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https://www.readbyqxmd.com/read/29141187/factors-associated-with-final-year-nursing-students-desire-to-work-in-the-primary-health-care-setting-findings-from-a-national-cross-sectional-survey
#1
Jacqueline G Bloomfield, Christina Aggar, Tamsin H T Thomas, Christopher J Gordon
BACKGROUND: Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs...
October 23, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29140917/medical-trainees-experiences-of-treating-people-with-chronic-pain-a-lost-opportunity-for-medical-education
#2
Kathleen Rice, Jae Eun Ryu, Cynthia Whitehead, Joel Katz, Fiona Webster
PURPOSE: Evidence suggests that physicians' opinions about chronic pain patients become progressively negative over the course of medical training, leading to a decline in empathy for these patients. Few qualitative studies have focused on this issue and thus the experiences shaping this process remain unexplored. This study addressed how medical trainees learn about chronic pain management through informal and formal curricula. METHOD: This study adopted a descriptive qualitative interview-based approach informed by the theoretical lens of the hidden curriculum...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29138742/hysterectomy-pathway-as-the-global-engine-of-practice-change-implications-for-value-in-care
#3
Amin Sanei-Moghaddam, Sharon Goughnour, Robert Edwards, John Comerci, Joseph Kelley, Nicole Donnellan, Faina Linkov, Suketu Mansuria
Introduction: In 2012, University of Pittsburgh Medical Center (UPMC) introduced a hysterectomy clinical pathway to reduce the number of total abdominal hysterectomies performed for benign gynecological indications. This study focused on exploring physician and patient factors impacting the utilization of hysterectomy clinical pathways. Methods: An online survey with 24 questions was implemented to explore physicians' attitudes and perceived barriers toward implementing the pathway...
2017: Central Asian Journal of Global Health
https://www.readbyqxmd.com/read/29138614/development-of-a-health-care-systems-curriculum
#4
Zachary Pruitt, Rahul Mhaskar, Bryan G Kane, Robert D Barraco, Deborah J DeWaay, Alex M Rosenau, Kristin A Bresnan, Marna Rayl Greenberg
Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29138528/the-predictive-value-of-pitx2-dna-methylation-for-high-risk-breast-cancer-therapy-current-guidelines-medical-needs-and-challenges
#5
REVIEW
Michaela Aubele, Manfred Schmitt, Rudolf Napieralski, Stefan Paepke, Johannes Ettl, Magdalena Absmaier, Viktor Magdolen, John Martens, John A Foekens, Olaf G Wilhelm, Marion Kiechle
High-risk breast cancer comprises distinct tumor entities such as triple-negative breast cancer (TNBC) which is characterized by lack of estrogen (ER) and progesterone (PR) and the HER2 receptor and breast malignancies which have spread to more than three lymph nodes. For such patients, current (inter)national guidelines recommend anthracycline-based chemotherapy as the standard of care, but not all patients do equally benefit from such a chemotherapy. To further improve therapy decision-making, predictive biomarkers are of high, so far unmet, medical need...
2017: Disease Markers
https://www.readbyqxmd.com/read/29138124/comparison-of-allergen-responses-based-on-the-true-test-and-iq-chamber-system-in-korean-patients
#6
Won Joo Kwon, Joo Yeon Ko, Young Suck Ro, Myung Hwa Kim, Byung Soo Kim, Hye One Kim, Jae Hui Nam, Ga-Young Lee, Mi Youn Park, Sang Wook Son, Jun Mo Yang, Dong Hun Lee, Ai Young Lee, Jun Young Lee, Sung Eun Chang, Hae Young Choi, Eun Joo Park
A comparison between responses to allergens based on the TRUE Test(®)(TT) and IQ(®) Chamber (IQC) in Europeans has been previously reported, however, no such study has been performed in Asians. To compare allergen responses using the TT and IQC (using the Korean standard series) in order to gather more information regarding the positive response rates for each allergen and the clinical value of IQC. Suspected contact dermatitis patients were enrolled and tested with 18 allergens using the TT and IQC. The test was performed in 214 patients...
November 14, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/29137959/moving-from-clinic-to-home-what-the-future-holds-for-ophthalmic-telemedicine
#7
Nancy M Holekamp
PURPOSE: To describe the expanding role of telemedicine in healthcare, the key criteria required for a successful device and program implementation, and the current and future role of home monitoring in ophthalmology. DESIGN: Expert perspective METHODS: Analysis with real-world interpretation of home monitoring technologies including current adoption barriers and expanded future demands based on demographic and market forces. RESULTS: Remote patient monitoring represents a paradigm shift in the way physicians care for patients...
