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https://www.readbyqxmd.com/read/28444519/intention-to-enact-and-enactment-of-gatekeeper-behaviors-for-suicide-prevention-an-application-of-the-theory-of-planned-behavior
#1
Shane T W Kuhlman, Susan E Walch, Kristina N Bauer, April D Glenn
Gatekeeper training for suicide prevention was evaluated on a college campus to examine the impact of training on gatekeeper enactment of behaviors in support of suicide prevention and identify predictors of enactment of gatekeeper behaviors. Trained gatekeepers (N = 216) displayed greater perceived knowledge and self-efficacy for suicide prevention and reported higher rates of self-reported actual gatekeeper behaviors, including inquiring about suicidal ideation and referring for mental health treatment when they encountered someone in distress, compared to their untrained counterparts (N = 169)...
April 25, 2017: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/28442899/approaches-to-drug-therapy-for-copd-in-russia-a-proposed-therapeutic-algorithm
#2
Kirill A Zykov, Svetlana I Ovcharenko
Until recently, there have been few clinical algorithms for the management of patients with COPD. Current evidence-based clinical management guidelines can appear to be complex, and they lack clear step-by-step instructions. For these reasons, we chose to create a simple and practical clinical algorithm for the management of patients with COPD, which would be applicable to real-world clinical practice, and which was based on clinical symptoms and spirometric parameters that would take into account the pathophysiological heterogeneity of COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#3
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28438918/does-the-impact-of-biodiversity-differ-between-emerging-and-endemic-pathogens-the-need-to-separate-the-concepts-of-hazard-and-risk
#4
REVIEW
Parviez R Hosseini, James N Mills, Anne-Hélène Prieur-Richard, Vanessa O Ezenwa, Xavier Bailly, Annapaola Rizzoli, Gerardo Suzán, Marion Vittecoq, Gabriel E García-Peña, Peter Daszak, Jean-François Guégan, Benjamin Roche
Biodiversity is of critical value to human societies, but recent evidence that biodiversity may mitigate infectious-disease risk has sparked controversy among researchers. The majority of work on this topic has focused on direct assessments of the relationship between biodiversity and endemic-pathogen prevalence, without disentangling intervening mechanisms; thus study outcomes often differ, fuelling more debate. Here, we suggest two critical changes to the approach researchers take to understanding relationships between infectious disease, both endemic and emerging, and biodiversity that may help clarify sources of controversy...
June 5, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28414044/the-impact-of-the-medicare-access-and-chip-reauthorization-act-macra-on-the-field-of-ophthalmology
#5
Brenton Kinker, Kaitlyn Dobesh, Nariman Nassiri, Mark S Juzych, M Roy Wilson
PURPOSE: To analyze the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on the field of ophthalmology. DESIGN: A perspective on the effects of MACRA's Quality Payment Program after analysis of the proposed rule, final rule, and commentary submitted by relevant stakeholders. RESULTS: Physicians will need to use one of two payment structures: Merit Based Incentive Payment Systems (MIPS), or Alternative Payment Models (APMs)...
April 13, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28407748/the-role-of-ethnicity-in-pathways-to-emergency-psychiatric-services-for-clients-with-psychosis
#6
Martin Rotenberg, Andrew Tuck, Rachel Ptashny, Kwame McKenzie
BACKGROUND: This study investigates the role of ethnicity in pathways to emergency mental health care in Toronto for clients with psychosis, while taking into account neighborhood factors. Previous literature has focused on Afro-Caribbean clients, reporting an increased risk of accessing mental health care through negative pathways. METHODS: A retrospective chart review for clients from 6 different ethnic origin groups presenting with psychosis - East Asian, South Asian, Black African, Black Caribbean, White European, and White North American - was undertaken in a psychiatric emergency department (ED)...
