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https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#1
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448162/joblessness-and-lost-earnings-after-ards-in-a-1-year-national-multicenter-study
#2
Biren B Kamdar, Minxuan Huang, Victor D Dinglas, Elizabeth Colantuoni, Till M von Wachter, Ramona O Hopkins, Dale M Needham
RATIONALE: Following acute respiratory distress syndrome (ARDS), joblessness is common, but poorly understood. OBJECTIVES: To evaluate the timing of return to work following ARDS, and associated risk factors, lost earnings, and changes in healthcare coverage Methods: Over 12-month longitudinal follow-up, ARDS survivors from 43 U.S. ARDSNet hospitals provided employment and healthcare coverage data via structured telephone interviews. Factors associated with the timing of return to work were assessed using Fine and Gray regression analysis...
April 27, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28446379/group-a-rotavirus-genotypes-in-hospital-acquired-gastroenteritis-in-italy-2012-14
#3
G Ianiro, R Delogu, L Fiore, M Monini, F M Ruggeri
BACKGROUND: Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young (aged <5 years) children, causing ∼250,000 deaths worldwide, mostly in developing countries. Differences on nucleotide sequences of VP7 (G-type) and VP4 (P-type) genes are the basis for the binary RVA nomenclature. Although at least 32 G-types and 47 P-types of rotavirus are presently known, most RVA infections in humans worldwide are related to five major G/P combinations: G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8]...
April 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28446169/the-relative-importance-of-large-problems-far-away-versus-small-problems-closer-to-home-insights-into-limiting-the-spread-of-antimicrobial-resistance-in-england
#4
Tjibbe Donker, Katherine L Henderson, Katie L Hopkins, Andrew R Dodgson, Stephanie Thomas, Derrick W Crook, Tim E A Peto, Alan P Johnson, Neil Woodford, A Sarah Walker, Julie V Robotham
BACKGROUND: To combat the spread of antimicrobial resistance (AMR), hospitals are advised to screen high-risk patients for carriage of antibiotic-resistant bacteria on admission. This often includes patients previously admitted to hospitals with a high AMR prevalence. However, the ability of such a strategy to identify introductions (and hence prevent onward transmission) is unclear, as it depends on AMR prevalence in each hospital, the number of patients moving between hospitals, and the number of hospitals considered 'high risk'...
April 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28445903/patient-reported-adverse-events-after-colonoscopy-in-norway
#5
Geir Hoff, Thomas de Lange, Michael Bretthauer, Magne Buset, Stein Dahler, Fred-Arne Halvorsen, Jörg Michael Halwe, Mathis Heibert, Ole Høie, Øystein Kjellevold, Volker Moritz, Per Sandvei, Birgitte Seip, Lars Aabakken, Øyvind Holme
Background and aims Patient-reported outcome measures are increasingly important in healthcare. European guidelines have recommended inclusion of patient feedback to capture adverse events due to colonoscopy, but this is rarely implemented. Methods The Norwegian Quality Assurance network for endoscopy (Gastronet) collects patient-reported outcome for colonoscopies. Free-text comments on patient reports from January to December 2015 were characterized as positive or negative. All negative free-text comments were scrutinized for information that might suggest colonoscopy-related adverse events...
April 26, 2017: Endoscopy
https://www.readbyqxmd.com/read/28445873/pregnancy-outcomes-in-patients-with-glomerular-disease-attending-a-single-academic-center-in-north-carolina
#6
Michelle M O'Shaughnessy, Meghan A Jobson, Katy Sims, Abigail L Liberty, Patrick H Nachman, William F Pendergraft
BACKGROUND: Contemporary data regarding pregnancy outcomes in US patients with primary glomerular diseases are lacking. We aimed to report fetal and maternal outcomes among women with biopsy-proven primary glomerular disease who received obstetric care at a single large academic US center. METHODS: All women with a biopsy-confirmed primary glomerular disease diagnosis and without end-stage kidney disease who received obstetric care at the University of North Carolina (UNC) Hospitals (1996-2015) were identified using the Glomerular Disease Collaborative Network registry and the UNC Hospitals Perinatal Database...
