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https://www.readbyqxmd.com/read/29330237/-the-hand-on-the-doorknob-visit-agenda-setting-by-complex-patients-and-their-primary-care-physicians
#1
Christine P Kowalski, Deanna B McQuillan, Neetu Chawla, Courtney Lyles, Andrea Altschuler, Connie S Uratsu, Elizabeth A Bayliss, Michele Heisler, Richard W Grant
BACKGROUND: Choosing which issues to discuss in the limited time available during primary care visits is an important task for complex patients with chronic conditions. DESIGN, SETTING, AND PARTICIPANTS: We conducted sequential interviews with complex patients (n = 40) and their primary care physicians (n = 17) from 3 different health systems to investigate how patients and physicians prepare for visits, how visit agendas are determined, and how discussion priorities are established during time-limited visits...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29325786/a-proactive-outreach-intervention-that-decreases-readmission-after-hepatectomy
#2
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29321008/effects-of-a-culturally-specific-tobacco-cessation-intervention-among-african-american-quitline-enrollees-a-randomized-controlled-trial
#3
Monica Webb Hooper, Kelly Carpenter, Michael Payne, Ken Resnicow
BACKGROUND: African Americans suffer disproportionately from tobacco-related illness and have more difficulty quitting smoking than other racial/ethnic groups. Previous research indicates that African American treatment-seekers are high utilizers of tobacco quitlines, yet cessation rates via quitlines are lower relative to whites. The goal of the present study is to test the effectiveness of adding a culturally specific, video-based, adjunct to standard quitline care. It is hypothesized that the integration of an evidence-based intervention (Pathways to Freedom: Leading the Way to a Smoke-Free Community©; PTF) into quitline services will increase cessation and treatment engagement compared to control conditions, and that effects will be moderated by sociocultural factors (e...
January 10, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29314172/shifting-mindsets-a-realist-synthesis-of-evidence-from-self-management-support-training
#4
REVIEW
Freya Davies, Fiona Wood, Alison Bullock, Carolyn Wallace, Adrian Edwards
CONTEXT: Accompanying the growing expectation of patient self-management is the need to ensure health care professionals (HCPs) have the required attitudes and skills to provide effective self-management support (SMS). Results from existing training interventions for HCPs in SMS have been mixed and the evidence base is weaker for certain settings, including supporting people with progressive neurological conditions (PNCs). We set out to understand how training operates, and to identify barriers and facilitators to training designed to support shifts in attitudes amongst HCPs...
January 4, 2018: Medical Education
https://www.readbyqxmd.com/read/29310644/challenges-and-opportunities-for-healthcare-workers-in-a-rural-district-of-chad
#5
Fabienne N Jaeger, Mahamat Bechir, Moumini Harouna, Daugla D Moto, Jürg Utzinger
BACKGROUND: Trained healthcare workers are an essential resource for effective health systems. However, healthcare workers' perspective on healthcare, the challenges they face to provide quality health services, and opportunities to improve motivation and providing adequate care are rarely investigated in resource-constrained settings of sub-Saharan Africa. METHODS: All reachable nurses of Abou Deia, a primarily rural district in the south-eastern part of Chad, were invited to participate...
January 8, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29302797/proactive-care-of-older-people-undergoing-surgery
#6
Judith Partridge, Magda Sbai, Jugdeep Dhesi
The number of older patients undergoing surgery is increasing due to changing demographics, surgical and anaesthetic advances and shifts in patient expectations of healthcare. The benefits of surgery in older people are well documented and include symptom control and increased life expectancy. However, older surgical patients present not only with the index pathology requiring surgery but with concurrent age related physiological decline, multimorbidity and geriatric syndromes. These additional issues increase the risk of adverse postoperative outcome, in particular of postoperative medical and functional complications...
January 4, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29300275/proactive-risk-mitigation-using-failure-modes-and-effects-analysis-for-evaluating-vascular-access
#7
Shea Polancich, Loring Rue, Terri Poe, Rebecca Miltner
This department column highlights translation of research into healthcare quality practice. Achieving the highest quality in healthcare requires organizations to understand care delivery and to proactively mitigate risks in care delivery processes. The purpose of this article was to describe the process for using the failure modes and effects analysis process to provide evidentiary support and proactive risk mitigation for the establishment of a comprehensive vascular access team within an academic medical center...
