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https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#1
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28595690/understanding-health-talk-in-an-urban-aboriginal-and-torres-strait-islander-primary-healthcare-service-a-cross-sectional-study
#2
Prabha Lakhan, Deborah Askew, Mark F Harris, Corey Kirk, Noel Hayman
Health literacy is an important determinant of health status. This cross-sectional study aimed to describe the prevalence of adequate health literacy among Aboriginal and Torres Strait Islander patients or their carers including parents of sick children attending an urban primary healthcare clinic in Australia, and their experiences of communication with General Practitioners (GPs). A questionnaire, including questions from the Brief Health Literacy Screen (BHLS) and questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS): Communication with Provider, was administered to 427 participants...
June 9, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28586543/acute-fatigue-predicts-sickness-absence-in-the-workplace-a-1-year-retrospective-cohort-study-in-pediatric-nurses
#3
Knar Sagherian, George J Unick, Shijun Zhu, Debra Derickson, Pamela S Hinds, Jeanne Geiger-Brown
AIMS: To examine the relationship between fatigue and sickness absence in nurses from a pediatric hospital over 12 months of follow-up. A secondary aim was to identify other work and personal factors that predict sickness absence. BACKGROUND: Sickness absence is often related to worker-fatigue, yet few studies have explored this relationship in nurses despite documented high fatigue levels. DESIGN: The study used retrospective cohort design...
June 6, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28585868/long-term-effects-of-internet-delivered-cognitive-behavioral-therapy-for-depression-in-primary-care-the-prim-net-controlled-trial
#4
Maria C M Eriksson, Marie Kivi, Dominique Hange, Eva-Lisa Petersson, Nashmil Ariai, Per Häggblad, Hans Ågren, Fredrik Spak, Ulf Lindblad, Boo Johansson, Cecilia Björkelund
OBJECTIVE: Internet-delivered cognitive behavioral therapy (ICBT) is recommended as an efficient treatment alternative for depression in primary care. However, only few previous studies have been conducted at primary care centers (PCCs). We evaluated long-term effects of ICBT treatment for depression compared to treatment as usual (TAU) in primary care settings. DESIGN: Randomized controlled trial. SETTING: Patients were enrolled at16 PCCs in south-west Sweden...
June 6, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28464021/predictive-value-of-clinical-and-laboratory-features-for-the-main-febrile-diseases-in-children-living-in-tanzania-a-prospective-observational-study
#5
Olga De Santis, Mary Kilowoko, Esther Kyungu, Willy Sangu, Pascal Cherpillod, Laurent Kaiser, Blaise Genton, Valérie D'Acremont
BACKGROUND: To construct evidence-based guidelines for management of febrile illness, it is essential to identify clinical predictors for the main causes of fever, either to diagnose the disease when no laboratory test is available or to better target testing when a test is available. The objective was to investigate clinical predictors of several diseases in a cohort of febrile children attending outpatient clinics in Tanzania, whose diagnoses have been established after extensive clinical and laboratory workup...
2017: PloS One
https://www.readbyqxmd.com/read/28400524/women-s-healthcare-consultations-on-operations-a-multidisciplinary-provider-questionnaire
#6
Magdalena Thiel, S Evans, R Sawdy
BACKGROUND: 30% of UK primary care consultations relate to gynaecology. Servicewomen access healthcare in general more frequently than their NHS counterparts, so military medical professionals are thus more likely to be managing significant numbers of gynaecological conditions on deployed military operations. Little is known about their confidence and preparedness in managing female-specific complaints. This study aimed to assess clinicians' views as to their training and confidence in managing gynaecological conditions; to gauge the need for developing treatment guidelines and specific training opportunities and to establish the frequency and scope of female-specific presentations on a military deployment...
April 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28397521/improving-access-to-health-care-in-a-rural-regional-hospital-in-south-africa-why-do-patients-miss-their-appointments
#7
Lucy Frost, Louis S Jenkins, Benjamin Emmink
BACKGROUND: Access to health services is one of the Batho Pele ('people first') values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care...
