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https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#1
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28641166/care-coordination-at-a-pediatric-accountable-care-organization-aco-a-qualitative-analysis
#2
Baria Hafeez, Sophia Miller, Anup D Patel, Zachary M Grinspan
OBJECTIVE: Care coordinators may help manage care for children with chronic illness. Their role in pediatric epilepsy care is understudied. We aimed to qualitatively describe the content of a care coordination intervention for children with epilepsy. METHODS: We conducted nine semi-structured interviews and one focus group with care coordinators at a pediatric accountable care organization (ACO) in Ohio. The care coordinators used a modified version of a published care coordination checklist for children with epilepsy (Patel AD, 2014)...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28637558/travel-time-influences-readmission-risk-geospatial-mapping-of-surgical-readmissions
#3
Florence E Turrentine, Patrick J Buckley, Min-Woong Sohn, Michael D Williams
The University of Virginia (UVA) has recently become an Accountable Care Organization (ACO), intensifying efforts to provide better care for individuals. UVA's ACO population resides across the entire Commonwealth, with a large percentage of patients living in rural areas. To provide better health for this population, the central tenet of the ACO mission, we identified geographic risk factors influencing hospital readmission. We analyzed the relationship between the distance of patients' residence to the nearest hospital and 30-day readmission in general surgery patients...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636425/ats-nhlbi-asthma-copd-overlap-aco-workshop-report
#4
Prescott G Woodruff, Maarten van den Berge, Richard C Boucher, Christopher Brightling, Esteban G Burchard, Stephanie A Christenson, MeiLan K Han, Michael J Holtzman, Monica Kraft, David A Lynch, Fernando D Martinez, Helen K Reddel, Don D Sin, George R Washko, Sally E Wenzel, Antonello Punturieri, Michelle M Freemer, Robert A Wise
Asthma and COPD are highly prevalent chronic obstructive lung diseases with an associated high burden of disease. Asthma, which is often allergic in origin, frequently begins in infancy or childhood with variable airflow obstruction and intermittent wheezing, cough, and dyspnea. Patients with COPD, in contrast, are usually current or former smokers who present after the age of 40 years with symptoms (often persistent), including dyspnea and a productive cough. Based on age and smoking history, it is often easy to distinguish between asthma and COPD...
June 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28623919/effects-of-karela-bitter-melon-momordica-charantia-on-genes-of-lipids-and-carbohydrates-metabolism-in-experimental-hypercholesterolemia-biochemical-molecular-and-histopathological-study
#5
Dalia Yossri Saad, Mohamed Mohamed Soliman, Ahmed A Baiomy, Magdy Hassan Yassin, Hanan Basiouni El-Sawy
BACKGROUND: Hypercholesterolemia is a serious diseases associated with type-2 diabetes, atherosclerosis, cardiovascular disorders and liver diseases. Humans seek for safe herbal medication such as karela (Momordica charantia/bitter melon) to treat such disorders to avoid side effect of pharmacotherapies widely used. METHODS: Forty male Wistar rats were divided into four equal groups; control group with free access to food and water, cholesterol administered group (40 mg/kg BW orally); karela administered group (5 g /kg BW orally) and mixture of cholesterol and karela...
June 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28614437/chronic-disease-in-childhood-and-adolescence-continuity-of-care-in-the-health-care-network
#6
Vanessa Medeiros da Nóbrega, Maria Elizabete de Amorim Silva, Leiliane Teixeira Bento Fernandes, Claudia Silveira Viera, Altamira Pereira da Silva Reichert, Neusa Collet
OBJECTIVE: To evaluate the continuity of care for children and adolescents with chronic diseases in the health care network. METHODS: This qualitative study was conducted between February and October 2013 with 12 families, six health managers, and 14 health professionals from different health care services in a municipality of the state of Paraíba, Brazil, using focal groups, semi-structured interviews, and medical record consultation. The data were analyzed by triangulation and thematic analysis...
June 12, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28614432/characteristics-of-nursing-professionals-and-the-practice-of-ecologically-sustainable-actions-in-the-medication-processes
#7
Patricia de Oliveira Furukawa, Isabel Cristina Kowal Olm Cunha, Mavilde da Luz Gonçalves Pedreira, Patricia Beryl Marck
Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument...
June 8, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28614431/factors-associated-with-the-risk-of-fall-in-adults-in-the-postoperative-period-a-cross-sectional-study
#8
Luciana Regina Ferreira da Mata, Cissa Azevedo, Aryanne Gabrielle Policarpo, Juliano Teixeira Moraes
Objective: to assess the factors associated with the risk of fall in patients undergoing surgical procedures. Method: quantitative and cross-sectional study carried out with 257 adult patients in a hospital in the state of Minas Gerais, Brazil. Data were collected using the sociodemographic and clinical questionnaire, the Morse Fall Scale, and the Quality of Recovery Score. Data were submitted to descriptive statistical analysis and multinomial logistic regression...
