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https://www.readbyqxmd.com/read/29052504/family-effects-on-the-rurality-of-gp-s-work-location-a-longitudinal-panel-study
#1
Matthew R McGrail, Deborah J Russell, Belinda G O'Sullivan
BACKGROUND: Reduced opportunities for children's schooling and spouse's/partner's employment are identified internationally as key barriers to general practitioners (GPs) working rurally. This paper aims to measure longitudinal associations between the rurality of GP work location and having (i) school-aged children and (ii) a spouse/partner in the workforce. METHODS: Participants included 4377 GPs responding to at least two consecutive annual surveys of the Medicine in Australia: Balancing Employment and Life (MABEL) national longitudinal study between 2008 and 2014...
October 19, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/29049425/comparison-of-internal-medicine-and-general-surgery-residents-assessments-of-risk-of-postsurgical-complications-in-surgically-complex-patients
#2
James M Healy, Kimberly A Davis, Kevin Y Pei
Importance: Anticipating postsurgical complications is a vital physician skill, particularly when counseling surgically complex patients on their risks of intervention. Although internists and surgeons both counsel patients on surgical risks, it is uncertain who is better equipped to accurately anticipate surgical complications. Objective: To examine how internal medicine and general surgery trainees compare in their assessment of risk of surgically complex patients...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049130/explanatory-versus-pragmatic-trials-an-essential-concept-in-study-design-and-interpretation
#3
Zamir Merali, Jefferson R Wilson
Randomized clinical trials often represent the highest level of clinical evidence available to evaluate the efficacy of an intervention in clinical medicine. Although the process of randomization serves to maximize internal validity, the external validity, or generalizability, of such studies depends on several factors determined at the design phase of the trial including eligibility criteria, study setting, and outcomes of interest. In general, explanatory trials are optimized to demonstrate the efficacy of an intervention in a highly selected patient group; however, findings from these studies may not be generalizable to the larger clinical problem...
November 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29047339/exploring-the-evidence-base-for-how-people-with-dementia-and-their-informal-carers-manage-their-medication-in-the-community-a-mixed-studies-review
#4
Lydia Aston, Andrea Hilton, Tiago Moutela, Rachel Shaw, Ian Maidment
BACKGROUND: Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. METHODS: A mixed studies review was conducted...
October 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29045622/international-exchanges-in-primary-care-learning-from-thy-neighbour
#5
Bernadeta Bridgwood, John Park, Claire Hawcroft, Natasha Kay, Eugene Tang
This systematic review describes how international exchange programmes in primary care have been received and evaluated. Electronic databases (MEDLINE, Embase, PsycINFO, EBM reviews, CAB abstracts and PubMED) were searched to identify articles where the main focus of the study was exchanges undertaken in primary care/family medicine until March 2016. Articles were included if they (i) discussed participant exchanges in primary care; (ii) presented associated outcome data-this included (a) individual/group experience of exchange; (b) mechanism of exchange and (c) observations during the exchange...
October 14, 2017: Family Practice
https://www.readbyqxmd.com/read/29043285/the-relationship-between-health-locus-of-control-and-health-behaviors-in-emergency-medicine-personnel
#6
Mansour Pourhoseinzadeh, Mahin Gheibizadeh, Mehrnaz Moradikalboland
BACKGROUND: Health locus of control defined as individual beliefs based on past experiences in health issues and having external or internal control over them, could affect health. Health locus of control plays a role in health behaviors. We aimed to investigate the relationship between health locus of control and health behavior in emergency medical personnel in Ahvaz during 2016. METHODS: This is a cross-sectional descriptive study, which began in August 2016 for a period of six months on 215 emergency medical personnel in Ahvaz who were selected randomly...
October 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/29042808/first-visit-patients-without-a-referral-to-the-department-of-internal-medicine-at-a-medium-sized-acute-care-hospital-in-japan-an-observational-study
#7
Nobuyuki Kajiwara, Kazuyuki Hayashi, Masahiro Misago, Shinichiro Murakami, Takato Ueoka
PURPOSE: We sought to profile first-time patients without a referral who sought medical care at the Department of Internal Medicine at a medium-sized acute care hospital in Japan. We anticipated that the analysis would highlight the demand for medical care needs from acute care hospitals and help confirm one of the problems associated with primary care in Japan. PATIENTS AND METHODS: The study population comprised 765 patients who sought outpatient consultation without a referral at "the Department of General Internal Medicine" at the Ikeda City Hospital on Fridays over 4 years...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29039627/beliefs-endorsement-and-application-of-homeopathy-disclosed-a-survey-among-ambulatory-care-physicians
#8
Stefan Markun, Marc Maeder, Thomas Rosemann, Sima Djalali
BACKGROUND: Explanation models for the effectiveness of homeopathy are not supported by natural sciences and the aggregated evidence from clinical trials is unconvincing. From this standpoint, placebo effects seem the most obvious explanation for the therapeutic effects experienced in homeopathy. Still, many physicians continue to prescribe homeopathic treatments. OBJECTIVES: Whether physicians who prescribe homeopathic treatments aim to achieve placebo effects or actually believe in specific effects is poorly understood...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29038670/can-total-body-resistance-measured-using-bioelectrical-impedance-analysis-be-the-index-of-dehydration-in-older-japanese-patients
#9
Miyuki Shimizu, Kensuke Kinoshita, Takami Maeno, Hiroyuki Kobayashi, Tetsuhiro Maeno
BACKGROUND: Dehydration in older patients has long been considered a significant health problem because it implies increased morbidity and mortality. However, dehydration is detected by a combination of physical signs and blood tests. For older people dwelling at home and in nursing homes, a simple and non-invasive method for detecting dehydration by caregivers is needed. The total body resistance is measured using bioelectrical impedance analysis and is known as an indicator of dehydration...
