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https://www.readbyqxmd.com/read/28813636/using-systems-science-to-inform-population-health-strategies-in-local-health-departments-a-case-study-in-san-antonio-texas
#1
Yan Li, Norma A Padrón, Anil T Mangla, Pamela G Russo, Thomas Schlenker, José A Pagán
OBJECTIVES: Because of state and federal health care reform, local health departments play an increasingly prominent role leading and coordinating disease prevention programs in the United States. This case study shows how a local health department working in chronic disease prevention and management can use systems science and evidence-based decision making to inform program selection, implementation, and assessment; enhance engagement with local health systems and organizations; and possibly optimize health care delivery and population health...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28813536/tuberculosis-patients-in-an-indian-mega-city-where-do-they-live-and-where-are-they-diagnosed
#2
Ramnath Subbaraman, Beena E Thomas, Senthil Sellappan, Chandra Suresh, Lavanya Jayabal, Savari Lincy, Agnes L Raja, Allison McFall, Sunil Suhas Solomon, Kenneth H Mayer, Soumya Swaminathan
OBJECTIVE: Tuberculosis (TB) is a major source of mortality in urban India, with many structural challenges to optimal care delivery. In the government TB program in Chennai, India's fourth most populous city, there is a 49% gap between the official number of smear-positive TB patients diagnosed and the official number registered in TB treatment within the city in 2014. We hypothesize that this "urban registration gap" is partly due to rural patients temporarily visiting the city for diagnostic evaluation...
2017: PloS One
https://www.readbyqxmd.com/read/28813175/qualitative-analysis-of-registered-nurses-perceptions-of-lactation-assessment-tools-why-and-how-they-are-completed
#3
Joan Esper Kuhnly, Donna J Chapman
BACKGROUND: Although lactation assessment tools are consistently used in clinical practice, there is no evidence describing registered nurses' perspectives regarding the purpose and thought processes involved when conducting a breastfeeding assessment. Research aim: This study aimed to explore registered nurses' perceptions on the purpose of lactation assessment tools and the thought processes involved in completing one. METHODS: Seven focus groups were held from April 2015 through July 2015, in coordination with regional and international lactation and perinatal conferences...
August 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28812833/evaluating-the-implementation-and-feasibility-of-a-web-based-tool-to-support-timely-identification-and-care-for-the-frail-population-in-primary-healthcare-settings
#4
Beverley Lawson, Tara Sampalli, Stephanie Wood, Grace Warner, Paige Moorhouse, Rick Gibson, Laurie Mallery, Fred Burge, Lisa G Bedford
BACKGROUND: Understanding and addressing the needs of frail persons is an emerging health priority for Nova Scotia and internationally. Primary healthcare (PHC) providers regularly encounter frail persons in their daily clinical work. However, routine identification and measurement of frailty is not standard practice and, in general, there is a lack of awareness about how to identify and respond to frailty. A web-based tool called the Frailty Portal was developed to aid in identifying, screening, and providing care for frail patients in PHC settings...
March 7, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28811918/shared-decision-making-in-medication-management-development-of-a-training-intervention
#5
Ute Stead, Nicola Morant, Shulamit Ramon
Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project...
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28811747/what-establishes-an-excellent-nurse-a-focus-group-and-delphi-panel-approach
#6
Wolter Paans, Patricia Robbe, Inge Wijkamp, Marca V C Wolfensberger
BACKGROUND: Over the past few years, the complexity of the health care system in which nurses are required to practice has increased considerably, magnifying the need for excellent professionals with a specific set of knowledge, skills and attitudes. However, the characteristics that distinguish an excellent nurse have not yet been clarified. The aim of this study was to determine nurses' perspectives regarding characteristics associated with an excellent nurse in order to elicit a conceptual profile...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28811343/comparative-genomics-of-escherichia-coli-isolated-from-skin-and-soft-tissue-and-other-extraintestinal-infections
#7
Amit Ranjan, Sabiha Shaik, Nishant Nandanwar, Arif Hussain, Sumeet K Tiwari, Torsten Semmler, Savita Jadhav, Lothar H Wieler, Munirul Alam, Rita R Colwell, Niyaz Ahmed
Escherichia coli, an intestinal Gram-negative bacterium, has been shown to be associated with a variety of diseases in addition to intestinal infections, such as urinary tract infections (UTIs), meningitis in neonates, septicemia, skin and soft tissue infections (SSTIs), and colisepticemia. Thus, for nonintestinal infections, it is categorized as extraintestinal pathogenic E. coli (ExPEC). It is also an opportunistic pathogen, causing cross infections, notably as an agent of zoonotic diseases. However, comparative genomic data providing functional and genetic coordinates for ExPEC strains associated with these different types of infections have not proven conclusive...
