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https://www.readbyqxmd.com/read/28807893/optimizing-the-use-of-electronic-health-records-to-identify-high-risk-psychosocial-determinants-of-health
#1
Nicolas Michel Oreskovic, Jennifer Maniates, Jeffrey Weilburg, Garry Choy
BACKGROUND: Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data. However, not all clinically relevant data reside in claims and formatted data. Recently, there has been increasing interest in including patients with complex psychosocial determinants of health in care coordination programs. Psychosocial risk factors, including social determinants of health, mental health disorders, and substance abuse disorders, are less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data, and due to US Health Insurance Portability and Accountability Act (HIPAA) regulations are often not available as claims data...
August 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28769587/health-care-resource-use-and-cost-differences-by-opioid-therapy-type-among-chronic-noncancer-pain-patients
#2
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna O D'Souza, Sham L Chaudhari, Paul P Yeung, Richard White
The study assessed 12-month chronic pain (CP)-related health care utilization and costs among chronic noncancer pain (CNCP) patients who initiated various long-term opioid treatments. Treatments included monotherapy with long-acting opioids (mono-LAOs), mono-therapy with short-acting opioids (mono-SAOs), both LAOs and SAOs (combination), and opioid therapy initiated with SAO or LAO and switched to the other class (switch). Using MarketScan(®) claims databases (2006-2012), we identified CNCP patients with ≥90 days opioid supply after pain diagnosis and continuous enrollment 12 months before pain diagnosis (baseline period) and 12 months after opioid start (post-index period)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28768610/behavior-change-techniques-in-physical-activity-ehealth-interventions-for-people-with-cardiovascular-disease-systematic-review
#3
Orlaith Mairead Duff, Deirdre Mj Walsh, Bróna A Furlong, Noel E O'Connor, Kieran A Moran, Catherine B Woods
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of premature death and disability in Europe, accounting for 4 million deaths per year and costing the European Union economy almost €196 billion annually. There is strong evidence to suggest that exercise-based secondary rehabilitation programs can decrease the mortality risk and improve health among patients with CVD. Theory-informed use of behavior change techniques (BCTs) is important in the design of cardiac rehabilitation programs aimed at changing cardiovascular risk factors...
August 2, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28760602/longer-wait-times-affect-future-use-of-vha-primary-care
#4
Edwin S Wong, Chuan-Fen Liu, Susan E Hernandez, Matthew R Augustine, Karin Nelson, Stephan D Fihn, Paul L Hebert
BACKGROUND: Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. METHODS: This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP)...
July 29, 2017: Healthcare
https://www.readbyqxmd.com/read/28755996/receptor-visualization-and-the-atomic-bomb-a-historical-account-of-the-development-of-the-chemical-neuroanatomy-of-receptors-for-neurotransmitters-and-drugs-during-the-cold-war
#5
REVIEW
J M Palacios, G Mengod
This is a historical account of how receptors for neurotransmitters and drugs got to be seen at the regional, cellular, and subcellular levels in brain, in the years going from the end of the World War II until the collapse of the Soviet Union, the Cold War (1945-1991). The realization in the US of the problem of mental health care, as a consequence of the results of medical evaluation for military service during the war, let the US Government to act creating among other things the National Institute for Mental Health (NIMH)...
July 26, 2017: Journal of Chemical Neuroanatomy
https://www.readbyqxmd.com/read/28751087/the-effect-of-medicaid-expansion-on-utilization-in-maryland-emergency-departments
#6
Eili Y Klein, Scott Levin, Matthew F Toerper, Michael D Makowsky, Tim Xu, Gai Cole, Gabor D Kelen
STUDY OBJECTIVE: A proposed benefit of expanding Medicaid eligibility under the Patient Protection and Affordable Care Act (ACA) was a reduction in emergency department (ED) utilization for primary care needs. Pre-ACA studies found that new Medicaid enrollees increased their ED utilization rates, but the effect on system-level ED visits was less clear. Our objective was to estimate the effect of Medicaid expansion on aggregate and individual-based ED utilization patterns within Maryland...
