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https://www.readbyqxmd.com/read/28109011/individual-physician-penalties-resulting-from-violation-of-emtala-a-review-of-office-of-the-inspector-general-patient-dumping-settlements-2002-2015
#1
Sophie Terp, Brandon Wang, Brian Raffetto, Seth A Seabury, Michael Menchine
OBJECTIVE: To describe characteristics of civil monetary penalty settlements levied by the Office of the Inspector General (OIG) against individual physicians related to violation of the Emergency Medical Treatment and Labor Act (EMTALA). METHODS: Descriptions of all civil monetary penalty settlements between 2002 and 2015 were obtained from the OIG. Characteristics of settlements against individual physicians related to EMTALA violations were described including settlement date, location, amount, whether there was an associated hospital settlement, the medical specialty of the physician involved, and the nature of the allegation...
January 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28108913/religion-and-public-health-moral-tradition-as-both-problem-and-solution
#2
Michael Rozier
Despite strong religious influence in the development of medicine and medical ethics, religion has been relatively absent in the rise of preventive medicine and population health. Episodic, clinical medicine has a powerful hold on the religious imagination in health care. Nevertheless, Hebrew Scripture, elements of rabbinical teaching, and modern concepts of social justice all can be used to inspire action in health care that goes beyond clinical medicine. The Christian tradition can call upon the corporal works of mercy, virtue ethics, and Catholic social teaching, as well as the modern history Catholic sisters in the U...
January 20, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#3
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28108781/potentially-inappropriate-medications-predictor-for-mortality-in-a-cohort-of-community-dwelling-older-adults
#4
Mariana Martins Gonzaga do Nascimento, Juliana Vaz de Melo Mambrini, Maria Fernanda Lima-Costa, Josélia Oliveira Araújo Firmo, Sérgio William Viana Peixoto, Antônio Ignácio de Loyola Filho
PURPOSE: The objective of this study was to investigate whether the potentially inappropriate medication (PIM) use is a predictor for mortality in a community-based population of older adults. METHODS: A cohort study was performed between January 1, 1997, and December 31, 2011, based on data from a representative sample of the population aged 60 years or older living in Bambuí, Brazil. Univariate and multivariate analyses of the association between the variable of interest (use of PIM or pharmacological groups of PIM) and mortality were based on the extended Cox model for proportional hazards...
January 20, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28108666/antibiotic-induced-elevations-of-plasma-bile-acids-in-rats-independent-of-bsep-inhibition
#5
Yutai Li, Michael J Hafey, Hong Duong, Raymond Evers, Kyeongmi Cheon, Daniel J Holder, Alema Galijatovic-Idrizbegovic, Frank D Sistare, Warren E Glaab
Drug-induced liver injury (DILI) is a common toxicity observed in drug development and can lead to withdrawal of approved drugs from the market. To better understand the numerous mechanisms of DILI, recent efforts have focused on transporter inhibition, specifically liver canalicular bile salt export pump (Bsep) as one mechanism of DILI, and on the potential use of plasma bile acids as monitorable mechanism-based biomarkers of Bsep inhibition. To explore alternative mechanisms of bile acid increases in plasma, six antibiotic and two non-antibiotic drugs unlikely to be Bsep inhibitors were evaluated in rat studies...
January 20, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28108430/remote-monitoring-of-patients-with-heart-failure-an-overview-of-systematic-reviews
#6
REVIEW
Nazli Bashi, Mohanraj Karunanithi, Farhad Fatehi, Hang Ding, Darren Walters
BACKGROUND: Many systematic reviews exist on the use of remote patient monitoring (RPM) interventions to improve clinical outcomes and psychological well-being of patients with heart failure. However, research is broadly distributed from simple telephone-based to complex technology-based interventions. The scope and focus of such evidence also vary widely, creating challenges for clinicians who seek information on the effect of RPM interventions. OBJECTIVE: The aim of this study was to investigate the effects of RPM interventions on the health outcomes of patients with heart failure by synthesizing review-level evidence...
January 20, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28108231/interconception-challenges-of-women-who-had-prior-preterm-births
#7
Doris M Boutain, Shuyuann Wang Foreman, Jane Hitti
OBJECTIVE: To describe the interconception challenges of women who had prior preterm births. DESIGN: We used a cross-sectional design and collected data via survey. SETTING: King County, Washington. PARTICIPANTS: Ninety-two women who had prior early preterm births (20-33 weeks gestation) were included. METHODS: Women were recruited from a larger study focused on exploring the infectious pathways for early preterm birth...
January 17, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28107790/a-qualitative-inquiry-of-lower-extremity-disease-knowledge-among-african-americans-living-with-type-2-diabetes
#8
Timethia Bonner, Idethia S Harvey, Ledric Sherman
The purpose of this study was to investigate how personal illness representations of type 2 diabetes affected the level of foot care knowledge and self-care strategies among African Americans adults. Thirteen African Americans (ages 32-72 years) participated in individual semistructured qualitative interviews regarding self-care practices and lower extremity disease knowledge related to type 2 diabetes. Using phenomenological methodology, all interviews were transcribed and analyzed by the research team for themes...
January 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/28107604/predicting-recovery-in-patients-with-acute-low-back-pain-a-clinical-prediction-model
#9
T da Silva, P Macaskill, K Mills, C Maher, C Williams, C Lin, M J Hancock
BACKGROUND: There is substantial variability in the prognosis of acute low back pain (LBP). The ability to identify the probability of individual patients recovering by key time points would be valuable in making informed decisions about the amount and type of treatment to provide. Predicting recovery based on presentation 1-week after initially seeking care is clinically important and may be more accurate than predictions made at initial presentation. The aim of this study was to predict the probability of recovery at 1-week, 1-month and 3-months after 1-week review in patients who still have LBP 1-week after initially seeking care...