August 15, 2017: MBio
https://www.readbyqxmd.com/read/28811281/multimorbidity-dementia-and-health-care-in-older-people-a-population-based-cohort-study
#8
Marcello Tonelli, Natasha Wiebe, Sharon Straus, Martin Fortin, Bruce Guthrie, Matthew T James, Scott W Klarenbach, Helen Tam-Tham, Richard Lewanczuk, Braden J Manns, Hude Quan, Paul E Ronksley, Peter Sargious, Brenda Hemmelgarn
BACKGROUND: Little is known about how multimorbidity, dementia and increasing age combine to influence health outcomes or utilization. Our objective was to examine the joint associations between age, dementia and burden of morbidity with mortality and other clinical outcomes. METHODS: We did a retrospective population-based cohort study of all adults aged 65 years and older residing in Alberta, Canada, between 2002 and 2013. We used validated algorithms applied to administrative and laboratory data from the provincial health ministry to assess the presence/absence of dementia and 29 other morbidities, and their associations with mortality (our primary outcome), other clinical outcomes (emergency department visits, all-cause hospital admissions) and a proxy for loss of independent living (discharge to long-term care)...
August 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28811158/high-hcv-cure-rates-for-people-who-use-drugs-treated-with-direct-acting-antiviral-therapy-at-an-urban-primary-care-clinic
#9
Brianna L Norton, Julia Fleming, Marcus A Bachhuber, Meredith Steinman, Joseph DeLuca, Chinazo O Cunningham, Nirah Johnson, Fabienne Laraque, Alain H Litwin
BACKGROUND: Though direct acting antivirals (DAAs) promise high cure rates, many providers and payers remain concerned about successful treatment for people who use drugs (PWUD), even among those engaged in opioid agonist treatment (OAT). The efficacy of DAAs among PWUD in real-world settings is unclear. METHODS: We conducted a cohort study of patients initiating HCV treatment between January 2014 and August 2015 (n=89) at a primary care clinic in the Bronx, NY...
August 12, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28811123/emergency-department-involvement-in-accountable-care-organizations-in-massachusetts-a-survey-study
#10
Nissa J Ali, J Michael McWilliams, Stephen K Epstein, Peter B Smulowitz
STUDY OBJECTIVE: We assess Massachusetts emergency department (ED) involvement and internal ED constructs within accountable care organization contracts. METHODS: An online survey was distributed to 70 Massachusetts ED directors. Questions attempted to assess involvement of EDs in accountable care organizations and the structures in place in EDs-from departmental resources to physician incentives-to help achieve accountable care organization goals of decreasing spending and improving quality...
August 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28811089/physician-experiences-with-clinical-pharmacists-in-primary-care-teams
#11
Gerardo Moreno, Sarah Lonowski, Jeffrey Fu, Janet S Chon, Natalie Whitmire, Carolina Vasquez, Samuel A Skootsky, Douglas S Bell, Richard Maranon, Carol M Mangione
BACKGROUND: Improving medication management is an important component of comprehensive care coordination for health systems. The Managing Your Medication for Education and Daily Support (MyMeds) medication management program at the University of California Los Angeles addresses medication management issues by embedding trained clinical pharmacists in primary care practice teams. OBJECTIVES: The aim of this work was to examine and explore physician opinions about the clinical pharmacist program and identify common themes among physician experiences as well as barriers to integration of clinical pharmacists into primary care practice teams...
August 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28811014/assessing-need-for-pharmacist-involvement-to-improve-care-coordination-for-patients-on-lai-antipsychotics-transitioning-from-hospital-to-home-a-work-system-approach
#12
Olufunmilola Abraham, Michelle N Myers, Amanda L Brothers, Jamie Montgomery, Bryan A Norman, Tanya Fabian
BACKGROUND: The use of Long-Acting Injectable (LAI) antipsychotic medications has increased for patients with Serious Mental Illness (SMI). Care coordination for this population is complex, and pharmacist involvement may improve and support long-term medication adherence and patient outcomes. OBJECTIVES: (1) Examine pharmacists' role in addressing care coordination and adherence challenges for patients taking Long-Acting Injectable (LAI) antipsychotics; and (2) explore patients' medication use experiences with LAI antipsychotics and educational needs...
