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Primary care behavioral health

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https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#1
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28207666/are-they-complying-physicians-knowledge-attitudes-and-readiness-to-change-regarding-low-back-pain-treatment-guideline-adherence
#2
Sheera Epstein-Sher, Dena H Jaffe, Amnon Lahad
STUDY DESIGN: Cross-sectional survey of 145 primary care practitioners (PCPs). OBJECTIVE: To examine low back pain (LBP) guideline knowledge, readiness to implement (RTI) these guidelines, and LBP attitudes and beliefs among Israeli PCPs and determine whether physician age, guideline familiarity, and medical specialty affect these variables. SUMMARY OF BACKGROUND DATA: LBP is a common condition managed primarily by PCPs. Little is known, however, about physician's LBP knowledge, attitudes, and beliefs and how these factors (knowledge, A&B) influence their practice behavior...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28198998/physical-activity-counseling-in-primary-care-insights-from-public-health-and-behavioral-economics
#3
REVIEW
Kerem Shuval, Tammy Leonard, Jeffrey Drope, David L Katz, Alpa V Patel, Melissa Maitin-Shepard, On Amir, Amir Grinstein
Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle...
February 15, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28193744/impact-of-the-integration-of-water-treatment-hygiene-nutrition-and-clean-delivery-interventions-on-maternal-health-service-use
#4
Kirsten Fagerli, Katherine O'Connor, Sunkyung Kim, Maureen Kelley, Aloyce Odhiambo, Sitnah Faith, Ronald Otieno, Benjamin Nygren, Mary Kamb, Robert Quick
Reducing barriers associated with maternal health service use, household water treatment, and improved hygiene is important for maternal and neonatal health outcomes. We surveyed a sample of 201 pregnant women who participated in a clinic-based intervention in Kenya to increase maternal health service use and improve household hygiene and nutrition through the distribution of water treatment products, soap, protein-fortified flour, and clean delivery kits. From multivariable logistic regression analyses, the adjusted odds of ≥ 4 antenatal care (ANC4+) visits (odds ratio [OR] = 3...
February 13, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28191035/the-prevalence-of-suicidal-ideation-and-depression-among-primary-care-patients-and-current-management-in-south-korea
#5
Yoon-Joo Choi, Weon-Young Lee
BACKGROUND: Primary care in South Korea has no effective screening system to identify high-risk suicide patients despite to the possibility of hidden patients. The present study examined the prevalence of suicidal ideation and depression among primary care patients and investigated rates of recognition and management strategies of physicians as they encountering patients with suicidal ideation and depression in primary care settings. METHODS: This study was conducted as a two-part survey of patients visiting primary care clinics and their physicians...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28184182/coronary-heart-disease-incidence-and-mortality-and-all-cause-mortality-among-diabetic-and-non-diabetic-people-according-to-their-smoking-behavior-in-finland
#6
Noël C Barengo, Yvonne Teuschl, Vladislav Moltchanov, Tiina Laatikainen, Pekka Jousilahti, Jaakko Tuomilehto
BACKGROUND: As type 2 diabetes (T2D) patients have a high risk for coronary heart disease (CHD) and all-cause mortality and smoking is a major single risk factor for total and CHD mortality, it is important to understand the impact of smoking to the outcome events in comparison to people without T2D. Studies of excess risk of CHD incidence and mortality, and all-cause mortality in T2D patients related to smoking are controversial. We aimed to assess the risk of CHD incidence and mortality, and all-cause mortality in a large Finnish population cohort consisting of people with and without T2Daccording to smoking status...
2017: Tobacco Induced Diseases
https://www.readbyqxmd.com/read/28183323/the-tech-home-study-a-technological-intervention-to-reduce-caregiver-burden-for-informal-caregivers-of-people-with-dementia-study-protocol-for-a-randomized-controlled-trial
#7
Agneta Malmgren Fänge, Steven M Schmidt, Maria H Nilsson, Gunilla Carlsson, Anna Liwander, Caroline Dahlgren Bergström, Paolo Olivetti, Per Johansson, Carlos Chiatti
BACKGROUND: It is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28181702/cerebrovascular-burden-and-depressive-symptomatology-interrelate-over-18%C3%A2-years-support-for-the-vascular-depression-hypothesis
#8
Rosanna Scott, Daniel Paulson
OBJECTIVE: Potentially incongruent research literatures suggest three divergent hypotheses about depressive symptomatology: (1) symptoms are recurrent; (2) later-life depression results from high cerebrovascular burden (CVB); and (3) depressive symptoms contribute to comorbidities causing vascular burden. Past vascular depression research assumes that later-life depressive symptoms relate uniquely to high CVB and not to prior, recurrent depression. This study examines these divergent hypotheses...
