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https://www.readbyqxmd.com/read/28087291/primary-care-perspectives-on-hepatitis-c-virus-screening-diagnosis-and-linking-patients-to-appropriate-care
#1
Edward Lebovics, Richard Torres, Lucinda K Porter
Enormous progress has been made in recent years toward effectively treating and curing patients with chronic hepatitis C (CHC). However, at least half of the possible 7 million individuals infected with hepatitis C virus (HCV) in the US remain undiagnosed. The formidable task of increasing the number of patients diagnosed, and subsequently linked to appropriate care has fallen to primary care clinicians, who are mandated by some US States to offer screening to individuals born between 1945 and 1965 (the Baby Boomer Generation)...
January 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28077195/evidence-based-medicine-in-the-era-of-social-media-scholarly-engagement-through-participation-and-online-interaction
#2
Teresa Chan, N Seth Trueger, Damian Roland, Brent Thoma
The integration of new knowledge into clinical practice continues to lag behind discovery. The use of Free Open Access Medical education (FOAM) has disrupted communication between emergency physicians, making it easy for practicing clinicians to interact with colleagues from around the world to discuss the latest and highest impact research. FOAM has the potential to decrease the knowledge translation gap, but the concerns raised about its growing influence are 1) research that is translated too quickly may cause harm if its findings are incorrect; 2) there is little editorial oversight of online material; and 3) eminent online individuals may develop an outsized influence on clinical practice...
January 12, 2017: CJEM
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#3
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28076262/physician-cost-consciousness-and-use-of-low-value-clinical-services
#4
Michael Grover, Neena Abraham, Yu-Hui Chang, Jon Tilburt
PURPOSE: Choosing Wisely(TM) engaged medical specialties, creating "top 5 lists" of low-value services. We describe primary care physicians' (PCPs') self-reported use of these services and perceived barriers to guideline adherence. We quantify physician cost consciousness and determine associations with use. METHODS: PCP attendees of a continuing medical education conference completed a survey. For each Family Medicine Choosing Wisely behavior, participants reported clinical adherence...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28075109/patient-centered-communication-basic-skills
#5
M Jawad Hashim
Communication skills needed for patient-centered care include eliciting the patient's agenda with open-ended questions, especially early on; not interrupting the patient; and engaging in focused active listening. Understanding the patient's perspective of the illness and expressing empathy are key features of patient-centered communication. Understanding the patient's perspective entails exploring the patient's feelings, ideas, concerns, and experience regarding the impact of the illness, as well as what the patient expects from the physician...
January 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28074635/physician-step-prescription-and-monitoring-to-improve-arterial-health-smarter-a-randomized-controlled-trial-in-type-2-diabetes-and-hypertension
#6
Kaberi Dasgupta, Ellen Rosenberg, Lawrence Joseph, Alexandra B Cooke, Luc Trudeau, Simon L Bacon, Deborah Chan, Mark Sherman, Rémi Rabasa-Lhoret, Stella S Daskalopoulou
AIMS: There are few strategies proven to enhance physical activity and cardiometabolic profiles in type 2 diabetes and hypertension. We examined the effects of physician-delivered step count prescriptions and monitoring. METHODS: Participants randomized to the active arm were provided with pedometers and recorded step counts. Over a 1-year period, their physicians reviewed their records and provided a written step count prescription at each clinic visit. The overall goal was a 3,000 step/day increase over 1-year (individualized rate of increase)...
January 11, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28072917/a-provider-based-survey-to-assess-bereavement-care-knowledge-attitudes-and-practices-in-pediatric-oncologists
#7
Jasmin Jensen, Cindy Weng, Holly L Spraker-Perlman
BACKGROUND: Bereavement support is a core tenet of palliative care that may prove difficult for clinicians as it is time-consuming, emotionally charged, and not emphasized in pediatrics training. This project is intended to describe the opinions, knowledge, and practice of bereavement care among pediatric oncologists to identify gaps in clinical care. PROCEDURES: An internet-based survey instrument was pilot tested, refined, and distributed to pediatric oncologists in the United States...
January 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28066820/hiv-care-providers-attitudes-regarding-mobile-phone-applications-and-web-based-dashboards-to-support-patient-self-management-and-care-coordination-results-from-a-qualitative-feasibility-study
#8
Dallas Swendeman, Shu Farmer, Deborah Mindry, Sung-Jae Lee, Melissa Medich
In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination...
