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Family practitioner

Hadrien Stolz, Thierry Rod Fleury, Sana Boudabbous, Didier Hannouche
Cartilaginous tumours are rare and often incidentally discovered on imaging. They can also be responsible for osteoarticular symptoms (pain, joint stiffness, deformity or fracture) and will require a clinical, radiological and a histopathological assessment. Depending on the lesion, the management may consist of observation or a complex surgical procedure that will take place after a multidisciplinary discussion including the radiologist, the pathologist and the orthopaedic surgeon. The discovery of such cartilage tumours often induces a significant dose of anxiety in the affected patients...
December 12, 2018: Revue Médicale Suisse
Maria Noonan, Owen Doody, Andrew O'Regan, Julie Jomeen, Rose Galvin
BACKGROUND: Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and supporting women and this study aimed to explore GPs' experiences of caring for women with perinatal mental health problems in primary care. The results of this study may provide guidance to inform policy, practice, research and development of curriculum and continuous professional development resources...
December 13, 2018: BMC Family Practice
Jillian M Haines
Megaesophagus affects dogs worldwide but limited information is available regarding its characteristics in the general population of dogs. The objectives of this study were to provide information on a large population of dogs diagnosed with megaesophagus in regards to population characteristics, medical and family history, diagnosis, concurrent disease, and predisposing factors. A link to a web-based survey was provided on megaesophagus support websites and 838 eligible surveys were evaluated. Breeds most frequently associated with congenital megaesophagus were German shepherds, mixed breed "goldendoodles", Labrador retrievers, great Danes, and dachshunds...
November 30, 2018: Research in Veterinary Science
Lois E H Smith, Ann Hellström, Andreas Stahl, Alistair Fielder, Wiley Chambers, Jane Moseley, Cynthia Toth, David Wallace, Brian A Darlow, Jacob V Aranda, Boubou Hallberg, Jonathan M Davis
Importance: To facilitate drug and device development for neonates, the International Neonatal Consortium brings together key stakeholders, including pharmaceutical companies, practitioners, regulators, funding agencies, scientists, and families, to address the need for objective, standardized clinical trial outcome measurements to fulfill regulatory requirements. Retinopathy of prematurity (ROP) is a disease that affects preterm neonates. The current International Classification of Retinopathy of Prematurity does not take into account all of the characteristics of ROP and does not adequately discriminate small changes in disease after treatment...
December 13, 2018: JAMA Ophthalmology
Pauline Joyce, Zena Eh Moore, Janice Christie
BACKGROUND: Pressure ulcers, which are a localised injury to the skin, or underlying tissue, or both, occur when people are unable to reposition themselves to relieve pressure on bony prominences. Pressure ulcers are often difficult to heal, painful, expensive to manage and have a negative impact on quality of life. While individual patient safety and quality care stem largely from direct healthcare practitioner-patient interactions, each practitioner-patient wound-care contact may be constrained or enhanced by healthcare organisation of services...
December 9, 2018: Cochrane Database of Systematic Reviews
Judy Neubrander, Susan R Franzen, Rebecca Mathis
The INPUT project is a model partnership that changed the way health care was offered to the underserved in rural Western North Carolina. Grant funding provided a full-time Family Nurse Practitioner (FNP) to a free clinic and created clinical placements for FNP students. Students had opportunities to learn about unique aspects of care for vulnerable, underserved populations to encourage them to consider working in rural communities. The clinic saw an increase in patient visits and offered more continuity in follow-up care...
December 9, 2018: Public Health Nursing
Dorothea Iannuzzi, Patricia Rissmiller, Susan M Duty, Susan Feeney, Maura Sullivan, Carol Curtin
A mixed-methods randomized controlled trial pilot study evaluated an educational curriculum focused on the medical needs of transition-age youth (TAY) with autism (ASD) for family nurse practitioner students. Fourteen out of a cohort of 16 (87.5%) nursing students consented to participate in the study and were randomly assigned to either a waitlist control group (WLC) (n = 8) or an intervention group (INT) (n = 6). Three measures were used to determine pre- and post-intervention levels of self-efficacy, knowledge, and attitudes...