September 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28810985/multimedia-campaign-enhances-orthopaedic-patient-perceptions-of-health-care-quality-a-prospective-analysis-of-effect-at-a-military-treatment-facility
#13
Andrew J Sheean, James N Foster, James K Aden, Creighton C Tubb, Anthony E Johnson, Daniel J Stinner
BACKGROUND: The importance of patient satisfaction as a measure of quality has grown with initiatives intended to enhance demand for services, refocus reimbursement paradigms, encourage health care efficiencies, and ultimately improve clinical outcomes. The purpose of our performance improvement project was to (1) characterize the effect of a two-pronged multimedia initiative on patient perceptions of health care quality and satisfaction as assessed by the Army Provider Level Satisfaction Survey (APLSS) and (2) assess for differences in APLSS scores between the surgeons that did and did not participate in the program...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810277/-concepts-to-optimize-home-care-of-patients-with-mechanical-ventilation
#14
Miranda Nafe, Kristian Herberger, Barbara Wiesner, Christian Grohé
The care of patients with extraclinical mechanical ventilation has to be improved particularly with regard to their specialist care. One care option is the empowering of clinicians at the respiratory centers to enable ambulant care of patients and home visits. An intersectoral linkage in the form of transfer management is the basis for competent coordination. Aim is to ensure the necessary multidisciplinary collaboration in the outpatient care of multimorbid chronically ill patients. For the optimal care of chronically ill patients, sectoral limits should become more permeable...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28809113/theoretical-investigation-of-methane-hydroxylation-over-isoelectronic-feo-2-and-mno-exchanged-zeolites-activated-by-n2o
#15
M Haris Mahyuddin, Yoshihito Shiota, Aleksandar Staykov, Kazunari Yoshizawa
While the most likely structure of the active site in iron-containing zeolites has been recently identified as [FeO](2+) (Snyder et al. Nature 2016, 536, 317-321), the mechanism for the direct conversion of methane to methanol over this active species is still debatable between the direct-radical-rebound or nonradical (concerted) mechanism. Using density functional theory on periodic systems, we calculated the two reaction mechanisms over two d(4) isoelectronic systems, [FeO](2+) and [MnO](+) zeolites. We found that [FeO](2+) zeolites favor the direct-radical-rebound mechanism with low CH4 activation energies, while [MnO](+) zeolites prefer the nonradical mechanism with higher CH4 activation energies...
August 15, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#16
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807953/developing-family-practice-to-respond-to-global-health-challenges-the-besrour-papers-a-series-on-the-state-of-family-medicine-in-the-world
#17
REVIEW
Neil Arya, Bruce Dahlman, Christine Gibson, David Ponka, Cynthia Haq, Katherine Rouleau, Stephanie Hansel
OBJECTIVE: To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. COMPOSITION OF THE COMMITTEE: A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28807893/optimizing-the-use-of-electronic-health-records-to-identify-high-risk-psychosocial-determinants-of-health
#18
Nicolas Michel Oreskovic, Jennifer Maniates, Jeffrey Weilburg, Garry Choy
BACKGROUND: Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data. However, not all clinically relevant data reside in claims and formatted data. Recently, there has been increasing interest in including patients with complex psychosocial determinants of health in care coordination programs. Psychosocial risk factors, including social determinants of health, mental health disorders, and substance abuse disorders, are less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data, and due to US Health Insurance Portability and Accountability Act (HIPAA) regulations are often not available as claims data...
August 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28807702/factors-associated-with-use-of-u-s-community-based-palliative-care-for-children-with-life-limiting-or-life-threatening-illnesses-and-their-families-an-integrative-review
#19
REVIEW
Jackelyn Y Boyden, Martha A Q Curley, Janet A Deatrick, Mary Ersek
CONTEXT: As children with life-limiting and life-threatening illnesses live longer, challenges to meeting their complex health care needs arise in homes and communities, as well as in hospitals. Integrated knowledge regarding community-based pediatric palliative care (CBPPC) is needed to strategically plan for a seamless continuum of care for children and their families. OBJECTIVE: The purpose of this integrative review paper is to explore factors that are associated with the use of CBPPC for U...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807700/unfinished-business-in-families-of-terminally-ill-with-cancer-patients
#20
Ryoko Yamashita, Harue Arao, Ayumi Takao, Eiko Masutani, Tatsuya Morita, Yasuo Shima, Yoshiyuki Kizawa, Satoru Tsuneto, Maho Aoyama, Mitsunori Miyashita
CONTEXT: Unfinished business often causes psychological issues after bereavement. Providing care for families of terminally ill patients with cancer to prevent unfinished business is important. OBJECTIVES: To clarify the prevalence and types of unfinished business in families of end-of-life patients with cancer admitted to palliative care units (PCUs), explore depression and grief associated with unfinished business, and explore the factors affecting unfinished business...
August 11, 2017: Journal of Pain and Symptom Management
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