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Family practice medicine

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https://www.readbyqxmd.com/read/28638507/the-impact-of-using-mean-versus-mode-when-assessing-resident-competency
#1
Patrick B Barlow, Kate DuChene Thoma, Kristi J Ferguson
BACKGROUND: The Accreditation Council for Graduate Medical Education Milestone Project was implemented in 2014 to standardize assessments and progression of residents. While it is recommended that milestones not be used as tools for direct assessments of resident competency, many programs have used or adapted milestone tools for this purpose. OBJECTIVE: We sought to explore use of the most frequent milestone level at which a resident was evaluated (ie, the mode), and compared this to the standard practice of using the arithmetic mean for summarizing performance...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28633176/determinants-of-the-5-year-retention-and-rural-location-of-family-physicians-results-from-the-iowa-family-medicine-training-network
#2
Gregory C Nelson, Thomas S Gruca
BACKGROUND AND OBJECTIVES: States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)-eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). METHODS: Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633173/exploring-residents-skills-in-diagnosing-dementia-the-unexpected-dissonance-between-ability-and-confidence
#3
Brian S Lerner, Virginia Kalish, Christy J W Ledford
BACKGROUND AND OBJECTIVES: The diagnosis of dementia is a challenge for physicians due to numerous interrelated barriers. Research shows that this difficulty may be rooted in an incomplete knowledge about dementia. To address this gap, we developed an assessment scale of resident confidence in the diagnosis of dementia and used it to compare resident confidence to their practical ability to diagnose dementia. METHODS: The study used a piloted confidence assessment tool for diagnosing dementia correlated with family medicine residents (n=45) performance during an objective structured clinical examination (OSCE)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28633168/integration-of-clinical-pharmacists-in-family-medicine-residency-programs
#4
Jody L Lounsbery, Jennie B Jarrett, Lori M Dickerson, Stephen A Wilson
BACKGROUND AND OBJECTIVES: Clinical pharmacists are valued educators and practitioners within family medicine residency programs (FMRPs). Since the last survey of clinical pharmacists within FMRPs, there have been significant advancements to pharmacy education and training as well as growth of interprofessional education and collaborative practice within family medicine. The objective of this study is to describe the integration of clinical pharmacists within FMRPs. METHODS: All 480 Accreditation Council for Graduate Medical Education (ACGME)-approved FMRPs were contacted to identify clinical pharmacists involved with their programs...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28630258/realization-of-entry-to-practice-milestones-by-canadians-who-studied-medicine-abroad-and-other-international-medical-graduates-a-retrospective-cohort-study
#5
Maria Mathews, Rima Kandar, Steve Slade, Yanqing Yi, Sue Beardall, Ivy Bourgeault
BACKGROUND: International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. METHODS: Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28629455/an-investigation-of-the-relationship-between-autonomy-childbirth-practices-and-obstetric-fistula-among-women-in-rural-lilongwe-district-malawi
#6
Julika Ayla Kaplan, Jonathan Kandodo, Joseph Sclafani, Susan Raine, Jennifer Blumenthal-Barby, Alison Norris, Abigail Norris-Turner, Elly Chemey, John Michael Beckham, Zara Khan, Reginald Chunda
BACKGROUND: Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor...
June 19, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28622010/-are-you-in-or-are-you-out-moral-appeals-to-the-public-in-organ-donation-poster-campaigns-a-multimodal-and-ethical-analysis
#7
Solveig L Hansen, Marthe I Eisner, Larissa Pfaller, Silke Schicktanz
Organ transplantation is a well-established practice in modern medicine. However, many countries, especially those with an opt-in regulation, face the problem of low donation numbers. Respective public campaigns attempt to increase the number of donors by swaying public opinion with the use of carefully selected bits of information. Germany serves as a case study for an opt-in country investing approximately €7.5 million/year in the distribution of respective campaigns. To address diverse populations, large-scale posters in various public spaces still display a multitude of moral messages for organ donation...
