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Quality of improvement

Amy M Kilbourne, Michelle M Barbaresso, Zongshan Lai, Kristina M Nord, Margretta Bramlet, David E Goodrich, Edward P Post, Daniel Almirall, Mark S Bauer
OBJECTIVE: Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. METHODS: This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147)...
October 25, 2016: Journal of Clinical Psychiatry
Robert Westermann, Chris A Anthony, Kyle R Duchman, Yubo Gao, Andrew J Pugely, Carolyn M Hettrich, Ned Amendola, Brian R Wolf
Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013...
October 25, 2016: Journal of Knee Surgery
H U Brauer, W Walther, M Dick
Background: Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. Methods: 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. Results: A catalogue of 68 ideas was generated for improvement and divided into 15 categories...
October 25, 2016: Das Gesundheitswesen
Sarah B Bateni, Frederick J Meyers, Richard J Bold, Robert J Canter
BACKGROUND: The impact of surgery on end of life care for patients with disseminated malignancy (DMa) is incompletely characterized. The purpose of this study was to evaluate postoperative outcomes impacting quality of care among DMa patients, specifically prolonged length of hospital stay, readmission, and disposition. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for years 2011-2012. DMa patients were matched to non-DMa patients with comparable clinical characteristics and operation types...
2016: PloS One
Jason Echavez Abello, Julita Gil Cuesta, Boyd Roderick Cerro, Debarati Guha-Sapir
In cases of Dengue fever, late hospital admission can lead to treatment delay and even death. In order to improve early disease notification and management, it is essential to investigate the factors affecting the time of admission of Dengue cases. This study determined the factors associated with the time of admission among notified Dengue cases. The study covered the period between 2008 and 2014 in Region VIII, Philippines. The factors assessed were age, sex, hospital sector, hospital level, disease severity based on the 1997 WHO Dengue classification, and period of admission (distinguishing between the 2010 Dengue epidemic and non-epidemic time)...
October 2016: PLoS Neglected Tropical Diseases
Lisa I Iezzoni
Erroneous assumptions among health care professionals about the daily lives, preferences, values, and expectations of persons with disability can contribute to documented health care disparities, faulty communication, and substandard quality of care affecting this heterogeneous population. Efforts to reduce racial and ethnic disparities have focused on expanding diversity in the physician workforce. Would expanding the numbers of physicians with disability benefit patients with disability? Increasing the number of physicians who identify as "disabled" is one strategy for proactively confronting disability-related barriers affecting patients, but such efforts will likely face substantial challenges...
October 1, 2016: AMA Journal of Ethics
Aaron B Parrish, Yas Sanaiha, Beverley A Petrie, Marcia M Russell, Formosa Chen
The American Society of Colon and Rectal Surgeons rectal cancer checklist describes a set of best practices for rectal cancer surgery. The objective of this study was to assess the quality of operative reports for rectal cancer surgery based on the intraoperative American Society of Colon and Rectal Surgeons checklist items. Patients undergoing rectal cancer surgery at two public teaching hospitals from 2009 to 2015 were included. A total of 12 intraoperative checklist items were assessed. One hundred and fifty-eight operative reports were reviewed...
October 2016: American Surgeon
Reza Fazl Alizadeh, Zhobin Moghadamyeghaneh, Matthew D Whealon, Mark H Hanna, Steven D Mills, Alessio Pigazzi, Michael J Stamos, Joseph C Carmichael
There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013. Multivariate regression analysis was used to assess the independent effect of BMI on outcomes...
October 2016: American Surgeon
Shawn Diamond, Hassan S Moghaddas, Stephen S Kaminski, Jonathan Grotts, Lisa Ferrigno, Wesley Schooler
Over two million Americans receive treatment for pressure ulcers (PUs) annually, but national surgical outcomes are not well described. This study investigated rates and risk factors of postoperative complications in patients with PU. The 2011 and 2012 American College of Surgeons-National Surgical Quality Improvement Project database was queried and PU patients undergoing flap closure were identified. Descriptive statistics and multivariate regression analysis was used and reported as odds ratios (ORs) if (P < 0...
October 2016: American Surgeon
Son Nguyen, Allen Zhu, William Toppen, Adeel Ashfaq, Jessica Davis, Richard Shemin, Abie H Mendelsohn, Peyman Benharash
Although the true incidence of postoperative dysphagia after cardiac surgery is unknown, it has been reported to occur in 3 to 21.6 per cent of patients. Historically, dysphagia has been associated with increased surgical complications and prolonged hospital stay. This study aimed to evaluate the costs and outcomes associated with dysphagia after cardiac surgery. Patients undergoing nonemergent, nontransplant cardiac operations between June 2013 and June 2014 were eligible for inclusion. Independent predictors of cost were identified through a multivariate linear regression model...
October 2016: American Surgeon
Mohammed Al-Temimi, Charles Trujillo, John Agapian, Hanna Park, Ahmad Dehal, Samir Johna, Deron Tessier
Incidental appendectomy (IA) could potentially increase the risk of morbidity after abdominal procedures; however, such effect is not clearly established. The aim of our study is to test the association of IA with morbidity after abdominal procedures. We identified 743 (0.37%) IA among 199,233 abdominal procedures in the National Surgical Quality Improvement Program database (2005-2009). Cases with and without IA were matched on the index current procedural terminology code. Patient characteristics were compared using chi-squared test for categorical variables and Student t test for continuous variables...
October 2016: American Surgeon
Courtney A Pinard, Hollyanne E Fricke, Teresa M Smith, Leah R Carpenter, Amy L Yaroch
OBJECTIVES: Rural communities face unique challenges to and opportunities for offering more healthful foods and are often understudied in comparison to their urban counterparts. The purpose of this study was to conduct a qualitative assessment of rural storeowners' perceptions of their communities, their business practices, and factors that influences their viability, sustainability, and ability to support healthy food choices. METHODS: We conducted interviews with storeowners (N = 15) in small stores in rural Nebraska and explored perceptions of business practices, role in the community, and consumer demand for more healthful foods...
