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https://www.readbyqxmd.com/read/28230452/prescription-drug-utilization-and-reimbursement-increased-following-state-medicaid-expansion-in-2014
#1
Nirosha Mahendraratnam, Stacie B Dusetzina, Joel F Farley
BACKGROUND: The Affordable Care Act (ACA) expanded health care and medication insurance coverage through Medicaid expansion in select states. Expansion has the potential to increase the availability of health services to patients, including prescription medications. However, limited studies have examined how expansion affected prescription drug utilization and reimbursement. OBJECTIVE: To compare prescription drug utilization (number of prescriptions filled) and reimbursement trends between states that did and did not expand Medicaid coverage in 2014, while accounting for known effects of expansion on Medicaid enrollment...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#2
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#3
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28196085/what-device-would-be-best-for-early-infant-male-circumcision-in-east-and-southern-africa-provider-experiences-and-opinions-with-three-different-devices-in-kenya
#4
Robert C Bailey, Irene Nyaboke, Fredrick O Otieno
Voluntary medical male circumcision (VMMC) reduces risk of HIV acquisition in heterosexual men by approximately 60%. As some countries approach targets for proportions of adolescents and adults circumcised, some are considering early infant male circumcision (EIMC) as a means to achieve sustainability of VMMC for long term reduction of HIV incidence. Evaluations of specialized devices for EIMC are important to provide programs with information required to make informed decisions about how to design safe, effective EIMC programs...
2017: PloS One
https://www.readbyqxmd.com/read/28188778/work-limitations-four-years-following-mild-traumatic-brain-injury-a-cohort-study
#5
Alice Theadom, Suzanne Barker-Collo, Kelly Jones, Michael Kahan, Braden Te Ao, Kathryn McPherson, Nicola Starkey, Valery Feigin
OBJECTIVE: To explore employment status, work limitations and productivity loss following mild traumatic brain injury (TBI). STUDY DESIGN: Inception cohort study over four years. SETTING: General community. PARTICIPANTS: 245 Adults (>16 years at the time of injury), who experienced a mild TBI and who were employed prior to their injury. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Details of the injury, demographic information and pre-injury employment status were collected from medical records and self-report...
February 7, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28161917/enhancing-medical-student-education-by-implementing-a-competency-based-ophthalmology-curriculum
#6
Tony Succar, Peter McCluskey, John Grigg
PURPOSE: To evaluate innovative educational strategies that help optimize ophthalmology teaching in a crowded medical curriculum. The knowledge acquisition and perceptions of medical students undertaking the revised competency-based curriculum were compared with the prior content-based curriculum within the Sydney Medical Program. DESIGN: A mixed-methods research design was employed to include both quantitative and qualitative dimensions in evaluating the revised curriculum with medical students (n = 328) undergoing their ophthalmology rotation...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28148604/the-impact-of-oral-systemic-health-on-advancing-interprofessional-education-outcomes
#7
Judith Haber, Erin Hartnett, Kenneth Allen, Ruth Crowe, Jennifer Adams, Abigail Bella, Thomas Riles, Anna Vasilyeva
The aim of this study was to evaluate the effectiveness of an interprofessional education (IPE) clinical simulation and case study experience, using oral-systemic health as the clinical population health example, for nurse practitioner/midwifery, dental, and medical students' self-reported attainment of interprofessional competencies. A pretest-posttest evaluation method was employed, using data from the Interprofessional Collaborative Competency Attainment Scale (ICCAS) completed by two large cohorts of nurse practitioner/midwifery, dental, and medical students at one U...
