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https://www.readbyqxmd.com/read/28327096/exploring-why-a-complex-intervention-piloted-in-general-practices-did-not-result-in-an-increase-in-chlamydia-screening-and-diagnosis-a-qualitative-evaluation-using-the-fidelity-of-implementation-model
#1
R Allison, D M Lecky, K Town, C Rugman, E J Ricketts, N Ockendon-Powell, K A Folkard, J K Dunbar, C A M McNulty
BACKGROUND: Chlamydia trachomatis (chlamydia) is the most commonly diagnosed sexually transmitted infection (STI) in England; approximately 70% of diagnoses are in sexually active young adults aged under 25. To facilitate opportunistic chlamydia screening in general practice, a complex intervention, based on a previously successful Chlamydia Intervention Randomised Trial (CIRT), was piloted in England. The modified intervention (3Cs and HIV) aimed to encourage general practice staff to routinely offer chlamydia testing to all 15-24 year olds regardless of the type of consultation...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28325823/video-conferences-preceded-by-uploading-of-measurements-as-add-on-to-standard-care-among-patients-with-type-2-diabetes-not-responding-to-standard-regimens-a-randomized-controlled-trial
#2
Caroline Raun Hansen, Hans Perrild, Birgitte Gade Koefoed, Mette Zander
OBJECTIVE: To examine whether video consultations preceded by measurements of blood glucose, weight and blood pressure as add-on to standard care could contribute to achieving and maintaining good diabetes control among patients with poorly regulated type 2 diabetes (T2D). DESIGN: Randomized controlled trial. METHODS: 165 patients with T2D were randomized 1:1 to telemedicine intervention as add-on to clinic based care or control (clinic based care)...
March 21, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28320334/use-of-a-patient-decision-aid-for-prenatal-screening-for-down-syndrome-what-do-pregnant-women-say
#3
Maria Esther Leiva Portocarrero, Anik M C Giguère, Johanie Lépine, Mirjam M Garvelink, Hubert Robitaille, Agathe Delanoë, Isabelle Lévesque, Brenda J Wilson, François Rousseau, France Légaré
BACKGROUND: Patient decision aids (PtDAs) help people make difficult, values-sensitive decisions. Prenatal screening for assessing the risk of genetic conditions in the fetus is one such decision and patient decision aids are rarely used in this clinical context. We sought to identify factors influencing pregnant women's use of a patient decision aid for deciding about prenatal screening for Down syndrome (DS). METHODS: This qualitative study was embedded in a sequential mixed-methods research program whose main aim is to implement shared decision-making (SDM) in the context of prenatal screening for DS in the province of Quebec, Canada...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28318845/specifying-the-effects-of-physician-s-communication-on-patients-outcomes-a-randomised-controlled-trial
#4
Mara van Osch, Sandra van Dulmen, Liesbeth van Vliet, Jozien Bensing
OBJECTIVE: To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. METHODS: Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain)...
March 6, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28317462/witnesses-in-the-consultation-room-experiences-of-peer-group-supervision
#5
Helena Galina Nielsen, Annette Sofie Davidsen
BACKGROUND: In Denmark group supervision for general practitioners is an established part of continuing professional development. Several different approaches are used, including Balint Groups and Bendix Groups. The aim of this paper is to describe the benefits and challenges of a peer group supervision model with the role of supervisor taken by group members in turn. The setting was a group of general practitioners using a patient-centred consultation model and video-recordings of consultations...
March 19, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28303507/laparoscopic-conversion-of-one-anastomosis-gastric-bypass-to-a-standard-roux-en-y-gastric-bypass
#6
Imed Ben Amor, Niccolo Petrucciani, Radwan Kassir, Abdullah Al Munifi, Thierry Piche, Tarek Debs, Jean Gugenheim
INTRODUCTION: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. METHODS: We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014...
