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https://www.readbyqxmd.com/read/28732397/combined-sewer-overflow-events-and-childhood-emergency-department-visits-a-case-crossover-study
#1
Cole Brokamp, Andrew F Beck, Louis Muglia, Patrick Ryan
In localities with combined sewer systems, combined sewer overflow (CSO) events frequently occur following high precipitation and can result in the release of untreated sewage and industrial wastewater into surface waters. We hypothesized that either direct contact with or proximity to aerosolized CSO effluent would increase the risk for childhood emergency department (ED) visits for asthma, gastrointestinal (GI) illnesses, and skin and soft tissue infections (SSTIs) in Cincinnati, OH, USA. ED visits for 2010-2014 due to GI diseases, asthma, and SSTIs were extracted from the Cincinnati Children's Hospital Medical Center electronic health records...
July 17, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28729710/learning-a-health-knowledge-graph-from-electronic-medical-records
#2
Maya Rotmensch, Yoni Halpern, Abdulhakim Tlimat, Steven Horng, David Sontag
Demand for clinical decision support systems in medicine and self-diagnostic symptom checkers has substantially increased in recent years. Existing platforms rely on knowledge bases manually compiled through a labor-intensive process or automatically derived using simple pairwise statistics. This study explored an automated process to learn high quality knowledge bases linking diseases and symptoms directly from electronic medical records. Medical concepts were extracted from 273,174 de-identified patient records and maximum likelihood estimation of three probabilistic models was used to automatically construct knowledge graphs: logistic regression, naive Bayes classifier and a Bayesian network using noisy OR gates...
July 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28729308/the-effect-of-combined-resistance-exercise-training-and-vitamin-d3-supplementation-on-musculoskeletal-health-and-function-in-older-adults-a-systematic-review-and-meta-analysis
#3
Anneka Elizabeth Antoniak, Carolyn A Greig
OBJECTIVES: In older adults, there is a blunted responsiveness to resistance training and reduced muscle hypertrophy compared with younger adults. There is evidence that both exercise training and vitamin D supplementation may benefit musculoskeletal health in older adults, and it is plausible that in combination their effects may be additive. The aim of this systematic review was to evaluate the effectiveness of combined resistance exercise training and vitamin D3 supplementation on musculoskeletal health in older adults...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729232/development-feasibility-and-small-scale-implementation-of-a-web-based-prognostic-tool-surveillance-epidemiology-and-end-results-cancer-survival-calculator
#4
Michelle Henton, Bridget Gaglio, Laurie Cynkin, Eric J Feuer, Borsika A Rabin
BACKGROUND: Population datasets and the Internet are playing an ever-growing role in the way cancer information is made available to providers, patients, and their caregivers. The Surveillance, Epidemiology, and End Results Cancer Survival Calculator (SEER*CSC) is a Web-based cancer prognostic tool that uses SEER data, a large population dataset, to provide physicians with highly valid, evidence-based prognostic estimates for increasing shared decision-making and improving patient-provider communication of complex health information...
July 20, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28728623/veterans-affairs-primary-care-provider-perceptions-of-insomnia-treatment
#5
Christi S Ulmer, Hayden B Bosworth, Jean C Beckham, Anne Germain, Amy S Jeffreys, David Edelman, Stephanie Macy, Angela Kirby, Corrine I Voils
STUDY OBJECTIVES: Insomnia is a widespread issue among United States adults and rates of insomnia among veterans are even higher than the general population. Prior research examining primary care provider (PCP) perspectives on insomnia treatment found that: sleep hygiene and pharmacotherapy are the primary treatments offered; PCPs tend to focus on perceived causes of insomnia rather than the insomnia itself; and neither patients nor providers are satisfied with insomnia treatment options...
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28728114/variation-in-receipt-of-pharmacotherapy-for-alcohol-use-disorders-across-racial-ethnic-groups-a-national-study-in-the-u-s-veterans-health-administration
#6
Emily C Williams, Shalini Gupta, Anna D Rubinsky, Joseph E Glass, Rhonda Jones-Webb, Kara M Bensley, Alex H S Harris
OBJECTIVE: Pharmacologic treatment is recommended for alcohol use disorders (AUD), but most patients do not receive it. Although racial/ethnic minorities have greater AUD consequences than whites, whether AUD medication receipt varies across race/ethnicity is unknown. We evaluate this in a national sample. METHODS: Electronic health records data were extracted for all black, Hispanic, and/or white patients who received care at the U.S. Veterans Health Administration (VA) during Fiscal Year 2012 and had a documented AUD diagnosis...
