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https://www.readbyqxmd.com/read/28930820/gatekeeping-and-the-utilization-of-community-health-services-in-shenzhen-china-a-cross-sectional-study
#1
Wenzhen Li, Yong Gan, Xiaoxin Dong, Yanfeng Zhou, Shiyi Cao, Naomiem Kkandawire, Yingjie Cong, Huilian Sun, Zuxun Lu
To assess the effects of the gatekeeper policy implemented in Shenzhen, China, in conjunction with a labor health insurance program, on channeling patients toward community health centers (CHCs).Eight thousand patients who visited 8 CHCs in Shenzhen were surveyed between May 1, 2013 and July 28, 2013. Half of the patients were subject to gatekeeper policy and the other half of them were not. Structured questionnaire was used to collect patients' choices of initial medical institution, use of CHCs and their satisfaction with health care...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930792/laser-treatment-of-professional-tattoos-with-a-1064-532-nm-dual-wavelength-picosecond-laser
#2
Arielle N B Kauvar, Terrence C Keaney, Tina Alster
BACKGROUND: Picosecond-domain laser pulses improve the photomechanical disruption of tattoos. OBJECTIVE: This study evaluates the efficacy and safety of a novel, dual-wavelength, 1,064/532-nm, picosecond-domain laser for tattoo clearance. MATERIALS AND METHODS: This was a prospective, self-controlled, clinical study of 34 subjects with 39 tattoos treated at 2 sites with an interval of 4.8 ± 1.6 weeks and up to 10 treatments (mean, 7.5). Blinded evaluation and investigator assessment of serial digital images was performed to evaluate treatment efficacy in the 36 tattoos that received at least 3 treatments...
September 19, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28930788/observation-of-dog-ear-regression-by-anatomical-location
#3
Thomas A Jennings, James C Keane, Rajat Varma, Stephanie B Walsh, Conway C Huang
BACKGROUND: When an excision is performed by a method other than elliptical excision, direct primary wound closure can result in standing cones or "dog-ears." In 2008, Lee and colleagues noted that dog-ears of <8 mm in height have a statistically greater tendency to resolve without further surgical correction than larger dog-ears. OBJECTIVE: To stratify dog-ears by anatomic location and inform on the need for correction at the time of surgery. MATERIALS AND METHODS: After tumor extirpation, patients were counseled that primary closure of the surgical wound would result in dog-ears at the wound apices...
September 19, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28929939/the-development-of-the-professional-values-model-in-nursing
#4
Ayla Kaya, İlkay Boz
One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28929892/exploration-of-a-new-model-of-care-in-a-psychiatry-unit
#5
R Zacharias, S Belcher, M Rodway-Norman, D Guller, A Chawla, P Hough, W G Smith
The model established at Orillia Soldiers Memorial Hospital involves family physicians as the most responsible physician. They act as "admission gatekeeper" for all unattached patients who are admitted to the psychiatry in-patient unit. A PubMed, EBSCO, OVID Medline, Embase, CINAHL, and Web of Science database review of the last 10 years (2006-2016) was undertaken. A satisfaction survey was undertaken. An intensive literature review found this model to be unique. The model has proved to be extremely efficient and cost-effective...
March 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929794/primary-care-group-visits-for-childhood-obesity-clinical-program-evaluation
#6
Clement J Bottino, Gabriella C Puente, Amanda Burrage, Candace Tannis, Jennifer K Cheng, Alexandra Epee-Bounya, Joanne E Cox
We conducted 29 group visits targeting children with elevated body mass index (BMI) and their families. Visit activities focused on social support, mind-body techniques, exercise, and nutrition. Measures included attendance, family satisfaction scores, and per-patient change in BMI percentile. Ninety-six patients attended ≥1 group visit, mean 2.0 (SD ±1.8; range 1-14). Mean patient age was 9.6 years (SD ±2.4; range 4-15 years); 53.1% were female; 44.8% had a BMI 95th to 99th percentile for age/sex; 35.4% had a BMI >99th percentile...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28929299/the-t-plasty-as-therapy-for-recurrent-bladder-neck-stenosis-success-rate-functional-outcome-and-patient-satisfaction
#7
Clemens M Rosenbaum, Roland Dahlem, Valentin Maurer, Luis A Kluth, Malte W Vetterlein, Margit Fisch, Victor Schuettfort, C Philip Reiss
PURPOSE: To determine success rate (SR), functional outcome, and patient satisfaction of a modified YV-plasty for reconstruction of the bladder neck in case of recurrent bladder neck stenosis (BNS) after transurethral surgery of the prostate: the T-plasty. PATIENTS AND METHODS: We identified all patients who underwent T-plasty at our center between December 2008 and July 2016. Patients' charts were reviewed. Patients were queried by telephone and by mail at time of follow-up (FU)...