June 16, 2017: Health Communication
https://www.readbyqxmd.com/read/28620736/revisiting-prostate-cancer-screening-practices-among-vermont-primary-care-physicians
#8
Laura Donnelly, Kevan M Sternberg, Takamaru Ashikaga, Mark K Plante, Scott D Perrapato
The objective of this study was to assess the prostate cancer screening practices of Vermont primary care physicians and compare them with a prior study in 2001. An electronic survey was created and emailed to all currently practicing primary care physicians in Vermont. Data was stratified by practice length, practice location, university affiliation, and internal medicine versus family practice. Surveys were received from 123 (27.2%) primary care physicians. 27.7% of physicians in practice <10 years recommended prostate specific antigen (PSA) testing, compared with 55...
June 15, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28617024/evaluating-transformation-with-available-resources-the-influence-of-apex-on-depression-screening
#9
Peter C Smith, Shandra M Brown Levey, Corey Lyon
OBJECTIVE: The University of Colorado developed and piloted a team-based primary care delivery model called ambulatory process excellence (APEX) in a family medicine residency in 2015. We evaluated its impact on depression screening using found data and tools readily available to practice-based evaluators. METHOD: The APEX model calls for 5 medical assistants (MAs) supporting 2 providers. MAs have dedicated time to provide delegated care, including depression screening with 2 versions of the Patient Health Questionnaire: PHQ-2 and PHQ-9...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#10
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617013/the-role-of-policy-in-supporting-clinician-led-research-on-behavioral-health-integration
#11
Nathaniel Z Counts
In Best Care at Lower Cost, the Institute of Medicine laid out a vision for continuously learning health systems (Institute of Medicine of the National Academies, 2016). This issue of Families, Systems, & Health represents a substantial step toward this vision, with on-the-ground clinicians and administrators testing empirically informed hypotheses about practice transformation and population health management, and using those results to produce shared learning within and across systems. While the studies in this issue demonstrate that producing generalizable knowledge from clinician-led initiatives is feasible, they also demonstrate that the current system does not adequately support clinicians in doing so...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28616160/cardiopulmonary-arrest-in-primary-care-clinics-more-holes-than-cheese-a-survey-of-the-knowledge-and-attitudes-of-primary-care-physicians-regarding-resuscitation
#12
Sharon Einav, Oren Wacht, Nechama Kaufman, Eliezer Alkalay
BACKGROUND: Patients experiencing pre-arrest symptoms may first refer to their primary care physician. The study's aim was to determine the likelihood that a patient undergoing out-of-hospital cardiac arrest will receive appropriate resuscitation efforts in a primary care clinic in a country with a directive that clinics maintain resuscitation equipment and physicians undergo periodic resuscitation training. METHODS: An anonymous, 23-question online cross-sectional survey was created and administered to primary care physicians working in community clinics (10/1/2015-5/3/2015)...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28616065/human-management-and-hybridization-shape-treegourd-fruits-in-the-brazilian-amazon-basin
#13
Priscila Ambrósio Moreira, Cédric Mariac, Leila Zekraoui, Marie Couderc, Doriane Picanço Rodrigues, Charles R Clement, Yves Vigouroux
Local people's perceptions of cultivated and wild agrobiodiversity, as well as their management of hybridization are still understudied in Amazonia. Here we analyze domesticated treegourd (Crescentia cujete), whose versatile fruits have technological, symbolic, and medicinal uses. A wild relative (C. amazonica) of the cultivated species grows spontaneously in Amazonian flooded forests. We demonstrated, using whole chloroplast sequences and nuclear microsatellites, that the two species are strongly differentiated...
July 2017: Evolutionary Applications
https://www.readbyqxmd.com/read/28615021/general-perception-and-self-practice-of-complementary-and-alternative-medicine-cam-among-undergraduate-pharmacy-students-of-bangladesh
#14
Bijoy Laxmi Saha, Md Omar Reza Seam, Md Mainul Islam, Abhijit Das, Sayed Koushik Ahamed, Palash Karmakar, Md Fokhrul Islam, Sukalyan Kumar Kundu
BACKGROUND: Complementary and Alternative Medicine (CAM) is a combination of herbal medicine, traditional therapies, and mind-body intervention. This descriptive study was designed to assess the knowledge, attitudes, perception and self-use of CAM among Bangladeshi undergraduate pharmacy students. The study also evaluated their opinions about its integration into the pharmacy course curriculum. METHODS: It was a cross-sectional, questionnaire-based study conducted on 250 pharmacy students of five reputed public universities of Bangladesh...