April 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28384862/enzymatic-and-non-enzymatic-virulence-activities-of-dermatophytes-on-solid-media
#7
Elangovan Elavarashi, Anupma Jyoti Kindo, Sudha Rangarajan
INTRODUCTION: Dermatophytes are keratinophilic fungi causing superficial cutaneous infections that account 20-25% of the global population. As per literature search, there is a dearth in the study on virulence factors of dermatophytes from the Indian sub-continent and moreover the association of the virulence factors and the host tissue in vitro helps in understanding the host-pathogen interaction. AIM: To analyse the enzymatic and non-enzymatic virulence activities of dermatophytes on solid media...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28376842/pattern-of-acute-organophosphorus-poisoning-at-university-of-gondar-teaching-hospital-northwest-ethiopia
#8
Getnet Mequanint Adinew, Assefa Belay Asrie, Eshetie Melese Birru
BACKGROUND: Despite the apparent benefits of organophosphate compounds (OPCs) acute organophosphate (OP) pesticide poison is an increasing problem worldwide. In a country like Ethiopia, where agriculture is a major component of the economy, these compounds are readily available to the general public. There is paucity of evidence from Ethiopia showing the pattern of organophosphate poisoning (OPP) in healthcare facilities. The objective of this study was to evaluate retrospectively the pattern of acute OPP at the University of Gondar Teaching Hospital in northwest Ethiopia, during September 2010 through December 2014 was conducted...
April 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28375590/medicaid-program-disproportionate-share-hospital-payments-treatment-of-third-party-payers-in-calculating-uncompensated-care-costs-final-rule
#9
(no author information available yet)
This final rule addresses the hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments under section 1923(g)(1)(A) of the Social Security Act (Act), and the application of such limitation in the annual DSH audits required under section 1923(j) of the Act, by clarifying that the hospital-specific DSH limit is based only on uncompensated care costs. Specifically, this rule makes explicit in the text of the regulation, an existing interpretation that uncompensated care costs include only those costs for Medicaid eligible individuals that remain after accounting for payments made to hospitals by or on behalf of Medicaid eligible individuals, including Medicare and other third party payments that compensate the hospitals for care furnished to such individuals...
April 3, 2017: Federal Register
https://www.readbyqxmd.com/read/28375501/seven-ethical-issues-affecting-neurosurgeons-in-the-context-of-health-care-reform
#10
T Forcht Dagi
Ethical discussions around health care reform typically focus on problems of social justice and health care equity. This review, in contrast, focuses on ethical issues of particular importance to neurosurgeons, especially with respect to potential changes in the physician-patient relationship that may occur in the context of health care reform.The Patient Protection and Affordable Care Act (ACA) of 2010 (H.R. 3590) was not the first attempt at health care reform in the United States but it is the one currently in force...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28375499/episode-based-payment-and-direct-employer-purchasing-of-healthcare-services-recent-bundled-payment-innovations-and-the-geisinger-health-system-experience
#11
Jonathan R Slotkin, Olivia A Ross, Eric D Newman, Janet L Comrey, Victoria Watson, Rachel V Lee, Megan M Brosious, Gloria Gerrity, Scott M Davis, Jacquelyn Paul, E Lynn Miller, David T Feinberg, Steven A Toms
One significant driver of the disjointed healthcare often observed in the United States is the traditional fee-for-service payment model which financially incentivizes the volume of care delivered over the quality and coordination of care. This problem is compounded by the wide, often unwarranted variation in healthcare charges that purchasers of health services encounter for substantially similar episodes of care. The last 10 years have seen many stakeholder organizations begin to experiment with novel financial payment models that strive to obviate many of the challenges inherent in customary quantity-based cost paradigms...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28375497/a-direct-experience-in-a-new-accountable-care-organization-results-challenges-and-the-role-of-the-neurosurgeon
#12
Dong H Kim, Christopher Lloyd, Douglas K Fernandez, Amanda Spielman, David Bradshaw
The passage of the Affordable Care Act saw the creation of Accountable Care Organizations (ACOs), a new approach to healthcare delivery moving from fee-for-service toward population health. This paper presents a case study of the Memorial Hermann ACO (MHACO), launched in response to the Medicare Shared Savings Program, with goals to align physician and hospital incentives, practice evidence-based medicine, develop care coordination, and increase efficiency. Building blocks included an affiliated primary care network, a clinical integration program (involving shared electronic medical record platforms and quality data reporting), and significant investments in information technology...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28373326/low-income-children-with-chronic-conditions-face-increased-costs-if-shifted-from-chip-to-marketplace-plans
#13
Alon Peltz, Amy J Davidoff, Cary P Gross, Marjorie S Rosenthal
More than eight million children risk having their health insurance coverage disrupted if federal funding for the Children's Health Insurance Program (CHIP) is not extended beyond 2017. In this study we explored two current policy alternatives: extending federal funding for CHIP or enrolling children in the existing health insurance Marketplace plans. We simulated annual out-of-pocket expenses using detailed health plan data from CHIP and federally facilitated Marketplace plans for a nationally representative cohort of children with chronic conditions, conducting comparisons at four different percentage categories of the federal poverty level...
