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https://www.readbyqxmd.com/read/29908361/incidence-of-upper-and-lower-gastrointestinal-bleeding-in-new-users-of-low-dose-aspirin
#1
Lucía Cea Soriano, Angel Lanas, Montse Soriano-Gabarró, Luis A García Rodríguez
BACKGROUND & AIMS: There are few data on the incidence of upper and lower gastrointestinal bleeding (UGIB and LGIB) from observational studies of low-dose aspirin users. We aimed to estimate incidence rates of UGIB and LGIB in a large cohort of new users of low-dose aspirin in the United Kingdom, with sub-analyses of hospitalization status and fatalities. METHODS: We performed a population-based study of 199,079 new users of low-dose aspirin (median age, 64...
June 13, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29908022/relationship-between-lean-practices-soft-total-quality-management-and-innovation-skills-in-lebanese-hospitals
#2
Malak Aoun, Norlena Hasnan, Hassan Al-Aaraj
Background: Lean practices are critical to eliminate waste and enhance the quality of healthcare services through different improvement approaches of total quality management (TQM). In particular, the soft side of TQM is used to develop the innovation skills of employees that are essential for the continuous improvement strategies of hospitals. Aim: The main objective was to study the relationship between lean practices, soft TQM and innovation skills in Lebanese hospitals...
June 10, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/29907560/validation-of-a-natural-language-processing-algorithm-for-detecting-infectious-disease-symptoms-in-primary-care-electronic-medical-records-in-singapore
#3
Antony Hardjojo, Arunan Gunachandran, Long Pang, Mohammed Ridzwan Bin Abdullah, Win Wah, Joash Wen Chen Chong, Ee Hui Goh, Sok Huang Teo, Gilbert Lim, Mong Li Lee, Wynne Hsu, Vernon Lee, Mark I-Cheng Chen, Franco Wong, Jonathan Siung King Phang
BACKGROUND: Free-text clinical records provide a source of information that complements traditional disease surveillance. To electronically harness these records, they need to be transformed into codified fields by natural language processing algorithms. OBJECTIVE: The aim of this study was to develop, train, and validate Clinical History Extractor for Syndromic Surveillance (CHESS), an natural language processing algorithm to extract clinical information from free-text primary care records...
June 11, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29907323/taking-the-measure-of-the-profession-physician-associations-in-the-measurement-age
#4
REVIEW
Baruch Levi, Amos Zehavi, David Chinitz
Systematic measurement of healthcare services enables evaluation of health professionals' quality of work. Whereas policy makers find measurement a useful mechanism for quality improvement, a public choice perspective implies that physicians would resent such an initiative, which undermines their professional autonomy. In this article, we compare two healthcare systems of economically developed countries - Israel and the UK. Both systems share common features such as universal coverage, strong state intervention, and enthusiasm for New Public Management...
June 8, 2018: Health Policy
https://www.readbyqxmd.com/read/29906642/the-effect-of-simethicone-on-postoperative-ileus-in-patients-undergoing-colorectal-surgery-spot-a-randomized-controlled-trial
#5
Jeremy E Springer, Shiraz Elkheir, Cagla Eskicioglu, Aristithes G Doumouras, Stephen Kelly, Ilun Yang, Shawn Forbes
BACKGROUND: Postoperative ileus is a poorly understood multifactorial outcome following colorectal surgery that presents significant clinical challenges and contributes to increased morbidity, length of stay, and healthcare cost. To date, there are few pharmacological interventions that shorten the duration of postoperative ileus. OBJECTIVE: This study is the first to evaluate the efficacy of simethicone in treating postoperative ileus symptoms in patients undergoing colorectal surgery...
June 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29906426/importance-of-early-insertion-of-inferior-vena-cava-filters-in-unstable-patients-with-acute-pulmonary-embolism
#6
Paul D Stein, Fadi Matta, Frank R Lawrence, Mary J Hughes
BACKGROUND: Immortal time bias is a possible confounding factor in cohort studies. In this investigation, we assessed mortality with inferior vena cava (IVC) filters in unstable patients with pulmonary embolism using a design that eliminated immortal time bias. METHODS: Data are from Premier Healthcare Database, 2010-2014. International Classification of Disease-9th Clinical Modification codes were used. Unstable patients with pulmonary embolism and an admitting diagnosis of pulmonary embolism as well as a primary diagnosis of pulmonary embolism were included...
June 12, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29905920/breast-cancer-risk-evaluation-by-utilizing-gail-model-and-association-between-breast-cancer-risk-perception-with-early-diagnosis-applications-among-midwives-and-nurses-working-in-primary-health-services
#7
Ebru Turhan, Gokben Yasli
OBJECTIVE: The present study was performed to detect cancer risk of the midwifes and nurses playing central role in raising awareness in the society using Gail's model. MATERIALS AND METHODS: Sample of the present cross sectional study consists of 750 volunteer midwifes and nurses in 2016. Breast cancer risk was calculated using the Gail Risk Assessment Tool. Perceived and calculated risk levels were compared. Descriptive statistics and Chi-Square analysis, t-test, Multivariate Linear Regression Analysis, the Logistic Regression Analysis were conducted...
