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https://www.readbyqxmd.com/read/28108581/reduced-emergency-department-utilization-by-patients-with-epilepsy-using-qi-methodology
#1
Anup D Patel, Eric G Wood, Daniel M Cohen
BACKGROUND: Epilepsy or seizure care is the most common neurologic condition that presents to an emergency department (ED) and accounts for a large number of annual cases. Our aim was to decrease seizure-related ED visits from our baseline of 17 ED visits per month per 1000 patients to 13.6 ED visits per month per 1000 patients (20%) by July 2014. METHODS: Our strategy was to develop a quality improvement (QI) project utilizing the Institute for Healthcare Improvement model...
January 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28108238/effect-of-an-evidence-based-guideline-on-the-treatment-of-maxillofacial-cancer-a-prospective-analysis
#2
Klaus-Dietrich Wolff, Andrea Rau, Julia Ferencz, Thomas Langer, Marco Kesting, Markus Nieberler, Simone Wesselmann
BACKGROUND: In 2012, a guideline for the diagnosis and treatment of oral cavity cancer based on the best available evidence was implemented at certified German cancer centres for head and neck carcinomas. The present analysis was performed to determine whether the implementation of the guideline via certification improved the level of care, leading to a benefit for the patients. METHODS: A prospective observational study was performed based on the annual operating figures at 31 certified head and neck cancer centres...
December 20, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28107594/weighing-the-evidence-from-surgical-trials
#3
Quoc-Dien Trinh, Alexander P Cole, Prokar Dasgupta
With growing calls to improve value in health care, the assessment of surgical outcomes has moved to the spotlight. Public awareness of medical errors has spurred initiatives like the ProPublica "Surgeon Scorecard" to measure and report complications (h t t p s : //projects. propublica. org/surgeons/). High-tech and expensive innovations such as robot-assisted surgery must be measured against traditional approaches. This article is protected by copyright. All rights reserved.
January 20, 2017: BJU International
https://www.readbyqxmd.com/read/28107351/high-concentrations-of-angiopoietin-like-protein-4-detected-in-serum-from-patients-with-rheumatoid-arthritis-can-be-explained-by-non-specific-antibody-reactivity
#4
Elena Makoveichuk, Toralph Ruge, Solveig Nilsson, Anna Södergren, Gunilla Olivecrona
Angiopoietin-like protein 4 (ANGPTL4) is suggested to be a master regulator of plasma triglyceride metabolism. Our aim was to study whether the previously reported high levels of ANGPTL4 detected in serum from patients with rheumatoid arthritis (RA) by ELISA was due to any specific molecular form of this protein (oligomers, monomers or fragments). ANGPTL4 levels were first determined in serum from 68 RA patients and 43 age and sex matched control subjects and the mean values differed by a factor of 5.0. Then, ANGPTL4 was analyzed after size exclusion chromatography (SEC) of serum samples...
2017: PloS One
https://www.readbyqxmd.com/read/28106511/telementoring-primary-care-clinicians-to-improve-geriatric-mental-health-care
#5
Elisa Fisher, Michael Hasselberg, Yeates Conwell, Linda Weiss, Norma A Padrón, Erin Tiernan, Jurgis Karuza, Jeremy Donath, José A Pagán
Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28106257/limitations-of-polyethylene-glycol-induced-precipitation-as-predictive-tool-for-protein-solubility-during-formulation-development
#6
Melanie Hofmann, Matthias Winzer, Christian Weber, Henning Gieseler
OBJECTIVE: Polyethylene glycol (PEG)-induced protein precipitation is often used to extrapolate apparent protein solubility at specific formulation compositions. The procedure was used for several fields of application such as protein crystal growth but also protein formulation development. Nevertheless, most studies focused on applicability in protein crystal growth. In contrast, this study focuses on applicability of PEG-induced precipitation during high-concentration protein formulation development...
January 20, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28105883/measuring-health-literate-discharge-practices
#7
Jennifer Innis, Jan Barnsley, Whitney Berta, Imtiaz Daniel
Purpose Health literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new survey. Design/methodology/approach This survey was administered to hospitals in Ontario, Canada. Exploratory factor analysis and reliability testing were performed...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28104463/moving-from-outcomes-to-values-to-deliver-high-quality-health-care
#8
Logan Trenaman, Nick Bansback
No abstract text is available yet for this article.
