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https://www.readbyqxmd.com/read/29684614/barriers-and-facilitators-for-implementing-programmes-and-services-to-address-hyperglycaemia-in-pregnancy-in-low-and-middle-income-countries-a-systematic-review
#1
REVIEW
Karoline Kragelund Nielsen, Peter Damm, Ib C Bygbjerg, Anil Kapur
AIMS: An estimated 87.6% of hyperglycaemia in pregnancy cases is in low and middle income countries (LMICs). The aim of this study is to review the evidence on barriers and facilitators to programmes and services addressing hyperglycaemia in pregnancy in LMICs. METHODS: A systematic review and narrative synthesis was conducted based on searches in PubMed. A total of 23 qualitative and quantitative studies were included. RESULTS: Barriers and facilitators exist at the health system level, individual level and social and societal levels and are often interacting...
April 20, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29680815/patient-trajectories-and-their-impact-on-mobility-social-participation-and-quality-of-life-in-patients-with-vertigo-dizziness-balance-disorders-and-osteoarthritis-mobile-tra-study-protocol-of-an-observational-practice-based-cohort-study
#2
Rebecca Kisch, Antje Bergmann, Daniela Koller, Reiner Leidl, Ulrich Mansmann, Martin Mueller, Linda Sanftenberg, Joerg Schelling, Leonie Sundmacher, Karen Voigt, Eva Grill
INTRODUCTION: Mobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several shortcomings regarding mobility sustainment of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions and deficiencies in personalising care based on patients' needs and experiences...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29676584/current-practice-of-ototoxicity-management-across-the-united-kingdom-uk
#3
Devina Maru, Ghada-Al Malky
OBJECTIVE: Effective management of patients diagnosed with ototoxicity is needed to reduce hearing and balance damage which affects communication and life quality. Despite widespread recommendations to monitor and manage ototoxicity in an early and effective manner, there is limited evidence to support the actual implementation of these recommendations for affected patient groups in healthcare services across the UK with limited publications available. In this study, an online questionnaire analysed the current practice of ototoxicity management and patient pathways across the UK once the diagnosis of ototoxicity was confirmed, targeting Audiologists, ENTs/AVPs and GPs...
April 20, 2018: International Journal of Audiology
https://www.readbyqxmd.com/read/29673303/paramedics-as-a-new-resource-for-women-experiencing-intimate-partner-violence
#4
Simon Sawyer, Jan Coles, Angela Williams, Brett Williams
Intimate partner violence (IPV) has a major impact on the health and well-being of women. The need for a coordinated response from health care professions encountering IPV patients is well established, and guidelines for individual health care professions are needed. Paramedics are believed to frequently encounter IPV patients, and this study aims to create a guideline to direct their response based on expert opinion. A clinical guideline for paramedics was created using current evidence and recommendations from health agencies...
April 1, 2018: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29668935/systematic-review-of-diagnostic-pathways-for-patients-presenting-with-acute-abdominal-pain
#5
Kirsten J de Burlet, Andrew J Ing, Peter D Larsen, Elizabeth R Dennett
Purpose: Abdominal pain is the most common reason for surgical referral. Imaging, aids early diagnosis and treatment. However unnecessary requests are associated with increased costs, radiation exposure and increased length of stay. Pathways can improve the quality of the diagnostic process. The aim of this systematic review was to identify the current evidence for diagnostic pathways and their use of imaging and effect on final outcomes. Data sources: A systematic search of Embase, Medline and Cochrane databases was performed using keywords and MeSH terms for abdominal pain...
April 13, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29660226/delays-in-lung-cancer-referral-pathways-between-rural-and-urban-patients-in-north-queensland-a-mixed-methods-study
#6
R Verma, S Pathmanathan, Z Otty, J Binder, V Vangaveti, P Buttner, S Sabesan
INTRODUCTION: Aims of this study were to examine time delays in lung cancer referral pathways in North Queensland (NQ), Australia, and explore patients' perspective of factors causing these delays. METHODS: Prospective study of patients attending three cancer centres in Townsville, Cairns and Mackay in NQ from 2009 to 2012. Times along referral pathway were divided as follows: Onset of symptoms to treatment (T1), symptoms to general practitioner(GP) (T2), GP to specialist (T3), and Specialist to treatment (T4)...
