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https://www.readbyqxmd.com/read/29044669/the-advantages-of-intermediate-tier-inter-optometric-referral-of-low-risk-pigmented-lesions
#1
Angelica Ly, Lisa Nivison-Smith, Michael Hennessy, Michael Kalloniatis
PURPOSE: Pigmented ocular lesions are commonly encountered by eye-care professionals, and range from benign to sight or life-threatening. After identifying a lesion, the primary care professional must establish the likely diagnosis and decide either to reassure, to monitor or to refer. The increasing use of ocular imaging technologies has contributed to an increase in the detection rate of pigmented lesions and a higher number of referrals, which may challenge existing pathways of health-care delivery...
November 2017: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
https://www.readbyqxmd.com/read/29042760/a-scoping-review-of-crisis-teams-managing-dementia-in-older-people
#2
Amy Streater, Donna Maria Coleston-Shields, Jennifer Yates, Miriam Stanyon, Martin Orrell
BACKGROUND: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. METHODS: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29038871/the-global-spine-care-initiative-a-consensus-process-to-develop-and-validate-a-stratification-scheme-for-surgical-care-of-spinal-disorders-as-a-guide-for-improved-resource-utilization-in-low-and-middle-income-communities
#3
Emre Acaroğlu, Tiro Mmopelwa, Selcen Yüksel, Selim Ayhan, Margareta Nordin, Kristi Randhawa, Scott Haldeman
PURPOSE: The purpose of this study was to develop a stratification scheme for surgical spinal care to serve as a framework for referrals and distribution of patients with spinal disorders. METHODS: We used a modified Delphi process. A literature search identified experts for the consensus panel and the panel was expanded by inviting spine surgeons known to be global opinion leaders. After creating a seed document of five hierarchical levels of surgical care, a four-step modified Delphi process (question validation, collection of factors, evaluation of factors, re-evaluation of factors) was performed...
October 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29038180/appropriateness-of-cases-presenting-in-the-emergency-department-following-ambulance-service-secondary-telephone-triage-a-retrospective-cohort-study
#4
Kathryn Eastwood, Karen Smith, Amee Morgans, Johannes Stoelwinder
OBJECTIVE: To investigate the appropriateness of cases presenting to the emergency department (ED) following ambulance-based secondary telephone triage. DESIGN: A pragmatic retrospective cohort analysis of all the planned and unplanned ED presentations within 48 hours of a secondary telephone triage. SETTING: The secondary telephone triage service, called the Referral Service, and the hospitals were located in metropolitan Melbourne, Australia and operated 24 hours a day, servicing 4...
October 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29034438/the-pathways-fertility-preservation-decision-aid-website-for-women-with-cancer-development-and-field-testing
#5
Terri L Woodard, Aubri S Hoffman, Laura A Covarrubias, Deborah Holman, Leslie Schover, Andrea Bradford, Derek B Hoffman, Aakrati Mathur, Jerah Thomas, Robert J Volk
PURPOSE: To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. METHODS: Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14)...
October 15, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29031387/metabolic-pathways-of-oleic-and-palmitic-acid-are-intensified-in-pcos-patients-with-normal-androgen-levels
#6
Szczuko Małgorzata, Zapałowska-Chwyć Marta, Drozd Arleta, Maciejewska Dominika, Starczewski Andrzej, Stachowska Ewa
CONTEXT: The aetiology and pathogenesis polycystic ovary syndrome (PCOS) remain uncertain and thus the relative studies are still crucial. OBJECTIVE: Our aim was to analyse the fatty acids profiles of the main phospholipids species in serum from women with PCOS classified into phenotypes, and to diagnose women more susceptible to the occurrence of inflammatory state. DESIGN: PCOS screening tests were performed in The Clinic of Gynecology and Urogynecology of Pomeranian Medical University in the 2014-2015 years...
November 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29028376/interprofessional-pulmocheck-care-pathway-an-innovative-approach-to-managing-pediatric-asthma-care-in-the-netherlands
#7
J M J E Meuwissen, J Heynens, T Dauven, L Crasborn, F W J M Smeenk, T van der Weijden, J W M Muris
OBJECTIVES: Under-diagnosis and suboptimal asthma control in children persists. An innovative care pathway was developed by a hospital department of pediatrics with the aim to detect pulmonary problems in children and provide appropriate treatment possibilities through systematic feedback towards the referring primary care physician. Primary care physicians can use this pathway to refer children with asthma-like symptoms for a one-day assessment. Goals are to measure the usage of the pathway by primary care general practitioners (GPs), the outcomes in terms of new diagnoses of asthma, the reduction in regular referrals, generated recommendations/therapy and the adequacy of asthma follow-up...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29025191/essr-consensus-document-for-detection-characterization-and-referral-pathway-for-tumors-and-tumorlike-lesions-of-bone
#8
Radhesh Lalam, Johan L Bloem, Iris M Noebauer-Huhmann, Klaus Wörtler, Alberto Tagliafico, Filip Vanhoenacker, Violeta Vasilevska Nikodinovska, Hatice Tuba Sanal, Henk-Jan van der Woude, Olympia Papakonstantinou, Gunnar Åström, Mark Davies, Amanda Isaac, Marc-André Weber
No abstract text is available yet for this article.