June 2018: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/29905084/test-results-management-and-distributed-cognition-in-electronic-health-record-enabled-primary-care
#8
Michael W Smith, Ashley M Hughes, Charnetta Brown, Elise Russo And, Traber D Giardina, Praveen Mehta, Hardeep Singh
Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses...
June 1, 2018: Health Informatics Journal
https://www.readbyqxmd.com/read/29903802/study-protocol-for-a-feasibility-study-of-an-internet-administered-guided-cbt-based-self-help-intervention-engage-for-parents-of-children-previously-treated-for-cancer
#9
Joanne Woodford, Anna Wikman, Martin Cernvall, Gustaf Ljungman, Amanda Romppala, Helena Grönqvist, Louise von Essen
INTRODUCTION: A subgroup of parents of children previously treated for cancer report long-term psychological distress after end of treatment. However, needs for psychological support are commonly unmet and there is a lack of evidence-based treatments tailored to the specific needs of this population. An internet-administered, guided, cognitive-behavioural therapy-based, self-help intervention (ENGAGE) for parents of children previously treated for cancer may provide a solution. The aim is to examine the feasibility and acceptability of the intervention ENGAGE and the study procedures for a future controlled trial...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903795/hepatitis-c-virus-infection-and-hospital-related-outcomes-a-systematic-review-protocol
#10
Lianping Ti, Michelle Ng, Lindila Awendila, Patrizia Maria Carrieri
INTRODUCTION: People living with hepatitis C virus (HCV) infection are disproportionately over-represented in the healthcare system due to various individual and contextual circumstances, including comorbidities and socioeconomic marginalisation. With growing trends in morbidity and mortality related to HCV infection, HCV is becoming a significant health and financial burden on the healthcare system, particularly in acute hospital settings. It is noteworthy that with the advent of direct-acting antiviral therapy the increasing number of patients who are cured of HCV could potentially result in different patterns of hospital-related outcomes over time...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903785/cost-effectiveness-analysis-of-internet-mediated-cognitive-behavioural-therapy-for-depression-in-the-primary-care-setting-results-based-on-a-controlled-trial
#11
Anna Holst, Cecilia Björkelund, Alexandra Metsini, Jens-Henrik Madsen, Dominique Hange, Eva-Lisa L Petersson, Maria Cm Eriksson, Marie Kivi, Per-Åke Å Andersson, Mikael Svensson
OBJECTIVE: To perform a cost-effectiveness analysis of a randomised controlled trial of internet-mediated cognitive behavioural therapy (ICBT) compared with treatment as usual (TaU) for patients with mild to moderate depression in the Swedish primary care setting. In particular, the objective was to assess from a healthcare and societal perspective the incremental cost-effectiveness ratio (ICER) of ICBT versus TaU at 12 months follow-up. DESIGN: A cost-effectiveness analysis alongside a pragmatic effectiveness trial...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903781/how-good-are-gps-at-adhering-to-a-pragmatic-trial-protocol-in-primary-care-results-from-the-addition-cambridge-cluster-randomised-pragmatic-trial
#12
Michael Laxy, Edward C F Wilson, Clare E Boothby, Simon J Griffin
OBJECTIVE: To assess the fidelity of general practitioners' (GPs) adherence to a long-term pragmatic trial protocol. DESIGN: Retrospective analyses of electronic primary care records of participants in the pragmatic cluster-randomised ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care)-Cambridge trial, comparing intensive multifactorial treatment (IT) versus routine care (RC). Data were collected from the date of diagnosis until December 2010...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903711/cost-effectiveness-analysis-of-initial-treatment-strategies-for-mild-to-moderate-clostridium-difficile-infection-in-hospitalized-patients
#13
Diana C Ford, Mary C Schroeder, Dilek Ince, Erika J Ernst
PURPOSE: The cost-effectiveness of initial treatment strategies for mild-to-moderate Clostridium difficile infection (CDI) in hospitalized patients was evaluated. METHODS: Decision-analytic models were constructed to compare initial treatment with metronidazole, vancomycin, and fidaxomicin. The primary model included 1 recurrence, and the secondary model included up to 3 recurrences. Model variables were extracted from published literature with costs based on a healthcare system perspective...
June 14, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29903687/adolescents-experiences-of-obesity-surgery-a-qualitative-study
#14
Karin Nordin, Anna-Lena Brorsson, Kerstin Ekbom
BACKGROUND: The positive effects of behavioural treatment and weight management in adolescents with severe obesity are modest. Obesity surgery can be an option for adolescents, but is not the first-hand choice of treatment. The knowledge about adolescents' own experiences of having undergone surgery and their thoughts and feelings of the follow-up period are limited. OBJECTIVES: To describe adolescents' decision to go through obesity surgery as teenager and their experiences of the follow-up period...
