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https://www.readbyqxmd.com/read/29760022/burnout-and-scope-of-practice-in-new-family-physicians
#1
Amanda K H Weidner, Robert L Phillips, Bo Fang, Lars E Peterson
PURPOSE: Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. METHODS: Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29746814/a-case-series-on-the-use-of-levonorgestrel-52mg-intrauterine-system-after-organ-transplant
#2
Cassia R T Juliato, Paulo Stahlscmidt, Arlete Fernandes, Ilza Monteiro, Luis Bahamondes
OBJECTIVE: To assess the clinical performance (pregnancy and occurrence of pelvic infection) of the levonorgestrel 52-mg intrauterine system (LNG IUS) in solid organ transplant recipients. STUDY DESIGN: We performed a retrospective chart review of all patients seen in the Family Planning Clinic at the University of Campinas Department of Obstetrics and Gynecology from 2007-2017 to identify women with solid organ transplantation using immunosuppression who received a LNG- IUS...
May 7, 2018: Contraception
https://www.readbyqxmd.com/read/29743211/advancing-the-science-of-implementation-in-primary-health-care
#3
EDITORIAL
Andrew Bazemore, Anne Victoria Neale, Phillip Lupo, Dean Seehusen
Implementation Science is commonly described as the study of methods and approaches that promote the uptake and use of evidence-based interventions into routine practice and policymaking. In this issue of JABFM , investigators share a wealth of new insights from the frontlines of Implementation Science in primary care: what it is, how we are doing it, and how it is advancing the evidence base of primary care. The breadth of implementation science in primary care is affirmed by the range of topics covered, from thought leader recommendations on future directions for the field, to reports on how best practices in policy and practice are shaping primary care implementation in the United States and Canada...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29686763/international-medical-graduates-in-the-us-physician-workforce-and-graduate-medical-education-current-and-historical-trends
#4
Awad A Ahmed, Wei-Ting Hwang, Charles R Thomas, Curtiland Deville
Background : Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective : We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods : We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties...
April 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29683194/clinical-experience-with-multigene-carrier-panels-in-the-reproductive-setting
#5
Catherine Terhaar, Nicole Teed, Rachel Allen, Lindsay Dohany, Christina Settler, Carol Holland, Ryan E Longman
OBJECTIVES: Expanded carrier testing is acknowledged as an acceptable strategy for carrier testing by the American College of Obstetrics and Gynecology. Limited studies have investigated positivity rates of expanded carrier panels. We describe our experience with three commercial laboratory panels varying in size from 3 to 218 disorders. METHODS: We reviewed outcomes for three multigene carrier screening panels: Trio (3 diseases), Standard (23 diseases), and Global (218 diseases)...
April 23, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29617477/-social-practices-in-the-medicalization-and-humanization-of-prenatal-care
#6
Cristine Maria Warmling, Ananyr Porto Fajardo, Dagmar Estermann Meyer, Cristophe Bedos
The study's main objective is to analyze how discourses of medicalization and humanization reconnect in primary healthcare and shape prenatal care for pregnant women provided by family health teams. This was a single and integrated case study with multiple analytical units and a qualitative approach. A total of 17 focus groups were performed, in which 47 health professionals were heard (14 physicians, 19 nurses, and 14 dentists), members of 17 family health teams in 16 municipalities in the South of Brazil...
March 29, 2018: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/29566667/work-related-adverse-events-leaving-their-mark-a-cross-sectional-study-among-dutch-gynecologists
#7
Melanie A M Baas, Karel W F Scheepstra, Claire A I Stramrood, Ruth Evers, Lea M Dijksman, Maria G van Pampus
BACKGROUND: Health care professionals who are frequently coping with traumatic events have an increased risk of developing a posttraumatic stress disorder. Research among physicians is scarce, and obstetrician-gynecologists may have a higher risk. Work-related traumatic events and posttraumatic stress disorder among obstetricians-gynecologists and the (desired) type of support were studied. METHODS: A questionnaire was emailed to all members of the Dutch Society of Obstetrics and Gynaecology, which included residents, attending, retired and non-practicing obstetricians-gynecologists...
March 22, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29547381/a-quantitative-day-in-the-life-of-a-saskatchewan-rural-physician
#8
Emmett Harrison, Paul B A Dhillon
INTRODUCTION: Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. METHODS: We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision...
