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https://www.readbyqxmd.com/read/28538918/mental-health-care-for-brazilian-juvenile-offenders
#1
Nilson do Rosário Costa, Paulo Roberto Fagundes da Silva
This paper analyzes the use of psychoactive drugs by juvenile offenders in Brazil in socio-educational facilities (USEs). It describes the guidelines of the national public policy and the quality of mental healthcare coordination by subnational public governments. This work draws on the hypothesis that USEs vertical governance is associated with the use of psychoactive medication. This is comparative study of two cases in Rio Grande do Sul and Minas Gerais. Data resulted from a sample of medical records and interviews with key informants...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28538835/ghrelin-plasma-levels-gastric-ghrelin-cell-density-and-bone-mineral-density-in-women-with-rheumatoid-arthritis
#2
F A N Maksud, A M Kakehasi, M F B R Guimarães, C J Machado, A J A Barbosa
Generalized bone loss can be considered an extra-articular manifestation of rheumatoid arthritis (RA) that may lead to the occurrence of fractures, resulting in decreased quality of life and increased healthcare costs. The peptide ghrelin has demonstrated to positively affect osteoblasts in vitro and has anti-inflammatory actions, but the studies that correlate ghrelin plasma levels and RA have contradictory results. We aimed to evaluate the correlation between total ghrelin plasma levels, density of ghrelin-immunoreactive cells in the gastric mucosa, and bone mineral density (BMD) in twenty adult women with established RA with 6 months or more of symptoms (mean age of 52...
May 18, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#3
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538532/identification-and-management-of-obese-patients-in-a-pediatric-orthopaedic-clinic
#4
Natalia Davila, Joy Vess, Emily E Johnson
BACKGROUND: Childhood obesity is a complex healthcare problem that affects all aspects of a child's health. The American Academy of Pediatrics and the Expert Committee recommends that all children be evaluated for current medical conditions including the risk for obesity by identifying elevated body mass index (BMI), physical activity habits, and diet. Childhood obesity is defined as a BMI of 95th percentile or greater on standardized age-based growth charts. Abdominal and visceral fat mass has a negative effect on bone formation during childhood and adolescence...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538455/operative-fixation-for-clavicle-fractures-socioeconomic-differences-persist-despite-overall-population-increases-in-utilization
#5
William W Schairer, Benedict U Nwachukwu, Russell F Warren, David M Dines, Lawrence V Gulotta
BACKGROUND: Clavicle fractures were traditionally treated conservatively, but recent evidence has shown improved outcomes with surgical management. The purpose of this study was to evaluate the recent trends in operative treatment of clavicle fractures, and to analyze for patient related factors that may affect treatment strategy. METHODS: The Healthcare Cost and Utilization Project (HCUP) California and Florida inpatient, outpatient, and the Emergency Department databases were used to identify all patients with clavicle fractures between 2005 and 2010...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538436/how-electronic-health-records-can-unmask-the-hidden-value-of-pas
#6
Folusho Ogunfiditimi, Scott P Sherry, Monica Foote, Sarah L Christie, Lisa P Shock, James Cawley, Aaron Browne
The Fee for Value (FFV) Task Force, a subgroup of the American Academy of PAs' Research and Strategic Initiatives Commission, has examined tools and mechanisms aimed at better clarifying the volume and value of PA work and how that work contributes to improving access to high-quality care. Establishing the value of PAs has been a challenging task for many healthcare providers. Often, PA value has been defined by their clinical productivity, without any clear direction as to what constitutes value versus productivity...
