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https://www.readbyqxmd.com/read/28637571/workforce-issues-in-pediatric-surgery
#1
Don K Nakayama
High salaries indicate a demand for pediatric surgeons in excess of the supply, despite only a slight growth in the pediatric-age population and a sharp increase in numbers of trainees. Top-level neonatal intensive care units require 24-hour-7-day pediatric surgical availability, so hospitals are willing to pay surgeons a premium and engage high-priced locum tenens surgeons to fill vacancies in coverage. With increased supply comes an erosion of the numbers of cases performed by trainees and surgeons in practice...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28623159/epigenetic-biomarkers-and-cardiovascular-disease-circulating-micrornas
#2
David de Gonzalo-Calvo, Eduardo Iglesias-Gutiérrez, Vicenta Llorente-Cortés
MicroRNAs (miRNAs) are a class of small noncoding RNA (20-25 nucleotides) involved in gene regulation. In recent years, miRNAs have emerged as a key epigenetic mechanism in the development and physiology of the cardiovascular system. These molecular species regulate basic functions in virtually all cell types, and are therefore directly associated with the pathophysiology of a large number of cardiovascular diseases. Since their relatively recent discovery in extracellular fluids, miRNAs have been studied as potential biomarkers of disease...
June 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28613066/balance-billing-by-health-care-providers-assessing-consumer-protections-across-states
#3
Kevin Lucia, Jack Hoadley, Ashley Williams
ISSUE: Privately insured consumers expect that if they pay premiums and use in-network providers, their insurer will cover the cost of medically necessary care beyond their cost-sharing. However, when obtaining care at emergency departments and in-network hospitals, patients treated by an out-of-network provider may receive an unexpected "balance bill" for an amount beyond what the insurer paid. With no explicit federal protections against balance billing, some states have stepped in to protect consumers from this costly and confusing practice...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28544860/behavioral-processes-in-long-lag-intervention-studies
#4
Dale T Miller, Jennifer E Dannals, Julian J Zlatev
We argue that psychologists who conduct experiments with long lags between the manipulation and the outcome measure should pay more attention to behavioral processes that intervene between the manipulation and the outcome measure. Neglect of such processes, we contend, stems from psychology's long tradition of short-lag lab experiments where there is little scope for intervening behavioral processes. Studying process in the lab invariably involves studying psychological processes, but in long-lag field experiments it is important to study causally relevant behavioral processes as well as psychological ones...
May 2017: Perspectives on Psychological Science: a Journal of the Association for Psychological Science
https://www.readbyqxmd.com/read/28531819/welfare-consequences-for-people-with-epilepsy-and-their-partners-a-matched-nationwide-study-in-denmark
#5
Poul Jennum, Anne Sabers, Jakob Christensen, Rikke Ibsen, Jakob Kjellberg
PURPOSE: We aimed to evaluate the excess direct and indirect costs associated with epilepsy. METHODS: From the Danish National Patient Registry (1998-2013), we identified people within all ages with an epilepsy diagnosis and matched them to control individuals. Additionally, partners of people with epilepsy were identified, who were compared with control partners. Direct costs included frequencies and costs of hospitalizations and weighted outpatient use according to diagnosis-related group, and specific outpatient costs based on data from the Danish Ministry of Health...
July 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28522118/a-national-survey-of-hdr-source-knowledge-among-practicing-radiation-oncologists-and-residents-establishing-a-willingness-to-pay-threshold-for-cobalt-60-usage
#6
Raymond Mailhot Vega, Wesley Talcott, Omar Ishaq, Patrice Cohen, Christina J Small, Tamara Duckworth, Gustavo Sarria Bardales, Carmen A Perez, Peter B Schiff, William Small, Matthew M Harkenrider
PURPOSE: Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. METHODS AND MATERIALS: A nationwide survey of U...
May 15, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28499436/inequality-in-healthcare-costs-between-residing-and-non-residing-patients-evidence-from-vietnam
#7
Hieu M Nguyen
BACKGROUND: Place of residence has been shown to impact health. To date, however, previous studies have only focused on the variability in health outcomes and healthcare costs between urban and rural patients. This study takes a different approach and investigates cost inequality facing non-residing patients - patients who do not reside in the regions in which the hospitals are located. Understanding the sources for this inequality is important, as they are directly related to healthcare accessibility in developing countries...
