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https://www.readbyqxmd.com/read/28237955/advance-care-planning-uptake-among-patients-with-severe-lung-disease-a-randomised-patient-preference-trial-of-a-nurse-led-facilitated-advance-care-planning-intervention
#1
Craig Sinclair, Kirsten Anne Auret, Sharon Frances Evans, Fiona Williamson, Siobhan Dormer, Anne Wilkinson, Kim Greeve, Audrey Koay, Dot Price, Fraser Brims
OBJECTIVE: Advance care planning (ACP) clarifies goals for future care if a patient becomes unable to communicate their own preferences. However, ACP uptake is low, with discussions often occurring late. This study assessed whether a systematic nurse-led ACP intervention increases ACP in patients with advanced respiratory disease. DESIGN: A multicentre open-label randomised controlled trial with preference arm. SETTING: Metropolitan teaching hospital and a rural healthcare network...
February 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28235523/fast-track-anesthesia-in-patients-undergoing-outpatient-laparoscopic-cholecystectomy-comparison-of-sevoflurane-with-total-intravenous-anesthesia
#2
Ceyda Özhan Çaparlar, Mehmet Özgür Özhan, Mehmet Anıl Süzer, Dilek Yazicioğlu, Mehmet Burak Eşkin, Serkan Şenkal, Mehmet Ali Çaparlar, Ersin Özkan Imren, Bülent Atik, Nedim Çekmen
BACKGROUND: The use of short-acting anesthetics has introduced a "fast-track anesthesia" concept in outpatient surgery which provides discharge of the patients from operation room directly to the phase II recovery area without entering into postanesthesia care unit. The aim of this prospective and randomized study was to compare general anesthesia using sevoflurane with propofol-remifentanil-based total intravenous anesthesia (TIVA) for fast-track eligibility in patients undergoing outpatient laparoscopic cholecystectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#3
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28226301/the-influence-of-welfare-systems-on-pay-for-performance-programs-for-general-practitioners-a-critical-review
#4
REVIEW
Mehdi Ammi, Grant Fortier
While pay-for-performance (P4P) programs are increasingly common tools used to foster quality and efficiency in primary care, the evidence concerning their effectiveness is at best mixed. In this article, we explore the influence of welfare systems on four P4P-related dimensions: the level of healthcare funders' commitment to P4Ps (by funding and length of program operation), program design (specifically target-based vs. participation-based program), physicians' acceptance of the program and program effects...
February 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28225542/historical-overview-of-leprosy-control-in-cuba
#5
Enrique Beldarraín-Chaple
INTRODUCTION Leprosy, an infectious disease caused by Mycobacterium leprae, affects the nervous system, skin, internal organs, extremities and mucous membranes. Biological, social and environmental factors influence its occurrence and transmission. The first effective treatments appeared in 1930 with the development of dapsone, a sulfone. The main components of a control and elimination strategy are early case detection and timely administration of multidrug therapy. OBJECTIVES Review the history of leprosy control in Cuba, emphasizing particularly results of the National Leprosy Control Program, its modifications and influence on leprosy control...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28224944/managing-ckd-by-telemedicine-the-zuni-telenephrology-clinic
#6
REVIEW
Andrew S Narva, Gayle Romancito, Thomas Faber, Michael E Steele, Kenneth M Kempner
Telemedicine has significant potential to extend nephrology consultation to rural and isolated communities. We describe a telenephrology clinic that has delivered ongoing consultative care from a nephrologist based at the National Institutes of Health in Bethesda, MD, to the Zuni Comprehensive Health Center in western New Mexico. Over the past 9 years, the clinic has conducted 1870 patient visits managing patients using a collaborative approach engaging a nurse case manager, nephrologist, primary clinicians, pharmacists, and community health nurses...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28223463/impact-of-a-respiratory-therapy-assess-and-treat-protocol-on-adult-cardiothoracic-icu-readmissions
#7
Robert T Dailey, Thomas Malinowski, Mitchel Baugher, Daniel D Rowley
BACKGROUND: The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a respiratory therapy assess-and-treat (RTAT) protocol. Our primary null hypothesis was that there would be no difference in all-cause unexpected readmissions and escalations between the RTAT group and the physician-ordered respiratory care group. Our secondary null hypothesis was that there would be no difference in primary respiratory-related readmissions, ICU length of stay, or hospital length of stay...