November 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29025820/well-being-of-family-medicine-graduates
#10
Olga Szafran, Wayne Woloschuk, Jacqueline M I Torti, Douglas Myhre
OBJECTIVE: To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). DESIGN: Retrospective, cross-sectional survey. SETTING: University of Alberta in Edmonton and the University of Calgary in Alberta...
October 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29023361/procalcitonin-and-mr-proadrenomedullin-combination-with-sofa-and-qsofa-scores-for-sepsis-diagnosis-and-prognosis-a-diagnostic-algorithm
#11
Silvia Spoto, Eleonora Cella, Marina de Cesaris, Luciana Locorriere, Silvia Mazzaroppi, Edoardo Nobile, Arcangela M Lanotte, Lucia Pedicino, Marta Fogolari, Sebastiano Costantino, Giordano Dicuonzo, Massimo Ciccozzi, Silvia Angeletti
PURPOSE: The third Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as an organ dysfunction consequent to infection. A SOFA score ≥2 identifies sepsis. In this study, PCT and MR-proADM were evaluated along with SOFA and qSOFA scores in patients with sepsis or septic shock. METHODS: One hundred and nine septic patients and 50 patients with non-infectious disease admitted at the Department of Internal Medicine and General Surgery of the University Hospital Campus Bio-Medico of Rome were enrolled...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/29020790/-endometriosis-and-quality-of-life
#12
P Koliba, D Kužel, M Fanta
OBJECTIVE: This article aims to provide a comprehensive overview of the possibilities of evaluating the impact of symptoms of endometriosis on quality of life of affected women and to overview the effect of treatment modalities in improving of the quality of their life. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague. METHODS: Review of results of published studies evaluating quality of life in patients with endometriosis...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29019353/hot-news-ready-for-hiv-dual-therapy-new-data-from-international-hiv-aids-society-2017
#13
George A Yendewa, Robert A Salata
The introduction of combination antiretroviral therapy (ART) in the 1990s has fundamentally transformed the landscape of HIV medicine, greatly improved disease morbidity and mortality, and reduced transmission rates across all demographic groups. Central to this success was the idea that to achieve best disease outcomes and minimize the development of drug resistance, at least three antiretroviral agents should be used for HIV treatment. This therapeutic strategy is a core tenet of HIV medicine, backed by incontrovertible scientific evidence, and made easy to deploy by the high compliance levels with once-daily coformulations, which have generally been well tolerated...
October 11, 2017: AIDS Reviews
https://www.readbyqxmd.com/read/28991204/influence-of-plant-growth-retardants-on-quality-of-codonopsis-radix
#14
Yinyin Liao, Lanting Zeng, Pan Li, Tian Sun, Chao Wang, Fangwen Li, Yiyong Chen, Bing Du, Ziyin Yang
Plant growth retardant (PGR) refers to organics that can inhibit the cell division of plant stem tip sub-apical meristem cells or primordial meristem cell. They are widely used in the cultivation of rhizomatous functional plants; such as Codonopsis Radix, that is a famous Chinese traditional herb. However, it is still unclear whether PGR affects the medicinal quality of C. Radix. In the present study, amino acid analyses, targeted and non-targeted analyses by ultra-performance liquid chromatography combined with time-of-flight mass spectrometry (UPLC-TOF-MS) and gas chromatography-MS were used to analyze and compare the composition of untreated C...