November 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/29024327/effect-of-a-see-and-treat-clinic-on-skin-cancer-treatment-time
#9
Scott J P McLaughlin, John Kenealy, Michelle B Locke
BACKGROUND: Many plastic surgery departments in Australasia have experienced increasing referrals for management of skin lesions. This has driven a demand for new strategies to decrease patient waiting time and administrative costs. The aim of this study was to determine if a purpose-built See and Treat skin cancer clinic could provide a faster skin cancer treatment pathway with comparable clinical outcomes and acceptability to patients. METHODS: This was a prospective observational study of patients treated through the See and Treat clinic with a retrospective control cohort...
October 11, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29020216/outpatient-management-of-children-with-world-health-organization-chest-indrawing-pneumonia-implementation-risks-and-proposed-solutions
#10
Eric D McCollum, Amy Sarah Ginsburg
This Viewpoints article details our recommendation for the World Health Organization Integrated Management of Childhood Illness guidelines to consider additional referral or daily monitoring criteria for children with chest indrawing pneumonia in low-resource settings. We review chest indrawing physiology in children and relate this to the risk of adverse pneumonia outcomes. We believe there is sufficient evidence to support referring or daily monitoring of children with chest indrawing pneumonia and signs of severe respiratory distress, oxygen saturation <93% (when not at high altitude), moderate malnutrition, or an unknown human immunodeficiency virus (HIV) status in an HIV-endemic setting...
June 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29019048/parental-action-and-referral-patterns-in-spatial-clusters-of-childhood-autism-spectrum-disorder
#11
David Schelly, Patricia Jiménez González, Pedro J Solís
Sociodemographic factors have long been associated with disparities in autism spectrum disorder (ASD) diagnosis. Studies that identified spatial clustering of cases have suggested the importance of information about ASD moving through social networks of parents. Yet there is no direct evidence of this mechanism. This study explores the help-seeking behaviors and referral pathways of parents of diagnosed children in Costa Rica, one of two countries in which spatial clusters of cases have been identified. We interviewed the parents of 54 diagnosed children and focused on social network connections that influenced parents' help seeking and referral pathways that led to assessment...
October 10, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28990727/magnetic-resonance-imaging-of-the-prostate-and-targeted-biopsy-comparison-of-pirads-and-gleason-grading
#12
Matthew Bastian-Jordan
INTRODUCTION: Multiparametric magnetic resonance imaging (mpMRI) of the prostate has become integral in the investigation of suspected prostate cancer. Regions of interest are graded using the PIRADS scoring system, and in our institution, lesions graded as PIRADS 3-5 undergo sampling by MRI-guided biopsy. Limited data currently exists on PIRADS grading and biopsy results. METHODS: Retrospective review of 343 MRI-guided biopsies (MRGB) performed between April 2013 and December 2016 was conducted...
October 9, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28988447/online-and-call-center-referral-for-endocrine-surgical-pathology-within-institutions
#13
Vaninder K Dhillon, Mai G Al Khadem, Ralph P Tufano, Jonathon O Russell
OBJECTIVES/HYPOTHESIS: We hypothesized that self-referred patients to academic centers will be equally distributed between general surgery and otolaryngology departments that perform thyroid surgery. We sought to quantify disparities in the assignment of these self-referred patients who may reach an institution through call centers or online pathways. STUDY DESIGN: Cross-sectional survey. METHODS: Key words "thyroid surgery" and "thyroid cancer" were used along with the name of the Accreditation Council for Graduate Medical Education-listed otolaryngology program in both Google and Bing search engines...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28986071/severe-asthma-and-the-primary-care-provider-identifying-patients-and-coordinating-multidisciplinary-care
#14
Barbara P Yawn, Michael E Wechsler
Without proper care, patients with severe forms of asthma face substantial medical risks, marked reductions in quality of life, and other significant disease-related burdens. Therefore, it is essential that primary care clinicians and other healthcare providers are adept at identifying cases of severe asthma on the basis of symptom control, exacerbation risks, and the need for relatively aggressive treatment regimens (eg, high-dose inhaled corticosteroids with long-acting controller medications or frequent oral corticosteroid use)...
