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Annals of Family Medicine

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https://www.readbyqxmd.com/read/29133509/auscultation-while-standing
#1
Michael E Johansen, Samantha N Wu
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133508/napcrg-annual-meeting-distinguished-papers
#2
Jill Haught
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133507/getting-the-most-from-the-acgme-annual-resident-and-faculty-survey
#3
Karen B Mitchell, Thomas Miller
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133506/a-physician-scientist-pathway-in-family-medicine-residency-training-programs
#4
Chyke A Doubeni, Ardis Davis, Janice L Benson, Bernard Ewigman
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133505/quality-mentorship-through-stfm
#5
Joedrecka S Brown Speights, Edgar Figueroa, Evelyn Figueroa, Judy Washington
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133504/pisacano-leadership-foundation-names-2017-pisacano-scholars
#6
Jane Ireland
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133503/new-aafp-president-hears-understands-family-physicians-concerns
#7
Sheri Porter
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133502/huddling-up-expanding-clinic-huddles
#8
Ann Tseng
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133501/how-health-systems-can-promote-healthier-eating
#9
Amanda Parsons, Elizabeth Spurrell-Huss, Sean C Lucan
No abstract text is available yet for this article.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133500/hatpins
#10
Irene Koplinka-Loehr
Hatpins is a first-person narrative that delves into a physician's experience of a patient death during the early years of residency. The essay reflects on the conflicted physician-patient relationships that can develop even over the short tenure of residency. While residency seeks to create medically prepared and compassionate physicians, this piece speaks to the importance of the often subtle learning that comes from ethical, social, and cultural aspects of both the lives and deaths of our patients.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133499/caring-for-the-tribe-from-addiction-to-zen
#11
David Loxterkamp
The culture of medicine is rapidly changing. The majority of primary care physicians are now employed, and the decisions that govern us are made farther and farther from the point of care. Our sense of well-being is threatened less by the demands of clinical practice than it is by the emptiness of our job: we have forgotten who we are working for, or working with, or why we are working at all. The solution lies in creating the kind of practice environment that we advocate for in each of our patients' lives.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133498/the-foundations-framework-for-developing-and-reporting-new-models-of-care-for-multimorbidity
#12
Jonathan Stokes, Mei-See Man, Bruce Guthrie, Stewart W Mercer, Chris Salisbury, Peter Bower
PURPOSE: Multimorbidity challenges health systems globally. New models of care are urgently needed to better manage patients with multimorbidity; however, there is no agreed framework for designing and reporting models of care for multimorbidity and their evaluation. METHODS: Based on findings from a literature search to identify models of care for multimorbidity, we developed a framework to describe these models. We illustrate the application of the framework by identifying the focus and gaps in current models of care, and by describing the evolution of models over time...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133497/comparative-associations-between-measures-of-anti-cholinergic-burden-and-adverse-clinical-outcomes
#13
Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
PURPOSE: No consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults. METHODS: From Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133496/factors-influencing-allopurinol-initiation-in-primary-care
#14
Lorna E Clarson, Samantha L Hider, John Belcher, Edward Roddy, Christian D Mallen
Despite guidance on appropriate initiation, urate-lowering therapy is prescribed for only a minority of patients with gout. Electronic health records for 8,142 patients with gout were used to investigate the effect of age, sex, comorbidities, number of consultations, and meeting internationally agreed eligibility criteria on time to allopurinol initiation. Time to first prescription was modeled using multilevel Cox proportional hazards regression. Allopurinol initiation was positively associated with meeting eligibility criteria at diagnosis of gout, but negatively associated with becoming eligible after diagnosis...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133495/trends-in-patient-perceived-shared-decision-making-among-adults-in-the-united-states-2002-2014
#15