June 8, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28614267/regional-cost-and-experience-not-size-or-hospital-inclusion-helps-predict-aco-success
#9
John Schulz, Matthew DeCamp, Scott A Berkowitz
The Medicare Shared Savings Program (MSSP) continues to expand and now includes 434 accountable care organizations (ACOs) serving more than 7 million beneficiaries. During 2014, 86 of these ACOs earned over $300 million in shared savings payments by promoting higher-quality patient care at a lower cost.Whether organizational characteristics, regional cost of care, or experience in the MSSP are associated with the ability to achieve shared savings remains uncertain.Using financial results from 2013 and 2014, we examined all 339 MSSP ACOs with a 2012, 2013, or 2014 start-date...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28604689/pyrazinamide-and-derivatives-block-ethylene-biosynthesis-by-inhibiting-acc-oxidase
#10
Xiangzhong Sun, Yaxin Li, Wenrong He, Chenggong Ji, Peixue Xia, Yichuan Wang, Shuo Du, Hongjiang Li, Natasha Raikhel, Junyu Xiao, Hongwei Guo
Ethylene is an important phytohormone that promotes the ripening of fruits and senescence of flowers thereby reducing their shelf lives. Specific ethylene biosynthesis inhibitors would help to decrease postharvest loss. Here, we identify pyrazinamide (PZA), a clinical drug used to treat tuberculosis, as an inhibitor of ethylene biosynthesis in Arabidopsis thaliana, using a chemical genetics approach. PZA is converted to pyrazinecarboxylic acid (POA) in plant cells, suppressing the activity of 1-aminocyclopropane-1-carboxylic acid oxidase (ACO), the enzyme catalysing the final step of ethylene formation...
June 12, 2017: Nature Communications
https://www.readbyqxmd.com/read/28591356/early-detection-of-breast-cancer-in-brazil-data-from-the-national-health-survey-2013
#11
Gulnar Azevedo E Silva, Paulo Roberto Borges de Souza-Júnior, Giseli Nogueira Damacena, Célia Landmann Szwarcwald
OBJECTIVE: To analyze whether the actions of early detection of breast cancer, initiated with the medical request for mammography, differ between users of the Brazilian Unified Health System (SUS) and those who have private health insurance. METHODS: From the data collected in the National Health Survey, we estimated the proportions of women who had medical request for mammography according to presence or absence of private health insurance. For assessing the factors related to having mammography medical request, we estimated crude and adjusted odds ratios and respective 95%CI by logistic regression...
June 1, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28591354/inequalities-in-healthy-life-expectancy-by-federated-states
#12
Célia Landmann Szwarcwald, Dália Elena Romero Montilla, Aline Pinto Marques, Giseli Nogueira Damacena, Wanessa da Silva de Almeida, Deborah Carvalho Malta
OBJECTIVES: To estimate the healthy life expectancy at 60 years by sex and Federated States and to investigate geographical inequalities by socioeconomic status. METHODS: Healthy life expectancy was estimated by the Sullivan method, based on the information of the National Survey on Health, 2013. Three criteria were adopted for the definition of "unhealthy state": self-assessment of bad health, functionality for performing the activities of daily living, and the presence of noncommunicable disease with intense degree of limitation...
June 1, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28591352/depression-and-health-behaviors-in-brazilian-adults-pns-2013
#13
Marilisa Berti de Azevedo Barros, Margareth Guimarães Lima, Renata Cruz Soares de Azevedo, Lhais Barbosa de Paula Medina, Claudia de Souza Lopes, Paulo Rossi Menezes, Deborah Carvalho Malta
OBJECTIVE: To evaluate the prevalence of health-related behaviors according to presence and type of depression in Brazilian adults. METHODS: Based on a sample of 49,025 adults (18 to 59 years) from the National Survey on Health 2013 (PNS 2013), we estimated the prevalence of health-related behaviors (smoking; passive smoking; frequent or risky alcohol consumption; leisure time physical activity; time watching TV; and eating pattern indicators), according to the presence of depression (minor and major), evaluated by the Patient Health Questionnaire - 9 (PHQ-9), and the report of depressive mood (in up to seven days or more than seven days) over a two-week period...
