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https://www.readbyqxmd.com/read/28342891/cost-utility-of-group-acceptance-and-commitment-therapy-for-fibromyalgia-versus-recommended-drugs-an-economic-analysis-alongside-a-6-month-randomised-controlled-trial-conducted-in-spain-effigact-study
#1
Juan V Luciano, Francesco D'Amico, Albert Feliu-Soler, Lance M McCracken, Jaume Aguado, María T Peñarrubia-María, Martin Knapp, Antoni Serrano-Blanco, Javier García-Campayo
The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively...
March 22, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28342621/how-nurse-led-practices-perceive-implementation-of-the-patient-centered-medical-home
#2
Rosemary Frasso, A Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-McArthur, Michelle Miller-Day, Robert Gabbay, Peter F Cronholm
PURPOSE: The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. METHODS: Data were collected through in-depth interviews with providers and staff in nurse-led practices...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#3
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339331/differential-diagnosis-of-a-patient-referred-to-physical-therapy-for-dizziness-a-case-report
#4
Zachary Rethorn, Susan J Barlow, Emily Gavlick
STUDY DESIGN: Case report. BACKGROUND: Dizziness is a common and debilitating condition across the lifespan. Patients with this complaint must be carefully examined to determine the cause of dizziness, rule out the presence of central nervous system dysfunction, and determine the appropriateness of physical therapy intervention. CASE DESCRIPTION: A 90-year-old male was referred to physical therapy six months after the onset of dizziness. A thorough history was taken and examination was performed...
March 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28338551/standardizing-robotic-lobectomy-feasibility-and-safety-in-128-consecutive-lobectomies-within-a-single-healthcare-system
#5
John F Lazar, Laurence N Spier, Alan R Hartman, Richard S Lazzaro
OBJECTIVE: Single-surgeon cohorts assessing robotically assisted video-assisted thoracic (RA-VATS) lobectomy have reported good outcomes, but there are little data regarding multiple surgeons applying a standard technique in separate hospitals. The purpose of this study was to show how a standardized robotic technique is both safe and reproducible between surgeons and institutions. METHODS: From July 1, 2012, to October 1, 2013, patients undergoing RA-VATS lobectomy for both benign and malignant disease were identified from a prospectively collected database of two thoracic surgeons from different hospitals within the same healthcare system and retrospectively analyzed...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338038/school-based-dental-sealant-programmes-may-be-effective-in-caries-prevention
#6
Tarek Himida, Ucheka Promise
DesignSplit-mouth randomised controlled clinical trial.InterventionSchool-based dental sealant (SBDS) programme. The study population that was selected from 67-year-old pupils of 16 elementary schools in areas of low socioeconomic status within Nice, France. Children with first permanent molar pairs sufficiently erupted for sealing with no caries (ICDAS [International Caries Detection and Assessment System] 0) or initial enamel lesions (ICDAS 1-2) were included. Children were randomised to either the intervention group (light polymerised resin-based sealant with fluoride) or the control group (no treatment)...
March 2017: Evidence-based Dentistry
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#7
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28337038/pilot-study-of-methods-for-assessing-unmet-secondary-health-care-need-in-new-zealand
#8
Philip Bagshaw, Susan Bagshaw, Christopher Frampton, Robin Gauld, Terri Green, Charlotte Harris, Andrew Hornblow, Ben Hudson, Antony Raymont, Ann Richardson, Carl Shaw, Les Toop
AIMS: In this pilot study, the primary aim was to compare four potential methods for undertaking a national survey of unmet secondary healthcare need in New Zealand (one collecting data from GPs, and three from community surveys). The secondary aim was to obtain an estimate of the prevalence of unmet secondary healthcare need, to inform sample size calculations for a national survey. METHODS: An electronic system was set up for GPs in Christchurch (Pegasus PHO) and Auckland (Auckland PHO) to record cases of unmet need as encountered in clinics...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28336742/current-and-potential-providers-of-blood-pressure-self-screening-a-mixed-methods-study-in-oxfordshire
#9
A C Tompson, S G Fleming, C J Heneghan, R J McManus, S M Greenfield, F D R Hobbs, A M Ward
OBJECTIVES: To (1) establish the extent of opportunities for members of the public to check their own blood pressure (BP) outside of healthcare consultations (BP self-screening), (2) investigate the reasons for and against hosting such a service and (3) ascertain how BP self-screening data are used in primary care. DESIGN: A mixed methods, cross-sectional study. SETTING: Primary care and community locations in Oxfordshire, UK. PARTICIPANTS: 325 sites were surveyed to identify where and in what form BP self-screening services were available...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336249/current-epidemiology-of-revision-total-hip-arthroplasty-in-the-united-states-national-inpatient-sample-2009-to-2013
#10
Chukwuweike U Gwam, Jaydev B Mistry, Nequesha S Mohamed, Melbin Thomas, Kevin C Bigart, Michael A Mont, Ronald E Delanois
BACKGROUND: Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure...