March 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28289305/interprofessional-curbside-consults-to-develop-team-communication-and-improve-student-achievement-of-learning-outcomes
#7
Jennifer Kirwin, Kristin Curry Greenwood, Janet Rico, Romesh Nalliah, Margarita DiVall
Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students' attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question...
February 25, 2017: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28279994/multicentre-randomised-study-of-the-effect-and-experience-of-an-early-inhome-programme-prehomecare-for-preterm-infants-using-video-consultation-and-smartphone-applications-compared-with-inhospital-consultations-protocol-of-the-prehomecare-study
#8
Mai-Britt Hägi-Pedersen, Annelise Norlyk, Ram Dessau, Hristo Stanchev, Hanne Kronborg
INTRODUCTION: Although premature infants and their parents are discharged earlier to inhomecare programmes, how to optimally support parents during this transition remains unknown. The aim of this study is to compare the effects of early inhomecare (PreHomeCare) including video consultations and mobile applications with those of inhospital consultations regarding breast feeding, parental confidence and parent-infant interactions. METHODS AND ANALYSIS: A randomised controlled intervention study will be conducted in four neonatal departments offering PreHomeCare (ie, premature infant inhomecare) in Denmark...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28270396/affording-opportunities-to-discuss-deterioration-in-paediatric-palliative-care-consultations-a-conversation-analytic-study
#9
Stuart Ekberg, Susan Danby, Anthony Herbert, Natalie K Bradford, Patsy Yates
OBJECTIVE: Discussing the potential deterioration of a child who has a life-limiting condition has recognised benefits for future care, but can be challenging in a clinical context where uncertain illness trajectories are common. Existing research is restricted to indirect forms of evidence such as self-report data from clinicians and families. This study directly explores how discussions about deterioration are managed within actual paediatric palliative care consultations. METHODS: 9 consultations were video recorded in an Australian paediatric palliative care service...
March 7, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28255096/investigating-the-meaning-of-good-or-very-good-patient-evaluations-of-care-in-english-general-practice-a-mixed-methods-study
#10
Jenni Burt, Jenny Newbould, Gary Abel, Marc N Elliott, Julia Beckwith, Nadia Llanwarne, Natasha Elmore, Antoinette Davey, Chris Gibbons, John Campbell, Martin Roland
OBJECTIVE: To examine concordance between responses to patient experience survey items evaluating doctors' interpersonal skills, and subsequent patient interview accounts of their experiences of care. DESIGN: Mixed methods study integrating data from patient questionnaires completed immediately after a video-recorded face-to-face consultation with a general practitioner (GP) and subsequent interviews with the same patients which included playback of the recording...
March 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28247870/teledermatology-in-the-inpatient-setting
#11
Rechelle Tull, Karolyn A Wanat
Teledermatology (TD) is a health care delivery modality that uses telecommunication technology to provide dermatologic care. It has grown to be a reliable and diagnostically accurate means of producing quality care while increasing access and reducing wait times in the outpatient setting. In the inpatient setting, TD may be an effective method to improve access to dermatologic care by remotely triaging, assisting, or providing dermatologic consultative services. For inpatient dermatology, there is the potential for TD to increase access to care in the community setting where dermatologists have full outpatient schedules...
March 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28235396/are-psychophysiological-arousal-and-self-reported-emotional-stress-during-an-oncological-consultation-related-to-memory-of-medical-information-an-experimental-study
#12
Leonie N C Visser, Marieke S Tollenaar, Jos A Bosch, Lorenz J P van Doornen, Hanneke C J M de Haes, Ellen M A Smets
Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i...
