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https://www.readbyqxmd.com/read/29781557/supplier-induced-demand-for-urgent-after-hours-primary-care-services
#1
Thomas Longden, Jane Hall, Kees van Gool
Australia is one of nine Organisation for Economic Co-operation and Development (OECD) countries that utilise deputising services to provide after-hours primary care. While the provision of this service is supposed to be on behalf of regular general practitioners, businesses have adapted to the financial incentives on offer and are directly advertising their services to consumers emphasising patient convenience and no copayments. The introduction of corporate entities has changed the way that deputising services operate...
May 21, 2018: Health Economics
https://www.readbyqxmd.com/read/29781372/chinese-perspectives-on-primary-care-for-common-mental-disorders-barriers-and-policy-implications
#2
Kai Sing Sun, Tai Pong Lam, Dan Wu
BACKGROUND: The World Health Organization (WHO) has called for integration of mental health into primary care for a decade. In Western countries, around 15% to 25% of patients with common mental disorders including mood and anxiety disorders seek help from primary care physicians (PCPs). The rate is only about 5% in China. AIMS: This article reviews the Chinese findings on the barriers to primary care for common mental disorders and how they compared with Western findings...
May 1, 2018: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/29779089/duration-of-opening-statement-of-patients-attending-a-chronic-pain-clinic-consultation
#3
Ather Imran, Deepak Doltani, Jean Saunders, Dominic Harmon
BACKGROUND: The opening patient statement is an important part of the medical consultation. It is where after the initial solicitation the physician gets information about the patient's current problems and concerns. Previous research shows that 23-28% of patients are allowed to complete their opening statement un-interruptedly in the general practice setting. Interruption results in fewer patient concerns expressed and failure to gather potentially important patient information. OBJECTIVES: The objective of the study was to assess the duration of opening statements of patients attending a chronic pain clinic consultation...
May 19, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29767229/usability-of-world-health-organization-disability-assessment-schedule-in-chronic-traumatic-brain-injury
#4
Sinikka Tarvonen-Schröder, Olli Tenovuo, Anne Kaljonen, Katri Laimi
OBJECTIVES: To investigate functioning measured with the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) in patients with mild, moderate and severe traumatic brain injury, and to compare patients' experiences with assessments made by their significant others and by consultant neurologists. METHODS: A total of 112 consecutive patients with traumatic brain injury (29 mild, 43 moderate, 40 severe) and their significant others completed a 12-item WHODAS 2...
May 16, 2018: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29766150/psychometrics-properties-of-the-iranian-version-of-fertility-quality-of-life-tool-a-cross-sectional-study
#5
Seyedeh-Fatemeh Hekmatzadeh, Fatemeh Bazarganipour, Nazafarin Hosseini, Helen Allan, Somayeh Jalali, Zahra Abbasian, Akram Barani, Fereshteh Balochi, Saeideh Khademi, Tahereh Mahmoudi, Roghayeh Niknam, Zahra Khashavi, Seyed Abdolvahab Taghavi
Background: Clinical measurement of quality of life (QoL) for assessing reproductive problems should be considered as a standard investigation at the initial and continuing medical consultations with infertile people. Objective: The purpose of this study was comprehensive testing the psychometric properties of the Iranian version of fertility quality of life (FertiQoL). Materials and Methods: This cross-sectional study was conducted on300 women referred to infertility clinic...
March 2018: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29764111/public-spending-on-health-services-and-policy-research-in-canada-a-reflection-on-thakkar-and-sullivan-comment-on-public-spending-on-health-service-and-policy-research-in-canada-the-united-kingdom-and-the-united-states-a-modest-proposal
#6
Owen Adams
Vidhi Thakkar and Terrence Sullivan have done a careful and thought-provoking job in trying to establish comparable estimates of public spending on health services and policy research (HSPR) in Canada, the United Kingdom and the United States. Their main recommendation is a call for an international collaboration to develop common terms and categories of HSPR. This paper raises two additional questions that have an international comparative dimension: There is little doubt that public spending on HSPR represents more than the "tip of the iceberg," but how much more? And how do the countries fare on the uptake of HSPR by decision-makers? I have long speculated that probably as much or more is spent by provincial/territorial governments, regional health authorities, hospitals and other agencies on HSPR activities carried out by consultants in Canada than by the federal, provincial/territorial granting agencies...
September 16, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29761488/psychological-therapies-for-treatment-resistant-depression-in-adults
#7
REVIEW
Sharea Ijaz, Philippa Davies, Catherine J Williams, David Kessler, Glyn Lewis, Nicola Wiles
BACKGROUND: Antidepressants are a first-line treatment for adults with moderate to severe major depression. However, many people prescribed antidepressants for depression don't respond fully to such medication, and little evidence is available to inform the most appropriate 'next step' treatment for such patients, who may be referred to as having treatment-resistant depression (TRD). National Institute for Health and Care Excellence (NICE) guidance suggests that the 'next step' for those who do not respond to antidepressants may include a change in the dose or type of antidepressant medication, the addition of another medication, or the start of psychotherapy...
