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https://www.readbyqxmd.com/read/27899227/challenges-to-estimating-vaccine-impact-using-hospitalization-data
#1
Cynthia Schuck-Paim, Robert J Taylor, Lone Simonsen, Roger Lustig, Esra Kürüm, Christian A W Bruhn, Daniel M Weinberger
Because the real-world impact of new vaccines cannot be known before they are implemented in national programs, post-implementation studies at the population level are critical. Studies based on analysis of hospitalization rates of vaccine-preventable outcomes are typically used for this purpose. However, estimates of vaccine impact based on hospitalization data are particularly prone to confounding, as hospitalization rates are tightly linked to changes in the quality, access and use of the healthcare system, which often occur simultaneously with introduction of new vaccines...
November 26, 2016: Vaccine
https://www.readbyqxmd.com/read/27898563/patient-characteristics-associated-with-primary-care-pa-and-aprn-roles
#2
Christine M Everett, Perri Morgan, George L Jackson
OBJECTIVES: Physician assistants (PAs) and advanced practice registered nurses (APRNs) can perform multiple roles on primary care teams, but limited research describes the patients they serve. We sought to identify patient characteristics associated with roles of primary care PAs and APRNs. METHODS: We analyzed adult respondents to the 2010 Health Tracking Household Survey with a primary care usual provider (physician, PA, or APRN). The dependent variable is the PA or APRN role...
December 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27882650/a-qualitative-assessment-of-west-virginia-pharmacist-activities-and-attitude-in-diabetes-management
#3
Aymen Shatnawi, David A Latif
AIMS AND OBJECTIVES: The role of pharmacists in chronic disease state management has been shown to significantly improve patient health outcomes and reduce overall health care costs. The current study is designed to assess the roles and attitudes of West Virginia (WV) pharmacists toward diabetes, evaluate services provided, address pharmacist clinical understanding and training, and demonstrate the challenges that limit pharmacists ability to deliver an efficient disease state management...
November 24, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27878710/the-differential-effect-of-compensation-structures-on-the-likelihood-that-firms-accept-new-patients-by-insurance-type
#4
Justin B Bullock, W David Bradford
Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid...
March 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27869620/safety-and-outcomes-of-inpatient-compared-with-outpatient-surgical-procedures-for-ankle-fractures
#5
Charles Qin, Robert G Dekker, Jordan T Blough, Anish R Kadakia
BACKGROUND: As the cost of health-care delivery rises in the era of bundled payments for care, there is an impetus toward minimizing hospitalization. Evidence to support the safety of open reduction and internal fixation (ORIF) of ankle fractures in the outpatient setting is largely anecdotal. METHODS: Patients who underwent ORIF from 2005 to 2013 were identified via postoperative diagnoses of ankle fracture and Current Procedural Terminology codes; patients with open fractures and patients who were emergency cases were excluded...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27859524/knowledge-attitudes-and-practices-for-respiratory-and-hearing-health-among-midwestern-farmers
#6
Mary E Cramer, Mary J Wendl, Harlan Sayles, Ellen Duysen, Chandran Achutan
OBJECTIVE: The purpose of this study was to assess knowledge, attitudes, and practices for hearing and respiratory health/safety among farmers in seven Midwestern states served by a federally funded Agricultural Center. Findings provided a baseline to longitudinally track the Agricultural Center's program outcomes and to design community education to improve safety and health among farmers. DESIGN AND SAMPLE: This was a cross-sectional study using a 30 item mailed survey to describe farmers' operations, demographics, health conditions, related information sources, and knowledge/attitude/practices for personal protective equipment (PPE) (i...
November 14, 2016: Public Health Nursing
https://www.readbyqxmd.com/read/27844477/videolaryngoscopy-versus-direct-laryngoscopy-for-adult-patients-requiring-tracheal-intubation
#7
REVIEW
Sharon R Lewis, Andrew R Butler, Joshua Parker, Tim M Cook, Andrew F Smith
BACKGROUND: Successful tracheal intubation during general anaesthesia traditionally requires a line of sight to the larynx attained by positioning the head and neck and using a laryngoscope to retract the tongue and soft tissues of the floor of the mouth. Difficulties with intubation commonly arise, and alternative laryngoscopes that use digital and/or fibreoptic technology have been designed to improve visibility when airway difficulty is predicted or encountered. Among these devices, a rigid videolaryngoscope (VLS) uses a blade to retract the soft tissues and transmits a lighted video image to a screen...
