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Referral pathway

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https://www.readbyqxmd.com/read/28524896/distress-screening-evaluating-a-protocol-for-gynecologic-cancer-survivors%C3%A2
#1
Cynae Johnson, Marshalee George, Amanda N Fader
BACKGROUND: A gynecologic cancer diagnosis and subsequent treatment may cause significant morbidity, leading to increased distress levels and poorer quality of life (QOL) for survivors. Clinicians have explored opportunities to integrate comprehensive distress management protocols into clinical settings using existing supportive care resources.
. OBJECTIVES: The aims were to improve multidisciplinary management of distress using a clinical pathway for gynecologic cancer survivors and to improve patient satisfaction with distress management...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28521831/the-sitless-project-exercise-referral-schemes-enhanced-by-self-management-strategies-to-battle-sedentary-behaviour-in-older-adults-study-protocol-for-a-randomised-controlled-trial
#2
Maria Giné-Garriga, Laura Coll-Planas, Míriam Guerra, Àlex Domingo, Marta Roqué, Paolo Caserotti, Michael Denkinger, Dietrich Rothenbacher, Mark A Tully, Frank Kee, Emma McIntosh, Carme Martín-Borràs, Guillermo R Oviedo, Javier Jerez-Roig, Marta Santiago, Oriol Sansano, Guillermo Varela, Mathias Skjødt, Katharina Wirth, Dhayana Dallmeier, Jochen Klenk, Jason J Wilson, Nicole E Blackburn, Manuela Deidda, Guillaume Lefebvre, Denise González, Antoni Salvà
BACKGROUND: Older adults are the fastest growing segment of the world's population. Recent evidence indicates that excessive sitting time is harmful to health, independent of meeting the recommended moderate to vigorous physical activity (PA) guidelines. The SITLESS project aims to determine whether exercise referral schemes (ERS) can be enhanced by self-management strategies (SMSs) to reduce sedentary behaviour (SB), increase PA and improve health, quality of life and function in the long term, as well as psychosocial outcomes in community-dwelling older European citizens from four countries, within a three-armed pragmatic randomised controlled trial, compared with ERS alone and also with general recommendations about PA...
May 18, 2017: Trials
https://www.readbyqxmd.com/read/28521830/evidence-based-policy-responses-to-strengthen-health-community-and-legislative-systems-that-care-for-women-in-australia-with-female-genital-mutilation-cutting
#3
REVIEW
Nesrin Varol, John J Hall, Kirsten Black, Sabera Turkmani, Angela Dawson
BACKGROUND: The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C...
May 18, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28521010/prospective-audit-of-a-pathway-for-in-patient-pain-management-of-chronic-abdominal-pain-a-novel-and-cost-effective-strategy
#4
Gopinath Niraj, Sanjay Chaudhri
Background.:  Unexplained abdominal pain is a common cause of hospital admission and utilizes significant resource. Current in-patient pain management of acute exacerbation of chronic abdominal pain is primarily directed at pharmacological and psychological management strategies in this group of complex patients. We adopted a novel approach that proved to be both clinically effective and cost-effective. Design.:  Adult patients admitted to a surgical ward with acute exacerbation of chronic abdominal pain referred to in-patient pain management were prospectively audited over a two-year period at a single tertiary centre...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28513052/primary-care-and-cancer-facing-the-challenge-of-early-diagnosis-and-survivorship
#5
Thomas Round
With ageing populations and an increasing lifetime risk of cancer, primary care will continue to play an increasingly important role in early diagnosis and cancer survivorship, especially with the lowering of risk thresholds for referral and diagnostic investigations. However, primary care in many countries is in crisis with increasing workloads for primary care physicians. Potential solutions to these challenges will be outlined including development of multidisciplinary teams, diagnostic decision support, increasing access to diagnostics and cost-effective referral pathways...
May 17, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28510760/what-factors-hinder-the-decision-making-process-for-women-with-cancer-and-contemplating-fertility-preservation-treatment
#6
Georgina Jones, Jane Hughes, Neda Mahmoodi, Emily Smith, Jonathan Skull, William Ledger
BACKGROUND: Although fertility preservation (FP) treatment options have increased, the existing evidence suggests that many women with cancer do not feel well supported in making these decisions, but find them stressful and complex and fail to take up fertility care at this crucial time. Whilst existing reviews have all made important contributions to our understanding of the FP decision-making process, none of them examine solely and specifically these processes for women of reproductive age with a diagnosis of any cancer, leaving a gap in the knowledge base...
May 16, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28508958/modeling-the-critical-care-pathway-for-cardiothoracic-surgery
#7
Nicolas Bahou, Claire Fenwick, Gillian Anderson, Robert van der Meer, Tony Vassalos
The west of Scotland heart and lung center based at the Golden Jubilee National Hospital houses all adult cardiothoracic surgery for the region. Increased demand for scheduled patients and fluctuations in emergency referrals resulted in increasing waiting times and patient cancellations. The main issue was limited resources, which was aggravated by the stochastic nature of the length of stay (LOS) and arrival of patients. Discrete event simulation (DES) was used to assess if an enhanced schedule was sufficient, or more radical changes, such as capacity or other resource reallocations should be considered in order to solve the problem...
