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https://www.readbyqxmd.com/read/28076579/factors-that-influence-career-choice-in-primary-care-among-medical-students-starting-social-service-in-honduras
#1
E Benjamín Puertas, Tamara Y Rivera
Objective: To 1) describe patterns of specialty choice; 2) investigate relationships between career selection and selected demographic indicators; and 3) identify salary perception, factors that influence career choice in primary care, and factors that influence desired location of future medical practice. Methods: The study used a mixed-methods approach that included a cross-sectional questionnaire survey applied to 234 last-year medical students in Honduras (September 2014), and semi-structured interviews with eight key informants (October 2014)...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28074564/sustaining-sbirt-in-the-wild-simulating-revenues-and-costs-for-screening-brief-intervention-and-referral-to-treatment-programs
#2
Alexander J Cowell, William N Dowd, Michael J Mills, Jesse M Hinde, Jeremy W Bray
AIMS: To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. DESIGN: A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. SETTING: Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists...
February 2017: Addiction
https://www.readbyqxmd.com/read/28074563/a-time-and-motion-study-of-screening-brief-intervention-and-referral-to-treatment-implementation-in-health-care-settings
#3
Alexander J Cowell, William N Dowd, Justin Landwehr, Carolina Barbosa, Jeremy W Bray
AIMS: Screening and brief intervention for harmful substance use in medical settings is being promoted heavily in the United States. To justify service provision fiscally, the field needs accurate estimates of the number and type of staff required to provide services, and thus the time taken to perform activities used to deliver services. This study analyzed the time spent in activities for the component services of the substance misuse Screening, Brief Intervention and Referral to Treatment (SBIRT) program implemented in emergency departments, in-patient units and ambulatory clinics...
February 2017: Addiction
https://www.readbyqxmd.com/read/28065204/risk-factors-for-pertussis-in-adults-and-teenagers-in-england
#4
A Wensley, G J Hughes, H Campbell, G Amirthalingam, N Andrews, N Young, L Coole
Pertussis is a vaccine-preventable respiratory infection caused by Bordetella pertussis which can be fatal in infants. Although high vaccine coverage led to prolonged disease control in England, a national outbreak of pertussis in 2011 led to the largest increase in over two decades, including a marked increase in cases aged ⩾15 years. A case-control study in four regions of England was undertaken to investigate risk factors for pertussis in adolescents and adults, specifically employment type and professional and household contact with children...
January 9, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28064011/is-it-time-to-talk-understanding-specialty-child-mental-healthcare-providers-decisions-to-engage-in-interdisciplinary-communication-with-pediatricians
#5
Michael Reiss, Carolyn A Greene, Julian D Ford
Communication between pediatric mental health and primary care providers is often inconsistent and frequently rated as unsatisfactory by providers of both disciplines. While numerous studies report pediatricians' desire for increased feedback from mental health providers, less is known about mental health providers' perspectives on collaborative communication with pediatricians. In the current qualitative study, 9 practitioners at 2 mental health practices participated in interviews about their experiences related to collaborating and communicating with pediatric providers...
December 27, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/28060178/assessment-of-splints-applied-for-pediatric-fractures-in-an-emergency-department-urgent-care-environment
#6
Joshua M Abzug, Brandon S Schwartz, Aaron J Johnson
BACKGROUND: Fractures are common in the pediatric population. The initial evaluation is rarely by an orthopaedic surgeon, but commonly an emergency room or urgent care center physician/extender. This typically involves splint application by a nonorthopaedist to immobilize the extremity and provide stabilization. Iatrogenic injuries from inappropriate splint placement are a potential public health and legal concern that can lead to complications. The primary purpose of this study was to prospectively evaluate the adequacy of all splints placed on patients who presented to a pediatric orthopaedic office; secondary outcomes included assessing prevalence and types of complications that were associated with inadequate splints...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28050709/experiences-with-the-survivorship-care-plan-in-primary-care-providers-of-childhood-cancer-survivors-a-mixed-methods-approach
#7
Neel S Iyer, Hannah-Rose Mitchell, Daniel J Zheng, Wilhelmenia L Ross, Nina S Kadan-Lottick
PURPOSE: Focusing on primary care providers (PCPs) of known childhood cancer survivors, we used a mixed methods approach to understand providers' experiences with the survivorship care plan (SCP), as well as preferences and barriers regarding survivorship care. METHODS: The SCP was sent to 202 eligible PCPs of patients attending a regional survivorship clinic. The PCPs then completed quantitative postal surveys. Sixteen PCPs underwent an additional qualitative interview...