February 9, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28179049/promoting-hand-hygiene-compliance
#9
Thomas von Lengerke, Bettina Lutze, Christian Krauth, Karin Lange, Jona Theodor Stahmeyer, Iris Freya Chaberny
BACKGROUND: The German "Clean Hands Campaign" (an adaptation of the WHO "Clean Care is Safer Care" programme) to promote hand hygiene among hospital personnel at Hannover Medical School (MHH, Medizinische Hochschule Hannover), known as Aktion Saubere Hände (ASH), met with initial success. By 2013, however, compliance rates with hygienic hand disinfection in the hospital's ten intensive care units (ICUs) and two hematopoietic stem cell transplantation units (HSCTUs) had relapsed to their initial levels (physicians: 48%; nurses: 56%)...
January 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28168590/meeting-women-where-they-are-integration-of-care-as-the-foundation-of-treatment-for-at-risk-pregnant-and-postpartum-women
#10
Melanie Thomas, Margaret Hutchison, Gloria Castro, Melissa Nau, Martha Shumway, Naomi Stotland, Anna Spielvogel
Purpose In these times of rapidly changing health care policies, those involved in the health care of women, especially during the reproductive years, have a unique and daunting opportunity. There is great potential to positively impact women's health through focus on prevention, attention to addressing disparities, and new focus on the integration of behavioral health care in primary care settings. Description In this report from the field, we suggest that the integration of mental health care into other health services and addressing underlying social needs by partnering with community-based organizations should be a top priority for all settings seeking to provide excellent health care for women...
February 6, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28161071/-intimate-partner-violence-types-and-risk-in-primary-care-health-users-in-cancun-quintana-roo-mexico
#11
Luis Sandoval-Jurado, María Valeria Jiménez-Báez, Gloria Rovira Alcocer, Omar Vital Hernandez, Fany Guadalupe Pat Espadas
OBJECTIVE: To identify the prevalence and type of intimate partner violence in women assigned at primary care health and estimates the risks for violence. DESIGN: Case (incident cases)-control. LOCATION: Primary health care unit in Cancun, Quintana Roo, Mexico. PARTICIPANTS: Women over 18years old living in couple at last 12months. MAIN MEASUREMENTS: Validated violence scale for Mexican population was evaluated: total partner violence, physical, psychological and sexual violence...
February 1, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28159871/trends-in-the-diagnosis-of-vitamin-d-deficiency
#12
Emre Basatemur, Laura Horsfall, Louise Marston, Greta Rait, Alastair Sutcliffe
BACKGROUND: Vitamin D has attracted considerable interest in recent years, and health care providers have reported large increases in vitamin D test requests. However, rates of diagnosis of vitamin D deficiency in clinical practice have not been investigated. We examined trends in diagnosis of vitamin D deficiency in children in England over time, and by sociodemographic characteristics. METHODS: Cohort study using primary care records of 711 788 children aged 0 to 17 years, from the Health Improvement Network database...
February 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28152186/initial-and-follow-up-evaluations-of-integrated-psychological-services-for-anxiety-and-depression-in-a-safety-net-primary-care-clinic
#13
Elizabeth Sadock, Paul B Perrin, Renée M Grinnell, Bruce Rybarczyk, Stephen M Auerbach
OBJECTIVE: Despite the recognized importance of integrated behavioral health, particularly in safety net primary care, its effectiveness in real world settings has not been extensively evaluated. This article presents 2 successive studies examining the effectiveness of integrated behavioral care in a safety net setting. METHOD: Study 1 compared the depression and anxiety scores of predominately low-income and minority patients who underwent brief interventions (N = 147) to those of patients from a demographically similar comparison clinic without integrated psychological services, matched on baseline levels of anxiety and depression and length of time between assessments (N = 139)...
February 2, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28151830/religiousness-spirituality-and-salivary-cortisol-in-breast-cancer-survivorship-a-pilot-study
#14
Jennifer M Hulett, Jane M Armer, Emily Leary, Bob R Stewart, Roxanne McDaniel, Kandis Smith, Rami Millspaugh, Joshua Millspaugh
BACKGROUND: Psychoneuroimmunological theory suggests a physiological relationship exists between stress, psychosocial-behavioral factors, and neuroendocrine-immune outcomes; however, evidence has been limited. OBJECTIVE: The primary aim of this pilot study was to determine feasibility and acceptability of a salivary cortisol self-collection protocol with a mail-back option for breast cancer survivors. A secondary aim was to examine relationships between religiousness/spirituality (R/S), perceptions of health, and diurnal salivary cortisol (DSC) as a proxy measure for neuroendocrine activity...
