia is common and is linked to adverse patient outcomes. New methods to improve glycemic control are needed. Objective: To determine whether a virtual glucose management service (vGMS) is associated with improved inpatient glycemic control. Design: Cross-sectional analyses of three 12-month periods (pre-vGMS, transition, and vGMS) between 1 June 2012 and 31 May 2015. Setting: 3 University of California, San Francisco, hospitals...
March 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28346622/future-of-family-medicine-faculty-development-in-sub-saharan-africa
#2
Paul R Larson, Patrick Chege, Bruce Dahlman, Christine Gibson, Ann Evensen, Maria C Colon-Gonzalez, Stephanie Onguka, Roberta Lamptey, William E Cayley, Bich-May Nguyen, Brian Johnson, Sawra Getnet, Memoona Hasnain
BACKGROUND AND OBJECTIVES: High-quality family medicine education is needed in sub-Saharan Africa to facilitate the future growth of primary care health systems. Current faculty educators recognize the value of dedicated teacher training and ongoing faculty development. However, they are constrained by inadequate faculty development program availability and institutional support. METHODS: A cross-sectional study design was used to conduct a qualitative needs assessment comprised of 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#3
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28345444/budgetary-impact-of-cabazitaxel-use-after-docetaxel-treatment-for-metastatic-castration-resistant-prostate-cancer
#4
Kyle Flannery, Ed Drea, Louis Hudspeth, Shelby Corman, Xin Gao, Mei Xue, Raymond Miao
BACKGROUND: With the approval of several new treatments for metastatic castration-resistant prostate cancer (mCRPC), budgetary impact is a concern for health plan decision makers. Budget impact models (BIMs) are becoming a requirement in many countries as part of formulary approval or reimbursement decisions. Cabazitaxel is a second-generation taxane developed to overcome resistance to docetaxel and is approved for the treatment of patients with mCRPC previously treated with a docetaxel-containing regimen...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#5
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28345362/mindfulness-based-movement
#6
Alexander R Lucas, Heidi D Klepin, Stephen W Porges, W Jack Rejeski
Compelling evidence suggests that physical activity is an effective intervention for cancer survivors, including for those undergoing active cancer treatments. However, to date most evidence has emerged from interventions that have promoted moderate to vigorous physical activity. In this conceptual review, we argue that attention should be given to the entire continuum of physical activity from reducing sedentary behavior to increasing higher levels of physical activity when possible. In addition, considerable evidence in the cancer literature supports the value of mindfulness-based interventions as a means of helping patients and survivors cope with the variety of threats that accompany this disease...
December 1, 2016: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/28345067/utility-of-360-degree-assessment-of-residents-in-a-turkish-academic-emergency-medicine-residency-program
#7
Cem Oktay, Yesim Senol, Stephan Rinnert, Yildiray Cete
OBJECTIVES: This study was designed to test a 360-degree assessment tool for four of the emergency medicine resident competencies as outlined by the Council of Residency Directors in Emergency Medicine on patient care, communication skills, professionalism and system based practice in an academic Emergency Department. MATERIAL AND METHODS: Using the competency framework of the American Accreditation Council for Graduate Medical Education, a 57 item-containing assessment tool was created...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28344745/can-molecular-biomarkers-replace-a-clinical-risk-score-for-resectable-colorectal-liver-metastasis
#8
EDITORIAL
Torhild Veen, Kjetil Søreide
In resectable colorectal liver metastasis (CRLM) the role and use of molecular biomarkers is still controversial. Several biomarkers have been linked to clinical outcomes in CRLM, but none have so far become routine for clinical decision making. For several reasons, the clinical risk score appears to no longer hold the same predictive value. Some of the reasons include the ever expanding indications for liver resection, which now increasingly tend to involve extrahepatic disease, such as lung metastases (both resectable and non-resectable) and the shift in indication from "what is taken out" (e...
