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https://www.readbyqxmd.com/read/28719230/help-seeking-for-mental-health-problems-in-an-adolescent-population-the-effect-of-gender
#1
L Haavik, I Joa, K Hatloy, H J Stain, J Langeveld
BACKGROUND: While the onset of many mental health problems occurs in adolescence, these problems are severely undertreated in this age group. To inform early intervention for adolescents, we investigated the effect of gender and education type on perception of barriers to help seeking, mental health literacy, and the awareness and use of mental health services. METHOD: A web-based survey using vignettes, open-ended and multiple choice items was administered to upper secondary school students in two counties in Norway...
July 18, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#2
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28716050/working-for-patient-safety-a-qualitative-study-of-women-s-help-seeking-during-acute-perinatal-events
#3
Nicola Mackintosh, Susanna Rance, Wendy Carter, Jane Sandall
BACKGROUND: Women and their relatives can play an important role in early detection and help seeking for acute perinatal events. Recent UK reports indicate that patient-professional partnership in 'working for safety' can be difficult to achieve in practice, sometimes with catastrophic consequences. This research explored the experiences of women and relatives who had experienced early warning signs about their condition and sought help in escalating care. METHODS: Secondary analysis of case study data which included qualitative interviews with 22 women purposively sampled on account of experiencing a step up in care and 4 of their relatives from two NHS Trusts in England during 2010...
July 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28716022/crisis-resolution-and-home-treatment-stakeholders-views-on-critical-ingredients-and-implementation-in-england
#4
Nicola Morant, Brynmor Lloyd-Evans, Danielle Lamb, Kate Fullarton, Eleanor Brown, Beth Paterson, Hannah Istead, Kathleen Kelly, David Hindle, Sarah Fahmy, Claire Henderson, Oliver Mason, Sonia Johnson
BACKGROUND: Crisis resolution teams (CRTs) can provide effective home-based treatment for acute mental health crises, although critical ingredients of the model have not been clearly identified, and implementation has been inconsistent. In order to inform development of a more highly specified CRT model that meets service users' needs, this study used qualitative methods to investigate stakeholders' experiences and views of CRTs, and what is important in good quality home-based crisis care...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28714723/the-implementation-and-testing-of-a-referral-management-system-to-address-barriers-to-treatment-seeking-among-primary-care-veterans-with-ptsd
#5
Kyle Possemato, Emily M Johnson, Laura O Wray, Brad Webster, Tracy Stecker
Primary care (PC) patients have low rates of engagement in evidence-based psychotherapy for PTSD due to a variety of patient- and system-level barriers. We conducted a hybrid effectiveness-implementation study of a referral management system, called coordinated and alternative pathway to engagement (CAPE), to address barriers to receiving evidence-based treatment for PTSD. CAPE included the delivery of 1 session of cognitive-behavioral therapy (CBT) within PC to identify and change treatment-seeking beliefs, phone contacts to assist veterans in attending appointments, and PC staff trainings on how to implement clinical practice guidelines for PTSD in PC...
July 17, 2017: Psychological Services
https://www.readbyqxmd.com/read/28709391/gp-training-practices-in-england-a-description-of-their-unique-features-based-on-national-data
#6
Charlotte Weston, Sanjiv Ahluwalia, Paul Bassett, Justin Lock, Stevo Durbaba, Mark Ashworth
Postgraduate general practitioner (GP) training structures have been reorganised with the formation of Health Education England (HEE). We aimed to broaden the findings of previous studies and identify key features of GP training practices. In particular, we wanted to extend previous findings regarding QOF achievement and patient experience derived from the General Practice Patient Survey (GPPS), with recent data on the use of urgent cancer referral pathways ('Two Week Wait', or '2WW,' referrals) and secondary care utilisation by GP training Practices...
July 14, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28705204/delay-along-the-care-seeking-journey-of-patients-with-ocular-surface-squamous-neoplasia-in-kenya
#7
Stephen Gichuhi, Joy Kabiru, Alain M'bongo Zindamoyen, Hillary Rono, Ernest Ollando, Joseph Wachira, Rhoda Munene, Timothy Onyuma, Mandeep S Sagoo, David Macleod, Helen A Weiss, Matthew J Burton
BACKGROUND: In Africa, accessing eye health services is a major challenge. Ocular surface squamous neoplasia (OSSN) is a substantial ocular health problem in Africa related to solar UV light exposure and HIV infection among other risk factors. The disease causes visual loss and even death in advanced cases. This study was conducted to assess referral pathway and treatment delay for patients with OSSN in Kenya. METHODS: Adults with conjunctival lesions presenting to four eye centres were asked about their occupations, when they noticed the growth, health facilities visited in seeking care, cost of consultation, surgery, medicines and histopathology and dates at each step...