February 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28223112/understanding-and-applying-the-concept-of-value-creation-in-radiology
#8
David B Larson, Daniel J Durand, Daniel S Siegal
The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer. We propose that the primary purpose of diagnostic radiology is to answer clinical questions using medical imaging to help guide management of patient care...
February 17, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28222707/comparison-of-the-swedish-start-back-screening-tool-and-the-short-form-of-the-%C3%A3-rebro-musculoskeletal-pain-screening-questionnaire-in-patients-with-acute-or-subacute-back-and-neck-pain
#9
Malin Forsbrand, Birgitta Grahn, Jonathan C Hill, Ingemar F Petersson, Charlotte Post Sennehed, Kjerstin Stigmar
BACKGROUND: Patients with back and neck pain are often seen in primary care and it is important to provide them with tailored interventions based on risk stratification/triage. The STarT Back Screening Tool (SBT) is a widely used screening questionnaire which has not yet been validated for a population with back and/or neck pain with short duration. Our aim was to compare the concurrent validity of the SBT and the short form of the ÖMPSQ including psychometric properties and clinical utility in a primary care setting...
February 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28220586/prevalence-of-anxiety-and-depressive-symptoms-and-their-association-with-pelvic-floor-dysfunctions-a-cross-sectional-cohort-study-at-a-pelvic-care-centre
#10
Desiree Vrijens, Bary Berghmans, Fred Nieman, Jim van Os, Gommert van Koeveringe, Carsten Leue
AIMS: Pelvic floor dysfunctions (PFDs), like voiding complaints, urinary and fecal incontinence, and prolapse, are prevalent and associated with decrease in quality of life. PFDs are often complex and multifactorial in origin showing interrelationships between different PFD and with affective conditions. The primary aim of this study is to describe the prevalence of affective complaints in a cohort of Pelvic Care Centre (PCC) patients. The secondary aim is to describe associations between PFDs and depression or anxiety...
February 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28220581/effect-of-organizational-features-on-patient-satisfaction-with-care-in-italian-multiple-sclerosis-centres
#11
K Mattarozzi, E Baldin, C Zenesini, A Solari, M P Amato, M Leone, G Mancardi, V Martinelli, G Savettieri, C Solaro, M R Tola, R D'Alessandro
BACKGROUND AND PURPOSE: Receiving clear, complete and up-to-date information and having a satisfying relationship with the health professional (HP) are of primary importance for MS patients. Healthcare organization plays a key role in promoting an effective relationship and communication between patients and HPs. The present study aims to explore which care organization and service characteristics provided by Italian MS centres best predict patients' satisfaction with healthcare. METHODS: Eighty-one centres and 707 patients (502 women, mean age 40...
February 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28217581/status-of-governmental-oral-health-care-delivery-system-in-haryana-india
#12
Ashish Vashist, Swati Parhar, Ramandeep Singh Gambhir, Ramandeep Kaur Sohi, Puneet Singh Talwar
BACKGROUND: Health system should be organized to meet the needs of entire population of the nation. This means that the state has the direct responsibility for the health of its population and improving the quality of life through research, education, and provision of health services. The present study was conducted to evaluate the government oral health care delivery system in Haryana, India. MATERIALS AND METHODS: The present cross-sectional study was conducted among 135 dental care units (DCUs) of various primary health centers (PHCs), community health centers (CHCs), and general hospitals (GHs) existing in the state by employing a cluster random sampling technique...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217465/cutaneous-manifestations-in-disorders-of-hepatobiliary-system
#13
Shashi K Godara, Devinder M Thappa, Biju Pottakkatt, Abdoul Hamide, Jagadisan Barath, Malathi Munisamy, Minu J Chiramel
BACKGROUND: Hepatobiliary diseases are associated with various mucocutaneous changes that are directly and indirectly associated with these diseases. There is a dearth of studies from India dealing with cutaneous manifestations in liver disorders. AIM: This study was conducted to know the spectrum of cutaneous changes and their correlation with liver function tests in patients with disorders of hepatobiliary system. METHODS: This was a descriptive study conducted among in patients and outpatients with primary hepatobiliary disorders at a tertiary care center in South India...