November 2016: American Journal of Health Behavior
Rebecca Ruch-Gallie, Heather Weir, Lori R Kogan
Cognitive functioning is often compromised with increasing levels of stress and fatigue, both of which are often experienced by veterinarians. Many high-stress fields have implemented checklists to reduce human error. The use of these checklists has been shown to improve the quality of medical care, including adherence to evidence-based best practices and improvement of patient safety. Although it has been recognized that veterinary medicine would likely demonstrate similar benefits, there have been no published studies to date evaluating the use of checklists for improving quality of care in veterinary medicine...
October 25, 2016: Journal of Veterinary Medical Education
Richard D Scheffe, Madeleine Strum, James Thurman, Sharon B Phillips, Alison Eyth, Steve Fudge, Mark Morris, Ted Palma, Richard Cook
A hybrid air quality model has been developed and applied to estimate annual concentrations of 40 hazardous air pollutants (HAPs) across the continental United States (CONUS) to support the 2011 calendar year National Air Toxics Assessment (NATA). By combining a chemical transport model (CTM) with a Gaussian dispersion model, both reactive and non-reactive HAPs are accommodated across local to regional spatial scales, through a multiplicative technique designed to improve mass conservation relative to previous additive methods...
October 25, 2016: Environmental Science & Technology
Linda Govere, Ephraim M Govere
BACKGROUND: With the rapid growth of minority populations in the United States, the need to train healthcare providers to give culturally competent care has never been greater. Extensive research on cultural competence of healthcare providers has been conducted, but no systematic review specifically focused on the effect of cultural competence training on patient satisfaction of clients from minority groups. AIMS: To search and critically appraise published research articles that evaluated the effectiveness of cultural competence training of healthcare providers on improving patient satisfaction of clients from minority groups...
October 25, 2016: Worldviews on Evidence-based Nursing
Virginie Gaget, Angela Keulen, Melody Lau, Paul Monis, Justin D Brookes
AIMS: Benthic cyanobacteria produce toxic and odorous compounds similar to their planktonic counterparts, challenging the quality of drinking water supplies. The biofilm that benthic algae and other micro-organisms produce is a complex and protective matrix. Monitoring to determine the abundance and identification of cyanobacteria therefore relies on molecular techniques, with the choice of DNA isolation technique critical. This study investigated which DNA extraction method is optimal for DNA recovery in order to guarantee the best DNA yield for PCR-based analysis of benthic cyanobacteria...
October 25, 2016: Journal of Applied Microbiology
Mei-Chuan Huang, Chich-Hsiu Hung, Ching-Yun Yu, Diane C Berry, Shyi-Jang Shin, Yu-Yun Hsu
AIMS: To explore the effectiveness of two types of health education on improving knowledge concerning diabetes and insulin injection, insulin injection skills and self-efficacy, satisfaction with health education and glycated hemoglobin (HbA1c) and creatinine levels among patients with type 2 diabetes who began insulin therapy using a pen injector. BACKGROUND: Insulin therapy is recommended to facilitate the regulation of plasma glucose; however, patient's acceptance of insulin therapy is generally low...
October 25, 2016: Journal of Advanced Nursing
Lawrence Tim Goodnough, Josep Comin-Colet, Santiago Leal-Noval, Sherri Ozawa, Jacqueline Takere, David Henry, Mazyar Javidroozi, Benjamin Hohmuth, Elvira Bisbe, Irwin Gross, Aryeh Shander
Anemia is an independent risk factor for adverse patient outcomes. There are no guidelines for management of anemia in patients withcongestive heart failure (CHF), despite itshigh incidence. Four objectives were defined by the International Anemia Management and Clinical Outcomes Expert Panel (AMCO), a multinational group of interdisciplinary experts identified by the Society for the Advancement of Blood Management (SABM) to: determine the prevalence of anemia in outpatients; to determine the prevalence of hospital-acquired anemia; to assess the impact of anemia management on clinical outcomes such as quality of life and functional status; and to provide recommendations for primary care physicians and specialists for the diagnosis, evaluation, and management of anemia in patients with CHF...
October 25, 2016: American Journal of Hematology
Nittaya Srisuk, Jan Cameron, Chantal F Ski, David R Thompson
AIM: To evaluate a heart failure education program developed for patients and carers in Thailand. BACKGROUND: Heart failure is major health problem. This is the first trial of a family-based education program for heart failure patients and carers residing in rural Thailand. DESIGN: Randomized controlled trial. METHODS: One hundred patient-carer dyads attending cardiac clinics in southern Thailand from April 2014-March 2015 were randomized to usual care (n=50) or a family-based education program (n=50) comprising face-to-face counselling, a heart failure manual and DVD and telephone support...
October 25, 2016: Journal of Advanced Nursing
Nicoline Callesen Do, Anna Lilja Secher, Per Cramon, Lene Ringholm, Torquil Watt, Peter Damm, Elisabeth Reinhardt Mathiesen
INTRODUCTION: To explore changes in health-related quality of life, anxiety and depression symptoms during pregnancy in women with pregestational diabetes. MATERIAL AND METHODS: An observational cohort study including 137 pregnant women with pregestational diabetes (110 with type 1 and 27 with type 2). To evaluate changes from early to late pregnancy, the internationally validated questionnaires 36-Item Short-Form Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS), were completed at 8 and 33 gestational weeks...
October 25, 2016: Acta Obstetricia et Gynecologica Scandinavica
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