February 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/28148256/defining-reasonable-patient-standard-and-preference-for-shared-decision-making-among-patients-undergoing-anaesthesia-in-singapore
#8
J L J Yek, A K Y Lee, J A D Tan, G Y Lin, T Thamotharampillai, H R Abdullah
BACKGROUND: A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS: A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28144171/advances-in-medical-education-and-practice-student-perceptions-of-the-flipped-classroom
#9
REVIEW
Christopher J Ramnanan, Lynley D Pound
The flipped classroom (FC) approach to teaching has been increasingly employed in undergraduate medical education in recent years. In FC applications, students are first exposed to content via online resources. Subsequent face-to-face class time can then be devoted to student-centered activities that promote active learning. Although the FC has been well received by students in other contexts, the perceptions of medical students regarding this innovation are unclear. This review serves as an early exploration into medical student perceptions of benefits and limitations of the FC...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28142100/epilepsy-and-treatment-gap-in-urban-and-rural-areas-of-the-southern-kazakhstan-in-adults
#10
Alla Guekht, Nazira Zharkinbekova, Alexander Shpak, W Allen Hauser
PURPOSE: There are no data in the English literature about the epidemiology of epilepsy in the large countries in the Asian region of the former Soviet Union. This paper presents the results of epidemiological studies of active epilepsy in the population 14years of age and older in the Province of South Kazakhstan. METHODS: The study population consisted of 306.44 thousand persons: 139.42 in the urban Enbekshinskiy district of the city of Shymkent and 167.02 in the rural Sairam district...
January 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28131640/the-burden-of-healthcare-associated-clostridium-difficile-infection-in-a-non-metropolitan-setting
#11
S E Bond, C S Boutlis, W W Yeo, W A B Pratt, M E Orr, S Miyakis
OBJECTIVE: Healthcare-associated Clostridium difficile infection (HCA-CDI) remains a major cause of morbidity and mortality in industrialized countries. However, few data exist on the burden of HCA-CDI in multi-site non-metropolitan settings. This study examined the introduction of an antimicrobial stewardship programme (ASP) in relation to HCA-CDI rates, and the effect of HCA-CDI on length of stay (LOS) and hospital costs. METHODS: A comparative before-and-after intervention study of patients aged ≥16 years with HCA-CDI from December 2010 to April 2016 across the nine hospitals of a non-metropolitan health district in New South Wales, Australia was undertaken...
December 18, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28103722/accreditation-of-medical-schools-in-saudi-arabia-a-qualitative-study
#12
S A Alrebish, B C Jolly, E K Molloy
CONTEXT: The accreditation of undergraduate medical education is a universal undertaking. Despite the widespread adoption of accreditation processes and an increasing focus on accreditation as a mechanism to ensure minimum standards are met in various fields, there is little evidence to support the effectiveness of accreditation. Traditionally, accreditation has worked toward achieving two ends: assuring and improving quality. Many recent articles emphasize the need for continuous quality improvement mechanisms to work, as well as the quality assurance role of accreditation...
January 20, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28096255/sheppheartcabg-trial-comprehensive-early-rehabilitation-after-coronary-artery-bypass-grafting-a-protocol-for-a-randomised-clinical-trial
#13
Ida Elisabeth Højskov, Philip Moons, Niels Viggo Hansen, Søren La Cour, Peter Skov Olsen, Christian Gluud, Per Winkel, Jane Lindschou, Lau Caspar Thygesen, Ingrid Egerod, Selina Kikkenborg Berg
INTRODUCTION: Patients undergoing coronary artery bypass graft surgery often experience a range of symptoms. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation have a positive physiological and psychological effect in early outpatient rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28095032/the-trajectories-of-overall-disability-in-the-first-5-years-after-moderate-and-severe-traumatic-brain-injury
#14
Marit V Forslund, Cecilie Roe, Paul B Perrin, Solrun Sigurdardottir, Juan Lu, Svein Berntsen, Nada Andelic
PRIMARY OBJECTIVES: To assess longitudinal trajectories of overall disability after moderate-to-severe traumatic brain injury (TBI) and to examine whether those trajectories could be predicted by socio-demographic and injury characteristics. METHODS: Demographics and injury characteristics of 105 individuals with moderate-to-severe TBI were extracted from medical records. At the 1-, 2-, and 5-year follow-ups, TBI-related disability was assessed by the GOSE. A hierarchical linear model (HLM) was used to examine functional outcomes up to 5 years following injury and whether those outcomes could be predicted by: time, gender, age, relationship, education, employment pre-injury, occupation, GCS, cause of injury, length of post-traumatic amnesia (PTA), CT findings and injury severity score, as well as the interactions between each of these predictors and time...
