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Consultation models

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https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#1
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318540/physical-and-mental-health-of-children-with-substantiated-sexual-abuse-gender-comparisons-from-a-matched-control-cohort-study
#2
Isabelle Daigneault, Pascale Vézina-Gagnon, Catherine Bourgeois, Tonino Esposito, Martine Hébert
When compared to children from the general population, sexually abused children receive more medical services, both for physical and mental health problems. However, possible differences between sexually abused boys and girls remain unknown. The lack of control group in studies that find gender differences also prevents from determining if the differences are specific to sexual abuse or to gender. The objective of the study was to assess differences in physical and mental health between sexually abused boys and girls in comparison to those from the general population...
March 15, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28317462/witnesses-in-the-consultation-room-experiences-of-peer-group-supervision
#3
Helena Galina Nielsen, Annette Sofie Davidsen
BACKGROUND: In Denmark group supervision for general practitioners is an established part of continuing professional development. Several different approaches are used, including Balint Groups and Bendix Groups. The aim of this paper is to describe the benefits and challenges of a peer group supervision model with the role of supervisor taken by group members in turn. The setting was a group of general practitioners using a patient-centred consultation model and video-recordings of consultations...
March 19, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28314558/a-patient-and-provider-research-agenda-on-diabetes-and-hypertension-management
#4
Emily B Zimmerman, Sarah K Cook, Amber D Haley, Steven H Woolf, Sarah K Price, Danielle Berman, Thomas DeLeire, Rebecca Etz, Jag Khalsa, Kirsten Knutson, Kathryn Kolasa, Alex Krist, Anton Kuzel, Pearl Lee, Theresa J Nartea, Gretchen Piatt, Hilary Seligman, Joni Strom Williams, Josh Brown, Jennifer Early, Jill Hellman, Julie Karr, Megan Kervin, Isra Malik, Albert Walker, Sheila Goode, Danita Gregory, Sharon Herman, Brenda Kenney, Chimere Miles, Audrey Smith, Travis White
INTRODUCTION: A demonstration project in Richmond, Virginia involved patients and other stakeholders in the creation of a research agenda on dietary and behavioral management of diabetes and hypertension. Given the impact of these diseases on morbidity and mortality, considerable research has been directed at the challenges patients face in chronic disease management. The continuing need to understand disparities and find evidence-based interventions to improve outcomes has been fruitful, but disparities and unmet needs persist...
March 14, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28306372/standardized-criteria-for-palliative-care-consultation-on-a-solid-tumor-oncology-service-reduces-downstream-health-care-use
#5
Kerin Adelson, Julia Paris, Jay R Horton, Lorena Hernandez-Tellez, Doran Ricks, R Sean Morrison, Cardinale B Smith
PURPOSE: Hospitalized patients with advanced cancer have a high symptom burden and need for support. Integration of palliative care (PC) improves symptom control and decreases unwanted health care use, yet many patients are never offered these services. In 2016, ASCO called for incorporation of PC into oncologic care for all patients with metastatic cancer. To improve the quality of cancer care, we developed standardized criteria, or triggers, for PC consultation on the inpatient solid tumor service...
March 17, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28299592/the-effect-of-a-celebrity-health-disclosure-on-demand-for-health-care-trends-in-brca-testing-and-subsequent-health-services-use
#6
Megan C Roberts, Stacie B Dusetzina
In May 2013, an internationally renowned celebrity-Angelina Jolie-disclosed her receipt of BRCA1/BRCA2 (BRCA) testing and subsequent double mastectomy in a highly publicized editorial. Publicity surrounding celebrity health services use increases awareness of important health issues and demand for health services. We aimed to describe BRCA testing trends before and after Jolie's disclosure, breast cancer-related services use following testing, and test reimbursement trends. MarketScan Commercial Claims data were used to compare trends in BRCA testing before and after Jolie's health disclosure using an interrupted time series model among women aged 18-64...
March 15, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28299371/effect-of-mass-paediatric-influenza-vaccination-on-existing-influenza-vaccination-programmes-in-england-and-wales-a-modelling-and-cost-effectiveness-analysis
#7
David Hodgson, Marc Baguelin, Edwin van Leeuwen, Jasmina Panovska-Griffiths, Mary Ramsay, Richard Pebody, Katherine E Atkins
BACKGROUND: In 2013 England and Wales began to fund a live attenuated influenza vaccine programme for individuals aged 2-16 years. Mathematical modelling predicts substantial beneficial herd effects for the entire population as a result of reduced influenza transmission. With a decreased influenza-associated disease burden, existing immunisation programmes might be less cost-effective. The aim of this study was to assess the epidemiological effect and cost-effectiveness of the existing elderly and risk group vaccination programme under the new policy of mass paediatric vaccination in England...
