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https://www.readbyqxmd.com/read/28930956/implications-of-the-trauma-quality-improvement-project-inclusion-of-nonsurvivable-injuries-in-performance-benchmarking
#1
Jiselle Bock Heaney, Rebecca Schroll, Jennifer Turney, Lance Stuke, Alan B Marr, Patrick Greiffenstein, Rosemarie Robledo, Amanda Theriot, Juan Duchesne, John Hunt
BACKGROUND: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a Level I high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with nonsurvivable injuries. METHODS: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013 to 2014 with length of stay (LOS) less than 1 day to determine survivability of the injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930892/costs-and-trends-in-utilization-of-low-value-services-among-older-adults-with-commercial-insurance-or-medicare-advantage
#2
Elizabeth A Carter, Pamela E Morin, Keith D Lind
BACKGROUND: Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. OBJECTIVES: To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. RESEARCH DESIGN: A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930815/variability-in-usual-care-mechanical-ventilation-for-pediatric-acute-respiratory-distress-syndrome-time-for-a-decision-support-protocol
#3
Christopher J L Newth, Katherine A Sward, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Richard Holubkov, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#4
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28930362/rapid-development-of-specialty-population-registries-and-quality-measures-from-electronic-health-record-data-an-agile-framework
#5
Vaishnavi Kannan, Jason S Fish, Jacqueline M Mutz, Angela R Carrington, Ki Lai, Lisa S Davis, Josh E Youngblood, Mark R Rauschuber, Kathryn A Flores, Evan J Sara, Deepa G Bhat, DuWayne L Willett
BACKGROUND: Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch...
June 14, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28929965/-a-negleted-bacteria-with-a-case-bartonella-henselae
#6
Kamuran Türker, Bekir Çelebi, Şeyda Andaç, Pınar Bulut, Şenay Yalçın, Saniye Dolhan
Bartonella henselae the causative agent of cat scratch disease (CSD), is a gram-negative, coccobacillus, facultative intracellular bacterium CSD usually presents as a clinical form of benign local lymphadenopathy (LAP) but sometimes it may progress to severe life threatening complications. Despite the fact that CSD is known to be a common disease, which is one of the important causes of local LAPs in the world, there are few publications in our country. For the diagnosis, the clinician should suspect for CSD and has to ask to the patient whether there is a story of cat scratch or not...
July 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28929939/the-development-of-the-professional-values-model-in-nursing
#7
Ayla Kaya, İlkay Boz
One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28929667/-efficacy-and-safety-of-danhong-injection-for-idiopathic-pulmonary-fibrosis%C3%AF-meta-analysis
#8
Li-Li Xin, Miao Jiang, Geng Zhang, Jie-Ning Gong
To systematically review the efficacy and safety of Danhong injection for patients with idiopathic pulmonary fibrosis(IPF), two researchers electronically searched PubMed, EMbase, Web of Science, Cochrane Library, CNKI, CBM, WanFang Data and VIP databases from the date of establishment to May 2016 for all randomized controlled trials(RCTs) and quasi-RCTs on the use of Danhong injection in patients with IPF. Manual search in relevant journals and search of relevant literature on other websites were also performed...
October 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28929623/influence-of-combined-iron-supplementation-and-simulated-hypoxia-on-the-haematological-module-of-the-athlete-biological-passport
#9
Laura A Garvican-Lewis, Victor L Vuong, Andrew D Govus, Yorck Olaf Schumacher, David Hughes, Greg Lovell, Daniel Eichner, Christopher J Gore
The integrity of Athlete Biological Passport (ABP) is underpinned by understanding normal fluctuations of its biomarkers to environmental or medical conditions, e.g. altitude training or iron deficiency. The combined impact of altitude and iron supplementation on the ABP was evaluated in endurance-trained athletes (n=34) undertaking 3-weeks of simulated live-high: train-low (14 h.d(-1) , 3000m). Athletes received either oral, intravenous (IV) or placebo iron supplementation, commencing two weeks prior and continuing throughout hypoxic exposure...
September 19, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28928111/personalized-hypertension-management-using-patient-generated-health-data-integrated-with-electronic-health-records-empower-h-six-month-pre-post-study
#10
Nan Lv, Lan Xiao, Martha L Simmons, Lisa G Rosas, Albert Chan, Martin Entwistle
BACKGROUND: EMPOWER-H (Engaging and Motivating Patients Online With Enhanced Resources-Hypertension) is a personalized-care model facilitating engagement in hypertension self-management utilizing an interactive Web-based disease management system integrated with the electronic health record. The model is designed to support timely patient-provider interaction by incorporating decision support technology to individualize care and provide personalized feedback for patients with chronic disease...
September 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28927475/impact-of-discontinuing-contact-precautions-for-mrsa-and-esble-in-an-intensive-care-unit-a-prospective-noninferiority-before-and-after-study
#11
Laurie Renaudin, Mathieu Llorens, Christophe Goetz, Sébastien Gette, Vincente Citro, Sylvia Poulain, Marie-Laure Vanson, Jocelyne Sellies
OBJECTIVE To compare incidence densities of methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE) acquisition in the intensive care unit (ICU) before and after discontinuation of contact precautions (CP) and application of standard precautions (SP). DESIGN Prospective noninferiority before-and-after study comparing 2 periods: January 1, 2012, to January 31, 2014 (the CP period) and February 1, 2014, to February 29, 2016 (the SP period). SETTING A 16-bed polyvalent ICU in France with only single-bed rooms with dedicated equipment and reusable medical devices...
