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https://www.readbyqxmd.com/read/27921992/the-hubble-trial-haemorrhoidal-artery-ligation-hal-versus-rubber-band-ligation-rbl-for-symptomatic-second-and-third-degree-haemorrhoids-a-multicentre-randomised-controlled-trial-and-health-economic-evaluation
#1
Steven Brown, Jim Tiernan, Katie Biggs, Daniel Hind, Neil Shephard, Mike Bradburn, Allan Wailoo, Abualbishr Alshreef, Lizzie Swaby, Angus Watson, Simon Radley, Oliver Jones, Paul Skaife, Anil Agarwal, Pasquale Giordano, Marc Lamah, Mark Cartmell, Justin Davies, Omar Faiz, Karen Nugent, Andrew Clarke, Angus MacDonald, Phillip Conaghan, Paul Ziprin, Rohit Makhija
BACKGROUND: Optimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious. OBJECTIVE: The comparison of HAL with RBL for the treatment of grade II/III haemorrhoids. DESIGN: A multicentre, parallel-group randomised controlled trial. PERSPECTIVE: UK NHS and Personal Social Services...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27920322/patients-who-choose-primary-care-physicians-based-on-low-office-visit-price-can-realize-broader-savings
#2
Ateev Mehrotra, Peter J Huckfeldt, Amelia M Haviland, Laura Gascue, Neeraj Sood
Price transparency initiatives encourage patients to save money by choosing physicians with a relatively low price per office visit. Given that the price of such visits represents a small fraction of total spending, the extent of the savings from choosing such physicians has not been clear. Using a national sample of commercial claims data, we compared the care received by patients of high- and low-price primary care physicians. The median price for an established patient's office visit was $60 among low-price physicians and $86 among high-price physicians (price was calculated as reimbursement plus out-of-pocket spending)...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920012/effect-of-cataract-surgery-volume-constraints-on-recently-graduated-ophthalmologists-a-population-based-cohort-study
#3
Robert J Campbell, Sherif R El-Defrawy, Chaim M Bell, Sudeep S Gill, Philip L Hooper, Marlo Whitehead, Erica de L P Campbell, Robert Nesdole, Daniel Warder, Martin Ten Hove
BACKGROUND: Across Canada, graduates from several medical and surgical specialties have recently had difficulty securing practice opportunities, especially in specialties dependent upon limited resources. In most developed nations, cataract surgery is the most common operation performed, making practice opportunities sensitive to access to health system resources and making this procedure an exemplar of issues facing resource-intensive specialties. METHODS: We used population-based administrative data from Ontario for the period Jan...
December 5, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27919177/economic-burden-of-inadequate-symptom-control-among-us-commercially-insured-irritable-bowel-syndrome-patients-with-diarrhea
#4
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
AIMS: To assess healthcare resource use and costs among irritable bowel syndrome (IBS) with diarrhea (IBS-D) patients with and without evidence of inadequate symptom control on current prescription therapies and estimate incremental all-cause costs associated with inadequate symptom control. METHODS: IBS-D patients aged ≥18 years with ≥1 medical claim for IBS (ICD-9-CM 564.1x) and either ≥2 claims for diarrhea (ICD-9-CM 787.91, 564.5x), or ≥1 claim for diarrhea plus ≥1 claim for abdominal pain (ICD-9-CM 789...
