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https://www.readbyqxmd.com/read/28222271/pathways-to-lung-cancer-diagnosis-a-qualitative-study-of-patients-and-general-practitioners-about-diagnostic-and-pre-treatment-intervals
#1
Nicole M Rankin, Sarah York, Emily Stone, David Barnes, Deborah McGregor, Michelle Lai, Tim Shaw, Phyllis N Butow
RATIONALE: Pathways to lung cancer diagnosis and treatment are complex. International evidence shows significant variations in pathways. Qualitative research investigating pathways to lung cancer diagnosis rarely considers both patient and general practitioner views simultaneously. OBJECTIVES: To describe the lung cancer diagnostic pathway, focusing on the perspective of patients and general practitioners about diagnostic and pre-treatment intervals. METHODS: This qualitative study of lung cancer patients and general practitioners in Australia used qualitative interviews or a focus group in which participants responded to a semistructured questionnaire designed to explore experiences of the diagnostic pathway...
February 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28222225/daylight-photodynamic-therapy-vs-conventional-photodynamic-therapy-as-skin-cancer-preventive-treatment-in-patients-with-face-and-scalp-cancerization-an-intra-individual-comparison-study
#2
Elena Sotiriou, Demetrios Ioannides, Fotini Vrani, Elizabeth Lazaridou, Efstratios Vakirlis, Aimilios Lallas, Zoe Apalla
BACKGROUND: Individuals with medical history of non-melanoma skin cancers (NMSCs) usually develop multiple and/or recurrent malignant lesions around the site of the primary neoplasm. The latter represents the clinical expression of the "field cancerization" theory; supporting the presence of multiple malignant clones of dysplastic keratinocytes over the entire epithelium that potentially can progress into clinical lesions. Taking into consideration that the burden of NMSCs on public health and health-care cost is high, adequate control of recurrences and management of field change is challenging...
February 21, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28222118/social-structural-behavioral-and-clinical-factors-influencing-retention-in-pre-exposure-prophylaxis-prep-care-in-mississippi
#3
Trisha Arnold, Lauren Brinkley-Rubinstein, Philip A Chan, Amaya Perez-Brumer, Estefany S Bologna, Laura Beauchamps, Kendra Johnson, Leandro Mena, Amy Nunn
Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi...
2017: PloS One
https://www.readbyqxmd.com/read/28221820/risks-benefits-and-importance-of-collecting-sexual-orientation-and-gender-identity-data-in-healthcare-settings-a-multi-method-analysis-of-patient-and-provider-perspectives
#4
Allysha C Maragh-Bass, Maya Torain, Rachel Adler, Eric Schneider, Anju Ranjit, Lisa M Kodadek, Ryan Shields, Danielle German, Claire Snyder, Susan Peterson, Jeremiah Schuur, Brandyn Lau, Adil H Haider
PURPOSE: Research suggests that LGBT populations experience barriers to healthcare. Organizations such as the Institute of Medicine recommend routine documentation of sexual orientation (SO) and gender identity (GI) in healthcare, to reduce LGBT disparities. We explore patient views regarding the importance of SO/GI collection, and patient and provider views on risks and benefits of routine SO/GI collection in various settings. METHODS: We surveyed LGBT/non-LGBT patients and providers on their views on SO/GI collection...
February 21, 2017: LGBT Health
https://www.readbyqxmd.com/read/28220984/enacting-open-disclosure-in-the-uk-national-health-service-a-qualitative-exploration
#5
Reema Harrison, Yvonne Birks, Kate Bosanquet, Rick Iedema
BACKGROUND: Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurses report as facilitating the enactment of open disclosure. METHODS: Semistructured interviews with 13 doctors and 22 nurses from a range of levels and specialities from 5 national health service hospitals and primary care trusts in the UK were conducted and analysed using a framework approach...
February 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28220581/effect-of-organizational-features-on-patient-satisfaction-with-care-in-italian-multiple-sclerosis-centres
#6
K Mattarozzi, E Baldin, C Zenesini, A Solari, M P Amato, M Leone, G Mancardi, V Martinelli, G Savettieri, C Solaro, M R Tola, R D'Alessandro
BACKGROUND AND PURPOSE: Receiving clear, complete and up-to-date information and having a satisfying relationship with the health professional (HP) are of primary importance for MS patients. Healthcare organization plays a key role in promoting an effective relationship and communication between patients and HPs. The present study aims to explore which care organization and service characteristics provided by Italian MS centres best predict patients' satisfaction with healthcare. METHODS: Eighty-one centres and 707 patients (502 women, mean age 40...
