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https://www.readbyqxmd.com/read/29786592/obstetric-and-gynecological-care-by-family-doctors-in-ukraine-literature-review
#1
Oksana V Bakun, Svitlana Y Karatieieva, Svitlana B Semenenko, Oksana I Yurkiv, Ksenia V Slobodian
OBJECTIVE: Introduction: The analysis of literature on the questions of obstetrical and gynecologic care by general practitioners - family doctors in Ukraine has been presented in the article. Special attention has been paid to the actual problems of primary health care implementation on the basis of family medicine. The aim of the study is to find out the depth of the problem "A female doctor as an obstetrician-gynecologist" by analyzing scientific relevant literature data...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29785952/diagnostic-accuracy-of-point-of-care-natriuretic-peptide-testing-for-chronic-heart-failure-in-ambulatory-care-systematic-review-and-meta-analysis
#2
Kathryn S Taylor, Jan Y Verbakel, Benjamin G Feakins, Christopher P Price, Rafael Perera, Clare Bankhead, Annette Plüddemann
OBJECTIVE: To assess the diagnostic accuracy of point-of-care natriuretic peptide tests in patients with chronic heart failure, with a focus on the ambulatory care setting. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Ovid Medline, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Embase, Health Technology Assessment Database, Science Citation Index, and Conference Proceedings Citation Index until 31 March 2017...
May 21, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29785895/complexity-in-pediatric-primary-care
#3
Arwa Nasir, Laeth Nasir, Ariel Tarrell, David Finken, Amy Lacroix, Swetha Pinninti, Sheryl Pitner, Molly McCarthy
BACKGROUND: The management of patients in primary care is often complicated by the presence of multiple chronic conditions and psychosocial issues that increase the complexity of the encounter and have important impacts on care. There is a paucity of literature on this subject in the pediatric population. OBJECTIVES: The aim of this study was to quantify the burden of chronic conditions in pediatric primary care. METHODS: The problem lists of 3995 randomly selected patients from a community pediatric clinic and an academic hospital-based pediatric clinic in the same metropolitan area were analyzed for the presence and number of any chronic condition...
May 22, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29785890/family-networks-and-healthy-behaviour-evidence-from-nepal
#4
Jolene Skordis, Noemi Pace, Marcos Vera-Hernandez, Imran Rasul, Emla Fitzsimons, David Osrin, Dharma Manandhar, Anthony Costello
Models of household decision-making commonly focus on nuclear family members as primary decision-makers. If extended families shape the objectives and constraints of households, then neglecting the role of this network may lead to an incomplete understanding of health-seeking behaviour. Understanding the decision-making processes behind care-seeking may improve behaviour change interventions, better intervention targeting and support health-related development goals. This paper uses data from a cluster randomised trial of a participatory learning and action cycle (PLA) through women's groups, to assess the role of extended family networks as a determinant of gains in health knowledge and health practice...
May 22, 2018: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/29785757/a-nursing-solution-to-primary-care-delivery-shortfall
#5
Michael Carter, Phillip Moore, Nina Sublette
Many countries project that they will have difficulty to meet their demand for primary care based on an inadequate supply of primary care doctors. There are many reasons for this, and they tend to vary by country. The policy options available to these countries are to increase the number of local primary care doctors, recruit doctors from other countries, ration primary care, shift more primary care to specialists, or authorize other disciplines to provide primary care. This article examines lessons learned in the United States over the past 50 years and proposes that expanding the use of nurse practitioners is the best solution when measured by feasibility, costs, ethics, and scope of the care delivered...
May 21, 2018: Nursing Inquiry
https://www.readbyqxmd.com/read/29785703/a-cross-sectional-study-evaluating-the-use-of-free-clinics-in-syracuse-ny-patient-demographics-and-barriers-to-accessing-healthcare-in-traditional-settings
#6
Simone Arvisais-Anhalt, Matthew MacDougall, Michael Rosenthal, Peter Congelosi, Daniel F Farrell, Paula Rosenbaum
Free clinics provide healthcare to underserved patient populations, playing a critical role in the medical safety-net. Syracuse, New York has notable racial, socioeconomic, and educational disparities and is home to four free clinics. Little is known about these clinics' patient population. This study attempts to better define this population and the barriers they face accessing traditional care. We developed a 27-question survey investigating patient demographics, barriers to traditional healthcare, and experience at local free clinics...
