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https://www.readbyqxmd.com/read/28549339/typical-and-atypical-presenting-symptoms-of-breast-cancer-and-their-associations-with-diagnostic-intervals-evidence-from-a-national-audit-of-cancer-diagnosis
#1
Minjoung Monica Koo, Christian von Wagner, Gary A Abel, Sean McPhail, Greg P Rubin, Georgios Lyratzopoulos
INTRODUCTION: Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible. METHODS: We examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n=2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression...
May 23, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28548896/implementation-of-asthma-clinical-practice-guidelines-in-primary-care-a-cross-sectional-study-based-on-the-knowledge-to-action-cycle
#2
Myriam E Gagné, Louis-Philippe Boulet
OBJECTIVE: Based on the Knowledge-to-Action Cycle, we assessed the self-reported implementation and perception of asthma clinical practice guideline (CPG) recommendations in primary care physicians (PCPs), along with the barriers and facilitators to CPG use in primary care. METHODS: We conducted a cross-sectional study. Using the extended Asthma Physicians' Practice Assessment Questionnaire(©), PCPs self-reported the following: their knowledge of 15 key asthma CPG recommendations, the perceived usefulness of each of these recommendations, their motivation to apply these recommendations, and their agreement with the content of these recommendations...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28548676/the-diagnosis-and-management-of-chronic-migraine-in-primary-care
#3
Werner J Becker
BACKGROUND: Chronic migraine is common, affecting approximately 1% of the general population, and causes significant disability. OBJECTIVE: To summarize optimal involvement of primary care physicians in chronic migraine care, and to provide algorithms to assist them in the diagnosis and management of patients with chronic migraine. METHODS: An analysis of diagnostic and treatment needs in chronic migraine, based on a synthesis of the medical literature and clinical experience...
May 26, 2017: Headache
https://www.readbyqxmd.com/read/28548190/-clinical-features-of-major-depressive-disorders-treated-in-secondary-health-care-facilities-in-chile
#4
Lilian Salvo, Sandra Saldivia, Carlos Parra, Román Rodríguez, Manuel Cifuentes, Paola Acevedo, Marcela Díaz, Mitza Ormazabal, Ivonne Guerra, Nicol Navarrete, Verónica Bravo, Andrea Castro
BACKGROUND: Depression is considered the second leading cause of disability worldwide. AIM: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). MATERIAL AND METHODS: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women)...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28547735/the-burden-of-headache-disorders-in-ethiopia-national-estimates-from-a-population-based-door-to-door-survey
#5
Mehila Zebenigus, Redda Tekle-Haimanot, Dawit K Worku, Hallie Thomas, Timothy J Steiner
BACKGROUND: Headache disorders are the third-highest cause of disability worldwide, with migraine and medication-overuse headache (MOH) the major contributors. In Ethiopia we have shown these disorders to be highly prevalent: migraine 17.7%, TTH 20.6%, probable MOH (pMOH) 0.7%, any headache yesterday (HY) 6.4%. To inform local health policy, we now estimate disability and other burdens attributable to headache in this country. METHODS: In a cross-sectional survey using cluster-randomized sampling, we visited households unannounced in four diverse regions (urban and rural) of Ethiopia...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28547268/primary-care-providers-experience-management-and-referral-patterns-regarding-pelvic-floor-disorders-a-national-survey
#6
Donna Mazloomdoost, Catrina C Crisp, Steven D Kleeman, Rachel N Pauls
INTRODUCTION AND HYPOTHESIS: Primary care physicians can impact womens' access to care. We assessed primary care providers' experience and management regarding pelvic floor disorders. METHODS: This Institutional Review Board approved study invited internal and family Medicine Program Directors to complete and distribute to faculty an online survey designed to query demographics, perceptions, management, and referral patterns regarding urinary incontinence (UI), overactive bladder (OAB), and pelvic organ prolapse (POP) in females...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#7
