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https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#1
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29145359/racial-ethnic-health-disparities-among-rural-adults-united-states-2012-2015
#2
Cara V James, Ramal Moonesinghe, Shondelle M Wilson-Frederick, Jeffrey E Hall, Ana Penman-Aguilar, Karen Bouye
PROBLEM/CONDITION: Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States. REPORTING PERIOD: 2012-2015...
November 17, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29145209/methodological-issues-for-psychological-evaluation-across-the-lifespan-of-individuals-with-a-difference-disorder-of-sex-development
#3
Franco D'Alberton, Sofia Vissani, Chiara Ferracuti, Vickie Pasterski
The aim of the current report is to provide guidance relevant to psychological evaluation for healthcare providers and researchers working in the field of disorders of sexual development (DSD). In doing so, we give careful consideration to methodological issues and limitations that may influence the utility of investigations. For example, rarity and heterogeneity of DSD conditions restrict sample sizes when conducting evaluations aimed at establishing condition-specific psychological outcomes. At the same time, the potential for stigmatization by virtue of conducting psychological evaluations is particularly high given the fundamental contribution of sex and gender to one's sense of self and integrity...
November 17, 2017: Sexual Development: Genetics, Molecular Biology, Evolution, Endocrinology, Embryology, and Pathology of Sex Determination and Differentiation
https://www.readbyqxmd.com/read/29144892/preventable-tooth-loss-in-hawai-i-the-role-of-socioeconomic-status-diabetes-and-dental-visits
#4
Mikako Deguchi, Marjorie K Leimomi Mala Mau, James Davis, Richard Niederman
INTRODUCTION: Tooth preservation in adults and children is one of the Healthy People 2020 goals for oral health. Although the overall prevalence of tooth loss has been declining in the United States, substantial racial/ethnic differences in preventable tooth loss persist as a public health problem. We examined the strength of the association of health risk factors and tooth loss in Hawai'i. METHODS: We used data from the Hawai'i Behavioral Risk Factor Surveillance System survey collected from 2011 through 2014...
November 16, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#5
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29143901/combined-vertebral-augmentation-and-radiofrequency-ablation-in-the-management-of-spinal-metastases-an-update
#6
REVIEW
Ning Mao Kam, Julian Maingard, Hong Kuan Kok, Dinesh Ranatunga, Duncan Brooks, William C Torreggiani, Peter L Munk, Michael J Lee, Ronil V Chandra, Hamed Asadi
Spinal metastases are the most commonly encountered tumour of the spine, occurring in up to 40% of patients with cancer. Each year, approximately 5% of cancer patients will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with spinal metastases experience severe and frequently debilitating pain, which often decreases their remaining quality of life. With a median survival of less than 1 year, the goals of treatment in spinal metastases are reducing pain, improving or maintaining level of function and providing mechanical stability...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29143891/in-search-of-the-ideal-promotility-agent-optimal-use-of-currently-available-promotility-agents-for-nutrition-therapy-of-the-critically-ill-patient
#7
REVIEW
Sarah J Diamond, Endashaw Omer, Laszlo Kiraly
PURPOSE OF REVIEW: Enteral nutrition therapy is essential in the management of critically ill patients. Prokinetic agents have been used successfully to aid in the delivery of nutrition and improve feeding tolerance in patients in the intensive care unit (ICU). The aim of this report is to review the existing promotility agents available for use in the critically ill as well as outline the role of potential investigative drugs in order to provide a guide to the management of this difficult and important clinical dilemma...
November 16, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29143622/lives-saved-tool-list-costing-a-module-to-examine-costs-and-prioritize-interventions
#8
Lori A Bollinger, Rachel Sanders, William Winfrey, Adebiyi Adesina
BACKGROUND: Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST) has been used widely to calculate the impact of maternal, neonatal and child health (MNCH) interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries...
November 7, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29143161/point-of-care-b-type-natriuretic-peptide-and-portable-echocardiography-for-assessment-of-patients-with-suspected-heart-failure-in-primary-care-rationale-and-design-of-the-three-part-handheld-bnp-program-and-results-of-the-training-study
#9
Caroline Morbach, Thomas Buck, Christian Rost, Sebastian Peter, Stephan Günther, Stefan Störk, Christiane Prettin, Raimund Erbel, Georg Ertl, Christiane E Angermann
BACKGROUND: Patients with suspected heart failure (HF) often present first to general practitioners (GPs). Timely and accurate HF diagnosis and reliable prognostic information have remained unmet goals in primary care, where patient evaluation often relies on clinical assessment only. The Handheld-BNP program investigates whether additional use of portable echocardiography (ECHO) and point-of-care determination of B-type natriuretic peptide (BNP) improves the accuracy of HF diagnosis and aids risk prediction in primary care...
