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https://www.readbyqxmd.com/read/27922466/smartphone-based-electrocardiographic-and-cardiac-implantable-electronic-device-monitoring
#1
Suneet Mittal
The field of arrhythmia monitoring is changing rapidly. The rapid advent of technology in combination with marked improvements in cellular communication and an increased desire by patients to be actively engaged in their care has ushered in a new era of clinical care. Today, physicians need to think about their patients outside the traditional in-office setting. Two technologies that embody this changing landscape are smartphone-based electrocardiographic (ECG) monitors and remote monitoring of cardiac implantable electronic devices (CIEDs)...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#2
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27918478/parks-and-green-areas-are-associated-with-decreased-risk-for-hyperlipidemia
#3
Hye-Jin Kim, Jin-Young Min, Hyun-Jin Kim, Kyoung-Bok Min
This study aimed to investigate the association between parks and green areas and hyperlipidemia in adults with groups stratified by moderate physical activity as a behavioral modification using the 2009 Korean Community Health Survey data and 212,584 participants enrolled in this study. The geographical codes of study participants were all matched on the basis of the amount of parks and green areas in each administrative district. Compared with participants living in the highest quartile of parks and green areas (Quartile 4), those living in the lowest quartile of green and park area (Quartile 1) were at an increased risk of physician-diagnosed hyperlipidemia and hyperlipidemia currently under treatment...
December 3, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27918400/a-strategic-approach-for-developing-an-advanced-practice-workforce-from-postgraduate-transition-to-practice-fellowship-programs-and-beyond
#4
Dennis A Taylor, Britney S Broyhill, Allison M Burris, Mary Ann Wilcox
The healthcare provider landscape is rapidly changing. Given the imminent retirement of baby boomer physicians, implementation of the Affordable Care Act, and the increased utilization of health care services by an ever-aging population, the supply of providers cannot keep pace with the demand for services. This has led to an increased utilization of advanced clinical practitioners (ACPs). This article shows how one large highly-matrixed health care system approached identifying this workforce, and how thought leaders worked collaboratively with physicians, administrators, and ACPs to meet a growing demand for providers...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27914734/applying-a-deliberation-model-to-the-analysis-of-consultations-in-haemophilia-implications-for-doctor-patient-communication
#5
Giulia Lamiani, Sarah Bigi, Maria Elisa Mancuso, Antonio Coppola, Elena Vegni
OBJECTIVE: Literature highlights the importance of communication in order to achieve patient's adherence. However, the specific dialogical components likely to favor patient adherence are not clear. In this study, the deliberation dialogue model was applied as an ideal model of optimal deliberation to real physician-patient consultations in the field of hemophilia in order to identify misalignments with the model and possible improvements in physician-patient communication. METHODS: By applying the deliberation model, we analyzed a corpus of 30 check-up consultations in hemophilia...
November 28, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27910099/physician-engagement-strategies-in-care-coordination-findings-from-the-centers-for-medicare-medicaid-services-health-care-innovation-awards-program
#6
Megan Skillman, Caitlin Cross-Barnet, Rachel Friedman Singer, Sarah Ruiz, Christina Rotondo, Roy Ahn, Lynne Page Snyder, Erin M Colligan, Katherine Giuriceo, Adil Moiduddin
OBJECTIVE: To identify roles physicians assumed as part of new health care delivery models and related strategies that facilitated physician engagement across 21 Health Care Innovation Award (HCIA) programs. DATA SOURCES: Site-level in-depth interviews, conducted from 2014 to 2015 (N = 672) with program staff, leadership, and partners (including 95 physicians) and direct observations. STUDY DESIGN: NORC conducted a mixed-method evaluation, including two rounds of qualitative data collected via site visits and telephone interviews...
December 2, 2016: Health Services Research
https://www.readbyqxmd.com/read/27910035/self-care-as-a-professional-imperative-physician-burnout-depression-and-suicide
#7
Catherine M Kuhn, Ellen M Flanagan
PURPOSE: Burnout has been identified in approximately half of all practicing physicians, including anesthesiologists. In this narrative review, the relationship between burnout, depression, and suicide is explored, with particular attention to the anesthesiologist. Throughout this review, we highlight our professional imperative regarding this epidemic. SOURCE: The authors searched the existing English language literature via PubMed from 1986 until present using the search terms physician burnout, depression, and suicide, with particular attention to studies regarding anesthesiologists and strategies to address these problems...
December 1, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27908645/a-brief-measure-of-language-skills-at-3-years-of-age-and-special-education-use-in-middle-childhood
#8
Laura Lee McIntyre, William E Pelham, Matthew H Kim, Thomas J Dishion, Daniel S Shaw, Melvin N Wilson
OBJECTIVE: To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood. STUDY DESIGN: A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27906479/knowledge-and-practice-in-cardiovascular-disease-prevention-among-hospital-registered-nurses-a-cross-sectional-study
#9
Shu Ding, Ying Deng, Sai Lu, Karen V Lamb, Ying Zhang, Ying Wu
AIMS AND OBJECTIVES: To investigate the knowledge and clinical practices of cardiovascular disease (CVD) prevention among registered nurses (RNs) who worked on three major clinical units in Beijing hospitals. BACKGROUND: Health education on CVD prevention is an important component of nursing practice, however, Chinese RNs' knowledge and practice patterns have been poorly explored in previous studies. DESIGN: A cross-sectional study. METHODS: A stratified random sample of three hundred RNs was recruited from two tertiary hospitals in Beijing, China...
