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Referral pathway

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https://www.readbyqxmd.com/read/29241339/a-novel-model-for-a-hub-and-spoke-spinal-service-and-improvements-in-the-treatment-of-spinal-pathology-in-a-rural-hospital-setting
#1
Erden Ali, Andrew Macdowell, Thomas Pagonis
INTRODUCTION:   We present a unique pathway for care aimed specifically at spinal patients. As a result of the shift of the spoke direction from the existing hub-and-spoke model, patient care is being redirected successfully with great benefit to a rural department. Within the rural community, it is the spoke that is the main locality to which patients present and at which they are treated. Subspecialty procurement is often more central and located in tertiary referral centres outside of a rural position...
December 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29239130/establishing-the-cascade-of-care-for-hepatitis-c-in-england-benchmarking-to-monitor-impact-of-direct-acting-antivirals
#2
Ruth Simmons, Georgina Ireland, Will Irving, Matthew Hickman, Caroline Sabin, Samreen Ijaz, Mary Ramsay, Sam Lattimore, Sema Mandal
Little is known about engagement and retention in care of people diagnosed with chronic hepatitis C (HCV) in England. Establishing a cascade of care informs targeted interventions for improving case-finding, referral, treatment uptake and retention in care. Using data from the Sentinel Surveillance of Blood Borne Virus testing (SSBBV) between 2005-2014 we investigate the continuum of care of those tested for HCV in England. Persons ≥1 years old, with an anti-HCV test and subsequent RNA tests between 2005-2014 reported to SSBBV were collated...
December 14, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29238607/protocol-for-a-feasibility-randomised-controlled-trial-of-the-use-of-physical-activity-monitors-in-an-exercise-referral-setting-the-pacers-study
#3
Jemma Hawkins, Michelle Edwards, Joanna Charles, Russell Jago, Mark Kelson, Kelly Morgan, Simon Murphy, Emily Oliver, Sharon Simpson, Rhiannon Tudor Edwards, Graham Moore
Background: Exercise referral schemes are recommended by the National Institute for Clinical Excellence (NICE) for physical activity promotion among inactive patients with health conditions or risk factors. Whilst there is evidence for the initial effectiveness and cost-effectiveness of such schemes for increasing physical activity, evidence of long-term effects is limited. Techniques such as goal setting, self-monitoring and personalised feedback may support motivation for physical activity...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29236204/the-burden-of-pure-anisometropic-amblyopia-a-cross-sectional-study-on-2800-iranians
#4
Siamak Akbarzadeh, Reihaneh Vahabi, Nooshin Bazzazi, Ghodratollah Roshanaei, Samira Heydarian, Daniel F Fouladi
PURPOSE: To assess the proportion of pure anisometropic amblyopia in a sample Iranian (white) population. METHODS: A total of 2800 consecutive individuals who presented at a referral eye clinic for any reason were examined for the presence of pure anisometropic amblyopia. Anisometropia was reported when a spherical equivalent refraction difference of at least 1.0 D with or without a cylinder refraction difference of at least 1.0 D was present between the two eyes...
December 13, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/29233671/endoscopic-detection-rate-of-sessile-serrated-lesions-in-lynch-syndrome-patients-is-comparable-to-an-age-and-gender-matched-control-population-case-control-study-with-expert-pathology-review
#5
Jasper L A Vleugels, Husna Sahin, Yark Hazewinkel, Lianne Koens, Jose G van den Berg, Monique E van Leerdam, Evelien Dekker
BACKGROUND: Carcinogenesis in Lynch syndrome involves fast progression of adenomas to colorectal cancer (CRC) due to microsatellite instability. The role of sessile serrated lesions (SSLs) and the serrated neoplasia pathway in these patients is unknown. The aim of this matched case-control study was to compare endoscopic detection rates and distribution of SSLs in Lynch syndrome patients to a matched control population. METHODS: We collected data of Lynch syndrome patients with a proven germline mutation who underwent colonoscopy between January 2011 and April 2016 in 2 tertiary referral hospitals...
December 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29233505/outcome-measurement-in-plastic-surgery
#6
REVIEW
Justin C R Wormald, Jeremy N Rodrigues
Outcome measurement in plastic surgery is often surgeon-centred, and clinician-derived. Greater emphasis is being placed on patient-reported outcomes (PROs), in which the patients' perspective is measured directly from them. Numerous patient-reported outcome measures (PROMs) have been developed in a range of fields, with a number of good quality PROMs in plastic surgery. They can be deployed to support diagnosis, disease severity determination, referral pathways, treatment decision-making, post-operative care and in determining cost-effectiveness...
