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https://www.readbyqxmd.com/read/28545159/the-value-transformation-of-health-care-impact-on-neuromuscular-and-electrodiagnostic-medicine
#1
Pushpa Narayanaswami, Millie Suk, Lyell K Jones
INTRODUCTION: Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. METHODS: Review of emerging trends in development of value-based healthcare systems in the US. RESULTS: MACRA and the resulting Quality Payment Program (QPP) create two participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway...
May 25, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28544903/estrogen-receptor-%C3%AE-deficiency-impairs-bdnf-5-ht2a-signaling-in-the-hippocampus-of-female-brain-a-possible-mechanism-for-menopausal-depression
#2
Anindit Chhibber, Sarah K Woody, M A Karim Rumi, Michael J Soares, Liqin Zhao
Depression currently affects 350 million people worldwide and 19 million Americans each year. Women are 2.5 times more likely to experience major depression than men, with some women appearing to be at a heightened risk during the menopausal transition. Estrogen signaling has been implicated in the pathophysiology of mood disorders including depression; however, the underlying mechanisms are poorly understood. In this study, the role of estrogen receptor (ER) subtypes, ERα and ERβ, in the regulation of brain-derived neurotrophic factor (BDNF) and serotonin (5-HT) signaling was investigated; two pathways that have been hypothesized to be interrelated in the etiology of depression...
May 18, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28544576/atypical-adenoma-of-the-thyroid-diagnosed-as-anaplastic-cancer-by-cytopathology
#3
Hiromitsu Hatakeyama, Kimiko Hoshino, Kenji Mizoguchi, Takayoshi Suzuki, Kanako C Hatanaka, Yukie Yamaya, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma
Atypical adenoma of the thyroid is a rare form of tumor, and its accurate diagnosis prior to surgical resection is difficult as the histological and pathological morphologies are very similar to those of anaplastic thyroid carcinoma (ATC), and its anaplastic transformation remains to be elucidated. We reported a case of a 75-year-old female with a thyroid isthmus nodule diagnosed repeatedly by FNAC as anaplastic carcinoma. Both the first and second FNAC specimen slides showed a large number of scattered or aggregated atypical cells consisting of large, pleomorphic nuclei with irregular membranes, chromatin clumps and prominent nucleoli...
May 22, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28544421/japan-s-115-year-trend-of-inter-prefectural-disparities-in-under-five-mortality
#4
Chie Nagata, Akinori Moriichi, Naho Morisaki, Ruoyan Gai-Tobe, Akira Ishiguro, Rintaro Mori
BACKGROUND: Child poverty is a growing, serious issue in Japan, where various social disparities are widening. Numerous reports have focused on the relationship between social inequity and health. However, few studies have assessed how the overall magnitude of disparities in child health has changed over the course of drastic social and economic transitions from 1899 to more recent times. In this study, we assessed the trend of the under-five mortality rate (U5MR) and its inter-prefectural disparities in Japan...
May 23, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28544070/the-importance-of-assessing-out-of-pocket-payments-when-the-financing-of-antiretroviral-therapy-is-transitioned-to-domestic-funding-findings-from-vietnam
#5
Benjamin Johns, Le Bao Chau, Kieu Huu Hanh, Nguyen Thuy Huong, Hoa Mai Do, Anh Thuy Duong, Long Hoang Nguyen
OBJECTIVE: To assess out-of-pocket payments and catastrophic health expenditures among antiretroviral therapy (ART) patients in Vietnam, and to model catastrophic payments under different copayment scenarios when the primary financing of ART changes to social health insurance. METHODS: Cross-sectional facility-based survey of 843 patients at 42 health facilities representative of 87% of ART patients in 2015. RESULTS: Because of donor and government funding, no payments were made for antiretroviral drugs...
May 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28543762/male-partnered-bisexual-women-s-perceptions-of-disclosing-sexual-orientation-to-family-across-the-transition-to-parenthood-intensifying-heteronormativity-or-queering-family
#6
Abbie E Goldberg, Katherine R Allen, Themal Ellawala, Lori E Ross
Drawing from queer and communication privacy management frameworks, this study examines the narratives of 22 bisexual, male-partnered women who were interviewed during the perinatal period and one year postnatally about their disclosures of sexual identity to family of origin. Most women rarely discussed their sexual identity with family; participants who had disclosed described such disclosures as provoking discomfort. Some women stated that their parental status seemed to invalidate the need to talk about their sexual history or identity with family, due its declining salience and increased concerns about judgment...
May 24, 2017: Journal of Marital and Family Therapy
https://www.readbyqxmd.com/read/28542399/cost-effectiveness-of-a-school-based-health-promotion-program-in-canada-a-life-course-modeling-approach
#7
John Paul Ekwaru, Arto Ohinmaa, Bach Xuan Tran, Solmaz Setayeshgar, Jeffrey A Johnson, Paul J Veugelers
BACKGROUND: The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools) has been recognized as a "best practice" in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project's cost-effectiveness following a life-course approach. METHODS: We developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools...
