Read by QxMD icon Read

Referral pathway

Marianne Williams, Yvonne Barclay, Rosie Benneyworth, Steve Gore, Zoe Hamilton, Rudi Matull, Iain Phillips, Leah Seamark, Kate Staveley, Steve Thole, Emma Greig
BACKGROUND: Irritable bowel syndrome (IBS) costs the National Health Service almost £12 million per annum. Despite national guidelines advising primary care management, these have failed to stem secondary care referrals of patients with likely IBS for unnecessary and costly assessment and investigation without necessarily achieving resolution of their symptoms. METHODS: In 2011, an integrated team from primary and secondary care developed a business case using baseline data to create a Somerset-wide IBS pathway using Clinical Commissioning Group funding...
October 2016: Frontline Gastroenterology
Shirley J Ingram, Gabrielle McKee, Mary B Quirke, Niamh Kelly, Ashling Moloney
BACKGROUND: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). METHODS: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge...
October 14, 2016: Journal of Cardiovascular Nursing
Katarzyna Anna Campbell, Katharine Anna Bowker, Felix Naughton, Melanie Sloan, Sue Cooper, Tim Coleman
Introduction: UK guidance recommends routine exhaled carbon monoxide (CO) screening for pregnant women and "opt-out" referrals to stop smoking services (SSS) of those with CO ≥ 4 ppm. We explored staff views on this referral pathway when implemented in one UK hospital Trust. Methods: Seventeen semi-structured interviews with staff involved in the implementation of the new referral pathway: six antenatal clinic staff (before and after implementation); five SSS staff (after). Data were analyzed using framework analysis...
October 12, 2016: International Journal of Environmental Research and Public Health
Clara Ugolini, Nicla Borrelli, Cristina Niccoli, Rossella Elisei, David Viola, Paolo Vitti, Paolo Miccoli, Fulvio Basolo
CONTEXT: Yes-associated protein-1 (YAP-1) is a player of the Hippo pathway and is involved in regulating cell proliferation. YAP-1 is overexpressed in papillary and anaplastic thyroid cancers. However, a correlation between YAP-1 expression and outcome in thyroid carcinoma has not been conclusively demonstrated. OBJECTIVE: This study was designed to clarify whether YAP-1 may be considered a marker of worse prognosis and outcome in thyroid cancer. DESIGN: A large series of cases of thyroid cancer with a long follow-up were investigated for YAP-1 expression...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Samuel R Friedman, Enrique R Pouget, Milagros Sandoval, Diana Rossi, Pedro Mateu-Gelabert, Georgios K Nikolopoulos, John A Schneider, Pavlo Smyrnov, Ron D Stall
Attacks on peoples' dignity help to produce and maintain stigmatization and interpersonal hostility. As part of an effort to develop innovative measures of possible pathways between structural interventions or socially-disruptive Big Events and HIV outbreaks, we developed items to measure dignity denial. These measures were administered to 300 people who inject drugs (PWID), 260 high-risk heterosexuals who do not inject drugs, and 191 men who have sex with men who do not inject drugs (MSM). All of the PWID and many of the high risk heterosexuals and MSM were referred to our study in 2012-2015 by a large New York city study that used respondent-driven sampling; the others were recruited by chain-referral...
October 17, 2016: AIDS and Behavior
Catherine McParlin, Ruth Bell, Stephen C Robson, Colin R Muirhead, Vera Araújo-Soares
OBJECTIVE: to investigate barriers and facilitators to physical activity (PA) guideline implementation for midwives when advising obese pregnant women. DESIGN: a cross-sectional, self-completion, anonymous questionnaire was designed using the Theoretical Domains Framework. this framework was developed to evaluate the implementation of guidelines by health care professionals. A total of 40 questions were included. These were informed by previous research on pregnant women's and midwives views, knowledge and attitudes to PA, and supported by national evidence based guidelines...
September 28, 2016: Midwifery
N M Rankin, D McGregor, E Stone, P N Butow, J M Young, K White, T Shaw
Lung cancer is a significant international health problem. Aligning clinical practice with evidence-based guideline recommendations has the potential to improve patient outcomes. This scoping review describes evidence-practice gaps across the diagnostic and management care pathway for lung cancer. We conducted searches of online databases Medline, PsychInfo, Cinahl and the Cochrane Library to identify studies published between 2008 and 2012. Of 614 articles screened, 65 met inclusion criteria. We identified seven evidence-practice gaps: (1) delays in timely diagnosis and referral; (2) curative and (3) palliative treatments are under-utilised; (4) older age and co-morbidities influence the use of treatments; (5) the benefits of multidisciplinary team review are not available to all lung cancer patients; (6) psychosocial needs are unmet; and (7) early referral to palliative care services is under-utilised...
