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https://www.readbyqxmd.com/read/27913030/confounding-variables-and-the-performance-of-triggers-in-detecting-unreported-adverse-drug-reactions
#1
Fabiana Rossi Varallo, Carolina Dagli-Hernandez, Caroline Pagotto, Tales Rubens de Nadai, Maria Teresa Herdeiro, Patricia de Carvalho Mastroianni
PURPOSE: This study explored the performance of trigger in detecting adverse drug reactions (ADRs), the confounding variables impairing the causal association of the ADRs, and the underreporting rate by hospital health professionals. METHODS: A 6-month cross-sectional study was conducted in a public general hospital. Data collection was conducted in 2 stages: (1) screening of patient hospitalizations to identify suspected ADRs with 9 triggers developed by the Institute of Healthcare Improvement; and (2) chart review to perform the causality assessment of the suspected ADRs identified, to describe the confounding variables associated with detection of suspected ADRs that were not drug induced, and to analyze the positive predictive value of triggers in recognizing ADRs...
November 29, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27912763/global-health-partnership-for-student-peer-to-peer-psychiatry-e-learning-lessons-learned
#2
REVIEW
Roxanne C Keynejad
BACKGROUND: Global 'twinning' relationships between healthcare organizations and institutions in low and high-resource settings have created growing opportunities for e-health partnerships which capitalize upon expanding information technology resources worldwide. E-learning approaches to medical education are increasingly popular but remain under-investigated, whilst a new emphasis on global health teaching has coincided with university budget cuts in many high income countries. RESULTS: King's Somaliland Partnership (KSP) is a paired institutional partnership health link, supported by Tropical Health and Education Trust (THET), which works to strengthen the healthcare system and improve access to care through mutual exchange of skills, knowledge and experience between Somaliland and King's Health Partners, UK...
December 3, 2016: Globalization and Health
https://www.readbyqxmd.com/read/27908502/centralized-capacity-building-training-of-lichtenstein-hernioplasty-in-brazil
#3
Alexandra M Moore, Néha Datta, Justin P Wagner, Alexander D Schroeder, Wolfgang Reinpold, Maurice Y Franciss, Rodrigo A Silva, David C Chen, Charles J Filipi, Sergio Roll
BACKGROUND: In Brazil, access to healthcare varies widely by community. Options for repair of surgically correctable conditions, such as inguinal hernias, are limited. A training program was instituted to expand access to Lichtenstein hernioplasty. METHODS: Between September, 2014 and September, 2015, 3 orders of training series took place in São Paulo, Brazil. Participating surgeons received training and assessments from expert trainers using the Operative Performance Rating Scale (OPRS)...
November 22, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27906759/development-of-a-disease-based-hernia-program-and-the-impact-on-cost-for-a-hospital-system
#4
David M Krpata, Ivy N Haskins, Steven Rosenblatt, Sharon Grundfest, Ajita Prabhu, Michael J Rosen
OBJECTIVE: The aim of this study was to assess the impact of developing a hernia program on mesh utilization. BACKGROUND: With the ongoing changes in healthcare, the value of all interventions will see increased scrutiny. Hernia mesh can be one of the most costly components of hernia repairs. A disease-based institutional hernia program that defines roles for mesh utilization and measures outcomes has the potential to add significant value to hospital systems. METHODS: In August 2014, a disease-based hernia program was initiated across a hospital system...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27900923/-the-infection-risk-scan-in-clinical-practice-improving-infection-prevention-and-antibiotic-use-through-transparency
#5
I Willemsen, J A J W Kluytmans
OBJECTIVE: The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use. DESIGN: Cross-sectional, observational study. METHOD: The Infection RIsk Scan (IRIS) measures a number of objectifiable variables in the field of infection prevention, including the dissemination of HRMO, the use of antibiotics and indwelling medical devices, environmental contamination, hand hygiene and personal hygiene of healthcare workers, and various infection control preconditions...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27899012/disease-outcomes-and-care-fragmentation-among-patients-with-systemic-lupus-erythematosus
#6
Theresa L Walunas, Kathryn L Jackson, Anh H Chung, Karen A Mancera-Cuevas, Daniel L Erickson, Rosalind Ramsey-Goldman, Abel Kho
OBJECTIVE: To examine the impact of care fragmentation across multiple healthcare institutions on disease outcomes in patients with systemic lupus erythematosus (SLE). METHODS: Using the Chicago HealthLNK Data Repository (HDR), an assembly of electronic health records from six institutions, we identified patients with SLE, using ICD-9 codes, whose care was delivered at more than one organization. We examined whether patients had severe infections or comorbidities (ICD-9 code defined) that indicate SLE-induced damage...