July 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28693625/a-role-for-antimicrobial-stewardship-in-clinical-sepsis-pathways-a-prospective-interventional-study
#8
John Burston, Suman Adhikari, Andrew Hayen, Heather Doolan, Melissa L Kelly, Kathy Fu, Tomas O Jensen, Pamela Konecny
OBJECTIVE To evaluate the impact of early infectious diseases (ID) antimicrobial stewardship (AMS) intervention on inpatient sepsis antibiotic management. DESIGN Interventional, nonrandomized, controlled study. SETTING Tertiary-care referral hospital, Sydney, Australia. PATIENTS Consecutive, adult, non-intensive care unit (non-ICU) inpatients triggering an institutional clinical sepsis pathway from May to August 2015. INTERVENTION All patients reviewed by an ID Fellow within 24 hours of sepsis pathway trigger underwent case review and clinic file documentation of recommendations...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28682128/the-effects-of-centralisation-of-vascular-surgical-services-in-the-bath-bristol-and-weston-area-on-the-carotid-endarterectomy-pathway
#9
E Partridge, M Brooks, C Curd, V Davis, C Oates, D McGeeney
Introduction Patients who experience a transient ischaemic attack are at the highest risk of having a subsequent stroke immediately after their symptoms. A carotid endarterectomy should be performed on symptomatic, surgically suitable patients who present with a greater than 50% North American Symptomatic Carotid Endarterectomy Trial stenosis of the internal carotid artery within 2 weeks of their symptoms. This study aimed to determine whether the effectiveness of the carotid endarterectomy pathway has been impacted by the centralisation of vascular surgical services in the Bath, Bristol and Weston area...
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28679676/economic-evaluation-of-a-community-based-diagnostic-pathway-to-stratify-adults-for-non-alcoholic-fatty-liver-disease-a-markov-model-informed-by-a-feasibility-study
#10
Lukasz Tanajewski, Rebecca Harris, David J Harman, Guruprasad P Aithal, Timothy R Card, Georgios Gkountouras, Vladislav Berdunov, Indra N Guha, Rachel A Elliott
OBJECTIVES: To assess the long-term cost-effectiveness of a risk stratification pathway, compared with standard care, for detecting non-alcoholic fatty liver disease (NAFLD) in primary care. SETTING: Primary care general practices in England. PARTICIPANTS: Adults who have been identified in primary care to have a risk factor for developing NAFLD, that is, type 2 diabetes without a history of excessive alcohol use. INTERVENTION: A community-based pathway, which uses transient elastography and hepatologists to stratify patients at risk of NAFLD, has been implemented and demonstrated to be feasible (NCT02037867)...
July 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28679383/strengthening-close-to-community-provision-of-maternal-health-services-in-fragile-settings-an-exploration-of-the-changing-roles-of-tbas-in-sierra-leone-and-somaliland
#11
Evelyn Orya, Sunday Adaji, Thidar Pyone, Haja Wurie, Nynke van den Broek, Sally Theobald
BACKGROUND: Efforts to take forward universal health coverage require innovative approaches in fragile settings, which experience particularly acute human resource shortages and poor health indicators. For maternal and newborn health, it is important to innovate with new partnerships and roles for Traditional Birth Attendants (TBAs) to promote maternal health. We explore perspectives on programmes in Somaliland and Sierra Leone which link TBAs to health centres as part of a pathway to maternal health care...
July 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28678547/referral-rates-of-postlingually-deafened-adult-hearing-aid-users-for-a-cochlear-implant-candidacy-assessment
#12
Valerie Looi, Cleo Bluett, Isabelle Boisvert
OBJECTIVE: The aims of this study were: to investigate the referral rates of postlingually deafened adult cochlear implant (CI) candidates from a hearing aid (HA) clinic for a CI candidacy assessment and to gain insight about factors influencing the referral pathways to CI assessments. DESIGN: Two methodologies were used: a retrospective cohort study reviewing clinical files and a questionnaire to clinicians. STUDY SAMPLE: The files of 1249 adult clients from the HA clinic who had average puretone hearing thresholds greater or equal to 65 dB HL in the better hearing ear and unaided phoneme recognition scores of less than 50% in both ears were reviewed...
July 5, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28673416/peripheral-nerve-injuries-in-sport
#13
REVIEW
Ricardo Olivo, Bryan Tsao
Sport-related peripheral nerve injuries (SRNIs) can occur in virtually any sport whether or not enjoyed by an amateur or in the career of a professional athlete. The diagnosis of SRNIs can be difficult, especially when trying to differentiate nerve injury from musculoskeletal pain. Clinicians should be able to recognize when a significant SRNI occurs and how to initiate a diagnostic and treatment pathway and referral to a specialist. This article reviews SRNIs and their specific sports, how to diagnose SRNIs, and how to select conservative or surgical management of these injuries...
