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https://www.readbyqxmd.com/read/29231837/the-primary-health-care-system-in-china
#1
REVIEW
Xi Li, Jiapeng Lu, Shuang Hu, K K Cheng, Jan De Maeseneer, Qingyue Meng, Elias Mossialos, Dong Roman Xu, Winnie Yip, Hongzhao Zhang, Harlan M Krumholz, Lixin Jiang, Shengshou Hu
China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes)...
December 9, 2017: Lancet
https://www.readbyqxmd.com/read/29230894/vouchers-for-primary-healthcare-services-in-an-ageing-world-the-perspectives-of-elderly-voucher-recipients-in-hong-kong
#2
Angel Hor-Yan Lai, Zoey Kuang, Carrie Ho-Kwan Yam, Shereen Ayub, Eng-Kiong Yeoh
Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services...
December 11, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/29230472/individualized-glycemic-control-for-u-s-adults-with-type-2-diabetes-a-cost-effectiveness-analysis
#3
Neda Laiteerapong, Jennifer M Cooper, M Reza Skandari, Philip M Clarke, Aaron N Winn, Rochelle N Naylor, Elbert S Huang
Background: Intensive glycemic control in type 2 diabetes (glycated hemoglobin [HbA1c] level <7%) is an established, cost-effective standard of care. However, guidelines recommend individualizing goals on the basis of age, comorbidity, diabetes duration, and complications. Objective: To estimate the cost-effectiveness of individualized control versus uniform intensive control (HbA1c level <7%) for the U.S. population with type 2 diabetes. Design: Patient-level Monte Carlo-based Markov model...
December 12, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29230305/changes-needed-to-medicine-in-the-uk-before-senior-uk-trained-doctors-working-outside-the-uk-will-return-questionnaire-surveys-undertaken-between-2004-and-2015
#4
Trevor W Lambert, Fay Smith, Michael J Goldacre
Objective: To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Design: Questionnaire survey. Setting: UK-trained medical graduates. Participants: Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned...
December 2017: JRSM Open
https://www.readbyqxmd.com/read/29230253/barriers-to-clinical-adoption-of-next-generation-sequencing-a-policy-delphi-panel-s-solutions
#5
Donna A Messner, Pei Koay, Jennifer Al Naber, Robert Cook-Deegan, Mary Majumder, Gail Javitt, Rachel Dvoskin, Juli Bollinger, Margaret Curnutte, Amy L McGuire
Aim: Identify solutions to the most important policy barriers to the clinical adoption of next-generation sequencing. Materials & methods: Four-round modified policy Delphi with a multistakeholder panel of 48 experts. The panel deliberated policy solutions to (previously reported) challenges deemed most important to address. Results: The group advocated using consensus panels to promote consistency in payer policies and to standardize test reporting, and favored making genomic data-sharing a condition of regulatory clearance, certification, or accreditation processes...
2017: Personalized Medicine
https://www.readbyqxmd.com/read/29229057/functional-limitations-in-adults-who-utilize-chiropractic-or-osteopathic-manipulation-in-the-united-states-analysis-of-the-2012-national-health-interview-survey
#6
Mary L Forte, Michele Maiers
OBJECTIVES: The goals of this study were to identify self-reported differences in function, comorbidities, and medical service utilization among adults who reported using chiropractic and/or osteopathic manipulation in the 2012 National Health Interview Survey, and to compare these between older and younger adults. METHODS: We conducted a descriptive study of adults aged 18 or older who were included in the 2012 National Health Interview Survey and the Alternative Medicine Questionnaire...
November 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/29228931/research-protocol-cisplatin-associated-ototoxicity-amongst-patients-receiving-cancer-chemotherapy-and-the-feasibility-of-an-audiological-monitoring-program
#7
J Paken, C D Govender, V Sewram
BACKGROUND: Cisplatin is an anti-cancer chemotherapy drug classified as an alkylating agent. It is used for the treatment of a variety of cancers such as cervical, breast, stomach, prostate, bladder and oesophageal, to name a few. However due to its expansive toxicity profile, patients receiving cisplatin can experience high frequency hearing loss, a side effect known as ototoxicity. The dearth of information on the extent and severity of cisplatin-associated ototoxicity in South Africa prevents the implementation of a context-specific audiological monitoring programme...
