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https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#1
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319706/fire-spread-predictions-sweeping-uncertainty-under-the-rug
#2
Akli Benali, Ana C L Sá, Ana R Ervilha, Ricardo M Trigo, Paulo M Fernandes, José M C Pereira
Predicting fire spread and behavior correctly is crucial to minimize the dramatic consequences of wildfires. However, our capability of accurately predicting fire spread is still very limited, undermining the utility of such simulations to support decision-making. Improving fire spread predictions for fire management purposes, by using higher quality input data or enhanced models, can be expensive, unfeasible or even impossible. Fire managers would benefit from fast and inexpensive ways of improving their decision-making...
March 15, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28319275/mrf-ann-a-machine-learning-approach-for-automated-er-scoring-of-breast-cancer-immunohistochemical-images
#3
T Mungle, S Tewary, D K DAS, I Arun, B Basak, S Agarwal, R Ahmed, S Chatterjee, C Chakraborty
Molecular pathology, especially immunohistochemistry, plays an important role in evaluating hormone receptor status along with diagnosis of breast cancer. Time-consumption and inter-/intraobserver variability are major hindrances for evaluating the receptor score. In view of this, the paper proposes an automated Allred Scoring methodology for estrogen receptor (ER). White balancing is used to normalize the colour image taking into consideration colour variation during staining in different labs. Markov random field model with expectation-maximization optimization is employed to segment the ER cells...
March 20, 2017: Journal of Microscopy
https://www.readbyqxmd.com/read/28317449/safety-leadership-and-systems-thinking-application-and-evaluation-of-a-risk-management-framework-in-the-mining-industry
#4
Sarah-Louise Donovan, Paul M Salmon, Michael G Lenné, Tim Horberry
Safety leadership is an important factor in supporting safety in high-risk industries. This article contends that applying systems-thinking methods to examine safety leadership can support improved learning from incidents. A case study analysis was undertaken of a large-scale mining landslide incident in which no injuries or fatalities were incurred. A multi-method approach was adopted, in which the Critical Decision Method, Rasmussen's Risk Management Framework, and Accimap method were applied to examine the safety leadership decisions and actions which enabled the safe outcome...
March 18, 2017: Ergonomics
https://www.readbyqxmd.com/read/28314449/aligning-mental-health-treatments-with-the-developmental-stage-and-needs-of-late-adolescents-and-young-adults
#5
REVIEW
Brian Skehan, Maryann Davis
Transitional age youth (TAY) are in a discrete developmental stage, different from both adolescents and mature adults. Serious mental illness can result in their delayed psychosocial development and morbidity. Systemic, provider, and individual barriers result in poor access to care for these youth, potentially impeding their transition to mature adulthood. Current strategies for TAY treatment include patient centered care, vocational and educational support, and shared decision making. There is a paucity of evidence-based practices to effectively treat this population or provide practice guidelines...
April 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28314191/robust-detection-and-segmentation-of-cell-nuclei-in-biomedical-images-based-on-a-computational-topology-framework
#6
Rodrigo Rojas-Moraleda, Wei Xiong, Niels Halama, Katja Breitkopf-Heinlein, Steven Dooley, Luis Salinas, Dieter W Heermann, Nektarios A Valous
The segmentation of cell nuclei is an important step towards the automated analysis of histological images. The presence of a large number of nuclei in whole-slide images necessitates methods that are computationally tractable in addition to being effective. In this work, a method is developed for the robust segmentation of cell nuclei in histological images based on the principles of persistent homology. More specifically, an abstract simplicial homology approach for image segmentation is established. Essentially, the approach deals with the persistence of disconnected sets in the image, thus identifying salient regions that express patterns of persistence...
March 6, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28304392/metrics-for-glycaemic-control-from-hba1c-to-continuous-glucose-monitoring
#7
REVIEW
Boris P Kovatchev
As intensive treatment to lower levels of HbA1c characteristically results in an increased risk of hypoglycaemia, patients with diabetes mellitus face a life-long optimization problem to reduce average levels of glycaemia and postprandial hyperglycaemia while simultaneously avoiding hypoglycaemia. This optimization can only be achieved in the context of lowering glucose variability. In this Review, I discuss topics that are related to the assessment, quantification and optimal control of glucose fluctuations in diabetes mellitus...