October 13, 2016: European Journal of Cancer Care
Reza Najafi, Mahin Hashemipour, Omid Yaghini, Fatemeh Najafi, Amirsalar Rashidianfar
CONTEXT: Aminoacidopathies refer to defects in protein synthesis pathways which result in a range of biochemical disorders and clinical presentations. The enzyme defects in intermediate metabolic pathways lead to accumulation of one or more amino acids or metabolites. Despite higher prevalence rates, screening infants for inherited metabolic disorders is not run in many Middle East countries. AIM: This research is part of a larger study of inherited metabolic disorders to characterize and measure the prevalence of aminoacidopathies...
September 2016: Indian Journal of Endocrinology and Metabolism
Eleanor R Gunn, Benjamin B Albert, Paul L Hofman, Wayne S Cutfield, Alistair J Gunn, Craig A Jefferies
BACKGROUND: There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. OBJECTIVES: To assess potentially modifiable antecedents of DKA in children <15 years of age with new onset T1DM. METHODS: Retrospective review of prospectively collected data from a complete regional cohort of children with T1DM in Auckland (New Zealand) from 2010 to 2014...
October 11, 2016: Pediatric Diabetes
Seza Ozen, Jasmin B Kuemmerle-Deschner, Rolando Cimaz, Avi Livneh, Pierre Quartier, Isabelle Kone-Paut, Andrew Zeft, Steve Spalding, Ahmet Gul, Veronique Hentgen, Sinisa Savic, Ivan Foeldvari, Joost Frenkel, Luca Cantarini, Dony Patel, Jeffrey Weiss, Nina Marinsek, Ravi Degun, Kathleen G Lomax, Helen J Lachmann
OBJECTIVES: Periodic fever syndromes (PFS) are characterised by recurrent attacks of fever and localised inflammation. This study examined the diagnostic pathway and treatments at tertiary centres for FMF, TRAPS and MKD/HIDS. METHODS: PFS specialists at medical centres in the USA, European Union and Eastern Mediterranean participated in a retrospective chart review, providing de-identified data in an electronic case report form. Patients were treated between 2008-2012 with at least 1 year of follow-up, all had clinical and/or genetically proven disease, and were on/eligible for biologic treatment...
October 9, 2016: Arthritis Care & Research
A S Kalsi, N J Lewis, K W Hemmings
A recent national survey has shown the need for clarification regarding the various disciplines encompassed by restorative dentistry and their respective training pathways. This document aims to address this by outlining the remit of restorative dentistry, in addition to the various job roles involved. This information is being disseminated by the British Society for Restorative Dentistry, and given the relevance to referrers and those looking for insight into the speciality, it has been reproduced here. Roles within the speciality range from dentists with special interests to specialists and consultants, whether primarily academic or clinical...
October 7, 2016: British Dental Journal
Alessandro Sturiale, Jacopo Martellucci, Letizia Zurli, Carla Vaccaro, Luigi Brusciano, Paolo Limongelli, Ludovico Docimo, Andrea Valeri
PURPOSE: This is a retrospective analysis including all of the patients that have undergone anterior resection for rectal cancer from January 1998 to December 2005 in two tertiary referral centers. The study aims to evaluate the long term functional results after low anterior resection and to identify the risk factors of postoperative bowel disorders. METHOD: Data were collected from the clinical records, and then the low anterior resection syndrome score which is a specific questionnaire to investigate the symptoms after surgery was submitted to the selected patients...
September 30, 2016: International Journal of Colorectal Disease
Ali Ben Charif, Anne-Déborah Bouhnik, Blandine Courbiere, Dominique Rey, Marie Préau, Marc-Karim Bendiane, Patrick Peretti-Watel, Julien Mancini
INTRODUCTION: A discussion about sexuality should become a routine part of the personalized care pathway for patients with cancer. AIM: To assess rates of patient discussion about sexuality with health care providers after cancer. METHODS: We used data from the representative French nationwide 2012 VICAN survey, which included 4,349 adults 18 to 82 years old who were still alive 2 years after diagnosis at 12 cancer sites. MAIN OUTCOME MEASURES: Self-reported rates of discussion about sexuality with health care providers were assessed, and associated factors were tested after systematic adjustment for a sexual health indicator (created from six items of the Relationship and Sexuality Scale)...
