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https://www.readbyqxmd.com/read/28430040/foraging-value-risk-avoidance-and-multiple-control-signals-how-the-acc-controls-value-based-decision-making
#1
Joshua W Brown, William H Alexander
Recent work on the role of the ACC in cognition has focused on choice difficulty, action value, risk avoidance, conflict resolution, and the value of exerting control among other factors. A main underlying question is what are the output signals of ACC, and relatedly, what is their effect on downstream cognitive processes? Here we propose a model of how ACC influences cognitive processing in other brain regions that choose actions. The model builds on the earlier Predicted Response Outcome model and suggests that ACC learns to represent specifically the states in which the potential costs or risks of an action are high, on both short and long timescales...
April 21, 2017: Journal of Cognitive Neuroscience
https://www.readbyqxmd.com/read/28427303/values-based-practice-a-framework-for-thinking-with
#2
Kay Mohanna
Values are those principles that govern behaviours, and values-based practice has been described as a theory and skills base for effective healthcare decision-making where different (and hence potentially conflicting) values are in play. The emphasis is on good process rather than pre-set right outcomes, aiming to achieve balanced decision-making. In this article we will consider the utility of this model by looking at leadership development, a current area of much interest and investment in healthcare. Copeland points out that 'values based leadership behaviors are styles with a moral, authentic and ethical dimension', important qualities in healthcare decision-making...
April 21, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28426971/metaplasticity-as-a-neural-substrate-for-adaptive-learning-and-choice-under-uncertainty
#3
Shiva Farashahi, Christopher H Donahue, Peyman Khorsand, Hyojung Seo, Daeyeol Lee, Alireza Soltani
Value-based decision making often involves integration of reward outcomes over time, but this becomes considerably more challenging if reward assignments on alternative options are probabilistic and non-stationary. Despite the existence of various models for optimally integrating reward under uncertainty, the underlying neural mechanisms are still unknown. Here we propose that reward-dependent metaplasticity (RDMP) can provide a plausible mechanism for both integration of reward under uncertainty and estimation of uncertainty itself...
April 19, 2017: Neuron
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#4
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28421386/technology-assessment-and-cost-effectiveness-in-orthopedics-how-to-measure-outcomes-and-deliver-value-in-a-constantly-changing-healthcare-environment
#5
REVIEW
Jeremy M Burnham, Fabien Meta, Vincent Lizzio, Eric C Makhni, Kevin J Bozic
PURPOSE OF REVIEW: The purpose of this study is to review the basic concepts of healthcare value, patient outcome measurement, and cost-effectiveness analyses as they relate to the introduction of new surgical techniques and technologies in the field of orthopedic surgery. RECENT FINDINGS: An increased focus on financial stewardship in healthcare has resulted in a plethora of cost-effectiveness and patient outcome research. Recent research has made great progress in identifying orthopedic technologies that provide exceptional value and those that do not meet adequate standards for widespread adoption...
April 19, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28419657/a-new-approach-to-clinical-research-integrating-clinical-care-quality-reporting-and-research-using-a-wound-care-network-based-learning-healthcare-system
#6
Thomas E Serena, Caroline E Fife, Kristen A Eckert, Raphael A Yaakov, Marissa J Carter
The disparity between ideal evidence from randomized controlled trials and real-world evidence in medical research has prompted the United States Food and Drug Administration to consider the use of real-world data to better understand safety and effectiveness of new devices for a broader patient population and to prioritize real-world data in regulatory decision making. As the healthcare system transitions from volume- to value-based care, there is a growing need to harness the power of real-world data to change the paradigm for wound care clinical research and enable more generalizable clinical trials...
April 17, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28418474/comparative-trends-in-payment-adjustments-between-safety-net-and-other-hospitals-since-the-introduction-of-the-hospital-readmission-reduction-program-and-value-based-purchasing
#7
Nathan Favini, Jason M Hockenberry, Matlin Gilman, Sanjula Jain, Michael K Ong, E Kathleen Adams, Edmund R Becker
No abstract text is available yet for this article.