December 6, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27917765/safeguarding-maternal-and-child-health-in-south-africa-by-starting-the-child-support-grant-before-birth-design-lessons-from-pregnancy-support-programmes-in-27-countries
#5
M F Chersich, S Luchters, D Blaauw, F Scorgie, E Kern, A Van den Heever, H Rees, E Peach, S Kharadi, S Fonn
BACKGROUND: Deprivation during pregnancy and the neonatal period increases maternal morbidity, reduces birth weight and impairs child development, with lifelong consequences. Many poor countries provide grants to mitigate the impact of poverty during pregnancy. South Africa (SA) offers a post-delivery Child Support Grant (CSG), which could encompass support during pregnancy, informed by lessons learnt from similar grants. OBJECTIVES: To review design and operational features of pregnancy support programmes, highlighting features that promote their effectiveness and efficiency, and implications thereof for SA...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917666/safety-of-out-of-hours-operating-in-trauma-and-orthopaedics-at-a-district-general-hospital
#6
M A Gulamhussein, S Chaudhry, S Noor, T Chaudhry, A Guha, R Knebel
INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917092/colorectal-cancer-screening-navigation-for-the-underserved-experience-of-an-urban-program
#7
Alicia Lamanna, Heather Sheaffer, Carmen Guerra, Michael Kochman
Colorectal cancer is the third leading cause of cancer deaths in the United States. Although colorectal cancer screenings are effective and recommended by all clinical practice guidelines, only 65.7% of adults ages 50 to 75 years are screened. Colorectal cancer screening is disproportionately underutilized in inner city populations. In 2011, the University of Pennsylvania Health System created a navigation program to specifically address poor colorectal cancer screening rates and increase access to colorectal cancer screening colonoscopies for patients in the underserved areas of West, South, and Southwest Philadelphia...
September 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27916929/a-framework-to-implement-iot-network-performance-modelling-techniques-for-network-solution-selection
#8
Declan T Delaney, Gregory M P O'Hare
No single network solution for Internet of Things (IoT) networks can provide the required level of Quality of Service (QoS) for all applications in all environments. This leads to an increasing number of solutions created to fit particular scenarios. Given the increasing number and complexity of solutions available, it becomes difficult for an application developer to choose the solution which is best suited for an application. This article introduces a framework which autonomously chooses the best solution for the application given the current deployed environment...
December 1, 2016: Sensors
https://www.readbyqxmd.com/read/27915188/combined-cluster-and-discriminant-analysis-an-efficient-chemometric-approach-in-diesel-fuel-characterization
#9
Márton Novák, Dóra Palya, Zsolt Bodai, Zoltán Nyiri, Norbert Magyar, József Kovács, Zsuzsanna Eke
Combined cluster and discriminant analysis (CCDA) as a chemometric tool in compound specific isotope analysis of diesel fuels was studied. The stable carbon isotope ratios (δ(13)C) of n-alkanes in diesel fuel can be used to characterize or differentiate diesels originating from different sources. We investigated 25 diesel fuel samples representing 20 different brands. The samples were collected from 25 different service stations in 11 European countries over a 2 year period. The n-alkane fraction of diesel fuels was separated using solid-state urea clathrate formation combined with silica gel fractionation...
November 23, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27915015/who-seeks-teratology-information-service-s-advice-assessing-the-risk-of-selection-bias-in-observational-cohort-studies-on-drug-risks-in-pregnancy
#10
Evelin Beck, Anna Lechner, Christof Schaefer
All women of reproductive age should have access to Teratology Information Services (TIS). Observational cohort studies based on TIS data are one of the most important sources for risk characterization of drugs during pregnancy. A selection in TIS populations towards higher socioeconomic level would compromise the TIS' goal of health prevention and the quality of research. The aim of this study is to investigate in which respect Berlin TIS enquirers are different from the general female population of reproductive age in Germany...
November 30, 2016: Reproductive Toxicology
https://www.readbyqxmd.com/read/27914487/factors-affecting-job-satisfaction-of-aboriginal-mental-health-workers-working-in-community-mental-health-in-rural-and-remote-new-south-wales
#11
Catherine Cosgrave, Myfanwy Maple, Rafat Hussain
Objective The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs).Methods Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers' decisions to stay or leave their CMH positions.Results Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality...