April 27, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28445636/disposable-autonomous-device-for-rapid-swab-to-result-diagnosis-of-influenza
#7
Shichu Huang, Koji Abe, Steven Bennett, Tinny Liang, Paula D Ladd, Lindsay Yokobe, Caitlin E Anderson, Kamal Shah, Josh Bishop, Mike Purfield, Peter C Kauffman, Sai Paul, AnneMarie E Welch, Bonnie Strelitz, Kristin Follmer, Kelsey Pullar, Luis Sanchez-Erebia, Emily Gerth-Guyette, Gonzalo J Domingo, Eileen Klein, Janet A Englund, Elain Fu, Paul Yager
A prototype of a self-contained, automated, disposable device for chemically-amplified protein-based detection of influenza virus from nasal swab specimens was developed and evaluated in a clinical setting. The device required only simple specimen manipulation without any dedicated instrumentation or specialized training by the operator for interpretation. The device was based on a sandwich immunoassay for influenza virus nucleoprotein; it used an enzyme-labeled antibody and a chromogenic substrate to provide an amplified visible signal, in a two-dimensional paper network format...
April 26, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28445559/association-of-us-centers-for-medicare-and-medicaid-services-hospital-30-day-risk-standardized-readmission-metric-with-care-quality-and-outcomes-after-acute-myocardial-infarction-findings-from-the-national-cardiovascular-data-registry-acute-coronary-treatment
#8
Ambarish Pandey, Harsh Golwala, Hurst M Hall, Tracy Y Wang, Di Lu, Ying Xian, Karen Chiswell, Karen E Joynt, Abhinav Goyal, Sandeep R Das, Dharam Kumbhani, Howard Julien, Gregg C Fonarow, James A de Lemos
Importance: The US Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program penalizes hospitals with higher-than-expected risk-adjusted 30-day readmission rates (excess readmission ratio [ERR] > 1) after acute myocardial infarction (MI). However, the association of ERR with MI care processes and outcomes are not well established. Objective: To evaluate the association between ERR for MI with in-hospital process of care measures and 1-year clinical outcomes...
April 26, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28444166/the-effect-of-a-piperacillin-tazobactam-shortage-on-antimicrobial-prescribing-and-clostridium-difficile-risk-in-88-u-s-medical-centers
#9
Alan E Gross, Richard S Johannes, Vikas Gupta, Ying P Tabak, Arjun Srinivasan, Susan C Bleasdale
Background: Anti-infective shortages are a pervasive problem in the U.S. The objective of this study was to identify any associations between changes in antibiotic prescribing during a piperacillin/tazobactam (PIP/TAZO) shortage and hospital-onset Clostridium difficile infection (HO-CDI) risk in 88 U.S medical centers. Methods: We analyzed electronically captured microbiology and antibiotic use data from a network of U.S. hospitals from July 2014 through June 2015...
April 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28444049/healthcare-financing-decentralization-and-regional-health-planning-federal-transfers-and-the-healthcare-networks-in-minas-gerais-brazil
#10
Laura Monteiro de Castro Moreira, Felipe Ferré, Eli Iola Gurgel Andrade
The Decrees 4279/10 and 7508/11 established norms to guide health politics, with impacts on funding of the Middle and High Complexity Hospital and Outpatient. To verify the effects on the consolidation of care networks in Minas Gerais, we performed an analytical-descriptive study of the National Health Fund from 2006 to 2014. We observed decentralization of responsibilities, accompanied of resources and innovative financing mechanisms, resulting expansion of the network care model. The federal government definitions suggest reduction of the autonomy and limitation of regional solutions...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28443354/optimization-of-intelligent-infusion-pump-technology-to-minimize-vasopressor-pump-programming-errors
#11
Nina Vadiei, Carrie A Shuman, Manasa S Murthy, Mitchell J Daley
STUDY OBJECTIVE: To determine if incorporation of vasopressor upper hard limits (UHL) into intelligent infusion pump technology (IIPT) increases efficacy of alerts by preventing pump programming errors. DESIGN & METHODS: Retrospective review from five hospitals within a single healthcare network between April 1, 2013 and May 31, 2014. A total of 65,680 vasopressor data entries were evaluated; 19,377 prior to hard limit implementation and 46,303 after hard limit implementation...
April 26, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28442293/effect-of-appropriate-combination-therapy-on-mortality-of-patients-with-bloodstream-infections-due-to-carbapenemase-producing-enterobacteriaceae-increment-a-retrospective-cohort-study
#12
Belén Gutiérrez-Gutiérrez, Elena Salamanca, Marina de Cueto, Po-Ren Hsueh, Pierluigi Viale, José Ramón Paño-Pardo, Mario Venditti, Mario Tumbarello, George Daikos, Rafael Cantón, Yohei Doi, Felipe Francisco Tuon, Ilias Karaiskos, Elena Pérez-Nadales, Mitchell J Schwaber, Özlem Kurt Azap, Maria Souli, Emmanuel Roilides, Spyros Pournaras, Murat Akova, Federico Pérez, Joaquín Bermejo, Antonio Oliver, Manel Almela, Warren Lowman, Benito Almirante, Robert A Bonomo, Yehuda Carmeli, David L Paterson, Alvaro Pascual, Jesús Rodríguez-Baño
BACKGROUND: The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. METHODS: In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries...