October 2016: Journal of HIV and AIDS
https://www.readbyqxmd.com/read/28062341/implementation-and-impact-of-patient-lay-navigator-led-advance-care-planning-conversations
#9
Gabrielle B Rocque, J Nicholas Dionne-Odom, Chao-Hui Sylvia Huang, Soumya J Niranjan, Courtney P Williams, Bradford E Jackson, Karina I Halilova, Kelly M Kenzik, Kerri S Bevis, Audrey S Wallace, Nedra Lisovicz, Richard A Taylor, Maria Pisu, Edward E Partridge, Linda A Briggs, Elizabeth A Kvale
CONTEXT: Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). OBJECTIVES: To evaluate implementation of lay navigator-led ACP. METHODS: A convergent, parallel mixed-methods design was employed to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included: (1) electronic navigation records, (2) navigator surveys (n=45), (3) claims-based patient outcomes (n=820), and (4) semi-structured navigator interviews (n=26)...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28060854/leveraging-social-media-to-promote-evidence-based-continuing-medical-education
#10
Simone Flynn, Paul Hebert, Deborah Korenstein, Mark Ryan, William B Jordan, Salomeh Keyhani
IMPORTANCE: New dissemination methods are needed to engage physicians in evidence-based continuing medical education (CME). OBJECTIVE: To examine the effectiveness of social media in engaging physicians in non-industry-sponsored CME. DESIGN: We tested the effect of different media platforms (e-mail, Facebook, paid Facebook and Twitter), CME topics, and different "hooks" (e.g., Q&A, clinical pearl and best evidence) on driving clicks to a landing site featuring non-industry sponsored CME...
2017: PloS One
https://www.readbyqxmd.com/read/28052165/integrating-spirituality-into-outpatient-practice-in-the-adventist-health-system
#11
Harold G Koenig, Kathleen Perno, Ted Hamilton
OBJECTIVES: We examined Adventist Health System (AHS)-affiliated providers and staff regarding controversial spiritual practices such as praying led by a practitioner, sharing of personal religious beliefs, and encouraging patients' religious beliefs for health reasons. METHODS: Approached were 1082 providers to participate in a project to integrate spirituality into outpatient care. Those who agreed were asked to identify staff in their practice to assist. Providers and staff were asked to complete a baseline questionnaire examining attitudes/practices concerning spiritual activities with patients...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28050638/patients-control-preferences-and-results-in-knee-arthroplasty
#12
G Filardo, A Roffi, G Merli, T Marcacci, F Berti Ceroni, D Raboni, E Kon, M Marcacci
PURPOSE: Patient engagement in a patient-physician decision-making process has been correlated with satisfaction and clinical outcomes. Aim of this study is to evaluate if patient control preference may also influence TKA results. METHODS: One hundred and seventy-six patients (120w-56m, age 66 ± 9 years, BMI 28 ± 4) underwent TKA and were prospectively evaluated, before surgery and at 6 and 12 months. The preoperative assessment included the Control Preference Scale (CPS) and other scales measuring psychological aspects (STAI, BDI, TSK), as well as SF12 (physical and mental subscales) and the assessment of pain and function...