October 9, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28991104/international-consensus-statement-on-the-clinical-and-therapeutic-management-of-leber-s-hereditary-optic-neuropathy
#15
Valerio Carelli, Michele Carbonelli, Irenaeus F de Coo, Aki Kawasaki, Thomas Klopstock, Wolf A Lagrèze, Chiara La Morgia, Nancy J Newman, Christophe Orssaud, Jan Willem R Pott, Alfredo A Sadun, Judith van Everdingen, Catherine Vignal-Clermont, Marcela Votruba, Patrick Yu-Wai-Man, Piero Barboni
Leber hereditary optic neuropathy (LHON) is currently estimated as the most frequent mitochondrial disease (1 in 27,000-45,000). Its molecular pathogenesis and natural history is now fairly well understood. LHON also is the first mitochondrial disease for which a treatment has been approved (idebenone-Raxone, Santhera Pharmaceuticals) by the European Medicine Agency, under exceptional circumstances because of the rarity and severity of the disease. However, what remains unclear includes the optimal target population, timing, dose, and frequency of administration of idebenone in LHON due to lack of accepted definitions, criteria, and general guidelines for the clinical management of LHON...
October 3, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28990685/national-trends-in-otolaryngology-intern-curricula-following-accreditation-council-for-graduate-medical-education-changes
#16
Kevin J Kovatch, Rebecca S Harvey, Mark E P Prince, Marc C Thorne
OBJECTIVES/HYPOTHESIS: In 2016, Accreditation Council for Graduate Medical Education (ACGME) requirements for curriculum and resident experiences were modified to require entering postgraduate year (PGY)-1 residents to spend 6 months of structured education on otolaryngology-head and neck surgery (ORL-HNS) rotations. We aimed to determine how ORL-HNS training programs have adapted curricula in response to 2016 ACGME curriculum requirement changes. STUDY DESIGN: Survey study...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28990244/a-comparison-of-two-tools-to-screen-potentially-inappropriate-medication-in-internal-medicine-patients
#17
A-L Blanc, S Spasojevic, A Leszek, M Théodoloz, P Bonnabry, T Fumeaux, N Schaad
WHAT IS KNOWN: Potentially inappropriate medication (PIM) is an important issue for inpatient management; it has been associated with safety problems, such as increases in adverse drugs events, and with longer hospital stays and higher healthcare costs. OBJECTIVE: To compare two PIM-screening tools-STOPP/START and PIM-Check-applied to internal medicine patients. A second objective was to compare the use of PIMs in readmitted and non-readmitted patients. METHOD: A retrospective observational study, in the general internal medicine ward of a Swiss non-university hospital...
October 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28988780/clinical-studies-in-restorative-dentistry-design-conduct-analysis
#18
REVIEW
Falk Schwendicke, Niek Opdam
OBJECTIVE: Clinical studies should be one main aspect underlying dentists' decision-making towards dental materials. Study design, conduct, analysis and reporting impact on the usefulness of studies. We discuss problems with current studies and highlight areas where improvement might be possible. METHODS: Based on systematically and non-systematically collected data, we demonstrate where and why current studies in clinical dentistry deliver less-than-optimal results...
October 5, 2017: Dental Materials: Official Publication of the Academy of Dental Materials
https://www.readbyqxmd.com/read/28988170/effectiveness-of-the-hucare-quality-improvement-strategy-on-health-related-quality-of-life-in-patients-with-cancer-study-protocol-of-a-stepped-wedge-cluster-randomised-controlled-trial-hucare2-study
#19
Caterina Caminiti, Elisa Iezzi, Rodolfo Passalacqua
INTRODUCTION: Our group previously demonstrated the feasibility of the HuCare Quality Improvement Strategy (HQIS), aimed at integrating into practice six psychosocial interventions recommended by international guidelines. This trial will assess whether the introduction of the strategy in oncology wards improves patient's health-related quality of life (HRQoL). METHODS AND ANALYSIS: Multicentre, incomplete stepped-wedge cluster randomised controlled trial, conducted in three clusters of five centres each, in three equally spaced time epochs...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28985729/a-novel-bedside-cardiopulmonary-physical-diagnosis-curriculum-for-internal-medicine-postgraduate-training
#20
Brian Thomas Garibaldi, Timothy Niessen, Allan Charles Gelber, Bennett Clark, Yizhen Lee, Jose Alejandro Madrazo, Reza Sedighi Manesh, Ariella Apfel, Brandyn D Lau, Gigi Liu, Jenna VanLiere Canzoniero, C John Sperati, Hsin-Chieh Yeh, Daniel J Brotman, Thomas A Traill, Danelle Cayea, Samuel C Durso, Rosalyn W Stewart, Mary C Corretti, Edward K Kasper, Sanjay V Desai
BACKGROUND: Physicians spend less time at the bedside in the modern hospital setting which has contributed to a decline in physical diagnosis, and in particular, cardiopulmonary examination skills. This trend may be a source of diagnostic error and threatens to erode the patient-physician relationship. We created a new bedside cardiopulmonary physical diagnosis curriculum and assessed its effects on post-graduate year-1 (PGY-1; interns) attitudes, confidence and skill. METHODS: One hundred five internal medicine interns in a large U...
October 6, 2017: BMC Medical Education
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