January 16, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28104459/validation-of-the-intervertebral-disc-histological-degeneration-score-in-cervical-intervertebral-discs-and-their-endplates
#9
Krzysztof A Tomaszewski, Brandon Michael Henry, Tomasz Gładysz, Roman Głowacki, Jerzy A Walocha, Romana Tomaszewska
BACKGROUND CONTEXT: Vertebral joints consist of intervertebral discs (IVDs) and cartilaginous endplates (EP) that lie superiorly and inferiorly to the IVDs and separate them from the adjacent vertebral bodies. With ageing, both IVDs and EPs undergo degeneration. The Histologic Degeneration Score (HDS) is a grading system which microscopically evaluates the degree of degeneration in lumbar discs and predicts it with high accuracy basing on several histological markers of IVD and EP. There is currently a lack of validated histologic grading schemes for cervical spine degeneration...
January 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28103931/developing-a-framework-to-guide-the-de-adoption-of-low-value-clinical-practices-in-acute-care-medicine-a-study-protocol
#10
Jeanna Parsons Leigh, Daniel J Niven, Jamie M Boyd, Henry T Stelfox
BACKGROUND: Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103300/expression-profiling-of-ribosome-biogenesis-factors-reveals-nucleolin-as-a-novel-potential-marker-to-predict-outcome-in-aml-patients
#11
Virginie Marcel, Frédéric Catez, Caroline M Berger, Emeline Perrial, Adriana Plesa, Xavier Thomas, Eve Mattei, Sandrine Hayette, Pierre Saintigny, Philippe Bouvet, Jean-Jacques Diaz, Charles Dumontet
Acute myeloid leukemia (AML) is a heterogeneous disease. Prognosis is mainly influenced by patient age at diagnosis and cytogenetic alterations, two of the main factors currently used in AML patient risk stratification. However, additional criteria are required to improve the current risk classification and better adapt patient care. In neoplastic cells, ribosome biogenesis is increased to sustain the high proliferation rate and ribosome composition is altered to modulate specific gene expression driving tumorigenesis...
2017: PloS One
https://www.readbyqxmd.com/read/28102961/assessing-the-use-of-4dct-ventilation-in-pre-operative-surgical-lung-cancer-evaluation
#12
Yevgeniy Vinogradskiy, Matthew Jackson, Leah Schubert, Bernard Jones, Richard Castillo, Edward Castillo, Thomas Guerrero, John Mitchell, Chad Rusthoven, Moyed Miften, Brian Kavanagh
PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28102557/cardiovascular-disease-and-prediabetes-as-complex-illness-people-s-perspectives
#13
Kim van Wissen, Michelle Thunders, Karen Mcbride-Henry, Margaret Ward, Jeremy Krebs, Rachel Page
Cardiovascular disease (CVD) and sustained high blood glucose as prediabetes are an established comorbidity. People's experience in reconciling these long-term conditions requires deeper appreciation if nurses are to more effectively support person-centred care for people who have them. Our analysis explores the initial experience of people admitted to hospital with CVD who then find they also have sustained high blood glucose. Our methodology is informed by the philosophy of Gadamer and applies interpretive description to develop an interpretation of participant experiences...
January 19, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28100661/weak-beam-scanning-transmission-electron-microscopy-for-quantitative-dislocation-density-measurement-in-steels
#14
Kenta Yoshida, Masaki Shimodaira, Takeshi Toyama, Yasuo Shimizu, Koji Inoue, Toshimasa Yoshiie, Konstantinovic J Milan, Robert Gerard, Yasuyoshi Nagai
To evaluate dislocations induced by neutron irradiation, we developed a weak-beam scanning transmission electron microscopy (WB-STEM) system by installing a novel beam selector, an annular detector, a high-speed CCD camera and an imaging filter in the camera chamber of a spherical aberration-corrected transmission electron microscope. The capabilities of the WB-STEM with respect to wide-view imaging, real-time diffraction monitoring and multi-contrast imaging are demonstrated using typical reactor pressure vessel steel that had been used in an European nuclear reactor for 30 years as a surveillance test piece with a fluence of 1...