May 16, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28506388/discordant-response-of-low-density-lipoprotein-cholesterol-and-lipoprotein-a-levels-to-monoclonal-antibodies-targeting-proprotein-convertase-subtilisin-kexin-type-9
#8
Jonathan B Edmiston, Nathan Brooks, Hagai Tavori, Jessica Minnier, Bart Duell, Jonathan Q Purnell, Tina Kaufman, Cezary Wojcik, Szilard Voros, Sergio Fazio, Michael D Shapiro
BACKGROUND: Clinical trials testing proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) have demonstrated an unanticipated but significant lipoprotein (a) (Lp(a))-lowering effect, on the order of 25% to 30%. Although the 50% to 60% reduction in low-density lipoprotein (LDL)-cholesterol (LDL-C) achieved by PCSK9i is mediated through its effect on LDL receptor (LDLR) preservation, the mechanism for Lp(a) lowering is unknown. OBJECTIVE: We sought to characterize the degree of concordance between LDL-C and Lp(a) lowering because of PCSK9i in a standard of care patient cohort...
May 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28498889/uk-anaesthetists-perspectives-and-experiences-of-severe-perioperative-anaphylaxis-nap6-baseline-survey%C3%A2
#9
H I Kemp, T M Cook, M Thomas, N J N Harper
Background: There is limited information on UK anaesthetists' perspectives and experiences of perioperative anaphylaxis. This baseline survey of the Sixth National Audit Project (NAP6) aimed to identify relevant departmental preparedness and practices, and individual experiences, perceptions and drug-avoidance patterns. Methods: All anaesthetists in 356 UK NHS hospitals were invited to complete an electronic survey. Results: 11 104 anaesthetists (77% crude response rate) from 341 (96%) hospitals responded...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28497265/proteomics-analysis-of-pleomorphic-adenoma-of-the-human-parotid-gland
#10
Ahmet Mutlu, Murat Ozturk, Gurler Akpinar, Murat Kasap, Aylin Kanli
The objective of this study is to perform proteomic analysis of pleomorphic adenoma (PA) in the human parotid gland (PG) with comparison of normal PG. This is an individual prospective randomized controlled trial. This study was performed in a tertiary referral center. Tissue samples of PG and PA were taken after surgical excision of PG from 13 patients. Protein extracts were prepared and protein pools created from the soluble extracts were subjected to 2D-DIGE analysis. Proteins displaying regulation in their abundance were determined and identified using MALDIT-OF/TOF analysis...
May 11, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28493352/should-pre-operative-optimisation-of-colorectal-cancer-patients-supersede-the-demands-of-the-62-day-pathway
#11
Saranga Sothisrihari, Christopher Wright, Toby Hammond
In April 2005 the government in power during their general election campaign promised to reduce waiting times for headline cancers including colorectal cancer (CRC). The manifesto pledged specifically to reduce the current 18 month wait to 18 weeks for any NHS operation from date of referral, and go further for cancer [1]. Cancer operation waiting times have since been set at 62 days, timed from receipt of referral. Fast forward to 2016; do these targets still demand respect or should individualised perioperative management now take greater priority? A week is considered a long time in politics but equally a decade is a very long time in healthcare...
May 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28483821/gps-confidence-in-caring-for-their-patients-on-the-autism-spectrum-an-online-self-report-study
#12
Silvana Unigwe, Carole Buckley, Laura Crane, Lorcan Kenny, Anna Remington, Elizabeth Pellicano
BACKGROUND: In the UK, GPs play a key role in the identification and management of children, young people, and adults on the autism spectrum, but there is a paucity of research on GPs' perceptions of working with these patients. AIM: To understand GPs' perceived self-efficacy in identifying and managing their patients on the autism spectrum, and the factors affecting this. DESIGN AND SETTING: An online self-report survey was developed for completion by GPs across the UK...