November 11, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29137505/choosing-wisely-how-to-fulfill-the-promise-in-the-next-5-years
#8
Eve A Kerr, Jeffrey T Kullgren, Sameer D Saini
Low-value care-the use of unnecessary and potentially harmful health care services-accounted for roughly $200 billion in wasteful spending in the United States in 2011. In 2012 the ABIM Foundation and Consumer Reports launched the Choosing Wisely® campaign, inspired by the idea that professional societies and health care providers should take the lead in defining and motivating efforts to reduce the use of low-value care. But decreases in that use have been slow in coming. We discuss the campaign's significant accomplishments in the past five years and summarize the work that is needed to fulfill the promise of Choosing Wisely...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29136895/reactive-low-temperature-plasma-ionization-mass-spectrometry-for-the-determination-of-organic-uv-filters-in-personal-care-products
#9
Xuelu Ding, Stefanie Gerbig, Bernhard Spengler, Sabine Schulz
Organic UV filters in personal care products (PCPs) have been persistently reported as a potential threat to human health. In order to guarantee consumers(') safety, the dose of these compounds in PCPs needs to be monitored. Here, a methodology based on reactive low temperature plasma ionization (LTP) mass spectrometry (MS) has been developed for the determination of common organic UV filters in PCPs including benzophenone-3, ethylhexyl dimethyl p-aminobenzoic acid, ethylhexyl methoxycinnamate, 4-methylbenzylidene camphor, octocrylene, and ethylhexyl salicylate...
February 1, 2018: Talanta
https://www.readbyqxmd.com/read/29136461/enzyme-free-nucleic-acid-amplification-assay-using-a-cellphone-based-well-plate-fluorescence-reader
#10
Donghyuk Kim, Qingshan Wei, Dong Hyeok Kim, Derek Tseng, Jingzi Zhang, Eric Pan, Omai Brandt Garner, Aydogan Ozcan, Dino Di Carlo
Nucleic acids, DNA and RNA, provide important fingerprint information for various pathogens and have significant diag-nostic value; however, improved approaches are urgently needed to enable rapid detection of nucleic acids in simple point-of-care formats with high sensitivity and specificity. Here, we present a system that utilizes a series of toehold-triggered hy-bridization/displacement reactions that are designed to convert a given amount of RNA molecules (i.e., the analyte) into an amplified amount of signaling molecules without any washing steps or thermocycling...
November 14, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29136443/derivation-and-external-validation-of-prediction-models-for-advanced-chronic-kidney-disease-following-acute-kidney-injury
#11
Matthew T James, Neesh Pannu, Brenda R Hemmelgarn, Peter C Austin, Zhi Tan, Eric McArthur, Braden J Manns, Marcello Tonelli, Ron Wald, Robert R Quinn, Pietro Ravani, Amit X Garg
Importance: Some patients will develop chronic kidney disease after a hospitalization with acute kidney injury; however, no risk-prediction tools have been developed to identify high-risk patients requiring follow-up. Objective: To derive and validate predictive models for progression of acute kidney injury to advanced chronic kidney disease. Design, Setting, and Participants: Data from 2 population-based cohorts of patients with a prehospitalization estimated glomerular filtration rate (eGFR) of more than 45 mL/min/1...
November 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29136150/using-value-stream-mapping-to-improve-quality-of-care-in-low-resource-facility-settings
#12
Rohit Ramaswamy, Claire Rothschild, Funmi Alabi, Eric Wachira, Faith Muigai, Nick Pearson
Quality problem or issue: Jacaranda Health (JH) is a Kenya-based organization that attempts to provide affordable, high-quality maternal and newborn healthcare through a chain of private health facilities in Nairobi. Initial assessment: JH needed to adopted quality improvement as an organization-wide strategy to optimize effectiveness and efficiency. Choice of solution: Value Stream Mapping, a Lean Management tool, was used to engage staff in prioritizing opportunities to improve clinical outcomes and patient-centered quality of care...
November 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29135761/ten-ceo-imperatives-for-healthcare-transformation-lessons-from-top-performing-academic-medical-centers
#13
J Seth Chatfield, Clinton O Longenecker, Laurence S Fink, Jeffery P Gold
The transition from a delivery model based on volume to a model based on value is underpinning an unprecedented rate of change in healthcare. Our research identifies academic medical centers that have successfully moved their organizations from a volume-based care delivery model to a model that is based on value, achieving top decile performance in the transition. We asked senior leaders about their key imperatives in achieving system-wide healthcare transformations.Major teaching hospitals were sampled using data envelopment analysis to identify hospitals that produced the best value-based purchasing process of care, Hospital Consumer Assessment of Healthcare Providers and Systems scores, and mortality scores with the most efficient utilization of human and financial organizational resources...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#14
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135615/diffusion-of-bevacizumab-across-oncology-practices-an-observational-study
#15
Nancy L Keating, Haiden A Huskamp, Deborah Schrag, John M McWilliams, Barbara J McNeil, Bruce E Landon, Michael E Chernew, Sharon-Lise T Normand
BACKGROUND: Technological advances can improve care and outcomes but are a primary driver of health care spending growth. Understanding diffusion and use of new oncology therapies is important, given substantial increases in prices and spending on such treatments. OBJECTIVES: Examine diffusion of bevacizumab, a novel (in 2004) and high-priced biologic cancer therapy, among US oncology practices during 2005-2012 and assess variation in use across practices. RESEARCH DESIGN: Population-based observational study...