March 30, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28362063/adherence-to-antiretroviral-therapy-for-hiv-in-sub-saharan-africa-and-asia-a-comparative-analysis-of-two-regional-cohorts
#8
Rimke Bijker, Awachana Jiamsakul, Cissy Kityo, Sasisopin Kiertiburanakul, Margaret Siwale, Praphan Phanuphak, Sulaimon Akanmu, Romanee Chaiwarith, Ferdinand W Wit, Benedict Lh Sim, Tamara Sonia Boender, Rossana Ditangco, Tobias F Rinke De Wit, Annette H Sohn, Raph L Hamers
INTRODUCTION: Our understanding of how to achieve optimal long-term adherence to antiretroviral therapy (ART) in settings where the burden of HIV disease is highest remains limited. We compared levels and determinants of adherence over time between HIV-positive persons receiving ART who were enrolled in a bi-regional cohort in sub-Saharan Africa and Asia. METHODS: This multicentre prospective study of adults starting first-line ART assessed patient-reported adherence at follow-up clinic visits using a 30-day visual analogue scale...
March 3, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28261274/assessment-of-antiretroviral-treatment-adherence-among-children-attending-care-at-a-tertiary-hospital-in-southeastern-nigeria
#9
Cletus Akahara, Emeka Nwolisa, Kelechi Odinaka, Seline Okolo
Background. Adherence is the strongest predictor of successful treatment outcome among children infected with HIV. Our aim was to assess the antiretroviral drugs adherence status of HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria. Method. The study involved a cross-sectional survey of 210 HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria using self-report method of assessment. Optimal ART adherence is defined as patient taking not missing more than 1 dose of combined antiretroviral therapy medication in the preceding 2 weeks prior to the study...
2017: Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28249602/relating-professionalism-and-conscientiousness-to-develop-an-objective-scalar-proxy-measure-of-professionalism-in-anaesthetic-trainees
#10
M A Sawdon, K Whitehouse, G M Finn, J C McLachlan, D Murray
BACKGROUND: The concept of professionalism is complex and subjective and relies on expert judgements. Currently, there are no existing objective measures of professionalism in anaesthesia. However, it is possible that at least some elements of professionalism may be indicated by objective measures. A number of studies have suggested that conscientiousness as a trait is a significant contributor to professionalism. METHODS: A 'Conscientiousness Index' (CI) was developed by collation of routinely collected data from tasks expected to be carried out by anaesthetic trainees such as punctual submission of holiday and 'not-on-call' requests, attendance at audit meetings, timely submission of completed appraisal documentation and sickness/absence notifications...
March 1, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28241032/utilization-of-health-services-in-a-resource-limited-rural-area-in-kenya-prevalence-and-associated-household-level-factors
#11
Anthony K Ngugi, Felix Agoi, Megan R Mahoney, Amyn Lakhani, David Mang'ong'o, Esther Nderitu, Robert Armstrong, Sarah Macfarlane
BACKGROUND AND METHODS: Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month...
2017: PloS One
https://www.readbyqxmd.com/read/28129344/high-adherence-to-iron-folic-acid-supplementation-during-pregnancy-time-among-antenatal-and-postnatal-care-attendant-mothers-in-governmental-health-centers-in-akaki-kality-sub-city-addis-ababa-ethiopia-hierarchical-negative-binomial-poisson-regression
#12
Bisratemariam Gebreamlak, Abel Fekadu Dadi, Azeb Atnafu
BACKGROUND: Iron deficiency during pregnancy is a risk factor for anemia, preterm delivery, and low birth weight. Iron/Folic Acid supplementation with optimal adherence can effectively prevent anemia in pregnancy. However, studies that address this area of adherence are very limited. Therefore, the current study was conducted to assess the adherence and to identify factors associated with a number of Iron/Folic Acid uptake during pregnancy time among mothers attending antenatal and postnatal care follow up in Akaki kality sub city...
2017: PloS One
https://www.readbyqxmd.com/read/28125978/expectations-of-pain-and-functioning-in-patients-with-musculoskeletal-disorders-a-cross-sectional-study
#13
Sigrid Skatteboe, Cecilie Røe, Morten Wang Fagerland, Lars-Petter Granan
BACKGROUND: Research has suggested that patient expectations are associated with treatment outcome and evolve along with patient communication within the musculoskeletal field. However, few studies have investigated if or how physical medicine and rehabilitation (PMR) consultations affect the attending patients' expectations regarding pain and functional improvement. Hence, the aims of the present study were to compare patient expectations regarding pain and functional improvement before and after a PMR consultation and to assess patient characteristics, including diagnosis, that could perhaps predict changes in expectations...