January 17, 2017: Microscopy
https://www.readbyqxmd.com/read/28100641/new-sources-of-value-for-health-and-care-in-a-carbon-constrained-world
#15
Kate Emma Charlesworth, Maggie Jamieson
BACKGROUND: Due to the climate crisis, it is increasingly evident that countries will have to decarbonize. Healthcare, which has a large carbon footprint and uses vast quantities of resources, will have to undergo significant transformation. In this research, we sought the ideas of leading thinkers in the field, to address the question of how health systems can provide high-quality care in a carbon-constrained world. METHODS: Semi-structured, qualitative in-depth interviews with 15 healthcare thought leaders from Australia, the UK, the USA and New Zealand...
January 17, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28100293/psychiatric-rehabilitation-in-europe
#16
W Rössler, R E Drake
To describe the core elements of modern psychiatric rehabilitation. Based on selected examples we describe the discussion about values in mental health care with focus on Europe. We present outcome data from studies, which have tried to implement care structures based on this value discussion. In the second half of the 20th century, mental health care in all European and other high-income countries changed conceptually and structurally. Deinstitutionalisation reduced the number of psychiatric beds and transferred priority to outpatient care and community-based services, but community mental health programs developed differently across and within these countries...
January 19, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28099979/milrinone-pharmacokinetics-and-pharmacodynamics-in-neonates-with-persistent-pulmonary-hypertension-of-the-newborn
#17
Annie Giaccone, Athena F Zuppa, Beena Sood, Meryl S Cohen, Michael L O'Byrne, Ganesh Moorthy, Amit Mathur, Haresh Kirpalani
Objective To describe the pharmacokinetics and pharmacodynamics of milrinone in infants with persistent pulmonary hypertension of the newborn (PPHN) and to explore the impact of age on milrinone disposition. Design Randomized, open label pilot study. Setting Multicenter; level 3 and level 4 neonatal intensive care units. Patients Six infants ≥34 weeks' gestational age and <10 days of life with persistent hypoxemia receiving inhaled nitric oxide. Intervention Intravenous milrinone lactate in one of two dosing regimens: (1) low dose, 20 mcg/kg bolus followed by 0...
January 18, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28099667/clinical-functional-vulnerability-index-20-ivcf-20-rapid-recognition-of-frail-older-adults
#18
Edgar Nunes de Moraes, Juliana Alves do Carmo, Flávia Lanna de Moraes, Raquel Souza Azevedo, Carla Jorge Machado, Dalia Elena Romero Montilla
OBJECTIVE: To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS: The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults...
December 22, 2016: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28099636/use-of-reactive-hyperemia-peripheral-arterial-tonometry-and-circulating-biological-markers-to-predict-outcomes-in-sepsis
#19
Vandack Nobre, Thiago Bragança Ataíde, Luisa Caldeira Brant, Clara Rodrigues Oliveira, Lucas Vieira Rodrigues, Antonio Luiz Pinho Ribeiro, Fernanda Barbosa Lopes, Ivan Euclides Saraiva, Marcus Vinícius Andrade
Objective: To evaluate the usefulness and prognostic value of reactive hyperemia - peripheral arterial tonometry in patients with sepsis. Moreover, we investigated the association of reactive hyperemia - peripheral arterial tonometry results with serum levels of certain inflammatory molecules. Methods: Prospective study, conducted in an 18-bed mixed intensive care unit for adults. The exclusion criteria included severe immunosuppression or antibiotic therapy initiated more than 48 hours before assessment...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099585/impact-of-different-normality-thresholds-for-24-hour-abpm-at-the-primary-health-care-level
#20
Guilherme Brasil Grezzana, David William Moraes, Airton Tetelbon Stein, Lucia Campos Pellanda
Background: Hypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC) physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP) remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM) can lead to different medical decisions in PHC. Objective: To evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines...
January 16, 2017: Arquivos Brasileiros de Cardiologia
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