David M Levine, Bruce E Landon, Jeffrey A Linder
To ascertain changes in shared decision making (SDM), we analyzed data from the nationally representative Medical Expenditure Panel Survey. We aggregated responses to questions into a 7-point SDM composite score. Between 2002 and 2014, the mean SDM composite score increased from 4.4 to 5.0 (P <.01), indicating greater patient-perceived SDM. In multivariate modeling, SDM scores were higher for black vs white patients (+0.33 points) and those with a same-race/ethnicity usual source of care (+0.24 points; both P <...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133494/multimorbidity-and-decision-making-preferences-among-older-adults
#16
Winnie C Chi, Jennifer Wolff, Raquel Greer, Sydney Dy
PURPOSE: Understanding individuals' preferences for participating in health care decisions is foundational to delivering person-centered care. We aimed to (1) explore preferences for health care decision making among older adults, and (2) identify multimorbidity profiles associated with preferring less active, ie, passive, participation among older US adults. METHOD: Ours was a cross-sectional, nationally representative study of 2,017 National Health and Aging Trends Study respondents...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133493/an-autoethnographic-examination-of-postpartum-depression
#17
Tara Lynn Frankhouser, Nicole L Defenbaugh
PURPOSE: This article examines postpartum depression (PPD) using autoethnography to explore the stigmatization of depression and cultural expectations of motherhood. Because the personal experiences of living with PPD are often absent from primary care literature, this article uses first-person narrative and analysis of intensive mothering to explore the barriers to seeking PPD treatment, the need for increasing physician confidence and comfort using screening tools, and the impact PPD stigma has on patients and their health care...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133492/general-practitioner-performed-compression-ultrasonography-for-diagnosis-of-deep-vein-thrombosis-of-the-leg-a-multicenter-prospective-cohort-study
#18
Nicola Mumoli, Josè Vitale, Matteo Giorgi-Pierfranceschi, Silvia Sabatini, Renato Tulino, Marco Cei, Eugenio Bucherini, Carlo Bova, Daniela Mastroiacovo, Alberto Camaiti, Gerardo Palmiero, Luca Puccetti, Francesco Dentali
BACKGROUND: Patients with suspected deep vein thrombosis (DVT) of the lower limb represent a diagnostic dilemma for general practitioners. Compression ultrasonography (US) is universally recognized as the best test of choice. We assessed the diagnostic accuracy of compression US performed by general practitioners given short training in the management of symptomatic proximal DVT. METHODS: From May 2014 to May 2016, we evaluated in a multicenter, prospective cohort study all consecutive outpatients with suspected DVT; bilateral proximal lower limb compression US was performed by general practitioners and by physicians expert in vascular US, each group blinded to the other's findings...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133491/exploring-attributes-of-high-value-primary-care
#19
Melora Simon, Niteesh K Choudhry, Jim Frankfort, David Margolius, Julia Murphy, Luis Paita, Thomas Wang, Arnold Milstein
PURPOSE: Medicare's merit-based incentive payment system and narrowing of physician networks by health insurers will stoke clinicians' and policy makers' interest in care delivery attributes associated with value as defined by payers. METHODS: To help define these attributes, we analyzed 2009 to 2011 commercial health insurance claims data for more than 40 million preferred provider organization patients attributed to over 53,000 primary care practice sites. We identified sites ranking favorably on both quality and low total annual per capita health care spending ("high-value") and sites ranking near the median ("average-value")...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133490/auscultation-while-standing-a-basic-and-reliable-method-to-rule-out-a-pathologic-heart-murmur-in-children
#20
Bruno Lefort, Elodie Cheyssac, Nathalie Soulé, Jacques Poinsot, Marie-Catherine Vaillant, Alaeddin Nassimi, Alain Chantepie
PURPOSE: The distinction between physiologic (innocent) and pathologic (organic) heart murmurs is not always easy in routine practice, leading too often to unnecessary cardiology referrals and expensive investigations. We aimed to test the hypothesis that the complete disappearance of murmur on standing can exclude cardiac disease in children. METHODS: From January 2014 to January 2015, we prospectively included 194 consecutive children aged 2 to 18 years who were referred for heart murmur evaluation to pediatric cardiologists at 2 French medical centers...
November 2017: Annals of Family Medicine
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