April 16, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29629676/a-proposed-management-algorithm-for-late-onset-efavirenz-neurotoxicity
#7
H M Cross, S Chetty, M T Asukile, H S Hussey, E B Lee Pan, L M Tucker
A high proportion of HIV-positive patients in South Africa receive concomitant efavirenz (EFV) and isoniazid (INH) therapy. EFV is metabolised in the liver via CYP2B6, and genetic polymorphism of CYP2B6 is known to result in slowed metabolism of the drug. INH is also metabolised in the liver, causing inhibition of a pathway that plays an important role in slow EFV metabolisers. Concomitant INH use therefore affects plasma levels of EFV. EFV is well known to cause neuropsychiatric side-effects on initiation, and a recent adult case series described late-onset neurotoxicity in the form of subacute ataxia and encephalopathy in patients treated with EFV for a median of 2 years, in association with toxic plasma levels of the drug...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29629615/optimal-screening-for-prediction-of-referral-and-outcome-ospro-for-musculoskeletal-pain-conditions-results-from-the-validation-cohort
#8
Steven Z George, Jason M Beneciuk, Trevor A Lentz, Samuel S Wu, Yunfeng Dai, Joel E Bialosky, Giorgio Zeppieri
Study Design Observational, prospective cohort. Background Musculoskeletal pain is a common reason to seek healthcare and earlier non-pharmacological treatment and enhancement of personalized care options are two high priority areas. Validating concise assessment tools is an important step in establishing better care pathways. Objectives To determine the predictive validity of Optimal Screening for Prediction of Referral and Outcome (OSPRO) tools for individuals with neck, low back, shoulder, or knee pain. Methods A convenience sample (n = 440) was gathered by Orthopaedic Physical Therapy-Investigator Network clinics (n = 9)...
April 7, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29629206/enhanced-recovery-pathways-in-thoracic-surgery-the-quebec-experience
#9
Julien Hubert, Etienne Bourdages-Pageau, Charles Antoine Paradis Garneau, Catherine Labbé, Paula A Ugalde
Background: Canada has a universal public health system where all resources must be allocated to optimize cost-effectiveness. Rapid diagnostic assessment programs (DAPs) and enhanced recovery protocols (ERPs) may improve timeliness of care and postoperative outcomes and thus reduce costs. The use of DAPs and ERPs in lung cancer patients who undergo lobectomy via video-assisted thoracoscopic surgery (VATS) is still controversial. This study measured the time between preoperative workup and treatment with a DAP and evaluated the impact of an ERP postoperatively in patients with early-stage non-small cell lung cancer (NSCLC) who received a VATS lobectomy...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29629205/enhanced-recovery-pathways-in-thoracic-surgery-the-shanghai-experience
#10
REVIEW
Firas Abu Akar, Zhigang Chen, Chenlu Yang, Jian Chen, Lei Jiang
The attempts to implement the enhanced recovery (ER) program based on multiple specialties to minimize errors and complications in addition to speeding up the patient's treatment and recovery as much as possible. In China mainland, there is no unified hospital system and there are large differences between hospitals' results and protocols. The patient length of stay rate at the Shanghai Pulmonary Hospital (very high-volume referral hospital) is 7 days and may be considered a very good result compared to international rates...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29625949/optimizing-electronic-consultation-between-primary-care-providers-and-psychiatrists-mixed-methods-study
#11
Jennifer M Hensel, Rebecca Yang, Minnie Rai, Valerie H Taylor
BACKGROUND: The use of electronic consultation (e-consult) between primary care providers (PCPs) and psychiatrists has potential, given the high prevalence of mental health issues in primary care and problematic access to specialist care. Utilization and uptake, however, appears to be lower than would be expected. OBJECTIVE: This study aimed to examine actual utilization of e-consult between PCPs and psychiatrists and investigate the perceptions of PCPs about this form of psychiatric advice to inform how to optimize the utility and thereby the uptake of this service...