February 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28335987/community-health-indicators-associated-with-outcomes-of-pancreatectomy
#11
Lauren Slakey Pointer, Zaid Al-Qurayshi, David Taylor Pointer, Emad Kandil, Douglas Philip Slakey
PURPOSE: This study evaluates the association of environmental, social and health risk factors in relation to outcomes of pancreatic surgery. METHODS: Patients who underwent pancreatectomy with a 30 day postoperative follow up in Florida, New York and Washington states were identified using the State Inpatient Databases (SID) from 2010 to 2011. This data was merged with community health indicators complied from the County Health Ranking database. Fourteen community health indicators were used to determine higher risk communities...
March 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28335734/evaluation-of-amstar-to-assess-the-methodological-quality-of-systematic-reviews-in-overviews-of-reviews-of-healthcare-interventions
#12
Michelle Pollock, Ricardo M Fernandes, Lisa Hartling
BACKGROUND: Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews...
March 23, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28335444/hiv-education-and-welfare-services-in-primary-care-an-empirical-model-of-integration-in-brazil-s-unified-health-system
#13
Rahbel Rahman, Rogério M Pinto, Melanie M Wall
Integration of health education and welfare services in primary care systems is a key strategy to solve the multiple determinants of chronic diseases, such as Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS). However, there is a scarcity of conceptual models from which to build integration strategies. We provide a model based on cross-sectional data from 168 Community Health Agents, 62 nurses, and 32 physicians in two municipalities in Brazil's Unified Health System (UHS)...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28335320/cellular-interactions-and-formation-of-an-epithelial-nanocoating-like-barrier-with-mesoporous-silica-nanoparticles
#14
Xuan Li, Ka Yan Pang, Tsz Wing Ng, Ping Chung Leung, Cheng Fei Zhang, Ken Cham-Fai Leung, Lijian Jin
Oral mucosa as the front-line barrier in the mouth is constantly exposed to a complex microenvironment with multitudinous microbes. In this study, the interactions of mesoporous silica nanoparticles (MSNs) with primary human gingival epithelial cells were analyzed for up to 72 h, and their diffusion capacity in the reconstructed human gingival epithelia (RHGE) and porcine ear skin models was further assessed at 24 h. It was found that the synthesized fluorescent mesoporous silica nanoparticles (RITC-NPs) with low cytotoxicity could be uptaken, degraded, and/or excreted by the human gingival epithelial cells...
October 27, 2016: Nanomaterials
https://www.readbyqxmd.com/read/28335011/understanding-public-perception-of-the-need-for-major-change-in-latin-american-healthcare-systems
#15
Ricardo Pérez-Cuevas, Frederico C Guanais, Svetlana V Doubova, Leonardo Pinzón, Luis Tejerina, Diana Pinto Masis, Marcia Rocha, Donna O Harris, James Macinko
The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers...
