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https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#1
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28230696/the-call-to-service-is-personal-from-vietnam-to-red-cross-volunteer
#2
Robert J Hassmiller
Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to bring AJN readers recent posts that we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28230450/characteristics-and-medication-use-of-psoriasis-patients-who-may-or-may-not-qualify-for-randomized-controlled-trials
#3
William Malatestinic, Beth Nordstrom, Jashin J Wu, Orin Goldblum, Kathleen Solotkin, Chen-Yen Lin, Kristin Kistler, Kathy Fraeman, Joseph Johnston, Lcdr Lesley Hawley, Nicholas Sicignano, Andre Araujo
BACKGROUND: Clinical trials impose exclusion criteria that may limit the generalizability of results. OBJECTIVES: To (a) determine the percentage of real-world patients who would qualify for psoriasis randomized controlled trials; (b) ascertain differences between moderate-to-severe psoriasis patients who would be eligible, ineligible, or potentially eligible for clinical trials; and (c) compare their biologic treatment patterns. METHODS: Moderate-to-severe psoriasis patients were identified from the U...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230447/effect-of-medicaid-policy-changes-on-medication-adherence-differences-by-baseline-adherence
#4
Krutika Amin, Joel F Farley, Matthew L Maciejewski, Marisa E Domino
BACKGROUND: In 2001, the North Carolina (NC) Medicaid program reduced the number of days prescription supply that enrollees could fill from 100 days to 34 days and increased copayments for brand-name medications. Previous work has shown that a change in these policies led to a decrease in medication adherence from 2.9 to 8.0 percentage points in specific populations with chronic conditions. Studies have also shown that days supply limits and copayment increases have heterogeneous effects based on enrollees' baseline characteristics, including baseline adherence...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230295/associations-of-domain-specific-physical-activities-with-insomnia-symptoms-among-0-5-million-chinese-adults
#5
Bang Zheng, Canqing Yu, Liling Lin, Huaidong Du, Jun Lv, Yu Guo, Zheng Bian, Yiping Chen, Min Yu, Jianguo Li, Junshi Chen, Zhengming Chen, Liming Li
Previous studies have demonstrated the association between physical activity and sleep quality. However, there is little evidence regarding different domains of physical activity. This study aimed to examine the associations between domain-specific physical activities and insomnia symptoms among Chinese men and women. Data of 452 024 Chinese adults aged 30-79 years from the China Kadoorie Biobank Study were analysed. Insomnia symptoms were assessed with self-reported difficulties in initiating or maintaining sleep, early morning awakening, daytime dysfunction and any insomnia symptoms...
February 23, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28229983/establishment-and-application-of-early-risk-stratification-method-for-acute-abdominal-pain-in-adults
#6
Yu Wang, Hong Zhao, Zhen Zhou, Ci Tian, Hong-Li Xiao, Bao-En Wang
BACKGROUND: Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies. METHODS: In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28229306/behavioral-and-social-sciences-at-the-national-institutes-of-health-adoption-of-research-findings-in-health-research-and-practice-as-a-scientific-priority
#7
William T Riley
The National Institutes of Health's Office of Behavioral and Social Sciences Research (OBSSR) recently released its Strategic Plan for 2017 to 2021. This plan highlights three scientific priorities: (1) improve the synergy of basic and applied behavioral and social sciences research, (2) enhance and promote the research infrastructure, methods, and measures needed to support a more cumulative and integrated approach to behavioral and social sciences research, and (3) facilitate the adoption of behavioral and social sciences research findings in health research and in practice...