March 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28344737/non-invasive-measures-of-core-temperature-versus-ingestible-thermistor-during-exercise-in-the-heat
#9
Donovan L Fogt, Andrea L Henning, Adam S Venable, Brian K McFarlin
The accuracy of core temperature (Tc) thermometry from temporal, tympanic, and oral thermometry devices has been variable during exercise in a hot, humid environment. The purpose of the present study was to cross-validate temporal, two tympanic devices, and oral devices compared to an ingestible thermistor during exercise in a hot, humid environment. Fourteen young, active adults (6 women) completed a graded exercise test until voluntary exhaustion in an environmental chamber (35.5 ± 0.6 °C, 53.9 ± 5.8 % RH)...
2017: International Journal of Exercise Science
https://www.readbyqxmd.com/read/28344716/an-examination-of-entrance-criteria-for-international-medical-graduates-imgs-into-canadian-psychiatry-residency-programs
#10
Ashok Soma, Mathew Myatt, Mario McKenna, Soma Ganesa, Ka Wai Leung
BACKGROUND: Although international medical graduates (IMGs) are essential in health care service delivery, a gap exists in the literature about how IMGs are selected into psychiatry residency programs in Canada. The purpose of this study was to identify the relative weight or importance that Canadian program directors (PDs) of psychiatry place on certain selection criteria when matching IMGs into residency programs. METHODS: We electronically distributed a web-based questionnaire to 16 university residency program directors of psychiatry in Canada...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28344600/staged-reconstruction-brachytherapy-has-lower-overall-cost-in-recurrent-soft-tissue-sarcoma
#11
Arash O Naghavi, Ricardo J Gonzalez, Jacob G Scott, Youngchul Kim, Yazan A Abuodeh, Tobin J Strom, Michelle Echevarria, John E Mullinax, Kamran A Ahmed, Louis B Harrison, Daniel C Fernandez
PURPOSE: Adjuvant brachytherapy (AB) with immediate (IR) and staged reconstruction (SR) are distinct treatment modalities available for patients with recurrent soft tissue sarcoma (STS). Although SR may offer local control and toxicity benefit, it requires additional upfront procedures, and there is no evidence that it improves overall survival. With the importance of value-based care, our goal is to identify which technique is more cost effective. MATERIAL AND METHODS: A retrospective review of 22 patients with recurrent extremity STS treated with resection followed by AB alone...
February 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28344140/high-value-cost-conscious-care-iterative-systems-based-interventions-to-reduce-unnecessary-lab-testing
#12
Brett W Sadowski, Alison B Lane, Shannon M Wood, Sara L Robinson, Chin Hee Kim
BACKGROUND: Inappropriate testing contributes to soaring health care costs within the United States and teaching hospitals are vulnerable to providing care largely for academic development. Via its 'Choosing Wisely' campaign, the American Board of Internal Medicine recommends avoiding repetitive testing for stable inpatients. We designed systems-based interventions to reduce laboratory orders for patients admitted to the wards at an academic facility. METHODS: We identified the computer-based order entry system as an appropriate target for sustainable intervention...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28342618/a-realist-synthesis-of-social-connectivity-interventions-during-transition-to-parenthood-the-value-of-relationships
#13
Claudine T Bennett, Judy L Buchan, Nicole Letourneau, Stuart G Shanker, Anne Fenwick, Brenda Smith-Chant, Cyndi Gilmer
BACKGROUND: Social connections are important during the transition to parenthood. A wide body of literature suggests that these connections enhance health and contribute to wellbeing. In the case of parents and families, social connections can influence child development. Nurses and public health agencies are in a unique position to advocate for resources and approaches to enhance social connectivity for parents during this important life transition. OBJECTIVES: The aim of this review was to identify the universal social connectivity interventions that work, and the conditions that foster social connections for parents and enhance child development...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342433/-evaluation-of-the-degree-of-patient-information-to-be-included-in-the-home-based-palliative-care-program
#14
Ana María Tordable Ramírez
The fact of communicating to a patient his or her diagnosis when it is unfavourable, this becomes a really human issue. The bioethics and the legislation protect this right of information. The aim of this study is to evaluate the degree of information of patients when they are included in the home palliative care program. This is a quantitative, descriptive, retrospective and transversal study. The year of the study is 2012 in patients diagnosed with advanced terminal illnesses processes valued by the Team of Home Palliative Attention Support, of the North Welfare Direction of the Community of Madrid...
