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College Males' Enduring and Novel Health Beliefs about the HPV Vaccine

HEALTH COMMUNICATION 2017年第8期32卷 995-1003页

作者： Pitts, Margaret Jane Stanley, Samantha J. Kim, Sara Univ Arizona Dept Commun Tucson AZ 85721 USA Univ Maryland Dept Commun College Pk MD 20742 USA

College males represent an important and overlooked catch-up population in the pursuit of human papillomavirus (HPV) prevention. An in-depth understanding of college males' health beliefs about HPV and HPV prevention can guide the development of HPV health promotion messages targeted toward college males. We convened 9 focus groups among 84 college-aged males to discuss their perceptions of benefits and barriers toward HPV prevention 4years after vaccine approval. Through participants' discourse, we identified health beliefs that continue to endure as barriers to HPV prevention (e.g., lack of knowledge/awareness, apathy, dismissiveness, stigma, practical barriers, and skepticism). Prevention and protection endure as perceived benefits to HPV prevention. We also identified novel college male health beliefs that have emerged since vaccine approval and hold great potential for the development of more effective health messaging. One novel barrier that emerged was the perception that it was too late for college males to benefit from the vaccine. Several novel benefits also emerged including a perception of wider social benefit beyond the self and partner, reduced worry and anticipated regret, and the belief that there is no reason not to [vaccinate]. This study was guided by the health belief model (HBM) and implications are discussed.

关键词： MALE college students PSYCHOLOGY HUMAN Papillomavirus vaccination HEALTH Belief Model PAPILLOMAVIRUSES NOVELTY (Perception) HEALTH promotion PREVENTION of sexually transmitted diseases AWARENESS ATTITUDES toward health CHEMOPREVENTION COLLEGE students FOCUS groups INTERVIEWING MEN STUDENT attitudes medical coding FIELD notes (Science) UNITED States

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Take-Home Trial Comparing Fast Fourier Transformation-Based and Filter Bank-Based Cochlear Implant Speech coding Strategies

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BIOMED RESEARCH INTERNATIONAL 2017年第0期2017卷 7915042-7915042页

作者： de Jong, Monique A. M. Briaire, Jeroen J. Frijns, Johan H. M. Leiden Univ Med Ctr ENT Dept Leiden Netherlands Leiden Univ Leiden Inst Brain & Cognit Leiden Netherlands

Previous studies have demonstrated no improved or deteriorated speech intelligibility with the HiResolution Fidelity 120 (TM) speech coding strategy (HiResF120) over the original HiRes strategy. Improved spectral and deteriorated temporal sensitivities have been shown, making it plausible that the beneficial effect in the spectral domain was offset by the worsened temporal sensitivity. We hypothesize that the implementation of fast Fourier transform (FFT) processing, instead of the traditionally used bandpass filters, explains the reduction of temporal sensitivity. In this study, spectral ripple discrimination, temporal modulation detection, and speech intelligibility in noise were assessed in a two-week take-home trial with 3 speech coding strategies: one with conventional bandpass filters (HiRes), one with FFT-based filters (HiRes FFT), and one with FFT-based filters and current steering (HiRes Optima). One participant dropped out due to discomfort with both research programs. The 10 remaining participants performed equally well on all tasks with all three speech coding strategies, implying that FFT processing does not change the ability of CI recipients to discriminate spectral or temporal information or speech understanding.

关键词： DIAGNOSIS of deafness COCHLEAR implants -- Evaluation ANALYSIS of variance CELLULAR signal transduction NOISE-induced deafness ETHICS medical protocols FINANCING of research SPEECH STATISTICS BIOINFORMATICS DATA analysis ACOUSTIC localization DATA analysis software medical coding

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Accuracy of clinical coding for febrile seizures and implications for activity-based funding

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INTERNAL MEDICINE JOURNAL 2017年第Sup3期47卷 21-21页

作者： Nguyen, L. Whitehall, J. Edwards, M. Western Sydney Univ Campbelltown NSW Australia

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Addressing Methodological Challenges in Large Communication Data Sets: Collecting and coding Longitudinal Interactions in Home Hospice Cancer Care

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HEALTH COMMUNICATION 2016年第7期31卷 789-797页

作者： Reblin, Maija Clayton, Margaret F. John, Kevin K. Ellington, Lee H Lee Moffitt Canc Ctr & Res Inst Dept Hlth Outcomes & Behav 12902 Magnolia Dr Tampa FL 33612 USA Univ Utah Coll Nursing Salt Lake City UT 84112 USA Brigham Young Univ Sch Commun Provo UT 84602 USA

In this article, we present strategies for collecting and coding a large longitudinal communication data set collected across multiple sites, consisting of more than 2000hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication data sets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multisite secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges has the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a how-to example for managing large, digitally recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research.