May 21, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29785689/the-impact-of-hospital-costing-methods-on-cost-effectiveness-analysis-a-case-study
#7
José Leal, Stefania Manetti, James Buchanan
BACKGROUND: Several methods exist to cost hospital contacts when estimating the cost effectiveness of a new intervention. However, the implications of choosing a particular approach remain unclear. We compare the use of the three main diagnosis-related group (DRG)-based national unit costs in England to determine whether choice of approach can impact on economic evaluation results. METHODS: A cost-utility model was developed to compare secondary fracture prevention models of care for hip fracture patients, using data from large primary and hospital care administrative datasets in England...
May 22, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29784868/delivering-a-primary-care-based-social-prescribing-initiative-a-qualitative-study-of-the-benefits-and-challenges
#8
Kathryn Skivington, Mathew Smith, Nai Rui Chng, Mhairi Mackenzie, Sally Wyke, Stewart W Mercer
BACKGROUND: Social prescribing is a collaborative approach to improve inter-sectoral working between primary health care and community organisations. The Links Worker Programme (LWP) is a social prescribing initiative in areas of high deprivation in Glasgow, Scotland, that is designed to mitigate the negative impacts of the social determinants of health. AIM: To investigate issues relevant to implementing a social prescribing programme to improve inter-sectoral working to achieve public health goals...
May 21, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29784866/a-computer-template-to-enhance-patient-centredness-in-multimorbidity-reviews-a-qualitative-evaluation-in-primary-care
#9
Cindy Mann, Alison Shaw, Lesley Wye, Chris Salisbury, Bruce Guthrie
BACKGROUND: Computer templates for review of single long-term conditions are commonly used to record care processes, but they may inhibit communication and prevent patients from discussing their wider concerns. AIM: To evaluate the effect on patient-centredness of a novel computer template used in multimorbidity reviews. DESIGN AND SETTING: A qualitative process evaluation of a randomised controlled trial in 33 GP practices in England and Scotland examining the implementation of a patient-centred complex intervention intended to improve management of multimorbidity...
May 21, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29784865/opportunistic-pulse-checks-in-primary-care-to-improve-recognition-of-atrial-fibrillation-a-retrospective-analysis-of-electronic-patient-records
#10
James Cole, Payam Torabi, Isabel Dostal, Kate Homer, John Robson
BACKGROUND: Atrial fibrillation (AF) is an important and modifiable risk factor for stroke. Earlier identification may reduce stroke-related morbidity and mortality. Trial evidence shows that opportunistic pulse regularity checks in individuals aged ≥65 years increases detection of AF. However, this is not currently recommended by the National Screening Programme or implemented by most clinical commissioning groups (CCGs). AIM: To evaluate the impact of a systematic programme to promote pulse regularity checks, the programme's uptake in general practice, and the prevalence of AF...
May 21, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29784635/acceptability-of-an-mhealth-app-intervention-for-persons-with-type-2-diabetes-and-its-associations-with-initial-self-management-randomized-controlled-trial
#11
Astrid Torbjørnsen, Milada Cvancarova Småstuen, Anne Karen Jenum, Eirik Årsand, Lis Ribu
BACKGROUND: Mobile health interventions are increasingly used in health care. The level of acceptability may indicate whether and how such digital solutions will be used. OBJECTIVE: This study aimed to explore associations between the level of acceptability of a mobile diabetes app and initial ability of self-management for patients with type 2 diabetes. METHODS: Participants with type 2 diabetes were recruited from primary health care settings to a 3-armed randomized controlled trial in the Norwegian study in the RENEWING HEALTH project...
May 21, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29784592/short-term-resource-utilization-and-cost-effectiveness-of-comprehensive-geriatric-assessment-in-acute-hospital-care-for-severely-frail-elderly-patients
#12
Niklas Ekerstad, Björn W Karlson, David Andersson, Magnus Husberg, Per Carlsson, Emelie Heintz, Jenny Alwin
OBJECTIVE: The objective of this study was to estimate the 3-month within-trial cost-effectiveness of comprehensive geriatric assessment (CGA) in acute medical care for frail elderly patients compared to usual medical care, by estimating health-related quality of life and costs from a societal perspective. DESIGN: Clinical, prospective, controlled, 1-center intervention trial with 2 parallel groups. INTERVENTION: Structured, systematic interdisciplinary CGA-based care in an acute elderly care unit...
