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https://www.readbyqxmd.com/read/29150147/clinic-and-home-based-behavioral-intervention-for-obesity-in-preschoolers-a-randomized-trial
#1
Lori J Stark, Stephanie Spear Filigno, Christopher Bolling, Megan B Ratcliff, Jessica C Kichler, Shannon M Robson, Stacey L Simon, Mary Beth McCullough, Lisa M Clifford, Cathleen Odar Stough, Cynthia Zion, Richard F Ittenbach
OBJECTIVE: To test the hypotheses that an innovative skills-based behavioral family clinic and home-based intervention (LAUNCH) would reduce body mass index z score (BMIz) compared with motivational interviewing and to standard care in preschool-aged children with obesity. STUDY DESIGN: Randomized controlled trial with children between the ages of 2 and 5 years above the 95(th) percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012 and June 8, 2015...
November 14, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29149792/case-management-for-people-with-dementia-and-its-translations-a-discussion-paper
#2
Steve Iliffe, Jane Wilcock, Michal Synek, Radek Carboch, Dana Hradcová, Iva Holmerová
Case management is generally seen as a way to provide efficient, cost-saving person-centred care for people with dementia by connecting together fragmented services, but the available evidence in favour of its merits is often considered inconclusive, unclear and sketchy. This discussion paper investigates the evidence of the benefit of case management for people with dementia and explores the complexity of the concept and the experiences of its implementation. It offers a comprehensive framework for conceptualising various types of case management and asks the question: who can be a case manager? Building on examples from three European countries it addresses the problem of the expansion and adoption of the case management method...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/29146648/economic-evaluation-of-an-e-mental-health-intervention-for-patients-with-retinal-exudative-diseases-who-receive-intraocular-anti-vegf-injections-e-pseye-protocol-for-a-randomised-controlled-trial
#3
Hilde P A van der Aa, Ger H M B van Rens, Frank D Verbraak, Machteld Bosscha, Marc A Koopmanschap, Hannie C Comijs, Pim Cuijpers, Ruth M A van Nispen
INTRODUCTION: Because of the great potential of vascular endothelial growth factor inhibitors (anti-VEGF) for retinal exudative diseases, an increased number of patients receives this treatment. However, during this treatment, patients are subjected to frequent invasive intravitreal injections, and the effects on reversing the process of vision loss are uncertain, which may have negative consequences for patients' mental health. One in three patients experience at least mild symptoms of depression/anxiety...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146240/channelled-tablets-an-innovative-approach-to-accelerating-drug-release-from-3d-printed-tablets
#4
Muzna Sadia, Basel Arafat, Waqar Ahmed, Robert E Forbes, Mohamed A Alhnan
Conventional immediate release dosage forms involve compressing the powder with a disintegrating agent that enables rapid disintegration and dissolution upon oral ingestion. Among 3D printing technologies, the fused deposition modelling (FDM) 3D printing technique has considerable potential for patient-specific dosage form. However, the use of FDM 3D printing in tablet manufacturing requires large portion of polymer, which slows down drug release through erosion and diffusion mechanisms. In this study, we demonstrate for the first time the use of a novel design approach of caplets with perforating channels to accelerate drug release from 3D printed tablets...
November 13, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29145728/understanding-how-emergency-medicine-physicians-survive-and-thrive-in-rural-practice-a-theoretical-model
#5
Ashra Kolhatkar, Andrea Keesey, Bob Bluman, Brenna Lynn, Tandi Wilkinson
INTRODUCTION: The challenges facing emergency medicine (EM) services in Canada reflect the limitations of the entire healthcare system. The emergency department (ED) is uniquely situated in the healthcare system such that shortcomings in hospital- and community-based services are often first revealed there. This is especially true in rural settings, where there are additional site-specific barriers to the provision of EM care. Existing studies look at the factors that influence rural EM physicians in isolation...
November 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29143673/the-heptestcontest-a-global-innovation-contest-to-identify-approaches-to-hepatitis-b-and-c-testing
#6
Joseph D Tucker, Kathrine Meyers, John Best, Karyn Kaplan, Razia Pendse, Kevin A Fenton, Isabelle Andrieux-Meyer, Carmen Figueroa, Pedro Goicochea, Charles Gore, Azumi Ishizaki, Giten Khwairakpam, Veronica Miller, Antons Mozalevskis, Michael Ninburg, Ponsiano Ocama, Rosanna Peeling, Nick Walsh, Massimo G Colombo, Philippa Easterbrook
BACKGROUND: Innovation contests are a novel approach to elicit good ideas and innovative practices in various areas of public health. There remains limited published literature on approaches to deliver hepatitis testing. The purpose of this innovation contest was to identify examples of different hepatitis B and C approaches to support countries in their scale-up of hepatitis testing and to supplement development of formal recommendations on service delivery in the 2017 World Health Organization hepatitis B and C testing guidelines...