April 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28416322/nephrologists-and-integrated-kidney-disease-care-roles-and-skills-essential-for-nephrologists-for-future-success
#8
Allen R Nissenson, Franklin W Maddux
As the costs of caring for patients with end-stage renal disease have grown, so has the pressure to provide high-quality care at a lower cost. Prompted in large part by regulatory and legislative changes, reimbursement is shifting from a fee-for-service environment to one of value-based payment models. Nephrologists in this new environment are increasingly responsible not only for direct patient care, but also for population management and the associated clinical outcomes for this vulnerable population. This Perspective article aims to recognize the key role and skills needed in order to successfully practice within these new value-based care models...
April 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28413140/is-day-of-surgery-associated-with-adverse-clinical-and-economic-outcomes-following-primary-total-knee-arthroplasty
#9
Matthew R Boylan, Dean C Perfetti, Qais Naziri, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
BACKGROUND: As orthopedics transition to value-based purchasing, hospitals and providers are incentivized to identify inefficiencies of care delivery. In our experience, weekends are characterized by decreased staffing of ancillary services to coordinate patient discharges, which can lead to prolonged hospital stays for many of our primary total knee arthroplasty (TKA) admissions. METHODS: We identified 115,053 patients who underwent primary TKA on a weekday between 2009 and 2013 in New York State...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28412775/defining-value-in-radiation-oncology-approaches-to-weighing-benefits-vs-costs
#10
REVIEW
Andre A Konski
The passage of the Affordable Care Act in 2010 initiated discussion regarding transitioning from a fee-for-service arrangement of care reimbursement to value-based care. Cost-effectiveness analysis (CEA) has been used in the past to quantify value as it relates to the provision of healthcare. New treatments or techniques being compared with other new or existing therapies or approaches to care were determined to be cost-effective if the incremental cost-effectiveness ratio was less than $50,000/life-year or quality-adjusted life-year...
April 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28410917/the-relative-contribution-of-provider-and-ed-level-factors-to-variation-among-the-top-15-reasons-for-ed-admission
#11
Imad Khojah, Suhui Li, Qian Luo, Griffin Davis, Jessica E Galarraga, Michael Granovsky, Ori Litvak, Samuel Davis, Robert Shesser, Jesse M Pines
STUDY OBJECTIVE: We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. METHODS: This was a retrospective, cross-sectional study of ED encounters (≥18years) from 19 EDs and 603 providers (January 2012-December 2013), linked to the Area Health Resources File for county-level information on healthcare resources...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410099/confidence-based-data-association-and-discriminative-deep-appearance-learning-for-robust-online-multi-object-tracking
#12
Seung-Hwan Bae, Kuk-Jin Yoon
Online multi-object tracking aims at estimating the tracks of multiple objects instantly with each incoming frame and the information provided up to the moment. It still remains a difficult problem in complex scenes, because of the large ambiguity in associating multiple objects in consecutive frames and the low discriminability between objects appearances. In this paper, we propose a robust online multi-object tracking method that can handle these difficulties effectively. We first define the tracklet confidence using the detectability and continuity of a tracklet, and decompose a multi-object tracking problem into small subproblems based on the tracklet confidence...
April 6, 2017: IEEE Transactions on Pattern Analysis and Machine Intelligence
https://www.readbyqxmd.com/read/28409068/redefining-health-implication-for-value-based-healthcare-reform
#13
REVIEW
Ikhwanuliman Putera
Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should include all domains of health in a full cycle of care...
March 2, 2017: Curēus
https://www.readbyqxmd.com/read/28409064/value-based-health-care-delivery-preventive-medicine-and-the-medicalization-of-public-health
#14
REVIEW
Andreas Vilhelmsson
The real paradigm shift for healthcare is often stated to include a transition from accentuating health care production and instead emphasize patient value by moving to a 'value-based health care delivery'. In this transition, personalized medicine is sometimes referred to as almost a panacea in solving the current and future health challenges. In theory, the progress of precision medicine sounds uncontroversial and most welcomed with its promise of a better healthcare for all, with real benefits for the individual patient provided a tailored and optimized treatment plan suitable for his or her genetic makeup...