January 2017: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
https://www.readbyqxmd.com/read/28340161/organizational-benchmarks-for-test-utilization-performance-an-example-based-on-positivity-rates-for-genetic-tests
#15
Joseph Rudolf, Brian R Jackson, Andrew R Wilson, Kristi J Smock, Robert L Schmidt
Objectives: Health care organizations are under increasing pressure to deliver value by improving test utilization management. Many factors, including organizational factors, could affect utilization performance. Past research has focused on the impact of specific interventions in single organizations. The impact of organizational factors is unknown. The objective of this study is to determine whether testing patterns are subject to organizational effects, ie, are utilization patterns for individual tests correlated within organizations...
March 15, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#16
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340009/designing-an-optimal-screening-program-for-unknown-atrial-fibrillation-a-cost-effectiveness-analysis
#17
Mattias Aronsson, Emma Svennberg, Mårten Rosenqvist, Johan Engdahl, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Lars-Åke Levin
Aims: The primary objective of this study was to use computer simulations to suggest an optimal age for initiation of screening for unknown atrial fibrillation and to evaluate if repeated screening will add value. Methods and results: In the absence of relevant clinical studies, this analysis was based on a simulation model. More than two billion different designs of screening programs for unknown atrial fibrillation were simulated and analysed. Data from the published scientific literature and registries were used to construct the model and estimate lifelong effects and costs...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339592/active-collaboration-with-clients-an-underemphasized-but-vital-part-of-evidence-based-practice
#18
James Drisko
Evidence-based practice (EBP) is a widely recognized concept in contemporary social work practice. However, recent studies have shown that social workers do not understand EBP correctly. Standardized administrative approaches to implementing EBP have led to confusion about its core practice decision-making process. This collaborative process is the heart of EBP in direct social work practice. This article explores the EBP process and addresses a vital but often underemphasized step of EBP: active collaboration with the client in decision making...
January 28, 2017: Social Work
https://www.readbyqxmd.com/read/28338946/instrumental-variable-methods-for-continuous-outcomes-that-accommodate-nonignorable-missing-baseline-values
#19
Ashkan Ertefaie, James H Flory, Sean Hennessy, Dylan S Small
Instrumental variable (IV) methods provide unbiased treatment effect estimation in the presence of unmeasured confounders under certain assumptions. To provide valid estimates of treatment effect, treatment effect confounders that are associated with the IV (IV-confounders) must be included in the analysis, and not including observations with missing values may lead to bias. Missing covariate data are particularly problematic when the probability that a value is missing is related to the value itself, which is known as nonignorable missingness...
March 16, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28338472/robust-cardiac-motion-estimation-using-ultrafast-ultrasound-data-a-low-rank-topology-preserving-approach
#20
Angelica I Aviles, Thomas Widlak, Alicia Casals, Maartje Nillesen, Habib Ammari
Cardiac motion estimation is an important diagnostic tool to detect heart diseases and it has been explored with modalities such as MRI and conventional ultrasound (US) sequences. US cardiac motion estimation still presents challenges because of the complex motion patterns and the presence of noise. In this work, we propose a novel approach to estimate the cardiac motion using ultrafast ultrasound data. -- Our solution is based on a variational formulation characterized by the L2-regularized class. The displacement is represented by a lattice of b-splines and we ensure robustness by applying a maximum likelihood type estimator...
March 24, 2017: Physics in Medicine and Biology
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