2018: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/29537478/characteristics-of-graduating-family-medicine-residents-who-intend-to-practice-maternity-care
#9
Sebastian T Tong, Camille J Hochheimer, Wendy B Barr, Matteo Leveroni-Calvi, Nicholas M Lefevre, Jordyn T Wallenborn, Lars E Peterson
BACKGROUND AND OBJECTIVES: Prior research found that 24% of graduating family medicine residents intend to provide obstetrical deliveries, but only 9% of family physicians 1 to 10 years into practice are doing so. Our study aims to describe the individual and residency program characteristics associated with intention to provide obstetrical deliveries and prenatal care. METHODS: Cross-sectional data on 2014-2016 graduating residents were obtained from the American Board of Family Medicine certification examination demographic questionnaire that asked about intended provision of specific clinical activities...
March 8, 2018: Family Medicine
https://www.readbyqxmd.com/read/29530663/maternal-breastfeeding-indicators-and-factors-associated-with-exclusive-breastfeeding-in-a-subnormal-urban-cluster-assisted-by-the-family-health-strategy
#10
Vera A A L Silva, Maria F C Caminha, Suzana L Silva, Vilneide M S B D Serva, Pedro T A C C Azevedo, Malaquias Batista Filho
OBJECTIVE: To describe and analyze indicators of feeding practices related to breastfeeding and factors associated with exclusive breastfeeding (EBF) in a subnormal urban cluster (slums) in Pernambuco, Brazil. METHODS: Four breastfeeding indicators were used to interview mothers of children under 3 years of age. An inventory of the families' socioeconomic and environmental factors, maternal obstetric history, and basic health care access was undertaken. The sample consisted of all 310 children under the age of 3 years from Coelhos, PE, Brazil...
March 9, 2018: Jornal de Pediatria
https://www.readbyqxmd.com/read/29514775/scope-breadth-and-differences-in-online-physician-ratings-related-to-geography-specialty-and-year-observational-retrospective-study
#11
Jessica Janine Liu, John Justin Matelski, Chaim M Bell
BACKGROUND: Physician ratings websites have emerged as a novel forum for consumers to comment on their health care experiences. Little is known about such ratings in Canada. OBJECTIVE: We investigated the scope and trends for specialty, geographic region, and time for online physician ratings in Canada using a national data source from the country's leading physician-rating website. METHODS: This observational retrospective study used online ratings data from Canadian physicians (January 2005-September 2013; N=640,603)...
March 7, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29514607/initiation-of-traditional-birth-attendants-and-their-traditional-and-spiritual-practices-during-pregnancy-and-childbirth-in-ghana
#12
Lydia Aziato, Cephas N Omenyo
BACKGROUND: Prior to the advent of modern obstetric services, traditional birth attendants (TBAs) have rendered services to pregnant women and women in labour for a long time. Although it is anticipated that women in contemporary societies will give birth in hospitals and clinics, some women still patronize the services of TBAs. The study therefore sought to gain an in-depth understanding of the initiation of TBAs and their traditional and spiritual practices employed during pregnancy and childbirth in Ghana...
March 7, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29470814/continuing-professional-development-in-maternal-health-care-barriers-to-applying-new-knowledge-and-skills-in-the-hospitals-of-rwanda
#13
Germaine Tuyisenge, Celestin Hategeka, Isaac Luginaah, Yolanda Babenko-Mould, David Cechetto, Stephen Rulisa
Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda...
February 22, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29465664/knowledge-practices-and-barriers-to-hiv-pre-exposure-prophylaxis-prep-prescribing-among-washington-state-medical-providers
#14
Brian R Wood, Vanessa M McMahan, Kelly Naismith, Jonathan B Stockton, Lori A Delaney, Joanne D Stekler
BACKGROUND: We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. METHODS: In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. RESULTS: Of 735 eligible providers, 64...
January 4, 2018: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29450226/alcohol-reduction-in-the-first-trimester-is-unrelated-to-smoking-patient-or-pregnancy-characteristics
#15
Kristen A Schmidt, Andrew J Lancia, Saad Alvi, Jean C Aldag
Introduction: Studies show alcohol-preferring mice reduce their alcohol intake during pregnancy; this study questions if the same is true for humans. The current investigation compares women's pre-pregnancy and first trimester alcohol consumption, examines if women with problem drinking diminish their alcohol intake during pregnancy, and determines if prenatal alcohol reduction is associated with characteristics of pregnancy, patients or smoking. Methods: 126 participants in weeks 1-12 of pregnancy, recruited from Obstetric and Family Practices, completed a survey during their initial prenatal visit including two gender-specific AUDITs (Alcohol Use Disorders Identification Tests) querying current and pre-pregnancy alcohol use...