December 5, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27913910/a-randomized-trial-of-displaying-paid-price-information-on-imaging-study-and-procedure-ordering-rates
#12
Alyna T Chien, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Meredith B Rosenthal, Thomas D Sequist
BACKGROUND: Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. OBJECTIVE: To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). DESIGN: Block randomized controlled trial for 1 year...
December 2, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27913227/assisted-partner-services-for-hiv-in-kenya-a-cluster-randomised-controlled-trial
#13
Peter Cherutich, Matthew R Golden, Beatrice Wamuti, Barbra A Richardson, Kristjana H Ásbjörnsdóttir, Felix A Otieno, Ann Ng'ang'a, Peter Maingi Mutiti, Paul Macharia, Betsy Sambai, Matt Dunbar, David Bukusi, Carey Farquhar
BACKGROUND: Assisted partner services for index patients with HIV infections involves elicitation of information about sex partners and contacting them to ensure that they test for HIV and link to care. Assisted partner services are not widely available in Africa. We aimed to establish whether or not assisted partner services increase HIV testing, diagnoses, and linkage to care among sex partners of people with HIV infections in Kenya. METHODS: In this cluster randomised controlled trial, we recruited non-pregnant adults aged at least 18 years with newly or recently diagnosed HIV without a recent history of intimate partner violence who had not yet or had only recently linked to HIV care from 18 HIV testing services clinics in Kenya...
November 29, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27913044/clinical-validation-of-the-50-gene-ampliseq-cancer-panel-v2-for-use-on-a-next-generation-sequencing-platform-using-formalin-fixed-paraffin-embedded-and-fine-needle-aspiration-tumour-specimens
#14
Vivek Rathi, Gavin Wright, Diana Constantin, Siok Chang, Huong Pham, Kerryn Jones, Atha Palios, Sue-Anne Mclachlan, Matthew Conron, Penny McKelvie, Richard Williams
The advent of massively parallel sequencing has caused a paradigm shift in the ways cancer is treated, as personalised therapy becomes a reality. More and more laboratories are looking to introduce next generation sequencing (NGS) as a tool for mutational analysis, as this technology has many advantages compared to conventional platforms like Sanger sequencing. In Australia all massively parallel sequencing platforms are still considered in-house in vitro diagnostic tools by the National Association of Testing Authorities (NATA) and a comprehensive analytical validation of all assays, and not just mere verification, is a strict requirement before accreditation can be granted for clinical testing on these platforms...
November 29, 2016: Pathology
https://www.readbyqxmd.com/read/27912990/cancer-rehabilitation-an-overview-of-current-need-delivery-models-and-levels-of-care
#15
REVIEW
Andrea L Cheville, Karen Mustian, Kerri Winters-Stone, David S Zucker, Gail L Gamble, Catherine M Alfano
The relevance of cancer rehabilitation as a public health issue grows steadily as cancer incidence, survival, and mean patient age increase. Reported rates of physical impairment and disability are already high, prior to the anticipated influx of aged cancer survivors. Despite the high prevalence of cancer-related disablement, treatment rates, even for readily remediable physical impairments, are as low as 1-2%. In addition to low referral rates, a challenge to patient-centric cancer rehabilitation is a fractured system that requires multiple visits to a range of specialists to address even a single issue, and cancer survivors generally have several...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27911995/allometry-data-and-equations-for-coastal-marsh-plants
#16
Meng Lu, Joshua S Caplan, Jonathan D Bakker, J Adam Langley, Thomas J Mozdzer, Bert G Drake, J Patrick Megonigal
Coastal marshes are highly valued for ecosystem services such as protecting inland habitats from storms, sequestering carbon, removing nutrients and other pollutants from surface water, and providing habitat for fish, shellfish, and birds. Because plants largely determine the structure and function of coastal marshes, quantifying plant biomass is essential for evaluating these ecosystem services, understanding the biogeochemical processes that regulate ecosystem function, and forecasting tidal wetland responses to accelerated sea level rise...