December 11, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29228640/comparison-of-primary-endpoints-between-publications-registries-and-protocols-of-phase-iii-cancer-clinical-trials
#8
Fei Liang, Xinmei Guo, Sheng Zhang, Hongxi Xue, Qiang Chen, Xichun Hu
Background: Decisions by leading journals to require trial registration and to make protocols of phase III randomized clinical trials (RCTs) publicly accessible were landmark events in clinical trial reporting. Materials and Methods: We identified phase III cancer RCTs published between 2013 and 2015 in New England Journal of Medicine (NEJM), The Lancet, The lancet Oncology, JAMA and Journal of Clinical Oncology (JCO). Results: We identified 345 reports of phase III RCTs of which 217 (62...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228415/the-implementation-of-a-hospital-wide-practice-for-the-selective-use-of-carbapenems-based-on-the-monitoring-of-susceptibility-of-pseudomonas-aeruginosa-isolates
#9
Toshio Ohshima, Satomi Asai, Miki Miyazawa, Yukari Yamamoto, Akifumi Hisada, Chie Kumazawa, Masayoshi Hashimoto, Katsuji Fukawa, Hideo Iwashita, Kazuo Umezawa, Sanetoshi Yamada, Yoshiro Yamamoto, Hayato Miyachi
OBJECTIVES: To control carbapenem-resistant Pseudomonas aeruginosa, we implemented a hospital-wide policy concerning the selective use of carbapenems based on the monitoring of P. aeruginosa isolates for susceptibility to five carbapenems using a customized dry plate method. In this study, we retrospectively investigated the outcome of our measures to control carbapenem-resistant P. aeruginosa. METHODS: To select effective carbapenems, 100 clinical isolates were collected, and the minimum inhibitory concentration (MIC) to 5 carbapenems (IPM/CS, MEPM, DRPM, BIPM and PAPM/BP) was monitored using a customized dry plate method from 2006 to 2013...
December 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/29227734/influenza-immunization-policies-which-could-be-the-main-reasons-for-differences-among-countries
#10
Nicola Principi, Barbara Camilloni, Susanna Esposito
Despite the availability of effective prophylactic and therapeutic measures, influenza remains one of the most important infectious disease threats to the human population. Every year, seasonal influenza epidemics infect up to 30% of the population; a relevant portion of the ill are hospitalized, and more than a marginal number die. In an attempt to reduce the medical, social and economic burden of influenza, vaccines are recommended by many health authorities worldwide. However, not all countries have a national program for influenza immunization...
December 11, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29227466/morbidity-and-mortality-of-a-cohort-of-peruvian-hiv-infected-children-2003-2012
#11
Amira N Baker, Angela M Bayer, Rolando M Viani, Lenka Kolevic, Myung-Shin Sim, Jaime G Deville
BACKGROUND: Data on pediatric HIV in Peru is limited. The National Institute of Child Health (Instituto Nacional de Salud del Niño: INSN) cares for the most HIV-infected children under age 18 in the country. We describe the outcomes of children seen at INSN's HIV clinic over the 10 years when antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) interventions became available in 2004. METHODS: We conducted a retrospective review of INSN HIV clinic patients between 2003-2012...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29226604/an-international-qualitative-study-of-functioning-in-autism-spectrum-disorder-using-the-world-health-organization-international-classification-of-functioning-disability-and-health-framework
#12
Soheil Mahdi, Marisa Viljoen, Tamara Yee, Melissa Selb, Nidhi Singhal, Omar Almodayfer, Mats Granlund, Petrus J de Vries, Lonnie Zwaigenbaum, Sven Bölte
This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi-structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden...
December 11, 2017: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/29226231/the-postgraduate-medical-education-pathway-an-international-comparison
#13
Margot M Weggemans, Bruce van Dijk, Birgit van Dooijeweert, Anne G Veenendaal, Olle Ten Cate
An at first sight seemingly coherent, global medical workforce, with clearly recognizable specialities, subspecialties and primary care doctors, appears at a closer look quite variable. Even within the most progressive countries as to the development of medical education, with educators who regularly meet at conferences and share major journals about medical education, the differences in structures and regulations are big. This contribution focuses on the preparation, admission policy, duration, examinations, and national competency frameworks in postgraduate speciality training in Germany, the USA, Canada, the UK, Australia and the Netherlands...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29226008/variation-in-results-release-and-patient-portal-access-to-diagnostic-test-results-at-an-academic-medical-center
#14
Matthew D Krasowski, Caleb V Grieme, Brian Cassady, Nicholas R Dreyer, Karolyn A Wanat, Maia Hightower, Kenneth G Nepple
Background: Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. Methods: We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs...