January 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28216215/direct-admission-versus-interhospital-transfer-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction
#14
Damian Kawecki, Marek Gierlotka, Beata Morawiec, Michał Hawranek, Mateusz Tajstra, Michał Skrzypek, Wojciech Wojakowski, Lech Poloński, Ewa Nowalany-Kozielska, Mariusz Gąsior
OBJECTIVES: This study sought to assess the influence of direct admission versus transfer via regional hospital to a percutaneous coronary intervention (PCI) center on time delays and 12-month mortality in ST-segment elevation myocardial infarction (STEMI) patients from a real-life perspective. BACKGROUND: Reduction of delays to reperfusion is crucial in a STEMI system of care. However, it is still debated whether direct admission to a PCI center is superior to interhospital transfer in terms of long-term prognosis...
February 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28215120/strategies-and-actions-of-multi-purpose-health-communication-on-vaccine-preventable-infectious-diseases-in-order-to-increase-vaccination-coverage-in-the-population-the-esculapio-project
#15
Angela Bechini, Paolo Bonanni, Sara Lauri, Emilia Tiscione, Miriam Levi, Rosa Prato, Francesca Fortunato, Domenico Martinelli, Roberto Gasparini, Donatella Panatto, Daniela Amicizia, Rosa Cristina Coppola, Barbara Pellizzari, Garden Tabacchi, Claudio Costantino, Francesco Vitale, Stefania Iannazzo, Sara Boccalini
The ESCULAPIO Project aims at increasing awareness on vaccine preventable infectious diseases (VPID) and vaccinations in different target populations and to spread the culture of prevention. Information/training interventions on VPID have been developed and health promotion activities for the general population, students and their parents, teachers and health care workers (HCWs) were set up. In Tuscany, educational courses on VPID in high schools were organized and students were stimulated to prepare informative materials on VPID for lower grade school pupils...
February 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28213993/healthcare-resources-and-needs-in-anticoagulant-therapy-for-patients-with-nonvalvular-atrial-fibrillation-samoa-study
#16
V Barrios, M I Egocheaga-Cabello, J Gállego-Culleré, E Ignacio-García, L Manzano-Espinosa, A Martín-Martínez, J Mateo-Arranz, J Polo-García, D Vargas-Ortega
INTRODUCTION AND OBJECTIVES: To determine, in the various medical specialties, the healthcare process for anticoagulated patients with nonvalvular atrial fibrillation, to determine the available and necessary resources and to identify potential areas of improvement in the care of these patients. METHODS: We performed a cross-sectional survey of primary care and specialised physicians involved in the care of anticoagulated patients. The questionnaires referred to the healthcare process, the indication and prescription of anticoagulant therapy and the barriers and deficiencies present for these patients...
February 14, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28213381/outcomes-of-treatment-with-direct-acting-antivirals-for-infection-with-hepatitis-c-virus-genotypes-1-4-in-an-ambulatory-care-setting
#17
Timothy A Bach, Kathy Zaiken
PURPOSE: Outcomes with direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) genotypes 1-4 were determined. METHODS: A total of 360 patients at 36 clinical sites in Massachusetts with HCV genotypes 1-4 and a prescription for at least one DAA medication between May 2011 and October 2015 were included. The primary investigator completed a retrospective and concurrent chart review, and data were collected through April 2016. RESULTS: A total of 446 patients were assessed for eligibility into the study, with 86 patients excluded...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28212606/the-implementation-of-health-promotion-in-primary-and-community-care-a-qualitative-analysis-of-the-prescribe-vida-saludable-strategy
#18
Catalina Martinez, Gonzalo Bacigalupe, Josep M Cortada, Gonzalo Grandes, Alvaro Sanchez, Haizea Pombo, Paola Bully
BACKGROUND: The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. METHODS: We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#19
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#20
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
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