December 2016: Ecology
https://www.readbyqxmd.com/read/27911328/the-clinical-use-of-cerebrospinal-fluid-biomarkers-for-alzheimer-s-disease-diagnosis-the-italian-selfie
#17
Giulia M Sancesario, Sofia Toniolo, Davide Chiasserini, Simona G Di Santo, Josh Zegeer, Gaetano Bernardi, Massimo Musicco, Carlo Caltagirone, Lucilla Parnetti, Sergio Bernardini
Although the use of cerebrospinal fluid (CSF) amyloid β1-42 (Aβ42), tau (T-tau), and phosphorylated tau (p-tau181) gives added diagnostic and prognostic values, the diffusion is still limited in clinical practice and only a restricted number of patients receive an integrated clinico-biological diagnosis. By a survey, we aimed to do a "selfie" of the use and diffusion of CSF biomarkers of dementia in Italy, the standardization of pre-analytical procedures, the harmonization of ranges, and the participation to Quality Control programs...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27910018/fluorescence-in-situ-hybridization-probe-validation-for-clinical-use
#18
Jun Gu, Janice L Smith, Patricia K Dowling
In this chapter, we provide a systematic overview of the published guidelines and validation procedures for fluorescence in situ hybridization (FISH) probes for clinical diagnostic use. FISH probes-which are classified as molecular probes or analyte-specific reagents (ASRs)-have been extensively used in vitro for both clinical diagnosis and research. Most commercially available FISH probes in the United States are strictly regulated by the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) the Clinical Laboratory Improvement Amendments (CLIA), and the College of American Pathologists (CAP)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27906994/enhancing-hiv-testing-and-treatment-among-men-who-have-sex-with-men-in-china-a-pilot-model-with-two-rapid-tests-single-blood-draw-session-and-intensified-case-management-in-six-cities-in-2013
#19
Dapeng Zhang, Hongyan Lu, Minghua Zhuang, Guohui Wu, Hongjing Yan, Jun Xu, Xiaoli Wei, Chengmei Li, Sining Meng, Xiaojing Fu, Jinlei Qi, Peng Wang, Mei Luo, Min Dai, Ray Yip, Jiangping Sun, Zunyou Wu
OBJECTIVES: To explore models to improve HIV testing, linkage to care and treatment among men who have sex with men (MSM) in cooperation with community-based organizations (CBOs) in China. METHODS: We introduced a new model for HIV testing services targeting MSM in six cities in 2013.These models introduced provision of rapid HIV testing by CBO staff and streamlined processes for HIV screening, confirmation of initial reactive screening results, and linkage to care among diagnosed people...
2016: PloS One
https://www.readbyqxmd.com/read/27906915/the-value-of-ct-cardiac-angiography-and-ct-calcium-score-testing-in-a-modern-cardiology-service-in-new-zealand-a-report-of-a-single-centre-eight-year-experience-from-5-237-outpatient-procedures
#20
Chris Ellis, Greg Gamble, Colin Edwards, Niels van Pelt, Ruvin Gabriel, Boris Lowe, Jonathan Christiansen, Andrew To, Helen Winch, Mark Osborne, John Ormiston, Malcolm Legget
BACKGROUND: Computed tomographic (CT) cardiac angiography is of increasing value in several areas of patient management in cardiology. We assessed the ability of CT cardiac angiography to effectively 'rule out' severe coronary stenoses in patients presenting with 'atypical' symptoms and/or an equivocal stress test, which offers a new approach to the management of coronary artery disease. We also examined the use of the CT calcium score test in cardiovascular (CVS) risk assessment. METHODS: From a large single centre (Mercy Hospital) in Auckland, using a prospectively acquired, comprehensive database, we audited the entire eight-year experience of 5,169 patients (7/8/06 to 31/1/14) who underwent 5,237 64-slice computed tomographic (CT) cardiac angiogram or CT calcium score tests (GE Lightspeed scanner)...
December 2, 2016: New Zealand Medical Journal
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