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https://www.readbyqxmd.com/read/29927661/patient-and-provider-perspectives-on-uptake-of-a-shared-decision-making-intervention-for-asthma-in-primary-care-practices
#1
Madelyn Welch, Tom Ludden, Kathleen Mottus, Paul Bray, Lori Hendrickson, Jennifer Rees, Jacqueline Halladay, Hazel Tapp
OBJECTIVE: Poor outcomes and health disparities related to asthma result in part from difficulty disseminating new evidence such as shared decision making (SDM) into clinical practice. As part of a three-arm cluster randomized dissemination study, evaluation of the impact of different dissemination methods was studied. Here we evaluate themes from patient and provider focus groups to assess the impact of a facilitated, traditional dissemination approach, or no intervention, on patient and provider perspectives of asthma care...
June 21, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29927654/incarceration-as-a-health-determinant-for-sexual-orientation-and-gender-minority-persons
#2
Valerio Baćak, Kate Thurman, Katie Eyer, Rubab Qureshi, Jason D P Bird, Luis M Rivera, Suzanne A Kim
Incarceration is considerably more prevalent among sexual and gender minority persons (SGM) than among the general population. Once behind bars, they are at the greatest risk for health-related harms. Although a growing number of studies have assessed health disparities produced by mass incarceration, scholars are yet to systematically assess the health consequences of incarceration on the basis of sexual orientation and gender identity. We invite public health scholars to study the effects of incarceration on health in the SGM population and provide a roadmap to aid these research efforts...
June 21, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29927641/disparities-in-smoking-cessation-assistance-in-us-primary-care-clinics
#3
Steffani R Bailey, John Heintzman, R Lorie Jacob, Jon Puro, Miguel Marino
OBJECTIVES: To examine associations between patient factors and smoking cessation assistance in US safety-net clinics. METHODS: Using electronic health record data from the OCHIN network, we identified adults with at least 1 primary care visit to a study clinic (n = 143 clinics in 12 states) with at least 1 documented "current smoker" status during 2014 to 2016 (n = 136 314; 29.8%). We estimated odds ratios (ORs) of smoking cessation assistance receipt (none [reference], counseling, medication, or both) by patient covariates...
June 21, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29926960/international-comparisons-of-disparities-in-access-to-care-for-people-with-mental-health-conditions
#4
Lisa Corscadden, Emily J Callander, Stephanie M Topp
OBJECTIVE: Relatively little is known about experiences of barriers in access to overall care for people with mental health conditions (MHCs), or disparities between people with and without MHCs, or how patterns vary across countries. DATA AND METHOD: The 2016 Commonwealth Fund International Health Policy Survey of adults was used to compare access barriers for people with MHCs across 11 countries, and disparities within countries between people with and without an MHC, using normalized scores...
June 21, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29926556/optimal-bronchodilation-for-copd-patients-are-all-long-acting-%C3%AE-%C3%A2-agonist-long-acting-muscarinic-antagonists-the-same
#5
REVIEW
Marc Miravitlles, Seungjae Baek, Vatsal Vithlani, Rahul Lad
Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting β₂-agonist/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making...
June 19, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29926271/addressing-health-insurance-literacy-gaps-in-an-urban-african-american-population-a-qualitative-study
#6
Nida M Ali, Ryan M Combs, Baraka Muvuka, Suur D Ayangeakaa
Health insurance and health systems literacy needs are evolving with changes to the U.S. healthcare system. Following the implementation of the Affordable Care Act, many residents in West Louisville, Kentucky, a predominantly African American community, gained health insurance coverage for the first time. A qualitative study was conducted to assess residents' health insurance and health systems needs and to identify ways of assisting residents with navigating the healthcare system and utilizing their health insurance coverage...
June 20, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29925702/reducing-the-medical-economic-burden-of-health-insurance-in-china-achievements-and-challenges
#7
Guanshen Dou, Qun Wang, Xiaohua Ying
The aims of this study were to describe health insurance reforms initiated by the Chinese government over the past two decades, to review their achievements in reducing the medical economic burden, and to summarize the challenges that still exist regarding a further reduction in out-of-pocket expenditures in this country. China has successfully attained the goal of providing health insurance coverage to almost the entire population by developing a mixed health insurance system, which consists of Urban Employees Basic Medical Insurance (UEBMI), Urban Resident Basic Medical Insurance (URBMI), New Rural Cooperative Medical Scheme (NCMS), and supplementary Catastrophic Health Insurance...