January 3, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28031934/stories-of-experiences-of-care-for-growth-hormone-deficiency-the-crescere-project
#13
Maria G Marini, Paola Chesi, Laura Mazzanti, Laura Guazzarotti, Teresa D Toni, Maria C Salerno, Annunziata Officioso, Maria Parpagnoli, Cristina Angeletti, Maria F Faienza, Maria L Iezzi, Tommaso Aversa, Cinzia Sacchetti
AIMS: Growth hormone deficiency therapy is demanding for patients and caregivers. Teams engaged in the clinical management of growth hormone deficiency therapy need to know how families live with this condition, to provide an adequate support and prevent the risk of withdrawal from therapy. METHODS: Using Narrative Medicine, testimonies from patients, their parents and providers of care were collected from 11 Italian centers. Narrations were analyzed throughout an elaboration of recurring words and expressions...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28027254/evidence-based-medicine-cutaneous-facial-malignancies-nonmelanoma-skin-cancer
#14
Karen L Connolly, Kishwer S Nehal, Joseph J Disa
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Identify clinical features of nonmelanoma skin cancer; 2. Distinguish low-risk versus high-risk basal cell carcinoma and squamous cell carcinoma; 3. Define appropriate management based on current guidelines for various types of basal cell and squamous cell carcinoma. SUMMARY: Skin malignancies are the most prevalent cancers, and plastic surgeons are often the primary physicians engaged in diagnosis and management of these lesions...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28024312/factors-that-distinguish-high-performing-accountable-care-organizations-in-the-medicare-shared-savings-program
#15
Thomas D'Aunno, Lauren Broffman, Michael Sparer, Sumit R Kumar
OBJECTIVE: To identify factors that promote the effective performance of accountable care organizations (ACOs) in the Medicare Shared Savings Program. DATA SOURCES/STUDY SETTING: Data come from a convenience sample of 16 Medicare Shared Savings ACOs that were organized around large physician groups. We use claims data from the Center for Medicaid and Medicare Services and data from 60 interviews at three high-performing and three low-performing ACOs. STUDY DESIGN: Explanatory sequential design, using qualitative data to account for patterns observed in quantitative assessment of ACO performance...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28017274/macra-mips-and-the-new-medicare-quality-payment-program-an-update-for%C3%A2-radiologists
#16
Andrew B Rosenkrantz, Gregory N Nicola, Bibb Allen, Danny R Hughes, Joshua A Hirsch
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 advances the goal of tying Medicare payments to quality and value. In April 2016, CMS published an initial proposed rule for MACRA, renaming it the Quality Payment Program (QPP). Under QPP, clinicians receive payments through either advanced alternative payment models or the Merit-Based Incentive Payment System (MIPS), a consolidation of existing federal performance programs that applies positive or negative adjustments to fee-for-service payments...
December 21, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28009697/an-intervention-bundle-to-facilitate-return-to-work-for-burn-injured-workers-report-from-a-burn-model-system-investigation
#17
Gretchen J Carrougher, Sabina B Brych, Tam N Pham, Samuel P Mandell, Nicole S Gibran
Rates of return to work (RTW) after burn injury vary. A 2012 systematic review of the burn literature reported that nearly 28% of all adult burn survivors never return to any form of employment. These authors called for interventions designed to assist survivors' ability to function in an employed capacity. In 2010, our burn center outpatient clinic instituted an intervention aimed to return injured workers to employment within 90 days of their insurance claims. The interventions include patient/family education focused on recovery rather than disability, employer contact and education by the vocational rehabilitation (VR) counselor, physician recommendations for work accommodations, provision of employee status letters, and Activity Prescription Forms (APFs)...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28008236/communicating-laboratory-test-results-for-rheumatoid-factor-what-do-patients-and-physicians-want
#18
Ariella Kelman, Caroline O Robinson, Elisenda Cochin, Nina J Ahluwalia, Julia Braverman, Emil Chiauzzi, Kristina Simacek
OBJECTIVE: This study aimed to explore patient and physician perspectives on current laboratory test reporting practices and to elicit ideas for improvement. METHODS: Two independent studies were conducted. The first solicited members of an online physician community for opinions on current laboratory test reporting practices and possible improvements. The second addressed the same topic, but solicited patient feedback, and included an evaluation of a mock laboratory test report for the rheumatoid factor blood test...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28001135/a-survey-of-physicians-attitudes-toward-decision-making-authority-for-initiating-and-withdrawing-va-ecmo-results-and-ethical-implications-for-shared-decision-making
#19
Ellen C Meltzer, Natalia S Ivascu, Meredith Stark, Alexander V Orfanos, Cathleen A Acres, Paul J Christos, Thomas Mangione, Joseph J Fins
OBJECTIVE: Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians' attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27999951/physician-role-in-physical-activity-for-african-american-males-undergoing-radical-prostatectomy-for-prostate-cancer
#20
Faustine Williams, Kellie R Imm, Graham A Colditz, Ashley J Housten, Lin Yang, Keon L Gilbert, Bettina F Drake
PURPOSE: Physical activity is recognized as a complementary therapy to improve physical and physiological functions among prostate cancer survivors. Little is known about communication between health providers and African-American prostate cancer patients, a high risk population, regarding the health benefits of regular physical activity on their prognosis and recovery. This study explores African-American prostate cancer survivors' experiences with physical activity prescription from their physicians...
December 21, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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