February 2017: Lancet Public Health
https://www.readbyqxmd.com/read/28297275/how-dose-sparing-of-cardiac-structures-correlates-with-in-field-heart-volume-and-sternal-displacement
#8
Taeho Kim, Kelli Reardon, Daniel M Trifiletti, Constance Geesey, Kaitlyn Sukovich, Edwin Crandley, Paul W Read, Krishni Wijesooriya
Cardiac irradiation increases the risk of coronary artery disease in patients with left-sided breast cancer. Techniques exist to reduce cardiac irradiation, but the optimum technique depends on individual patient anatomy and physiology. We investigated the correlation of delta heart volume in field (dHVIF) and sternal excursion with dose sparing in heart and left anterior descending artery (LAD) to develop quantitative predictive models for expected dose to heart and LAD. A treatment planning study was performed on 97 left-breast cancer patients who underwent whole breast radiotherapy (prescription dose = 50 Gy) under deep inspiratory breath hold (DIBH)...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296992/association-of-dermatology-consultations-with-patient-care-outcomes-in-hospitalized-patients-with-inflammatory-skin-diseases
#9
Nima Milani-Nejad, Myron Zhang, Benjamin H Kaffenberger
Importance: The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown. Objective: To determine the association of dermatology consultations with patient care in hospitalized patients using objective values. Design, Setting, and Participants: We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28296019/health-care-provider-communication-training-in-rural-tanzania-empowers-hiv-infected-patients-on-antiretroviral-therapy-to-discuss-adherence-problems
#10
S Erb, E Letang, T R Glass, A Natamatungiro, D Mnzava, H Mapesi, M Haschke, U Duthaler, B Berger, L Muri, J Bader, C Marzolini, L Elzi, T Klimkait, W Langewitz, M Battegay
OBJECTIVES: Self-reported adherence assessment in HIV-infected patients on antiretroviral therapy (ART) is challenging and may overestimate adherence. The aim of this study was to improve the ability of health care providers to elicit patients' reports of nonadherence using a "patient-centred" approach in a rural sub-Saharan African setting. METHODS: A prospective interventional cohort study of HIV-infected patients on ART for ≥ 6 months attending an HIV clinic in rural Tanzania was carried out...
March 13, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28294509/validation-of-an-emergency-triage-scale-for-obstetrics-and-gynaecology-a-prospective-study
#11
N Veit-Rubin, P Brossard, A Gayet-Ageron, C-Y Montandon, J Simon, O Irion, O T Rutschmann, B Martinez de Tejada
OBJECTIVE: To evaluate the reliability of a four-level triage scale for obstetrics and gynaecology emergencies and to explore the factors associated with an optimal triage. DESIGN: Thirty clinical vignettes presenting the most frequent indications for obstetrics and gynaecology emergency consultations were evaluated twice using a computerised simulator. SETTING: The study was performed at the emergency unit of obstetrics and gynaecology at the Geneva University Hospitals...
March 15, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28291697/early-prehospital-assessment-of-non-urgent-patients-and-outcomes-at-the-appropriate-level-of-care-a-prospective-exploratory-study
#12
Glenn Larsson, Anders Holmén, Kristina Ziegert
INTRODUCTION: The Ambulance Organization of Sweden provides qualified medical assessment and treatment by ambulance nurses based on patient needs regarding appropriate levels of care. A new model for patients with non-urgent medical conditions has been introduced. The main objective of this study was to examine early prehospital assessment of non-urgent patients, and its impact on the choice of the appropriate level of care. METHODS: The study design was a 1-year, prospective study, involving an ambulance district in southwestern Sweden with a population of 78,000...
March 10, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28291646/does-seasonal-vaccination-affect-the-clinical-presentation-of-influenza-among-the-elderly-a-cross-sectional-analysis-in-the-outpatient-setting-in-france-2003-2014
#13
Anne Mosnier, Isabelle Daviaud, Saverio Caini, Hervé Berche, Jean-Michel Mansuy, Sylvie van der Werf, Jean Marie Cohen, Bruno Lina
Vaccine-induced protection against influenza is not optimal, however it has been suggested that the vaccine may reduce the severity of symptoms among those who develop illness despite being vaccinated. We tested this hypothesis within a countrywide, sentinel general practitioners-based surveillance system in France. We included 2277 individuals aged 65years or older (of whom 1293 had been vaccinated against influenza, 56.8%) who consulted a general practitioner because of an acute respiratory infection (ARI) during 2003-2014...