December 8, 2018: Journal of Autism and Developmental Disorders
Stephanie L Harrison, Monica Cations, Tiffany Jessop, Sarah N Hilmer, Mouna Sawan, Henry Brodaty
Psychotropic medications have a high risk of serious adverse events and small effect size for changed behaviours for people with dementia. Non-pharmacological approaches are recommended as first-line treatment for changed behaviours, yet psychotropic medications remain highly prevalent in long-term aged care settings. This narrative review describes the current evidence regarding deprescribing psychotropic medications for people with dementia in long-term care. Deprescribing psychotropic medications can be achieved without harm to the person with dementia, and most people experience no withdrawal symptoms...
December 11, 2018: Drugs & Aging
Mohammadali Akkafi, Haniye Sadat Sajadi, Zainab Sadat Sajadi, Edward Krupat
Understanding patient-physician relationships in mental care services is an indispensable element to improve the quality of mental care, yet little is known about it in Iran. This study measured the attitudes of the patients' family and personal caregivers (FPCs) and psychiatrists toward patient-centered care. A sample of 88 FPCs of mental patients and 29 psychiatrists in four teaching hospitals of Isfahan city, Iran, providing mental care, were asked to complete the patient-practitioner orientation scale (PPOS)...
December 10, 2018: Community Mental Health Journal
Amanda M Stylianou, Elisabeth Counselman-Carpenter, Alex Redcay
While social support is critical in helping intimate partner violence (IPV) survivors heal and build hope, social isolation is a frequent experience for survivors. For survivors residing in domestic violence (DV) emergency shelters, the isolation from social supports is often exacerbated by shelter rules and policies. This study uses a 20th century feminist framework to understand the ways in which social support networks are maintained and/or strained when survivors reside in DV emergency shelters. Among this sample of 76 survivors, 40 participants identified family members as their support system, with siblings and mothers most frequently identified, and 14 participants identified friends as their social support...
December 10, 2018: Journal of Interpersonal Violence
S Dhaked, N Sharma, K K Chopra, A Khanna, R Kumar
BACKGROUND: The treatment seeking pathways prior to initiation of Direct Observed Treatment Short-course Therapy (DOTS), provides the extent of patient and health system delays among pediatric tuberculosis (TB) patients. OBJECTIVES: The study attempted to understand the treatment seeking pathways of pediatric TB patients under revised national tuberculosis control program (RNTCP). STUDY DESIGN AND SETTING: It was a prospective observational study carried out from January 2015 to December 2015...
October 2018: Indian Journal of Tuberculosis
Christos Lazaridis
The goal of shared decision making in the neurocritical care setting is to form plans of care that are consistent with best medical practice and are respectful of the patient's values. Close cooperation and meaningful interaction must be achieved with family members so that the patient's "person can emerge" through discussions. This article highlights several caveats that can subvert this complex process, including the cognitive biases that affect both clinicians and surrogates. Impact, optimism, and gain-framing biases may be particularly relevant when considering patients who are receiving neurocritical care...
December 2018: Continuum: Lifelong Learning in Neurology
Tanya Halsall, Ian Manion, Joanna Henderson
Integrated youth service (IYS) is a collaborative approach that brings practitioners together from across disciplines to provide comprehensive services including mental health care for youth and their families. IYS models serve as an advancement in practice as they go beyond the capacity of individual programs and services to reduce the fragmentation of care. Yet, there continue to be opportunities to expand on this perspective and promote health beyond the scope of formalized services. The bioecological model is a theoretical model that examines individual development within multiple systems of influence as well as through interactional processes between the individual and their environment...
