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Quality improvement in primary care

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https://www.readbyqxmd.com/read/29917115/study-protocol-for-a-randomized-controlled-trial-evaluating-the-efficacy-of-an-evidence-based-ipad-app-for-cognitive-rehabilitation-in-patients-with-primary-brain-tumors
#1
Sophie Dorothee van der Linden, Margriet Maria Sitskoorn, Geert-Jan Maria Rutten, Karin Gehring
BACKGROUND: Many patients with primary brain tumors suffer from cognitive deficits, which negatively impact their quality of life. However, cognitive rehabilitation programs for these patients are scarce. We developed an iPad-based cognitive rehabilitation program for brain tumor patients, which was based on our effective face-to-face cognitive rehabilitation program. After successful completion of a feasibility study, a randomized controlled trial has been started. OBJECTIVE: To evaluate the immediate and long-term effects of the iPad-based program on cognitive performance and patient-reported outcome measures (PROMs) in patients with primary brain tumors in an early stage of the disease...
June 16, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29916866/the-practice-of-overlapping-colorectal-operations-in-a-tertiary-care-center-is-safe-a-model-for-advancing-team-based-care
#2
Benjamin D Shogan, William S Harmsen, Eric J Dozois, Heidi Nelson, David W Larson
OBJECTIVE: Determine the safety of overlapping surgery in a tertiary care colorectal surgery practice. SUMMARY: Although overlapping surgery is common in academic centers, reports on outcomes of this practice are limited. The primary aim of this study was to investigate the safety of overlapping surgery in a dedicated tertiary care academic colorectal practice by comparing groups of patients who did or did not have their surgery performed in an overlapping fashion...
June 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29916413/the-health-needs-of-women-prisoners-an-italian-field-survey
#3
Giovanni Antonetti, Daniela D'Angelo, Paola Scampati, Ileana Croci, Narciso Mostarda, Saverio Potenza, Rosaria Alvaro
INTRODUCTION: Health care in prisons represents an important part of public health due to the interaction between prisons and society. Women prisoners have needs that distinguish them from male prisoners, however little is known about how those needs are met. The aim of the study was to gather information about the needs of women in prison and to identify which of their needs are the most or the least met. METHODS: This study investigated the needs of detained women using a newly developed Questionnaire based on Gordon's model...
April 2018: Annali Dell'Istituto Superiore di Sanità
https://www.readbyqxmd.com/read/29915725/the-use-of-quality-circles-as-a-support-tool-in-the-taking-over-of-practices-by-young-general-practitioners
#4
Norbert Král, Bohumil Seifert, Jan Kovář, Cyril Mucha, Jana Vojtíšková, Jáchym Bednár, Seifert Martin
Introduction: Although informal meetings of healthcare professionals in smaller groups are common in the area of primary care in the Czech Republic, the method of quality circles is not in wide use. The aim of our project is to use this method to help new general practitioners (GPs) when they take over a medical practice and to suggest measures to improve the organization and overall attractiveness of new practices, as well as patient satisfaction. Materials and Methods: For the purposes of this observation, an already existing informal group formed by healthcare professionals and their trainees was used...
January 2018: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29914880/antibiotic-prescribing-for-acute-respiratory-tract-infections-in-primary-care-an-updated-and-expanded-meta-ethnography
#5
Evi Germeni, Julia Frost, Ruth Garside, Morwenna Rogers, Jose M Valderas, Nicky Britten
BACKGROUND: Reducing unnecessary prescribing remains a key priority for tackling the global rise of antibiotic-resistant infections. AIM: The authors sought to update a 2011 qualitative synthesis of GPs' experiences of antibiotic prescribing for acute respiratory tract infections (ARTIs), including their views of interventions aimed at more prudent prescribing. They expanded the original scope to encompass all primary care professionals (PCPs) who can prescribe or dispense antibiotics for ARTIs (for example, nurses and pharmacists)...