February 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28220337/one-key-question-%C3%A2-first-things-first-in-reproductive-health
#7
Deborah Allen, Michele Stranger Hunter, Susan Wood, Tishra Beeson
Objectives Preconceptional health care is increasingly recognized as important to promotion of healthy birth outcomes. Preconceptional care offers an opportunity to influence pregnancy timing and intent and mother's health status prior to conception, all predictors of individual outcomes and of inequality in birth outcomes based on race, ethnicity and class. Methods One Key Question, a promising practice developed in Oregon which is now attracting national interest, provides an entry point into preconceptional care by calling on providers to screen for pregnancy intent in well woman and chronic disease care for women of reproductive age...
February 20, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28220251/triple-aim-improvement-for-individuals-services-and-society-in-dementia-care-the-dementianet-collaborative-care-approach
#8
M S Nieuwboer, A Richters, M A van der Marck
BACKGROUND: A redesigning of primary care is required to meet dementia patients' needs. In the Netherlands, current dementia care still falls short in areas including ad hoc collaboration, lack of feedback on quality to professionals involved, and insufficient implementation of established multidisciplinary guidelines. OBJECTIVE: DementiaNet is a collaborative care approach, which aims to reduce the burden of the disease on individuals, healthcare services and society via network-based care that encourages collaboration, enhances knowledge and skills and stimulates quality improvement cycles...
February 20, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#9
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28219619/effect-of-availability-of-hiv-self-testing-on-hiv-testing-frequency-in-gay-and-bisexual-men-at-high-risk-of-infection-forth-a-waiting-list-randomised-controlled-trial
#10
Muhammad S Jamil, Garrett Prestage, Christopher K Fairley, Andrew E Grulich, Kirsty S Smith, Marcus Chen, Martin Holt, Anna M McNulty, Benjamin R Bavinton, Damian P Conway, Handan Wand, Phillip Keen, Jack Bradley, Johann Kolstee, Colin Batrouney, Darren Russell, Matthew Law, John M Kaldor, Rebecca J Guy
BACKGROUND: Frequent testing of individuals at high risk of HIV is central to current prevention strategies. We aimed to determine if HIV self-testing would increase frequency of testing in high-risk gay and bisexual men, with a particular focus on men who delayed testing or had never been tested before. METHODS: In this randomised trial, HIV-negative high-risk gay and bisexual men who reported condomless anal intercourse or more than five male sexual partners in the past 3 months were recruited at three clinical and two community-based sites in Australia...
February 16, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28219612/hyperoxia-and-hypertonic-saline-in-patients-with-septic-shock-hypers2s-a-two-by-two-factorial-multicentre-randomised-clinical-trial
#11
Pierre Asfar, Frédérique Schortgen, Julie Boisramé-Helms, Julien Charpentier, Emmanuel Guérot, Bruno Megarbane, David Grimaldi, Fabien Grelon, Nadia Anguel, Sigismond Lasocki, Matthieu Henry-Lagarrigue, Frédéric Gonzalez, François Legay, Christophe Guitton, Maleka Schenck, Jean Marc Doise, Jérôme Devaquet, Thierry Van Der Linden, Delphine Chatellier, Jean Philippe Rigaud, Jean Dellamonica, Fabienne Tamion, Ferhat Meziani, Alain Mercat, Didier Dreyfuss, Valérie Seegers, Peter Radermacher
BACKGROUND: There is insufficient research into the use of mechanical ventilation with increased inspiratory oxygen concentration (FiO2) and fluid resuscitation with hypertonic saline solution in patients with septic shock. We tested whether these interventions are associated with reduced mortality. METHODS: This two-by-two factorial, multicentre, randomised, clinical trial (HYPERS2S) recruited patients aged 18 years and older with septic shock who were on mechanical ventilation from 22 centres in France...
February 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28219460/collaborative-care-model-in-mental-health-scope-and-experiences-after-three-years-of-activity-in-mexico-city
#12
Valerio Villamil-Salcedo, Blanca E Vargas-Terrez, Adriana Díaz-Anzaldúa
: Aim The aim of this study was to evaluate the experience of the Collaborative Care model with general practitioners (GPs) for diagnosis and treatment of depression and anxiety disorders in primary care centers (PCC). BACKGROUND: For many years, different ways to address mental health problems in primary care settings have been evaluated. However, there is still debate over how to treat psychiatric conditions in such a context. METHOD: A cross-sectional design was used...
February 21, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28219452/stop-stroke-a-brief-report-on-door-to-needle-times-and-performance-after-implementing-an-acute-care-coordination-medical-application-and-implications-to-emergency-medical-services
#13
Robert Dickson, Adrian Nedelcut, Melissa McPeek Nedelcut
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period...