November 30, 2018: International Journal of Integrated Care
Andrée-Anne Paré-Plante, Antoine Boivin, Djamal Berbiche, Mylaine Breton, Maryse Guay
BACKGROUND: First-contact accessibility remains an important problem in Canada, with this indicator staying the worst of all Organization for Economic Co-operation and Development countries. In the province of Quebec, a number of primary healthcare (PHC) organizations have adopted measures to improve access (e.g. advance access scheduling, expanded nursing role, electronic medical record, financial incentives). The impact of those changes is unknown. The goal of this study is to assess which PHC organizations' characteristics are associated with improved first-contact accessibility...
December 3, 2018: BMC Family Practice
Patricia Kelly, Heather J Gotham, Sarah Knopf-Amelung, Kendall Kohnle, Araba Kuofie
BACKGROUND: Although the individual and public health consequences of alcohol and drug use are substantial, nursing education programs generally lack content on addiction. The goal of this evaluation was to compare the initial outcomes of on-site versus distance methods for training graduate nurse practitioner students in Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use. METHOD: A nonrandomized two-group pretest-posttest design was used to compare knowledge, attitudes, and skills learning outcomes between on-site (n = 45) and distance (n = 18) family or adult/geriatric Master of Science in Nursing nurse practitioner students receiving SBIRT training...
October 2018: Journal of Addictions Nursing
Hanne Birgit Alfheim, Milada Cvancarova Småstuen, Kristin Hofsø, Kirsti Tøien, Leiv Arne Rosseland, Tone Rustøen
BACKGROUND: Family caregivers of patients in the intensive care unit (ICU) experience impairments in the quality of life. Previous studies report that psychological quality of life improves over time, but there has been limited longitudinal research, and measurement points have differed. Factors such as age, gender, and posttraumatic stress symptoms have been found to be associated with the quality of life, but level of hope and its associations with the quality of life have not been investigated...
November 29, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Lena Aadal, Hanne Pallesen, Cathrine Arntzen, Siri Moe
Aim: To explore and compare the content of rehabilitation practices in, respectively, a Danish and a Norwegian region, focusing on how the citizens' rehabilitation needs are met during rehabilitation in the municipalities. Method: Six Danish and five Norwegian cases were followed 12 months after the onset of stroke. Field work and focus group interviews with multidisciplinary teams in the municipalities were conducted. The conceptual frame of the International Classification of Functioning was used to outline general patterns and local variation in the rehabilitation services...
2018: Rehabilitation Research and Practice
Thea Senger-Carpenter, Elizabeth A Doyle
Families may approach primary care providers for advice and treatment for tall stature (height more than two standard deviations above the mean height for a given age) in pre-pubertal children. The following case report describes an 11-year-old girl who was referred to an endocrinology specialist for familial tall stature. Potential pathological causes for tall stature are reviewed. The assessment, management, and risks and benefits of treatment for this condition are described. Finally, the role of the pediatric nurse practitioner in caring for youth with this chief complaint is discussed...
November 26, 2018: Journal of Pediatric Health Care
Mette Sagbakken, Ragnhild Storstein Spilker, T Rune Nielsen
BACKGROUND: Along with the ageing of the general population, Europe's migrant populations are also ageing, thus posing new challenges for dementia care services, particularly if the services are to be adjusted to persons with different linguistic and cultural backgrounds. From the perspective of health professionals, this study aims to explore challenges involved in identifying, assessing and diagnosing people with cognitive impairment/dementia who have different linguistic and cultural backgrounds...
November 29, 2018: BMC Health Services Research
Toshichika Mitsuyama, Daisuke Son, Masato Eto
BACKGROUND: The medical practice of general practitioners/family physicians in urban areas differs from that in rural areas, accounting for the difference in specific competencies. However, variations in competencies in community healthcare required for general practitioners/family physicians in urban areas compared with those in rural areas have not yet been fully clarified. Thus, this study aimed to elucidate the competencies required for general practitioners/family physicians, especially in those characteristic to urban areas, and compare them with those in non-urban/rural areas...
November 29, 2018: BMC Family Practice
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