2017: Journal of Pathology Informatics
https://www.readbyqxmd.com/read/29225941/beyond-menstrual-hygiene-addressing-vaginal-bleeding-throughout-the-life-course-in-low-and-middle-income-countries
#15
REVIEW
Marni Sommer, Penelope A Phillips-Howard, Therese Mahon, Sasha Zients, Meredith Jones, Bethany A Caruso
Girls and women experience numerous types of vaginal bleeding. These include healthy reproductive processes, such as menstruation and bleeding after childbirth, but also bleeding related to health conditions, such as fibroids or cancer. In most societies, the management of menstruation is handled covertly, something girls are often instructed about at menarche. The management of other vaginal bleeding is often similarly discreet, although behaviours are not well documented. In many societies, cultural taboos frequently hinder open discussion around vaginal bleeding, restricting information and early access to healthcare...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225935/gendered-negotiations-for-research-participation-in-community-based-studies-implications-for-health-research-policy-and-practice
#16
Dorcas M Kamuya, Catherine S Molyneux, Sally Theobald
There is a growing literature documenting the complex realities of consent processes in the field, and the negotiations and ethical dilemmas involved. Much has also been written about how gender and power shape household decision-making processes. However, these bodies of literature have rarely been brought together to inform research theory and practice in low-income settings. In this paper, qualitative research (observation, focus group discussions and interviews) were used alongside large clinical community-based studies conducted on the Kenyan Coast to explore how gender and power relations within households and communities and between fieldworkers and communities shape consent processes and interactions...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225934/health-policy-and-systems-research-towards-a-better-understanding-and-review-of-ethical-issues
#17
REVIEW
Valerie Ann Luyckx, Nikola Biller-Andorno, Abha Saxena, Nhan T Tran
Given the focus on health systems in the post-millennium development goal era and moving towards the sustainable development goals, there is a compelling need for a common framework for health policy and systems research ethics to guide researchers and facilitate review by research ethics committees. A consultation of global health policy and systems research and ethics experts was convened to identify ethical considerations relevant to health policy and systems research based on existing knowledge and to identify knowledge gaps through a scoping review and further expert deliberation...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225915/mdhaq-rapid3-scores-in-patients-with-osteoarthritis-are-similar-to-or-higher-than-in-patients-with-rheumatoid-arthritis-a-cross-sectional-study-from-current-routine-rheumatology-care-at-four-sites
#18
Carlos El-Haddad, Isabel Castrejon, Kathryn A Gibson, Yusuf Yazici, Martin J Bergman, Theodore Pincus
Objective: To compare patients with a primary diagnosis of osteoarthritis (OA) versus rheumatoid arthritis (RA) for scores on a patient self-report MDHAQ/RAPID3 (Multidimensional Health Assessment Questionnaire/Routine Assessment of Patient Index Data 3), and for physician global assessment (DOCGL). Methods: All patients with all diagnoses complete an MDHAQ/RAPID3 at all routine rheumatology visits in the waiting area before seeing a rheumatologist at four sites, one in Australia and three in the USA...
2017: RMD Open
https://www.readbyqxmd.com/read/29225582/significant-need-for-a-french-network-of-expert-centers-enabling-a-better-characterization-and-management-of-treatment-resistant-depression-fondation-fondamental
#19
Antoine Yrondi, Djamila Bennabi, Emmanuel Haffen, Marion Garnier, Frank Bellivier, Thierry Bourgerol, Vincent Camus, Thierry D'Amato, Olivier Doumy, Frédéric Haesebaert, Jérôme Holtzmann, Christophe Lançon, Philippe Vignaud, Fanny Moliere, Isabel Nieto, Raphaëlle Marie Richieri, Philippe Domenech, Corentin Rabu, Luc Mallet, Liova Yon, Laurent Schmitt, Florian Stephan, Guillaume Vaiva, Michel Walter, Pierre-Michel Llorca, Philippe Courtet, Marion Leboyer, Wissam El-Hage, Bruno Aouizerate
Background: Major depression is characterized by (i) a high lifetime prevalence of 16-17% in the general population; (ii) a high frequency of treatment resistance in around 20-30% of cases; (iii) a recurrent or chronic course; (iv) a negative impact on the general functioning and quality of life; and (v) a high level of comorbidity with various psychiatric and non-psychiatric disorders, high occurrence of completed suicide, significant burden along with the personal, societal, and economic costs...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29224232/physical-activity-and-family-based-obesity-treatment-a-review-of-expert-recommendations-on-physical-activity-in-youth
#20
REVIEW
C Foster, J B Moore, C R Singletary, J A Skelton
Targeting physical inactivity in children is pertinent to aiding in the decrease of childhood obesity rates. Only 33% of adolescents are obtaining the recommended goal of at least 60 min of physical activity per day. The objectives of this review are to summarize professional recommendations for physical activity and exercise in children and adolescents, and identify family-centred strategies that can be implemented by weight management clinicians. Clinically oriented recommendations and policy statements from professional organizations were identified through literature and internet searches, summarized using rubrics of aerobic, muscle strengthening and bone strengthening exercise, then examined for details on family-based focus, inclusion of child developmental stage and age, and application to the prevention and treatment of obesity...
December 10, 2017: Clinical Obesity
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