关键词： CAREGIVERS COMMUNICATION CONCEPTUAL structures (Information theory) DATABASE management FAMILIES HOME care services HOME nursing HOSPICE care LONGITUDINAL method medical cooperation medical personnel NURSING -- Practice NURSING specialties OBSERVATION (Scientific method) RESEARCH FINANCING of research HOSPICE nurses HOME environment DATA security PATIENTS' families medical coding

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Factors Affecting Unscheduled Return Visits to the Emergency Department among Minor Head Injury Patients

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BIOMED RESEARCH INTERNATIONAL 2017年第0期2017卷 8963102-8963102页

作者： Wang, Kuo-Cheng Chaou, Chung-Hsien Liu, Peng-Huei Chien, Cheng-Yu Lee, Ching-Hsing Chang Gung Mem Hosp Dept Emergency Med Linkou Taiwan Chang Gung Univ Coll Med Taoyuan Taiwan Chang Gung Med Educ Res Ctr Taoyuan Taiwan Chang Gung Mem Hosp Dept Emergency Med Taipei Taiwan Ton Yen Gen Hosp Dept Emergency Med Hsinchu Taiwan Chang Gung Mem Hosp Dept Emergency Med Keelung Taiwan

Study Objectives. Differences between returning and non-returning minor head injury (MHI) emergency department (ED) patients, between the characteristics of the first visit and revisit, and between admitted and nonadmitted returning patients were investigated. Methods. This was a retrospective study. All discharged ED patients with ICD-9 codes 850.0 to 850.9, 920, and 959.01 in 2013 were enrolled. Patients' demographic data, vital signs, Glasgow Coma Scale, ED diagnosis, length of stay, triage levels, ED examinations performed, and comorbidities were recorded for analysis. Results. A total of 2,815 patients were enrolled. Of 57 (2%) patients who revisited the ED, 47 (82%) were discharged from the ED and ten (18%) were admitted to the hospital. Patients who returned to the ED were older, and they exhibited more comorbidities. Those who presented with vomiting, triage level of 1 or 2, and GCS score of <15 and who received more blood tests during their first visit were more likely to be admitted when they returned to the ED. Conclusions. Discharging MHI patients who are older or exhibit comorbidities only when symptoms and concerns are relieved completely, providing clear discharge instructions, and arranging timely clinical follow-ups may help reduce such patients' return rate.

关键词： HOSPITAL admission & discharge EVALUATION PATIENTS HEAD injury diagnosis CHI-squared test LENGTH of stay in hospitals HOSPITAL emergency services medical appointments & schedules NEEDS assessment (medical care) NOSOLOGY T-test (Statistics) TRIAGE (Medicine) COMORBIDITY DISCHARGE planning DATA analysis software medical coding DESCRIPTIVE statistics GLASGOW Coma Scale

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Systematic Approach for the Formulation and Optimization of Solid Lipid Nanoparticles of Efavirenz by High Pressure Homogenization Using Design of Experiments for Brain Targeting and Enhanced Bioavailability

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BIOMED RESEARCH INTERNATIONAL 2017年第20170101期2017卷 5984014-5984014页

作者： Gupta, Shweta Kesarla, Rajesh Chotai, Narendra Misra, Ambikanandan Omri, Abdelwahab Parul Univ Dept Pharmaceut Technol Vadodara Gujarat India Oxbridge Coll Pharm Dept Pharmaceut Bangalore Karnataka India AR Coll Pharm Dept Pharmaceut Anand Gujarat India Maharaja Sayajirao Univ Baroda Fac Engn & Technol Dept Pharm Vadodara Gujarat India Laurentian Univ Dept Chem & Biochem Greater Sudbury ON Canada

The nonnucleoside reverse transcriptase inhibitors, used for the treatment of HIV infections, are reported to have low bioavailability pertaining to high first-pass metabolism, high protein binding, and enzymatic metabolism. They also show low permeability across blood brain barrier. The CNS is reported to be the most important HIV reservoir site. In the present study, solid lipid nanoparticles of efavirenz were prepared with the objective of providing increased permeability and protection of drug due to biocompatible lipidic content and nanoscale size and thus developing formulation having potential for enhanced bioavailability and brain targeting. Solid lipid nanoparticles were prepared by high pressure homogenization technique using a systematic approach of design of experiments (DoE) and evaluated for particle size, polydispersity index, zeta potential, and entrapment efficiency. Particles of average size 108.5 nm having PDI of 0.172 with 64.9% entrapment efficiency were produced. Zeta potential was found to be -21.2 mV and the formulation was found stable. The in-vivo pharmacokinetic studies revealed increased concentration of the drug in brain, as desired, when administered through intranasal route indicating its potential for an attempt towards complete eradication of HIV and cure of HIV-infected patients.

