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https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#1
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28214992/data-mining-in-hiv-aids-surveillance-system-application-to-portuguese-data
#2
Alexandra Oliveira, Brígida Mónica Faria, A Rita Gaio, Luís Paulo Reis
The Human Immunodeficiency Virus (HIV) is an infectious agent that attacks the immune system cells. Without a strong immune system, the body becomes very susceptible to serious life threatening opportunistic diseases. In spite of the great progresses on medication and prevention over the last years, HIV infection continues to be a major global public health issue, having claimed more than 36 million lives over the last 35 years since the recognition of the disease. Monitoring, through registries, of HIV-AIDS cases is vital to assess general health care needs and to support long-term health-policy control planning...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28214614/predicting-medical-professionals-intention-to-allow-family-presence-during-resuscitation-a-cross-sectional-survey
#3
Meng-Kuan Lai, Bayu Aji Aritejo, Jing-Shia Tang, Chien-Liang Chen, Chia-Chang Chuang
BACKGROUND: Family presence during resuscitation is an emerging trend, yet it remains controversial, even in countries with relatively high acceptance of family presence during resuscitation among medical professionals. Family presence during resuscitation is not common in many countries, and medical professionals in these regions are unfamiliar with family presence during resuscitation. Therefore, this study predicted the medical professionals' intention to allow family presence during resuscitation by applying the theory of planned behaviour...
February 11, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28213602/understanding-the-epidemiology-of-avoidable-significant-harm-in-primary-care-protocol-for-a-retrospective-cross-sectional-study
#4
Brian G Bell, Stephen Campbell, Andrew Carson-Stevens, Huw Prosser Evans, Alison Cooper, Christina Sheehan, Sarah Rodgers, Christine Johnson, Adrian Edwards, Sarah Armstrong, Rajnikant Mehta, Antony Chuter, Ailsa Donnelly, Darren M Ashcroft, Joanne Lymn, Pam Smith, Aziz Sheikh, Matthew Boyd, Anthony J Avery
INTRODUCTION: Most patient safety research has focused on specialist-care settings where there is an appreciation of the frequency and causes of medical errors, and the resulting burden of adverse events. There have, however, been few large-scale robust studies that have investigated the extent and severity of avoidable harm in primary care. To address this, we will conduct a 12-month retrospective cross-sectional study involving case note review of primary care patients. METHODS AND ANALYSIS: We will conduct electronic searches of general practice (GP) clinical computer systems to identify patients with avoidable significant harm...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28213601/protocol-for-a-scoping-review-of-post-trial-extensions-of-randomised-controlled-trials-using-individually-linked-administrative-and-registry-data
#5
Tiffany Fitzpatrick, Laure Perrier, Andrea C Tricco, Sharon E Straus, Peter Jüni, Merrick Zwarenstein, Lisa M Lix, Mark Smith, Laura C Rosella, David A Henry
INTRODUCTION: Well-conducted randomised controlled trials (RCTs) provide the least biased estimates of intervention effects. However, RCTs are costly and time-consuming to perform and long-term follow-up of participants may be hampered by lost contacts and financial constraints. Advances in computing and population-based registries have created new possibilities for increasing the value of RCTs by post-trial extension using linkage to routinely collected administrative/registry data in order to determine long-term interventional effects...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28213577/economic-evaluation-of-universal-prenatal-hiv-screening-compared-with-current-at-risk-policy-in-a-very-low-prevalence-country
#6
Michal Chowers, Oren Shavit
OBJECTIVES: Our objective was to economically evaluate universal HIV prenatal screening in Israel, a very low prevalence country (0.1%), compared with the current policy of testing only women belonging to high-risk (HR) groups. DESIGN: A cost-effectiveness analytical model was constructed. Life expectancies, direct medical costs and utility weights of an HIV-positive newborn and a healthy newborn were derived from the literature. Screening was assessed using fourth-generation combo tests...
March 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28212657/pharmacists-views-and-reported-practices-in-relation-to-a-new-generic-drug-substitution-policy-in-lebanon-a-mixed-methods-study
#7
Fadi El-Jardali, Racha Fadlallah, Rami Z Morsi, Nour Hemadi, Mounir Al-Gibbawi, Magda Haj, Suzan Khalil, Youssef Saklawi, Diana Jamal, Elie A Akl
BACKGROUND: Governments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy...