June 1, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28591319/self-reported-high-cholesterol-prevalence-in-the-brazilian-population-analysis-of-the-2013-national-health-survey
#14
Paulo A Lotufo, Raul D Santos, Andrei C Sposito, Marcelo Bertolami, Jose Rocha-Faria, M Cristina Izar, Celia Szwarcwald, Rogério R Prado, Sheila R Stoppa, Deborah C Malta, Isabela M Bensenor
Background: Data on the prevalence of dyslipidemia in Brazil are scarce, with surveys available only for some towns. Objective: To evaluate the prevalence of the self-reported medical diagnosis of high cholesterol in the Brazilian adult population by use of the 2013 National Health Survey data. Methods: Descriptive study assessing the 2013 National Health Survey data, a household-based epidemiological survey with a nationally representative sample and self-reported information...
May 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28591297/organization-of-professional-practices-against-intrafamily-violence-against-children-and-adolescents-in-the-institutional-context
#15
Gabriele Schek, Mara Regina Santos da Silva, Carl Lacharité, Maria Emília Nunes Bueno
Objective: to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. Method: qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis...
June 5, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28583262/different-prevalence-and-clinical-characteristics-of-asthma-chronic-obstructive-pulmonary-disease-overlap-syndrome-according-to-accepted-criteria
#16
Yong Suk Jo, Jinwoo Lee, Ho Il Yoon, Deog Kyeom Kim, Chul-Gyu Yoo, Chang-Hoon Lee
BACKGROUND: A unified definition of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) is not available, which makes it difficult to evaluate the prevalence and clinical features of patients with ACOS. OBJECTIVE: To investigate the prevalence and clinical characteristics of ACOS according to the updated widely accepted diagnostic criteria. METHODS: Participants were enrolled from a prospective cohort study conducted between April 2013 and November 2016 in South Korea...
June 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28569652/something-new-about-something-old-a-10-year-follow-up-on-classical-and-new-psychoactive-tryptamines-and-results-of-analysis
#17
Álvaro José Palma-Conesa, Mireia Ventura, Liliana Galindo, Francina Fonseca, Marc Grifell, Pol Quintana, Iván Fornís, Cristina Gil, Magí Farré, Marta Torrens
New psychoactive tryptamines may be a public health risk since they intend to mimic the hallucinogenic effects of regulated psychoactive drugs. Few studies describe uses and clinical effects of unregulated new psychoactive tryptamines. This study aims (1) to explore the presence of tryptamines classified as NPS among the substances delivered for analysis to a harm-reduction organization; (2) to describe the substances found in the samples after analysis; and (3) to compare analytical results of regulated vs...
June 1, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28562803/the-experience-of-rural-families-in-the-face-of-cancer
#18
Nara Marilene Oliveira Girardon-Perlini, Margareth Ângelo
Objective: To understand the meanings of cancer within the experience of rural families and how such meanings influence family dynamics. Method: Qualitative study guided by Symbolic Interactionism as a theoretical framework and Grounded Theory as a methodological framework. Six rural families (18 participants) undergoing the experience of having a relative with cancer participated in the interview. Results: Constant comparative analysis of data allowed the elaboration of an explanatory substantive theory, defined by the main category Caregiving to support the family world, which represents the family's symbolic actions and strategies to reconcile care for the patient and care for family life...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28562799/promoting-oral-care-in-the-preschool-child-effects-of-a-playful-learning-intervention
#19
Cecília Helena de Siqueira Sigaud, Bruna Rodrigues Dos Santos, Priscila Costa, Aurea Tamami Minagawa Toriyama
Objective: To compare the number of appropriate behaviors for tooth brushing before and after a playful learning intervention with preschool children. Method: A quasi-experimental, quantitative, before and after study design was conducted in an early childhood educational institution, with children between three and five years of age. The intervention consisted of three meetings with educational activities about tooth brushing, whose outcome was evaluated by means of observation of ten behaviors suitable for tooth brushing...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28562798/violence-against-children-and-adolescents-the-perspective-of-primary-health-care
#20
Diene Monique Carlos, Elisabete Matallo Marchesini de Pádua, Maria das Graças Carvalho Ferriani
Objective: To analyze the care provided by Basic Health Units (BHU) to families involved in domestic intrafamily violence against children and adolescents. Method: Qualitative research, based on the Paradigm of Complexity. Data collection was performed with 41 professionals through focus groups and semi-structured interviews. Results: The following categories emerged from data analysis: 'Everything comes here', which reflects the legitimate place of BHUs for the population and the actions taken to build care for families; and 'We only do what is really necessary', which brings the look to violence still based on the positivist and biomedical paradigm...
May 2017: Revista Brasileira de Enfermagem
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