关键词： ANALYSIS of variance ANIMAL experimentation BIOAVAILABILITY ELECTRON microscopy HIGH performance liquid chromatography HISTOLOGICAL technique NANOPARTICLES RATS SURFACE active agents SUSPENSIONS (Chemistry) T-test (Statistics) DATA analysis software medical coding DESCRIPTIVE statistics EFAVIRENZ IN vitro studies IN vivo studies

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A BEME (Best Evidence in medical Education) review of the use of workplace-based assessment in identifying and remediating underperformance among postgraduate medical trainees: BEME Guide No. 43

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medical TEACHER 2016年第12期38卷 1188-1198页

作者： Barrett, Aileen Galvin, Rose Steinert, Yvonne Scherpbier, Albert O'Shaughnessy, Ann Horgan, Mary Horsley, Tanya Royal Coll Phys Ireland Educ Innovat & Res Frederick House19 South Frederick St Dublin 2 Ireland Univ Coll Cork Sch Med Coll Med & Hlth Sci Brookfield Hlth Sci Complex Cork Ireland Univ Limerick Fac Educ & Hlth Sci Dept Clin Therapies Discipline Physiotherapy Limerick Ireland McGill Univ Ctr Med Educ Fac Med Montreal PQ Canada Maastricht Univ Fac Hlth Med & Life Sci Maastricht Netherlands Royal Coll Phys & Surg Canada Res Unit Ottawa ON Canada Univ Ottawa Fac Med Ottawa ON Canada

Introduction: The extent to which workplace-based assessment (WBA) can be used as a facilitator of change among trainee doctors has not been established;this is particularly important in the case of underperforming trainees. The aim of this review is to examine the use of WBA in identifying and remediating performance among this ***: Following publication of a review protocol a comprehensive search of eight databases took place to identify relevant articles published prior to November 2015. All screening, data extraction and analysis procedures were performed in duplicate or with quality checks and necessary consensus methods throughout. Given the study-level heterogeneity, a descriptive synthesis approach informed the study ***: Twenty studies met the inclusion criteria. The use of WBA within the context of remediation is not supported within the existing literature. The identification of underperformance is not supported by the use of stand-alone, single-assessor WBA events although specific areas of underperformance may be identified. Multisource feedback (MSF) tools may facilitate identification of ***: The extent to which WBA can be used to detect and manage underperformance in postgraduate trainees is unclear although evidence to date suggests that multirater assessments (i.e. MSF) may be of more use than single-rater judgments (e.g. mini-clinical evaluation exercise).

关键词： CLINICAL competence EVALUATION CINAHL (Information retrieval system) ERIC (Information retrieval system) medical information storage & retrieval systems PSYCHOLOGY information storage & retrieval systems medical personnel & patient medical students MEDICINE -- Study & teaching MEDLINE SYSTEMATIC reviews (medical research) JOB performance EDUCATIONAL outcomes medical coding

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Interprofessional learning through shadowing: Insights and lessons learned

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medical TEACHER 2016年第12期38卷 1278-1284页

作者： Kusnoor, Anita V. Stelljes, Linda A. Baylor Coll Med One Baylor PlazaMS BCM 285 Houston TX 77030 USA

Background: Interprofessional education (IPE) aims to improve patient outcomes. Interprofessional shadowing improves students' knowledge of different roles and attitudes toward other ***: This study evaluates (1) how pre-clinical medical students describe the roles of the healthcare professionals they shadowed, and (2) whether shadowing can be used to introduce medical students to the benefits of interprofessional collaboration, and if so, in what ***: Second-year medical students shadow another discipline and write a reflection on the shadowed discipline (SD)'s role and collaboration in patient care. A non-proportional stratified random sample of these reflections was coded during an iterative process. Any number of the 13 possible codes could be assigned to each reflection. Codes relevant to the research questions underwent narrative ***: The most frequent codes were specific function of SD (88%), SD's general purpose (86%), and value of SD's role (68%). One-third of reflections referenced communication, and one-third mentioned teamwork. Insights gained included an appreciation for interprofessional care and a global perspective on patient care, extending beyond the inpatient ***: Through shadowing, students achieve several IPE core competencies and a broader perspective on patient care. Shadowing is an effective pedagogical method for IPE in the pre-clerkship curriculum.