June 20, 2018: Bioscience Trends
https://www.readbyqxmd.com/read/29925364/the-interaction-of-socioeconomic-status-with-place-of-death-a-qualitative-analysis-of-physician-experiences
#8
Joshua Wales, Allison M Kurahashi, Amna Husain
BACKGROUND: Home is a preferred place of death for many people; however, access to a home death may not be equitable. The impact of socioeconomic status on one's ability to die at home has been documented, yet there remains little literature exploring mechanisms that contribute to this disparity. By exploring the experiences and insights of physicians who provide end-of-life care in the home, this study aims to identify the factors perceived to influence patients' likelihood of home death and describe the mechanisms by which they interact with socioeconomic status...
June 20, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29922896/mapping-hot-spots-of-breast-cancer-mortality-in-the-united-states-place-matters-for-blacks-and-hispanics
#9
Justin Xavier Moore, Kendra J Royston, Marvin E Langston, Russell Griffin, Bertha Hidalgo, Henry E Wang, Graham Colditz, Tomi Akinyemiju
PURPOSE: The goals of this study were to identify geographic and racial/ethnic variation in breast cancer mortality, and evaluate whether observed geographic differences are explained by county-level characteristics. METHODS: We analyzed data on breast cancer deaths among women in 3,108 contiguous United States (US) counties from years 2000 through 2015. We applied novel geospatial methods and identified hot spot counties based on breast cancer mortality rates. We assessed differences in county-level characteristics between hot spot and other counties using Wilcoxon rank-sum test and Spearman correlation, and stratified all analysis by race/ethnicity...
June 19, 2018: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/29921533/orthogeriatric-co-management-managing-frailty-as-well-as-fragility
#10
Giulio Pioli, Chiara Bendini, Paolo Pignedoli, Andrea Giusti, David Marsh
A high proportion of patients with fragility fracture, mainly hip fracture, have a variable degree of comorbidity and show some degree of dependence in basic or more complex activities of daily living. Evaluating these patents following the geriatric concept of frailty, about one third of hip fracture patients may be categorised as frail with high risk of poor outcomes and prolonged length of stay, one third as not frail, and about one third with an intermediate condition. Due to the high vulnerability, combined with the hip fracture event and surgical repair procedures, a multidisciplinary approach that includes geriatric competencies becomes essential to improve short and long-term outcomes after hip fracture...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29921271/what-is-the-overall-impact-or-effectiveness-of-visiting-primary-health-care-services-in-rural-and-remote-communities-in-high-income-countries-a-systematic-review
#11
Timothy A Carey, David Sirett, Deborah Russell, John S Humphreys, John Wakerman
BACKGROUND: Visiting services address the problem of workforce deficit and access to effective primary health care services in isolated remote and rural locations. Little is known about their impact or effectiveness and thereby the extent to which they are helping to reduce the disparity in access and health outcomes between people living in remote areas compared with people living in urban regions of Australia. The objective of this study was to answer the question "What is the impact or effectiveness when different types of primary health care services visit, rather than reside in, rural and remote communities?" METHOD: We conducted a systematic review of peer-reviewed literature from established databases...
June 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29920158/barriers-to-end-of-life-care-for-lgbt-persons-in-the-absence-of-legal-marriage-or-adequate-legal-documentation
#12
Jessica Marsack, Rob Stephenson
End-of-life care has attracted increased attention in recent years due to increases in both the number and mean age of the world's population; however, the experiences of LGBT persons during end-of-life care remain understudied. Given the health disparities and barriers to care experienced throughout the life course of LGBT persons, the frequent involvement of legal spouses in end-of-life care, and the recency of marriage equality, it can be surmised that LGBT persons might experience significantly different barriers to their desired end-of-life care compared to their heterosexual and cisgender counterparts...
June 19, 2018: LGBT Health
https://www.readbyqxmd.com/read/29920148/the-impact-of-the-patient-centered-medical-home-on-health-care-disparities-exploring-stakeholder-perspectives-on-current-standards-and-future-directions
#13
Emilia H De Marchis, Kirti Doekhie, Rachel Willard-Grace, J Nwando Olayiwola
Over the past decade, the Patient-Centered Medical Home (PCMH) has become a preeminent model for primary care delivery. Simultaneously, health care disparities have gained increasing attention. There has been limited research on whether and how the PCMH can or should affect health care disparities. The authors conducted qualitative interviews with key stakeholders and experts on the PCMH model and health care disparities, including grant and policy makers, accreditors, researchers, patient advocates, primary care practices, practice transformation organizations, and payers, to assess perspectives on the role of the PCMH in addressing health care disparities...
June 19, 2018: Population Health Management
https://www.readbyqxmd.com/read/29916328/quantum-caring-leadership-integrating-quantum-leadership-with-caring-science
#14
Jean Watson, Tim Porter-O'Grady, Sara Horton-Deutsch, Kathy Malloch
The authors of this article integrate two historically parallel yet disparate fields of nursing, caring science theory and nursing quantum leadership science. Through a nursing, discipline-specific unitary paradigm lens, intersecting principles of caring science and quantum leadership science are uncovered. The result is a model for unitary, discipline-specific, nursing healthcare leadership: Quantum Caring Healthcare Leadership. Ontological congruence is uncovered among the philosophical-ethical-theoretical principles of caring science and the unifying disciplinary structural concepts from quantum leadership...