May 8, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28483033/process-to-establish-11-primary-contact-allied-health-pathways-in-a-public-health-service
#13
Michelle Stute, Nicole Moretto, Maree Raymer, Merrilyn Banks, Peter Buttrum, Sonia Sam, Marita Bhagwat, Tracy Comans
Objective Faced with longstanding and increasing demand for specialist out-patient appointments that was unable to be met through usual medical consultant led care, Metro North Hospital and Health Service in 2014-15 established 11 allied health primary contact out-patient models of care.Methods The models involved six different allied health professions and nine specialist out-patient departments.Results All the allied health models have been endorsed for continuation following demonstration of their contribution to managing demand on specialist out-patient services...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28477307/quality-indicators-in-headache-care-an-implementation-study-in-six-italian-specialist-care-centres
#14
L Pellesi, S Benemei, V Favoni, C Lupi, E Mampreso, A Negro, M Paolucci, T J Steiner, M Ulivi, S Cevoli, S Guerzoni
BACKGROUND: Headache disorders are highly prevalent, and have a substantial and negative impact on health worldwide. They are largely treatable, but differences in structure, objectives, organization and delivery affect the quality of headache care. In order to recognize and remedy deficiencies in care, the Global Campaign against Headache, in collaboration with the European Headache Federation, recently developed a set of quality indicators for headache services. These require further assessment to demonstrate fitness for purpose...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28476323/the-malnutrition-screening-tool-in-geriatric-rehabilitation-a-comparison-of-validity-when-completed-by-health-professionals-with-and-without-malnutrition-screening-training-has-implications-for-practice
#15
Skye Marshall, Adrienne Young, Elizabeth Isenring
BACKGROUND: The validity of the Malnutrition Screening Tool (MST) in geriatric rehabilitation has been evaluated in a research environment but not in professional practice. OBJECTIVE: In older adults admitted to rehabilitation, this study was undertaken to compare the MST scoring agreement (inter-rater reliability) between health professionals with and without malnutrition risk and screening training; to evaluate the concurrent validity of the MST completed by the trained and untrained health professionals compared to the International Classification of Diseases, Tenth Revision, Australian Modification using different MST score cutoffs; and to determine whether patient characteristics were associated with MST scoring accuracy when completed by health professionals without malnutrition risk and screening training...
May 2, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28474459/use-of-guideline-recommended-adjuvant-therapies-and-survival-outcomes-for-people-with-colorectal-cancer-at-tertiary-referral-hospitals-in-south-australia
#16
Pamela Adelson, Kellie Fusco, Christos Karapetis, David Wattchow, Rohit Joshi, Timothy Price, Greg Sharplin, David Roder
RATIONALE, AIMS AND OBJECTIVES: Adjuvant care for colorectal cancer (CRC) has increased over the past 3 decades in South Australia (SA) in accordance with national treatment guidelines. This study explores the (1) receipt of adjuvant therapy for CRC in SA as related to national guideline recommendations, with a focus on stage C colon and stage B and C rectal cancer; (2) timing of these adjuvant therapies in relation to surgery; and (3) comparative survival outcomes. METHODS: Data from the SA Clinical Cancer Registry from 4 tertiary referral hospitals for 2000 to 2010 were examined...
May 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28474251/hip-fractures-in-young-adults-a-retrospective-cross-sectional-study-of-characteristics-injury-mechanism-risk-factors-complications-and-follow-up
#17
Michael T Wang, Sarah H Yao, Phillip Wong, Anne Trinh, Peter R Ebeling, Ton Tran, Frances Milat, Nora Mutalima
This study characterises risk factors, complications and follow-up of minimal trauma hip fractures in young adults, adding to limited information examining the management framework. This group have severe systemic disease and significant risk of post-operative complications and subsequent fractures. Improved medical referral pathways enable management of osteoporosis and comorbid diseases. AIMS: There is a paucity of literature examining minimal trauma hip fractures in young adults, despite extensive management guidelines for older patients...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28469906/improving-access-for-urgent-patients-in-paediatric-neurology
#18
Khalid Mohamed, Basema Al Houri, Khalid Ibrahim, Abdulhafeez M Khair
Referral and flow management is an important part of outpatient care; some patients require to be seen earlier than the next available appointment because of the nature of their presentation. We did not have a clear pathway for urgent patients being referred to our pediatric neurology service. When we reviewed this process in our Quality Improvement meeting we identified wide variation in the length of time such patients wait to be seen in clinic ranging from 2 to 11 weeks. Only 25% of patients identified as requiring urgent clinic appointments were seen in clinic within 2 weeks of triage...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28463989/identifying-sources-pathways-and-risk-drivers-in-ecosystems-of-japanese-encephalitis-in-an-epidemic-prone-north-indian-district
#19
Manish Kakkar, Sanjay Chaturvedi, Vijay Kumar Saxena, Tapan N Dhole, Ashok Kumar, Elizabeth T Rogawski, Syed Abbas, Vidya V Venkataramanan, Pranab Chatterjee
Japanese Encephalitis (JE) has caused repeated outbreaks in endemic pockets of India. This study was conducted in Kushinagar, a highly endemic district, to understand the human-animal-ecosystem interactions, and the drivers that influence disease transmission. Utilizing the ecosystems approach, a cross-sectional, descriptive study, employing mixed methods design was employed. Four villages (two with pig-rearing and two without) were randomly selected from a high, a medium and a low burden (based on case counts) block of Kushinagar...
2017: PloS One
https://www.readbyqxmd.com/read/28449017/a-multifaceted-intervention-to-improve-primary-care-radiology-referral-quality-and-value-in-canterbury
#20
Kieran Holland, Graham McGeoch, Carolyn Gullery
AIMS: This article describes a seven-year multifaceted intervention leading to sustained improvement in primary care radiology referral quality and value in Canterbury, New Zealand, and discusses the transferability to other health systems. METHODS: Access criteria were developed with input from general practitioners and hospital-based specialists, and embedded in locally developed clinical pathways. A referral management service was created to streamline referral processes...
April 28, 2017: New Zealand Medical Journal
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