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https://www.readbyqxmd.com/read/28436048/dealing-with-the-tension-how-residents-seek-autonomy-and-participation-in-the-workplace
#1
Francisco M Olmos-Vega, Diana H J M Dolmans, Nicolas Vargas-Castro, Renée E Stalmeijer
CONTEXT: The workplace can be a strenuous setting for residents: although it offers a wealth of learning opportunities, residents find themselves juggling their responsibilities. Even though supervisors regulate what is afforded to residents, the former find it difficult to strike the proper balance between residents' independence and support, which could create tensions. But what tensions do residents experience during clinical supervision and how do they cope with them to maximise their learning opportunities? Understanding how residents act on different affordances in the workplace is of paramount importance, as it influences their learning...
April 24, 2017: Medical Education
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#2
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435690/the-complex-legal-and-ethical-issues-related-to-generic-medications-viral-hepatitis-a-case-study
#3
EDITORIAL
M Danta, N Ghinea
The economic impact of medications is significant, with many countries unable to afford the essential medicines listed by the WHO. Generic medications are one strategy to address this issue. Generic medications are similar to but not the same as originator medications. They have a significant cost advantage because they do not require the background research and development studies to support registration. Consequently, they are gaining increased market share in both the developed and developing world. Many new medications are now licensed to generic manufacturers in the developing world...
April 1, 2017: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#4
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#5
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#6
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429990/medicaid-waivers-and-negotiated-federalism-in-the-us-is-there-relevance-to-other-federal-systems
#7
Carol S Weissert, William G Weissert
Medicaid waivers have been a principal tool of innovation in health policy in the US since at least the mid 1970s. As Republicans seek to give the states more flexibility in their implementation and management of both Medicaid and the Affordable Care Act or its replacement, waiver authority is likely to be one of the key work arounds for avoiding political barriers in the US Senate. While block-granting Medicaid may require 60 senate votes, waiver authority already exists in both Medicaid law and the Affordable Care Act...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#8
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
April 20, 2017: Nursing Research
https://www.readbyqxmd.com/read/28426332/buprenorphine-treatment-and-patient-use-of-health-services-after-the-affordable-care-act-in-an-integrated-health-care-system
#9
Cynthia I Campbell, Sujaya Parthasarathy, Kelly C Young-Wolff, Derek D Satre
The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258)...
April 20, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28426315/medicaid-expansion-and-aca-repeal-evidence-from-ohio
#10
Eric E Seiber, Micah L Berman
OBJECTIVES: To examine the health insurance coverage options for Medicaid expansion enrollees if the Affordable Care Act (ACA) is repealed, using evidence from Ohio, where more than half a million adults have enrolled in the state's Medicaid program through the ACA expansion. METHODS: The Ohio Medicaid Assessment Survey interviewed 42 000 households in 2015. We report data from a unique battery of questions designed to identify insurance coverage immediately prior to Medicaid enrollment...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28425731/changes-in-perception-action-tuning-over-long-time-scales-how-children-and-adults-perceive-and-act-on-dynamic-affordances-when-crossing-roads
#11
Elizabeth E O'Neal, Yuanyuan Jiang, Lucas J Franzen, Pooya Rahimian, Junghum Paul Yon, Joseph K Kearney, Jodie M Plumert
This investigation examined developmental change in how children perceive and act on dynamic affordances when crossing roads on foot. Six- to 14-year-olds and adults crossed roads with continuous cross-traffic in a large-screen, immersive pedestrian simulator. We observed change both in children's gap choices and in their ability to precisely synchronize their movement with the opening of a gap. Younger children were less discriminating than older children and adults, choosing fewer large gaps and more small gaps...
April 20, 2017: Journal of Experimental Psychology. Human Perception and Performance
https://www.readbyqxmd.com/read/28425687/patient-protection-and-affordable-care-act-market-stabilization-final-rule
#12
(no author information available yet)
This rule finalizes changes that will help stabilize the individual and small group markets and affirm the traditional role of State regulators. This final rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year; standards related to network adequacy and essential community providers for qualified health plans; and the rules around actuarial value requirements.
April 18, 2017: Federal Register
https://www.readbyqxmd.com/read/28425546/variable-coordination-of-tris-2-pyridyl-phosphine-and-its-oxide-toward-m-hfac-2-a-metal-specifiable-switching-between-the-formation-of-mono-and-bis-scorpionate-complexes
#13
Alexander V Artem'ev, Alexey V Kashevskii, Artem S Bogomyakov, Alexander Yu Safronov, Anastasiya O Sutyrina, Anton A Telezhkin, Irina V Sterkhova
An unexpected substitution of the anionic chelating ligands at the M(II) centre by a neutral tripodal ligand has been observed in the reaction of Mn(II), Co(II), Ni(II) and Cu(II) hexafluoroacetylacetonates (hfac) with tris(2-pyridyl)phosphine (Py3P) or its oxide (Py3P = O). The nature of the metal ion in M(hfac)2 and the M/L ratio determine the degree of substitution of hfac-anions (partial vs. total) and therefore, the structure of the complex formed (scorpionate vs. bis-scorpionate ones, respectively). Hence, the reaction of the ligands with [Cu(hfac)2(H2O)2] in an equimolar ratio affords scorpionate [Cu(N,N',N''-Py3P = X)(O,O'-hfac)(O-hfac)], wherein one hfac-ligand chelates metal, while the other hfac acts as an O-monodentate one...