April 26, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29903496/a-systematic-map-of-medical-data-preprocessing-in-knowledge-discovery
#15
REVIEW
A Idri, H Benhar, J L Fernández-Alemán, I Kadi
BACKGROUND AND OBJECTIVE: Datamining (DM) has, over the last decade, received increased attention in the medical domain and has been widely used to analyze medical datasets in order to extract useful knowledge and previously unknown patterns. However, historical medical data can often comprise inconsistent, noisy, imbalanced, missing and high dimensional data. These challenges lead to a serious bias in predictive modeling and reduce the performance of DM techniques. Data preprocessing is, therefore, an essential step in knowledge discovery as regards improving the quality of data and making it appropriate and suitable for DM techniques...
August 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29902036/a-service-user-co-facilitated-intervention-to-reduce-mental-illness-stigma-among-primary-healthcare-workers-utilizing-perspectives-of-family-members-and-caregivers
#16
Sauharda Rai, Dristy Gurung, Bonnie N Kaiser, Kathleen J Sikkema, Manoj Dhakal, Anvita Bhardwaj, Cori Tergesen, Brandon A Kohrt
INTRODUCTION: Service users' involvement as cofacilitators of mental health trainings is a nascent endeavor in low- and middle-income countries, and the role of families on service user participation in trainings has received limited attention. This study examined how caregivers perceive and facilitate service user's involvement in an antistigma program that was added to mental health Gap Action Program (mhGAP) trainings for primary care workers in Nepal. METHOD: Service users were trained as cofacilitators for antistigma and mhGAP trainings delivered to primary care workers through the REducing Stigma among HealthcAre ProvidErs (RESHAPE) program...
June 2018: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29901661/interprofessional-care-in-teaching-practices-lessons-from-bright-spots
#17
Thomas Bodenheimer, Margae Knox, Sara Syer
In this issue, Brandt and colleagues and Uhlig and colleagues highlight barriers faced by health professional schools implementing interprofessional education and describe how clinical learning environments can overcome those obstacles. Primary care residency teaching clinics provide an excellent opportunity for interprofessional education and patient care, with teachers and learners from various professions caring for patients together. This Invited Commentary offers three interprofessional education strategies used by five "bright spot" family medicine teaching clinics: (1) separate clinics for patients with complex healthcare needs during which learners from various professions see patients together; (2) interprofessional interactions in day-to-day patient care; and (3) case conferences across professions to discuss patients...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29899763/prospective-single-center-implementation-and-response-evaluation-of-pressurized-intraperitoneal-aerosol-chemotherapy-pipac-for-peritoneal-metastasis
#18
Martin Graversen, Sönke Detlefsen, Jon Kroll Bjerregaard, Claus Wilki Fristrup, Per Pfeiffer, Michael Bau Mortensen
Background: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a laparoscopy-guided administration of aerosolized chemotherapy. PIPAC seems to improve objective tumor response, survival and quality of life in patients with peritoneal metastasis. We assessed feasibility and efficacy of PIPAC in patients with peritoneal metastasis (PM). Methods: Patients were included in a prospective PIPAC protocol. Patients with colorectal PM were treated with oxaliplatin, patients with other primary tumors were treated with cisplatin and doxorubicin...
2018: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29899056/health-inequalities-in-hospitalisation-and-mortality-in-patients-diagnosed-with-heart-failure-in-a-universal-healthcare-coverage-system
#19
Raquel Garcia, Rosa Abellana, Jordi Real, José-Luis Del Val, Jose Maria Verdú-Rotellar, Miguel-Angel Muñoz
BACKGROUND: Information regarding the effect of social determinants of health on heart failure (HF) community-dwelling patients is scarce. We aimed to analyse the presence of socioeconomic inequalities, and their impact on hospitalisations and mortality, in patients with HF attended in a universal healthcare coverage system. METHODS: A retrospective cohort study carried out in patients with HF aged >40 and attended at the 53 primary healthcare centres of the Institut Català de la Salut in Barcelona (Spain)...
June 13, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29898713/what-are-the-effective-elements-in-patient-centered-and-multimorbidity-care-a-scoping-review
#20
Marie-Eve Poitras, Marie-Eve Maltais, Louisa Bestard-Denommé, Moira Stewart, Martin Fortin
BACKGROUND: Interventions to improve patient-centered care for persons with multimorbidity are in constant growth. To date, the emphasis has been on two separate kinds of interventions, those based on a patient-centered care approach with persons with chronic disease and the other ones created specifically for persons with multimorbidity. Their effectiveness in primary healthcare is well documented. Currently, none of these interventions have synthesized a patient-centered care approach for care for multimorbidity...
June 14, 2018: BMC Health Services Research
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