January 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29298748/from-ehealth-to-ihealth-transition-to-participatory-and-personalized-medicine-in-mental-health
#8
Sofian Berrouiguet, Mercedes M Perez-Rodriguez, Mark Larsen, Enrique Baca-García, Philippe Courtet, Maria Oquendo
Clinical assessment in psychiatry is commonly based on findings from brief, regularly scheduled in-person appointments. Although critically important, this approach reduces assessment to cross-sectional observations that miss essential information about disease course. The mental health provider makes all medical decisions based on this limited information. Thanks to recent technological advances such as mobile phones and other personal devices, electronic health (eHealth) data collection strategies now can provide access to real-time patient self-report data during the interval between visits...
January 3, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29298737/a-feasible-model-for-early-intervention-for-high-risk-substance-use-in-the-emergency-department-setting
#9
Rebecca Howard, Stephanie Fry, Andrew Chan, Brigid Ryan, Yvonne Bonomo
Objective In response to escalating alcohol and other drug (AOD)-related emergency department (ED) presentations, a tertiary Melbourne hospital embedded experienced AOD clinical nurse consultants in the ED on weekends to trial a model for screening, assessment and brief intervention (BI). The aim of the present study was to evaluate the relative contributions of AOD to ED presentations and to pilot a BI model.Methods Using a customised AOD screening tool and a framework for proactive case finding, screened participants were offered a comprehensive AOD assessment and BI in the ED...
January 4, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29297770/the-influence-of-telepathology-on-coordination-practices
#10
Julien Meyer, Guy Paré
BACKGROUND: Coordination between physicians and allied professionals is essential to the effective delivery of care services and is associated with positive patient outcomes. As information technology can radically transform how professionals collaborate, both researchers and healthcare accreditation bodies are devoting a growing interest to the means of achieving better coordination. INTRODUCTION: The primary aim of this study is to explain the extent to which and how coordination practices between pathologists, technologists, and surgeons are transformed when telepathology is being implemented...
January 3, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29290168/the-economic-burden-of-acpa-positive-status-among-patients-with-rheumatoid-arthritis
#11
Jason Shafrin, Mahlet Gizaw Tebeka, Kwanza Price, Chad Patel, Kaleb Michaud
BACKGROUND: Anticitrullinated protein antibodies (ACPAs) are serological biomarkers associated with early, rapidly progressing rheumatoid arthritis (RA), including more severe disease and joint damage. ACPA testing has become a routine tool for RA diagnosis and prognosis. Furthermore, treatment efficacy has been shown to vary by ACPA-positive status. However, it is not clear if the economic burden of patients with RA varies by ACPA status. OBJECTIVE: To determine if the economic burden of RA varies by patient ACPA status...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29289764/unravelling-complex-primary-care-programmes-to-maintain-independent-living-in-older-people-a-systematic-overview
#12
L C Smit, M J Schuurmans, J W Blom, I N Fabbricotti, A P D Jansen, G I J M Kempen, R Koopmans, W M Looman, R J F Melis, S F Metzelthin, E P Moll van Charante, M E Muntinga, F G H Ruikes, S L W Spoorenberg, J J Suijker, K Wynia, J Gussekloo, N J De Wit, N Bleijenberg
OBJECTIVE: Complex interventions are criticized for being a 'black box', which makes it difficult to determine why they succeed or fail. Recently, nine proactive primary care programmes aiming to prevent functional decline in older adults showed inconclusive effects. The aim of this study was to systematically unravel, compare and synthesize the development and evaluation of nine primary care programs within a controlled trial to further improve the development and evaluation of complex interventions...
December 28, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29283211/differentiating-research-quality-improvement-and-case-studies-to-ethically-incorporate-pregnant-women
#13
REVIEW
Julia C Phillippi, Katherine E Hartmann
Pregnant women have been called therapeutic orphans because data supporting common interventions, medications, health teaching, and models of care are meager. The generation of quality evidence benefits from proactive approaches that ensure ethical standards are met to protect participants. The purpose of this article is to differentiate among health care, quality improvement, and research and to discuss ethical involvement of women who are pregnant and potentially childbearing in these initiatives. Health care is provided to protect and improve individual health...