February 21, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28219445/a-cross-sectional-study-of-the-income-sources-of-primary-care-health-workers-in-the-democratic-republic-of-congo
#14
Rishma Maini, David R Hotchkiss, Josephine Borghi
BACKGROUND: In the Democratic Republic of Congo (DRC), the state system to remunerate health workers is poorly functional, encouraging diversification of income sources and corruption. Given the central role that health workers play in health systems, policy-makers need to ensure health workers are remunerated in a way which best incentivises them to provide effective and good quality services. This study describes the different sources and quantities of income paid to primary care health workers in Equateur, Maniema, Kasai Occidental, Province Orientale and Kasai Oriental provinces...
February 20, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28219385/language-support-for-linguistic-minority-chronic-hepatitis-b-c-patients-an-exploratory-study-of-availability-and-clinicians-perceptions-of-language-barriers-in-six-european-countries
#15
Abby M Falla, Irene K Veldhuijzen, Amena A Ahmad, Miriam Levi, Jan Hendrik Richardus
BACKGROUND: Language support for linguistic minorities can improve patient safety, clinical outcomes and the quality of health care. Most chronic hepatitis B/C infections in Europe are detected among people born in endemic countries mostly in Africa, Asia and Central/Eastern Europe, groups that may experience language barriers when accessing health care services in their host countries. We investigated availability of interpreters and translated materials for linguistic minority hepatitis B/C patients...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28219372/impact-of-a-clinical-program-using-weekly-short-message-service-sms-on-antiretroviral-therapy-adherence-support-in-south-africa-a-retrospective-cohort-study
#16
Nathan Georgette, Mark J Siedner, Carter R Petty, Brian C Zanoni, Stephen Carpenter, Jessica E Haberer
BACKGROUND: In randomized controlled trials, short message service (SMS) programs have improved adherence to HIV antiretroviral therapy (ART). In response, the World Health Organization recommended use of SMS programs to support ART. However, there is limited data on real-world implementations of SMS programs. METHODS: We conducted a retrospective cohort study of an SMS program to improve ART adherence in a government-run HIV clinic in rural South Africa. We analyzed data from all adult patients who 1) enrolled at the clinic before the observation period (July 2013 through June 2014), 2) had ≥1 ART prescriptions in the observation period, and 3) had data on phone number availability (N = 2255)...
February 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28218938/voices-from-family-medicine-on-becoming-a-family-physician
#17
William B Ventres
In this essay-part memoir, part reflection, and part oral history-I review my early professional development, a several years' long progression after residency training, during which I grew from functioning as a technically competent primary care doctor to being a capable and compassionate family physician. As part of that development, and with my colleague John Frey, MD, I interviewed several of the founders of the modern family medicine movement. Here I review some of their answers to the fundamental question of my early practice years: What does it mean to be a family physician? I cite some of their words of wisdom, those of particular import for me, and discuss how these words both helped me become a family physician and ring true even today as we approach the 50th anniversary of the founding of family medicine...
February 2017: Family Medicine
https://www.readbyqxmd.com/read/28218819/healthcare-resource-utilization-and-related-financial-costs-associated-with-glucose-lowering-with-either-exenatide-or-basal-insulin-a-retrospective-cohort-study
#18
Sarah E Holden, Christopher Ll Morgan, Qing Qiao, Sara Jenkins-Jones, Ellen R Berni, Craig J Currie
AIMS: Type 2 diabetes is a major health problem placing increasing demands on healthcare systems. Our objective was to estimate healthcare resource use and related financial costs following treatment with exenatide-based regimens prescribed as once-weekly (EQW) or twice-daily (EBID) formulations, compared with regimens based on basal insulin (BI). MATERIALS AND METHODS: This retrospective cohort study used data from the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES)...
February 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28218688/determinants-of-health-care-services-utilization-among-first-generation-afghan-migrants-in-istanbul
#19
Qais Alemi, Carl Stempel, Patrick Marius Koga, Valerie Smith, Didem Danis, Kelly Baek, Susanne Montgomery
There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors...
February 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28218628/childhood-obesity-screening-and-treatment-practices-of-pediatric-healthcare-providers
#20
Amanda Staiano, Arwen Marker, Michelle Liu, Ellery Hayden, Daniel Hsia, Stephanie Broyles
This study evaluated physicians' childhood obesity screening and treatment practices. A 26-question survey was delivered to pediatric providers in-person or via mail, e-mail, or fax throughout Louisiana. Fifty-seven providers completed the survey, the majority in primary care clinics. Five providers met at least four of seven clinical guidelines, but no provider met all of the guidelines. Whereas 88% of providers screened for obesity, 7% met guidelines for referring patients with obesity to weight management services...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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