April 20, 2017: Dalton Transactions: An International Journal of Inorganic Chemistry
https://www.readbyqxmd.com/read/28424131/postoperative-complications-predict-30-day-readmission-in-geriatric-general-surgery-patients
#14
James D Dieterich, Celia M Divino
The Affordable Care Act has placed unplanned patient readmissions under more scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate amount of complications from any kind of hospitalization, including readmissions. This study seeks to identify risk factors in this population that predispose them to an unplanned readmission within 30 days after index surgery. The National Surgical Quality Improvement Program database was used to select patients 65 years and older, who underwent general surgery procedures in 2012...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422815/no-time-for-silence-an-urgent-need-for-political-activism-among-the-medical-community
#15
Erik Levinsohn, Karrin Weisenthal, Priscilla Wang, Andi Shahu, Matthew Meizlish, Talia Robledo-Gil, Eamon Duffy, Samara Fox, Juliana Berk-Krauss
Despite being a major stakeholder in the U.S. health care system, the medical community has remained relatively mute in the debate over the future of the Patient Protection and Affordable Care Act (ACA). If the ACA were repealed, tens of millions of Americans would be in danger of losing their insurance, resulting in a significant increase in mortality. Because misinformation about the ACA is rampant, it is imperative that health care providers explain to the public what exactly the ACA is and how repeal will affect patients...
April 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28420944/new-therapies-for-hepatitis-c-virus-infection
#16
Jennifer L Horsley-Silva, Hugo E Vargas
Approximately 350 million people worldwide are infected with hepatitis C virus (HCV), which is associated with morbidity and mortality related to cirrhosis, hepatocellular carcinoma, or liver failure. Recently, vast improvements have been made with the development of direct-acting antiviral (DAA) agents, which are all-oral, are better tolerated than interferon-based treatment, and provide a sustained virologic response in more than 90% of treated patients. This article reviews the new therapies available for HCV infection, with a focus on patients who have chronic HCV with and without compensated cirrhosis...
January 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28420765/plan-selection-in-the-non-group-market-in-the-first-year-of-the-health-insurance-marketplace
#17
Emily Gillen, Kristen Hassmiller Lich, Laurel Trantham, Pam Silberman, Morris Weinberger, Mark Holmes
BACKGROUND The Affordable Care Act (ACA)-created Marketplaces reduced barriers to entry in the non-group health insurance market. Although tax credits were available to individuals who enrolled in qualified health plans (QHPs) beginning in 2014, many individuals chose not to switch plans. We examined characteristics associated with switching from a non-ACA compliant plan to a QHP in 2014 and, conditional on switching, the characteristics associated with selection of a specific plan level.METHODS Using claims data from a large commercial insurer, we examined characteristics associated with switching to a QHP in 2014...
March 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28417968/rational-development-of-a-protective-p-vivax-vaccine-evaluated-with-transgenic-rodent-parasite-challenge-models
#18
Ahmed M Salman, Eduardo Montoya-Díaz, Heather West, Amar Lall, Erwan Atcheson, Cesar Lopez-Camacho, Jai Ramesar, Karolis Bauza, Katharine A Collins, Florian Brod, Fernando Reis, Leontios Pappas, Lilia González-Cerón, Chris J Janse, Adrian V S Hill, Shahid M Khan, Arturo Reyes-Sandoval
Development of a protective and broadly-acting vaccine against the most widely distributed human malaria parasite, Plasmodium vivax, will be a major step towards malaria elimination. However, a P. vivax vaccine has remained elusive by the scarcity of pre-clinical models to test protective efficacy and support further clinical trials. In this study, we report the development of a highly protective CSP-based P. vivax vaccine, a virus-like particle (VLP) known as Rv21, able to provide 100% sterile protection against a stringent sporozoite challenge in rodent models to malaria, where IgG2a antibodies were associated with protection in absence of detectable PvCSP-specific T cell responses...
April 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28417083/effects-of-turmeric-curcuminoids-and-metformin-against-central-sensitivity-to-pain-in-mice
#19
Suruchi Verma, Deepak Mundkinajeddu, Amit Agarwal, Shyam Sunder Chatterjee, Vikas Kumar
The reported experimental study was conducted to compare the effects of repeated daily oral doses of curcuminoids (CLE) with metformin as potential antidepressants and analgesics. Effects of a single and ten daily oral doses of CLE (5, 20, 80 mg/kg/day) and of 50 mg/kg/day metformin (MET) were compared in mice hot plate test (HPT) for analgesics. On the 11th treatment day, all animals were subjected to foot shock stress triggered hyperthermia test, and on the 12th treatment day to tail suspension test (TST) for antidepressants...
April 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28414626/the-future-of-occupational-health-nursing-in-a-changing-health-care-system
#20
Linda McCauley, Katherine Peterman
Repealing the Affordable Care Act (ACA) has significant implications for the future of occupational health nursing practice. As changes are proposed and implemented, occupational health nurses must continue to prioritize preventive care, chronic disease management, healthy communities, environmental health, and sustainability. In particular, immigrant workers are a vulnerable population needing attention by occupational health nurses.
April 2017: Workplace Health & Safety
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