July 24, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28732319/did-the-dependent-coverage-expansion-increase-risky-substance-use-among-young-adults
#7
Joshua Breslau, Hao Yu, Bing Han, Rosalie L Pacula, Rachel M Burns, Bradley D Stein
BACKGROUND: The dependent coverage expansion (DCE) enacted through the Affordable Care Act increased health insurance coverage among young adults. Increasing insurance coverage in this age group has the potential for unintended consequences on risky substance use. METHODS: Repeated cross-sectional surveys were used to compare change in substance use during the period the DCE was implemented in the 19-25year old target age group (Pre-DCE n=15,772, Post-DCE n=22,719) with contemporaneous change in a slightly older age group that was not targeted by the policy (Pre-DCE=19,851, Post-DCE n=28,157)...
July 14, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28723302/why-use-group-visits-for-opioid-use-disorder-treatment-in-primary-care-a-patient-centered-qualitative-study
#8
Randi Sokol, Chiara Albanese, Deviney Chaponis, Jessica Early, George Maxted, Diana Morrill, Grace Poirier, Fran Puopolo, Zev Schuman-Olivier
BACKGROUND: Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMA). While quantitative research has been previously conducted on SMAs with B/N, we conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients. METHODS: Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two one-hour-long focus groups, which were conducted as actual group visits...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28721980/risk-of-coronary-artery-disease-in-celiac-disease-population
#9
Rama D Gajulapalli, Deepak J Pattanshetty
BACKGROUND/AIMS: Celiac disease (CD), a chronic autoimmune condition, is associated with systemic inflammation capable of causing extra intestinal manifestations. Chronic inflammatory process has been implicated in the pathogenesis of accelerated atherosclerosis. Studies examining the burden of coronary artery disease (CAD) in patients with CD are lacking. We evaluated the prevalence of CAD in patients with CD. PATIENTS AND METHODS: Electronic health records from different health care systems were obtained utilizing a Health Insurance Portability and Accountability Act-compliant, patient de-identified web application...
July 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28721113/telehealth-and-ehealth-in-nurse-practitioner-training-current-perspectives
#10
REVIEW
Carolyn M Rutledge, Karen Kott, Patty A Schweickert, Rebecca Poston, Christianne Fowler, Tina S Haney
Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28721034/readmission-after-copd-exacerbation-scale-determining-30-day-readmission-risk-for-copd-patients
#11
Christine Sm Lau, Brianna L Siracuse, Ronald S Chamberlain
BACKGROUND: COPD affects over 13 million Americans, and accounts for over half a million hospitalizations annually. The Hospital Readmission Reduction Program, established by the Affordable Care Act requires the Centers for Medicare and Medicaid Services to reduce payments to hospitals with excess readmissions for COPD as of 2015. This study sought to develop a predictive readmission scale to identify COPD patients at higher readmission risk. METHODS: Demographic and clinical data on 339,389 patients from New York and California (derivation cohort) and 258,113 patients from Washington and Florida (validation cohort) were abstracted from the State Inpatient Database (2006-2011), and the Readmission After COPD Exacerbation (RACE) Scale was developed to predict 30-day readmission risk...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28720635/increased-public-accountability-for-hospital-nonprofit-status-potential-impacts-on-residency-positions
#12
Melanie C Raffoul, Robert L Phillips
BACKGROUND: The Institute of Medicine recently called for greater graduate medical education (GME) accountability for meeting the workforce needs of the nation. The Affordable Care Act expanded community health needs assessment (CHNA) requirements for nonprofit and tax-exempt hospitals to include community assessment, intervention, and evaluation every 3 years but did not specify details about workforce. Texas receives relatively little federal GME funding but has used Medicaid waivers to support GME expansion...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28710656/medicine-and-technology-remarks-on-the-notion-of-responsibility-in-the-technology-assisted-health-care
#13
Waldemar Kwiatkowski
The introduction of the modern diagnostic and therapeutic procedures to the medical practice provided a new challenge for the medicine. The art of medicine, with its default purpose of acting for the benefit of health, is therefore required to derive from technological progress effectively and rationally. As a result, the medical ethics has been engaged with the rules of economy and management of deficit medical procedures as well as their rational and fair distribution. The above suggests, that medics, given these recourses, should approach each patient with a consideration to their therapeutic rights...