January 3, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28049470/quality-indicators-for-the-referral-process-from-primary-to-specialised-mental-health-care-an-explorative-study-in-accordance-with-the-rand-appropriateness-method
#8
Miriam Hartveit, Kris Vanhaecht, Olav Thorsen, Eva Biringer, Kjell Haug, Aslak Aslaksen
BACKGROUND: Communication between involved parties is essential to ensure coordinated and safe health care delivery. However, existing literature reveals that the information relayed in the referral process is seen as insufficient by the receivers. It is unknown how this insufficiency affects the quality of care, and valid performance measures to explore it are lacking. The aim of the present study was to develop quality indicators to detect the impact that the quality of referral letters from primary care to specialised mental health care has on the quality of mental health services...
January 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28033136/permissive-hypotension-and-trauma-can-fluid-restriction-reduce-the-incidence-of-ards
#9
Melissa Kolarik, Eric Roberts
Emergency care, including the resuscitation of patients involved in traumatic events, has evolved over the years. A prior practice of utilizing large volumes of crystalloids has been found to contribute to complications such as coagulopathy, fluid overload, and adult respiratory distress syndrome (ARDS). In contrast, permissive hypotension is a method of fluid restriction that allows for low blood pressure and mean arterial pressure during the resuscitation period. When permissive hypotension occurs and fluids are restricted in trauma patients, the incidence of ARDS can be reduced significantly with improvement in patient outcomes...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28032432/perception-of-prognosis-of-cancer-patients-by-non-oncologists
#10
Hadar Goldvaser, Yonatan Milman, Tal Dujovni, Anat Stern, Muhamad Mahamid, Ekaterina Hanovich, Amir Zivony, Tzippy Shochat, Rinat Yerushalmi, Anat Gafter-Gvili, Baruch Brenner, Daniel Shepshelovich
BACKGROUND: Data are lacking regarding the perception of cancer patients' prognosis by physicians who are not oncologists. METHODS: This was a multicenter survey of seven university-affiliated hospitals, assessing physicians' perception of the median survival of patients with seven advanced malignancies. The study cohort included physicians from all 73 internal medicine, surgery, emergency medicine and critical care departments in the participating hospitals. Family practitioners were contacted through email...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28025845/managing-support-for-newly-qualified-practitioners-lessons-learnt-from-one-health-care-region-in-the-uk
#11
Julie Scholes, Nicola J Petty, Tania McIntosh, Anita Green, Mirika Flegg
AIM: The study mapped the support provided for newly qualified practitioners across Kent, Surrey and Sussex. BACKGROUND: Newly qualified practitioners require support and guidance to facilitate their transition from student to their new role as qualified practitioner. Professional bodies advocate that programmes be provided but the type and intensity of that support is variable. METHODS: Telephone interviews were conducted with 24 people delivering support for newly qualified practitioners across professions in 13 different health care trusts...
December 26, 2016: Journal of Nursing Management
https://www.readbyqxmd.com/read/28017276/patient-journey-in-decompensated-heart-failure-an-analysis-in-departments-of-cardiology-and-geriatrics-in-the-greater-paris-university-hospitals
#12
Florent Laveau, Nadjib Hammoudi, Emmanuelle Berthelot, Joël Belmin, Patrick Assayag, Ariel Cohen, Thibaud Damy, Denis Duboc, Olivier Dubourg, Albert Hagege, Olivier Hanon, Richard Isnard, Guillaume Jondeau, Florian Labouree, Damien Logeart, Nicolas Mansencal, Christophe Meune, Eric Pautas, Yves Wolmark, Michel Komajda
BACKGROUND: Hospitalization for worsening/acute heart failure is increasing in France, and limited data are available on referral/discharge modalities. AIM: To evaluate patients' journeys before and after hospitalization for this condition. METHODS: On 1 day per week, between October 2014 and February 2015, this observational study enrolled 260 consecutive patients with acute/worsening heart failure in all 10 departments of cardiology and four of the departments of geriatrics in the Greater Paris University Hospitals...
December 21, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28012799/clinic-personnel-facilitator-and-parent-perspectives-of-ehealth-familias-unidas-in-primary-care
#13
Lourdes Molleda, Monica Bahamon, Sara M St George, Tatiana Perrino, Yannine Estrada, Deborah Correa Herrera, Hilda Pantin, Guillermo Prado
INTRODUCTION: The purpose of this qualitative study was to understand the feasibility and acceptability of implementing eHealth Familias Unidas, an Internet-based, family-based, preventive intervention for Hispanic adolescents, in primary care. METHODS: Semistructured individual interviews with clinic personnel and facilitators (i.e., physicians, nurse practitioners, administrators, and mental health workers; n = 9) and one focus group with parents (n = 6) were audiorecorded, transcribed verbatim, and analyzed using a general inductive approach...
