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Family practitioner

Samuel Bulteau, Marie Grall-Bronnec, Pierre-Yves Bars, Edouard-Jules Laforgue, François Etcheverrigaray, Jean-Christophe Loirat, Caroline Victorri-Vigneau, Jean-Marie Vanelle, Anne Sauvaget
Objective: Therapeutic observance is one of the cornerstones of bipolar disease prognosis. Nostalgia of previous manic phase has been described as a cause of treatment retrieval in bipolar disorder. But to date no systematic study has examined manic episode remembering stories. Our aim was to describe manic experience from the patient's point of view and its consequences on subjective relation to care and treatment adherence. Patients and methods: Twelve euthymic patients with bipolar I disorder were interviewed about their former manic episodes and data was analyzed, thanks to a grounded theory method...
2018: Patient Preference and Adherence
J J Metcalfe, D Leonard
Unhealthy dietary intake among American children and adults is of great concern to public health practitioners, nutritional scientists, and child development experts. Cooking skills are related to healthier dietary intake among Americans of all ages, but remain a substantial barrier for many parents who want to serve healthy meals for their families at home. Culinary education interventions are effective solutions for many parents who do not know how to cook, but issues with participation bias mean that these programs are not effective solutions for all individuals...
September 1, 2018: Physiology & Behavior
Maria C Dolce, Judith Haber, Judith A Savageau, Erin Hartnett, Christine A Riedy
BACKGROUND AND PURPOSE: Nurse practitioners (NPs) are a significant segment of the US primary care workforce and have a pivotal role in improving access to oral health (OH) care. The purpose of this research was to assess OH curricular integration in primary care NP programs and to examine factors that influence integration and satisfaction with graduates' level of OH competence. METHODS: A cross-sectional, national survey of NP programs (N = 466) was conducted using an electronically distributed 19-item, self-administered questionnaire...
August 6, 2018: Journal of the American Association of Nurse Practitioners
Kathryn Dreyer, Robert A P Williamson, Dougal S Hargreaves, Rebecca Rosen, Sarah R Deeny
Objective: To identify the degree to which parental diagnosis of depression or other long-term conditions, parental health-seeking behaviours and household factors were associated with a healthcare utilisation among children and young people (CYP) (0-15 years). Design: Retrospective, cross-sectional study of electronic health records, from 25 252 patients registered at a large, London-based primary care provider. The associations between children's healthcare utilisation and the characteristics of the child, their parents/carers and their household structure were examined using multivariable regression...
2018: BMJ Paediatrics Open
Wadeia Mohammad AlSharief, Mahera Abdulrahman, Hamda Hassan Khansaheb, Shaima Amin Abdulghafoor, Ashraf Ahmed
Introduction: It is well known that family medicine (FM) is a cornerstone for developing a community-based health-care system, and training family physicians is critical for the society. In Middle East, only 5%-10% of physicians, nurses, and health technicians are citizens. This demands more efforts toward having national FM practitioners in the country. The development of FM residency training program through the past two decades in Dubai has played a crucial rule in this aspect. Methods: The primary purpose of this study is to review the status of FM specialty training in the Emirates of Dubai throughout the past two decades...
March 2018: Journal of Family Medicine and Primary Care
B C Rao, Ramakrishna Prasad
The term "principles" refers to a set of defining attributes and values that lie at the heart of a discipline. These are largely discovered by reflection and practice rather than learned by formal instruction. This article is written as a reflective dialogue between two teachers of family medicine, one who has been practicing for nearly five decades and another with training in contemporary academic family medicine, using a selection of case stories drawn from the practice of the first author. Several principles of family medicine such as "broad-based specialty"; "person and family orientation"; "continuity of care"; "community based care"; "building a trusting relationship"; "counseling"; and "an effective steward of resources" are highlighted...