May 14, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29754748/retrospective-analysis-of-postoperative-interventions-in-mandibular-fractures-a-shift-towards-outpatient-day-surgery-care
#8
Shiva Subramaniam, Anthony Febbo, James Clohessy, Alexander Bobinskas
The management of fractured mandibles typically involves admission and operation at the time of presentation. While this should involve only a short stay in hospital these patients are surgically stable, and so priority is often given to more urgent cases. We retrospectively evaluated the postoperative medical requirements of patients who were operated on at Fiona Stanley Hospital, Perth, Western Australia between 1 January 2015 and 31 December 2016. Patients were excluded if they had had multiple facial fractures, multiple injuries, had fractures that were comminuted or in edentulous mandibles, and those who had been in hospital for preoperative medical investigations and care...
May 10, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29753213/onabotulinumtoxina-detrusor-injection-improves-female-sexual-function-in-women-with-overactive-bladder-wet-syndrome
#9
Matteo Balzarro, Emanuele Rubilotta, Andrea Braga, Silvia Bassi, Tania Processali, Walter Artibani, Maurizio Serati
OBJECTIVES: The correlation between changes in sexual function and improvements in LUTD in patients treated with OnabotulinumtoxinA (onaBoNT-A) detrusor injection is unclear and limited only to women with neurogenic OAB. The aim of this study was to evaluate the impact of OnabotulinumtoxinA (onaBoNT-A) injection on sexual function in women undergoing this treatment for idiopathic wet overactive bladder (OAB). STUDY DESIGN: This is a pilot three-center observational study including women affected by idiopathic wet overactive bladder refractory to standard conservative treatments and underwent onaBoNT-A injection...
May 5, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29751801/effectiveness-of-a-multifaceted-implementation-strategy-compared-to-usual-care-on-low-back-pain-guideline-adherence-among-general-practitioners
#10
Arnela Suman, Frederieke G Schaafsma, Peter M van de Ven, Pauline Slottje, Rachelle Buchbinder, Maurits W van Tulder, Johannes R Anema
BACKGROUND: To improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners. METHODS: The implementation strategy included a multidisciplinary training, provision of educational material and an interactive website for healthcare professionals, supported by a multimedia eHealth intervention for patients with low back pain...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29751798/clinic-flow-for-sti-hiv-and-tb-patients-in-an-urban-infectious-disease-clinic-offering-point-of-care-testing-services-in-durban-south-africa
#11
Katrina J Stime, Nigel Garrett, Yukteshwar Sookrajh, Jienchi Dorward, Ntuthu Dlamini, Ayo Olowolagba, Monisha Sharma, Ruanne V Barnabas, Paul K Drain
BACKGROUND: Many clinics in Southern Africa have long waiting times. The implementation of point-of-care (POC) tests to accelerate diagnosis and improve clinical management in resource-limited settings may improve or worsen clinic flow and waiting times. The objective of this study was to describe clinic flow with special emphasis on the impact of POC testing at a large urban public healthcare clinic in Durban, South Africa. METHODS: We used time and motion methods to directly observe patients and practitioners...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29746682/improving-antibiotic-prescribing-skills-in-medical-students-the-effect-of-e-learning-after-6-months
#12
Jonne J Sikkens, Martine G Caris, Tim Schutte, Mark H H Kramer, Jelle Tichelaar, Michiel A van Agtmael
Background: Antimicrobial prescribing behaviour is first established during medical study, but teachers often cite lack of time as an important problem in the implementation of antimicrobial stewardship in the medical curriculum. The use of electronic learning (e-learning) is a potentially time-efficient solution, but its effectiveness in changing long-term prescribing behaviour in medical students is as yet unknown. Methods: We performed a prospective controlled intervention study of the long-term effects of a short interactive e-learning course among fourth year medical students in a Dutch university...
May 9, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29737972/a-systematic-review-of-patient-reported-outcomes-for-surgically-amenable-epiphora
#13
Christopher B Schulz, Alasdair Kennedy, Simon Rogers
PURPOSE: In evaluating epiphora and its management, the bottom line for all stakeholders is whether an intervention confers any real benefit on quality of life. A review was conducted to identify and appraise patient-reported outcome measures (PROMs) in surgically amenable epiphora. METHODS: A systematic search was conducted of studies relating to surgical intervention for epiphora. Patient-reported outcome measures were identified and assessed against standard criteria...