February 22, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28228934/osteosarcoma-follow-up-chest-x-ray-or-computed-tomography
#8
Anna Paioli, Michele Rocca, Luca Cevolani, Eugenio Rimondi, Daniel Vanel, Emanuela Palmerini, Marilena Cesari, Alessandra Longhi, Abate Massimo Eraldo, Emanuela Marchesi, Piero Picci, Stefano Ferrari
BACKGROUND: In patients with relapsed osteosarcoma, the surgical excision of all metastases, defined as second complete remission (CR-2), is the factor that mainly influences post-relapse survival (PRS). Currently a validated follow-up policy for osteosarcoma is not available, both chest X-ray and computed tomography (CT) are suggested for lung surveillance. The purpose of this study is to evaluate whether the type of imaging technique used for chest surveillance, chest X-ray or CT, influenced the rate of CR-2 and prognosis in patients with recurrent osteosarcoma...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28228134/the-impact-of-community-health-worker-led-home-delivery-of-antiretroviral-therapy-on-virological-suppression-a-non-inferiority-cluster-randomized-health-systems-trial-in-dar-es-salaam-tanzania
#9
Pascal Geldsetzer, Joel M Francis, Nzovu Ulenga, David Sando, Irene A Lema, Eric Mboggo, Maria Vaikath, Happiness Koda, Sharon Lwezaula, Janice Hu, Ramadhani A Noor, Ibironke Olofin, Elysia Larson, Wafaie Fawzi, Till Bärnighausen
BACKGROUND: Home delivery of antiretroviral therapy (ART) by community health workers (CHWs) may improve ART retention by reducing the time burden and out-of-pocket expenditures to regularly attend an ART clinic. In addition, ART home delivery may shorten waiting times and improve quality of care for those in facility-based care by decongesting ART clinics. This trial aims to determine whether ART home delivery for patients who are clinically stable on ART combined with facility-based care for those who are not stable on ART is non-inferior to the standard of care (facility-based care for all ART patients) in achieving and maintaining virological suppression...
February 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28228115/weight-loss-and-exercise-for-communities-with-arthritis-in-north-carolina-we-can-design-and-rationale-of-a-pragmatic-assessor-blinded-randomized-controlled-trial
#10
Stephen P Messier, Leigh F Callahan, Daniel P Beavers, Kate Queen, Shannon L Mihalko, Gary D Miller, Elena Losina, Jeffrey N Katz, Richard F Loeser, Sara A Quandt, Paul DeVita, David J Hunter, Mary F Lyles, Jovita Newman, Betsy Hackney, Joanne M Jordan
BACKGROUND: Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown...
February 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28227144/optimal-medication-dosing-from-suboptimal-clinical-examples-a-deep-reinforcement-learning-approach
#11
Shamim Nemati, Mohammad M Ghassemi, Gari D Clifford, Shamim Nemati, Mohammad M Ghassemi, Gari D Clifford, Gari D Clifford, Mohammad M Ghassemi
Misdosing medications with sensitive therapeutic windows, such as heparin, can place patients at unnecessary risk, increase length of hospital stay, and lead to wasted hospital resources. In this work, we present a clinician-in-the-loop sequential decision making framework, which provides an individualized dosing policy adapted to each patient's evolving clinical phenotype. We employed retrospective data from the publicly available MIMIC II intensive care unit database, and developed a deep reinforcement learning algorithm that learns an optimal heparin dosing policy from sample dosing trails and their associated outcomes in large electronic medical records...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227016/towards-sophisticated-learning-from-ehrs-increasing-prediction-specificity-and-accuracy-using-clinically-meaningful-risk-criteria
#12
Ieva Vasiljeva, Ognjen Arandjelovic, Ieva Vasiljeva, Ognjen Arandjelovic, Ieva Vasiljeva, Ognjen Arandjelovic
Computer based analysis of Electronic Health Records (EHRs) has the potential to provide major novel insights of benefit both to specific individuals in the context of personalized medicine, as well as on the level of population-wide health care and policy. The present paper introduces a novel algorithm that uses machine learning for the discovery of longitudinal patterns in the diagnoses of diseases. Two key technical novelties are introduced: one in the form of a novel learning paradigm which enables greater learning specificity, and another in the form of a risk driven identification of confounding diagnoses...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226421/opening-plenary-speaker-human-genomics-precision-medicine-and-advancing-human-health
#13
Eric D Green
Starting with the launch of the Human Genome Project in 1990, the past quarter-century has brought spectacular achievements in genomics that dramatically empower the study of human biology and disease. The human genomics enterprise is now in the midst of an important transition, as the growing foundation of genomic knowledge is being used by researchers and clinicians to tackle increasingly complex problems in biomedicine. Of particular prominence is the use of revolutionary new DNA sequencing technologies for generating prodigious amounts of DNA sequence data to elucidate the complexities of genome structure, function, and evolution, as well as to unravel the genomic bases of rare and common diseases...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#14
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28224453/national-estimates-and-correlates-of-secondhand-smoke-exposure-in-us-cancer-survivors
#15
Taghrid Asfar, Kristopher L Arheart, Tulay Koru-Sengul, Margaret M Byrne, Noella A Dietz, Charles Jeng Chen, David J Lee
PURPOSE: Cancer survivors comprise a vulnerable population for exposure to secondhand smoke (SHS). This study examined and compared the prevalence, time trends, and predictors of SHS exposure between nonsmoking adult cancer survivors and nonsmoking adults without cancer history (control group). METHODS: Data were obtained from the 2001-2012 National Health and Nutrition Examination Survey (survivors: n = 2168; controls: n = 19,436). All adults ≥20 years of age who reported not smoking and had a serum cotinine level of 0...
