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Emergency care practitioner

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https://www.readbyqxmd.com/read/28334728/does-emergency-presentation-of-cancer-represent-poor-performance-in-primary-care-insights-from-a-novel-analysis-of-linked-primary-and-secondary-care-data
#1
Peter Murchie, Sarah M Smith, Michael S Yule, Rosalind Adam, Melanie E Turner, Amanda J Lee, Shona Fielding
BACKGROUND: People diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand. METHODS: Analysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation...
March 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28332223/change-management-in-an-environment-of-ongoing-primary-health-care-system-reform-a-case-study-of-australian-primary-health-care-services
#2
Sara Javanparast, Janny Maddern, Fran Baum, Toby Freeman, Angela Lawless, Ronald Labonté, David Sanders
INTRODUCTION/BACKGROUND: Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers...
March 22, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28329800/characterizing-readiness-for-advance-care-planning-from-the-perspective-of-residents-families-and-clinicians-an-interpretive-descriptive-study-in-supportive-living
#3
Marta Shaw, Jennifer Hewson, David B Hogan, Shelley Raffin Bouchal, Jessica Simon
Background and Objectives: Advance care planning (ACP) involves reflection on health care preferences and communication of the person's wishes in case of future incapacity. ACP is particularly pertinent in supportive living (SL) as residents are at high risk of cognitive decline and changes in health status, but the readiness of residents, families, and health care practitioners to engage in ACP discussions is not known. The purpose of this study was to explore the readiness among these stakeholders and the factors that influence the degree of readiness...
February 18, 2017: Gerontologist
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#4
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28325535/age-is-just-a-number-wpath-affiliated-surgeons-experiences-and-attitudes-toward-vaginoplasty-in-transgender-females-under-18-years-of-age-in-the-united-states
#5
Christine Milrod, Dan H Karasic
BACKGROUND: A rising number of female-affirmed transgender adolescents are being treated with gonadotropin-releasing hormone analogues and subsequently cross-sex hormones at early or mid-puberty, with vaginoplasty as the presumed final step in their physical transition. But, despite the minimum age of 18 years defining eligibility to undergo this irreversible procedure, anecdotal reports have shown that vaginoplasties are being performed on minors by surgeons in the United States, thereby contravening the World Professional Association for Transgender Health (WPATH) standards of care (SOC)...
March 16, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28320586/patients-experience-in-the-early-recovery-phase-after-removal-of-intraoral-squamous-cell-carcinoma-with-carbon-dioxide-laser
#6
M Gilmartin, T Ali, S N Rogers
Laser excision of oral cancer is well established. The aim of this cross-sectional survey was to ask patients about their main symptoms and the severity of them during the first postoperative weeks. We devised a short questionnaire in collaboration with patients, and did a cross-sectional survey of 50 consecutive patients who had laser excision of T1 and T2 oral cancers over a two-year period. The response rate was 76% (38/50). Twenty patients reported that eating was "quite a bit" or "very much of a problem" and 13 reported similar for pain...
March 17, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28314493/beyond-visas-and-vaccines-preparing-students-for-domestic-and-global-health-engagement
#7
EDITORIAL
Lisa V Adams, Anne N Sosin
At campuses across the United States, scores of students are embarking on global health experiences in low- and middle-income countries. The desire to improve the health of poor communities while preparing for future health careers is often the main driver. The spotlight on domestic health issues also has fueled a resurgence of interest in underserved communities in the United States. Regardless of the destination, rigorous preparation is needed to ensure that the students' presence benefits the communities they aim to serve...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28303563/general-practitioners-and-preconception-weight-management-in-new-zealand
#8
Diana Fieldwick, Alesha Smith, Helen Paterson
BACKGROUND: Childhood obesity is a growing concern internationally and a top priority for the World Health Organization. Preconception overweight, obesity and excess gestational weight gain significantly increase childhood obesity risk. Optimising preconception weight is a key preventative measure toward reducing childhood obesity. In 2014, the New Zealand (NZ) Ministry of Health released guidance for health practitioners on healthy weight gain in pregnancy in an effort to reduce the burden of childhood obesity...
March 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#9
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28300480/impossible-decision-an-investigation-of-risk-trade-offs-in-the-intensive-care-unit
#10
Tom W Reader, Geetha Reddy, Stephen J Brett
In the intensive care unit (ICU), clinicians must often make risk trade-offs on patient care. For example, on deciding whether to discharge a patient before they have fully recovered in order to create a bed for another, sicker, patient. When misjudged, these decisions can negatively influence patient outcomes: yet it can be difficult, if not impossible, for clinicians to evaluate with certainty the safest course of action. Using a vignette-based interview methodology, a naturalistic decision-making approach was utilised to study this phenomena...
March 16, 2017: Ergonomics
https://www.readbyqxmd.com/read/28296158/perception-of-simulation-training-in-emergencies-for-dental-sedation-practitioners
#11
Andrew Hadfield, Shelagh Thompson, Judith Hall, Cristina Diaz-Navarro
BACKGROUND: Simulation education is an important part of health care education and training. There is growing evidence to support the usefulness of simulation, especially in training for infrequently occurring situations, such as medical emergencies seen by dental practitioners. There are, however, few data on the longer term effects of simulation, including usefulness, relevance, emotional effect and ability to affect changes to daily practice. METHODS: Dentists and dental nurses who had undergone simulation training in medical emergencies for dental sedation practitioners undertook a semi-structured interview about their perception of the simulation experience...