September 26, 2016: Journal of Sexual Medicine
A M M Strijbosch, R Zwart, N A Blom, B J Bouma, M Groenink, S M Boekholdt, R de Winter, B J M Mulder, A P Backx
INTRODUCTION: Adolescents with congenital heart disease transition from a paediatric to an adult setting. This is associated with loss-to-follow-up and suboptimal care. Increasing numbers of patients justify a special program. In this study we evaluated the cooperative program between paediatric and adult cardiology departments in a tertiary referral centre. METHODS: In this retrospective study, patients with congenital heart disease with at least one appointment scheduled at the transition program between January 2010 and January 2015 were included...
November 2016: Netherlands Heart Journal
Philippe Charbonneau, Paule Lessard Bonaventure, Laura M Drudi, Nathalie Beaudoin, Jean-François Blair, Stéphane Elkouri
OBJECTIVE: The aim of this study was to assess time delays between first cerebrovascular symptoms and carotid endarterectomy (CEA) at a single center and to systematically evaluate causes of these delays. METHODS: Consecutive adult patients who underwent CEAs between January 2010 and September 2011 at a single university-affiliated center (Centre Hospitalier de l'Université Montréal-Hôtel-Dieu Hospital, Montreal) were identified from a clinical database and operative records...
September 20, 2016: Journal of Vascular Surgery
Kate Fife, Robert Herd, Susan Lalondrelle, Ruth Plummer, Amy Strong, Sarah Jones, John T Lear
Basal cell carcinomas are the most common form of skin cancer. Some develop into advanced cases not suitable for standard therapy. Vismodegib is the first-in-class oral hedgehog pathway inhibitor (which is dysregulated in 90% of basal cell carcinomas), and has demonstrated efficacy for advanced disease in clinical trials. An UK expert panel met to discuss management strategies for adverse events associated with vismodegib (most commonly taste disturbances, muscle cramps and alopecia). Managing patient expectations and implementing treatment breaks were considered important strategies...
September 19, 2016: Future Oncology
Karina J Lewis, Leo Ross, Michel W Coppieters, Bill Vicenzino, Annina B Schmid
INTRODUCTION: Carpal tunnel syndrome (CTS) is a prevalent upper limb condition that results in significant individual and socioeconomic costs. Large patient numbers, long outpatient waiting times and traditional referral pathways in public health systems create delays in accessing treatment for this condition. Alternative care pathways aimed at streamlining access to treatment and reducing the need for surgical intervention warrant further investigation. METHODS: A randomised, single-blind controlled clinical trial will be conducted...
2016: BMJ Open
James B Haddow, Maria Walshe, Dinesh Aggarwal, Ankur Thapar, John Hardman, Jonathan Wilson, Ayo Oshowo, Chetan Bhan, Hasan Mukhtar
We aimed to improve the lead-time and the patient experience of the diagnostic stage of the suspected colorectal cancer pathway. This project worked within the constraints of limited resources and an austere environment. The core team included a project manager trained in quality improvement methodologies. Senior and Fleming's planned change model was used as the overall framework. Baseline data supported the case for change and highlighted targets for improvement. A stakeholder workshop employed social movement theory, lean thinking, experience-based design and patient stories to engage influential leaders and secure support and commitment...
September 2016: Healthcare
Kei Ouchi, Susan D Block, Mara A Schonberg, Emily S Jamieson, Emily L Aaronson, Daniel J Pallin, James A Tulsky, Jeremiah D Schuur
BACKGROUND: Seriously ill older adults in the emergency department (ED) may benefit from palliative care referral, yet little is known about how to identify these patients. OBJECTIVES: To assess the performance and determine the acceptability of a content-validated palliative care screening tool. DESIGN: We surveyed Emergency Medicine (EM) attending physicians at the end of their shifts using the screening tool and asked them to retrospectively apply it to all patients ≥65 years whom they had cared for...
September 15, 2016: Journal of Palliative Medicine
Christos Kontovounisios, Emile Tan, Nikhil Pawa, Gina Brown, Diana Tait, David Cunningham, Shahnawaz Rasheed, Paris Tekkis
AIM: There is wide disparity in the care of patients with multi-visceral involvement of rectal cancer. The results of treatment of advanced and recurrent colorectal cancer are presented from a centre where a dedicated Multidisciplinary Team (MDT) is central to the management. METHOD: All consecutive MDT referrals between 2010 and 2014 were examined. Analysis was undertaken of the referral pathway, site, selection process, management decision, R0 resection rate, mortality / morbidity / Clavien-Dindo (CD) classification of morbidity, length of stay (LOS), and improvement of quality of life...
September 15, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"