March 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334970/expenditure-tracking-and-review-of-reproductive-maternal-newborn-and-child-health-policy-in-pakistan
#16
Muhammad Ashar Malik, Abdul Sattar Nahyoun, Arjumand Rizvi, Zaid Ahmad Bhatti, Zulfiqar Ahmad Bhutta
Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals (MDGs) 4 and 5 were not achieved (2000-15). Maternal Mortality Ratio was reduced to 170 per 100 000 live births (target 100) by 2013 at an annual reduction rate of 3.6% (1990-2013). Against the target of 46 per 1000 live births, the Under Five Mortality Rate was reduced to 81 per 1000 live births by 2015 at an annual reduction rate of 2...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334244/cognitive-screening-tests-versus-comprehensive-neuropsychological-test-batteries-a-national-academy-of-neuropsychology-education-paper%C3%A2
#17
Tresa M Roebuck-Spencer, Tannahill Glen, Antonio E Puente, Robert L Denney, Ronald M Ruff, Gayle Hostetter, Kevin J Bianchini
The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations...
March 10, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28333923/interdisciplinary-approach-at-the-primary-healthcare-level-for-bolivian-immigrants-with-chagas-disease-in-the-city-of-s%C3%A3-o-paulo
#18
Maria Aparecida Shikanai Yasuda, Camila Gonçalves Sátolo, Noemia Barbosa Carvalho, Magda Maya Atala, Rosario Quiroga Ferrufino, Ruth Moreira Leite, Célia Regina Furucho, Expedito Luna, Rubens Antonio Silva, Marcia Hage, Caroline Medeji Ramos de Oliveira, Felipe Delatorre Busser, Vera Lucia Teixeira de Freitas, Dalva Marli Valerio Wanderley, Luzia Martinelli, Sonia Regina Almeida, Pedro Albajar Viñas, Nivaldo Carneiro
BACKGROUND/METHODS: In a pioneering cross-sectional study among Bolivian immigrants in the city of São Paulo, Brazil, the epidemiological profile, clinical manifestations and morbidity of Chagas disease were described. The feasibility of the management of Chagas disease at primary healthcare clinics using a biomedical and psychosocial interdisciplinary approach was also tested. Previously, a Trypanosoma cruzi (T. cruzi) infection rate of 4.4% among 633 immigrants was reported. The samples were screened using two commercial enzyme-linked immunoassay (ELISA) tests generated with epimastigote antigens, and those with discrepant or seropositive results were analyzed by confirmatory tests: indirect immunofluorescence (IFI), TESA-blot and a commercial recombinant ELISA...
March 23, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28333185/randomized-open-trial-comparing-a-modified-double-lumen-needle-follicular-flushing-system-with-a-single-lumen-aspiration-needle-in-ivf-patients-with-poor-ovarian-response
#19
Kyra von Horn, Marion Depenbusch, Askan Schultze-Mosgau, Georg Griesinger
STUDY QUESTION: Is a modified double-lumen aspiration needle system with follicular flushing able to increase the mean oocyte yield by at least one in poor response IVF patients as compared to single-lumen needle aspiration without flushing? SUMMARY ANSWER: Follicular flushing with the modified flushing system did not increase the number of oocytes, but increased the procedure duration. WHAT IS KNOWN ALREADY: Most studies on follicular flushing were performed with conventional double-lumen needles in patients who were normal responders...
February 9, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28332939/pediatric-asthma-hospitalizations-among-urban-minority-children-and-the-continuity-of-primary-care
#20
Levon H Utidjian, Alexander G Fiks, A Russell Localio, Lihai Song, Mark J Ramos, Ron Keren, Louis M Bell, Robert W Grundmeier
OBJECTIVE: To examine the effect of ambulatory health care processes on asthma hospitalizations. METHODS: A retrospective cohort study using electronic health records was completed. Patients aged 2-18 years receiving health care from 1 of 5 urban practices between Jan 1, 2004 and Dec 31, 2008 with asthma documented on their problem list were included. Independent variables were modifiable health care processes in the primary care setting: (1) use of asthma controller medications; (2) regular assessment of asthma symptoms; (3) use of spirometry; (4) provision of individualized asthma care plans; (5) timely influenza vaccination; (6) access to primary healthcare; and (7) use of pay for performance physician incentives...
February 25, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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