2017: PloS One
https://www.readbyqxmd.com/read/28542344/dynamic-changes-of-anterior-segment-in-patients-with-different-stages-of-primary-angle-closure-in-both-eyes-and-normal-subjects
#8
Jialiu Lin, Zhonghao Wang, Chuchen Chung, Jianan Xu, Miaomiao Dai, Jingjing Huang
PURPOSE: To compare changes in anterior segment parameters under light and dark (light-to-dark) conditions among eyes with chronic primary angle-closure glaucoma (CPACG), fellow eyes with confirmed or suspect primary angle-closure (PAC or PACS), and age-matched healthy eyes. METHODS: Consecutive patients with CPACG in one eye and PAC/PACS in the fellow eye, as well as age-matched healthy subjects were recruited. Anterior segment optical coherence tomography measurements were conducted under light and dark conditions, and anterior chamber, lens, and iris parameters compared...
2017: PloS One
https://www.readbyqxmd.com/read/28542322/transition-from-pediatric-to-adult-medical-care-a-survey-in-young-persons-with-inflammatory-bowel-disease
#9
Antje Timmer, Jenny Peplies, Max Westphal, Birgit Kaltz, Antje Ballauff, Martin Claßen, Martin W Laass, Sibylle Koletzko
BACKGROUND: Transition to adult health services is a vulnerable phase in young persons with chronic disease. We describe how young persons with inflammatory bowel disease in Germany and Austria experience care during the transitional age, focusing on differences by type of provider (pediatric vs. adult specialist, no specialist). METHODS: This was a follow up survey in patients previously registered with a pediatric IBD registry. Patients aged 15 to 25 received a postal questionnaire, including a measure of health care experience and satisfaction...
2017: PloS One
https://www.readbyqxmd.com/read/28541746/the-evolving-cystic-fibrosis-microbiome-a-comparative-cohort-study-spanning-sixteen-years
#10
Nicole Acosta, Fiona J Whelan, Ranjani Somayaji, Ali Poonja, Michael G Surette, Harvey R Rabin, Michael D Parkins
RATIONALE: The cystic fibrosis (CF) airways are infected with a diverse polymicrobial community. OBJECTIVES: Understanding how changes in the CF microbiome have occurred over time, similar to the observed changes in the prevalence of cultured pathogens, is key in understanding the microbiome's role in disease. METHODS: Drawing from a prospectively collected and maintained sputum biobank, we identified 45 patients with sputum samples collected between the ages of 18-21 years in three successive cohorts of adults transitioning to our CF clinic: A(1997-2000), B(2004-2007), and C(2010-2013)...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28541436/changes-in-sleep-duration-during-transition-to-statutory-retirement-a-longitudinal-cohort-study
#11
Saana Myllyntausta, Paula Salo, Erkki Kronholm, Ville Aalto, Mika Kivimäki, Jussi Vahtera, Sari Stenholm
Study Objectives: This study examined whether sleep duration changes during the transition from full-time work to statutory retirement and, if this were the case, which pre-retirement factors, including sociodemographic, work, lifestyle and health factors, predict these changes. Methods: Data from repeated surveys of the Finnish Public Sector study, linked to records of retirement, were used. The study population consisted of 5,785 participants who retired on a statutory basis in 2000-2011 and who had responded to surveys on sleep duration at least once immediately before and after their retirement (mean number of repeat study waves 3...
