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https://www.readbyqxmd.com/read/28188153/what-are-the-decision-making-preferences-of-patients-in-vascular-surgery-a-mixed-methods-study
#1
T B Katrien Santema, E Anniek Stoffer, Marleen Kunneman, Mark J W Koelemay, Dirk T Ubbink
OBJECTIVES: Shared decision-making (SDM) has been advocated as the preferred method of choosing a suitable treatment option. However, patient involvement in treatment decision-making is not yet common practice in the field of vascular surgery. The aim of this mixed-methods study was to explore patients' decision-making preferences and to investigate which facilitators and barriers patients perceive as important for the application of SDM in vascular surgery. DESIGN AND SETTING: Patients were invited to participate after visiting the vascular surgical outpatient clinic of an Academic Medical Center in the Netherlands...
February 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28160771/a-realist-review-of-shared-medical-appointments-how-for-whom-and-under-what-circumstances-do-they-work
#2
Susan R Kirsh, David C Aron, Kimberly D Johnson, Laura E Santurri, Lauren D Stevenson, Katherine R Jones, Justin Jagosh
BACKGROUND: Shared medical appointments (SMAs) are doctor-patient visits in which groups of patients are seen by one or more health care providers in a concurrent session. There is a growing interest in understanding the potential benefits of SMAs in various contexts to improve clinical outcomes and reduce healthcare costs. This study builds upon the existing evidence base that suggests SMAs are indeed effective. In this study, we explored how they are effective in terms of the underlying mechanisms of action and under what circumstances...
February 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28156512/a-cluster-randomized-trial-of-a-patient-centered-communication-intervention-in-advanced-cancer-the-values-and-options-in-cancer-care-voice-study
#3
Richard L Kravitz, Paul Duberstein, Daniel J Tancredi, Guibo Xing, Ronald M Epstein
: 2 Background: Observational studies demonstrate links between patient-centered communication, prognosis discordance, quality of life (QoL) and aggressive treatments near the end of life, yet there are few randomized evaluations of communication interventions in advanced cancer. METHODS: We completed a cluster randomized controlled trial in cancer clinics in Western NY and Northern CA with medical oncologists (n = 38 randomized to intervention or control) and their community-dwelling adult patients with advanced non-hematologic cancer (n = 265; 194 with enrolled caregivers)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28141731/growth-and-documentation-deficits-where-to-start-in-helping-families
#4
Wilhelmina Hernandez, Deborah A Frank, Samantha Morton, Carmen Palacios, Marilyn Augustyn
Pedro is a 2-year 7-month-old boy who was presented for the first time after a visit to a local emergency room (ER) for diarrhea. At the time of his birth, his undocumented mother, Clara, was 20 years old, uninsured, and with limited English proficiency living approximately 400 miles south of our practice in a different state. Although she had been brought to the United States as a child, she had never finished high school. Pedro was born what mother thought was full-term at his parent's home, where a lay midwife assisted during the delivery...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141671/community-health-workers-addressing-client-objectives-among-frequent-emergency-department-users
#5
Bethany M Kwan, Amy Rockwood, Brian Bandle, Douglas Fernald, Mika K Hamer, Roberta Capp
OBJECTIVES: To evaluate effectiveness of a community health worker (CHW) program designed to address client objectives among frequent emergency department (ED) users. DESIGN: Program evaluation using secondary analysis of client objectives from program records. Client objectives were characterized according to the World Health Organization's social determinants of health framework. Hierarchical generalized linear modeling was used to assess factors associated with objective achievement...
January 30, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28128966/assessing-patient-and-provider-perceptions-of-factors-associated-with-patient-engagement-in-asthma-care
#6
Tamar Sapir, Kathleen F Moreo, Laurence S Greene, Laura C Simone, Jeffrey D Carter, James J L Mateka, Nicola A Hanania
RATIONALE: National quality improvement initiatives emphasize building partnerships between patients and providers by promoting patient engagement through communication, shared decision-making, and self-care skills. Efforts to promote patient engagement are especially important for people with asthma. To cultivate effective partnerships in asthma care, patients and providers may benefit from understanding each other's values and perceptions regarding treatment goals, shared decision-making, and barriers to optimal care and outcomes...