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28546940/refractive-errors-among-children-adolescents-and-adults-attending-eye-clinics-in-mexico
#8
Francisco Gomez-Salazar, Abraham Campos-Romero, Humberto Gomez-Campaña, Cinthia Cruz-Zamudio, Mariano Chaidez-Felix, Nidia Leon-Sicairos, Jorge Velazquez-Roman, Hector Flores-Villaseñor, Secundino Muro-Amador, Alma Marlene Guadron-Llanos, Javier J Martinez-Garcia, Joel Murillo-Llanes, Jaime Sanchez-Cuen, Alejando Llausas-Vargas, Gerardo Alapizco-Castro, Ana Irineo-Cabrales, Enrique Graue-Hernandez, Tito Ramirez-Luquin, Adrian Canizalez-Roman
AIM: To assess the proportion of refractive errors in the Mexican population that visited primary care optometry clinics in fourteen states of Mexico. METHODS: Refractive data from 676 856 patients aged 6 to 90y were collected from optometry clinics in fourteen states of Mexico between 2014 and 2015. The refractive errors were classified by the spherical equivalent (SE), as follows: sphere+½ cylinder. Myopia (SE>-0.50 D), hyperopia (SE>+0.50 D), emmetropia (-0...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546866/a-diagnostic-protocol-designed-for-determining-allergic-causes-in-patients-with-blood-eosinophilia
#9
Jean-François Magnaval, Guy Laurent, Noémie Gaudré, Judith Fillaux, Antoine Berry
BACKGROUND: Blood eosinophilia is a common laboratory abnormality, and its characterization frequently represents a quandary for primary care physicians. Consequently, in France, specialists and particularly hematologists, often must investigate patients who present with blood eosinophilia that often, but not always, occurs because of allergic causes. Both the Departments of Hematology and Parasitology at Toulouse University Hospitals established a collaboration to rule out allergic causes of eosinophilia, particularly helminthiases, prior to initiating more sophisticated investigations...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28546626/re-shaping-nhs-orthodontic-provision-the-north-wales-experience
#10
B R K Lewis, D J Plunkett, J Hickman, J S Sandham
The orthodontic service provision within North Wales, in common with many areas of the United Kingdom, was experiencing increasing waiting times for assessment and treatment. Reasons for this included an increasing population, patient demand and fixed NHS contracted orthodontic provision. In addition to these universal challenges, the geography of North Wales contributed to difficulties in accessing care. It was felt that with a reshaping of the orthodontic services there was potential to enhance the quality of orthodontic care available to patients and deliver prudent NHS orthodontic services...
May 26, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28546608/patient-safety-in-dentistry-development-of-a-candidate-never-event-list-for-primary-care
#11
I Black, P Bowie
Introduction The 'never event' concept is often used in secondary care and refers to an agreed list of patient safety incidents that 'should not happen if the necessary preventative measures are in place'. Such an intervention may raise awareness of patient safety issues and inform team learning and system improvements in primary care dentistry.Objective To identify and develop a candidate never event list for primary care dentistry.Methods A literature review, eight workshops with dental practitioners and a modified Delphi with 'expert' groups were used to identify and agree candidate never events...
May 26, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28546417/improving-management-of-gout-in-primary-care-a-new-uk-management-guideline
#12
Christian D Mallen, Graham Davenport, Michelle Hui, George Nuki, Edward Roddy
No abstract text is available yet for this article.
June 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28546416/recognising-paediatric-obstructive-sleep-apnoea-in-primary-care-diagnosis-and-management
#13
Rebecca Harrison, Rachel Edmiston, Caroline Mitchell
No abstract text is available yet for this article.
June 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28546404/multidisciplinary-team-meetings-in-primary-care-could-they-help-to-attract-the-gps-of-tomorrow
#14
Jennifer Coventry, Claire Coventry, Peter Coventry
No abstract text is available yet for this article.