February 21, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/28224082/clinical-characteristics-of-adult-patients-with-inborn-errors-of-metabolism-in-spain-a-review-of-500-cases-from-university-hospitals
#16
J Pérez-López, L Ceberio-Hualde, J S García-Morillo, J M Grau-Junyent, A Hermida Ameijeiras, M López-Rodríguez, J C Milisenda, M Moltó Abad, M Morales-Conejo, J J Nava Mateos
Patients with inborn errors of metabolism (IEMs) have become an emerging and challenging group in the adult healthcare system whose needs should be known in order to implement appropriate policies and to adapt adult clinical departments. We aimed to analyze the clinical characteristics of adult patients with IEMs who attend the most important Spanish hospitals caring for these conditions. A cohort study was conducted in 500 patients, categorized by metabolic subtype according to pathophysiological classification...
March 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28223666/-geriatric-oncology
#17
Satoko Maeno, Fumio Nagashima, Daisuke Naruge, Naohiro Okano, Kirio Kawai, Takaaki Kobayashi, Hiroshi Kitamura, Junji Furuse
The number of older adults in Japan is rising, and healthcare for older patients differs from those of younger patients.We have limited available data regarding the outcomes of cancer treatment in this population.In addition, we have few guidelines to address the evaluation and treatment of older cancer patients in Japan.The Japan Agency for Medical Research and Development(AMED)has funded clinical research focusing on elderly cancer patients.We organized the Geriatric Study Committee in Japan Clinical Oncology Group(JCOG)to develop geriatric research policy in this area...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#18
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28222990/establishing-patient-specific-criteria-for-selecting-the-optimal-upper-extremity-vascular-access-procedure
#19
Karen Woo, Jesus Ulloa, Michael Allon, Christopher G Carsten, Eric S Chemla, Mitchell L Henry, Thomas S Huber, Jeffrey H Lawson, Charmaine E Lok, Eric K Peden, Larry Scher, Anton Sidawy, Melinda Maggard-Gibbons, David Cull
OBJECTIVE: The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dramatically, several reports have found that this singular focus on increasing AVFs has resulted in increased AVF nonmaturation/early failure and a high prevalence of catheter dependence...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222908/reports-of-child-sexual-abuse-of-boys-and-girls-longitudinal-trends-over-a-20-year-period-in-victoria-australia
#20
Ben Mathews, Leah Bromfield, Kerryann Walsh, Qinglu Cheng, Rosana E Norman
Although prevalence studies show girls are more frequently sexually abused than boys, a significant proportion of boys also experience child sexual abuse (CSA). The challenges for public policy are amplified for boys due to less developed public and professional sensitisation to boys' experiences, conceptions of masculinity, and less research on boys including into reporting trends and outcomes. We conducted a 20-year longitudinal time-trend analysis of government data to identify reporting trends and report outcomes for CSA in Victoria, Australia from 1993 to 2012...
February 17, 2017: Child Abuse & Neglect
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