April 6, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29622009/health-service-utilisation-during-the-last-year-of-life-a-prospective-longitudinal-study-of-the-pathways-of-patients-with-chronic-kidney-disease-stages-3-5
#12
Shirley Chambers, Helen Healy, Wendy E Hoy, Adrian Kark, Sharad Ratanjee, Geoffrey Mitchell, Carol Douglas, Patsy Yates, Ann Bonner
BACKGROUND: Chronic kidney disease (CKD) is a growing global problem affecting around 10% of many countries' populations. Providing appropriate palliative care services (PCS) to those with advanced kidney disease is becoming paramount. Palliative/supportive care alongside usual CKD clinical treatment is gaining acceptance in nephrology services although the collaboration with and use of PCS is not consistent. METHODS: The goal of this study was to track and quantify the health service utilisation of people with CKD stages 3-5 over the last 12 months of life...
April 5, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29617390/myeloma-patient-accounts-of-their-pathways-to-diagnosis
#13
Debra A Howell, Ruth I Hart, Alexandra G Smith, Una Macleod, Russell Patmore, Gordon Cook, Eve Roman
BACKGROUND: Pathways to myeloma diagnosis can be prolonged, and are often preceded by multiple GP consultations and emergency presentation. This is the first qualitative study to examine events leading to diagnosis by asking patients about their experiences during this time. METHODS: Set within a UK population-based cohort, semi-structured interviews were conducted with 20 myeloma patients with varying characteristics and pathways, 12 of whom invited their relatives to take part...
2018: PloS One
https://www.readbyqxmd.com/read/29616906/diagnostic-pathway-of-oral-cavity-cancer-in-an-integrated-health-care-system
#14
Kevin H Wang, Brian H Song, Jason E Gilde, Jeanne A Darbinian, Miranda L Ritterman Weintraub, Tara J Wu, Eleanor L Yang, James W Salazar, Deepak Gurushanthaiah
CONTEXT: Survival for patients with oral cavity squamous cell carcinoma (OCSCC) has remained relatively stagnant despite advances in treatment. Few studies have examined why advanced-stage disease is diagnosed in 40% of patients with OCSCC nationally. OBJECTIVE: To characterize the diagnostic pathway of OCSCC in an integrated health care system. DESIGN: Retrospective study of patients with OCSCC (2007-2010). MAIN OUTCOME MEASURES: Referral patterns and demographic, clinical, and tumor characteristics associated with time to diagnosis (diagnostic interval)...
March 30, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29609547/health-professional-perceptions-regarding-screening-tools-for-developmental-surveillance-for-children-in-a-multicultural-part-of-sydney-australia
#15
Pankaj Garg, My Trinh Ha, John Eastwood, Susan Harvey, Sue Woolfenden, Elisabeth Murphy, Cheryl Dissanayake, Katrina Williams, Bin Jalaludin, Anne McKenzie, Stewart Einfeld, Natalie Silove, Kate Short, Valsamma Eapen
BACKGROUND: Encouraging early child development and the early identification of developmental difficulties is a priority. The Ministry of Health in the Australian State of New South Wales (NSW), has recommended a program of developmental surveillance using validated screening questionnaires, namely, the Parents' Evaluation of Development Status (PEDS) and Ages and Stages Questionnaire (ASQs), however, the use of these tools has remained sub-optimal. A longitudinal prospective birth cohort "Watch Me grow" study was carried out in the South Western Sydney (SW) region of NSW to ascertain the uptake as well as the strategies and the resources required to maximise engagement in the surveillance program...
April 2, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29607679/time-to-implement-a-national-referral-pathway-for-suspected-cauda-equina-syndrome-review-and-outcome-of-250-referrals
#16
Muhammad Masood Hussain, Adam Alexander Razak, Syed Sibet Hassan, Kishor A Choudhari, George Michael Spink
INTRODUCTION: Cauda equina syndrome (CES) is a condition with significant implications and medico-legal profile. The literature still lacks large primary studies to provide strong evidence for a robust management pathway. Statements from Neurosurgical and Spinal societies support early diagnosis and imaging but this has not resulted in any noticeable shift in referral pattern. We strongly feel the need for a nationally agreed, evidence-based referral pathway in practice. We present our large series and in-depth analysis of the referral pathway to provide strong evidence for more robust referrals and management...