January 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#10
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107352/coping-well-with-advanced-cancer-a-serial-qualitative-interview-study-with-patients-and-family-carers
#11
Catherine Walshe, Diane Roberts, Lynda Appleton, Lynn Calman, Paul Large, Mari Lloyd-Williams, Gunn Grande
OBJECTIVES: To understand successful strategies used by people to cope well when living with advanced cancer; to explore how professionals can support effective coping strategies; to understand how to support development of effective coping strategies for patients and family carers. DESIGN: Qualitative serial (4-12 week intervals) interview study with people with advanced cancer and their informal carers followed by focus groups. The iterative design had a novel focus on positive coping strategies...
2017: PloS One
https://www.readbyqxmd.com/read/28107351/high-concentrations-of-angiopoietin-like-protein-4-detected-in-serum-from-patients-with-rheumatoid-arthritis-can-be-explained-by-non-specific-antibody-reactivity
#12
Elena Makoveichuk, Toralph Ruge, Solveig Nilsson, Anna Södergren, Gunilla Olivecrona
Angiopoietin-like protein 4 (ANGPTL4) is suggested to be a master regulator of plasma triglyceride metabolism. Our aim was to study whether the previously reported high levels of ANGPTL4 detected in serum from patients with rheumatoid arthritis (RA) by ELISA was due to any specific molecular form of this protein (oligomers, monomers or fragments). ANGPTL4 levels were first determined in serum from 68 RA patients and 43 age and sex matched control subjects and the mean values differed by a factor of 5.0. Then, ANGPTL4 was analyzed after size exclusion chromatography (SEC) of serum samples...
2017: PloS One
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#13
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/28107227/structural-level-differences-in-the-mother-to-child-hiv-transmission-rate-in-south-africa-a-multilevel-assessment-of-individual-health-facility-and-provincial-level-predictors-of-infant-hiv-transmission
#14
S Woldesenbet, D J Jackson, C J Lombard, T H Dinh, V Ramokolo, T Doherty, G G Sherman, Y Pillay, A E Goga
OBJECTIVES: In 2010, South Africa reported an early mother to child transmission (MTCT) rate of 3.5% at 4-8 weeks postpartum. Provincial early MTCT rates ranged from 1.4% (95% confidence interval [CI]: 0.1-3.4%) to 5.9% (95% CI: 3.8-8.0%). We sought to determine reasons for these geographic differences in MTCT rates. METHODS: This study employed multilevel modelling using 2010 South African PMTCT evaluation (SAPMTCTE) data from 530 facilities. Interview data and infant blood samples were collected from 3085 mother-infant pairs at 4-8 weeks postpartum...
January 18, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28107159/caring-for-the-trafficked-patient-ethical-challenges-and-recommendations-for-health-care-professionals
#15
Wendy L Macias-Konstantopoulos
Human trafficking is an egregious human rights violation with profound negative physical and psychological consequences, including communicable diseases, substance use disorders, and mental illnesses. The health needs of this population are multiple, complex, and influenced by past and present experiences of abuse, neglect, and exploitation. Effective health care services for trafficked patients require clinicians to consider individual patients' needs, wishes, goals, priorities, risks, and vulnerabilities as well as public health implications and even resource allocation...
January 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#16
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28106810/genetic-aspects-of-susceptibility-to-mercury-toxicity-an-overview
#17
REVIEW
Virginia Andreoli, Francesca Sprovieri
Human exposure to mercury is still a major public health concern. In this context, children have a higher susceptibility to adverse neurological mercury effects, compared to adults with similar exposures. Moreover, there exists a marked variability of personal response to detrimental mercury action, in particular among population groups with significant mercury exposure. New scientific evidence on genetic backgrounds has raised the issue of whether candidate susceptibility genes can make certain individuals more or less vulnerable to mercury toxicity...
January 18, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#18
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106612/the-brief-early-childhood-screening-assessment-preliminary-validity-in-pediatric-primary-care
#19
Elise M Fallucco, Tim Wysocki, Lauren James, Chelsea Kozikowski, Andre Williams, Mary M Gleason
OBJECTIVE: Brief, well-validated instruments are needed to facilitate screening for early childhood behavioral and emotional problems (BEPs). The objectives of this study were to empirically reduce the length of the Early Childhood Screening Assessment (ECSA) and to assess the validity and reliability of this shorter tool. METHODS: Using caregiver ECSA responses for 2467 children aged 36 to 60 months seen in primary care, individual ECSA items were ranked on a scale ranging from "absolutely retain" to "absolutely delete...
January 17, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28106553/attitudes-toward-potential-participant-registries
#20
Joshua D Grill, Andrew Holbrook, Aimee Pierce, Dan Hoang, Daniel L Gillen
Difficult participant recruitment is a consistent barrier to successful medical research. Potential participant registries represent an increasingly common intervention to overcome this barrier. A variety of models for registries exist, but few data are available to instruct their design and implementation. To provide such data, we surveyed 110 cognitively normal research participants enrolled in a longitudinal study of aging and dementia. Seventy-four (67%) individuals participated in the study. Most (78%, CI: 0...
January 18, 2017: Journal of Alzheimer's Disease: JAD
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