February 2, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28148227/effective-team-based-primary-care-observations-from-innovative-practices
#15
Edward H Wagner, Margaret Flinter, Clarissa Hsu, DeAnn Cromp, Brian T Austin, Rebecca Etz, Benjamin F Crabtree, MaryJoan D Ladden
BACKGROUND: Team-based care is now recognized as an essential feature of high quality primary care, but there is limited empiric evidence to guide practice transformation. The purpose of this paper is to describe advances in the configuration and deployment of practice teams based on in-depth study of 30 primary care practices viewed as innovators in team-based care. METHODS: As part of LEAP, a national program of the Robert Wood Johnson Foundation, primary care experts nominated 227 innovative primary care practices...
February 2, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28146586/making-the-continuum-of-care-work-for-mothers-and-infants-does-gender-equity-matter-findings-from-a-quasi-experimental-study-in-bihar-india
#16
Lotus McDougal, Yamini Atmavilas, Katherine Hay, Jay G Silverman, Usha K Tarigopula, Anita Raj
BACKGROUND: Improvements in continuum of care (CoC) utilization are needed to address inadequate reductions in neonatal and infant mortality in India and elsewhere. This study examines the effect of Ananya, a health system training and community outreach intervention, on reproductive, maternal and newborn health continuum of care (RMNH CoC) utilization in Bihar, India, and explores whether that effect is moderated by gender equity factors (child marriage, restricted mobility and low decision-making control)...
2017: PloS One
https://www.readbyqxmd.com/read/28143452/challenges-and-opportunities-in-establishing-a-collaborative-multisite-observational-study-of-chronic-diseases-and-lifestyle-factors-among-adults-in-puerto-rico
#17
Josiemer Mattei, José F Rodríguez-Orengo, Martha Tamez, Francheska Corujo, Aida Claudio, Héctor Villanueva, Hannia Campos, Walter C Willett, Katherine L Tucker, Carlos F Ríos-Bedoya
BACKGROUND: Prevalence of chronic diseases and unhealthy lifestyle behaviors among the adult population of Puerto Rico (PR) is high; however, few epidemiological studies have been conducted to address these. We aimed to document the methods and operation of establishing a multisite cross-sectional study of chronic diseases and risk factors in PR, in partnership with academic, community, clinical, and research institutions. METHODS: The Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD) documented lifestyle and health characteristics of adults living in PR, with the goal of informing future epidemiological and intervention projects, as well as public health, policy, and clinical efforts to help improve the population's health...
January 31, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28142364/increasing-recreational-physical-activity-in-patients-with-chronic-low-back-pain-a-pragmatic-controlled-clinical-trial
#18
Noa Ben-Ami, Gabriel Chodick, Yigal Mirovsky, Tamar Pincus, Yair Shapiro
Study Design Prospective, pragmatic, nonrandomized controlled clinical trial. Background Clinical guidelines recommend physical activity for the treatment of chronic low back pain. But engaging patients in physical activity has proven difficult. Known obstacles to physical activity include low self-efficacy and fear avoidance. Objectives This study tested the effectiveness of an enhanced transtheoretical model intervention (ETMI) aimed at increasing recreational physical activity in patients with chronic low back pain, in comparison to usual physical therapy...
February 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28141723/anxiety-associated-with-asthma-exacerbations-and-overuse-of-medication-the-role-of-cultural-competency
#19
Yousuke T Horikawa, Tina Y Udaka, Janet K Crow, John I Takayama, Martin T Stein
Toshi, a 14-year-old Japanese boy, had uncontrolled asthma after relocating from Japan with his family 1 year ago. In Japan, he was diagnosed with moderate, persistent asthma, which was controlled with salmeterol and albuterol on an as needed basis. Since moving to the United States, Toshi complained of frequent dyspnea.Initially, he was seen by a Japanese physician who prescribed 200 mg of fluticasone 3 times a day and albuterol nebulization as needed. When Toshi came to the Pediatric Primary Care Clinic, he reported using his nebulizer up to 25 times daily...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141672/conducting-community-health-needs-assessments-in-the-local-public-health-department-a-comparison-of-random-digit-dialing-and-the-community-assessment-for-public-health-emergency-response
#20
Kahler Stone, Allison Sierocki, Vaidehi Shah, Kelly R Ylitalo, Jennifer A Horney
CONTEXT: Community health needs assessments (CHNAs) are now required by the Affordable Care Act (ACA) for nonprofit hospitals and the Public Health Accreditation Board (PHAB) for local health departments that seek accreditation. Currently, various primary data collection methods exist that meet the ACA and PHAB requirements. OBJECTIVE: To compare 2 CHNA data collection methods implemented in the same geographical area from a local health department perspective. DESIGN AND SETTING: Two community surveys, one door-to-door and one telephone, in the 76706 zip code area of McLennan County, Texas...
January 30, 2017: Journal of Public Health Management and Practice: JPHMP
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