March 1, 2017: Curēus
https://www.readbyqxmd.com/read/28408782/assessment-of-regional-left-ventricular-systolic-function-by-strain-imaging-echocardiography-in-phenotypically-normal-and-abnormal-maine-coon-cats-tested-for-the-a31p-mutation-in-the-mybpc3-gene
#15
Arine Pellegrino, Alexandre G T Daniel, Guilherme G Pereira, Paula H Itikawa, Maria Helena M A Larsson
Myocardial dysfunction occurs in cats with hypertrophic cardiomyopathy (HCM), but little is known about the early stages of the disease. Strain imaging echocardiography is a method that enables the quantitative assessment of myocardial function and deformity, allowing the characterization of systolic dysfunction. The objective of this study was to assess systolic function using strain imaging echocardiography in Maine coon cats genetically tested for the A31P mutation in the MYBPC3 gene, with and without ventricular hypertrophy...
April 2017: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
https://www.readbyqxmd.com/read/28408154/outcomes-for-critical-limb-ischemia-are-driven-by-lower-extremity-revascularization-volume-not-distance-to-hospital
#16
Ankit N Medhekar, Doran S Mix, Christopher T Aquina, Lauren E Trakimas, Katia Noyes, Fergal J Fleming, Roan J Glocker, Michael C Stoner
OBJECTIVE: The objective of this study was to identify relationships among geographic access to care, vascular procedure volume, limb preservation, and survival in patients diagnosed with critical limb ischemia (CLI). METHODS: Using New York State administrative data from 2000 to 2013, we identified a patient's first presentation with CLI defined by International Classification of Diseases, Ninth Revision diagnosis and procedure codes. Distance from the patient's home to the index hospital was calculated using the centroids of the respective ZIP codes...
April 10, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28407517/social-status-strategy-in-early-adolescent-girls-testosterone-and-value-based-decision-making
#17
Stephanie L Cardoos, Ahna Ballonoff Suleiman, Megan Johnson, Wouter van den Bos, Stephen P Hinshaw, Ronald E Dahl
There has been strong interest, spanning several disciplines, in understanding adolescence as a developmental period of increased risk-taking behavior. Our goals focus on one line of investigation within this larger developmental risk framework. Specifically, we examined levels of pubertal hormones in girls in relation to their willingness to take greater financial risks to gain social status. To this end, we tested the hypothesis that higher levels of testosterone during the ages of pubertal maturation are associated with a greater willingness to sacrifice money for social admiration...
March 31, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28407260/the-value-of-nursing-care-a-concept-analysis
#18
Tracey K Dick, Patricia A Patrician, Lori A Loan
AIM: To report an analysis of the concept of value of nursing care. BACKGROUND: Value-based health care delivery and reimbursement models are focused on value as a product of quality and cost. Nursing care provides tangible and intangible contributions to patient and organizational outcomes. The nursing profession must be able to proactively and effectively communicate the value of nursing care. DESIGN: Concept analysis. DATA SOURCES: Thirty-five separate sources were chosen from database searches of CINAHL Complete and ABI/INFORM Complete...
April 13, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28406923/model-selection-with-multiple-regression-on-distance-matrices-leads-to-incorrect-inferences
#19
Ryan P Franckowiak, Michael Panasci, Karl J Jarvis, Ian S Acuña-Rodriguez, Erin L Landguth, Marie-Josée Fortin, Helene H Wagner
In landscape genetics, model selection procedures based on Information Theoretic and Bayesian principles have been used with multiple regression on distance matrices (MRM) to test the relationship between multiple vectors of pairwise genetic, geographic, and environmental distance. Using Monte Carlo simulations, we examined the ability of model selection criteria based on Akaike's information criterion (AIC), its small-sample correction (AICc), and the Bayesian information criterion (BIC) to reliably rank candidate models when applied with MRM while varying the sample size...
2017: PloS One
https://www.readbyqxmd.com/read/28406367/issue-relevant-values-and-opinions-about-gay-rights-beyond-equality-and-morality
#20
Laurie Rhodebeck
Although many studies have examined the role of values in shaping public opinion, the number of values that inform this research is limited. This paper employs the concept "issue-relevant values" as a means to explore the broader range of values associated with policy issues. After discussing the concept in general terms, the paper explores issue-relevant values pertinent to public opinion about gay rights. Using the policy examples of employment nondiscrimination and same-sex couple adoption, the present study identifies, measures, and assesses several values that add to the very short list previously used to explain public opinion about gay rights issues...
April 13, 2017: Journal of Homosexuality
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