November 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27842909/influence-of-a-negative-sestamibi-scan-on-the-decision-for-parathyroid-operation-by-the-endocrinologist-and-surgeon
#8
Susana Wu, Stephanie H Hwang, Philip I Haigh
BACKGROUND: It has been observed that negative sestamibi scans may impact practice patterns in patients with primary hyperparathyroidism. However, there are no published data on the issue. The objective was to elucidate the influence of negative sestamibi scans on referrals by endocrinologists for parathyroidectomy and surgeon decision-making. METHODS: All patients with primary hyperparathyroidism were identified within a region-wide health care system over a 2-year period...
November 11, 2016: Surgery
https://www.readbyqxmd.com/read/27829072/autopsy-prevalence-of-tuberculosis-and-other-potentially-treatable-infections-among-adults-with-advanced-hiv-enrolled-in-out-patient-care-in-south-africa
#9
Aaron S Karat, Tanvier Omar, Anne von Gottberg, Mpho Tlali, Violet N Chihota, Gavin J Churchyard, Katherine L Fielding, Suzanne Johnson, Neil A Martinson, Kerrigan McCarthy, Nicole Wolter, Emily B Wong, Salome Charalambous, Alison D Grant
BACKGROUND: Early mortality among HIV-positive adults starting antiretroviral therapy (ART) remains high in resource-limited settings, with tuberculosis (TB) the leading cause of death. However, current methods to estimate TB-related deaths are inadequate and most autopsy studies do not adequately represent those attending primary health clinics (PHCs). This study aimed to determine the autopsy prevalence of TB and other infections in adults enrolled at South African PHCs in the context of a pragmatic trial of empiric TB treatment ("TB Fast Track")...
2016: PloS One
https://www.readbyqxmd.com/read/27824609/prospective-validation-of-right-ventricular-role-in-primary-graft-dysfunction-after-lung-transplantation
#10
Purificación Pérez-Terán, Oriol Roca, José Rodríguez-Palomares, Juan C Ruiz-Rodríguez, Ana Zapatero, Joaquim Gea, Joaquim Serra, Arturo Evangelista, Joan R Masclans
Primary graft dysfunction is a significant cause of lung transplant morbidity and mortality, but its underlying mechanisms are not completely understood. The aims of the present study were: 1) to confirm that right ventricular function is a risk factor for severe primary graft dysfunction; and 2) to propose a clinical model for predicting the development of severe primary graft dysfunction.A prospective cohort study was performed over 14 months. The primary outcome was development of primary graft dysfunction grade 3...
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27818431/training-medical-students-for-rural-underserved-areas-a-rural-medical-education-program-in-california
#11
W Suzanne Eidson-Ton, Julie Rainwater, Donald Hilty, Stuart Henderson, Christine Hancock, Cathryn L Nation, Thomas Nesbitt
The Association of American Medical Colleges projects an increasing shortage of physicians in rural areas. Medical schools have developed specialty track programs to improve the recruitment and retention of physicians who can serve rural populations. One such program in California includes a variety of unique elements including outreach, admissions, rural clinical experiences, focused mentorship, scholarly and leadership opportunities, and engagement with rural communities. Preliminary outcomes demonstrate that this rural track program has achieved some success in the recruitment, retention, and training of students interested in future rural practice and in the placement of students in primary care residencies...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27815820/the-impact-of-patient-reported-outcome-measures-in-clinical-practice-for-pain-a-systematic-review
#12
REVIEW
Michelle M Holmes, George Lewith, David Newell, Jonathan Field, Felicity L Bishop
PURPOSE: Patient-reported outcome measures (PROMs) have increasingly been incorporated into clinical practice. Research suggests that PROMs could be viewed as active components of complex interventions and may affect the process and outcome of care. This systematic review examines PROMs in the context of treatment for non-malignant pain. METHODS: An electronic search on: MEDLINE, EMBASE, PsycINFO, PsycARTICLES, Cochrane Library and Web of Science identified relevant papers (February 2015)...