March 17, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28302523/evaluation-of-performance-indicators-applied-to-a-material-recovery-facility-fed-by-mixed-packaging-waste
#8
Maria Laura Mastellone, Raffaele Cremiato, Lucio Zaccariello, Roberta Lotito
Most of the integrated systems for municipal solid waste management aim to increase the recycling of secondary materials by means of physical processes including sorting, shredding and reprocessing. Several restrictions prevent from reaching a very high material recycling efficiency: the variability of the composition of new-marketed materials used for packaging production and its shape and complexity are critical issues. The packaging goods are in fact made of different materials (aluminium, polymers, paper, etc...
March 14, 2017: Waste Management
https://www.readbyqxmd.com/read/28302112/automation-bias-in-electronic-prescribing
#9
David Lyell, Farah Magrabi, Magdalena Z Raban, L G Pont, Melissa T Baysari, Richard O Day, Enrico Coiera
BACKGROUND: Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. METHODS: One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system...
March 16, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28302088/a-systematic-review-including-meta-analysis-of-work-environment-and-burnout-symptoms
#10
Gunnar Aronsson, Töres Theorell, Tom Grape, Anne Hammarström, Christer Hogstedt, Ina Marteinsdottir, Ingmar Skoog, Lil Träskman-Bendz, Charlotte Hall
BACKGROUND: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies - original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms...
March 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28301560/a-systematic-review-of-ecological-attributes-that-confer-resilience-to-climate-change-in-environmental-restoration
#11
Britta L Timpane-Padgham, Tim Beechie, Terrie Klinger
Ecological restoration is widely practiced as a means of rehabilitating ecosystems and habitats that have been degraded or impaired through human use or other causes. Restoration practices now are confronted by climate change, which has the potential to influence long-term restoration outcomes. Concepts and attributes from the resilience literature can help improve restoration and monitoring efforts under changing climate conditions. We systematically examined the published literature on ecological resilience to identify biological, chemical, and physical attributes that confer resilience to climate change...
2017: PloS One
https://www.readbyqxmd.com/read/28299667/runx3-and-cell-fate-decisions-in-pancreas-cancer
#12
Martin C Whittle, Sunil R Hingorani
The RUNX family transcription factors are critical regulators of development and frequently dysregulated in cancer. RUNX3, the least well characterized of the three family members, has been variously described as a tumor promoter or suppressor, sometimes with conflicting results and opinions in the same cancer and likely reflecting a complex role in oncogenesis. We recently identified RUNX3 expression as a crucial determinant of the predilection for pancreatic ductal adenocarcinoma (PDA) cells to proliferate locally or promulgate throughout the body...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28297010/computerized-clinical-decision-support-systems-for-prevention-of-venous-thromboembolism-why-can-t-my-electronic-health-record-be-more-like-netflix-amazon-google-and-apple
#13
https://www.readbyqxmd.com/read/28297002/use-of-computerized-clinical-decision-support-systems-to-prevent-venous-thromboembolism-in-surgical-patients-a-systematic-review-and-meta-analysis
#14
Zachary M Borab, Michael A Lanni, Michael G Tecce, Christopher J Pannucci, John P Fischer
Importance: Health care professionals do not adequately stratify risk or provide prophylaxis for venous thromboembolism (VTE) among surgical patients. Computerized clinical decision support systems (CCDSSs) have been implemented to assist clinicians and improve prophylaxis for VTE. Objective: To evaluate the effect of implementing CCDSSs on the ordering of VTE prophylaxis and the rates of VTE. Data Sources: PubMed, MEDLINE via OVID, EMBASE via OVID, Scopus, Cochrane CENTRAL Register of Controlled Trials, and clinicaltrials...