September 19, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28929198/-substance-abuse-detection-in-substitution-therapy-oral-fluid-versus-urine-screening
#8
Johannes Stein, Max Geraedts
BACKGROUND: A patient's health in an opioid maintenance program is potentially endangered due to concurrent consumption of drugs. Therefore, the German Medical Association requests evidence of compliant substitute intake while type and frequency of drug screening is chosen by the physician. This study comparatively assessed the feasibility and potential advantage of oral fluid drug testing versus urine screening in day-to-day practice. METHODS: Urine and oral fluid-samples of a randomly chosen third of a total of 361 patients, treated in four different practices in a major German city, were tested...
September 19, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28929073/septorhinoplasty-our-experience
#9
Jaimanti Bakshi, Sourabha K Patro
Rhinoplasty is one of the oldest known surgeries to the human kind. However, being a cosmetic of surgery of utmost importance, it has been an attractive and fascinating surgery for the otolaryngologists and plastic surgeons. Along with the evolution of improved techniques and better surgical modalities, this surgery has been growing in panorama including its indications, needs and techniques. We present our experience with rhinoplasty in a tertiary care center of north India. We have included all cases operated with septorhinoplasty from 2001 to 2014 by the senior author in the manuscript...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28929023/a-dark-past-a-restrained-present-and-an-apocalyptic-future-time-perspective-personality-and-life-satisfaction-among-anorexia-nervosa-patients
#10
Danilo Garcia, Alexandre Granjard, Suzanna Lundblad, Trevor Archer
BACKGROUND: Despite reporting low levels of well-being, anorexia nervosa patients express temperament traits (e.g., extraversion and persistence) necessary for high levels of life satisfaction. Nevertheless, among individuals without eating disorders, a balanced organization of the flow of time, influences life satisfaction beyond temperamental dispositions. A balanced time perspective is defined as: high past positive, low past negative, high present hedonistic, low present fatalistic, and high future...
2017: PeerJ
https://www.readbyqxmd.com/read/28928789/the-long-term-course-of-outcomes-for-lumbar-intervertebral-disc-herniation-following-integrated-complementary-and-alternative-medicine-inpatient-treatment-a-prospective-observational-study
#11
Moon-Hwi Kim, Yoon Jae Lee, Joon-Shik Shin, Jinho Lee, Haechan Jeong, Me-Riong Kim, Sam-Min Park, Ung Go, Sung-Moon Kim, Jae-Yeong Kim, Dong-Gyu Hwang, In-Hyuk Ha
A prospective observational study was conducted in 524 lumbar intervertebral disc herniation (LDH) inpatients to report the long-term effects of complementary and alternative medicine (CAM) treatment. Participants received integrative CAM treatment during hospitalization, from June 2012 to May 2013, and long-term outcomes were assessed from July to August 2016. Numerical rating scales (NRSs) of back and leg pain, the Oswestry disability index (ODI), satisfaction, surgery, recurrence, and current care status were investigated...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28928771/an-analysis-of-patient-perceptions-and-expectations-to-dental-implants-is-there-a-significant-effect-on-long-term-satisfaction-levels
#12
Shane J J McCrea
Here we present an analysis of patient perceptions and expectations to dental implant placement and their prosthetic reconstruction, to then consider whether they have an effect on long-term satisfaction levels. A Post-Treatment Completion Questionnaire was designed to analyse whether patient satisfaction is influenced by age and/or gender; has an effect on patient-reported self-confidence levels; contributes to increased levels of oral hygiene; provides further insight into the average pain levels during and after the surgical intervention; or influences further acceptance of dental implant surgery...