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28538055/high-reliability-principles-must-be-tied-to-value-based-outcomes
#7
Mitchell L Wasden
WellStar Health System and the Medical University of South Carolina (MUSC), highlighted in this issue's feature articles, are two organizations seeking to drive high reliability by educating leaders and incorporating high-reliability principles into their quality improvement (QI) efforts. The organizations have taken slightly different approaches to executing on high reliability, yet both are encouraged by the apparent success of high-reliability principles in other industries.The high-reliability framework is often applied to healthcare despite the limitations of comparing healthcare organizations to nuclear reactors, commercial airlines, and aircraft carriers...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28538054/achieving-high-reliability-with-people-processes-and-technology
#8
Candice L Saunders, John A Brennan
High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28538053/achieving-high-reliability-through-cultural-mindfulness
#9
Patrick J Cawley, Danielle B Scheurer
Healthcare has enthusiastically embraced quality and safety improvement. Yet, more radical transformation is clearly needed to make a more significant impact on error reduction and to ensure consistent quality. This need for transformation is leading healthcare to examine how other industries, such as nuclear power and aviation, improve safety to achieve a high degree of reliability and avoid potential catastrophes. Research has shown that successful organizations in high-risk industries achieve high reliability by maintaining a cultural mindfulness that allows them to continually reinvent themselves in complex environments...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28537762/creation-of-an-integrated-knowledge-translation-process-to-improve-pediatric-emergency-care-in-canada
#10
Robin M Featherstone, Carly Leggett, Lisa Knisley, Mona Jabbour, Terry P Klassen, Shannon D Scott, Greg Van De Mosselaer, Lisa Hartling
TREKK (Translating Emergency Knowledge for Kids) was established to address knowledge needs to support care of children in general emergency departments. To achieve this goal, we developed an integrated knowledge translation (KT) process based on identified priorities to create the TREKK Evidence Repository, containing "knowledge pyramids" and Bottom Line Recommendations (summary documents) on the diagnosis and treatment of emergency pediatric conditions. The objective of this article is to describe our methods for developing and disseminating the TREKK Evidence Repository to improve pediatric emergency care in Canada...
May 24, 2017: Health Communication
https://www.readbyqxmd.com/read/28535398/nurses-occupational-physical-activity-levels-a-systematic-review
#11
REVIEW
Stephanie E Chappel, Simone J J M Verswijveren, Brad Aisbett, Julie Considine, Nicola D Ridgers
BACKGROUND: Nurses' physical performance at work has implications both for nurses' occupational health and patient care. Although nurses are the largest healthcare workforce, are present 24-hours a day, and engage in many physically demanding tasks, nurses' occupational physical activity levels are poorly understood. OBJECTIVES: The aim of this systematic review was to examine nurses' occupational physical activity levels, and explore how nurses accumulate their physical activity during a shift...
May 10, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28535331/computer-and-mobile-technology-interventions-for-self-management-in-chronic-obstructive-pulmonary-disease
#12
REVIEW
Catherine McCabe, Margaret McCann, Anne Marie Brady
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction due to an abnormal inflammatory response of the lungs to noxious particles or gases, for example, cigarette smoke. The pattern of care for people with moderate to very severe COPD often involves regular lengthy hospital admissions, which result in high healthcare costs and an undesirable effect on quality of life. Research over the past decade has focused on innovative methods for developing enabling and assistive technologies that facilitate patient self-management...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28535103/value-frameworks-for-the-patient-provider-interaction-a-comparison-of-the-asco-value-framework-versus-nccn-evidence-blocks-in-determining-value-in-oncology
#13
Bijal Shah-Manek, Joseph S Galanto, Huong Nguyen, Robert Ignoffo
BACKGROUND: To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28534417/clinical-and-cost-effectiveness-of-home-based-cardiac-rehabilitation-compared-to-conventional-centre-based-cardiac-rehabilitation-results-of-the-fit-home-study
#14
Jos J Kraal, M Elske Van den Akker-Van Marle, Ameen Abu-Hanna, Wim Stut, Niels Peek, Hareld Mc Kemps
Aim Although cardiac rehabilitation improves physical fitness after a cardiac event, many eligible patients do not participate in cardiac rehabilitation and the beneficial effects of cardiac rehabilitation are often not maintained over time. Home-based training with telemonitoring guidance could improve participation rates and enhance long-term effectiveness. Methods and results We randomised 90 low-to-moderate cardiac risk patients entering cardiac rehabilitation to three months of either home-based training with telemonitoring guidance or centre-based training...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28534304/an-american-crisis-the-lack-of-black-men-in-medicine
#15
Cato T Laurencin, Marsha Murray
The current state of diversity within the US medical workforce does not reflect representative numbers of the Black male population. Research data continues to reveal continuing trends in the areas of discrimination, incarceration, health disparities, and mortality with respect to Black males. The lack of increase in Black male medical school applications and matriculation contrasted by the continuing trends mentioned above illustrates that there is in fact an American crisis. We present here a call to arms, to address the need of African-American men in medicine...