July 14, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28695684/the-pitfalls-of-qualified-moral-veganism-a-critique-of-jan-deckers-holistic-health-approach-to-animal-ethics
#14
Eze Paez
I critically examine Jan Deckers' position in Animal (De)liberation, where he defends two main views. The first is "qualified moral veganism": Most humans have a duty to abstain from consuming animal products, even if there are circumstances in which doing so is justified. The author argues, on the one hand, from a pan-sentientist view that attributes sentience to all elementary entities and their compounds. Thus, all living things (such as animals and plants) have a capacity for positive and negative experiences...
July 11, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28693450/transition-to-parenthood-in-the-neonatal-care-unit-a-qualitative-study-and-conceptual-model-designed-to-illuminate-parent-and-professional-views-of-the-impact-of-webcam-technology
#15
Susan Kerr, Caroline King, Rhona Hogg, Kerri McPherson, Janet Hanley, Maggie Brierton, Sean Ainsworth
BACKGROUND: Complications during pregnancy, childbirth and/or the postnatal period may result in the admission of a baby to a neonatal unit (NNU). While the survival and long-term prospects of high-risk infants are enhanced by admission, the enforced separation of the parent and child may have psychological consequences for both. There is a need to develop and evaluate interventions to help parents 'feel closer' to their infants in circumstances where they are physically separated from them...
July 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28669369/young-people-s-perspectives-on-open-communication-between-family-members-when-a-parent-is-dying
#16
Nicola Turner
OBJECTIVE: Living with a parent who is approaching the end of life is profoundly troubling for young people. Research indicates that family communication about life-limiting parental illness can influence how young people manage living with dying. In particular, open communication between family members has been shown to be helpful. This paper reports on a study of young people's experiences of family interaction when a parent is dying and considers the practice of open communication in the context of young people's involvement in giving and receiving family care...
July 3, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28666472/policy-entrepreneurship-in-the-reform-of-pediatric-dentistry
#17
Burton L Edelstein, William R Maas
In a recently published IJHPR article, Cohen and Horev ask whether an individual who holds rightful governmental power is able to effectively "challenge the equilibrium" in ways that might "clash with the goals" of an influential group". This question is raised within the context of a shift in governmental policy that imposed the potential for cost management by HMOs acting as financial intermediaries for pediatric dental care in an effort to provide Israeli children better access to affordable dental care...
June 30, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28666156/family-support-liaison-in-the-witnessed-resuscitation-a-phenomenology-study
#18
Hadi Hassankhani, Vahid Zamanzade, Azad Rahmani, Hamidreza Haririan, Joanne E Porter
BACKGROUND: Family-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. OBJECTIVE: To explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. DESIGN: The hermeneutic phenomenology. SETTINGS: The emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran...
June 13, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28653246/allergy-and-sexual-behaviours-an-update
#19
REVIEW
Marco Caminati, Veronica Giorgis, Boaz Palterer, Francesca Racca, Chiara Salvottini, Oliviero Rossi
The exact prevalence of hypersensitivity reactions related to sexual behaviours is not known; however, they heavily impact on the quality of life and of sex life of affected patients. In fact, not only common respiratory and skin allergies, such as asthma, rhinitis, urticaria and atopic dermatitis, but also food and drug allergy have been found to negatively affect the quality of sex life. Allergic diseases impact on the sexual function in both physical and psychological ways, representing one of the main complaints of a considerable proportion of patients...
June 26, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28647537/variation-in-compulsory-psychiatric-inpatient-admission-in-england-a-cross-classified-multilevel-analysis
#20
Scott Weich, Orla McBride, Liz Twigg, Craig Duncan, Patrick Keown, David Crepaz-Keay, Eva Cyhlarova, Helen Parsons, Jan Scott, Kamaldeep Bhui
BACKGROUND: The increasing rate of compulsory admission to psychiatric inpatient beds in England is worrying. Studying variation between places and services could be key to identifying targets for interventions to reverse this trend. We modelled spatial variation in compulsory admissions in England using national patient-level data and quantified the extent to which patient, local-area, and service-setting characteristics accounted for this variation. METHODS: This study is a cross-sectional, multilevel analysis of the 2010-11 Mental Health Minimum Data Set (MHMDS)...
August 2017: Lancet Psychiatry
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