April 21, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#13
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441233/acute-respiratory-distress-syndrome-due-to-tuberculosis-in-a-respiratory-icu-over-a-16-year-period
#14
Valliappan Muthu, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal, Ritesh Agarwal
OBJECTIVE: Whether tuberculosis-related acute respiratory distress syndrome is associated with worse outcomes when compared with acute respiratory distress syndrome secondary to other causes remains unknown. Herein, we compare the outcomes between the two groups. DESIGN: Retrospective analysis of all subjects admitted with acute respiratory distress syndrome over the last 16 years. SETTING: Respiratory ICU of a tertiary care hospital in North India...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28440252/adjustment-to-acquired-vision-loss-in-adults-presenting-for-visual-disability-certification
#15
Aditya Nakade, Jolly Rohatgi, Manjeet S Bhatia, Upreet Dhaliwal
CONTEXT: Rehabilitation of the visually disabled depends on how they adjust to loss; understanding contributing factors may help in effective rehabilitation. AIM: The aim of this study is to assess adjustment to acquired vision loss in adults. SETTINGS AND DESIGN: This observational study, conducted in the Department of Ophthalmology at a tertiary-level teaching hospital, included thirty persons (25-65 years) with <6/60 in the better eye, and vision loss since ≥6-months...
March 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28440047/mental-illness-in-bariatric-surgery-a-cohort-study-from-the-portal-network
#16
David Fisher, Karen J Coleman, David E Arterburn, Heidi Fischer, Ayae Yamamoto, Deborah R Young, Nancy E Sherwood, Connie Mah Trinacty, Kristina H Lewis
OBJECTIVE: To compare bariatric surgery outcomes according to preoperative mental illness category. METHODS: Electronic health record data from several US healthcare systems were used to compare outcomes of four groups of patients who underwent bariatric surgery in 2012 and 2013. These included the following: people with (1) no mental illness, (2) mild-to-moderate depression or anxiety, (3) severe depression or anxiety, and (4) bipolar, psychosis, or schizophrenia spectrum disorders...
May 2017: Obesity
https://www.readbyqxmd.com/read/28438987/major-trauma-from-suspected-child-abuse-a-profile-of-the-patient-pathway
#17
Ffion C Davies, Fiona E Lecky, Ross Fisher, Marisol Fragoso-Iiguez, Tim J Coats
BACKGROUND: Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. METHODS: The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI...
April 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28437843/a-bayesian-belief-network-model-assessing-the-risk-to-wastewater-workers-of-contracting-ebola-virus-disease-during-an-outbreak
#18
Joseph W Zabinski, Kelsey J Pieper, Jacqueline MacDonald Gibson
During an outbreak of Ebola virus disease (EVD), hospitals' connections to municipal wastewater systems may provide a path for patient waste bearing infectious viral particles to pass from the hospital into the wastewater treatment system, potentially posing risks to sewer and wastewater workers. To quantify these risks, we developed a Bayesian belief network model incorporating data on virus behavior and survival along with structural characteristics of hospitals and wastewater treatment systems. We applied the model to assess risks under several different scenarios of workers' exposure to wastewater for a wastewater system typical of a mid-sized U...
April 24, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#19
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437260/early-postoperative-neuropathic-pain-assessed-by-the-dn4-score-predicts-an-increased-risk-of-persistent-postsurgical-neuropathic-pain
#20
Helene Beloeil, Barthelemy Sion, Chloe Rousseau, Pierre Albaladejo, Mathieu Raux, Frederic Aubrun, Valeria Martinez
BACKGROUND: Acute neuropathic pain can occur in the postoperative period but any link with persistent post-surgical neuropathic pain remains unclear. OBJECTIVES: The objectives of this study were to prospectively describe the incidence of acute post-surgical neuropathic pain in a large population using the DN4 (clinician administered) questionnaire and to confirm the hypothetical link between acute and persistent neuropathic pain at 2 months after surgery in a large population using the DN2 (self administered) questionnaire...
April 21, 2017: European Journal of Anaesthesiology
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