June 18, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29914494/development-of-an-exercise-intervention-for-the-prevention-of-musculoskeletal-shoulder-problems-after-breast-cancer-treatment-the-prevention-of-shoulder-problems-trial-uk-prosper
#6
Helen Richmond, Clare Lait, Cynthia Srikesavan, Esther Williamson, Jane Moser, Meredith Newman, Lauren Betteley, Beth Fordham, Sophie Rees, Sarah E Lamb, Julie Bruce
BACKGROUND: Musculoskeletal shoulder problems are common after breast cancer treatment. There is some evidence to suggest that early postoperative exercise is safe and may improve shoulder function. We describe the development and delivery of a complex intervention for evaluation within a randomised controlled trial (RCT), designed to target prevention of musculoskeletal shoulder problems after breast cancer surgery (The Prevention of Shoulder Problems Trial; PROSPER). METHODS: A pragmatic, multicentre RCT to compare the clinical and cost-effectiveness of best practice usual care versus a physiotherapy-led exercise and behavioural support intervention in women at high risk of shoulder problems after breast cancer treatment...
June 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29914382/a-systematic-review-of-non-pharmacological-interventions-to-improve-nighttime-sleep-among-residents-of-long-term-care-settings
#7
Elizabeth Capezuti, Rana Sagha Zadeh, Kevin Pain, Aleksa Basara, Nancy Ziyan Jiang, Ana C Krieger
BACKGROUND: Disturbances in sleep and circadian rhythms are common among residents of long-term care facilities. In this systematic review, we aim to identify and evaluate the literature documenting the outcomes associated with non-pharmacological interventions to improve nighttime sleep among long-term care residents. METHODS: The Preferred Reporting Items for Systematic Reviews guided searches of five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane Library) for articles reporting results of experimental or quasi-experimental studies conducted in long-term care settings (nursing homes, assisted-living facilities, or group homes) in which nighttime sleep was subjectively or objectively measured as a primary outcome...
June 18, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29914051/impact-of-nurse-practitioner-practice-regulations-on-rural-population-health-outcomes
#8
Judith Ortiz, Richard Hofler, Angeline Bushy, Yi-Ling Lin, Ahmad Khanijahani, Andrea Bitney
Background: For decades, U.S. rural areas have experienced shortages of primary care providers. Nurse practitioners (NPs) are helping to reduce that shortage. However, NP scope of practice regulations vary from state-to-state ranging from autonomous practice to direct physician oversight. The purpose of this study was to determine if clinical outcomes of older rural adult patients vary by the level of practice autonomy that states grant to NPs. Methods: This cross-sectional study analyzed data from a sample of Rural Health Clinics (RHCs) (n = 503) located in eight Southeastern states...
June 15, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29913651/effectiveness-of-multidisciplinary-rehabilitation-treatment-for-patients-with-chronic-pain-in-a-primary-health-care-unit
#9
Klaus Felix Stein, Adriana Miclescu
Background In recent years, multidisciplinary rehabilitation (MDR) became an alternative treatment option for chronic non-cancer pain. MDR is mostly available in specialized pain units, usually at rehabilitation centers where the level of knowledge and therapeutically options to treat pain conditions are considered to be high. There is strong evidence that MDR in specialized pain units is affecting pain and improves the quality of life in a sustainable manner. There are few studies about MDR outcome in primary health care, especially in those units situated in rural areas and with a different population than that encountered in specialized hospitals...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29912446/quality-of-diabetes-care-in-cancer-a-systematic-review
#10
Robert I Griffiths, Nancy L Keating, Clare R Bankhead
Purpose: Overlooking other conditions during cancer could undermine gains associated with early detection and improved cancer treatment. We conducted a systematic review on the quality of diabetes care in cancer. Data sources: Systematic searches of Medline and Embase, from 1996 to present, were conducted to identify studies on the quality of diabetes care in patients diagnosed with cancer. Study selection: Studies were selected if they met the following criteria: longitudinal or cross-sectional observational study; population consisted of diabetes patients; exposure consisted of cancer of any type and outcomes consisted of diabetes quality of care indicators, including healthcare visits, monitoring and testing, control of biologic parameters, or use of diabetes and other related medications...