November 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29143169/predictors-and-patterns-of-psychiatric-treatment-dropout-during-pregnancy-among-low-income-women
#7
Sara L Kornfield, Christina D Kang-Yi, David S Mandell, C Neill Epperson
Objective This study compared psychiatric treatment discontinuation rates among pregnant women using psychotropic medications, outpatient psychotherapy, or both before conception. Methods Using data from Pennsylvania Medicaid Fee-For-Service and Managed Care Organization claims and Medicaid enrollment, 3030 women were identified who gave birth between 2007 and 2009, had ≥ 1 claim for psychiatric treatment during the 120 days prior to pregnancy, and were enrolled in Medicaid until they delivered. Kaplan-Meier and Cox regression analyses were used to estimate psychiatric treatment dropout rate during pregnancy and examine relationships between treatment dropout and age, race/ethnicity, and pre-pregnancy psychiatric diagnosis and treatment pattern...
November 15, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29141643/integrative-medicine-primary-care-assessing-the-practice-model-through-patients-experiences
#8
Robert L Crocker, Amy J Grizzle, Jason T Hurwitz, Rick A Rehfeld, Ivo Abraham, Randy Horwitz, Andrew Weil, Victoria Maizes
BACKGROUND: The University of Arizona Integrative Health Center (UAIHC) was an innovative integrative medicine (IM) adult primary care clinic in Phoenix, Arizona. UAIHC used a hybrid payment model to deliver comprehensive healthcare that includes conventional and complementary medical treatments. METHODS: Fidelity measures were collected to evaluate how well the IM care delivery process matched ideals for IM. Patient experiences are presented here. Patients visiting UAIHC on 1 of 10 randomly selected days between September 2013 and February 2015 were surveyed...
November 15, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29140919/collaboration-and-teamwork-in-the-health-professions-rethinking-the-role-of-conflict
#9
Quentin Eichbaum
Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict's positive attributes appears to be driven in part by (1) individuals' fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140497/integrating-complementary-and-traditional-practices-in-middle-eastern-supportive-cancer-care
#10
Eran Ben-Arye, Noah Samuels, Michel Daher, Ibrahim Turker, Omar Nimri, Maryam Rassouli, Michael Silbermann
The Middle East is a promising arena in which researchers can explore the interchange between cross-cultural traditional medicine and supportive cancer care, as provided within an integrative oncology setting. Integrative oncology research and clinical practice in this part of the world have been focusing, for the most part, on the use of herbal medicine and mind-body-spiritual modalities, both of which are deeply rooted in traditional medical care. A regional, multinational, and interdisciplinary collaboration is currently being undertaken as part of the academic activities of the Middle-East Research Group in Integrative Oncology (MERGIO)...
November 1, 2017: Journal of the National Cancer Institute. Monographs
https://www.readbyqxmd.com/read/29137510/accountable-care-reforms-improve-women-s-and-children-s-health-in-nepal
#11
Duncan Maru, Sheela Maru, Isha Nirola, Jonathan Gonzalez-Smith, Andrea Thoumi, Prajwol Nepal, Pushpa Chaudary, Indira Basnett, Krishna Udayakumar, Mark McClellan
Over the past decade the Ministry of Health of Nepal and the nonprofit Possible have partnered to deliver primary and secondary health care via a public-private partnership. We applied an accountable care framework that we previously developed to describe the delivery of their integrated reproductive, maternal, newborn, and child health services in the Achham district in rural Nepal. In a prospective pre-post study, examining pregnancies at baseline and 541 pregnancies in follow-up over the course of eighteen months, we found an improvement in population-level indicators linked to reducing maternal and infant mortality: receipt of four antenatal care visits (83 percent to 90 percent), institutional birth rate (81 percent to 93 percent), and the prevalence of postpartum contraception (19 percent to 47 percent)...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29137503/global-lessons-in-frugal-innovation-to-improve-health-care-delivery-in-the-united-states
#12
Yasser Bhatti, Andrea Taylor, Matthew Harris, Hester Wadge, Erin Escobar, Matt Prime, Hannah Patel, Alexander W Carter, Greg Parston, Ara W Darzi, Krishna Udayakumar
In a 2015 global study of low-cost or frugal innovations, we identified five leading innovations that scaled successfully in their original contexts and that may provide insights for scaling such innovations in the United States. We describe common themes among these diverse innovations, critical factors for their translation to the United States to improve the efficiency and quality of health care, and lessons for the implementation and scaling of other innovations. We highlight promising trends in the United States that support adapting these innovations, including growing interest in moving care out of health care facilities and into community and home settings; the growth of alternative payment models and incentives to experiment with new approaches to population health and care delivery; and the increasing use of diverse health professionals, such as community health workers and advanced practice providers...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29137501/parkinsonnet-a-low-cost-health-care-innovation-with-a-systems-approach-from-the-netherlands
#13
Bas R Bloem, Lonneke Rompen, Nienke M de Vries, Ab Klink, Marten Munneke, Patrick Jeurissen
ParkinsonNet, a low-cost innovation to optimize care for patients with Parkinson disease, was developed in 2004 as a network of physical therapists in several regions in the Netherlands. Since that time, the network has achieved full national reach, with 70 regional networks and around 3,000 specifically trained professionals from 12 disciplines. Key elements include the empowerment of professionals who are highly trained and specialized in Parkinson disease, the empowerment of patients by education and consultation, and the empowerment of integrated multidisciplinary teams to better address and manage the disease...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29135767/implementing-accountable-care-organizations-lessons-from-a-qualitative-analysis-of-four-private-sector-organizations