November 29, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27896407/mixed-methods-assessment-of-trauma-and-acute-care-surgical-quality-improvement-programs-in-peru
#7
Lacey N LaGrone, Amy K Fuhs, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Roberto Valderrama, Leah N Isquith-Dicker, Jaime Herrera-Matta, Charles N Mock
BACKGROUND: Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. METHODS: This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27894048/real-world-patterns-of-care-in-her2-overexpressing-breast-cancer-results-of-a-survey-of-teach-clinical-trial-investigators-in-2011
#8
Y Chavarri-Guerra, J St Louis, A Bukowski, E Soto-Perez-de-Celis, P E R Liedke, H Symecko, B Moy, M Higgins, D M Finkelstein, P E Goss
BACKGROUND: HER2-overexpressing breast cancer (BC) is common among young patients and poses a public health burden. Adjuvant anti-HER2/neu therapy with trastuzumab reduces the risk of recurrence and improves survival. METHODS: A web-based survey was sent to 386 physicians of the "TEACH" trial in 2011 to determine access to HER2/neu testing and treatment patterns for HER2-overexpressing BC. RESULTS: There were 151 responders (39%) from 28 countries...
November 25, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27893144/effectiveness-of-shared-medical-appointments-targeting-the-triple-aim-among-patients-with-overweight-obesity-or-diabetes
#9
Kristi H Trickett, Paul M Matiaco, Kathryn Jones, Bernadette Howlett, Kathaleen Briggs Early
BACKGROUND: Obesity and diabetes are epidemic in the United States, with many treatment options having limited long-term efficacy. A possible effective medical management tool is the shared medical appointment (SMA), which offers an efficient and cost-effective approach to behavior change and aligns with the Triple Aim (reduce costs, improve population health, and improve patient care experience) set forth by the Institute for Healthcare Improvement. OBJECTIVES: To assess the effectiveness of SMAs to achieve the Triple Aim and to improve the management of overweight/obesity or diabetes...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27892625/progress-at-the-intersection-of-patient-safety-and-medical-liability-insights-from-the-ahrq-patient-safety-and-medical-liability-demonstration-program
#10
M Susan Ridgely, Michael D Greenberg, Michelle B Pillen, James Bell
OBJECTIVE: To identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program. DATA SOURCES/STUDY SETTING: On September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27889288/quiet-dissent-the-attitudes-beliefs-and-behaviours-of-uk-osteopaths-who-reject-low-back-pain-guidance-a-qualitative-study
#11
Joanna Figg-Latham, Dévan Rajendran
INTRODUCTION: Clinical guidelines are derived from best research evidence and aim to: improve quality of non-specific low back pain (nsLBP) management and identify patients at risk of suffering chronic pain. However, guideline discordant attitudes and beliefs have been identified in healthcare students and practitioners, including osteopaths. DESIGN: A qualitative approach with elements of grounded theory was used to explore underlying attitudes and beliefs of practitioners/students working in a British osteopathic education institution...
October 18, 2016: Manual Therapy
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#12
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27884459/balance-evaluation-techniques-and-physical-therapy-in-post-stroke-patients-a-literature-review
#13
REVIEW
Eglė Lendraitienė, Agnė Tamošauskaitė, Daiva Petruševičienė, Raimondas Savickas
A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions...
November 17, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27884162/-the-stars-seem-aligned-a-qualitative-study-to-understand-the-effects-of-context-on-scale-up-of-maternal-and-newborn-health-innovations-in-ethiopia-india-and-nigeria
#14
Neil Spicer, Della Berhanu, Dipankar Bhattacharya, Ritgak Dimka Tilley-Gyado, Meenakshi Gautham, Joanna Schellenberg, Addis Tamire-Woldemariam, Nasir Umar, Deepthi Wickremasinghe
BACKGROUND: Donors commonly fund innovative interventions to improve health in the hope that governments of low and middle-income countries will scale-up those that are shown to be effective. Yet innovations can be slow to be adopted by country governments and implemented at scale. Our study explores this problem by identifying key contextual factors influencing scale-up of maternal and newborn health innovations in three low-income settings: Ethiopia, the six states of northeast Nigeria and Uttar Pradesh state in India...