September 20, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28926329/postoperative-haematocrit-and-outcome-in-critically-ill-surgical-patients
#12
Ana Martins Lopes, Diana Silva, Gabriela Sousa, Joana Silva, Alice Santos, Fernando José Abelha
INTRODUCTION: Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes. MATERIAL AND METHODS: This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently...
August 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#13
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924688/the-barrier-to-informed-choice-in-cancer-screening-statistical-illiteracy-in-physicians-and-patients
#14
Odette Wegwarth, Gerd Gigerenzer
An efficient health care requires both informed doctors and patients. Our current healthcare system falls short on both counts. Most doctors and patients do not understand the available medical evidence. To illustrate the extent of the problem in the setting of cancer screening: In a representative sample of some 5000 women in nine European countries, 92% overestimated the reduction of breast cancer mortality by mammography by a factor of 10-200, or did not know. For a similar sample of about 5000 men with respect to PSA screening, this number was 89%...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28924399/changing-the-rules-of-the-game-how-do-we-measure-success-in-social-media
#15
REVIEW
Aisling M Hogan, Desmond C Winter
Ours will be the generation proud to say we shifted the sands of educational deserts by open access and proliferation, seeding of data sharing, and watering grassroots research in resource-compromised environments. Universal "social" media is defining features of modern professional life that provide powerful modes of knowledge acquisition/sharing to that end. Altmetric and other measurements stratify academic communications according to this alternate, online media presence (not academic penetrance). Are they meaningless, self-absorbed integers, or reliable yardsticks of scientific and educational prowess? Far beyond this trite, patronizing question from the minds of outdated, terrified technophobes, the real impact of "social" media is not narcissistic solipsism...
September 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28923845/high-sensitivity-cardiac-troponin-i-as-a-gatekeeper-for-coronary-computed-tomography-angiography-and-stress-testing-in-patients-with-acute-chest-pain
#16
Maros Ferencik, Thomas Mayrhofer, Michael T Lu, Pamela K Woodard, Quynh A Truong, W Frank Peacock, Fabian Bamberg, Benjamin C Sun, Jerome L Fleg, John T Nagurney, James E Udelson, Wolfgang Koenig, James L Januzzi, Udo Hoffmann
BACKGROUND: Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS: We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing...
September 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28923809/a-randomized-trial-of-high-value-change-using-practice-facilitation
#17
LeAnn Michaels, Tracy Anastas, Elizabeth Needham Waddell, Lyle Fagnan, David A Dorr
PURPOSE: To understand how focused versus general practice facilitation can impact goal setting, action planning, and team performance in primary care transformation. BACKGROUND: Practice transformation in primary care is a crucial part of health reform, but can fatigue teams, leading to variable results. Practice facilitation may reduce primary care fatigue to help teams reach challenging transformation goals, but may require a more focused approach than previous studies suggest...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923341/acute-toxicity-bioconcentration-elimination-and-antioxidant-effects-of-fluralaner-in-zebrafish-danio-rerio
#18
Zhong-Qiang Jia, Di Liu, Cheng-Wang Sheng, John E Casida, Chen Wang, Ping-Ping Song, Yu-Ming Chen, Zhao-Jun Han, Chun-Qing Zhao
Fluralaner is a novel isoxazoline insecticide which shows high insecticidal activity against parasitic, sanitary and agricultural pests, but there is little information about the effect of fluralaner on non-target organisms. This study reports the acute toxicity, bioconcentration, elimination and antioxidant response of fluralaner in zebrafish. All LC50 values of fluralaner to zebrafish were higher than 10 mg L(-1) at 24, 48, 72 and 96 h. To study the bioconcentration and elimination, the zebrafish were exposed to sub-lethal concentrations of fluralaner (2...
September 15, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28923126/-drawing-aside-the-curtain-natural-childbirth-on-screen-in-1950s-britain
#19
Salim Al-Gailani
This article recovers the importance of film, and its relations to other media, in communicating the philosophies and methods of 'natural childbirth' in the post-war period. It focuses on an educational film made in South Africa around 1950 by controversial British physician Grantly Dick-Read, who had achieved international fame with bestselling books arguing that relaxation and education, not drugs, were the keys to freeing women from pain in childbirth. But he soon came to regard the 'vivid' medium of film as a more effective means of disseminating the 'truth of [his] mission' to audiences who might never have read his books...
September 2017: British Journal for the History of Science
https://www.readbyqxmd.com/read/28923120/high-dose-interleukin-2-hd-il-2-for-advanced-melanoma-a-single-center-experience-from-the-university-of-pittsburgh-cancer-institute
#20
Diwakar Davar, Fei Ding, Melissa Saul, Cindy Sander, Ahmad A Tarhini, John M Kirkwood, Hussein A Tawbi
BACKGROUND: Durable remissions are observed in a fraction of metastatic melanoma patients treated with high-dose interleukin-2 (HD IL-2). Early studies reported overall (OR) and complete response (CR) rates of 16% and 8% respectively. Toxicity limited use to specialized centers with standardized protocols. We report on 243 patients treated at the University of Pittsburgh in a non-intensive care unit (ICU) oncology specialty setting. METHODS: Clinical and radiological data were collected on 243 patients treated between 1992 and 2015...
September 19, 2017: Journal for Immunotherapy of Cancer
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