November 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29142964/impact-of-the-end-stage-renal-disease-prospective-payment-system-on-the-use-of-peritoneal-dialysis
#10
Qian Zhang, Mae Thamer, Onkar Kshirsagar, Yi Zhang
Introduction: The End Stage Renal Disease (ESRD) Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services in January 2011, encouraged use of peritoneal dialysis (PD) through various financial incentives. Our goal was to determine whether PPS effectively increased PD use in incident dialysis patients. Methods: Our study used the United States Renal Data System (USRDS) to identify 430,927 adult patients who initiated dialysis between 2009 and 2012...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29142798/verification-of-diagnosis-in-tuberculosis-a-case-report-and-discussion
#11
Amanda M Dave, Abed Adelrahman, Vishist Mehta, Stephen Cavalieri, Renuga Vivekanadan
Tuberculosis (TB), caused by strains of Mycobacterium tuberculosis complex (M. tuberculosis), is a pulmonary infection that is spread by airborne droplet transmission. The development and spread of drug-resistant strains of M. tuberculosisgreatly jeopardize TB control efforts. We report the case of a previously healthy 43-year-old male, visiting from China, who presented to the emergency department complaining of hemoptysis of 10 days' duration. Cultures were positive for acid fast bacteria and negative for fungi...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29141871/potential-approaches-to-prevent-hypoglycemia-associated-autonomic-failure
#12
REVIEW
Eric Lontchi-Yimagou, Jee Young You, Michelle Carey, Ilan Gabriely, Harry Shamoon, Meredith Hawkins
Clear health benefits are associated with intensive glucose control in type 1 diabetes mellitus (T1DM). However, maintaining near-normal glycemia remains an elusive goal for many patients, in large part owing to the risk of severe hypoglycemia. In fact, recurrent episodes of hypoglycemia lead to 'hypoglycemia-associated autonomic failure' (HAAF), characterized by defective counter-regulatory responses to hypoglycemia. Extensive studies to understand the mechanisms underlying HAAF have revealed multiple potential etiologies, suggesting various approaches to prevent the development of HAAF...
November 14, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29141839/patient-health-record-systems-scope-and-functionalities-literature-review-and-future-directions
#13
REVIEW
Lina Bouayad, Anna Ialynytchev, Balaji Padmanabhan
BACKGROUND: A new generation of user-centric information systems is emerging in health care as patient health record (PHR) systems. These systems create a platform supporting the new vision of health services that empowers patients and enables patient-provider communication, with the goal of improving health outcomes and reducing costs. This evolution has generated new sets of data and capabilities, providing opportunities and challenges at the user, system, and industry levels. OBJECTIVE: The objective of our study was to assess PHR data types and functionalities through a review of the literature to inform the health care informatics community, and to provide recommendations for PHR design, research, and practice...
November 15, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29141681/patient-influence-in-home-based-reablement-for-older-persons-qualitative-research
#14
Aud Moe, Kari Ingstad, Hildfrid V Brataas
BACKGROUND: Reablement services are rehabilitation for older people living at home, being person-centered in information, mapping and the goal-setting conversation. The purpose of this study was to gain knowledge about conversation processes and patient influence in formulating the patients' goals. There are two research questions: How do conversation theme, structure and processes appear in interactions aiming to decide goals of home-based reablement rehabilitation for the elderly? How professionals' communication skills do influence on patients' participation in conversation about everyday life and goals of home-based reablement? METHODS: A qualitative field study explored eight cases of naturally occurring conversations between patients and healthcare professionals in a rehabilitation team...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29141591/the-impact-of-pregnancy-loss-on-men-s-health-and-wellbeing-a-systematic-review
#15
Clemence Due, Stephanie Chiarolli, Damien W Riggs
BACKGROUND: Research indicates that men's psychological and physical health outcomes after pregnancy loss differ from those of women. Our goal was to identify all literature with a focus on men's experiences of pregnancy loss in order to outline current evidence concerning men's wellbeing. METHODS: A systematic review of literature on men and pregnancy loss was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Joanna Briggs Institute (JBI) and Social Care Institute for Excellence (SCIE) guidelines...
November 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29139337/do-people-with-severe-traumatic-brain-injury-benefit-from-making-errors-a-randomized-controlled-trial-of-error-based-and-errorless-learning
#16
Tamara Ownsworth, Jennifer Fleming, Robyn Tate, Elizabeth Beadle, Janelle Griffin, Melissa Kendall, Julia Schmidt, Amanda Lane-Brown, Mathilde Chevignard, David H K Shum
BACKGROUND: Errorless learning (ELL) and error-based learning (EBL) are commonly used approaches to rehabilitation for people with traumatic brain injury (TBI). However, it is unknown whether making errors is beneficial in the learning process to promote skills generalization after severe TBI. OBJECTIVE: To compare the efficacy of ELL and EBL for improving skills generalization, self-awareness, behavioral competency, and psychosocial functioning after severe TBI...
November 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29139336/home-health-aides-perceptions-of-quality-care-goals-challenges-and-implications-for-a-rapidly-changing-industry
#17
Emily Franzosa, Emma K Tsui, Sherry Baron
Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile...
January 1, 2017: New Solutions: a Journal of Environmental and Occupational Health Policy: NS
https://www.readbyqxmd.com/read/29139220/creating-and-facilitating-change-for-person-centred-coordinated-care-p3c-the-development-of-the-organisational-change-tool-p3c-oct
#18
Jane Horrell, Helen Lloyd, Thavapriya Sugavanam, James Close, Richard Byng
BACKGROUND: Person Centred Coordinated Care (P3C) is a UK priority for patients, carers, professionals, commissioners and policy makers. Services are developing a range of approaches to deliver this care with a lack of tools to guide implementation. METHODOLOGY: A scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C...
November 15, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#19
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29139070/mobile-health-application-and-e-health-literacy-opportunities-and-concerns-for-cancer-patients-and-caregivers
#20
Hyunmin Kim, Joy V Goldsmith, Soham Sengupta, Asos Mahmood, M Paige Powell, Jay Bhatt, Cyril F Chang, Soumitra S Bhuyan
Health literacy is critical for cancer patients as they must understand complex procedures or treatment options. Caregivers' health literacy also plays a crucial role in caring for cancer patients. Low health literacy is associated with low adherence to medications, poor health status, and increased health care costs. There is a growing interest in the use of mobile health applications (apps) to improve health literacy. Mobile health apps can empower underserved cancer patients and their caregivers by providing features or functionalities to enhance interactive patient-provider communication and to understand medical information more readily...
November 14, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
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