July 11, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28727714/3d-morphometric-analysis-of-normal-sacroiliac-joints-a-new-classification-of-surface-shape-variation-and-the-potential-implications-in-pain-syndromes
#7
Mary Kristen Jesse, Christopher Kleck, Adam Williams, Brian Petersen, Deborah Glueck, Kimberly Lind, Vikas Patel
BACKGROUND: Normal sacroiliac (SI) joints vary widely in shape, and it is unclear whether SI joint morphology plays a role in the development of pain. To answer this question, we used 3D-CT surface rendering to image healthy study participants and used the resulting images to develop a classification system for SI joint morphology. In a case-control study comparing health research participants to patients with SI pain, we assessed whether the classification of SI joint morphology was associated with pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727680/quickstats-percentage-of-office-based-primary-care-physicians-accepting-new-patients-by-source-of-payment-accepted-national-electronic-health-records-survey-2015
#8
(no author information available yet)
No abstract text is available yet for this article.
July 21, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28727539/state-and-local-chronic-disease-surveillance-using-electronic-health-record-systems
#9
Michael Klompas, Noelle M Cocoros, John T Menchaca, Diana Erani, Ellen Hafer, Brian Herrick, Mark Josephson, Michael Lee, Michelle D Payne Weiss, Bob Zambarano, Karen R Eberhardt, Jessica Malenfant, Laura Nasuti, Thomas Land
OBJECTIVES: To assess the feasibility of chronic disease surveillance using distributed analysis of electronic health records and to compare results with Behavioral Risk Factor Surveillance System (BRFSS) state and small-area estimates. METHODS: We queried the electronic health records of 3 independent Massachusetts-based practice groups using a distributed analysis tool called MDPHnet to measure the prevalence of diabetes, asthma, smoking, hypertension, and obesity in adults for the state and 13 cities...
July 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28726979/chronic-disease-registries-trends-and-challenges
#10
Joachim Schüz, Michael Fored
BACKGROUND: This accompanying editorial is an introduction to the focus theme of "chronic disease registries - trends and challenges". METHODS: A call for papers was announced on the website of Methods of Information in Medicine in April 2016 with submission deadline in September 2016. A peer review process was established to select the papers for the focus theme, managed by two guest editors. RESULTS: Three papers were selected to be included in the focus theme...
July 19, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28726971/an-environment-for-guideline-based-decision-support-systems-for%C3%A2-outpatients-monitoring
#11
Elisa M Zini, Giordano Lanzola, Paolo Bossi, Silvana Quaglini
OBJECTIVES: We propose an architecture for monitoring outpatients that relies on mobile technologies for acquiring data. The goal is to better control the onset of possible side effects between the scheduled visits at the clinic. METHODS: We analyze the architectural components required to ensure a high level of abstraction from data. Clinical practice guidelines were formalized with Alium, an authoring tool based on the PROforma language, using SNOMED-CT as a terminology standard...
July 19, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28726458/getting-started-reply-to-condon-et-al-2017-and-rossiter-2017
#12
Karen A Matthews, Nancy E Adler, Christopher B Forrest, William W Stead
Condon, Weston, and Hill (2017) and Rossiter (2017) expressed concerns about the recommended panel of psychosocial vital signs that should be included in electronic health records (EHRs). Condon et al. (2017) would prefer a broader array of measures and Rossiter (2017) a set of optimal measures based on consensus. Our task was to identify a core set of measures to be used now in all EHRs based on usefulness and low burden. We anticipate that with new evidence, changing needs, and greater input from stakeholders, the recommended measures will be elaborated or modified...
July 2017: American Psychologist
https://www.readbyqxmd.com/read/28726456/reconsidering-what-is-vital-about-vital-signs-in-electronic-health-records-comment-on-matthews-et-al-2016
#13
David M Condon, Sara J Weston, Patrick L Hill
The inclusion of psychosocial variables into electronic health records provides a unique opportunity for the translation of findings from social, psychological, and behavioral domains into patient care. This commentary is a response to the recommendations of a committee convened by the Institute of Medicine to address this opportunity (Matthews, Adler, Forrest, & Stead, 2016). We concur with the committee that the inclusion of psychosocial variables in electronic health records will broadly benefit researchers, practitioners, and patients and that there is clear need for a recommended panel of psychosocial measures that is ready for implementation in clinical settings...
July 2017: American Psychologist
https://www.readbyqxmd.com/read/28725983/dabigatran-and-vitamin-k-antagonists-use-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-a-cross-sectional-study-of-primary-care-based-electronic-health-records
#14
Bogdan Vlacho, Maria Giner-Soriano, Edurne Zabaleta-Del-Olmo, Albert Roso-Llorach, Ana García-Sangenís, Rosa Morros-Pedrós
PURPOSE: The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs). METHODS: We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed...