March 2018: Journal of Family Medicine and Primary Care
Jenifer Jeba, Shrikant Atreya, Sulagna Chakraborty, Nikki Pease, Ann Thyle, Alka Ganesh, Gayatri Palat, Lulu Matthew, Sahaya Anbarasi, Raman Kumar, Mary Ann Muckaden, Alan Barnard, Mhoira Leng, Dan Munday, Scott A Murray
Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit...
March 2018: Journal of Family Medicine and Primary Care
Quynh Nhu Natasha Bui, Meekyung Han, Sadhna Diwan, Tran Dao
While involvement of family caregivers can play an important role in the recovery process of persons with serious mental illness (SMI), family caregivers often endure poor health and mental health issues due to caregiving-related distress. These challenges may be exacerbated for Vietnamese American families due to cultural values (e.g., familism and stigma). This qualitative exploratory study examined how Vietnamese American family caregivers of persons with SMI describe their caregiving experience. Using convenience and snowball sampling, the study recruited 21 participants who took part in two Vietnamese-language focus groups...
August 8, 2018: Transcultural Psychiatry
Marcy Ainslie, Cheryl Bragdon
BACKGROUND AND PURPOSE: Assessment of clinical competency in distance education programs presents new challenges and yet is imperative to patient safety and continued success of the profession. Furthermore, employers increasingly expect a skill set in current informational technologies. Clinical competence has been assessed using high stakes, standardized patient simulation in traditional, on-campus educational programs. Telemedicine technology integrated with standardized patient simulations may provide a solution for teaching the essentials of information technology and provide a modality for clinical competency assessment in distance education...
August 2018: Journal of the American Association of Nurse Practitioners
Roxanne E Kirsch, Corrine R Balit, Franco A Carnevale, Jos M Latour, Victor Larcher
As part of the invited supplement on Death and Dying in the PICU, we reviewed ethical, cultural, and social considerations for the bedside healthcare practitioner prior to engaging with children and families in decisions about limiting therapies, withholding, or withdrawing therapies in a PICU. Clarifying beliefs and values is a necessary prerequisite to approaching these conversations. Striving for medical consensus is important. Discussion, reflection, and ethical analysis may determine a range of views that may reasonably be respected if professional disagreements persist...
August 2018: Pediatric Critical Care Medicine
Sándor Balogh, Ferenc Hajnal
It is internationally recognized that the best method for practicing general medical care is family medicine, based on the correct relationship between the physician and the patients/families, where the principles of disease prevention and patient care meet, and the cost-benefit rates are better. In Hungary, a major part of the health reform had been the advancement of a primary care system by the international standards of modern family medicine. The Scientific Association of the Hungarian General Practitioners (SAHGP), founded in 1967, has adviced - from its onset - to introduce a new, independent medical specialty named 'general practice' which was finally realised in 1974...
August 2018: Orvosi Hetilap
Adam Sacarny, Michael L Barnett, Jackson Le, Frank Tetkoski, David Yokum, Shantanu Agrawal
Importance: Antipsychotic agents, such as quetiapine fumarate, are frequently overprescribed for indications not supported by clinical evidence, potentially causing harm. Objective: To investigate if peer comparison letters targeting high-volume primary care prescribers of quetiapine meaningfully reduce their prescribing. Design, Setting, and Participants: Randomized clinical trial (intent to treat) conducted from 2015 to 2017 of prescribers and their patients nationwide in the Medicare program...
August 1, 2018: JAMA Psychiatry
Linton R Harriss, Fintan Thompson, Kenny Lawson, Mary O Loughlin, Robyn McDermott
Objective The aims of this study were to: (1) use local health data to examine potentially preventable hospitalisations (PPHs) as a proportion of total hospital separations and estimated costs to a large regional hospital in northern Queensland, including differences associated with Indigenous status; and (2) identify priority conditions and discuss issues related to strategic local primary health intervention. Methods A cross-sectional analysis was conducted using Queensland Hospital Admitted Patient Data Collection data (July 2012-June 2014) restricted to 51087 separations generated by 29485 local residents...