May 18, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29784223/the-effect-of-a-community-mental-health-training-program-for-multidisciplinary-staff
#13
Bing Xiang Yang, Teresa E Stone, Scott A Davis
BACKGROUND: Primary health workers play a critical role in providing health education to people with mental disorders. In China community health workers working with people with mental health problems lack experience and training in this area. Additionally, coordination between hospital and community staff is not well established. The aim of this study was to provide an interdisciplinary community mental health training program and to evaluate the effect of the training on staff knowledge about mental health and confidence in their roles...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29784059/diabetes-intervention-accentuating-diet-and-enhancing-metabolism-diadem-i-a-randomised-controlled-trial-to-examine-the-impact-of-an-intensive-lifestyle-intervention-consisting-of-a-low-energy-diet-and-physical-activity-on-body-weight-and-metabolism-in-early
#14
Shahrad Taheri, Odette Chagoury, Hadeel Zaghloul, Sara Elhadad, Salma Hayder Ahmed, Omar Omar, Sherryl Payra, Salma Ahmed, Neda El Khatib, Rasha Abou Amona, Katie El Nahas, Matthew Bolton, Henem Chaar, Noor Suleiman, Amin Jayyousi, Mahmoud Zirie, Ibrahim Janahi, Wahiba Elhag, Abdulla Alnaama, Abduljaleel Zainel, Dahlia Hassan, Tim Cable, Mary Charlson, Martin Wells, Abdulla Al-Hamaq, Samya Al-Abdulla, Abdul Badi Abou-Samra
BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29783981/implementing-integrated-services-for-people-with-epilepsy-in-primary-care-in-ethiopia-a-qualitative-study
#15
Raquel Catalao, Tigist Eshetu, Ruth Tsigebrhan, Girmay Medhin, Abebaw Fekadu, Charlotte Hanlon
BACKGROUND: In order to tackle the considerable treatment gap for epilepsy in many low- and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services. However, there are limited data on implementation and impact of such services in LMICs. Our study aimed to explore the perspectives of service users and caregivers on the accessibility, experience and perceived impact of epilepsy treatment received in a task-shared model in a rural district of Ethiopia...
May 21, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29783848/integrated-access-to-care-and-treatment-i-act-support-groups-for-adolescents-living-with-hiv-in-public-healthcare-facilities-in-south-africa-feasibility-and-acceptability-for-scaling-up
#16
Shamagonam James, Catherine E Martin, Bafentse Moalusi, Moira Beery, Shenaaz Pahad, John Imrie
Integrated Access to Care and Treatment (I ACT) for adolescents is an educational support group initiative conducted monthly by trained healthcare providers (counsellors/health promoters). It follows a defined educational curriculum of six topics including, HIV/AIDS, disclosure, sexual and reproductive and mental health. Qualitative assessments, conducted midway of I ACT implementation at four primary healthcare facilities in North West province, South Africa, aimed to explore the perceptions of healthcare providers and the experiences of adolescents living with HIV (ALHIV)...
May 21, 2018: AIDS Care
https://www.readbyqxmd.com/read/29783228/awareness-of-pediatric-palliative-care-among-health-care-workers
#17
Oryna Z Detsyk, Zhanna M Zolotarova, Iryna V Stovban, Roman M Melnyk
OBJECTIVE: Introduction: In order to develop such a relatively new type of medical care in Ukraine, as pediatric palliative care, first of all, qualified medical workers are needed. The aim: to assess the awareness of pediatric palliative care among healthcare workers providing medical services to children. PATIENTS AND METHODS: Materials and methods: It was carried out a survey at health facilities of Ivano-Frankivsk region, which provided medical care for children...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#18
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#19
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29782696/routine-antenatal-ultrasound-in-low-and-middle-income-countries-first-look-a-cluster-randomized-trial
#20
Robert L Goldenberg, Robert O Nathan, David Swanson, Sarah Saleem, Waseem Mirza, Fabian Esamai, David Muyodi, Ana L Garces, Lester Figueroa, Elwyn Chomba, Melody Chiwala, Musaku Mwenechanya, Antoinette Tshefu, Adrien Lokangako, Victor Lokomba Bolamba, Janet L Moore, Holly Franklin, Jonathan Swanson, Edward A Liechty, Carl L Bose, Nancy F Krebs, K Michael Hambidge, Waldemar A Carlo, Nancy Kanaiza, Farnaz Naqvi, Irma Sayury Pineda, Walter López-Gomez, Dorothy Hamsumonde, Margo S Harrison, Marion Koso-Thomas, Menachem Miodovnik, Dennis D Wallace, Elizabeth M McClure
OBJECTIVE: Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centers in resource-limited countries. DESIGN: Cluster randomized trial. SETTING: Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia). METHODS: Clusters were randomized to standard ANC or standard care plus two ultrasounds and referral for complications...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
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