November 25, 2016: Globalization and Health
https://www.readbyqxmd.com/read/27880665/the-current-treatment-landscape-candidiasis
#15
Matteo Bassetti, Maddalena Peghin, Jean-Francois Timsit
The epidemiology of Candida species infection has changed over recent decades, influenced by local hospital-related factors, patient predisposing conditions and type of antifungal agents administered. A shift from Candida albicans as the predominant pathogen towards an increasing prevalence of the species Candida glabrata and Candida parapsilosis amongst critically ill patients has been documented. Changes in Candida species distribution may impact treatment recommendations due to differences in susceptibility to antifungal agents among species...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27870795/achieving-equity-in-physical-activity-participation-acsm-experience-and-next-steps
#16
Rebecca E Hasson, David R Brown, Joan Dorn, Lisa Barkley, Carol Torgan, Melicia Whitt-Glover, Barbara Ainsworth, NiCole Keith
There is clear and consistent evidence that regular physical activity is an important component of healthy lifestyles, and fundamental to promoting health and preventing disease. Despite the known benefits of physical activity participation, many people in the United States (US) remain inactive. More specifically, physical activity behavior is socially patterned with lower participation rates among women, racial/ethnic minorities, sexual minority youth, individuals with less education, persons with physical, mental and cognitive disabilities, individuals > 65 years of age, and those living in the southeast region of the US...
November 19, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27865292/katrina-s-legacy-processes-for-patient-disaster-preparation-have-improved-but-important-gaps-remain
#17
Marjorie Icenogle, Sasha Eastburn, Martha Arrieta
BACKGROUND: Ensuring continuity of care for patients with chronic illness, who are elderly or indigent presents unique challenges after disasters; this population has fewer financial resources, is less likely to evacuate, has limited access to recovery resources and is significantly dependent on charitable and government-funded institutions for care. This study expands a previous investigation of the extent to which healthcare providers in coastal Mississippi and Alabama have made changes to facilitate continued care to these populations after disasters...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27864859/roles-and-competences-for-educators-of-undergraduate-dental-students-a-discussion-paper
#18
S Chuenjitwongsa, A Bullock, R G Oliver
INTRODUCTION: Dental educators are important people who contribute to the development of every aspect of dental education. In part due to the lack of understanding of their roles and competences, dental educator development has so far received little consideration. With the aim of enhancing the dental profession's contribution to the development of undergraduate dental education, this article explores common roles of educators of undergraduate dental students and the competences needed to be effective educators...
November 19, 2016: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/27855099/cluster-randomised-feasibility-trial-to-improve-the-control-of-hypertension-in-rural-india-chiri-a-study-protocol
#19
Michaela A Riddell, Rohina Joshi, Brian Oldenburg, Clara Chow, K R Thankappan, Ajay Mahal, Nihal Thomas, Velandai K Srikanth, Roger G Evans, Kartik Kalyanram, Kamakshi Kartik, Pallab K Maulik, Simin Arabshahi, R P Varma, Rama K Guggilla, Oduru Suresh, G K Mini, Fabrizio D'Esposito, Thirunavukkarasu Sathish, Mohammed Alim, Amanda G Thrift
INTRODUCTION: Hypertension is emerging in rural populations of India. Barriers to diagnosis and treatment of hypertension may differ regionally according to economic development. Our main objectives are to estimate the prevalence, awareness, treatment and control of hypertension in 3 diverse regions of rural India; identify barriers to diagnosis and treatment in each setting and evaluate the feasibility of a community-based intervention to improve control of hypertension. METHODS AND ANALYSIS: This study includes 4 main activities: (1) assessment of risk factors, quality of life, socioeconomic position and barriers to changes in lifestyle behaviours in ∼14 500 participants; (2) focus group discussions with individuals with hypertension and indepth interviews with healthcare providers, to identify barriers to control of hypertension; (3) use of a medicines-availability survey to determine the availability, affordability and accessibility of medicines and (4) trial of an intervention provided by Accredited Social Health Activists (ASHAs), comprising group-based education and support for individuals with hypertension to self-manage blood pressure...
October 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27852276/coverage-and-equity-in-reproductive-and-maternal-health-interventions-in-brazil-impressive-progress-following-the-implementation-of-the-unified-health-system
#20
Giovanny V A França, María Clara Restrepo-Méndez, Maria Fátima S Maia, Cesar G Victora, Aluísio J D Barros
BACKGROUND: The Brazilian SUS (Unified Health System) was created in 1988 within the new constitution, based on the premises of being universal, comprehensive, and equitable. The SUS offers free health care, independent of contribution or affiliation. Since then, great efforts and increasing investments have been made for the system to achieve its goals. We assessed how coverage and equity in selected reproductive and maternal interventions progressed in Brazil from 1986 to 2013. METHODS: We reanalysed data from four national health surveys carried out in Brazil in 1986, 1996, 2006 and 2013...
November 17, 2016: International Journal for Equity in Health
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