March 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28296456/improving-patient-safety-through-the-use-of-nursing-surveillance
#15
Karen K Giuliano
Surveillance and monitoring each represent a distinct process in patient care. Monitoring involves observation, measurement, and recording of physiological parameters, while surveillance is a systematic, goal-directed process based on early detection of signs of change, interpretation of the clinical implications of such changes, and initiation of rapid, appropriate interventions. Through use of an illustrative clinical example based on Early Warning System scoring and rapid response teams, this article seeks to distinguish between nurse monitoring and surveillance to demonstrate the impact of surveillance on improving both care processes and patient care...
February 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28295215/non-technical-skills-of-surgical-trainees-and-experienced-surgeons
#16
H Gostlow, N Marlow, M J W Thomas, P J Hewett, A Kiermeier, W Babidge, M Altree, G Pena, G Maddern
BACKGROUND: In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees...
March 13, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28295187/working-memory-moderates-the-effect-of-the-integrative-process-of-implicit-and-explicit-autonomous-motivation-on-academic-achievement
#17
Alexandre Gareau, Patrick Gaudreau
In previous research, autonomous motivation (AM) has been found to be associated with school achievement, but the relation has been largely heterogeneous across studies. AM has typically been assessed with explicit measures such as self-report questionnaires. Recent self-determination theory (SDT) research has suggested that converging implicit and explicit measures can be taken to characterize the integrative process in SDT. Drawing from dual-process theories, we contended that explicit AM is likely to promote school achievement when it is part of an integrated cognitive system that combines easily accessible mental representations (i...
March 10, 2017: British Journal of Psychology
https://www.readbyqxmd.com/read/28294136/opioid-modulation-of-value-based-decision-making-in-healthy-humans
#18
Marie Eikemo, Guido Biele, Frode Willoch, Lotte Thomsen, Siri Leknes
Modifying behavior to maximize reward is integral to adaptive decision making. In rodents, the μ-opioid receptor (MOR) system encodes motivation and preference for high-value rewards. Yet it remains unclear whether and how human MORs contribute to value-based decision making. We reasoned that if the human MOR system modulates value-based choice, this would be reflected by opposite effects of agonist and antagonist drugs. In a double-blind pharmacological cross-over study, 30 healthy men received morphine (10 mg), placebo and the opioid antagonist naltrexone (50 mg)...
March 15, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28293919/-extracorporeal-liver-support-of-liver-failure
#19
Hans Ulrich Gerth, Michele Pohlen, Hermann Pavenstädt, Hartmut Schmidt
Extracorporeal liver support can be classified into cell-free, artificial methods (artificial liver support, ALS) and cell-based bioartificial methods (bioartificial liver support, BLS). ALS improves biochemical parameters of liver failure by the simultaneous removal of protein-bound and water-soluble substances. Here, the MARS therapy belongs to the most studied methods with a proved beneficial effect on hepatic encephalopathy (HE), hepatorenal syndrome (HRS) or hyperbilirubinemia. However, a general survival advantage of any liver support for liver failure has not been shown yet and is restricted to meta-analyses or patient subgroups...
March 14, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28292502/opioid-overdose-education-and-naloxone-distribution-development-of-the-veterans-health-administration-s-national-program
#20
Elizabeth M Oliva, Melissa L D Christopher, Daina Wells, Mark Bounthavong, Michael Harvey, Julianne Himstreet, Thomas Emmendorfer, Michael Valentino, Mariano Franchi, Francine Goodman, Jodie A Trafton
OBJECTIVES: To prevent opioid-related mortality, the Veterans Health Administration (VHA) developed a national Opioid Overdose Education and Naloxone Distribution (OEND) program. SETTING: VHA's OEND program sought national implementation of OEND across all medical facilities (n = 142). PRACTICE DESCRIPTION: This paper describes VHA's efforts to facilitate nationwide health care system-based OEND implementation, including the critical roles of VHA's national pharmacy services and academic detailing services...
March 2017: Journal of the American Pharmacists Association: JAPhA
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