June 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28545752/emergency-department-as-a-first-contact-for-mental-health-problems-in-children-and-youth
#15
Peter J Gill, Natasha Saunders, Sima Gandhi, Alejandro Gonzalez, Paul Kurdyak, Simone Vigod, Astrid Guttmann
OBJECTIVE: To characterize youth who use the emergency department (ED) as a "first contact" for mental health (MH) problems. METHOD: This was a population-based cross-sectional cohort study using linked health and demographic administrative datasets of youth 10 to 24 years of age with an incident MH ED visit from April 1, 2010, to March 31, 2014, in Ontario, Canada. We modeled the association of demographic, clinical, and health service use characteristics with having no prior outpatient MH care in the preceding 2-year period ("first contact") using modified Poisson models...
June 2017: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28545740/-factors-associated-with-primary-care-professionals-readiness-to-respond-to-intimate-partner-violence-in-spain
#16
Pilar Murillo, Miguel San Sebastián, Carmen Vives-Cases, Isabel Goicolea
OBJECTIVE: To analyse the Spanish primary care professionals' readiness to respond to intimate partner violence (IPV) in primary care and identify possible determinants that could facilitate a better response. METHOD: A cross-sectional study with a non-probabilistic sampling by convenience was performed among healthcare professionals working in 15 primary care centres in Spain. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), the version validated and translated into Spanish, was the instrument used to collect information about knowledge, opinions and practices regarding intimate partner violence...
May 22, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28545557/children-with-cancer-a-survey-on-the-experience-of-italian-primary-care-pediatricians
#17
Marta Minute, Giorgio Cozzi, Chiara Plotti, Giuseppe Montanari, Paolo Pecile, Giulio Andrea Zanazzo, Alessandro Ventura, Egidio Barbi
BACKGROUND: Cancer is the second cause of death in children and its diagnosis can be difficult, due to the presence of vague and non-specific symptoms. The primary care pediatrician is often involved in the diagnostic process, but no longer in child care once the treatment started. Care models involving both primary care pediatricians and oncologic referral centre highlighted a higher family satisfaction when they worked together. We conducted a survey on primary care pediatricians involved in childhood cancer in order to describe the actual situation...
May 25, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#18
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28545514/a-coordinated-pcp-cardiologist-telemedicine-model-pctm-in-china-s-community-hypertension-care-study-protocol-for-a-randomized-controlled-trial
#19
Lei Xu, Wei-Yi Fang, Fu Zhu, Hong-Guang Zhang, Kai Liu
BACKGROUND: Hypertension is a major risk factor for cardiovascular disease, and its control rate has remained low worldwide. Studies have found that telemonitoring blood pressure (BP) helped control hypertension in randomized controlled trials. However, little is known about its effect in a structured primary care model in which primary care physicians (PCPs) are partnering with cardiology specialists in electronic healthcare data sharing and medical interventions. This study aims to identify the effects of a coordinated PCP-cardiologist model that applies telemedicine tools to facilitate community hypertension control in China...
May 25, 2017: Trials
https://www.readbyqxmd.com/read/28545493/three-approaches-to-glucose-monitoring-in-non-insulin-treated-diabetes-a-pragmatic-randomized-clinical-trial-protocol
#20
Laura A Young, John B Buse, Mark A Weaver, Maihan B Vu, April Reese, C Madeline Mitchell, Tamara Blakeney, Kimberlea Grimm, Jennifer Rees, Katrina E Donahue
BACKGROUND: For the nearly 75% of patients living with type 2 diabetes (T2DM) that do not use insulin, decisions regarding self-monitoring of blood glucose (SMBG) can be especially problematic. While in theory SMBG holds great promise for sparking favorable behavior change, it is a resource intensive activity without firmly established patient benefits. This study describes our study protocol to assess the impact of three different SMBG testing approaches on patient-centered outcomes in patients with non-insulin treated T2DM within a community-based, clinic setting...
May 25, 2017: BMC Health Services Research
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