July 2018: Nursing Science Quarterly
https://www.readbyqxmd.com/read/29915810/recommendations-from-transgender-healthcare-consumers-in-rural-areas
#15
Douglas Knutson, Meredith A Martyr, Travis A Mitchell, Tori Arthur, Julie M Koch
Purpose: Scholars indicate that rates of mental and physical health issues (e.g., substance use, anxiety, depression) may be much higher among transgender individuals relative to the general population. This disparity may be even greater for transgender individuals in rural areas. Clinical researchers suggest using affirmative therapeutic approaches and interventions to address the health concerns of transgender individuals, specifically to connect individuals with the transgender community. However, little is known about the content of information that is shared in transgender communities in rural areas...
2018: Transgender Health
https://www.readbyqxmd.com/read/29914717/future-directions-for-medication-assisted-treatment-for-opioid-use-disorder-with-american-indian-alaska-natives
#16
Kamilla L Venner, Dennis M Donovan, Aimee N C Campbell, Dennis C Wendt, Traci Rieckmann, Sandra M Radin, Sandra L Momper, Carmen L Rosa
The U.S. is experiencing an alarming opioid epidemic, and although American Indians and Alaska Natives (AI/ANs) are especially hard hit, there is a paucity of opioid-related treatment research with these communities. AI/ANs are second only to Whites in the U.S. for overdose mortality. Thus, the National Institute on Drug Abuse convened a meeting of key stakeholders to elicit feedback on the acceptability and uptake of medication assisted treatment (MAT) for opioid use disorders (OUDs) among AI/ANs. Five themes from this one-day meeting emerged: 1) the mismatch between Western secular and reductionistic medicine and the AI/AN holistic healing tradition; 2) the need to integrate MAT into AI/AN traditional healing; 3) the conflict between standardized MAT delivery and the traditional AI/AN desire for healing to include being medicine free; 4) systemic barriers; and 5) the need to improve research with AI/ANs using culturally relevant methods...
May 23, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29914469/variability-of-assister-availability-in-health-insurance-marketplace-in-the-u-s
#17
Jayoung Han, Dongwoo Ko
BACKGROUND: The Affordable Care Act (ACA) established the health insurance marketplaces to provide people the opportunity to obtain healthcare coverage. Assisters have worked with people who may have difficulty understanding the new system and selecting the right plan. This study aims to describe the local availability of assister programs, and examine the factors influencing assister provision. METHODS: The 2016 Small Area Health Insurance Estimates data and a database of assister programs constructed using healthcare...
June 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29914446/-improving-native-american-elder-access-to-and-use-of-health-care-through-effective-health-system-navigation
#18
Cathleen E Willging, David H Sommerfeld, Elise Trott Jaramillo, Erik Lujan, Roxane Spruce Bly, Erin K Debenport, Steven P Verney, Ron Lujan
BACKGROUND: Public insurance reforms of the past two decades have failed to substantively address the healthcare needs of American Indians in general, let alone the particular needs of American Indian elders, ages 55 years and older. Historically, this population is more likely to be uninsured and to suffer from greater morbidities, poorer health outcomes and quality of life, and lower life expectancies compared to all other United States aging populations, representing a neglected group within the healthcare system...
June 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29911113/survival-outcomes-for-advanced-kidney-cancer-patients-in-the-era-of-targeted-therapies
#19
Arpit Rao, Charles Wiggins, Richard C Lauer
Background: Advanced renal cell carcinoma (RCC) results in over 14,000 deaths each year in the United States alone. The therapeutic landscape for advanced RCC changed dramatically with the approval of tyrosine kinase inhibitors (TKI) between 2006 and 2012. A large-scale analysis of survival trends has not been performed in the TKI era to determine their impact on outcomes for advanced RCC patients. Methods: The Surveillance, Epidemiology and End-Results (SEER) database was queried for adult patients with advanced RCC diagnosed between 2000 and 2013...
May 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29909444/gender-disparities-in-presentation-management-and-outcomes-of-acute-myocardial-infarction
#20
REVIEW
Matthew Liakos, Puja B Parikh
PURPOSE OF REVIEW: This review provides updates in gender disparities in the symptom profile, risk factors, quality and timeliness of guideline-based medical care, and clinical outcomes, including mortality, bleeding, and vascular complications, in patients with acute myocardial infarction (AMI). RECENT FINDINGS: While AMI continues to be a leading cause of mortality in both men and women, significant gender differences exist in presentation, management, and outcomes...
June 16, 2018: Current Cardiology Reports
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