February 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28212496/antipsychotic-use-in-dementia
#8
Julia Kirkham, Chelsea Sherman, Clive Velkers, Colleen Maxwell, Sudeep Gill, Paula Rochon, Dallas Seitz
Antipsychotics are necessary for many older adults to treat major mental illnesses or reduce distressing psychiatric symptoms. Current controversy exists over the role of antipsychotics in the management of neuropsychiatric symptoms (NPS) in persons with dementia. Although some NPS may be appropriately and safely treated with antipsychotics, a fine balance must be achieved between the benefits of these medications, which are often modest, and adverse events, which may have significant consequences. Approximately one-third of all persons with dementia are currently prescribed antipsychotic medications, and there is significant variation in the use of antipsychotics across care settings and providers...
March 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28211039/cutaneous-squamous-cell-carcinoma-an-epidemiological-review
#9
REVIEW
A C Green, C M Olsen
Cutaneous squamous cell carcinoma (SCC) is a common cancer in white populations and its disease burden is often substantially underestimated. SCC occurs more often in men than women and increases dramatically with age; those affected often develop multiple primaries over time, which increases the burden. The main external cause is solar ultraviolet radiation (UVR), with immunosuppression being the other established risk factor, shown by the high SCC rates in organ transplant recipients. Sunbed use and certain genetic disorders and medical conditions are also associated with SCC, while associations with human papillomavirus infection and high bodyweight are not established...
February 16, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28209605/do-failures-in-non-technical-skills-contribute-to-fatal-medical-accidents-in-japan-a-review-of-the-2010-2013-national-accident-reports
#10
Masashi Uramatsu, Yoshikazu Fujisawa, Shinya Mizuno, Takahiro Souma, Akinori Komatsubara, Tamotsu Miki
OBJECTIVES: We sought to clarify how large a proportion of fatal medical accidents can be considered to be caused by poor non-technical skills, and to support development of a policy to reduce number of such accidents by making recommendations about possible training requirements. DESIGN: Summaries of reports of fatal medical accidents, published by the Japan Medical Safety Research Organization, were reviewed individually. Three experienced clinicians and one patient safety expert conducted the reviews to determine the cause of death...
February 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28208883/fostering-educational-research-among-medical-teachers-evaluation-of-a-faculty-development-program-in-india
#11
Tripti K Srivastava, Lalitbhushan S Waghmare, Alka Rawekar, Ved Prakash Mishra
INTRODUCTION: Medical education can be enormously benefitted from research. Since clinicians/medical teachers are directly involved in teaching learning processes, they should participate in Educational Research (ER) practices to generate evidence and insights about teaching learning. Faculty Development Program (FDP) has a positive influence amongst health professionals and therefore can prove to be of consequence in instilling a strong educational research culture. AIM: Present study was undertaken to evaluate the efficacy of a Faculty Development Fellowship Program in Medical Education to foster educational research culture amongst medical teachers...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208876/prescribing-pattern-of-antifungal-medications-at-a-tertiary-care-hospital-in-oman
#12
Khalid A Al Balushi, Mohammed A Alzaabi, Fatma Alghafri
INTRODUCTION: Inappropriate use of antifungal agents is implicated in the global burden of antifungal resistance, adverse outcomes like persistent infections, unnecessary exposure and increased cost. Data collection from time to time is to be done in order to have a check on the resistance/sensitivity pattern of the commonly prescribed antifungal drugs. AIM: To describe the pattern of antifungal drug prescription and administration to patients attending a university hospital in Oman...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208857/emergence-of-hospital-acquired-carbapenem-resistant-non-fermenters-in-teaching-institute
#13
Hariom Sharan, Neeraj Katare, Aparna Pandey, Ganesh Shivmurti Bhatambare, Trupti Bajpai
INTRODUCTION: Non-Fermenting Gram Negative Bacilli (NFGNB) are emerging now-a-days because of their tendency to colonize various surfaces and inherent resistance to commonly used disinfectants. They are responsible for multi-drug resistant hospital acquired infections. Detection of carbapenem resistance mechanisms is essential for treatment and infection control purpose as can spread to other organisms causing hospital outbreaks. AIM: To characterize non-fermenters from various clinical samples and to detect different carbapenem resistance mechanisms in meropenem resistant isolates...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208759/acute-effects-of-particulate-air-pollution-on-ischemic-heart-disease-hospitalizations-in-shanghai-china
#14
Anyang Xu, Zhe Mu, Bo Jiang, Wei Wang, Han Yu, Lijuan Zhang, Jue Li
Background: Air pollution has been demonstrated to be a major risk factor for the development of cardiovascular and respiratory diseases worldwide. This study examines the relationship between the exposure to fine particulate matter (PM) and patient hospitalizations as a result of ischemic heart disease (IHD) during 2013-2014 in Shanghai, China. Methods: Daily IHD hospitalization data were acquired from the Shanghai Health Insurance Bureau (SHIB) from 1 January 2013 to 21 December 2014. Daily average concentrations of air pollution as well as meteorological data were obtained from the database of Shanghai Environmental Monitoring Center (SEMC) during the same time period, and all data were analyzed using standard epidemiological methodology...