#14
Daniel M Walker, Jennifer L Hefner, Lindsey N Sova, Brian Hilligoss, Paula H Song, Ann Scheck McAlearney
Accountable care organizations (ACOs) are emerging across the healthcare marketplace and now include Medicare, Medicaid, and private sector payers covering more than 24 million lives. However, little is known about the process of organizational change required to achieve cost savings and quality improvements from the ACO model. This study applies the complex innovation implementation framework to understand the challenges and facilitators associated with the ACO implementation process. We conducted four case studies of private sector ACOs, selected to achieve variation in terms of geography and organizational maturity...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29132373/understanding-malaria-treatment-seeking-preferences-within-the-public-sector-amongst-mobile-migrant-workers-in-a-malaria-elimination-scenario-a-mixed-methods-study
#15
Aung Ye Naung Win, Thae Maung Maung, Khin Thet Wai, Tin Oo, Aung Thi, Rungrawee Tipmontree, Ngamphol Soonthornworasiri, Mondha Kengganpanich, Jaranit Kaewkungwal
BACKGROUND: Migration flows and the emerging resistance to artemisinin-based combination therapy in the Greater Mekong Sub-region (GMS) create programmatic challenges to meeting the AD 2030 malaria elimination target in Myanmar. The National Malaria Control Programme (NMCP) targeted migrant workers based mainly on the stability of their worksites (categories 1: permanent work-setting; categories 2 and 3: less stable work-settings). This study aims to assess the migration patterns, malaria treatment-seeking preferences, and challenges encountered by mobile/migrant workers at remote sites in a malaria-elimination setting...
November 13, 2017: Malaria Journal
https://www.readbyqxmd.com/read/29130479/implementing-models-of-geriatric-care-behind-the-scenes
#16
Joshua Chodosh, Michael Weiner
Innovative geriatric clinical programs have proliferated in the 21st century, and many have been highlighted in the Journal of the American Geriatrics Society (JAGS). The Affordable Care Act has supported the accelerated innovation of publicized and unpublicized program development, adaptation, and implementation. Many JAGS articles report work conducted in programs with significant improvements in quality; high satisfaction for patients and providers; and for some, reductions in costs. Despite considerable detail, enabling implementers to attempt to adopt reported programs or adapt them to local environments, much less is typically conveyed about the subtleties of the implementation process that led to a successful outcome...
November 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29129182/integrated-one-stop-shop-youth-health-care-best-available-evidence-and-future-directions
#17
Sarah E Hetrick, Alan P Bailey, Kirsten E Smith, Ashok Malla, Steve Mathias, Swaran P Singh, Aileen O'Reilly, Swapna K Verma, Laelia Benoit, Theresa M Fleming, Marie Rose Moro, Debra J Rickwood, Joseph Duffy, Trissel Eriksen, Robert Illback, Caroline A Fisher, Patrick D McGorry
Although mental health problems represent the largest burden of disease in young people, access to mental health care has been poor for this group. Integrated youth health care services have been proposed as an innovative solution. Integrated care joins up physical health, mental health and social care services, ideally in one location, so that a young person receives holistic care in a coordinated way. It can be implemented in a range of ways. A review of the available literature identified a range of studies reporting the results of evaluation research into integrated care services...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29123599/patient-satisfaction-with-chronic-hiv-care-provided-through-an-innovative-pharmacist-nurse-managed-clinic-and-a-multidisciplinary-clinic
#18
Jason Kielly, Deborah V Kelly, Shabnam Asghari, Kim Burt, Jessica Biggin
Background: Pharmacist/nurse-led clinics are an established model for many chronic diseases but not yet for HIV. At our centre, patients with HIV are seen by a multidisciplinary team (physician, nurse, pharmacist, social worker) at least yearly. Some attend an HIV-specialist pharmacist/nurse clinic (or "nonphysician clinic," NPC) for alternate biannual visits. Our objective was to assess patient satisfaction with care received through both clinics. Methods: The Patient Satisfaction Survey for HIV Ambulatory Care (assesses satisfaction with access to care, clinic visits and quality of care) was administered by telephone to adults who attended either clinic between January and July 2014...
November 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29122505/mayo-clinic-care-network-a-collaborative-health-care-model
#19
John T Wald, Sherri Lowery-Schrandt, David L Hayes, Amy L Kotsenas
By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network.
November 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29120700/basket-studies-redefining-clinical-trials-in-the-era-of-genome-driven-oncology
#20
Jessica J Tao, Alison M Schram, David M Hyman
Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncology care. "Basket studies," or histology-agnostic clinical trials in genomically selected patients, represent one important research tool to continue making progress in this field. We review key aspects of genome-driven oncology care, including the purpose and utility of basket studies, biostatistical considerations in trial design, genomic knowledge-base development, and patient matching and enrollment models, which are critical for translating our genomic knowledge into clinically meaningful outcomes...
November 8, 2017: Annual Review of Medicine
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