January 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28111335/assessment-of-abilities-of-gastroenterology-fellows-to-provide-information-to-patients-with-liver-disease
#7
Noami Chaudhary, Catherine Lucero, Gerald Villanueva, Michael Poles, Colleen Gillespie, Sondra Zabar, Elizabeth Weinshel
PURPOSE: Patient education is critical in ensuring patient compliance and good health outcomes. Fellows must be able to effectively communicate with their patients, delivering enough information for the patient to understand their medical problem and maximize patient compliance. We created an objective structured clinical examination (OSCE) with four liver disease cases to assess fellows' knowledge and ability to inform standardized patients about their clinical condition. METHODS: We developed four cases highlighting different aspects of liver disease and created a four station OSCE: hepatitis B, acute hepatitis C, new diagnosis of cirrhosis, and an end-stage cirrhotic non transplant candidate...
January 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28098586/comparing-the-outcomes-of-reporting-and-trigger-tool-methods-to-capture-adverse-events-in-the-emergency-department
#8
Wen-Huei Lee, Ewai Zhang, Charng-Yen Chiang, Yung-Lin Yen, Ling-Ling Chen, Mei-Hsiu Liu, Chia-Te Kung, Shih-Chiang Hung
BACKGROUND: Little is known about which methods are best for detecting adverse events in the emergency department (ED). OBJECTIVES: This study compared the ability of trigger tool and reporting methods to capture adverse events in the ED and investigated the characteristics of the adverse events identified by each. METHODS: This 1-year prospective observational cohort study evaluated a monitoring system that combined 2 reporting methods and 5 trigger tool methods to capture adverse events in the ED of an academic medical center...
January 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28079643/validation-of-retention-in-hiv-care-status-using-the-new-york-city-hiv-surveillance-registry-and-clinical-care-data-from-a-large-hiv-care-center
#9
Rituparna Pati, Rebekkah S Robbins, Sarah L Braunstein
CONTEXT: Improving retention in care is a key element of the National HIV/AIDS Strategy (NHAS). However, definitions for measuring retention in care are not standardized. OBJECTIVE: To compare measures of retention based on both clinic visit data and HIV laboratory surveillance data. DESIGN: Retrospective cohort study. SETTING: New York City (NYC), New York. PARTICIPANTS: We matched adult patients with HIV infection seen at the Spencer Cox Center for Health (SCC) in 2010 or 2011 with the NYC HIV Surveillance Registry...
January 11, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28078208/influence-of-different-second-generation-antipsychotics-on-the-qtc-interval-a-pragmatic-study
#10
Roy E Olsen, Rune A Kroken, Sigmund Bjørhovde, Kristina Aanesen, Hugo A Jørgensen, Else-Marie Løberg, Erik Johnsen
AIM: To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics (SGAs) in psychosis. METHODS: Data were drawn from a pragmatic, randomized head-to-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequence of the SGAs under investigation...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28069846/medicaid-expansion-and-grant-funding-increases-helped-improve-community-health-center-capacity
#11
Xinxin Han, Qian Luo, Leighton Ku
Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28047638/su-f-p-09-a-global-medical-physics-collaboration-for-implementation-of-modern-radiotherapy-in-botswana
#12
R Makufa, M Bvochora-Nsingo, T Karumekayi, R J Schneider, J A Efstathiou, S Dryden-Peterson, A Odom, A Shulman, Y Pipman, D P Gierga
PURPOSE: The global burden of cancer is considerable, particularly in low and middle-income countries. Massachusetts General Hospital (MGH) and Botswana-Harvard AIDS Institute have partnered with the oncology community and government of Botswana to form BOTSOGO (BOTSwana Oncology Global Outreach) to address the rising burden of cancer in Botswana. Currently, radiation therapy (RT) is only available at a single linear accelerator (LINAC) in Gaborone Private Hospital (GPH). BOTSOGO worked to limit the absence of RT during a LINAC upgrade and ensure a safe transition to modern radiotherapy techniques...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28028269/-promoting-appropriate-pharmacotherapy-for-home-care-patients-coordination-between-regional-comprehensive-support-centers-and-pharmacies
#13
Yasunori Ohno, Takashi Heima, Takao Ishikawa, Tomoko Kuramitsu, Hitomi Yamakage, Masayoshi Hirohara, Kazuki Kushida
Japan is rapidly developing into an aged society, and its construction of a regional comprehensive care system is urgently needed for the baby boomer generation, who will reach 75 years of age in 2025. As part of providing medical care and longterm caregiving in a regional comprehensive care system, ordinary citizens will be supported in their local neighborhoods by multidisciplinary care, team medicine, and information sharing. However, pharmacists visit only once or twice per month; therefore, it can be difficult for them to grasp the overall status of patients' lifestyles...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28017489/the-impact-of-telehealth-and-care-coordination-on-the-number-and-type-of-clinical-visits-for-children-with-medical-complexity
#14
Holly D McKissick, Rhonda G Cady, Wendy S Looman, Stanley M Finkelstein
INTRODUCTION: The purpose of this analysis was to evaluate the effects of an advanced practice nurse-delivered telehealth intervention on health care use by children with medical complexity (CMC). Because CMC account for a large share of health care use costs, finding effective ways to care for them is an important challenge requiring exploration. METHOD: This was a secondary analysis of data from a randomized clinical trial with a control group and two intervention groups...