June 14, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28612093/clinical-trial-design-in-juvenile-idiopathic-arthritis
#15
Stephen J Balevic, Mara L Becker, Michael Cohen-Wolkowiez, Laura E Schanberg
Randomized clinical trials provide the gold standard evidence base to guide clinical practice. Despite major advances in trial design, pediatric clinical trials are still difficult to perform and pose unique challenges, including the need to consider the impact of developmental changes in trial design. Advances within pediatric rheumatology combined with the need to comply with legislative requirements have driven new approaches to performing pediatric clinical trials such as utilization of large research networks, incorporation of patient and family stakeholders in the planning and implementation of clinical trials, and the development of novel trial designs...
June 13, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28608234/genomics-guided-precise-anti-epileptic-drug-development
#16
Norman Delanty, Gianpiero Cavallleri
Traditional antiepileptic drug development approaches have yielded many important clinically valuable anti-epileptic drugs. However, the screening of promising compounds has been naturally agnostic to epilepsy etiology in individual human patients. Now, genomic medicine is changing the way we view human disease. International collaborations are unraveling the many molecular genetic causes of the epilepsies, including the early onset epileptic encephalopathies, and some of the familial focal epilepsies. Further advances in precision diagnostics will be facilitated by ongoing large collaborations and the wider availability of whole exome and whole genome sequencing in clinical practice...
June 12, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28606370/factors-influencing-pediatrician-retirement-a-survey-of-american-academy-of-pediatrics-chapter-members
#17
Mary E Rimsza, Holly Ruch-Ross, Harold K Simon, Thomas W Pendergass, Holly J Mulvey
OBJECTIVE: To assess the factors that may influence physicians' desire to retire through an analysis of data collected through the American Academy of Pediatrics (AAP) State Pediatrician Workforce Survey. STUDY DESIGN: An electronic survey was sent to retired and nonretired US pediatricians who held AAP membership. The respondents were asked about the importance of 12 factors that would influence or had influenced their decision to retire. The physicians who were not yet retired also were asked: "If you could afford to today, would you retire from medicine?" RESULTS: The survey was completed by 8867 pediatricians...
June 9, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28600490/treating-tobacco-dependence-guidance-for-primary-care-on-life-saving-interventions-position-statement-of-the-ipcrg
#18
O C P Van Schayck, S Williams, V Barchilon, N Baxter, M Jawad, P A Katsaounou, B J Kirenga, C Panaitescu, K W I G Tsiligianni, N Zwar, A Ostrem
Tobacco smoking is the world's leading cause of premature death and disability. Global targets to reduce premature deaths by 25% by 2025 will require a substantial increase in the number of smokers making a quit attempt, and a significant improvement in the success rates of those attempts in low, middle and high income countries. In many countries the only place where the majority of smokers can access support to quit is primary care. There is strong evidence of cost-effective interventions in primary care yet many opportunities to put these into practice are missed...
June 9, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28600199/financing-of-vaccine-delivery-in-primary-care-practices
#19
Mandy A Allison, Sean T O'Leary, Megan C Lindley, Lori A Crane, Laura P Hurley, Brenda L Beaty, Michaela Brtnikova, Andrea Jimenez-Zambrano, Christine Babbel, Stephen Berman, Allison Kempe
OBJECTIVES: Vaccines represent a significant portion of primary care practices' expenses. Our objectives were to determine among Pediatric (Ped) and Family Medicine (FM): 1) relative payment for vaccine purchase and administration and estimated profit margin by payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines due to finances. METHODS: A national survey conducted April-September 2011 among Ped and FM in private, single-specialty practices...
June 6, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28599577/a-retrospective-comparison-of-pregnancy-outcomes-between-women-with-alpha-thalassaemia-1-trait-and-normal-controls
#20
Kuntharee Traisrisilp, Phudit Jatavan, Theera Tongsong
The objective of this retrospective cohort study was to compare pregnancy outcomes between low-risk pregnant women with alpha-thalassaemia-1 trait and normal controls. The database of the Maternal-Foetal Medicine unit was used to identify low-risk singleton pregnant women complicated by alpha-thalassaemia-1 trait who gave birth between January 2002 and October 2014. The low-risk pregnancies with non-carrier status for thalassaemia were assigned into the control group, with a control-to-case ratio of 10:1. During the study period, 595 women with alpha-thalassaemia-1 trait and 5950 normal controls were identified...
June 9, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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