April 2, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29606073/acceptability-of-psychosis-screening-and-factors-affecting-its-implementation-interviews-with-community-health-care-providers
#17
Mark Savill, Haley V Skymba, J Daniel Ragland, Tara Niendam, Rachel L Loewy, Tyler A Lesh, Cameron Carter, Howard H Goldman
OBJECTIVE: Although screening for psychosis may reduce the duration of untreated psychosis, the barriers and facilitators associated with implementing such a procedure in various care settings have not been explored. METHODS: Investigators conducted in-depth, semistructured interviews with 17 members of school counseling services or community mental health staff at sites that administer a psychosis screening tool. Using an inductive approach to thematic analysis, they evaluated the acceptability of psychosis screening and barriers to and facilitators of implementation...
April 2, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29605753/evaluation-of-a-midwifery-initiated-oral-health-dental-service-program-to-improve-oral-health-and-birth-outcomes-for-pregnant-women-a-multi-centre-randomised-controlled-trial
#18
Ajesh George, Hannah G Dahlen, Anthony Blinkhorn, Shilpi Ajwani, Sameer Bhole, Sharon Ellis, Anthony Yeo, Emma Elcombe, Maree Johnson
BACKGROUND: Oral health care during pregnancy is important for the health of the mother and child. However, pregnant women have limited knowledge about maternal oral health and seldom seek dental care. Further, due to limited training antenatal care providers like midwives rarely discuss oral health with pregnant women. The Midwifery-Initiated Oral Health Dental Service program was developed to address current gaps in oral promotional interventions during pregnancy. OBJECTIVES: To assess the effectiveness of a Midwifery-Initiated Oral Health Dental Service program in improving uptake of dental services, oral health knowledge, quality of oral health, oral health status and birth outcomes of pregnant women...
March 12, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29605573/multi-site-implementation-of-nutrition-screening-and-diagnosis-in-medical-care-units-success-of-the-more-2-eat-project
#19
Heather H Keller, Renata Valaitis, Celia V Laur, Tara McNicholl, Yingying Xu, Joel A Dubin, Lori Curtis, Suzanne Obiorah, Sumantra Ray, Paule Bernier, Leah Gramlich, Marilee Stickles-White, Manon Laporte, Jack Bell
BACKGROUND: Improving the detection and treatment of malnourished patients in hospital is needed to promote recovery. AIM: To describe the change in rates of detection and triaging of care for malnourished patients in 5 hospitals that were implementing an evidence-based nutrition care algorithm. To demonstrate that following this algorithm leads to increased detection of malnutrition and increased treatment to mitigate this condition. METHODS: Sites worked towards implementing the Integrated Nutrition Pathway for Acute Care (INPAC), including screening (Canadian Nutrition Screening Tool) and triage (Subjective Global Assessment; SGA) to detect and diagnose malnourished patients...
March 22, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29595814/whole-exome-sequencing-reanalysis-at-12-months-boosts-diagnosis-and-is-cost-effective-when-applied-early-in-mendelian-disorders
#20
Lisa J Ewans, Deborah Schofield, Rupendra Shrestha, Ying Zhu, Velimir Gayevskiy, Kevin Ying, Corrina Walsh, Eric Lee, Edwin P Kirk, Alison Colley, Carolyn Ellaway, Anne Turner, David Mowat, Lisa Worgan, Mary-Louise Freckmann, Michelle Lipke, Rani Sachdev, David Miller, Michael Field, Marcel E Dinger, Michael F Buckley, Mark J Cowley, Tony Roscioli
PurposeWhole-exome sequencing (WES) has revolutionized Mendelian diagnostics, however, there is no consensus on the timing of data review in undiagnosed individuals and only preliminary data on the cost-effectiveness of this technology. We aimed to assess the utility of WES data reanalysis for diagnosis in Mendelian disorders and to analyze the cost-effectiveness of this technology compared with a traditional diagnostic pathway.MethodsWES was applied to a cohort of 54 patients from 37 families with a variety of Mendelian disorders to identify the genetic etiology...
March 29, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
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