June 15, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29911893/effects-of-an-intensive-long-term-prevention-programme-after-myocardial-infarction-a-randomized-trial
#11
Harm Wienbergen, Andreas Fach, Sven Meyer, Jochen Meyer, Janina Stehmeier, Tina Backhaus, Stephan Michel, Kirsten Krämer, Rico Osteresch, Johannes Schmucker, Henning Haase, Tobias Härle, Albrecht Elsässer, Rainer Hambrecht
Background Long-term risk factor control after myocardial infarction (MI) is currently inadequate and there is an unmet need for effective secondary prevention programmes. Design and methods It was the aim of the study to compare a 12-month intensive prevention programme (IPP), coordinated by prevention assistants and including education sessions, telephone visits and telemetric risk factor control, with usual care after MI. Three hundred and ten patients were randomized to IPP vs. usual care one month after hospital discharge for MI in two German heart centres...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29909797/a-review-of-integrated-heart-failure-care
#12
Julie MacInnes, Liz Williams
AimThe aim of this integrative review is to determine the effectiveness of integrated heart failure (HF) care in terms of patient-, service- and resource-related outcomes, and to determine what model or characteristics of integrated care work best, for whom and in what contexts. BACKGROUND: Integration of health and social care services is a significant driver in the development of better and more cost-effective health and social care systems in Europe and developed countries. As high users of health and social care services, considerable attention has been paid to the care of people with long-term conditions...
June 18, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29908019/health-needs-and-priorities-of-syrian-refugees-in-camps-and-urban-settings-in-jordan-perspectives-of-refugees-and-health-care-providers
#13
Tala Al-Rousan, Zaker Schwabkey, Lara Jirmanus, Brett D Nelson
Background: The United Nations has declared the Syrian refugee crisis to be the biggest humanitarian emergency of our era. Neighbouring countries, such as Jordan, strain to meet the health needs of Syrian refugees in addition to their own citizens given limited resources. Objectives: This study aimed to determine the perspectives of Syrian refugees in Jordan, Jordanian health care providers and other stakeholders in addressing the public health issues of the refugee crisis...
June 10, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/29907335/trial-protocol-the-use-of-mindfulness-based-intervention-for-improving-bracing-compliance-for-adolescent-idiopathic-scoliosis-patients-protocol-for-a-randomised-controlled-trial
#14
Benjamin Hon Kei Yip, Xue Li, Christine Hiu Yan Leung, Ting Gao, Vincent Chi Ho Chung, Fiona Wai Ping Yu, Tsz Ping Lam, Jack Chun Yiu Cheng, Samuel Yeung Shan Wong
INTRODUCTION: Adolescent idiopathic scoliosis (AIS) is the most prevalent deforming orthopaedic condition; it causes significant disability when spinal curves progress beyond 45deg. Bracing is the primary treatment prescribed for adolescents with an immature skeleton who have spinal curves between 25 and 45deg. New evidence suggests that compliance with bracing significantly decreases the progression of high-risk curves to the threshold for surgery. Nonetheless, bracing is a stressful experience...
June 12, 2018: Journal of Physiotherapy
https://www.readbyqxmd.com/read/29907323/taking-the-measure-of-the-profession-physician-associations-in-the-measurement-age
#15
REVIEW
Baruch Levi, Amos Zehavi, David Chinitz
Systematic measurement of healthcare services enables evaluation of health professionals' quality of work. Whereas policy makers find measurement a useful mechanism for quality improvement, a public choice perspective implies that physicians would resent such an initiative, which undermines their professional autonomy. In this article, we compare two healthcare systems of economically developed countries - Israel and the UK. Both systems share common features such as universal coverage, strong state intervention, and enthusiasm for New Public Management...