June 2017: Addictive Behaviors Reports
https://www.readbyqxmd.com/read/29426317/barriers-and-enablers-to-skin-to-skin-contact-at-birth-in-healthy-neonates-a-qualitative-study
#16
Amala James Alenchery, Joanne Thoppil, Carl Denis Britto, Jimena Villar de Onis, Lavina Fernandez, P N Suman Rao
BACKGROUND: Skin to skin contact (SSC) at birth is the standard of care for newborns without risk factors. However, implementation of SSC at birth has been far from optimal. A qualitative study was undertaken to determine the barriers, enablers and potential solutions to implementation of SSC at birth in healthy newborn infants in a level III neonatal-care facility in Bangalore, India. METHODS: Consultants and residents/postgraduates (PG) from the departments of Obstetrics (n = 19) and Pediatrics (n = 14) and nurses (n = 8) in the labor room (LR) participated in the study...
February 9, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29417031/atypical-preeclampsia-gestational-proteinuria
#17
Amy B Stevens, Diane M Brasuell, Rebecca N Higdon
There are many rural areas where obstetric care is predominately performed by family medicine physicians. As such, it is important for family medicine physicians to stay up to date with the latest obstetric guidelines. Preeclampsia is a well-established disorder and the guidelines for screening and treatment are well known. However, atypical presentations of preeclampsia have been less studied. Notably, what constitutes atypical preeclampsia and when to be concerned for increased morbidity and mortality in the mother and neonate...
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29387439/assessment-of-knowledge-and-education-relating-to-asthma-during-pregnancy-among-women-of-childbearing-age
#18
Mohammed O Al Ghobain, Mohammed AlNemer, Mohammad Khan
Background: Misconceptions about medications' safety can lead pregnant women with asthma to stop their medications, resulting in asthma-related neonatal morbidity and mortality. Our aim was to assess the level of pregnancy-related asthma knowledge and education about asthma medications' safety, among women of childbearing age with a history of bronchial asthma. Methods: A cross-sectional survey of convenience sample of outpatient clinic attendees of Pulmonary, Family Medicine and Obstetrics & Gynecology among women of childbearing age with history of asthma at King Abdulaziz Medical City, Riyadh, Saudi Arabia...
2018: Asthma Research and Practice
https://www.readbyqxmd.com/read/29348260/the-canadian-preterm-birth-network-a-study-protocol-for-improving-outcomes-for-preterm-infants-and-their-families
#19
Prakesh S Shah, Sarah D McDonald, Jon Barrett, Anne Synnes, Kate Robson, Jonathan Foster, Jean-Charles Pasquier, K S Joseph, Bruno Piedboeuf, Thierry Lacaze-Masmonteil, Karel O'Brien, Sandesh Shivananda, Nils Chaillet, Petros Pechlivanoglou
BACKGROUND: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. METHODS: Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems...
January 18, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29261177/reproductive-genetic-carrier-screening-for-cystic-fibrosis-fragile-x-syndrome-and-spinal-muscular-atrophy-in-australia-outcomes-of-12-000-tests
#20
Alison Dalton Archibald, Melanie Jane Smith, Trent Burgess, Katrina Louise Scarff, Justine Elliott, Clare Elizabeth Hunt, Caitlin Barns-Jenkins, Chelsea Holt, Karina Sandoval, Vanessa Siva Kumar, Lisa Ward, Emily Caroline Allen, Sarah Valerie Collis, Shannon Cowie, David Francis, Martin B Delatycki, Eppie Mildred Yiu, R John Massie, Mark Domenic Pertile, Desirée du Sart, Damien Bruno, David J Amor
PurposeTo describe our experience of offering simultaneous genetic carrier screening for cystic fibrosis (CF), fragile X syndrome (FXS), and spinal muscular atrophy (SMA).MethodsCarrier screening is offered through general practice, obstetrics, fertility, and genetics settings before or in early pregnancy. Carriers are offered genetic counseling with prenatal/preimplantation genetic diagnosis available to those at increased risk.ResultsScreening of 12,000 individuals revealed 610 carriers (5.08%; 1 in 20): 342 CF, 35 FXS, 241 SMA (8 carriers of 2 conditions), approximately 88% of whom had no family history...
October 26, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
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