November 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29229653/investigation-of-time-to-first-presentation-and-extrahospital-factors-in-the-treatment-of-neovascular-age-related-macular-degeneration-a-retrospective-cross-sectional-study
#7
Peng Yong Sim, Sonul Gajree, Baljean Dhillon, Shyamanga Borooah
OBJECTIVES: To assess the time from symptom onset to treatment for neovascular age-related macular degeneration (nvAMD) and to measure the awareness of AMD in Southeast Scotland. DESIGN: Retrospective cross-sectional study. SETTING: Secondary care, Southeast of Scotland. METHODS: Patients treated with intravitreal therapy (IVT) for nvAMD in Southeast Scotland between 2013 and 2015 were identified using a treatment register...
December 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29225891/evaluation-of-a-type-2-diabetes-prevention-program-using-a-commercial-weight-management-provider-for-non-diabetic-hyperglycemic-patients-referred-by-primary-care-in-the-uk
#8
Carolyn Piper, Agnes Marossy, Zoe Griffiths, Amanda Adegboye
Objectives: To determine if a diabetes prevention program (DPP) delivered by a commercial weight management provider using a UK primary care referral pathway could reduce the progression to type 2 diabetes (T2D) in those diagnosed with non-diabetic hyperglycemia (NDH-being at high risk of developing T2D). Research design: This is a quasi-experimental translational research study. Methods: 14 primary care practices identified, recruited and referred patients with NDH (fasting plasma glucose ≥5...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29220703/referral-to-specialist-physiotherapists-in-the-management-of-whiplash-associated-disorders-perspectives-of-healthcare-practitioners
#9
Aila Nica Bandong, Andrew Leaver, Martin Mackey, Michele Sterling, Joan Kelly, Carrie Ritchie, Trudy Rebbeck
BACKGROUND: Guidelines for whiplash associated disorders (WAD) recommend early referral to specialists (e.g. specialist physiotherapists) of people who are not recovering. This recommendation is a key component of a proposed clinical pathway of care for WAD. OBJECTIVE: To explore healthcare practitioners' opinions about referral to specialist physiotherapists of people with WAD at high risk of non-recovery. DESIGN: Qualitative descriptive study...
November 22, 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/29205100/role-of-cortical-auditory-evoked-potentials-in-reducing-the-age-at-hearing-aid-fitting-in-children-with-hearing-loss-identified-by-newborn-hearing-screening
#10
Kinjal Mehta, Peter Watkin, Margaret Baldwin, Josephine Marriage, Merle Mahon, Deborah Vickers
Recording of free-field cortical auditory evoked potential (CAEP) responses to speech tokens was introduced into the audiology management for infants with a permanent childhood hearing impairment (PCHI) during 2011-2015 at a U.K. service. Children with bilateral PCHI were studied from two sequential cohorts. Thirty-four children had followed an audiology pathway prior to CAEP introduction, and 44 children followed a pathway after the introduction of CAEP and were tested with unaided and aided CAEP responses...
January 2017: Trends in Hearing
https://www.readbyqxmd.com/read/29202799/routine-blood-tests-and-probability-of-cancer-in-patients-referred-with-non-specific-serious-symptoms-a-cohort-study
#11
Esben Næser, Henrik Møller, Ulrich Fredberg, Jan Frystyk, Peter Vedsted
BACKGROUND: Danish cancer patients have lower survival rates than patients in many other western countries. Half of the patients present with non-alarm symptoms and thus have a long diagnostic pathway. Consequently, an urgent referral pathway for patients with non-specific serious symptoms was implemented throughout Denmark in 2011-2012. As part of the diagnostic workup, a panel of blood tests are performed for all patients referred by their general practitioner (GP) to the urgent referral pathway...
December 4, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29200980/locally-advanced-disease-and-pelvic-exenterations
#12
REVIEW
Christos Kontovounisios, Paris Tekkis
Advanced primary and recurrent colorectal cancer can be successfully treated by experienced, dedicated centers delivering good outcomes with low mortality and morbidity. Development and implementation of a comprehensive referral pathway is to be encouraged. Multidisciplinary team management is essential in the management of this complex group of patients and is associated with significantly more complete preoperative evaluation and more accurate provision of patient information, as well as improved access to the most appropriate individualized management plan...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29200525/mental-health-care-during-the-ebola-virus-disease-outbreak-in-sierra-leone
#13
Stania Kamara, Anna Walder, Jennifer Duncan, Antoinet Kabbedijk, Peter Hughes, Andrew Muana
Problem: Reported levels of mental health and psychosocial problems rose during the 2014-2015 Ebola virus disease outbreak in Sierra Leone. Approach: As part of the emergency response, existing plans to create mental health units within the existing hospital framework were brought forward. A nurse-led mental health and psychosocial support service, with an inpatient liaison service and an outpatient clinic, was set up at the largest government hospital in the country...