May 24, 2017: Sleep
https://www.readbyqxmd.com/read/28541122/chance-of-surgery-in-adult-congenital-heart-disease
#12
Carianne L Verheugt, Cuno Spm Uiterwaal, Ilonca Vaartjes, Enno T van der Velde, A C Zomer, Folkert J Meijboom, Petronella G Pieper, Marco C Post, Hubert W Vliegen, Mark G Hazekamp, Diederick E Grobbee, Barbara Jm Mulder
Background Young patients with congenital heart disease reaching adulthood face mandatory transition to adult cardiology. Their new cardiologist needs to assess the chances of major future events such as surgery. Using a large national registry, we assessed if patient characteristics at the age of 18 years could predict the chance of congenital heart surgery in adulthood. Design and methods Of 10,300 patients from the CONCOR national registry, we used general patient characteristics at age 18 years, underlying congenital heart defect, history of complications, and interventions in childhood as potential predictors of congenital heart surgery occurring from age 18 years up to age 40 and 60 years...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28540076/techniques-for-intraoperative-graft-assessment-in-coronary-artery-bypass-surgery
#13
REVIEW
Lucas B Ohmes, Antonino Di Franco, Gabriele Di Giammarco, Carlo Maria Rosati, Christopher Lau, Leonard N Girardi, Massimo Massetti, Mario Gaudino
Early graft patency is a major determinant of morbidity and mortality following coronary artery bypass surgery. Long-term graft failure is caused by intimal hyperplasia and atherosclerosis, while early failure, especially in the first year, has been attributed, in part, to surgical error. The need for intraoperative graft evaluation is paramount to determine need for revision and ensure future functioning grafts. Transit time flowmetry (TTFM) is the most commonly used intraoperative modality, however, only about 20% of cardiac surgeons in North America use TTFM...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28540048/medication-self-management-skills-and-cognitive-impairment-in-older-adults-hospitalized-for-heart-failure-a-cross-sectional-study
#14
Erik H Howell, Alpana Senapati, Eileen Hsich, Eiran Z Gorodeski
BACKGROUND: Cognitive impairment is highly prevalent among older adults (aged ≥65 years) hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management skills in this population has not been clearly defined. OBJECTIVE: We assessed the cognition of consecutive older adults hospitalized for heart failure, in relation to their medication self-management skills...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28539686/lifecourse-transitions-gender-and-drinking-in-later-life
#15
Clare Holdsworth, Martin Frisher, Marina Mendonça, Cesar DE Oliveiria, Hynek Pikhart, Nicola Shelton
Older people consume less alcohol than any other adult age group. However, in recent years survey data on alcohol consumption in the United Kingdom have shown that while younger age groups have experienced a decline in alcohol consumption, drinking behaviours among the elderly have not reduced in the same way. This paper uses data from the English Longitudinal Study of Ageing to analyse both the frequency and quantity of older adult's alcohol consumption using a lifecourse approach over a ten-year period. Overall drinking declined over time and the analysis examined how socio-economic characteristics, partnership, employment and health statuses were associated with differences in drinking behaviours and how these changed over time...
March 2017: Ageing and Society
https://www.readbyqxmd.com/read/28539674/nutrition-label-experience-and-consumption-of-transitional-foods-among-a-nationwide-cohort-of-42-750-thai-adults
#16
Wimalin Rimpeekool, Martyn Kirk, Vasoontara Yiengprugsawan, Cathy Banwell, Sam-Ang Seubsman, Adrian Sleigh
PURPOSE: The purpose of this paper is to assess the usefulness of nutrition labels in Thailand during nutrition transition from traditional to modern diets that increase salt, sugar, and calorie intake and to note socio-demographic interactions and associations with consumption of transitional processed foods. DESIGN/METHODOLOGY/APPROACH: The authors studied 42,750 distance learning Open University adults aged 23-96 years in 2013 residing nationwide and participating in an ongoing community-based prospective cohort study...
2017: Br Food J
https://www.readbyqxmd.com/read/28539632/a-seven-million-year-hornblende-mineral-record-from-the-central-chinese-loess-plateau
#17
Tong He, Lianwen Liu, Yang Chen, Xuefen Sheng, Junfeng Ji
Previous studies of the late Cenozoic erosion rate have yielded different views-long-term stable rates or a significant increase at climate transitions-leading to uncertainty concerning the hypothesized global erosion rate controlled by either tectonic uplift or climatic changes. Here, we present a seven-million-year hornblende mineral record along the Lingtai section of the Chinese Loess Plateau. By examining the spatial distribution of hornblende minerals in seven desert basins, which are potential loess source areas, we constructed a ratio of hornblende versus total heavy minerals to reflect past changes in physical/chemical weathering strength...
May 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#18
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28538287/cost-utility-analysis-of-reconstruction-compared-with-primary-amputation-for-patients-with-severe-lower-limb-trauma-in-colombia
#19
Mateo Ceballos, Carlos Oliver Valderrama, Luis Esteban Orozco, Laura Sánchez, Juan Pablo Valderrama, Luz Helena Lugo
BACKGROUND: To establish, from the health system perspective, the cost-utility relationship of limb reconstruction compared with primary amputation for patients over 32 years with grade IIIB and IIIC severe lower limb trauma in Colombia, S.A. METHODS: A Markov model was built including different short-term and long-term states that represent the main events that a patient could experience after a lower limb amputation or a reconstruction. A 42-year time horizon was considered for the base case...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28537853/dermatology-discharge-continuity-clinic-enhances-resident-autonomy-and-insight-into-transitions-of-care-competencies-a-cross-sectional-survey-study
#20
Jasmine Rana, Arash Mostaghimi
Dermatology residents perform consults on hospitalized patients, but are often limited in their ability to follow-up with these patients after discharge, leading to inadequate follow-up and understanding of post-discharge transitions of care. In 2013, a discharge continuity clinic (DCC) staffed by the inpatient consult dermatology resident and attending dermatologist was established at one of the four adult hospital sites residents rotate through in the Harvard Combined Dermatology Residency Program. Resident perceptions about the DCC and their educational experience on inpatient consult rotations with a DCC and without a DCC were obtained using a cross-sectional survey instrument in June 2016...
May 15, 2017: Dermatology Online Journal
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