January 17, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28076586/predictors-of-readiness-for-oral-rapid-hiv-testing-by-chilean-health-care-providers
#15
Lisette P Irarrázabal, Judith A Levy, Kathleen F Norr, Rosina Cianelli, L Michele Issel, Carlos M Pérez, Anna Hotton
Objective: This study identified the personal characteristics that affect Chilean health care providers' readiness to adopt HIV Oral Rapid Testing (ORT) in Chile as a new clinical evidence-based practice (EBP). Methods: Using a cross-sectional research design, the study sampled 150 nurses, midwives, and physicians employed at four clinics within the Pontifícia Universidad Católica de Chile Health Network in Santiago. Participants completed a self-administered survey asking about their demographic background, EBP attitudes and experience, personal beliefs related to HIV, the importance of HIV testing, and perceived self-comfort in performing a rapid HIV test...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28069654/reduced-chance-of-hearing-loss-associated-with-therapeutic-drug-monitoring-of-aminoglycosides-in-the-treatment-of-multidrug-resistant-tuberculosis
#16
R van Altena, J A Dijkstra, M E van der Meer, J F Borjas Howard, J G W Kosterink, D van Soolingen, T S van der Werf, J W C Alffenaar
Hearing loss and nephrotoxicity are associated with prolonged treatment duration and higher dosage of amikacin and kanamycin. In our Tuberculosis Center, we have employed therapeutic drug monitoring (TDM) targeting pre-set pharmacokinetic/pharmacodynamic (PK/PD) surrogate endpoints in an attempt to maintain efficacy while preventing (oto-)toxicity. To evaluate this strategy, we retrospectively evaluated medical charts of TB patients treated with amikacin or kanamycin in the period 2000 - 2012.Patients with culture-confirmed multi- or extensively drug resistant tuberculosis (MDR/XDR-TB) receiving amikacin or kanamycin as part of their TB treatment for at least 3 days were eligible for inclusion in this retrospective study...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28065484/predictors-of-favourable-outcome-in-young-people-with-a-first-episode-psychosis-without-antipsychotic-medication
#17
Philippe Conus, Sue M Cotton, Shona M Francey, Brian O'Donoghue, Benno G Schimmelmann, Patrick D McGorry, Martin Lambert
INTRODUCTION: Data from the literature suggests that some first episode psychosis (FEP) patients may recover without antipsychotic medication. There is however no reliable way to identify them. In a previous paper we found, in a cohort of 584 FEP patients, that those consistently refusing medication had poorer pre-morbid functioning, less insight, higher rate of substance use and poorer outcome. However, some medication refusers, had a favourable outcome. The study aim was to identify predictors of good short term outcome despite non-exposure to medication...
January 5, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28048745/tu-d-brc-01-novel-applications-for-current-epid-technology
#18
J Rottmann
There has been increased deployment of gantry-mounted linacs with onboard kilovoltage x-ray imagers. Despite this trend, most clinics still employ beam's-eye-view (BEV) imaging using flat panel electronic portal imaging devices (EPIDs) as a highly useful means of verifying geometric localization pre- and post-delivery. In recent years, there has been increased interest in the use of EPIDs for a variety of clinical and investigational applications ranging from megavoltage cone-beam CT, in vivo dosimetry, patient-specific QA to real-time target localization for dynamic MLC-based tumor tracking...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048087/tu-d-brc-02-free-information-epid-based-in-vivo-dosimetry
#19
P Greer
There has been increased deployment of gantry-mounted linacs with onboard kilovoltage x-ray imagers. Despite this trend, most clinics still employ beam's-eye-view (BEV) imaging using flat panel electronic portal imaging devices (EPIDs) as a highly useful means of verifying geometric localization pre- and post-delivery. In recent years, there has been increased interest in the use of EPIDs for a variety of clinical and investigational applications ranging from megavoltage cone-beam CT, in vivo dosimetry, patient-specific QA to real-time target localization for dynamic MLC-based tumor tracking...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046690/tu-d-brc-00-the-epid-strikes-back
#20
Amit Sawant
There has been increased deployment of gantry-mounted linacs with onboard kilovoltage x-ray imagers. Despite this trend, most clinics still employ beam's-eye-view (BEV) imaging using flat panel electronic portal imaging devices (EPIDs) as a highly useful means of verifying geometric localization pre- and post-delivery. In recent years, there has been increased interest in the use of EPIDs for a variety of clinical and investigational applications ranging from megavoltage cone-beam CT, in vivo dosimetry, patient-specific QA to real-time target localization for dynamic MLC-based tumor tracking...
June 2016: Medical Physics
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