May 12, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28426186/issue-at-the-heart-of-advancing-the-de-adoption-of-low-value-care-proceedings-from-an-expert-roundtable
#8
Janet Weiner, Rebecka Rosenquist
Identifying and paying for value has become a recurrent theme of health care reforms. Its corollary, reducing the prevalence of, and resources directed to, ineffective or marginally effective care, has received far less attention. In July 2016, the University of Pennsylvania’s Leonard Davis Institute of Health Economics (LDI) convened a diverse set of national leaders and stakeholders representing industry, think-tanks, provider and patient groups, and academic experts to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable...
April 2017: LDI Issue Brief
https://www.readbyqxmd.com/read/28406394/a-randomised-controlled-trial-to-compare-the-safety-effectiveness-and-cost-effectiveness-of-doxycycline-200%C3%A2-mg-day-with-that-of-oral-prednisolone-0-5%C3%A2-mg-kg-day-for-initial-treatment-of-bullous-pemphigoid-the-bullous-pemphigoid-steroids-and-tetracyclines-blister
#9
Joanne R Chalmers, Fenella Wojnarowska, Gudula Kirtschig, James Mason, Margaret Childs, Diane Whitham, Karen Harman, Anna Chapman, Shernaz Walton, Enno Schmidt, Thomas R Godec, Andrew J Nunn, Hywel C Williams
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with increased morbidity and mortality in the elderly. OBJECTIVES: To evaluate the effectiveness, safety and cost-effectiveness of a strategy of initiating BP treatment with oral doxycycline or oral prednisolone. We hypothesised that starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral prednisolone...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28348248/imaging-morphogenesis
#10
REVIEW
Donald M Bell
The hostile environment of the microscope stage poses numerous challenges to successful imaging of morphogenesis in live tissues. This review aims to highlight some of the main practical considerations to take into account when embarking on a project to image cell behaviour in the context of cells' normal surroundings. Scrutiny of these activities is likely to be the most informative approach to understanding mechanical morphogenesis but is often confounded by the substantial technical difficulties involved in imaging samples over extended periods of time...
May 19, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28346128/ethnicity-recording-in-primary-care-computerised-medical-record-systems-an-ontological-approach
#11
Zayd Tippu, Ana Correa, Harshana Liyanage, David Burleigh, Andrew McGovern, Jeremy Van Vlymen, Simon Jones, Simon De Lusignan
BACKGROUND: Ethnicity recording within primary care computerised medical record (CMR) systems is suboptimal, exacerbated by tangled taxonomies within current coding systems.Objective To develop a method for extending ethnicity identification using routinely collected data. METHODS: We used an ontological method to maximise the reliability and prevalence of ethnicity information in the Royal College of General Practitioner's Research and Surveillance database. Clinical codes were either directly mapped to ethnicity group or utilised as proxy markers (such as language spoken) from which ethnicity could be inferred...
March 14, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28330830/rates-delays-and-completeness-of-general-practitioners-responses-to-a-postal-versus-web-based-survey-a-randomized-trial
#12
Paul Sebo, Hubert Maisonneuve, Bernard Cerutti, Jean Pascal Fournier, Nicolas Senn, Dagmar M Haller
BACKGROUND: Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). OBJECTIVE: Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs' preventive practices. METHODS: This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015...
March 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28324029/vital-directions-for-health-and-health-care-priorities-from-a-national-academy-of-medicine-initiative
#13
Victor J Dzau, Mark B McClellan, J Michael McGinnis, Sheila P Burke, Molly J Coye, Angela Diaz, Thomas A Daschle, William H Frist, Martha Gaines, Margaret A Hamburg, Jane E Henney, Shiriki Kumanyika, Michael O Leavitt, Ruth M Parker, Lewis G Sandy, Leonard D Schaeffer, Glenn D Steele, Pamela Thompson, Elias Zerhouni
Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity...