July 19, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28725259/cardiovascular-disease-risk-and-prevention-amongst-syrian-refugees-mixed-methods-study-of-m%C3%A3-decins-sans-fronti%C3%A3-res-programme-in-jordan
#15
Dylan R J Collins, Kiran Jobanputra, Thomas Frost, Shoaib Muhammed, Alison Ward, Abed Alrazzaq Shafei, Taissir Fardous, Sadeq Gabashneh, Carl Heneghan
BACKGROUND: The growing burden of non-communicable diseases (NCDs) presented new challenges for medical humanitarian aid and little was known about primary health care approaches for these diseases in humanitarian response. We aimed to evaluate Médecins Sans Frontières (MSF's) use of total CVD risk based prevention strategies amongst Syrian refugees in northern Jordan to identify opportunities to improve total CVD risk based guidance for humanitarian settings. METHODS: We evaluated CVD risk assessment and management in two outpatient NCD clinics in the Irbid governorate of Jordan using a mixed methods design with qualitative and quantitative strands of equal priority, integrated during data collection and interpretation...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28724743/improving-the-healthcare-response-to-domestic-violence-and-abuse-in-sexual-health-clinics-feasibility-study-of-a-training-support-and-referral-intervention
#16
Alex Hardip Sohal, Neha Pathak, Sarah Blake, Vanessa Apea, Judith Berry, Jayne Bailey, Chris Griffiths, Gene Feder
OBJECTIVES: Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments)...
July 19, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28724368/utilizing-patient-data-from-the-veterans-administration-electronic-health-record-to-support-web-based-clinical-decision-support-informatics-challenges-and-issues-from-three-clinical-domains
#17
Nallakkandi Rajeevan, Kristina M Niehoff, Peter Charpentier, Forrest L Levin, Amy Justice, Cynthia A Brandt, Terri R Fried, Perry L Miller
BACKGROUND: The US Veterans Administration (VA) has developed a robust and mature computational infrastructure in support of its electronic health record (EHR). Web technology offers a powerful set of tools for structuring clinical decision support (CDS) around clinical care. This paper describes informatics challenges and design issues that were confronted in the process of building three Web-based CDS systems in the context of the VA EHR. METHODS: Over the course of several years, we implemented three Web-based CDS systems that extract patient data from the VA EHR environment to provide patient-specific CDS...
July 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28723845/lean-six-sigma-techniques-to-improve-ophthalmology-clinic-efficiency
#18
Thomas A Ciulla, Mohan V Tatikonda, Yehya A ElMaraghi, Rehan M Hussain, Amanda L Hill, Julie M Clary, Eyas Hattab
PURPOSE: Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care...
July 18, 2017: Retina
https://www.readbyqxmd.com/read/28723587/evaluation-of-an-electronic-clinical-decision-support-tool-for-incident-elevated-bp-in-adolescents
#19
Elyse Olshen Kharbanda, Stephen E Asche, Alan Sinaiko, James D Nordin, Heidi L Ekstrom, Patricia Fontaine, Steven P Dehmer, Nancy E Sherwood, Patrick J O'Connor
OBJECTIVE: To evaluate, among adolescents 10-17 years with an incident hypertensive BP (≥95(th) percentile) at a primary care visit, whether TeenBP, a novel electronic health record (EHR) linked clinical decision support tool (CDS), improved recognition of elevated BP and return for follow-up BP evaluation. METHODS: We conducted a pragmatic cluster randomized trial in 20 primary care clinics in a large Midwestern medical group. Ten clinics received the TeenBP CDS, including an alert to remeasure a hypertensive BP at that visit, an alert that a hypertensive BP should be repeated in 1-3 weeks and patient-specific order sets...
July 16, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28723312/alcohol-marijuana-and-opioid-use-disorders-5-year-patterns-and-characteristics-of-emergency-department-encounters
#20
Amber L Bahorik, Derek D Satre, Andrea H Kline-Simon, Constance M Weisner, Kelly C Young-Wolff, Cynthia I Campbell
BACKGROUND: Changes in substance use patterns stemming from opioid misuse, ongoing drinking problems, and marijuana legalization may result in new populations of patients with substance use disorders (SUDs) using emergency department (ED) resources. This study examined ED admission trends in a large sample of patients with alcohol, marijuana, and opioid use disorder in an integrated health system. METHODS: In a retrospective design, electronic health record (EHR) data identified patients with ≥ 1 of three common SUDs in 2010 (n = 17,574; alcohol, marijuana, or opioid use disorder) and patients without SUD (n = 17,574)...
July 19, 2017: Substance Abuse
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