May 22, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28534221/measuring-outcomes-in-adult-spinal-deformity-surgery-a-systematic-review-to-identify-current-strengths-weaknesses-and-gaps-in-patient-reported-outcome-measures
#16
REVIEW
Sayf S A Faraj, Miranda L van Hooff, Roderick M Holewijn, David W Polly, Tsjitske M Haanstra, Marinus de Kleuver
PURPOSE: Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. METHODS: Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015...
May 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28534094/lifetime-traumatic-events-health-related-quality-of-life-and-satisfaction-with-life-in-older-adults
#17
Catherine Lamoureux-Lamarche, Helen-Maria Vasiliadis
PURPOSES: The aims were to assess the association between lifetime traumatic events and post-traumatic stress syndrome (PTSS) and health-related quality of life (HRQOL) and satisfaction with life stratified by gender among a community-dwelling sample of older adults. METHODS: Data used came from the ESA-Services study (2011-2013) and included a large convenience sample of 1811 older adults. Traumatic events were measured using a list of 14 events. PTSS was measured using the Impact of Event Scale-Revised...
May 22, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28532974/cost-effectiveness-analysis-of-corneal-collagen-crosslinking-for-progressive-keratoconus
#18
Daniel A Godefrooij, Marie-Josee J Mangen, Elsie Chan, David P S O'Brart, Saskia M Imhof, G Ardine de Wit, Robert P L Wisse
PURPOSE: To evaluate the cost effectiveness of corneal collagen crosslinking (CXL) for progressive keratoconus from the healthcare payer's perspective. DESIGN: A probabilistic Markov-type model using data from published clinical trials and cohort studies. PARTICIPANTS: Two identical cohorts, each comprising 1000 virtual patients with progressive bilateral keratoconus, were modeled; one cohort underwent CXL and the other cohort received no intervention...
May 19, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28532725/empathy-and-feelings-of-guilt-experienced-by-nurses-a-cross-sectional-study-of-their-role-in-burnout-and-compassion-fatigue-symptoms
#19
Joana Duarte, José Pinto-Gouveia
AIMS: The main goal of this study was to explore the relationships between empathy, empathy-based pathogenic guilt and professional quality of life (burnout and compassion fatigue). We aim to test a model in which we hypothesize that when empathic feelings are related to pathogenic guilt, burnout and compassion fatigue symptoms may be increased. BACKGROUND: Empathy is at the core of nursing practice, and has been associated with positive outcomes not only for the healthcare provider but also for the patient...
June 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28532707/sedated-suture-adjustment-in-children-undergoing-adjustable-suture-strabismus-surgery
#20
Warachaya Phanphruk, Maan Alkharashi, Aykut Bilge, David G Hunter
PURPOSE: To study methods and adverse events of postoperative, sedated suture adjustment after strabismus surgery in the post-anesthesia care unit (PACU). METHODS: We reviewed the postoperative experience of all children ≤18 years of age undergoing adjustable suture strabismus surgery at Boston Children's Hospital over a 3-year period. Time in the hospital, adverse events, and surgical outcomes were reviewed to evaluate safety and healthcare resource utilization...
May 19, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
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