December 1, 2017: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29199901/an-evaluation-of-practitioner-s-experience-of-service-users-seeking-community-detoxification-from-benzodiazepines
#14
Marianne Wall, Sharon Lambert, Aidan Horan
A recent report in Ireland identified that two-thirds of poisoning deaths involved poly drug use with an average of four different drugs involved. Of these, benzodiazepines were the most common drug group involved. Concern has been expressed regarding high levels of benzodiazepine prescriptions globally. Community-based detoxification programs are required, but detoxification is complex with associated high risks, such as overdose. This study utilized a survey to gather the experiences of a range of drug workers in addiction settings in the southern region of Ireland who are tasked with the management of supporting service users who wish to detoxify from benzodiazepines...
December 4, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/29193092/imaging-in-retroperitoneal-soft-tissue-sarcoma
#15
Christina Messiou, Carlo Morosi
Patients with retroperitoneal sarcoma can present to a variety of clinicians with non-specific symptoms and retroperitoneal sarcomas can be incidental findings. Failure to recognize retroperitoneal sarcomas on imaging can lead to inappropriate management in non-specialist centers. Therefore it is critical that the possibility of retroperitoneal sarcoma should be considered with prompt referral to a soft tissue sarcoma unit. This review guides clinicians through a diagnostic pathway, introduces concepts in response assessment and new imaging developments...
November 28, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29191503/management-of-adults-with-congenital-heart-disease-and-pulmonary-arterial-hypertension-in-the-uk-survey-of-current-practice-unmet-needs-and-expert-commentary
#16
Robert Tulloh, Kostas Dimopoulos, Robin Condliffe, Paul Clift
BACKGROUND: Pulmonary arterial hypertension (PAH) is a well-recognised complication of adult congenital heart disease (CHD). However, management is not currently standardised between centres and specific guidelines are lacking. In order to identify and understand the unmet needs related to PAH associated with CHD (PAH-CHD), a survey of physicians was performed. METHODS: An electronic survey was sent to two physician groups: (1) cardiologists registered in a UK cardiology directory; (2) specialist pulmonary hypertension (PH) physicians known to manage patients with adult PAH-CHD...
November 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29189916/improving-efficiency-and-quality-of-the-children-s-asd-diagnostic-pathway-lessons-learned-from-practice
#17
Marion Rutherford, Morag Burns, Duncan Gray, Lynne Bremner, Sarah Clegg, Lucy Russell, Charlie Smith, Anne O'Hare
The 'autism diagnosis crisis' and long waiting times for assessment are as yet unresolved, leading to undue stress and limiting access to effective support. There is therefore a significant need for evidence to support practitioners in the development of efficient services, delivering acceptable waiting times and effectively meeting guideline standards. This study reports statistically significant reductions in waiting times for autism diagnostic assessment following a children's health service improvement programme...
November 30, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/29182609/variation-in-fast-track-referrals-for-suspected-cancer-by-patient-characteristic-and-cancer-diagnosis-evidence-from-670%C3%A2-000-patients-with-cancers-of-35-different-sites
#18
Y Zhou, S C Mendonca, G A Abel, W Hamilton, F M Walter, S Johnson, J Shelton, L Elliss-Brookes, S McPhail, G Lyratzopoulos
BACKGROUND: In England, 'fast-track' (also known as 'two-week wait') general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. METHODS: We examined data from 669 220 patients with 35 cancers diagnosed in 2006-2010 following either fast-track or 'routine' primary-to-secondary care referrals using 'Routes to Diagnosis' data...
November 28, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/29181378/screening-of-dementia-in-portuguese-primary-care-methodology-assessment-tools-and-main-results
#19
Laetitia Teixeira, Pedro Machado Dos Santos, Sara Alves, Maria João Azevedo, Mafalda Gomes Duarte, António Leuschner, Constança Paúl
The objectives of this article are as follows: (1) to describe the assessment protocol used to outline people with probable dementia in Primary Health Care; (2) to show the methodological design and procedure to obtain a representative sample of patients with probable dementia; and (3) to report the main characteristics of the sample collected in the context of the study "Characteristics and needs of people with probable dementia." The study protocol was based on the "Community Assessment of Risk and Treatment Strategies (CARTS) Program" and is composed by a set of instruments that allow the assessment of older adults with probable dementia in several areas (health, psychological, functionality, and other)...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29176933/a-clinical-pathway-for-the-management-of-difficult-venous-access
#20
Vanno Sou, Craig McManus, Nicholas Mifflin, Steven A Frost, Julie Ale, Evan Alexandrou
Background: Many patients are admitted to hospital with non-visible or palpable veins, often resulting in multiple painful attempts at cannulation, anxiety and catheter failure. We developed a difficult intravenous pathway at our institution to reduce the burden of difficult access for patients by increasing first attempt success with ultrasound guidance. The emphasis was to provide a solution for hospitalised patients after business hours by training the after-hours clinical support team in ultrasound guided cannulation...
2017: BMC Nursing
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