December 22, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28001098/pre-eclampsia-and-risk-of-subsequent-hypertension-in-an-american-indian-population
#15
Lyle G Best, Laramie Lunday, Elisha Webster, Gilbert R Falcon, James R Beal
BACKGROUND AND OBJECTIVES: Pre-eclampsia (PE) shares a number of proposed pathophysiologic mechanisms related to those implicated in cardiovascular disease (CVD), such as endothelial dysfunction, inflammation, insulin resistance, and impaired renal regulation. PE has also been associated with subsequent hypertension, CVD, and related mortality in later life. METHODS: At follow-up, the four most recent blood pressures, body mass index (BMI), and use of hypertensive medications were recorded from clinic visits of 130 PE cases and 289 normal pregnancies...
December 21, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27998880/social-media-use-among-living-kidney-donors-and-recipients-survey-on-current-practice-and-potential
#16
Abby Swanson Kazley, Bashir Hamidi, Wendy Balliet, Prabhakar Baliga
BACKGROUND: In the United States, there is a national shortage of organs donated for transplant. Among the solid organs, most often kidneys are donated by living donors, but the lack of information and complicated processes limit the number of individuals who serve as living kidney donors. Social media can be a tool for advocacy, educating the public about the need, process, and outcomes of live kidney donors, yet little is known about social media use by kidney transplant patients. OBJECTIVE: The purpose of this study was to examine the social media use of potential kidney transplant patients and their willingness to use social media and their networks to advocate and educate about living kidney donation...
December 20, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27998879/using-patient-flow-information-to-determine-risk-of-hospital-presentation-protocol-for-a-proof-of-concept-study
#17
Christopher M Pearce, Adam McLeod, Jon Patrick, Douglas Boyle, Marianne Shearer, Paula Eustace, Mary Catherine Pearce
BACKGROUND: Every day, patients are admitted to the hospital with conditions that could have been effectively managed in the primary care sector. These admissions are expensive and in many cases are possible to avoid if early intervention occurs. General practitioners are in the best position to identify those at risk of imminent hospital presentation and admission; however, it is not always possible for all the factors to be considered. A lack of shared information contributes significantly to the challenge of understanding a patient's full medical history...
December 20, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27979018/patient-adherence-and-effective-communication
#18
Don A Bukstein
BACKGROUND: Poor adherence to inhaled corticosteroid medication is a critical problem for asthma because it contributes to morbidity and mortality through poor asthma control, frequent asthma exacerbations, acute care visits, and oral corticosteroid use. OBJECTIVE: To discuss evidence-based, time-efficient strategies that can be adopted by most practitioners to try to increase patient adherence. METHODS: Asthma management guidelines and other key publications are used to enhance discussion...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27977288/our-continuing-exploration-of-medically-unexplained-symptoms
#19
Larry B Mauksch, Colleen T Fogarty
In this issue, the reader will find three articles examining different but converging perspectives on medically unexplained symptoms (MUS). In the first article, Gates, Petterson, Wingrove, Miller, and Klink (2016) examined 110,000 office visits to primary care providers between 2002 and 2010. In the second article, Clarke (2016), an internist and gastroenterologist, presents a model for diagnosing and treating MUS. The person most referenced in the first two articles and author of the landmark study-Kroenke (2016) writes the third article, an invited commentary...
December 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27957563/dental-attendance-and-self-reported-oral-health-status-of-renal-dialysis-patients-a-comparison-of-results-with-the-uk-adult-dental-health-survey
#20
Serpil Djemal, Adam Rumjon, Iain C Macdougall, Parmjit Singh, Saman Warnakulasuriya
PURPOSE: To compare the oral health status of renal patients attending a dialysis unit at a London teaching hospital with an age- and sex-matched sample from the Adult Dental Health Survey UK (ADHS) 2009. MATERIALS AND METHODS: Questions adapted from the ADHS 2009 national survey were used to interview renal dialysis patients about their oral health, oral hygiene and dental visits. Any significant differences between the two groups were statistically analysed using the chi-squared (χ2) test...
2016: Oral Health & Preventive Dentistry
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