March 10, 2017: Vaccine
https://www.readbyqxmd.com/read/28290927/understanding-primary-care-behavioral-health-across-military-settings-a-preliminary-comparison-between-deployed-and-in-garrison-care
#14
Ryan R Landoll, Matthew K Nielsen, Kathryn K Waggoner
BACKGROUND: Integrated primary care behavioral health (PCBH) is a growing trend in health care delivery, particularly in the Department of Defense and the Department of Veterans Affairs. This consultative model has been applied within the U.S. Air Force for over 15 years and has demonstrated positive health impacts and patient satisfaction. With extended conflicts and engagements, including Operation Enduring Freedom and Operation Iraqi Freedom, deployment behavioral health care has expanded and positively received, but there is less empirical support of particular models of care in a deployed environment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290805/-the-prediction-model-of-cardiovascular-events-among-the-russian-population-methodological-aspects
#15
A V Kontsevaya, S A Shalnova, E I Suvorova, Y A Balanova, S E Evstifeeva, A E Imaeva, A V Kapustina, A D Deev, Y A Karpov, O D Ostroumova, F T Ageev, O S Blinkov, I Yu Zinchuk, K A Repekto, A Boytsov S
Modeling is the common approach for predicting not only the population health, but also the social and economic burden of disease, which is an important argument while making decisions in health care and prevention. AIM: To develop the model for predicting cardiovascular risk, applicable for the assessment of clinical and socio-economic effects of preventive and therapeutic actions at the level of the whole population or part (region, city, group of patients). MATERIAL AND METHODS: An analytical model for making decision was performed by using a Markov model consisting of Markov states and probabilities of transition from one state to another within a certain time interval...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290143/brookings-supports-breastfeeding-using-public-deliberation-as-a-community-engaged-approach-to-dissemination-of-research
#16
Jenn Anderson, Rebecca A Kuehl, Sara A Mehltretter Drury, Lois Tschetter, Mary Schwaegerl, Julia Yoder, Heidi Gullickson, Jamison Lamp, Charlotte Bachman, Marilyn Hildreth
Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community...
March 13, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28290107/estimating-willingness-to-pay-for-online-health-services-with-discrete-choice-experiments
#17
Jieun Chang, Scott J Savage, Donald M Waldman
BACKGROUND: Research has outlined the benefits and costs of online health services, but these studies have typically focused on a specific geographic region or disease. Very few studies have estimated consumer demand for online health services. OBJECTIVE: This study estimated household's willingness to pay (WTP) for the ability to receive remote diagnosis, treatment, monitoring and consultations online (telehealth). METHODS: WTP was estimated with a random utility model and household data from a US survey employing repeated discrete-choice experiments...
March 13, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28287774/evaluation-of-a-shared-decision-making-intervention-on-the-utilization-of-evidence-based-psychotherapy-in-a-va-outpatient-ptsd-clinic
#18
Jonathan D Hessinger, Melissa J London, Sheila M Baer
The Veterans Health Administration (VHA) has continued to emphasize the availability, access, and utilization of high quality mental health care particularly in the treatment of posttraumatic stress disorder (PTSD). While dissemination and availability of evidence-based psychotherapies (EBPs) have only increased, treatment engagement and utilization have continued to be oft-noted challenges. Administrators, researchers, and individual clinicians have continued to develop and explore novel systemic and individualized interventions to address these issues...
March 13, 2017: Psychological Services
https://www.readbyqxmd.com/read/28284470/virtual-fracture-clinic-management-of-fifth-metatarsal-including-jones-fractures-is-safe-and-cost-effective
#19
Kit Brogan, Simon Bellringer, Harold Akehurst, Christopher Gee, Nada Ibrahim, Lucy Cassidy, Ben Rogers, James Gibbs
Virtual clinics have been shown to be safe and cost-effective in many specialties, yet barriers exist to their implementation in orthopaedics. The aims of this study were to look at whether the management of 5th metatarsal fractures using a virtual fracture clinic model is safe, cost effective and avoids adverse outcomes whilst being acceptable to patients using the service. All patients with a fifth metatarsal fracture between September 2013 and September 2015 had a standardised management plan initiated (blackboot, full weightbearing) in the emergency department (ED)...
February 12, 2017: Injury
https://www.readbyqxmd.com/read/28281849/feedback-mapping-the-curricular-cornerstone-of-an-educational-alliance
#20
Deborah Murdoch-Eaton, Lucy Bowen
PURPOSE: The "educational alliance" concept articulates a collaborative framework to facilitate effective feedback through transparency of opportunities aligned with learner stage and intended educational outcomes. Using this framework, we evaluated feedback across a 5 year undergraduate medical program to support embedding a successful learner - teacher "educational alliance". METHOD: A comprehensive mapping exercise used an iterative action research process of source documentary analysis, consultations with key curriculum stakeholders and qualitative analysis...
March 10, 2017: Medical Teacher
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