April 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28284366/-state-of-development-of-the-role-of-academic-nursing-staff-at-german-university-hospitals-in-2015
#14
Antje Tannen, Johanna Feuchtinger, Barbara Strohbücker, Andreas Kocks
INTRODUCTION: In order to meet the requirements of the increasing complexity of patient care it is recommended to promote more differentiated nursing staff structures and to integrate academic nurses, which is international standard and recommended by the German Science Council. The implementation level is unclear. What is the percentage of nurses with an academic degree at German university hospitals, and what are their task profiles? METHOD: Standardised written survey by nursing directors of all 32 German university hospitals and medical universities in 2015...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28226348/-the-key-points-of-prevention-for-special-surgical-complications-after-radical-operation-of-gastric-cancer
#15
Hao Xu, Weizhi Wang, Panyuan Li, Diancai Zhang, Li Yang, Zekuan Xu
Incidence of gastric cancer is high in China and standard radical operation is currently the main treatment for gastric cancer. Postoperative complications, especially some special complications, can directly affect the prognosis of patients, even result in the increase of mortality. But the incidences of these special complications are low, so these complications are often misdiagnosed and delayed in treatment owing to insufficient recognition of medical staff. These special complications include (1) Peterson hernia: It is an abdominal hernia developed in the space between Roux loop and transverse colon mesentery after Roux-Y reconstruction of digestive tract...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28166674/medical-managers-managerial-self-efficacy-and-role-clarity-how-do-they-bridge-the-budgetary-participation-performance-link
#16
Manuela S Macinati, Gabriele Cantaluppi, Marco Giovanni Rizzo
This study explains the process ''how'' organizational accounting practices, such as budgetary participation, influence medical doctors' perceptions and beliefs associated with their hybrid role and what the consequences are on their performance. Building on social cognitive theory, we hypothesize a structural model in which managerial self-efficacy and role clarity mediate the effects of budgetary participation on performance. The data were collected by a survey conducted in an Italian hospital. The research hypotheses were tested employing a path model...
February 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28152973/multidisciplinary-process-improvement-to-optimize-oral-chemotherapy-safety
#17
Kerin B Adelson, Monica Fradkin, Renee Havriliak, Michelle Renee Harrison, Osama Abdelghany, Stephanie Kregling, Jessica Wright, Bret Morrow, Roberta Sterling, Mandeep Smith, Frank Esposito, Martha Stutsky, LeeAnn Miller, Rogerio Lilenbaum, Catherine A Lyons, Anne C Chiang, Howard Cohen
134 Background: The rapid development of oral chemotherapy agents brings unique challenges. These drugs must be treated with the same vigilance as parenteral chemotherapy. The oral chemotherapy system is not optimized or integrated across our hospital. A quality assessment survey identified the need for a better means to monitor and improve oral chemotherapy patient outcomes. METHODS: Patient and staff satisfaction with the current process was measured. A chartered multidisciplinary task force reviewed existing practice and developed a program to identify patients, ensure drug access, standardize prescription and consent, ensure on-going clinical support including patient education, regimen specific adherence monitoring, toxicity assessment and address patient concerns...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28135379/comparison-of-nurses-self-reported-and-objectively-measured-evidence-based-practice-knowledge
#18
Amy Hagedorn Wonder, Angela M McNelis, Darrell Spurlock, Pamela M Ironside, Shelley Lancaster, Carmen R Davis, Marlena Gainey, Nancy Verwers
BACKGROUND: This study provides a first-time, objective assessment of the evidence-based practice (EBP) knowledge of RNs working in Magnet(®)-designated hospitals. METHOD: This multisite, cross-sectional, descriptive, correlational study uses the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN) and Evidence-Based Practice Questionnaire (EBPQ). RESULTS: EBPQ subscale scores revealed overall positive self-ratings of EBP knowledge/skills, attitudes, and practice/use...
February 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28110720/classification-based-quantitative-analysis-of-stable-isotope-labeling-by-amino-acids-in-cell-culture-silac-data
#19
Seongho Kim, Nicholas Carruthers, Joohyoung Lee, Sreenivasa Chinni, Paul Stemmer
BACKGROUND AND OBJECTIVE: Stable isotope labeling by amino acids in cell culture (SILAC) is a practical and powerful approach for quantitative proteomic analysis. A key advantage of SILAC is the ability to simultaneously detect the isotopically labeled peptides in a single instrument run and so guarantee relative quantitation for a large number of peptides without introducing any variation caused by separate experiment. However, there are a few approaches available to assessing protein ratios and none of the existing algorithms pays considerable attention to the proteins having only one peptide hit...
December 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28110265/comparative-effectiveness-of-two-disparate-policies-on-child-health-experimental-evidence-from-the-philippines
#20
John W Peabody, Stella Quimbo, Jhiedon Florentino, Riti Shimkhada, Xylee Javier, David Paculdo, Dean Jamison, Orville Solon
Background  : Should health systems invest more in access to care by expanding insurance coverage or in health care services including improving the quality of care? Comparing these options experimentally would shed light on the impact and cost-effectiveness of these strategies. Methods  : The Quality Improvement Demonstration Study (QIDS) was a randomized policy experiment conducted across 30 districts in the Philippines. The study had a control group and two policy intervention groups intended to improve the health of young children...
May 1, 2017: Health Policy and Planning
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