August 3, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Rachel A Madrid, William McGee
Management of limited health-care resources has been of growing concern. Stewardship of health-care dollars and avoidance of low-value care is being increasingly recognized as a matter that affects all practitioners. This review aims to examine a particular pathological state with multifactorial origins: chronic critical illness (CCI). This condition exerts a large toll on society as well as individual patients and their families. Here, we offer a brief review as to the incidence/prevalence of CCI and suggestions for prevention...
July 31, 2018: Journal of Intensive Care Medicine
Susan E Becker, Diane Nickloy
BACKGROUND: Heredity hemochromatosis (HH) is an underdiagnosed genetic disease that can lead to life-threatening multisystem organ failure. Identifying and treating HH early can prevent the progression of the disease. CASE PRESENTATION: For a 60-year-old white patient without obvious symptoms, it was a revelation to discover that he had HH. This patient, although receiving evidence-based care, ultimately required a liver transplant. As his condition deteriorated, the plan for this patient and his family involved working within an interdisciplinary team that included nurse practitioners and intensive care unit nurses...
September 2018: Dimensions of Critical Care Nursing: DCCN
Sophie Béliard, Jean-Pierre Rabès, Bertrand Cariou, Michel Farnier, Michel Krempf, Jean Ferrières, Nicolas Danchin, Eric Bruckert
INTRODUCTION: Heterozygous familial hypercholesterolemia (FH) is one of the most frequent genetic diseases with a prevalence of 1/250. It is characterized by a very high cholesterol level since birth and is often complicated by cardiovascular diseases (CV) in young patients. While early diagnosis and appropriate therapeutic management can avoid CV complications, HF is largely under-diagnosed and therefore under-treated. METHODS: To investigate the management of HF in France, we conducted a survey with 495 general practitioners (n=200) and specialists (n=295)...
July 27, 2018: La Presse Médicale
Lawrence Tan, Gisselle Gallego, Thi Thao Cam Nguyen, Les Bokey, Jennifer Reath
BACKGROUND: Colorectal cancer (CRC) survivors experience difficulty navigating complex care pathways. Sharing care between GPs and specialist services has been proposed to improve health outcomes in cancer survivors following hospital discharge. Culturally and Linguistically Diverse (CALD) groups are known to have poorer outcomes following cancer treatment but little is known about their perceptions of shared care following surgery for CRC. This study aimed to explore how non-English-speaking and English-speaking patients perceive care to be coordinated amongst various health practitioners...
July 30, 2018: BMC Family Practice
Pierpaolo Cavallo, Sergio Pagano, Mario De Santis, Enrico Capobianco
BACKGROUND: Comorbidity represents the co-occurrence of pathological conditions in the same individual, and presents with very complex patterns. In most cases, reference data for the study of various types of comorbidities linked to complex diseases are those of hospitalized patients. Such patients may likely require cure due to acute conditions. We consider the emerging role of EHR (Electronic Healthcare Records), and study comorbidity patterns in a general population, focusing on diabetic and non-diabetic patients...
July 27, 2018: Journal of Clinical Medicine
Stacy M Baldwin, Sharon Zook, Julie Sanford
PURPOSE/OBJECTIVES: Today's health care climate is composed of patients who experience complex conditions with multiple comorbidities, requiring higher utilization of acute care services. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, posthospital follow-up clinic (Discharge Clinic) is one approach that can be used to improve transitions of care and decrease preventable hospital readmissions...
September 2018: Professional Case Management
Abdurahaman Seid, Yeshi Metaferia
BACKGROUND: Delayed treatment of tuberculosis (TB) cases increases the risk of death and rate of infection in the community. Early diagnosis and initiation of treatment is essential for effective TB control. The aim of this study was to assess length of delays and analyze predictors of treatment delay of newly diagnosed TB patients. METHODS: A cross-sectional study was conducted in Dessie city and surroundings from April1, 2016 to January 30, 2017. Fifteen health facilities of study area were selected randomly and 382 adult TB patients were included consecutively...
July 28, 2018: BMC Public Health
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