November 4, 2016: Quality of Life Research
https://www.readbyqxmd.com/read/27801521/surgical-options-for-lumbar-spinal-stenosis
#13
REVIEW
Gustavo C Machado, Paulo H Ferreira, Rafael Ij Yoo, Ian A Harris, Marina B Pinheiro, Bart W Koes, Maurits W van Tulder, Magdalena Rzewuska, Christopher G Maher, Manuela L Ferreira
BACKGROUND: Hospital charges for lumbar spinal stenosis have increased significantly worldwide in recent times, with great variation in the costs and rates of different surgical procedures. There have also been significant increases in the rate of complex fusion and the use of spinal spacer implants compared to that of traditional decompression surgery, even though the former is known to incur costs up to three times higher. Moreover, the superiority of these new surgical procedures over traditional decompression surgery is still unclear...
November 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#14
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27784416/a-randomized-crossover-trial-of-a-novel-sound-to-sleep-mattress-technology-in-children-with-autism-and-sleep-difficulties
#15
Thomas W Frazier, Jyoti Krishna, Eric Klingemier, Mary Beukemann, Rawan Nawabit, Sally Ibrahim
STUDY OBJECTIVES: This preliminary study investigated the tolerability and efficacy of a novel mattress technology - the Sound-To-Sleep (STS) system - in the treatment of sleep problems in children with autism. METHODS: After screening, 45 children, ages 2.5 to 12.9 years, were randomized to order of mattress technology use (On-Off vs. Off-On). Treatment conditions (On vs. Off) lasted two weeks with immediate crossover. Tolerability, including study discontinuation and parent-report of mattress tolerance and ease of use, was tracked throughout the study...
October 20, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27779505/scholarly-concentration-program-development-a-generalizable-data-driven-approach
#16
Jesse Burk-Rafel, Patricia B Mullan, Heather Wagenschutz, Alexandra Pulst-Korenberg, Eric Skye, Matthew M Davis
PURPOSE: Scholarly concentration programs-also known as scholarly projects, pathways, tracks, or pursuits-are increasingly common in U.S. medical schools. However, systematic, data-driven program development methods have not been described. METHOD: The authors examined scholarly concentration programs at U.S. medical schools that U.S. News & World Report ranked as top 25 for research or primary care (n = 43 institutions), coding concentrations and mission statements...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27770155/addition-of-a-fracture-risk-assessment-to-a-coordinator-s-role-improved-treatment-rates-within-6%C3%A2-months-of-screening-in-a-fragility-fracture-screening-program
#17
D E Beaton, M Vidmar, K B Pitzul, R Sujic, N K Rotondi, E R Bogoch, J E M Sale, R Jain, J Weldon
: We evaluated the impact of a more intensive version of an existing post-fracture coordinator-based fracture prevention program and found that the addition of a full-risk assessment improved treatment rates. These findings provide additional support for more intensive programs aimed at reducing the risk of re-fractures. INTRODUCTION: Evidence-based guidelines support coordinator-based programs to improve post-fracture osteoporosis guideline uptake, with more intensive programs including bone mineral density (BMD) testing and/or treatment being associated with better patient outcomes...
October 21, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27766806/time-to-revisit-recommendations-on-doctor-to-population-ratio-in-india
#18
Madhav V Deo
A buzzword in Indian press and amongst the policy makers is that India is short of the WHO recommended doctor to population ratio of 1:1000. The recommendations were formulated to facilitate programs to achieve some of the health related UN-Millennium Development Goals (MDGs). Infections and malnutrition, which can be comfortably handled by a basic MBBS doctor, were the dominant health issues at the time of the formulation of the MDGs. However, all countries worldwide are going through health epidemiological transition and health impact of the non-communicable disorders (NCDs) can be no more ignored even by the low income nations...
October 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27763703/performance-measures-of-diagnostic-codes-for-detecting-opioid-overdose-in-the-emergency-department
#19
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27754160/pl-03-1-hypertension-management-in-the-era-of-digital-information-and-communication-technologies
#20
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
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