October 3, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28985973/treatment-challenges-in-and-outside-a-network-setting-soft-tissue-sarcomas
#15
Sandro Pasquali, Sylvie Bonvalot, Dimitri Tzanis, Paolo G Casali, Annalisa Trama, Alessandro Gronchi
Patients with soft tissue sarcoma (STS) experienced better outcomes when treated according to existing clinical practice guidelines either at reference institution or dedicated treatment networks. Despite increasing evidence supporting referral to sarcoma specialised units, up to half of patients are not managed according to guidelines, particularly those in the early stage of their disease requiring surgery. Also, criteria to certify expertise of institutions, such as the treatment volume, are debated and health authorities have only recently started identification of these centres and creation of treatment networks in Europe as well as in several countries...
September 19, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28982720/routes-to-diagnosis-of-heart-failure-observational-study-using-linked-data-in-england
#16
Alex Bottle, Dani Kim, Paul Aylin, Martin R Cowie, Azeem Majeed, Benedict Hayhoe
OBJECTIVE: Timely diagnosis and management of heart failure (HF) is critical, but identification of patients with suspected HF can be challenging, especially in primary care. We describe the journey of people with HF in primary care from presentation through to diagnosis and initial management. METHODS: We used the Clinical Practice Research Datalink (primary care consultations linked to hospital admissions data and national death registrations for patients registered with participating primary care practices in England) to describe investigation and referral pathways followed by patients from first presentation with relevant symptoms to HF diagnosis, particularly alignment with recommendations of the National Institute for Health and Care Excellence guideline for HF diagnosis...
October 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28979166/provoked-vestibulodynia-current-perspectives
#17
REVIEW
Helen Henzell, Karen Berzins, Jennifer P Langford
Provoked vestibulodynia (PVD) refers to vulvar pain of at least 3 months duration, localized to the vestibule, provoked by touch and sexual activity and occurring in the absence of a clear identifiable cause. The clinical spectrum ranges from mild with distressing discomfort through to severe and disabling pain. Current understanding is that PVD is one of many chronic pain conditions characterized by sensitization of peripheral and central nociceptive pathways, with pain arising due to dysfunctional neuronal activity in the absence of painful stimuli...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28978238/ototoxicity-monitoring-through-the-eyes-of-the-treating-physician-perspectives-from-pulmonology-and-medical-oncology
#18
Angela C Garinis, Alexandra Cornell, Gopal Allada, Kevin P Fennelly, Ronald J Maggiore, Dawn Konrad-Martin
OBJECTIVES: Integrating audiological management into the care pathways of clinical specialties that prescribe ototoxic medications for essential, often life-preserving medical care that is critical for early hearing loss identification and remediation. Research shows that successful implementation of a new health service or intervention requires alignment of goals among provider groups, institutional leadership and patients. Thoughtful consideration of the physician's viewpoints about ototoxicity and its implications for treatment planning is, therefore, important for the implementation and enduring success of an ototoxicity monitoring programme (OMP)...
October 5, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28977013/bereavement-support-for-family-caregivers-the-gap-between-guidelines-and-practice-in-palliative-care
#19
Samar M Aoun, Bruce Rumbold, Denise Howting, Amanda Bolleter, Lauren J Breen
BACKGROUND: Standards for bereavement care propose that support should be matched to risk and need. However, studies in many countries demonstrate that palliative care services continue to adopt a generic approach in offering support to bereaved families. OBJECTIVE: To identify patterns of bereavement support in palliative care services based upon the experience of bereaved people from a population based survey and in relation to clinical practice guidelines. DESIGN: An anonymous postal survey collected information from clients of six funeral providers in four Australian states (2014-15), 6 to 24 months after the death of their family member or friend, with 1,139 responding...
2017: PloS One
https://www.readbyqxmd.com/read/28974586/a-4-week-wait-fast-track-sleep-service-is-effective-at-establishing-vocational-drivers-on-continuous-positive-airway-pressure
#20
Sophie D West, Beatrice Downie, Gillian Olds, Mark Tomlinson, Claire Wotton, Emma Firth, Alison McMillan
We sought to establish whether an expedited or 'fast-track' NHS service to diagnose obstructive sleep apnoea (OSA) and establish vocational drivers on continuous positive airway pressure (CPAP) within 4 weeks of referral was possible. This model is recommended by the OSA Partnership Group. In total, 55 vocational drivers were referred to two sleep services. Assessment showed 73% had moderate or severe OSA on sleep study. Of those commenced on CPAP, review was a mean of 15 days after initiation (range 3-62 days)...
October 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
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