August 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28670761/models-of-childhood-cancer-survivorship-care-in-australia-and-new-zealand-strengths-and-challenges
#14
Christina Signorelli, Claire E Wakefield, Jordana K McLoone, Joanna E Fardell, Renae A Lawrence, Michael Osborn, Jo Truscott, Heather Tapp, Richard J Cohn
AIM: Childhood cancer survivors remain at risk of developing life-altering and/or life-threatening health conditions following the completion of curative treatment. However, no uniform model of care for childhood cancer survivors exists in Australia and New Zealand (ANZ). This study reports on current childhood cancer survivorship care in ANZ, highlighting the challenges childhood cancer survivor long-term follow-up (LTFU) clinics face. METHODS: We conducted semistructured, telephone interviews with the pediatric medical director and clinical nurse consultant from all 11 LTFU clinics at tertiary referral pediatric oncology units across ANZ (n = 19; 100% response rate)...
July 3, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28669651/frailty-in-major-oncologic-surgery-of-upper-gastrointestinal-tract-how-to-improve-postoperative-outcomes
#15
M Mazzola, C Bertoglio, M Boniardi, C Magistro, P De Martini, P Carnevali, L Morini, G Ferrari
INTRODUCTION: Certain surgical interventions, especially those involving upper GI tract remain challenging, due to high morbidity and mortality rates. The study of frailty in the surgical population has allowed the identification of those patients with a higher risk of poor postoperative outcomes. There remains a lack of evidence regarding the possibility of improving these results through a preoperative holistic management of the patients. The aim of this study is to evaluate whether preoperative treatment, in carefully selected patients, can improve the outcome following surgery...
June 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28661375/barriers-to-and-facilitators-of-smoking-cessation-in-pregnancy-and-following-childbirth-literature-review-and-qualitative-study
#16
Linda Bauld, Hilary Graham, Lesley Sinclair, Kate Flemming, Felix Naughton, Allison Ford, Jennifer McKell, Dorothy McCaughan, Sarah Hopewell, Kathryn Angus, Douglas Eadie, David Tappin
BACKGROUND: Although many women stop smoking in pregnancy, others continue, causing harm to maternal and child health. Smoking behaviour is influenced by many factors, including the role of women's significant others (SOs) and support from health-care professionals (HPs). OBJECTIVES: To enhance understanding of the barriers to, and facilitators of, smoking cessation and the feasibility and acceptability of interventions to reach and support pregnant women to stop smoking...
June 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28645556/breast-cancer-liver-metastases-in-a-uk-tertiary-centre-outcomes-following-referral-to-tumour-board-meeting
#17
Hiba Abbas, Simon Erridge, Mikael H Sodergren, Michail Papoulas, Aamir Nawaz, Krishna Menon, Nigel D Heaton, Andreas A Prachalias, Parthi Srinivasan
INTRODUCTION: To assess the outcomes from multidisciplinary board meetings (MDM) for patients with breast cancer liver metastases (BCLM) and identify prognostic factors for survival. MATERIALS AND METHODS: A retrospective review of MDM records for patients referred with BCLM to a tertiary centre between 2005 and 2016. Patient demographics, clinicopathological factors and intervention type were analysed to find predictive factors for overall survival. RESULTS: 61 patients with BCLM were referred to the MDM...
June 20, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28644736/asymptomatic-microscopic-hematuria-as-a-predictor-of-neoplasia-in-the-urinary-tract
#18
Maria Ordell Sundelin, Jørgen Bjerggaard Jensen
OBJECTIVE: The Danish hematuria guidelines were revised in January 2016. Before revision, it was recommended that asymptomatic microscopic hematuria in patients more than 40 years old should be routinely urologically investigated. In the revised guidelines, patients with asymptomatic microscopic hematuria are not recommended to be investigated, irrespective of age. The purpose of this study was to investigate whether asymptomatic microscopic hematuria was predictive of neoplasia of the urinary tract in a referred cohort of patients...
June 23, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28641316/a-cancer-geography-paradox-poorer-cancer-outcomes-with-longer-travelling-times-to-healthcare-facilities-despite-prompter-diagnosis-and-treatment-a-data-linkage-study
#19
Melanie Turner, Shona Fielding, Yuhan Ong, Chris Dibben, Zhiqianq Feng, David H Brewster, Corri Black, Amanda Lee, Peter Murchie
BACKGROUND: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure. METHODS: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12 339 patients. RESULTS: After controlling for important confounders, mainland patients with more than 60 min of travelling time to their cancer treatment centre ((OR 1...
June 22, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28640860/the-path-to-specialist-multidisciplinary-care-in-amyotrophic-lateral-sclerosis-a-population-based-study-of-consultations-interventions-and-costs
#20
Miriam Galvin, Padhraig Ryan, Sinead Maguire, Mark Heverin, Caoifa Madden, Alice Vajda, Charles Normand, Orla Hardiman
BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is a devastating neurological condition that requires coordinated, multidisciplinary clinical management. ALS is prone to misdiagnosis as its signs and symptoms may be non-specific, which may prolong patients' journey to multidisciplinary ALS care. METHODS: Using chart review and national register data, we have detailed the journey of a national cohort of ALS patients (n = 155) from the time of first symptom to presentation at a multidisciplinary clinic (MDC)...
2017: PloS One
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