2017: International Journal of Dentistry
https://www.readbyqxmd.com/read/28928585/postoperative-analgesic-efficacy-of-bilateral-transversus-abdominis-plane-block-in-patients-undergoing-midline-colorectal-surgeries-using-ropivacaine-a-randomized-double-blind-placebo-controlled-trial
#13
Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool
BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine. MATERIALS AND METHODS: Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928578/comparison-of-spinal-anesthesia-and-paravertebral-block-in-inguinal-hernia-repair
#14
Ranjana Khetarpal, Veena Chatrath, Arminder Kaur, Reeta Jassi, Renu Verma
CONTEXT: Inguinal hernia repair (IHR) is a common surgical procedure which can be performed under general, regional, or peripheral nerve block anesthesia. AIM: The aim of our study was to compare the efficacy of paravertebral block (PVB) with spinal anesthesia (SA) for IHR with respect to postoperative analgesia, ambulation, and adverse effects. SETTINGS AND DESIGN: This was a prospective, single-blind randomized controlled trial. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists Class I-II patients of 20-60 years scheduled for IHR were randomized by a computer-generated list into two groups of thirty each, to receive either PVB (Group PVB: at T12-L2 levels, 10 ml of 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928577/a-prospective-observational-study-to-evaluate-the-role-of-gabapentin-as-preventive-analgesic-in-thyroidectomy-under-general-anesthesia
#15
Vadakkoot Raghavan Hema, Konnanath Thekkethil Ramadas, Kannammadathy Poulose Biji, Suseela Indu, Aravind Arun
BACKGROUND: Effective management of postoperative pain is a part of well-organized perioperative care, which helps in reduced morbidity and improved patient satisfaction. Preventive analgesia can reduce acute and chronic pain by blocking the noxious inputs to pain pathways, preventing sensitization. Studies have reported efficacy of gabapentin as a preventive analgesic in perioperative pain. In this study, we aimed to determine whether preoperative gabapentin reduced postoperative pain and tramadol consumption after thyroidectomy under general anesthesia...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928565/clonidine-as-an-adjuvant-to-lignocaine-infiltration-for-prolongation-of-analgesia-after-episiotomy
#16
Upasna Bhatia, Premal Soni, Udit Khilji, Yamini N Trivedi
BACKGROUND: Epidural labor analgesia has not been fully accepted despite many advantages. Many times, the pregnant females reach hospital without antenatal checkup, and at that time, "episiotomy infiltration" becomes an ideal method for vaginal delivery. One of the most important problems after episiotomy is the severe perineal pain on the 1(st) day of postpartum period. OBJECTIVES: We compared the efficacy of clonidine 1 μg/kg as an adjuvant to 20 mg/ml lignocaine infiltration along the line of episiotomy incision for prolonging the duration and quality of analgesia with respect to various activities by single injection...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928325/transversus-abdominis-plane-block-for-pain-relief-in-patients-undergoing-in-endoscopic-repair-of-abdominal-wall-hernia-a-comparative-randomised-double-blind-prospective-study
#17
Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Pradeep Chowbey
INTRODUCTION: Transversus abdominis plane (TAP) block is now a well-established technique in post-operative analgesia for lower abdominal surgeries. We evaluated the effect of ultrasound-guided TAP block on recovery parameters in patients undergoing endoscopic repair of abdominal wall hernia. METHODS: Thirty adults were randomised to receive either ropivacaine with dexmedetomidine (TR) or saline (TP) in TAP block, before emergence from anaesthesia. The patients were assessed for pain relief, sedation, time to ambulate (TA), discharge readiness (DR), postoperative opioid requirement and any adverse events...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28928192/a-pragmatic-group-sequential-placebo-controlled-randomised-trial-to-determine-the-effectiveness-of-glyceryl-trinitrate-for-retained-placenta-got-it-a-study-protocol
#18
Fiona C Denison, John Norrie, Julia Lawton, Jane E Norman, Graham Scotland, Gladys C McPherson, Alison McDonald, Mark Forrest, Jemma Hudson, Jane Brewin, Mathilde Peace, Cynthia Clarkson, Sheonagh Brook-Smith, Susan Morrow, Nina Hallowell, Laura Hodges, Kathryn F Carruthers
INTRODUCTION: A retained placenta is diagnosed when the placenta is not delivered following delivery of the baby. It is a major cause of postpartum haemorrhage and treated by the operative procedure of manual removal of placenta (MROP). METHODS AND ANALYSIS: The aim of this pragmatic, randomised, placebo-controlled, double-blind UK-wide trial, with an internal pilot and nested qualitative research to adjust strategies to refine delivery of the main trial, is to determine whether sublingual glyceryl trinitrate (GTN) is (or is not) clinically and cost-effective for (medical) management of retained placenta...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28928100/effects-of-alfentanil-or-fentanyl-added-to-propofol-for-sedation-in-colonoscopy-on-cognitive-functions-randomized-controlled-trial
#19
Güler Doğanay, Perihan Ekmekçi, Baturay Kansu Kazbek, Hakan Yılmaz, Gülbanu Erkan, Filiz Tüzüner
BACKGROUND/AIMS: To assess the effect of propofol supplemented with alfentanil or fentanyl on cognitive functions for sedation during elective colonoscopy. MATERIALS AND METHODS: Patients (n=150, 18-65 years old, American Society of Anesthesiologists risk group I-III) scheduled undergo elective colonoscopy were included. They were randomized into three groups using the closed envelope methodpropofol-alfentanil (Group A), propofol-fentanyl (Group F), and propofol only (Group P)...
September 19, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28928097/tooth-colour-and-whiteness-a-review
#20
Andrew Joiner, Wen Luo
OBJECTIVES: To review current knowledge concerning the application of colour science on tooth colour and whiteness description, measurement, distribution and its psychological impact. DATA SOURCES: "Scopus" databases were searched electronically with the principal keywords tooth, teeth, colour, white, whiteness. Language was restricted to English and original studies and reviews were included. Conference papers and abstracts were excluded. CONCLUSIONS: The appearance and colour of teeth is a common concern for patients across many populations and is associated with an increased desire for treatments that improve dental aesthetics, including tooth whitening...
September 16, 2017: Journal of Dentistry
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