November 10, 2017: Medical Care
https://www.readbyqxmd.com/read/29135524/a-palliative-approach-for-heart-failure-end-of-life-care
#16
Jane Maciver, Heather J Ross
PURPOSE OF REVIEW: The current review discusses the integration of guideline and evidence-based palliative care into heart failure end-of-life (EOL) care. RECENT FINDINGS: North American and European heart failure societies recommend the integration of palliative care into heart failure programs. Advance care planning, shared decision-making, routine measurement of symptoms and quality of life and specialist palliative care at heart failure EOL are identified as key components to an effective heart failure palliative care program...
November 10, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29134954/completion-axillary-lymph-node-dissection-can-be-avoid-in-patients-with-invasive-breast-cancer-and-sentinel-lymph-node-micrometastases
#17
Calogero Cipolla, Giuseppa Graceffa, Sergio Calamia, Stefania Latteri, Marco Vito Marino, Mario Latteri, Salvatore Vieni
BACKGROUND: The prognostic value of sentinel lymph node (SLN) micrometastases in invasive breast cancer patients is still widely debated. Even if, in the absence of unequivocal guidelines, the axillary lynphadenectomy is not still performed in the routine clinical care of these patients. MATERIALS AND METHOD: We have retrospectively analyzed 897 patients with operable invasive breast cancer and clinically negative axillary lymph nodes underwent conservative surgery or total mastectomy with SLN biopsy...
November 14, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29134191/assessing-treatment-response-in-triple-negative-breast-cancer-from-quantitative-image-analysis-in-perfusion-magnetic-resonance-imaging
#18
Imon Banerjee, Sadhika Malladi, Daniela Lee, Adrien Depeursinge, Melinda Telli, Jafi Lipson, Daniel Golden, Daniel L Rubin
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is sensitive but not specific to determining treatment response in early stage triple-negative breast cancer (TNBC) patients. We propose an efficient computerized technique for assessing treatment response, specifically the residual tumor (RT) status and pathological complete response (pCR), in response to neoadjuvant chemotherapy. The proposed approach is based on Riesz wavelet analysis of pharmacokinetic maps derived from noninvasive DCE-MRI scans, obtained before and after treatment...
January 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29133491/exploring-attributes-of-high-value-primary-care
#19
Melora Simon, Niteesh K Choudhry, Jim Frankfort, David Margolius, Julia Murphy, Luis Paita, Thomas Wang, Arnold Milstein
PURPOSE: Medicare's merit-based incentive payment system and narrowing of physician networks by health insurers will stoke clinicians' and policy makers' interest in care delivery attributes associated with value as defined by payers. METHODS: To help define these attributes, we analyzed 2009 to 2011 commercial health insurance claims data for more than 40 million preferred provider organization patients attributed to over 53,000 primary care practice sites. We identified sites ranking favorably on both quality and low total annual per capita health care spending ("high-value") and sites ranking near the median ("average-value")...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133314/decisional-needs-assessment-of-patients-with-complex-care-needs-in-primary-care-a-participatory-systematic-mixed-studies-review-protocol
#20
Mathieu Bujold, Pierre Pluye, France Légaré, Jeannie Haggerty, Genevieve C Gore, Reem El Sherif, Marie-Eve Poitras, Marie-Claude Beaulieu, Marie-Dominique Beaulieu, Paula L Bush, Yves Couturier, Beatrice Débarges, Justin Gagnon, Anik Giguère, Roland Grad, Vera Granikov, Serge Goulet, Catherine Hudon, Bernardo Kremer, Edeltraut Kröger, Irina Kudrina, Bertrand Lebouché, Christine Loignon, Marie-Therese Lussier, Cristiano Martello, Quynh Nguyen, Rebekah Pratt, Benoit Rihoux, Ellen Rosenberg, Isabelle Samson, Nicolas Senn, David Li Tang, Masashi Tsujimoto, Isabelle Vedel, Bruno Ventelou, Michel Wensing
INTRODUCTION: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners)...
November 12, 2017: BMJ Open
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