February 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28207807/how-much-is-a-child-worth-providers-and-patients-views-and-responses-concerning-ethical-and-policy-challenges-in-paying-for-art
#15
Robert Klitzman
Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers...
2017: PloS One
https://www.readbyqxmd.com/read/28207297/measuring-the-influence-of-legally-recognized-partnerships-on-the-health-and-well-being-of-same-sex-couples-utility-of-the-california-health-interview-survey
#16
William N Elwood, Veronica L Irvin, Qiankun Sun, Nancy Breen
PURPOSE: This study explored the utility of the California Health Interview Survey (CHIS) to compare health-related outcomes among gay men, lesbians, and heterosexuals who reported being in a legally recognized partnership. METHODS: We regressed sexual identity and marriage/legally recognized partnership status on seven different outcomes related to health insurance coverage, medical services access and use, and general health and well-being using CHIS data collected between 2009 and 2013...
February 16, 2017: LGBT Health
https://www.readbyqxmd.com/read/28205370/progressive-universalism-the-impact-of-targeted-coverage-on-health-care-access-and-expenditures-in-peru
#17
Sven Neelsen, Owen O'Donnell
Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to health care by granting the poor entitlement to tax-financed basic care without charge. We identify the impact of this policy by comparing the target population's change in health care utilization with that of poor adults already covered through employment-based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest...
February 16, 2017: Health Economics
https://www.readbyqxmd.com/read/28203120/international-lessons-in-new-methods-for-grading-and-integrating-cost-effectiveness-evidence-into-clinical-practice-guidelines
#18
REVIEW
Kathryn M Antioch, Michael F Drummond, Louis W Niessen, Hindrik Vondeling
Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28202839/cost-outcome-description-of-peg-ifn-%C3%AE-2b-rbv-for-hepatitis-c-results-based-on-the-interferon-database
#19
Maiko Akutagawa, Yohei Kawasaki, Atsuko Kawasaki, Kazuki Ide, Hiroshi Yamada, Naohiko Masaki
Economic evaluation of drugs is used in decision-making on medical care and public policy. Recently, real-world data (RWD) have been used in the analysis. In this study, we discuss the risk and benefits of using RWD for economic evaluation. We conducted a cost-outcome description with RWD from a nationwide registry providing information on hepatitis treatment in Japan and estimated the utility of the analysis. We evaluated the cost-outcome description of peginterferon plus ribavirin (PEG-IFN-α2b + RBV) treatment in hepatitis C virus (HCV)-infected patients...
February 15, 2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28198932/eugenics-sterilization-and-historical-memory-in-the-united-states
#20
Alexandra Minna Stern
From the 1920s to the 1950s, California sterilized approximately 20,000 people in state homes and hospitals based on a eugenic law that authorized medical superintendents to perform reproductive surgeries on patients deemed unfit and "suffering from a mental affliction likely to be inherited." Working with a unique resource - a dataset created from 19,000 sterilization recommendations - my team and I have reconstructed patterns and experiences of institutionalization of sterilizations. This article presents several of our important initial findings related to ethnic and gender bias in sterilization policies, and reflects on the relevance of the history for contemporary issues in genomics and social justice...
December 2016: História, Ciências, Saúde—Manguinhos
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