关键词： MENTORING EVALUATION COMMUNICATION INTERDISCIPLINARY approach in education INTERPROFESSIONAL relations LEARNING strategies PRACTICE of medicine MEDICINE -- Study & teaching FINANCING of research STUDENT attitudes TEAMS in the workplace THEMATIC analysis DATA analysis software medical coding

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Rapid Onset of the Effects of Combined Selective Serotonin Reuptake Inhibitors and Electroacupuncture on Primary Depression: A Meta-Analysis

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JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE 2016年第1期22卷 1-8页

作者： Zhang, Yue Qu, Shan-shan Zhang, Ji-ping Sun, Ya-ling Liu, Wei-lu Xie, Ling Huang, Yong Chen, Jun-qi Southern Med Univ Dept Clin Med Clin Coll 1 Guangzhou 510515 Guangdong Peoples R China Southern Med Univ Coll Tradit Chinese Med Guangzhou 510515 Guangdong Peoples R China Southern Med Univ Affiliated Hosp 3 Dept Rehabil Med Guangzhou 510515 Guangdong Peoples R China

S Objectives: To evaluate the efficacy and safety of combined selective serotonin reuptake inhibitors (SSRIs) and electroacupuncture therapies for the early treatment of primary depression. Methods: Randomized controlled trials (RCTs) were analyzed to compare therapy combining SSRIs and electroacupuncture to SSRI therapy alone. The RCTs were identified by searching, among others, PubMed, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, and the Chinese Biological medical Literature Database. Scores from Self-Rated Depression Scale (SDS), the Hamilton Depression Scale (HAMD), the Side Effect Rating Scale (SERS), and the Treatment Emergent Symptom Scale (TESS) were analyzed and coded by two independent investigators and used to evaluate the safety and efficacy of treatment. Statistical analyses were performed using RevMan 5.2 software. Results: Six RCTs were analyzed. The meta-analysis revealed that the combined therapy of SSRIs and electroacupuncture were associated with superior scores on the HAMD, SDS, and SERS measures compared with SSRIs alone after 1-4 weeks of treatment: HAMD scores, mean difference (MD)(1 week), 2.32 (95% confidence interval [CI](1 week), 1.47-3.16, p(1 week)<0.00001);MD2 weeks, 2.65 (95% CI2 weeks, 1.81- 3.50, p(2 weeks)<0.00001);MD4 weeks, 2.70 (95% CI4 weeks, 1.90-3.51, p(4 weeks)<0.00001);SDS scores: MD1 week, 3.13 (95% CI1 week, 1.22-5.03, p(1 week)=0.001);MD2 weeks, 4.05 (95% CI2 weeks, 0.22-7.87, p(2 weeks)=0.04);MD4 weeks, 5.02 (95% CI4 weeks, 1.61-8.43, p(4 weeks)=0.004);SERS scores: MD2 weeks, 2.20 (95% CI2 weeks, 1.43-2.96, p(2 weeks)<0.00001);MD4 weeks, 2.12 (95% CI4 weeks, 1.42-2.83, p(4 weeks)<0.00001). However, two of the aforementioned outcomes were rated as medium quality because of heterogeneity, as assessed using the Grading of Recommendations Assessment, Development and Evaluation system. Conclusions: The available evidence sugges

关键词： TREATMENT of mental depression SEROTONIN uptake inhibitors RESEARCH methodology evaluation ALTERNATIVE medicine COMBINED modality therapy CONFIDENCE intervals ELECTROACUPUNCTURE EXPERIMENTAL design HAMILTON Depression Inventory INFORMATION storage & retrieval systems -- medical care MEDLINE META-analysis ONLINE information services PROBABILITY theory PSYCHOLOGICAL tests SYSTEMATIC reviews (medical research) EVIDENCE-based medicine PROFESSIONAL practice RANDOMIZED controlled trials TREATMENT effectiveness DATA analysis software medical coding DESCRIPTIVE statistics EVALUATION THERAPEUTIC use

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Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set

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INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 2016年第5期94卷 1000-1005页

作者： Vu, Charles C. Lanni, Thomas B. Robertson, John M. Beaumont Hlth Syst Dept Radiat Oncol Royal Oak MI USA

Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other specialists

关键词： MEDICARE reimbursement ONCOLOGY RADIOTHERAPY medical radiology ONCOLOGISTS medical coding medical care

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