December 1, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27906041/implementation-of-the-better-2-program-a-qualitative-study-exploring-barriers-and-facilitators-of-a-novel-way-to-improve-chronic-disease-prevention-and-screening-in-primary-care
#10
Nicolette Sopcak, Carolina Aguilar, Mary Ann O'Brien, Candace Nykiforuk, Kris Aubrey-Bassler, Richard Cullen, Eva Grunfeld, Donna Patricia Manca
BACKGROUND: BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) is a patient-based intervention to improve chronic disease prevention and screening (CDPS) for cardiovascular disease, diabetes, cancer, and associated lifestyle factors in patients aged 40 to 65. The key component of BETTER is a prevention practitioner (PP), a health care professional with specialized skills in CDPS who meets with patients to develop a personalized prevention prescription, using the BETTER toolkit and Brief Action Planning...
December 1, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27902576/implementing-huddles-improves-care-coordination-in-an-academic-health-center
#11
Carolyn S Townsend, Mary McNulty, Adria Grillo-Peck
PURPOSE OF THE STUDY: To determine whether routinely scheduled, organized interdisciplinary huddles result in decreased length of stay and readmissions. PRIMARY PRACTICE SETTING: The study was conducted in an academic health center (AHC) that also fills a community hospital need for a diverse inner-city population. Results are applicable in other care settings. METHODOLOGY AND SAMPLE: Daily interdisciplinary huddles were piloted on 5 medical/surgical units...
January 2017: Professional Case Management
https://www.readbyqxmd.com/read/27896293/yoga-related-injuries-in-the-united-states-from-2001-to-2014
#12
Thomas A Swain, Gerald McGwin
BACKGROUND: Yoga has become more popular among people in the United States and has been touted by both yoga participants as well as some physicians and researchers for its health benefits. While the health benefits have been studied, the frequency of injury among yoga participants has not been well documented. PURPOSE: Injury incidence, rates, and types associated with yoga in the United States have not been quantified. This study estimates US yoga-associated injury incidence and characterizes injury type over a 13-year period...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27893953/leveraging-telehealth-to-bring-volunteer-physicians-into-underserved-communities
#13
Lori Uscher-Pines, Robert Rudin, Ateev Mehrotra
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute...
November 28, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27893517/ready-for-change-the-role-of-physician-and-staff-engagement-burnout-and-workplace-attributes
#14
Dorothy Hung, Po-Han Chen
We examined factors associated with change readiness among 343 primary care physicians and 590 nonphysician staff undergoing "Lean"-based process improvements. Baseline levels of engagement were associated with greater readiness for change across all measured domains. Job-related burnout correlated with greater need for change, but lower self-efficacy and perceived support, whereas a personal sense of accomplishment was associated with higher efficacy to implement changes. At a department level, teamwork, participation in decision making, and change history were associated with higher engagement and lower burnout among physicians and staff; conversely, a busy or stressful department correlated with lower engagement and higher burnout...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#15
Julia Warner, Mary Ann Raible, Gina Hajduk, Jacqueline Collavo
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893295/medical-directors-of-breastfeeding-programs-at-academic-medical-centers-duties-and-challenges
#16
Casey B Rosen-Carole
INTRODUCTION: An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. OBJECTIVE: To determine the duties and challenges of directors of breastfeeding medicine in AMCs. METHODS: A survey was distributed four times over a 3-month period to three listservs with a total of 860 members...
November 28, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27893135/screening-for-colorectal-cancer-and-evolving-issues-for-physicians-and-patients-a-review
#17
REVIEW
David Lieberman, Uri Ladabaum, Marcia Cruz-Correa, Carla Ginsburg, John M Inadomi, Lawrence S Kim, Francis M Giardiello, Richard C Wender
Importance: Colorectal cancer (CRC) is the second-leading cause of cancer death in the United States. Screening can reduce CRC mortality and incidence, and numerous screening options, although available, complicate informed decision making. This review provides evidence-based tools for primary care physicians to identify patients with higher-than-average-risk and engage patients in informed decision making about CRC screening options. Observations: Recently, the US Preventive Services Task Force recommended any of 8 CRC screening approaches for average-risk individuals, beginning at age 50 years...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27888950/social-media-and-the-patient-experience
#18
C Matthew Hawkins, Andrew J DeLaO, Colin Hung
As patients continue to turn to online resources for health care information to guide their care decisions, it is becoming increasingly important for radiologists to engage with patients online via social media platforms. There are many ways physicians can use social media to provide patients with valuable information and improve the overall patient experience. By optimizing online discoverability, curating radiology content, engaging with patient communities, and producing mineable social media content, radiologists can emerge as thought leaders in this new form of patient-centered communication and information exchange...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27888948/web-applications-for-patient-communication
#19
Kristopher Lewis, Murray A Reicher
Communication between imaging professionals and patients can help achieve many goals, including improved patient understanding of imaging-related diagnostic and treatment options, better compliance with appropriate imaging screening procedures, and improved efficiency of service. The explosive growth of out-of-pocket consumer spending on health care has heightened health care shopping, thus making patient communication an important goal of any imaging practice or health care organization. Furthermore, the Merit-Based Incentive Payment System introduced by CMS will publicly disclose physicians' quality ratings, which are in part dependent on patient engagement...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27888944/focusing-on-the-person-in-personalized-medicine-the-future-of-patient-centered-care-in-radiation-oncology
#20
Abigail T Berman, Seth A Rosenthal, Drew Moghanaki, Kristina D Woodhouse, Benjamin Movsas, Neha Vapiwala
Numerous efforts in radiation oncology aim to improve the value of clinical care. To evaluate the success of these efforts, outcome measures must be well defined and incorporate the beliefs of the patients they affect. These outcomes have historically centered on rates of tumor control, overall survival, and adverse events as perceived and reported by providers. However, the future of patient-centered care in radiation oncology is increasingly focusing on the "person" in the population and the individual in the studies to more closely reflect the ideals of personalized medicine...
December 2016: Journal of the American College of Radiology: JACR
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