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28368543/morbidity-and-mortality-associated-with-surgery-of-traumatic-c2-fractures-in-octogenarians
#14
Sanjay S Dhall, John K Yue, Ethan A Winkler, Praveen V Mummaneni, Geoffrey T Manley, Phiroz E Tarapore
BACKGROUND: Management of axis fractures in the elderly remains controversial. As the US population increasingly lives past 80 years, published C2 fracture morbidity/mortality profiles in younger cohorts (55+) have become less applicable to octogenarians. OBJECTIVE: To report associations between surgery and mortality, hospital length of stay and discharge disposition in octogenarians with traumatic C2 fractures. METHODS: Retrospective cohort study of 3847 patients age ≥ 80 years representing 17 702 incidents nationwide, divided into surgery/nonsurgery cohorts, using the National Sample Program of the National Trauma Data Bank from 2003 to 2012...
March 23, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28365040/future-considerations-for-clinical-dermatology-in-the-setting-of-21st-century-american-policy-reform-the-medicare-access-and-children-s-health-insurance-program-reauthorization-act-and-alternative-payment-models-in-dermatology
#15
John S Barbieri, Jeffrey J Miller, Harrison P Nguyen, Howard P Forman, Jean L Bolognia, Marta J VanBeek
With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall...
March 30, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28364372/the-latino-physician-shortage-how-the-affordable-care-act-increases-the-value-of-latino-spanish-speaking-physicians-and-what-efforts-can-increase-their-supply
#16
David A Daar, Miguel Alvarez-Estrada, Abigail E Alpert
The United States Latino population is growing at a rapid pace and is set to reach nearly 30% by 2050. The demand for culturally and linguistically competent health care is increasing in lockstep with this growth; however, the supply of doctors with skills and experience suited for this care is lagging. In particular, there is a major shortage of Latino Spanish-speaking physicians, and the gap between demand and supply is widening. The implementation of the Affordable Care Act (ACA) has increased the capacity of the US healthcare system to care for the growing Latino Spanish-speaking population, through health insurance exchanges, increased funding for safety net institutions, and efforts to improve efficiency and coordination of care, particularly with Accountable Care Organizations and the Hospital Readmissions Reduction Program...
March 31, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28348255/the-temporal-basis-of-angiogenesis
#17
REVIEW
Katie Bentley, Shilpa Chakravartula
The process of new blood vessel growth (angiogenesis) is highly dynamic, involving complex coordination of multiple cell types. Though the process must carefully unfold over time to generate functional, well-adapted branching networks, we seldom hear about the time-based properties of angiogenesis, despite timing being central to other areas of biology. Here, we present a novel, time-based formulation of endothelial cell behaviour during angiogenesis and discuss a flurry of our recent, integrated in silico/in vivo studies, put in context to the wider literature, which demonstrate that tissue conditions can locally adapt the timing of collective cell behaviours/decisions to grow different vascular network architectures...
May 19, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#18
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28325130/antiretroviral-adherence-perspectives-of-pregnant-and-postpartum-women-in-guyana
#19
Deborah Vitalis, Zelee Hill
The Caribbean region has the second highest HIV prevalence after Sub-Saharan Africa. Guyana's adult HIV prevalence is 1.9% among pregnant women, with women accounting for an estimated 58% of all persons living with HIV. However, there are few studies on ART adherence in the Caribbean, none from Guyana, and none focusing on adherence in pregnancy and the postpartum period. The objective of this study was to explore the perspectives of HIV-infected pregnant and postpartum women and healthcare providers in Guyana about barriers and facilitators to ART adherence...
March 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28323472/the-affordable-care-act-insurance-coverage-and-health-care-utilization-of-previously-incarcerated-young-men-2008-2015
#20
Tyler N A Winkelman, HwaJung Choi, Matthew M Davis
OBJECTIVES: To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act's (ACA's) Medicaid expansion and Marketplace plans in 2014. METHODS: We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration...
May 2017: American Journal of Public Health
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