May 2018: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29737448/measuring-quality-of-life-in-patients-with-stress-urinary-incontinence-is-the-iciq-ui-sf-adequate
#14
Zuzanna Kurzawa, Jason M Sutherland, Trafford Crump, Guiping Liu
PURPOSE: The International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) is a widely used four-item patient-reported outcome (PRO) measure. Evaluations of this instrument are limited, restraining user's confidence in the instrument. This study conducts a comprehensive evaluation of the ICIQ-UI-SF on a sample of urological surgery patients in Canada. METHODS: One hundred and seventy-seven surgical patients with stress urinary incontinence completed the ICIQ-UI-SF pre-operatively...
May 8, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29727328/short-term-outcomes-of-ambulatory-colectomy-for-157-consecutive-patients
#15
Benoit Gignoux, Marilyn Gosgnach, Thomas Lanz, Alexandre Vulliez, Marie-Cecile Blanchet, Vincent Frering, Jean-Luc Faucheron, Philippe Chasserant
OBJECTIVE: To evaluate short-term outcomes of laparoscopic colectomy for selected consecutive patients in an ambulatory setting at two institutions. BACKGROUND: Several studies showed that an enhanced recovery protocol for colorectal surgery reduces postoperative morbidity and mortality, and shortens the length of hospital stay. The development of such a program has allowed us to gradually reduce the length of stay for colorectal surgery, until ambulatory management...
May 1, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29724124/how-do-biological-characteristics-of-primary-intracranial-tumors-affect-their-clinical-presentation-in-children-and-young-adults
#16
Thomas P C Chu, Anjali Shah, David Walker, Michel P Coleman
We demonstrated the pattern in presentation of primary intracranial tumors in a population-based cohort of patients aged 0-24 years identified from the National Cancer Registry for England, using linked medical records from primary care and hospitals. We used generalized additive models to estimate temporal changes in presentation rates. Borderline and malignant tumors presented at a similar rate in primary care (6.4 and 6.6 consultations per 100 patients each month) and in hospital (3.4 and 3.6). Benign tumors presented earlier but less frequently (rate = 4...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29719072/utilization-of-health-care-services-in-cancer-patients-with-elevated-fear-of-cancer-recurrence
#17
Alexandra Champagne, Hans Ivers, Josée Savard
BACKGROUND: Cancer patients commonly report experiencing fear of cancer recurrence (FCR), which may lead to several negative consequences. This study aimed at examining whether clinical levels of FCR are linked to a greater use of health care services. METHOD: This is a secondary analysis of a longitudinal study of 962 cancer patients on the epidemiology of cancer-related insomnia. They completed the Fear of Cancer Recurrence Inventory - Short form (FCRI-SF) and reported information on their consultations (medical, psychosocial and complementary and alternative medicine [CAM]) and medication usage (anxiolytics/hypnotics and antidepressants) at six time points over an 18-month period...
May 2, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29706578/does-depth-matter-factors-affecting-choice-of-vulvoplasty-over-vaginoplasty-as-gender-affirming-genital-surgery-for-transgender-women
#18
David Jiang, Jonathan Witten, Jens Berli, Daniel Dugi
BACKGROUND: Gender-affirming vaginoplasty aims to create the external female genitalia (vulva) as well as the internal vaginal canal; however, not all patients desire nor can safely undergo vaginal canal creation. AIM: Our objective is to describe the factors influencing patient choice or surgeon recommendation of vulvoplasty and to assess the patient's satisfaction with this choice. METHODS: Gender-affirming genital surgery consults were reviewed from March 2015 until December 2017, and patients scheduled for or who had completed vulvoplasty were interviewed by telephone...
April 26, 2018: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29704507/development-and-psychometric-evaluation-of-a-fatigability-index-for-full-time-wheelchair-users-with-spinal-cord-injury
#19
Alina Ionela Palimaru, William E Cunningham, Marcus Dillistone, Arturo Vargas-Bustamante, Honghu Liu, Ron D Hays
PURPOSE: To develop and evaluate psychometrically a self-reported instrument assessing physical fatigability (PF) and mental fatigability (MF) in adults with spinal cord injury (SCI). DESIGN: Cross-sectional. SETTING: Peer-support groups at rehabilitation centers, on-line support groups. PARTICIPANTS: Adults with SCI (N=464) in the US. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The dimensional structure was assessed by confirmatory factor analysis...
April 25, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29697546/outcomes-of-transvaginal-high-uterosacral-ligaments-suspension-over-500-patient-single-center-study
#20
Rodolfo Milani, Matteo Frigerio, Alice Cola, Carlo Beretta, Federico Spelzini, Stefano Manodoro
BACKGROUND: Uterosacral ligament (USL) suspension is a safe and effective procedure in terms of anatomical, functional, and subjective outcomes for primary surgical treatment of prolapse. OBJECTIVES: There has been a renewed interest toward native tissue prolapse repair by vaginal route because of low cost and lack of mesh-related complications. Uterosacral ligaments are considered safe, effective, and durable as suspending structures for primary surgical repair of the apical compartment...
May 2018: Female Pelvic Medicine & Reconstructive Surgery
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