June 8, 2018: Health Policy
https://www.readbyqxmd.com/read/29906434/incorporating-biomarkers-into-the-primary-prostate-biopsy-setting-a-cost-effectiveness-analysis
#16
Niranjan J Sathianathen, Karen M Kuntz, Fernando Alarid-Escudero, Nathan L Lawrentschuk, Damien M Bolton, Declan G Murphy, Christopher J Weight, Badrinath R Konety
PURPOSE: To perform a cost-effectiveness analysis of using Prostate Health Index (PHI), 4Kscore, SelectMDx and ExoDx Prostate IntelliScore (EPI) in men with an elevated PSA value to determine the need for biopsy. METHODS: We developed a decision-analytic model for men with an elevated PSA values (≥ 3ng/mL) where one of the biomarker tests was to determine which hypothetical individuals required a biopsy. In the current standard of care strategy, all individuals underwent a biopsy...
June 12, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29904596/scepticaemia-the-impact-on-the-health-system-and-patients-of-delaying-new-treatments-with-uncertain-evidence-a-case-study-of-the-sepsis-bundle
#17
Robin Blythe, David Cook, Nicholas Graves
BACKGROUND: A sepsis care bundle of intravenous vitamin C, thiamine, and hydrocortisone was reported to improve treatment outcomes. The data to support it are uncertain and decision makers are likely to be cautious about adopting it. The objective of this study was to model the opportunity costs in dollars and lives of waiting for better information before adopting the bundle. METHODS: A decision tree was built using information from the literature. We modelled the impact of bundle adoption under three scenarios using a simulation in which the bundle was effective as reported in the primary trial, less effective based on other information, and ineffective...
2018: F1000Research
https://www.readbyqxmd.com/read/29904160/genetic-evaluation-of-cardiomyopathy-a-clinical-practice-resource-of-the-american-college-of-medical-genetics-and-genomics-acmg
#18
Ray E Hershberger, Michael M Givertz, Carolyn Y Ho, Daniel P Judge, Paul F Kantor, Kim L McBride, Ana Morales, Matthew R G Taylor, Matteo Vatta, Stephanie M Ware
PURPOSE: The purpose of this document is to provide updated guidance for the genetic evaluation of cardiomyopathy and for an approach to manage secondary findings from cardiomyopathy genes. The genetic bases of the primary cardiomyopathies (dilated, hypertrophic, arrhythmogenic right ventricular, and restrictive) have been established, and each is medically actionable; in most cases established treatments or interventions are available to improve survival, reduce morbidity, and enhance quality of life...
June 14, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29903795/hepatitis-c-virus-infection-and-hospital-related-outcomes-a-systematic-review-protocol
#19
Lianping Ti, Michelle Ng, Lindila Awendila, Patrizia Maria Carrieri
INTRODUCTION: People living with hepatitis C virus (HCV) infection are disproportionately over-represented in the healthcare system due to various individual and contextual circumstances, including comorbidities and socioeconomic marginalisation. With growing trends in morbidity and mortality related to HCV infection, HCV is becoming a significant health and financial burden on the healthcare system, particularly in acute hospital settings. It is noteworthy that with the advent of direct-acting antiviral therapy the increasing number of patients who are cured of HCV could potentially result in different patterns of hospital-related outcomes over time...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903672/evaluation-of-tranexamic-acid-in-trauma-patients-a-retrospective-quantitative-analysis
#20
Michelle Ng, Jerrold Perrott, Sarah Burgess
INTRODUCTION: Tranexamic acid (TXA) has been shown to decrease mortality in adult trauma patients with or at significant risk of hemorrhage when administered within 3 h of injury. The use and appropriateness of TXA in adult trauma patients presenting to Royal Columbian Hospital (RCH) was investigated. METHODS: This retrospective chart review utilized the British Columbia Trauma Registry to identify 100 consecutive trauma patients that presented to the emergency department at RCH between April 2012 to June 2015 and met the following indications for TXA: systolic blood pressure <90 mm Hg and/or heart rate >110 bpm and presentation within 8 h of injury...
June 5, 2018: American Journal of Emergency Medicine
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