December 21, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28010145/strategies-for-overcoming-challenges-for-decentralised-diagnostics-in-resource-limited-and-catastrophe-settings
#14
Shikha Sharma, Aoife Crawley, Richard O'Kennedy
Globally, both communicable and non-communicable diseases pose a serious threat to populations in developed as well as developing countries. Access to reliable diagnostic testing along with qualified health practitioners is severely limited in low resource and very remote areas and following natural catastrophes. Areas covered: This paper provides an overview of the challenges involved and suggests strategies to address them. The emergence of more robust, user-friendly, cost-effective and 'sample-to-result' point-of-care (POC) tools, along with the proliferation of mobile technologies, may provide a practical approach in addressing some of the challenges...
January 2, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28005173/diabetes-education-of-patients-and-their-entourage-out-of-hospital-national-study-educated-2
#15
Frédéric Lapostolle, Nadia Hamdi, Majed Barghout, Louis Soulat, Anna Faucher, Yves Lambert, Nicolas Peschanski, Agnès Ricard-Hibon, Carine Chassery, Maryline Roti, Vincent Bounes, Guillaume Debaty, Tarak Mokni, Gérald Egmann, Pierre-Arnaud Fort, Karim Boudenia, Laurent Alayrac, Mohamed Safraou, Michel Galinski, Frédéric Adnet
AIMS: To determine the contributing factors in the successful diabetes education of patients and their entourage. METHODS: Prospective observational study conducted in a pre-hospital setting by 17 emergency services across France (September 2009-January 2011) included all insulin-treated patients (≥18 years) provided that at least one family member was present on scene. Data were collected from patients and their entourage: (1) personal details including language proficiency and educational attainment, (2) treatments, (3) diabetes-related data (log sheets, glucose meter, glucagon, glycated hemoglobin, prior hypoglycemic episodes); (4) care by diabetologist, general practitioner and/or visiting nurse...
December 22, 2016: Acta Diabetologica
https://www.readbyqxmd.com/read/28000575/-national-developments-in-emergency-departments-in-the-netherlands-numbers-and-origins-of-patients-in-the-period-from-2012-to-2015
#16
M I Gaakeer, C L van den Brand, E Gips, J M van Lieshout, R Huijsman, R Veugelers, P Patka
OBJECTIVE: Gaining insight into key figures of emergency departments (EDs) in the Netherlands and developments in these figures. DESIGN: Longitudinal survey study. METHOD: Over the period from 2012 up to and including 2015, the following key data were surveyed: number of EDs, number of ED patients, ED patients' origin, number of hospital admissions from the ED and form of cooperation between ED and a general practitioner centre (GPC). RESULTS: An average of 96% of all EDs responded...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27998879/using-patient-flow-information-to-determine-risk-of-hospital-presentation-protocol-for-a-proof-of-concept-study
#17
Christopher M Pearce, Adam McLeod, Jon Patrick, Douglas Boyle, Marianne Shearer, Paula Eustace, Mary Catherine Pearce
BACKGROUND: Every day, patients are admitted to the hospital with conditions that could have been effectively managed in the primary care sector. These admissions are expensive and in many cases are possible to avoid if early intervention occurs. General practitioners are in the best position to identify those at risk of imminent hospital presentation and admission; however, it is not always possible for all the factors to be considered. A lack of shared information contributes significantly to the challenge of understanding a patient's full medical history...
December 20, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27998498/tb-management-by-private-practitioners-is-it-bad-everywhere
#18
P S Rakesh, Shibu Balakrishnan, S Jayasankar, R V Asokan
INTRODUCTION: Poor prescribing practice is alleged to be one of the major factors fuelling the drug-resistant tuberculosis (DR TB) emergence. A study in Mumbai revealed the extent of inappropriate tuberculosis (TB) management practices of private practitioners and discussed that with the context of high DR TB. Kerala is rated among the well performing States in India as far as TB control is concerned with evidences for a lower level of TB transmission and DR TB. The current study was done in Kerala State to assess the prescribing practices of private sector doctors in the treatment of TB...
October 2016: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/27998315/acute-abdominal-pain-caused-by-hematometra-in-an-adolescent-female-a-case-report
#19
Benjamin Chou, Jacqueline Ann Bohn, Robert Mairs
BACKGROUND: Hematometra is a pathologic collection of blood in the uterus. It is a rare condition that is most commonly associated with congenital anomalies or prior surgical procedures causing an obstruction of the genitourinary outflow tract. We present an unusual case of hematometra in a healthy and active adolescent female with no prior risk factors. This is a rare and important case report due to the complexity of diagnosis when a young female presents with an acute abdomen. In addition, for a patient who presents with no prior risk factors for hematometra, such as in our patient, the diagnosis and workup may become overly complicated, adding strain to patient care and health care cost...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27997577/spatial-accessibility-to-health-care-services-identifying-under-serviced-neighbourhoods-in-canadian-urban-areas
#20
Tayyab Ikram Shah, Scott Bell, Kathi Wilson
BACKGROUND: Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. METHODS: This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings...
2016: PloS One
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