January 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28114968/motivators-of-couple-hiv-counseling-and-testing-chct-uptake-in-a-rural-setting-in-uganda
#14
Victoria Nannozi, Eric Wobudeya, Nicholas Matsiko, Jacqueline Gahagan
BACKGROUND: Couple HIV Counseling and Testing (CHCT) is one of the key preventive strategies used to reduce the spread of HIV. In Uganda, HIV prevalence among married/living together is 7.2% among women and 7.6% among men. CHCT can help ease disclosure of HIV-positive status, which in turn may help increase opportunities to get social support and reduce new infections. The uptake of CHCT among attendees of health facilities in rural Uganda is as high as 34%. The purpose of this study was to explore the motivators of CHCT uptake in Mukono district, a rural setting in Uganda...
January 23, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28099432/an-analysis-of-the-last-clinical-encounter-before-outpatient-mortality-among-children-with-hiv-infection-and-exposure-in-lilongwe-malawi
#15
Chris A Rees, Robert J Flick, David Sullivan, Menard Bvumbwe, Joseph Mhango, Mina C Hosseinipour, Peter N Kazembe
BACKGROUND: Human immunodeficiency virus (HIV) contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting. METHODS: This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children's Center of Excellence in Lilongwe, Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/28095408/patient-safety-incidents-involving-sick-children-in-primary-care-in-england-and-wales-a-mixed-methods-analysis
#16
Philippa Rees, Adrian Edwards, Colin Powell, Peter Hibbert, Huw Williams, Meredith Makeham, Ben Carter, Donna Luff, Gareth Parry, Anthony Avery, Aziz Sheikh, Liam Donaldson, Andrew Carson-Stevens
BACKGROUND: The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting. METHODS AND FINDINGS: We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013...
January 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28065259/predictors-of-ramadan-fasting-during-pregnancy
#17
Lily A van Bilsen, Ary I Savitri, Dwirani Amelia, Mohammad Baharuddin, Diederick E Grobbee, Cuno S P M Uiterwaal
Although the health effects of Ramadan fasting during pregnancy are still unclear, it is important to identify the predictors and motivational factors involved in women's decision to observe the fast. We investigated these factors in a cross sectional study of 187 pregnant Muslim women who attended antenatal care visits in the Budi Kemuliaan Hospital, Jakarta, Indonesia. The odds of adherence to fasting were reduced by 4% for every week increase in gestational age during Ramadan [odds ratio (OR) 0.96; 95% confidence interval (CI) 0...
December 2016: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/28052318/severe-fear-of-childbirth-indicates-high-perinatal-costs-for-swedish-women-giving-birth-to-their-first-child
#18
Katri Nieminen, Klaas Wijma, Sanna Johansson, Emelie K Kinberger, Elsa-Lena Ryding, Gerhard Andersson, Lars Bernfort, Barbro Wijma
INTRODUCTION: The objective of this study was to calculate costs associated with severe fear of childbirth (FOC) during pregnancy and peripartum by comparing two groups of women expecting their first child and attending an ordinary antenatal program; one with low FOC and one with severe FOC. MATERIAL AND METHODS: In a prospective case-control cohort study one group with low FOC [Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) sum score ≤60, n = 107] and one with severe FOC (W-DEQ ≥85, n = 43) were followed up till 3 months postpartum and included in the analysis...
April 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28040520/predictors-of-differences-in-health-services-utilization-for-children-in-nigerian-communities
#19
Victor T Adekanmbi, Sulaimon T Adedokun, Sian Taylor-Phillips, Olalekan A Uthman, Aileen Clarke
Health service utilization is an important component of child health promotion. Evidence shows that two-thirds of child deaths in low and middle income countries could be prevented if current interventions were adequately utilized. Aim of this study was to identify determinants of variation in health services utilization for children in communities in Nigeria. Multivariable negative binomial regression model attempting to explain observed variability in health services usage in Nigerian communities was applied to the 2013 Nigeria Demographic and Health Survey data...
March 2017: Preventive Medicine
https://www.readbyqxmd.com/read/27966193/optimization-of-methods-verifying-volunteers-ability-to-provide-hospice-care
#20
Marta Szeliga, Jadwiga Mirecka
The subject of the presented work was an attempt at optimization of the methods used for verification of the candidates for medical voluntary workers in a hospice and decreasing the danger of a negative influence of an incompetent volunteer on a person in a terminal stage of a disease and his or her relatives. The study was carried out in St. Lazarus Hospice in Krakow, Poland, and included 154 adult participants in four consecutive editions of "A course for volunteers - a guardian of the sick" organized by the hospice...
December 14, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
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