December 28, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#14
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29278986/reach-and-effectiveness-of-the-heartbeat-connections-telemedicine-pilot-program
#15
Gretchen A Benson, Abbey Sidebottom, Arthur Sillah, Jackie L Boucher, Michael D Miedema, Thomas Knickelbine, Jeffrey J VanWormer
Introduction Innovative care delivery programs that support primary care providers are needed to reduce the burden of cardiovascular disease (CVD). HeartBeat Connections (HBC) is a primary prevention telemedicine program utilizing registered dietitian nutritionists (RDNs) and registered nurses (RNs) to deliver health coaching and medication therapy protocols for dyslipidaemia and hypertension among patients at high risk for developing CVD. Methods This retrospective cohort study documents the reach and six-month effectiveness of the HBC program for improving CVD risk factors...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29261245/evaluation-of-the-quality-blue-primary-care-program-on-health-outcomes
#16
Qian Shi, Thomas J Yan, Peter Lee, Paul Murphree, Xiaojing Yuan, Hui Shao, William H Bestermann, Selina Loupe, Dawn Cantrell, David Carmouche, John Strapp, Lizheng Shi
OBJECTIVES: This study aimed to investigate the role of the Quality Blue Primary Care (QBPC) program on healthcare utilization and overall cost among the beneficiaries of Blue Cross and Blue Shield of Louisiana (BCBSLA). STUDY DESIGN: Retrospective observational cohort study using claims data from adults residing in QBPC-implemented regions continuously enrolled through BCBSLA from June 2012 to December 2014 (N = 89,034). METHODS: Controlling for age, gender, and risk score by propensity score weighting, inpatient, outpatient, and corresponding medical expenditures were each compared between the QBPC group and the control group using a difference-in-differences regression model...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29258374/falls-prevention-process-in-assisted-living-communities
#17
DaRae Coughlin, Susan E Nordman-Oliveira, Mary Schlaak, James H Ford
Falls are a significant issue for older adults, and many older adults who once received care in nursing homes now reside in assisted living communities (ALCs). ALC staff needs to address resident falls prevention; however, federal or state requirements or oversight are limited. This research explores falls prevention in Wisconsin ALCs in the context of the Kotter Change Model to identify strategies and inform efforts to establish a more consistent, proactive falls prevention process for ALCs. A mixed methods approach demonstrated inconsistency and variability in the use of falls risk assessments and prevention programs, which led to the development of standardized, proactive falls prevention process flowcharts...
December 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29250848/informal-caregivers-views-on-the-division-of-responsibilities-between-themselves-and-professionals-a-scoping-review
#18
REVIEW
Yvette Wittenberg, Rick Kwekkeboom, Janneke Staaks, Arnoud Verhoeff, Alice de Boer
This scoping review focuses on the views of informal caregivers regarding the division of care responsibilities between citizens, governments and professionals and the question of to what extent professionals take these views into account during collaboration with them. In Europe, the normative discourse on informal care has changed. Retreating governments and decreasing residential care increase the need to enhance the collaboration between informal caregivers and professionals. Professionals are assumed to adequately address the needs and wishes of informal caregivers, but little is known about informal caregivers' views on the division of care responsibilities...
December 18, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/29244105/the-gendered-health-workforce-mixed-methods-analysis-from-four-fragile-and-post-conflict-contexts
#19
Sophie Witter, Justine Namakula, Haja Wurie, Yotamu Chirwa, Sovanarith So, Sreytouch Vong, Bandeth Ros, Stephen Buzuzi, Sally Theobald
It is well known that the health workforce composition is influenced by gender relations. However, little research has been done which examines the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH)...
December 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29241469/-social-obstetrics-a-level-playing-field-when-it-comes-to-a-healthy-start
#20
E A P Steegers
Next to foetal growth, embryonic development during the first weeks of pregnancy is associated not only with the health of the newborn, but also with health and disease in later life. In the Netherlands, large disparities exist in perinatal health. These are not only related to medical risks but also to an accumulation of risks related to lifestyle and the social environment. The effects of poverty on perinatal health appear to be substantial. These new insights should lead to a renewal of pregnancy-related care in the form of the implementation of preconception care and 'social obstetrics', into which medical and social domains of care should be integrated...
2017: Nederlands Tijdschrift Voor Geneeskunde
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