January 2017: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#13
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28216702/evaluation-of-simple-pre-determined-length-insertion-technique-split-with-conventional-method-for-oral-fibreoptic-intubation-a-randomised-cross-over-study
#14
Elangovan Muthukumar, Lenin Babu Elakkumanan, Prasanna Udupi Bidkar, Mvs Satyaprakash, Sandeep Kumar Mishra
BACKGROUND AND AIMS: The difficulty during flexible fiber-optic bronchoscopy (FOB) guided tracheal intubation could be because of inability in visualising glottis, advancing and railroading of endotracheal tube. Several methods are available for visualising glottis, but none is ideal. Hence, this randomised controlled study was designed to evaluate the simple pre-determined length insertion technique (SPLIT) during oral FOB. METHODS: Fifty-eight patients were randomised into Group C and Group P...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#15
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28152768/improving-care-quality-for-patients-with-soft-tissue-and-bone-sarcoma-by-establishing-a-national-virtual-tumor-board-and-electronic-consultation-platform
#16
Andrew Fang, Maihgan Kavanagh, Brian Kim, Jason D Lee, Craig McCormick, Lee Jae Morse, Subir Nag, Grant Nybbaken, Peter Peng, Corey M Schwartz, Joseph Song, Denah Renee Taggart, Jeanette Cu Yu
211 Background: Bone and soft tissue sarcomas are relatively uncommon and their management is extremely complex requiring coordinated multidisciplinary expertise for optimal care. Because Kaiser Permanente operates across many geographic regions in the country, in-person tumor board is not practical. METHODS: The Kaiser Permanente Northern California medical oncology team has developed a system-based virtual tumor board (VTB) and electronic consultation (EC) platform comprised of experts from several key disciplines including musculoskeletal/surgical oncology, musculoskeletal radiology, pathology, radiation oncology, brachytherapy, medical adult and pediatric oncology...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148256/defining-reasonable-patient-standard-and-preference-for-shared-decision-making-among-patients-undergoing-anaesthesia-in-singapore
#17
J L J Yek, A K Y Lee, J A D Tan, G Y Lin, T Thamotharampillai, H R Abdullah
BACKGROUND: A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS: A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28143388/effects-of-cardiac-telerehabilitation-in-patients-with-coronary-artery-disease-using-a-personalised-patient-centred-web-application-protocol-for-the-smartcare-cad-randomised-controlled-trial
#18
Rutger W M Brouwers, Jos J Kraal, Simone C J Traa, Ruud F Spee, Laurence M L C Oostveen, Hareld M C Kemps
BACKGROUND: Cardiac rehabilitation has beneficial effects on morbidity and mortality in patients with coronary artery disease, but is vastly underutilised and short-term improvements are often not sustained. Telerehabilitation has the potential to overcome these barriers, but its superiority has not been convincingly demonstrated yet. This may be due to insufficient focus on behavioural change and development of patients' self-management skills. Moreover, potentially beneficial communication methods, such as internet and video consultation, are rarely used...
January 31, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28135690/wasting-the-doctor-s-time-a-video-elicitation-interview-study-with-patients-in-primary-care
#19
Nadia Llanwarne, Jennifer Newbould, Jenni Burt, John L Campbell, Martin Roland
Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient chose to consult when the disease was self-limiting and symptoms would have settled without medical input. A late visit may cause the doctor to express dismay that the patient waited so long before consulting. In the UK primary care context of constrained resources and government calls for cautious healthcare spending, there is all the more pressure on both doctor and patient to meet only when necessary...
March 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28132720/kidney-disease-population-health-management-in-the-era-of-accountable-care-a-conceptual-framework-for-optimizing-care-across-the-ckd-spectrum
#20
Mallika L Mendu, Sushrut S Waikar, Sandhya K Rao
Since its passage in 2010, the Affordable Care Act has led to the creation of numerous accountable care organizations that face the challenge of transforming the traditional care delivery model to provide more patient-centered, high-quality, and low-cost care. Complex patients, including those with chronic kidney disease (CKD), present the most challenges and opportunities. CKD is a condition with significant morbidity, mortality, and cost and thought to be partly secondary to known gaps in care delivery. Successful population management for CKD requires consideration of the needs of patients at all phases of the disease...
January 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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