March 14, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28294443/health-service-utilisation-attributable-to-methamphetamine-use-in-australia-patterns-predictors-and-national-impact
#12
Rebecca McKetin, Louisa Degenhardt, Marian Shanahan, Amanda L Baker, Nicole K Lee, Dan I Lubman
AIM AND BACKGROUND: We estimated health service utilisation attributable to methamphetamine use, its national impact and examined other predictors of health service utilisation among dependent methamphetamine users. METHOD: Past year rates of health service utilisation (number of attendances for general hospitals, psychiatric hospitals, emergency departments, general practitioners, psychiatrists, counsellors or psychologists, and dentists) were estimated for three levels of methamphetamine use (no use, < weekly, ≥ weekly) using panel data from a longitudinal cohort of 484 dependent methamphetamine users from Sydney and Brisbane, Australia...
March 12, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28289851/withdrawal-of-artificial-nutrition-and-hydration-in-neonatal-intensive-care-parents-and-healthcare-practitioners-views
#13
Véronique Fournier, Elisabeth Belghiti, Laurence Brunet, Marta Spranzi
Withdrawing Artificial Nutrition and Hydration (WANH) in the neonatal intensive care units (NICUs) has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders' experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals (HCP) perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 different clinical neonatology departments...
March 13, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28288649/medical-termination-of-pregnancy-in-general-practice-in-australia-a-descriptive-interpretive-qualitative-study
#14
Angela J Dawson, Rachel Nicolls, Deborah Bateson, Anna Doab, Jane Estoesta, Ann Brassil, Elizabeth A Sullivan
BACKGROUND: Australian Government approval in 2012 for the use of mifepristone and misoprostol for medical termination of pregnancy (MTOP) allows general practitioners (GPs) to provide early gestation abortion in primary care settings. However, uptake of the MTOP provision by GPs appears to be low and the reasons for this have been unclear. This study investigated the provision of and referral for MTOP by GPs. METHODS: We undertook descriptive-interpretive qualitative research and selected participants for diversity using a matrix...
March 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28283046/recommendations-from-the-european-working-group-for-value-assessment-and-funding-processes-in-rare-diseases-orph-val
#15
Lieven Annemans, Ségolène Aymé, Yann Le Cam, Karen Facey, Penilla Gunther, Elena Nicod, Michele Reni, Jean-Louis Roux, Michael Schlander, David Taylor, Carlo Tomino, Josep Torrent-Farnell, Sheela Upadhyaya, Adam Hutchings, Lugdivine Le Dez
Rare diseases are an important public health issue with high unmet need. The introduction of the EU Regulation on orphan medicinal products (OMP) has been successful in stimulating investment in the research and development of OMPs. Despite this advancement, patients do not have universal access to these new medicines. There are many factors that affect OMP uptake, but one of the most important is the difficulty of making pricing and reimbursement (P&R) decisions in rare diseases. Until now, there has been little consensus on the most appropriate assessment criteria, perspective or appraisal process...
March 10, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28277057/reasons-for-attending-a-general-emergency-outpatient-clinic-versus-a-regular-general-practitioner-a-survey-among-immigrant-and-native-walk-in-patients-in-oslo-norway
#16
Sven Eirik Ruud, Per Hjortdahl, Bård Natvig
OBJECTIVE: To explore reasons for attending a general emergency outpatient clinic versus a regular general practitioner (RGP). DESIGN: Cross-sectional study using a multilingual anonymous questionnaire. SETTING: Native and immigrant walk-in patients attending a general emergency outpatient clinic in Oslo (Monday-Friday, 08:00-23:00) during 2 weeks in September 2009. SUBJECTS: We included 1022 walk-in patients: 565 native Norwegians (55%) and 457 immigrants (45%)...
March 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28274237/comparison-of-two-european-paediatric-emergency-departments-does-primary-care-organisation-influence-emergency-attendance
#17
F Poropat, P Heinz, E Barbi, A Ventura
BACKROUND: To compare paediatric Emergency Department (ED) attendances and admission outcomes in two European hospitals with different paediatric primary care set-up. METHODS: This is a retrospective prevalence study comparing all paediatric ED attendances during calendar years 2013 in two EDs with similar catchment area: one in Italy (Trieste) where paediatric primary care is provided by office paediatricians, the other, in the UK (Cambridge), where paediatric primary care is provided by general practitioners...
March 8, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28274216/primary-care-physicians-educational-needs-and-learning-preferences-in-end-of-life-care-a-focus-group-study-in-the-uk
#18
Lucy Ellen Selman, Lisa Jane Brighton, Vicky Robinson, Rob George, Shaheen A Khan, Rachel Burman, Jonathan Koffman
BACKGROUND: Primary care physicians (General Practitioners (GPs)) play a pivotal role in providing end of life care (EoLC). However, many lack confidence in this area, and the quality of EoLC by GPs can be problematic. Evidence regarding educational needs, learning preferences and the acceptability of evaluation methods is needed to inform the development and testing of EoLC education. This study therefore aimed to explore GPs' EoLC educational needs and preferences for learning and evaluation...
March 9, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28274125/training-generalist-doctors-for-rural-practice-in-new-zealand
#19
Garry Nixon, Katharina Blattner, Martyn Williamson, Patrick McHugh, James Reid
Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28274015/anaphylaxis-complicated-by-acute-respiratory-distress-and-fatal-outcome-in-a-nigerian-family
#20
Efeturi Agelebe, Tawakalit Lily Musa, Idowu Adebowale Ajayi, Olusola Adetunji Oyedeji
Reports on hypersensitivity diseases in Nigerians are rare. We report the incidence of anaphylaxis in three siblings following fatal outcome in their mother. Urticarial rashes were noticed in three siblings' resident in a South Western Nigerian town, one week before presentation at our facility. All the three siblings developed respiratory distress four days after the rash was noticed. Onset of respiratory distress made the family seek care at a private hospital, where they were admitted and treated with intravenous aminophylline and ceftriaxone...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
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